Guidelines in Choosing a Field of Nursing PDF

October 19, 2021 (Tuesday) granted, write a letter of thanks especially if the desired position was obtained. GUIDELINES IN CHOOSING A FIELD OF...

October 19, 2021 (Tuesday) granted, write a letter of thanks especially if the desired position was obtained. GUIDELINES IN CHOOSING A FIELD OF 6. Enclose return postage so that the person NURSING to whom the letter is addressed will be PEOPLE have different motives or reasons encouraged to reply and will not have to for choosing a particular field of nursing. spend for postage in doing so. Nurses who have to make their choices A LETTER OF APPLICATION USUALLY should think of long-range goals so that they CONTAINS THE FOLLOWING FACTS: can build up a career ladder in nursing. 1. Source and purpose. The first paragraph There are factors to consider in making a self – usually contains the source of evaluation. information concerning the vacancy and 1. Qualifications the nurse's intent to apply to the position. 2. Years of Experience and Training These two points may be interchanged. 3. Age and Physical Condition 2. Qualifications. The second and third 4. Emotional Stability and Goals in life paragraphs must contain the applicant's qualifications, the school or college from FACTORS IN SELECTING A FIELD OF when he/she graduated, and the year of NURSING graduation. Experience and training a) Kind of work to be performed along the field applied for may also be b) Availability of the work included. c) Hours of work 3. Reference d) Qualifications 4. A request for a personal interview. e) Opportunities for advancement f) Method of Entering g) Earning h) Fringe benefits i) Other benefits USEFUL POINTERS IN MAKING A LETTER OF APPLICATION The letter of application enables the prospective employer to form an opinion about the nurse. Observe the following when writing a letter of application: 1. Use clean, white, unlined paper. If you are working in an agency, do not use the agency's stationery with letterhead. PERSON INTERVIEW 2. Use ink or ballpen in writing. You may An interview is a face-to-face conference between want to type the letter if you so prefer. two people about something. An interview between 3. Use proper salutation. Preferably know an applicant and a prospective employer gives both the name of the person to whom the letter a chance to assess each other. is to be addressed. 4. Observe proper margin and paragraphing. The following pointers will be help in preparing for Used good English and correct spelling. an interview 5. Write in a courteous manner. Ask 1. Make an appointment either by mail or permission before using a person's name telephone. as reference. After permission has been 2. Be at the place at the appointed time. d. Having self-confidence and being 3. Know something about the institution where cheerful. See the bright side of life, you will apply so that you can answer believe that others can also do good questions intelligently. work; and 4. Be at your best. e. Offering help when needed. A 5. Knock before you enter helping hand eases the burden of your 6. Bring credentials such as your registration co-workers. card, residence certificate, tax account 4. Develop proficiency in communication, both in number and the like. oral and in written forms. 7. Ask questions about the job. 8. Thank the interviewer for giving you some 5. Be able to adjust to working conditions and to life of his or her time. patterns 9. Give yourself time to think about the position. characteristics of particular occupations and 10. If the prospective employer does not answer, communities. Filipinos are well-known for their you may write a follow-up letter stating your pakikipag-kapwa tao or ability to relate with others interest in the position. and pakikisama or ability to get along well with co- workers. RETAINING A POSITION 6. Keep abreast with advances in medicine, nursing, Once you have obtained a position, strive to and related sciences by reading professional retain it and be successful in that chosen field. literature and attending activities of professional This will lead to self-satisfaction and building organizations. a career in nursing. How can you be successful in your chosen field of nursing? While there is no sure-time CAUSES OF FAILURE formula for success the following are suggested. Although nurses the opportunity to get a good 1. Have adequate knowledge and preparation position, some may fail in their jobs. Causes o failure for the job. Reading professional literature may be due to any of the following: and attending clinical conferences are some 1. Incompetence or the lack of the required ways of updating your knowledge. ability and knowledge for the particular 2. Have a well-developed personality. Cultivate 2. Poor interpersonal relationship, lack of a pleasing appearance. This gives a good first cooperation with coworkers, dishonestly, impression. boastfulness, and inability to get along with 3. Develop good interpersonal relationship with people; your con-workers by 3. Personality defects such as imprudence in a. Being enthusiastic in, and dedicated choosing friends insincerity, conceit, sarcasm to your work and being sincere and lack of tact, envy, discourtesy, being too considerate to others. Practice the argumentative, apathy towards work or being Golden Rule; too sensitive. b. Being tactful and dependable. 4. Inadequate knowledge in social conduct, too Practice self-control. Hot-headed little time for relaxation and recreation, persons frequently encounter trouble; unwholesome or unwise choice of recreation c. Developing ability to adhere to social 5. Indifference to need for professional growth, amenities and being socially always finding reason for not attending compatible. Remember: no man is an professional meetings or jointing the island; professional organization.  4. Implied contract 5. Void contract RESIGNING FROM A JOB 6. Illegal contract There are many reasons why nurses resign REQUISITES OF A CONTRACT from their jobs Primarily, the reason is to seek better positions whether in the Philippines or 1. To have a contract, two or more persons must abroad. Other reasons may be inability to participate adjust to the work situation, marriage, 2. The parties involved must give consent to the children and /or transfer of family to other contract. places. 3. The object which is the subject matter of the Write a letter of resignation. Observe the contract must be specified such as: following points: a. All things which are not outside the 1. Give the date of resignation commerce of man 2. State the reason for resigning b. All rights which are not in transmissible; 3. Express gratitude for kindness and c. future inheritance in cases expressly consideration given during the period of authorized by law; employment d. all services which are not contrary to 4. Attack clearance for money, work, and law, morals good customs, public order property responsibilities and public policy. 4. The cause of obligation is established the time, price, and subject matter are express. DISMISSAL FROM A POSITION 5. Contracting parties must have the legal capacity to enter into a contract.They must. It is seldom that a nurse gets a. Be of legal age dismissed. This is usually done for b. be of sound mid cause on the part of the nurse. c. not be under the influence of Reasons may include negligence, intoxicating drugs. or fear of bodily incompetence, malpractice, harm. unprofessional behavior or breach of d. Not be suffering for physical contract. disability such as those who are mentally incompetent A CONTRACT INEXISTENT CONTRACTS is a meeting of minds between two The following contracts are avoid or inexistent from persons whereby one binds himself, beginning. with respect to the other, give 1. Those whose cause, object or purpose are something or to render some service. contrary to law morals, good customs public A contact is a promise or a set of order or public policy. promises which the law recognizes as 2. Those whose or object did not exist from the a duty and when that duty is not time of transaction. performed, the law provides a 3. Those whose object is outside the commerce remedy. of man. 4. Those which contemplate an impossible Kinds of Contracts service 1. A formal contract 5. Those where the intention of the parties 2. Informal contract relative to the principal object, cannot be 3. Express contract ascertained  6. Those expressly prohibited or declared void ADVANTAGES OR WRITTEN CONTRACTS by law Many nurses fear written contracts. The following 7. Those which are absolute y simulated or are the advantages of written contacts over oral ones. fictitious 1. A written contract is certain. It avoids the Following are examples of illegal contracts: uncertainty of human memory. 1. Those that are made in protection of the law 2. It can specify a definite time within which it 2. Consent obtained by fraud is binding so as to protect both sides against 3. Those obtained under duress sudden changes without notice. It also fixes a 4. Those obtained under undue influence time limit after which conditions are no 5. Those obtained through material longer binding but may be opened for misrepresentation. rediscussion. 3. It sets a standard and relieves an individual BREACH OF CONTRACT professional person from haggling over is failure to perform an agreement, whether compensation. expressed or implied, without cause. 4. It is more likely to be open and well-known so that the use of written contracts tends to The following constitute breach of contract for establish minimum standards for professional nursing services. practitioners and to protect them against 1. presentation of performance discrimination in compensation. 2. failure to perform because of inconvenience 5. It is definite and can be definite on many or difficulty; details which may otherwise stimulate 3. failure of cooperation in performance favoritism or caprice even among 4. abandonment of duty professionals, such as hours of work, 5. substitution of performance vacation allowances, holiday privileges, 6. failure to use due care health and insurance provisions. 6. It can provide a definite procedure in case of complaints about substandard work, so that LEGAL EXCUSES IN REFUSING the employer has a clear course and the NEGLECTING OR FAILURE TO PERFORM professional nurse has protection against A CONTRACT arbitrary action. 7. It creates a minimum of certainty and security for the professional employee so that Following are legal excuses in refusing, neglecting he/she is free to concentrate on his/her work or failure to perform a contract; without concern for the details which the written contract has settled. 1. Discovery of material misrepresentation made and relied upon 2. Where performance would be illegal 3. Where performance is made impossible by reason of illness 4. Where performance is made impossible by death of patient or nurse 5. Where performance is made for other reasons 6. Where contact is insufficient. August 24, 2021 It is defined as the breath or the opportunity to function. It means how far the manager can on You can analyze the past, but you have to design the developing plans for self and others. future. – Edward de Bono Level of Management in the Nursing Service Difference between Nursing Process and Management Process Top Level Manager Nursing Process e.g. Director of Nursing Service Assessment, Diagnosis, Planning Its scope of responsibility is the overall Implementation management of the organization. Planning is more Evaluation critical at the top level. The chief nurse or the director of the nursing service plans for the organization. The Management Process assistant chief nurse is assigned to implement Planning specific programs and projects. Organizing, Staffing, Directing Middle Level Manager Controlling e.g. Supervisors Planning: At the middle management level, the nursing It is a continuous process of assessing and supervisors formulate policies, rules, regulations, establishing goals and objectives, implementing, or methods and procedures. controlling them which is subject to change as new facts are known. Lower Level Manager It is a rational process by which human beings’ e.g. Head Nurse and Staff Nurse controls and checks the past and discovers alternative The lower or the first level management, the courses of action for decision making in the future. senior nurse or head nurse schedules activity or It is having a specific purpose and mapping out of weekly plan for the administration of patient care in program or method before hand for the the unit. accomplishment of goals. Reasons for planning A process of making a plan of action for a 1. It leads to success in achieving goals and foreseeable future. objectives. It is deciding in advance what to do, how to do it, and 2. It gives meaning to work who is to do it. These refers to goals or objectives, 3. It provides for effective use of personnel and strategies, or procedures. facilities. 4. It helps in coping in crisis situation. It is a process that involves a wide range of activities. 5. It is cost effective. 6. It reduces the element of change. In nursing service, planning entails 7. It can be used to determine the need for forecasting or setting the board outline of work to be change. done. It is primary process of selecting and relating 8. It is needed for effective control. facts, making use of assumptions regarding the future, and formulating activities necessary to Two major types of Planning achieve the desired results in the nursing service. Strategic or long-term planning Scope of Planning: Operational or short-term planning Strategic Planning  It is a continuous systemic process of making It increases and balances utilization of risk-taking decisions with the greatest possible facilities knowledge of its effect on the future. It is a long- It answers the what if question range goal which extends 3 to 5 years in the future. It assists management in gaining status. It is a process by which management assess Characteristic of a Good Plan and evaluates organizational strength and weaknesses. It should be based on clearly defined objectives. Its goal is based on the acronym: It should be simple. SWOT (Strengths, Weaknesses, Opportunities, It should provide for proper analysis and Threats) classification of action. (i.e., It should establish standards). In the nursing service, strategic planning is at the first It should be flexible. level management, and planning is based on the It should be balanced. mission of the hospital. It should exhaust all available resources, S – Strength applying the principle of simplicity. Good points of the organization or the pros of Steps in Planning its employees 1. Being aware of opportunities – an W – Weaknesses awareness of the opportunities in the external as well as within the organization is the Cons of the organization which includes starting point of planning. deficiencies, absences of employees and their needed 2. Establishing objectives – objective skills and resources. specified expected results and the end point O – Opportunities of is to be done and is to be accomplished by the network of strategies, policies, rules and Future conditions in the environment which regulations. includes recruitment, population growth, technology, 3. Development premises – it is to establish, and facilities. circulate and obtain an agreement to utilize T – Threats planning premises which may serve as an assumption in which the plan is to be carried Conditions within the organization that helps out. develop a clear future of the organization for possible 4. Determining alternative courses and communication. evaluate this course – after having sought Operational Planning out alternatives, weighing strong and weak points, evaluate them in the light of premises It is a blueprint of achieving objectives and/or goals. converted into actions. Operational managers usually 5. Selecting a course – it is at this point at develop plan for short periods of time and focuses on which the plan is adopted and the point of routine task. decision making, analysis and evaluation of Importance and Advantages of Planning the alternative courses. 6. Formulating derivative plans – they are to It is for purposeful and orderly activities be considered to support the basic plan. It points out need for future change. 7. Numbering plans by budgeting – its It provides a basis for control purpose is to set operating cost limit. It It encourages achievement expresses the activities in terms of pesos. Constraints in Planning Maintain quality care while containing the cost. Managers may lack the knowledge of the It serves as a guide for nursing performance philosophy, goals, and objective of the and allocation of personnel, supplies, support organization. services and facilities. Managers may not understand the significance of the planning process. Criteria of an Effective Budget System Managers may think that the time spent in Enough resources to supply sufficient funds. planning may be wasted time. Allocate financial resources to specific units Some managers may lack confidence and fear based on certain criteria. failures. Conducts a control system for effective use of Some managers may prefer to act on financial resources. immediate plans. Classification of Organizational Budget Management by Objective (MBO) Centralized budgets are developed and imposed It is a process thereby the superior and by the controller, administrator of hospitals and the subordinate managers in an organization jointly administrator of nursing services with little or no identify common goals, identify individual areas of consultation with lower-level managers. responsibility in terms of results expected, an assessing the contribution of each member. Decentralized budget is prepared by those who implement them. It is a system for making an organizational structure work to bring about vitality and personnel Head nurse – they have more intimate view involvement in the hierarchy by means of a statement of their needs than those on top. of what is expected. It stresses the ability and Middle Managers – they can provide a more achievement rather than personality. realistic breakdown to support their needs. Advantages of MBO Types of Budget Leaders delegate responsibility to subordinates who Operational Budget – these refer to acquires management skills and a sense of personnel supplies, services, small equipment, and responsibility. miscellaneous expenses. Generates more effective planning at all Capital Budget – large equipment, physical levels of organizational hierarchy. changes Workers who set their goals are more Personnel budget – number of personnel, productive than those whose goals are salaries, working days and fringe benefits. imposed. Incremental or Historical – profit oriented; basis is income expenses. Budget as Tool for Planning Zero/based budgeting – designed to require Financial control system is implemented by a budget. even more jurisdiction from each department It is defined as a tool for planning, monitoring, and regarding any funds budgeted to for the next controlling cost as a system plan for meeting year. expenses. Budget Process Purpose of Budgeting 1. Planning – budget committee selected, and Allow the organization to stay on top of the deadline set = draft of the budget. changes in the health care system. 2. Preparation – objectives must be translated to probable cost and revenue figures according to guidelines.  3. Modification or approval – must compete Aim of the philosophy with budget of other nursing units. Should be measurable and ambitious but a. Final budget is prepared – approved realistic by administrator/governing board. b. Financial budget is needed. Objectives 4. Monitoring – the monthly summaries of Identifying how and when goal is to be expenses and income in depth analysis of accomplished various financial aspects your unit’s Motivate people to specific end operation. o Process objective Planning Tools Methods to be used o Result objective Mission (Purpose) Specify desired income - Brief statement identifying the reason an Policies organization exist and its future aims of functions. - Plans reduced to statements or instructions. - Influence the development of an - Direct organization in their decision making. organizational philosophy, goals, objectives, - Explain how goals will be met. policies, procedures, rules. - Guide the general course and scope of organizational activities. Vision Implied Policy – neither written or expressed - Mental image/power of imagination to see verbally. Usually developed over time and something that is not actually visible. follows and a precedent. Expressed – delineated verbally or in Philosophy (way of life) writing. - Flow from the purpose or mission statement. Procedures - Delineates the set value and beliefs that guides all actions of the organization. Plans that establish customary or acceptable - Found in policy manual or available in ways to accomplishing a task. request. Delineated a sequence of steps of required o Societal philosophies and values actions. o Individual philosophies and values Identify process or steps needed to implement - Shaped by socialization process expressed by a policy, generally found in a manual at the the person unit’s level of organization. - Influence decision making resolution of conflicts and perception of things. Rules/Regulations Characteristics of True Value (MC Nally) Plans that define specific action or non- action. Freely chosen – after reflection Include as part of policy and procedure Prized and cherished statement. Pattern – consciously and consistently Rules repeated Positively affirmed - Describe situations that allow only one choice of action. Goals Overcoming Barriers to Planning Ends towards which organization is working Operationalize the philosophy, desire result 1. Direction – specified goals and objectives towards which effort is directed. are more effective.  2. Should be flexible – allow for readjustment when needed. 3. People concerned units that can be affected by course of action. 4. Specific, simple and realistic. 5. Knowledge – when to plan or when not to plan. 6. Evaluation checkpoints – corrections/final evaluation – end of plan. If you fail to plan, you plan to fail. October 26, 2021 (Tuesday) Chain of command - organizations are established with hierarchical relationships "IF A LEADER DOESN'T CONVEY PASSION within which authority flows from top to AND INTENSITY THEN THERE WILL BE NO bottom PASSION AND INTENSITY WITHIN THE Unity of command - states that an employee ORGANIZATION AND THEY'LL START TO has one supervisor and there is one leader and FALL DOWN AND GET DEPRESSED" one plan for a group of activities with the same objective Span of control - a supervisor of the group ORGANIZING can effectively supervise in terms of part of managing that involves establishing an members, functions and geography intentional structure of roles for people to fill in Specialization - each person should perform an organization a single leading function. a process of identifying and grouping of work to ORGANIZATIONAL CHART be performed; defining and delegating responsibility and authority, and establishing ► Components: relationships for the purpose of enabling the people to work most effectively together to Responsibility - obligation to carry out tasks accomplish objectives. by the person to the best of his ability Authority - the power to command can be obliged by others. CONCEPTS AND DEFINITION Accountability - answerability for an action or the obligation to carry out on the delegate Organizational chart - a drawing that shows tasks, or the responsibility exercise authority how the parts of an organization is linked. Span granted to subordinates for the proper of performance of a tasks. Management - the number and diversity of Delegation - entrusting of responsibility and people who report to a manager authority granted to the employee by his Centralize - to concentrate power or authority superior Decentralize - to distribute power and authority Coordination - synchronizing and among more places establishing harmony between among the Line authority - the formal chain of command various activities of the organization Staff authority - advisory or service oriented in Cooperation - willingness to people to work nature. with each other Organization - Consolidated group of elements; Centrality - indicates the location of a systematized whole position in an organization where frequent Structure - formation or pattern of arrangement communication occurs. Hierarchy - a group of persons arranged by rank, grad, or class Bureaucracy - administration through CHARACTERISTIC OF THE departments and subdivisions managed by ORGANIZATIONAL CHART officials following an inflexible routine Adaptive - able to change make suitable to new or changed circumstances. 1. Division of work 2. Chain of Command PRINCIPLES OF ORGANIZING 3. Type of work performed  4. The groupings of wall segments handle details, local required 5. The levels of management data, and offer counsel or managerial problem. IMPORTANCE (2) MAJOR CATEGORIES OF STAFF AUTHORITY Promote collaboration and negotiation among individuals in groups, thus improving 1. Personal - includes the assistant and the general the effectiveness and efficiency of staff communication in an organization 2. Specialist - composed of advisory, service control, Create clean cut lines of authority and and functional personnel. responsibility, thus improving, activating, and controlling, the function of the manager Promotes maximum utilization of one's skills PERSONAL STAFF AUTHORITY and talents promote fair distribution of work. 1. Assistant staff - maybe called an assistant, staff assistant or administrative assistant. ADVANTAGES is responsible to one line manager contributes to sound organizational structure chief purpose is to extend the line manager's maps line of decision -making authority capacity for completing a large amount of shows formal lines of communication work by doing the more routine tasks that the shows how people fit into the organization manager would otherwise have to perform helps employee understand their assignments no specific functions, duties vary with the assignments do not act on own behalf but rather as DISADVANTAGES/LIMITATIONS personal representatives of a manager. shows only formal relations = only specific authority they have comes from a does not show informal communications manager on a limited basis, usually for a specific job may show how things are supposed to be rather over a brief time span than how they are 2. General staff - composed of top administrators may help confuse authority and status top administrators make the decision after receiving input from key people who together ORGANIZATIONAL RELATIONSHIPS: have the necessary expertise to make sound decisions for the agency 1. Line authority – is a chain of command; a manger coordinated group performing to maximize staff associate or leader follower relationship results manager delegates authority to a staff associate, who in turn delegates authority to staff SPECIALIST STAFF AUTHORITY oldest type of structure 1. Advisory staff - counsel line managers 2. Staff authority – staff support line of authority they study problems, collect and analyze relationships data, offer alternatives, and prepare plans advisory or service oriented in nature work maybe accepted, rejected, of modified by the line manager  ideas are heard, they are not always TYPES OF ORGANIZATIONAL STRUCTURE implemented 1. Formal structure 2. Service staff - they are not advisory DEFINED BY EXECUTIVE DECISION they perform a centralized service that has DETERMINE BY PLANNING been separated from the line to prevent o it can be diagrammed to shows duplication and to allow more economical relationships among people and their performance and good control positions includes dietary and laundry services in a o it describes positions, task, relationships hospital and responsibilities – o depending on organizational philosophy, 3. Control staff - they do not advise the formal structure may be rigid or loose. they control by restraining line authority Types of Formal Organizational Structure they have direct or indirect control over certain line performance 1. Bureaucratic - predominant type of they control directly by acting as an agent for organizational structure in health care institution a line manager or indirectly through characterized by many hierarchical levels procedural compliance and interpretation of and specialized positions policies and reports each level has a specific, clearly defined set of rules and regulations and scope of 4. Functional staff - exists when a specialist is given authority and accountability decision -making authority for specific activities each person at a particular level is directly outside the formal chain of command responsible to an immediate supervisor authority maybe delegate to line, staff or 2. Functionalized – staff have some authority over service managers and maybe exercised over line executives line, staff, and service personnel have limited line authority with power to staff expert responsible for a specific determine standards in their areas of management function such as staffing, staff specialization and to enforce them development or quality improvement has authority to command line executives to implement staff plans ORGANIZATIONAL STRUCTURE advantage is that it can increase staff morale Organization is a group of people working 3. AD HOC - Characterized by a more open, flexible together under formal and informal rules of operational mode behavior, to achieve a common purpose. Terms are created by top level management this is both structure and process for a specific purpose, such as a goal or task. Organizational structure- is a mechanism through These teams are supplementary and which work is arranged and distributed among temporary members of the organization, so that the goals of They operate within the formal structure as a the organization can logically be achieved. separate entity, depicted in the organizational chart as horizontally attached to the structure The teams give advice and coordinate the work of the organization. 4. Matrix – Characterized by teams built directly into the organizational structure  These teams are coordinated both vertically Horizontal line positions depict the division within the (hierarchy) of labor among persons with similar authority and horizontally. (among the groups involved and responsibility but different functions. The team has formal authority to make Span of control refers to the number of enforce decision. employees a manager can effectively Matrix structure usually involves less rigid oversee. adherence to rules and procedures. 5. Dual Management - Separate technical and CENTRALIZED STRUCTURE administrative responsibilities Power and authority are concentrated in has one hierarchy in which technical matters relatively few persons or positions and another hierarchy in which management Has many levels or departments, each one makes decision about issues such as highly specialized and subject to rigid rules personnel and budget. and procedure. With rigid rules and procedures, span of control is short and employees and managers INFORMAL STRUCTURE are in close contact. = comprises personal and social relationships that Generates a tall, pyramid - shaped organizational chart depicting the do not appear on the organizational chart this multileveled hierarchy of management and maybe a group that takes break together, individual managers' short span of control. works together on a particular unit, or a class In a centralized structure, leaders and together managers tend to function in an autocratic provides social control of behavior, has its management style, demanding rigid own channel of communication more broadly adherence to rules and procedures. and rapidly than the formal communication Span of control are short and employees and system. managers are close contact multileveled hierarchy. FORMS OF ORGANIZATIONAL STRUCTURE DECENTRALIZED ORGANIZATION The organizational chart delineates LINE Power and authority are shifted from the POSITION, STAFF POSITION and SPAN OF hands of a few people at the top of the CONTROL. organizational structure to subordinate Number of management levels and the extent hierarchical levels. of span of control indicate the degree of Promotes independence, responsibility, and centralization within an organization quicker decision making at all levels of an Line positions refer to the formal lines of organization. communication and authority depicted in an Depicts fewer management levels and wider organizational chart by solid vertical and span of control than seen in centralized horizontal lines. structure. Vertical lines positions extend from the CEO Has fewer hierarchical levels and tends to or other top official to the staff at the bottom, have better communication among levels? denoting the official chain of command. Leaders and Managers tend to function democratically  Autonomy and sense of empowerment pervade. A nursing unit often is a decentralized structure operating within an overall centralized health care organization. "THE BOTTOM LINE IS, WHEN PEOPLE ARE CRYSTAL CLEAR ABOUT THE MOST IMPORTANT PRIORITIES OF THE ORGANIZATION AND TEAM THEY WORK WITH AND PRIORITIZED THEIR WORK AROUND THOSE TOP PRIORITIES, NOT ONLY ARE THEY MANY TIMES MORE PRODUCTIVE, THEY DISCOVER THEY HAVE THE TIME THEY NEED TO HAVE A WHOLE LIFE" "TALENT WINS GAMES. TEAMWORK WINS CHAMPIONSHIP " November 2, 2021 Permanent shift – personnel working the same hour repeatedly. STAFFING Block scheduling – using the same schedule Staffing is the process of determining and providing repeatedly. the acceptable number and mix of nursing personnel to produce a desired level of care to meet the Variable staffing – determining the number and mix patient’s demand. of staff based on patient needs. The purpose of all staffing activities is to provide Patient classification systems – calculating staffing each nursing unit with an appropriate and acceptable needs based on patient acuity. number of workers in each category to perform the Staffing formulas – used to determine staffing number of tasks required. needs. Too few or an improper mixture of nursing personnel Factors affecting staffing will adversely affect the quality ang quantity of work performed. 1. Type, philosophy, and objectives of the hospital. Such situation can lead to high rates of absenteeism 2. Population served and staff turn-over resulting in low morale and 3. Number of patients and acuity of their illness. dissatisfaction. 4. Availability and characteristics of the nursing Definition of Terms: staff. 5. Administrative policies. Case method – assigning each patient to a nurse for 6. Standard of care desired. total patient care. 7. Lay-out of the various units and resources Functional nursing – hierarchical division of labor. available. 8. Budget Team nursing – Registered nurses supervising 9. Professional activities and priorities in non- auxiliary nursing staff. patient activities. Modular nursing – modification of team and 10. Teaching program. primary nursing, it uses smaller teams for patients 11. Expected hours of work per annum of each who are grouped geographically. employee. 12. Patterns of work schedule. Case management – management and coordination of the care a patient receives in all settings Patient Care Classification System throughout an episode of illness. - This is a method of grouping patients Primary nursing – Registered nurses giving total according to the amount and complexity of patient care to a few patients. their nursing care requirements; of nursing time and skill they require. Collaborative practice – cooperative interdisciplinary practice Classification Categories: Staffing schedules – work schedule for personnel. Level I: Self care or minimal care - Patient can be bathe, feed and performed his activities of daily Centralized schedule – scheduling done in one living. location. Examples: Ambulatory, executive check- Decentralized scheduling – scheduling done in up, doesn’t need any assistance and patients who local areas. are recovering. Rotating work shift alternating work hours between days, evening, and nights. Level II: Moderate care or Intermediate Care - Patient needs some assistance in bathing, feeding, or ambulating up and about for short periods of time, extreme symptoms have subsided or not yet appeared with slight emotional needs, vital signs ordered up to three times per shift with IVF or BT, requires periodic treatment, observations, and instructions. Level III: Total Complete or Intensive Care – Patients under this category are completely dependent under nursing personnel, they are provided complete lab, are fed, they may or may not be unconscious with marked emotional needs with vital signs more than three times per shift, may be in continuous oxygen therapy, and with chest or abdominal tubes. They require close observation at least every 30 minutes for impending hemorrhage with hypo or hypertension and/or cardiac arrythmia. Level IV: Highly specialized critical care – patients need maximum critical care need continuous treatment, observation, many medications, IV piggy backs, vital signs every 15- 30 minutes, hourly output, significant changes in the doctor orders and care hours per patient per day may range from 6-9 or more and the ratio of Patient Classification System professionals to non-professionals also range from 70:30 to 80:20. The Patient Care Classification System is a method of grouping patients according to the amount and complexity of their nursing care requirements and nursing time and skills they require. This assessment can serve in determining the amount of nursing care required, generally within 24 hours, as well as the category of nursing personnel who would provide that care. To develop a workable patient classification system, then nurse managers must determine the following: The number of categories into which the patients should be divided. Categories or levels of care of patients. Nursing The characteristics of patients in each care hours category. The type and number of care procedures that - Needed per patient per day and ration of will be needed by a typical patient in each professionals to non-professionals. category and, The time needed to perform these procedures that will be required by a typical patient in each category. The number of categories in a patient classification may range from three to four, which Is the most popular, from five to six. These classes relate to the acuity of illness and care requirements, whether minimal, moderate, or intensive care. Other factors affecting the classification system would relate to the patient’s capability to meet his physical needs. Assessing a Scheduling System 1. Ability to cover the needs of the unit. 2. Quality to enhance the nursing personnel’s knowledge, training and experience 3. Fairness to the staff 4. Stability 5. Flexibility. PLANNING FOR STAFFING Planning for Staffing I. Recruitment - A leading role in staffing includes identifying, recruiting a hiring gifted people. - The process of actively seeking out or attracting applicants for existing positions. - The organization’s ability to meet its goals and objectives is directly related to the quality of its employees. - Excellent employees reflect well on the C. Conduct Multiple Interviews manager because they prevent stagnation - When decisions are especially important, candidates should be interviewed more than II. Interview once on separate days. - Verbal interaction between individuals for a - Prevents applicants from being accepted or particular purpose. rejected merely because they were having a good or bad day. - Foundation for selecting people for positions - Person should be interviewed until all the purposes. interviewer’s questions have been answered, - The interviewer seeks to obtain enough and they feel confident they have enough information to determine the applicant’s suitability information to make the right decision. for the available position. D. Provide Training in Effective interviewing - The applicant obtains adequate information Technique (for personnel) to make an intelligent decision about accepting the - Training should be focus on communication job, should it be offered skills and advice on planning, conducting, Limitations: and controlling the interview. - It is unfair to expect a manager to make - Major defect is its subjectivity appropriate hiring decisions if he or she has - Interviewers generally require an interviewer never had adequate training interview to use judgments, biases, and values to make technique. decisions based on short interaction with an applicant SELECTION in an unnatural situation. - The process of choosing from among applicants the best qualified individual (s) for Overcoming Interview Limitation: a particular job or position. - Involves verifying the applicant’s A. Use a team approach qualifications, checking his or her work - Having more than one person interview job history, and deciding if a good match exist applicant reduces individual bias. between the applicant’s and organization’s - Involving staff on hiring committees or expectations. panels to interview job applicants can involve a significant commitment of employee time A. Educational and Credential Requirements and thus expense on the part of the B. Reference Check organization. C. Pre-employment testing D. Physical Examination B. Develop a structured interview format for E. Making the Selection each job classification. F. Placement - Each job has different position requirements, G. Indoctrination interviews must be structure to fit the position. STAFF DEVELOPMENT - Same structured interview should be used for - A continuing liberal education of the whole all employees applying for the same job person to develop her full potential. classification. - Deals with aesthetic senses, as well as - A well-developed structures interview uses technical and professional education. open ended questions and provides ample opportunity for the interviewee to talk. I. Preceptor ship - help recruit, retain, orient and develop staff. II. Mentorship Disadvantages: - Mentors give their time, energy, and material - Unfair treatment support to teach, guide, assist, and counsel - Schedule used to punish and reward and inspire a younger nurse. - Time-consuming for managers - Less efficient use of resources SKILLS NEEDED: BY STAFF NURSE - Cost containment is more difficult. A. Technical Skills – the ability top use tools, techniques, procedures, and approaches in a specified performance. Self-Scheduling B. Human Skills – working with people, one’s Advantages: ability to work with others in the achievement of - Coordinated by staff nurses goals, how are done. - Saves manager scheduling time C. Conceptual Skills – pertains to why something is - Helps develop accountability done one’s view of the organization as a whole - Increased perception of autonomy picture, and one’s ability to understand the - Increased job satisfaction complexities of the organization as it affects and - Improved team spirit being affected by its environment. - Improve morale D. Diagnostic Skills – includes the ability to - Decreased absenteeism determine, by analysis and exam, the nature and - Reduce turn over circumstances of a particular condition or situation. - Effective for recruitment and retention. E. Coach and Mentor Skills – hands on that helps Disadvantage: the employees to recognize opportunities and ways - Increases amount of time staff spends on to improve their performance and capabilities. scheduling. STAFFING SCHEDULES: Centralized Schedule Rotating of Work Shifts Advantages: - Uses 3 shifts, alternates days, evening, and - Fairness to employees through consistent, nights. objective, and impartial application of Advantage: policies and opportunities. - Cost containment through better use of - Can rotate teams resources. Disadvantage: Disadvantages: - Rotate among shifts - Lack of individualized treatment. - Increase stress - Affects health - Affects quality of work Decentralized Schedule - Disrupts development of work group - High turnover Advantages: - Managers have authority - Staff gets personalized attention Permanent Shifts - Staffing is easier - Day shift, evening shift, night shift rotations. - Staffing is less complicated Advantages: Ten-hour day, four day workweek - Can participate in social activities - 4 days of ten hours/week followed by 3 days - Job satisfaction off - Commitment to the organization Advantages: - Fewer health problems - Less tardiness - Time to complete work - Less absenteeism - Long weekends - Less turn over - Extra days off - Decreased overtime Disadvantages: - Cover peak workloads - Most want day shift - Decreases costs - New graduate predominately staff evenings Disadvantages: and nights - Difficulty evaluating evening and night staff. - Longer workday - Nurses may not appreciate the workload or - Fatigue problems of other shifts. - Overlap - Difficult to find substitute. Block or Cyclical Scheduling Ten hour shift, seven day workweek - 6 day forward rotation; 6 days of work – 2 days off. - 7 days of 10 hours/week followed by 7 days off. Advantages: - Same schedule repeatedly - Nurses not so exhausted Twelve hour, seven day workweek - Sick time reduced - 7 am to 7pm shift - Personnel know schedule in advance - 7 pm to 7 am shift - Personnel can schedule social events - Decreased time spent on scheduling Advantages: - Staff treated fairly - Helps establish work groups - Lower staffing requirements - Decrease floating - Lower cost per patient/day - Promotes team spirit - Increased knowledge of patient - Promotes continuity of care - Get new admission settled - Better continuity of care Disadvantages: - Less personal expenses for gas, meals, babysitting - Use census to determine number and mix of - Team development is possible staff - Reduced travel time - Little need to call in unscheduled staff. - Less time to do staffing - Less daily reporting Eight hour shift, five day workweek Disadvantages: - 5 day 40 hour work week - Overtime a. 7 am to 3 pm - Exhaustion increases at the end of workweek b. 3 pm to 11 pm - Tension increases at the end of workweek c. 11 pm to 7 am  - Increases in minor accident PRINCIPLES OF CONTROL - Increases medication errors (Laura Mae Dopuglass) - Home and social life suffers the week worked. 1. Strategic point control – control should point out exceptions at the ranges. 2. Feedback – the process of adjusting future November 14, 2021 actions on the basis of information about the past performance. CONTROLLING – (according to Swans berg…) 3. Flexible control – control should be stable yet flexible. It must be responsive to It includes the process of evaluating the changing conditions, adaptable to new implementation of the adopted plan, the given orders developments. and the established principles through establishing 4. Organizational Stability – control should standards, comparing performance with the standard take into consideration organizational and correcting deficiencies. structure. MANAGEMENT AUTHORS INCLUDING 5. Self-Control – Department must have a NURSES HAVE DESCRIBED THE control system of its own but this must be tied CONTROLLING PROCESS AS FOLLOWS: up with other sections by an overall control system. Establish standards for all elements of 6. Direct control – any control system should management in terms of expected and be designed to maintain a direct contact measurable outcomes. between the controller and the controlled. Apply the standard by collecting data and 7. Human Factor – people are affected by the measuring the activities of the nursing psychological manner in which they view the management, comparing standards with system. actual care. 8. Principle of standard – people should know To make improvements deemed necessary what they should now the system of control, from the feedback. the standard operation procedure (SOP’s) Keep the process continuous for all areas rules or policies etc. must be well understood. including: 9. Principles of objectives – control should o Management of the nursing division serve the needs for which it is intended. and each sub unit. 10. Control must be economical o Performance of personnel. 11. Control must assure corrective actions o Nursing process or product. 12. Control must be forward looking THE PRINCIPLES OF CONTROL by Urwick: PHASE OF CONTROL 1. The principle of uniformity ensures that Pre-action phase – Personal supervision is before controls are related to the organizational any work performance. structure. 2. The principle of comparison ensure that the On-going phase – evaluation is done during controls are stated in terms of the standards performance. of performance required, including past Post-action phase – evaluation after performance. performance. 3. The principles of exception provide ELEMENTS NEEDED IN ANY CONTROL summaries that identify exceptions to the SYSTEM standards. A. Predetermined Goal, Plan, Standard, Norm, Decision, Rule, Criterion Yardstick. This answer the question, “What should be results?” TEN CHARACTERISTICS OF A GOOD This element focuses on the future and what is CONTROL SYSTEM: desired and expected. 1. Controls must reflect the nature of the B. MEASURING CURRENT ACTIVITY activity. (Quantitative if possible) 2. Controls should report errors promptly. 3. Be forward-looking. Measuring – is the gathering of information 4. Point out expectation at critical points. about work performance and assessing its 5. Be objection. effectiveness. And this information is 6. Be flexible. retained in a form of records and reports. 7. Reflect the organizational pattern Records – are accounts, documents, 8. Be undesirable memorandums, of activities, facts or previous 9. Be economical experiences. 10. Indicate Corrective action. Reports – are statement of facts or figure ascertained by investigation. BASIC STEPS IN CONTROL PROCESS THE DIFFERENT KINDS OF RECORDS AND 1. Standard – predetermined level of REPORTS: excellence that serves as a guide for practice. Patient Chart CHARACTERISTICS: Policies and procedures, including the data they were Predetermined reviewed. Established by an authority Communicated to and accepted by people Job and performance description. Ex. Philippine Nurses Association, Scope of nursing Employee files, including applications references practice, Standards of nursing practice, Policy and other appropriate records. Procedures Manual. Statistic reports such as daily census, time sheet THREE TYPES OF STANDARDS: (DTR) narcotics records and untoward incident report. 1. Structure Standards – are those that focuses on the structure management or Management Organizational activities record (which include the system used by an agency to organize and number and kind of laboratory study performed and deliver care. types of surgeries performed). 2. Process Standard – refer to actual nursing C. COMPARE CURRENT ACTIVITY WITH procedures those activities engaged in by CRITERION. nurses to administer care. 3. Outcome Standard – are designed for The purpose of comparing past performances measuring the results of nursing care. with planned performances is not to determine when a mistake has been made, but to enable the manager METHODS FOR MEASURING to pre-determined future problems. PERFORMANCE: CONTROL AS MANAGEMENT Task Analysis – are used to determine issues such as how long it takes a nurse to give In the process of measuring the degree to medication, or how long it takes a nurse to which pre-determined goals are achieved. Applying give bath. necessary corrective actions to improve Anecdotal – is a written note/record of an performance, policies and procedures are used as observation about a person and a person’s standards. behavior.  Quality Control – generally focuses on Example, the firm products. measuring inputs, organizational functions, MANAGEMENT CONTROL TECHNIQUE IN and outputs. NURSING 1. Nursing Rounds – cover such issues as patient care, nursing practice and unit management. Part of the evaluation process takes place as a result of the communication during rounds. 2. Nursing operating instructions – instructions and policies become a standard for evaluation as well as controlling techniques. 3. Gannt chart – it depicted a series of events essential to the completion of a project or program. It is usually used for production activities. 4. Master control plan – a master control plan can be used by nurse manager to fulfill this PERFORMANCE APPRAISAL management function. 5. Performance rating – is the systematic and Comparing result of performance with standard uniform method of appraisal that rate and objectives – does performance match the efficiencies in performing his duties and standards and objectives. responsibilities. Reinforcing strengths or success and taking STRATEGIES FOR CHANGE IN AN corrective action as necessary – positive aspect ORGANIZATION FOR EMPLOYER translated into encouragement and motivation, corrective action necessitating changes in standards Orientation and objectives. Training TWO PRINCIPAL FACTORS TO CONSIDER Seminar Workshop FOR EFFECTIVE CONTROL: Continue staff development through small group meeting or conference. 1. Human Element of Control Employees participation in Organizational This involve in the attitude and overt activities responses of people in an organization. 2. Performance Appraisal REASONS WHY MAN OBJECT CONTROL: Is a method of acquiring and processing information needed to improve the individual Failure to accept objectives workers performance and accomplishments. Feeling the part is unreasonable Belief that measurement is in accurate Consists of setting standard and objectives, Dislike of unpleasant fact reviewing profess, having on-going feedback Pressures from illegitimate sources between the appraisal and the one who is appraised, Social pressure that runs against the and planning for reinforcements, deletion or company’s control correction of identifies behaviors as necessary. 2. Mechanical Element in Control This involves quality control.  METHODS OF MEASURING The nurse appraiser understand the appraisal PERFORMANCE process and uses the procedure effectively. Each individual is rated by immediate A. Informal Appraisal – occurs on a routine basis supervisor. may consist of the following: The performance appraisal concentrates on 1. Observation of work performance while areas of strength, as well as note weaknesses, engaged on individual or group functions. in the individual to improve performance. 2. Incidental face to face confrontation and The appraisal process encourages feedback collaboration with the workers. from nursing members about their 3. Responses offered of a workers during performance, needs and interest. conference. Provision is made for initiating preventive 4. Nothing the reaction to the worker of an and corrective actions and making involved person, such as the patient or client, adjustment to improve the worker’s family member, or staff person. performance. 5. Noting the effects of a worker’s actions on a patient or clients, family, personnel or 3. Quality Control or Quality Assurance environment. It is monitoring the compliance with B. Formal Appraisal – is best accomplished by established standards. It is achieved through a variety regularly and methodically collecting objectives of preventive and corrective methods that are facts that can then be calculated to tell the difference intended to ensure compliance with established between what was expected and what actually standards. occurred, to be effective methods used should be. COMPONENTS OF QUALITY ASSURANCE 1. Accurate PROGRAMS: 2. Timely 1. Standard setting 3. Objectively 2. Comparing standards with actual practices 4. Focused on the level of worker’s 3. Analyzing and interpreting these performance in every worker category. comparisons 5. Addressed to major roles expected of the 4. Selecting the implementing actions to workers (job description). improve practices 6. Economical realistic 5. Evaluates these action’s effectiveness. 7. Appropriate for organizational structure. 8. Acceptable to the members involved. METHODS AND TOOLS OF QUALITY ASSURANCE: COMPONENTS OF AN EFFECTIVE NURSING PERFORMANCE APPRAISAL 1. Slater nursing competencies rating scale – for SYSTEM measuring competencies displayed by a nurse. There is compatibility between criteria for 2. Quality patient care scale – for measuring the individual evaluation and organizational quality of nursing care received by a patient, while goals. on-going care given. Describe the nurse actions as it The nursing performance rated directly was received by the patient rather than as it was applies the performance standards objectives performed by the nurse. expected of the worker. 3. Nursing audit – for measuring the quality of Behavioral expectations have been developed nursing care received by patient, after a cycle of care or mutually agreed on by the nurse’s received and the patient is discharged. appraiser and the individual being evaluated. TYPES OF NURSING AUDIT 3. Evaluate the observation variables and decide which are justifiable in terms of the criteria 1. Retrospective or Close Chart Audit – Once the and acceptable nursing practice and which patient is already discharged from the hospital, or are unjustifiable and represent actual nursing home, or placed in an inactive status of a deficiencies. home health agency’s case. 4. Take suitable corrective actions to prevent 2. Current or open chart audit recurrence of such deficiencies. 5. Follow through. a. Application and execution of physician legal 6. Prepare an distributed suitable summary orders. reports to nursing hospital administration, b. Observation of symptoms and to the executive committee of the c. Supervision of the patient medical staff. d. Supervision of those participating in care e. Reporting and recording TEN STEPS IN MONITORING AND f. Application of nursing procedures and EVALUATION PROCESS: techniques 1. Responsibility g. Promotion of health directions and teaching 2. Scope of care 3. Structure Audit – assumes that a relationship 3. Important aspect of care indicators exist between quality care and appropriate structure. 4. Indicators 5. Threshold for evaluation Resource inputs – environment where health 6. Data collection care is delivered (+) unit. 7. Evaluation Staffing ratios 8. Corrective actions Emergency department wait times – safe 9. Follow up and effective environment but do not address 10. Communications the actual care provided. DISCIPLINE is the mode of life in accordance with 4. Process Audit – Measure the process of care on rules. how the care was carried out and assume that a relationship exists between process used and quality FROM EMPLOYEES’ STANDPOINT of care provided. Discipline is a form of self-control through Task Oriented which the individuals acts in accordance with the Focus on whether practice standards are institution’s code of behavior. being fulfilled. (ex., established policy for FROM MANAGERS’ STANDPOINT institution doctors order) Documented in NCP, procedure manuals Discipline is a process of insuring employees nursing protocols statements. compliance with the institutional rules and regulations. 5. Outcome Audit – end result of care, change in health status of patient as a result of intervention. EMPLOYEE CODE OF JUSTICE An absolute prerequisite for effective Outcome demonstrate the quality of care discipline awareness of those institutional rules and provided. regulations that governs workers behavior. Such Valid indicator of quality of care. rules should be written in clear and concise language, NURSING AUDIT STEPS ARE THE should be incorporated in an employee or worker FOLLOWING: handbook that is given to new employees and should be incorporated in an employee or worker handbook 1. Establish standard and criteria. that is given to new employees and should be poste 2. Measurement din all working unit. The following are examples of 6. Research may allow nurses to make more typical behavior rules imposed by health agency. informed decisions as each phase of the nursing process is clarified through research. THE EMPLOYEE SHALL NOT: 7. Research also enables nurses to understand a 1. Absent herself from scheduled assignment particular nursing situation about which little without approval of her immediate superior is known. or supervisor. ROLES OF RESEARCH IN NURSING 2. Physically or verbally abused by patient. 3. Transmit confidential information Fills the gaps in knowledge and practice concerning patient’s hospital affair to Provide basis for professionalism and unauthorized person. professional accountability 4. Appropriate patients and/or hospital Improves standards of nursing education belongings for personal use. Discovering new measures of nursing 5. Refuse to follow direction of a duty practice authorized superior. Molds attitudes, competencies, and skills 6. Intentionally falsify hospital records. Meeting the changing societal needs. 7. Sleep during duty hours. 8. Be under the influence of alcohol of A. Client Satisfaction and Safety unprescribed drugs while on institutional What is Patient Satisfaction? premise. Patient Satisfaction is an important and commonly used indicator for measuring the quality APPLICATION OF RESEARCH IN NURSING in health care. Patient satisfaction affects clinical LEADERSHIP AND MANAGEMENT outcomes, patient retention, and medical malpractice claims. It affects the timely, efficient, and patient- Research in Nursing centered delivery of quality health care. According to Polit and Beck (2006), Nursing 4 Nursing Strategies to Improve Patient Research is “systematic inquiry designed to develop Satisfaction knowledge about issues of importance to nurses, including nursing practice, nursing education and a. Focus on Effective Communication nursing administration.” b. Sit with Patients c. Prioritize Teamwork IMPORTANCE OF RESEARCH IN NURSING d. Advocate for Adequate Staffing Levels 1. Research is an important tool for the Link between patient safety and patient continual development of a relevant body of satisfaction knowledge in nursing. 2. Research generates information from nursing Patient safety and patient satisfaction should investigations which help define the unique hand-in-hand. role of nursing as a profession. Hospitals ought to be able to provide care that 3. Professional accountability of nurses to their is safe and meets or exce