Nursing Leadership & Management PDF

NURSING LEADERSHIP & MANAGEMENT WEEK 1 | Leadership | By: JK & Cheska Leadership Example is chief nurse. In - Leadership is a process of influencing others coordinating activities, it attempti...

NURSING LEADERSHIP & MANAGEMENT WEEK 1 | Leadership | By: JK & Cheska Leadership Example is chief nurse. In - Leadership is a process of influencing others coordinating activities, it attempting to achieve share quotes and includes the training for newly inspiring action. hired nurses and retraining of - Leadership is a dynamic, interactive process their old employees. that involves three dimensions: - Relationship-Oriented 1. Leader is the one who leads, It includes being friendly and conducts, or guides to process considered showing trust and 2. Follower confidence, expressing 3. Situation appreciation and providing - To lead is to go with or ahead of show us the recognition. way or guide Examples are supervisors and - “A leaders is one others follow willingly and head nurse. They are voluntarily” approachable, helpful, and do not hesitate to guide. Two Types of Leaders - Participative Leadership 1. Informal Leader Associates participation in - These leaders doesn’t have official making decisions. sanction to direct activities of others The higher ups ask the but are chosen by the group itself. nurses, what are their verdict - Usually the leaders become a leader in the machines or equipments because of their age, seniority, special to be purchased because competencies, they have an inviting nurses are the ones who use personality or ability to communicate the machines and equipment with and console others. Qualities of a Leader - In the Philippines it is common that - Intelligence senior nurses become a leader in the The leader must be area. The another example is the PNA knowledgeable, should have 2. Formal or Appointed Leader judgment and influence of - These leaders are chosen by the speech administration and given official and - Personality legitimate authority to act. The leader must be adaptable, - Example a elective officers of an alert, creative, cooperative, organization. and have personal integrity. - The example of Formal or appointed He or she should be leader is our Dean Ma’am Evangeline self-confident, have emotional Teruel as appointed by the President balancing control and be of the OLFU independent. - The main difference of the two is the - Abilities informal leader is chosen by the group Leaders should have the itself while the formal leader is ability to enlist cooperation, appointed by the administration popularity and prestige, sociable, should have 9 Theories of Leadership interpersonal skills, social Leadership Traits participation tacked on and - Task Oriented diplomacy. The behaviors include Great-Man Theory planning, scheduling, and - Leaders are born, not created coordinating activities. - Leaders are born, not made 1 | PRELIMS NCMB419  - Great leader will arise when there is a opinions before great lead making a decision - Argues that few people are born to be - Situational leadership great leaders who are well-rounded theory and simultaneously instrumental and It depends on the supportive but many find this theory level of the maturity of unattractive because of the premise individuals just like that leaders are born and made which contingency theory suggests that leadership cannot be Uses task behavior developed. and relationship Contingency Theory behavior in relation to - Leaders’ ability to lead is contingent the followers’ upon the situation. readiness and it is - The leader's ability is dependent on called majority. the situation because contingent is In order to emphasize object to change or dependent. the importance of the ○ Leadership-member maturity level of the relationship followers, the leader - Example is if the needs to adapt nurses are just leadership styles advanced beginner, accordingly based on they need authority the maturity. relation leadership This predicts the most ○ Task structure appropriate leadership - This refers to the large style from the level of task, this is broken maturity of followers. down to smaller or - Motivation more manageable Motivated by a certain tasks. factors like reward ○ Position power and punishment - Is power given to an - Capability of followers individual because of - Performance of leader and their specific rank or follower position in an - Attitudes, needs, and organization. expectations Integrative Leadership Model - There is no No matter how one best leadership style. knowledgeable and - Based on this theory, leaders are skilled, attitude is really totally people oriented or task important. oriented. Transactional Theory - Reward and - According to this theory, one should be Punishment aware of his/her own behavior and Transformational Theory - Empowerment learn to adapt. - According to this theory, ○ Behavioral Theory - successful empowerment is the key factor, people leadership is based in definable will follow who inspires them and who learnable behavior has vision and passion. - Participative leadership - It is a leadership style that builds itself People are more on values of both the leader and the committed to actions. team. For example is the - Examples are integrity and head nurse is asking transparency. Open and honest the members and communication with their team trying to get their members leading to a culture of trust and affordability. 2 | PRELIMS NCMB419  Path-Goal Theory - Derived from the Therefore, there is a high productivity Expectancy Theory where people act as they and this facilitates a quick response. do because they expect their behavior to Example in ER, there should be an produce satisfactory results. autocratic leadership because we ○ Leaders cannot get opinions of the members - Minimize obstruction to the because if there is an emergency then goals the head nurse or supervisor needs to - Reward followers for make a decision quickly and it is often completing their task necessary in crisis situations. ○ Task-oriented leader The disadvantages of autocratic - Preferred by people with high leadership, it inhibits the creativity and need for achievement autonomy of the members, promotes ○ Considerate Leader mistrust and fear among followers and - Preferred by people with high members may become hostile or need for affiliation passive. Strategy Theory ○ Strategy 1 - Attention through vision 2. Democratic / Participative ○ Strategy 2 - Meaning through - Involves subordinates in decision making communication - People-oriented ○ Strategy 3 - Trust through positioning Every member should have an input ○ Strategy 4 - Deployment of self and the communication in this through positive self regard leadership is open and mutual. The Charismatic Theory leader's behavior should act as a ○ “Charm is an inspirational quality” facilitator and serve as a resource ○ Charismatic theory leaders inspire person and encourage the members others by obtaining emotional active participation. commitment from followers and Potential impact on the group is there arousing feelings and loyalty and is an improved productivity and more enthusiasm. opportunity for personal growth, and ○ Leaders have strong conviction, high there is an increased cooperation and self-confidence and followers – Robert teamwork because the leader gets the House opinion of the other members ○ Leads into blind obedience but The advantages, it promotes transformational leaders use it to empowerment of team members this motivate members – Bernard Bass facilitates communication and ○ According to Conger (1988), they increases creativity and autonomy. found out that charisma is more of an However, although democratic attributional phenomenon, so charm leadership is good, it is time and grace are needed to create consuming and maybe less efficient in followers. quantifiable terms and disagreements may happen as members express 5 Styles of Leadership their own viewpoint. 1. Authoritarian / Autocratic - Strong control 3. Laissez-Faire / Permissive - Centralized decision making - Little / no direction - Concern with task accomplishments - Delegate approach In autocratic leadership, the - Passive, non-directive, inactive communication flows downward and - Chaos will happen if members work this is the basic premise that the independently leader knows best. However, the Leadership responsibilities are potential impact on group members is assumed by the group, almost any hostility and rebellion. There are behavior by the group is permissible different advantages for this autocratic due to the leaders lack of limit and leadership, which is task oriented. self-limiting and stated expectations 3 | PRELIMS NCMB419  Leaders behaviors, they are passive, individual strengths, weakness, and they provide little support or guidance potential. and it sets no limits. The knowledge of basic ingredients for For example, if the members said leadership and management and the he/she can’t go to work, then you’ll just systematic use of self to get things permit it and then there’s no one left to done at the right time. do the work. In other books, effective leadership The advantage, it promotes autonomy also includes vision. It is a mental and creativity in some members. image of possible and desirable future However, there are many states. disadvantages for this style of The leaders transform visions into leadership, this may evoke passivity in realistic goals and communicate your team members, there is aimless visions to others to accept them as behavior, chaos, inefficiency, and low their own. productivity. In effective leadership, there must be influence, it is an informal strategy 4. Situational / Multicratic used to gain the cooperation of others - Leader identifies which style of leadership a without exercising formal authority particular situation requires because in leadership, you influence others to follow you. 5. Charismatic Leaders should be role models. - Obtains emotional attachment from followers and by asrousing of loyalty and enthusiasm inspires others to follow In other books, they also include transformational and servant leadership styles. Transformational focuses on individual relationships and building motivation within the group. You might exchange effectively and appear inspired and confident. Servant leadership styles, the leader influences a group by focusing on relationships and developing skills of the group, listening to the group and accepting others. There is a collaboration and engagement group. Components of Effective Leadership - Understanding of the individual strength, weaknesses, and potential - Knowledge of basic ingredients for leadership and management - Systematic use of self to get things done at the right time According to Joyce Clifford, leadership is the essence of professionalism, and should be considered an essential component of all nurses and other professional roles. The components were effective leadership, the understanding of the 4 | PRELIMS NCMB419 NURSING LEADERSHIP & MANAGEMENT WEEK 2 | Management | By: JK & Cheska Management - They also do the - Process that involves guidance, direction of a decision making group of people toward organizational goals to ensuring that the team objectives works towards - Is a process which the objective of an common goals. organization are accomplished by utilizing the ○ As a liaison - is the human, physical and technical resources communication bridge - Act of: between the nursing staff and Planning - is tasked by improving other departments, ensuring patient quality in the surgical unit, of that information flows course we nurses start by setting smoothly. goals. - They also are ○ Example: reducing the responsible for post-op infection by 20% in 6 collaboration with months; so they develop a other healthcare detailed action plan that professionals. includes staff training, Informational Role updating protocols and ○ Monitors information - acquiring supplies. regularly reviews patient care Organizing - organizes resources and reports and quality care staff; they assign roles and indicators. responsibilities ensuring that all staff ○ Disseminates information - members know their tasks. shares new hospital policies Directing (leading) - directs the team from the administration so that by providing clear instructions and everyone is informed. guidance; they hold regular meetings ○ Spokesperson or to communicate the goals and representative - represents progress, motivates staff and the nursing department in addresses their concerns. meetings with hospital Controlling (evaluating) - monitors administration communicating the process towards the goals; they the needs and concerns of the collect data, and conduct regular nursing staff. audits to ensure compliance with the Decisional Role new protocols. ○ Entrepreneur or innovator - Identifies opportunities for Roles of Manager improvement and innovation - Manager - Facilitates the group in within the nursing department accomplishing its goals through effective and involving implementing new efficient use of resources. technologies, developmenting - Types of Roles of a Manager: new protocols or introducing Interpersonal Role new training programs. ○ As a symbol - represents the - They serve as project nursing staff and the nursing management, they profession within the often lead projects healthcare profession; they aimed at enhancing also serve as a role model. patient care and ○ As a leader - provides improving efficiency direction and motivation to the and addressing nursing team to achieve their specific challenges. best performance. ○ Troubleshooter 5 | PRELIMS NCMB419  - In problem solving department overseeing staff budgeting and when issues arise, patient care quality. And provide oversight and they step in to resolve improvement in clinical settings ensuring that them by analyzing the the patient care standards are met. situation, identifying Top Level the root cause and - Highest ranking executives who are implementing responsible for overall strategic directions of solutions. nursing department or health care in - In crisis organization management, - Examples: The chief nurse and the nurse or coordinates the the nursing director. The chief nurse which response, ensuring oversees all nursing operations and ensures that resources are that nursing practices are aligned with the allocated effectively organization’s goals & policies and the patient care is - Also manages nursing services across multiple maintained. departments or the entire organization ○ Negotiator focusing on the policy development & strategic - Responsible for planning conflict resolution and Management Theory resource allocation, - Purpose: they mediate conflicts Provide a stable focus of in the staff members understanding what we experience or even between the Enable us to communicate freely patients and staff Challenge us to keep learning from our members. work. - They work to find - You don’t need to memorize the theory but to mutually accepted understand through concepts and examples solutions that maintain since the examination is situational. a positive working environment and high Four Principles of Management (Modern Era) quality patient care. 1. Scientific Management (“Focused on the best way 3 Levels of Management to do a task”) - Each level plays a crucial role in ensuring that Frederick Taylor nursing services are delivered efficiently & Frank and Lilian Gilbreth effectively contributing to high quality patient Henry Gantt care & a well functioning health care environment. A. Frederick Taylor First Level - He emphasizes efficiency through - These managers are directly involved with the standardization, time studies and systematic nursing staff and patients. They focus on the training immediate operational aspects of nursing care. - Father of Scientific Management - Examples: The charge nurse & the team - Stressed the selection of qualified workers who leader supervise a shift of nurse ensuring that could be developed for a particular job patient care is delivered effectively & efficiently - Used stopwatch studies & applied the and then leads the team of nurses in providing principles of: direct patient care often coordinating with other Observation health care professionals. Measurement Middle Level - Example: nurse develops standardized - These managers bridge the gap between the procedures for wound dressing ensuring that top level management and the first level all nurses follow the same steps which managers. So they are involved in both minimizes errors and increases efficiency. day-to-day-operations and long term planning - Examples: the nurse manager & clinical nurse leader, so they manage the specific unit or 6 | PRELIMS NCMB419 B. Frank and Lillian Gilbreth moves towards a specific solution. It’s often - Developed a micro chronometer described as a top-down approach. - They focus on reducing unnecessary ○ Involves applying general principles to movements & increasing efficiency through specific cases to reach logically certain motion studies. conclusions - Emphasized the benefits of: Theory first, general to specific. Job simplification Inductive reasoning: It is a bottom-up Establishment of work standards approach that starts with a specific Effects of the incentives wage plan observation or data and moves towards the Fatigue on work performance general conclusion. Therefore, it is often - Example: When a nurse manager analyzes described as a bottom-up approach. the steps, nurses take during medication ○ Involves drawing general conclusions, administration by reorganizing the medication specific observations to general which room layout supplies & necessary movements are probable but not guaranteed. are eliminated reducing the time spent per Henry Fayol and Weber patient & decreasing the risk of errors. ○ It have also influenced nursing - Also, applying motion study principles in management by providing structured Operation Room to streamline the setup and approaches to organization, leadership instrument handling processes reducing the & administrative functions time required for surgeries and improving patient outcomes A. Henry Fayol - “Father of Management Process School” C. Henry Gantt - Believed that - Disciple of Taylor, was concerned with Management is Universal problems of efficiency Division of work - Gantt contribution focus on project Specialization increased efficiency management & scheduling particularly Group Harmony - Equal treatment through the Gantt chart which is a visual tool and stability of tenure for personnel for planning & tracking tasks A place for everything and everything - Refined previous work rather than introduce its place new concepts Henry Fayol theory emphasizes the - Developed a task and bonus remuneration functions of management which plan includes: planning, organizing, - Service rather than profit. coordinating, controlling. - Example: When a nurse manager uses Gantt Fayol's Management Principles charts to plan & track the implementation of a ○ Division of labor new electronic health record system in the ○ Authority hospital. So the chart helps that each step ○ Discipline from training to full implementation is ○ Unity of Command completed on time. ○ Unity of Direction - Also creating a Gantt chart to visualize and ○ Subordination of Individual manage nursing staff schedules ensuring Interest to the Common Good adequate coverage for each shift & making it ○ Remuneration easier to adjust when someone is sick or on ○ Centralization vacation ○ Hierarchy ○ Order 2. Classical Management ("Deductive rather than ○ Equity inductive") ○ Stability of staff Two different approaches to problem solving & ○ Initiative decision making. ○ Esprit de Corps Deductive reasoning: It is a top-down approach, meaning that deductive reasoning B. Max Weber starts with a general premise or theory and - “Father of Organizational Theory” - Conceptualized the following: 7 | PRELIMS NCMB419  Bureaucracy with emphasis on rules with focus on timely decision making instead of individuals, competency and resolution. over favoritism - Fayol’s emphasis on Structure of authority that would managerial functions facilitate the accomplishment of the - A hospital inspired by Fayol organizational objectives. might focus on managerial - Basic of Authority processes ensuring that nurse Traditional Authority managers are well trained in Charisma leadership functions such as Rational / Legal Authority decision making & ○ Example: in a large hospital communication which allows the nursing department is them to adopt policies as organized with a clear chain of needed to improve patient command from the chief nurse care. to nurse managers to charge nurses & staff nurses. So each 3. Behavioral Science level specific responsibilities Emphasizes the use of scientific procedures to the decision flow from to to study the psychological, sociological, & down, that’s why in classic anthropological aspects of human behavior in organization it is deductive organization rather than inductive. ○ Behavioral management theories ○ It’s from the higher ups going emphasize the importance of to the bottom “top-bottom”. understanding human behavior, ○ The bureaucratic theory of motivation, & leadership styles in the Max Weber is also involved in workplace. decision making. ○ In nursing management, these theories can be applied to improve The Difference of Weber and Fayol staff satisfaction performance & Administrative Flexibility patient care outcomes. ○ According to Weber: When a nurse Abraham Maslow manager in a bureaucratic hospital Frederick Herzberg follows a strict protocol for reporting Douglas Mcgregor incidents. Where each incident is Ouchi documented in specific format and Blake & Mouton reviewed by a series of supervisors before any action is taken. A. Abraham Maslow (Hierarchy of Needs Theory) - Weber's structure is stricter 1. Self-actualization - Morality, creativity, than Fayol's. spontaneity, problem-solving, lack of prejudice, - Weber’s emphasis on rules acceptance of facts - A hospital under Weber's 2. Esteem - Self-Esteem, confidence, influence might have a achievement, respect of others, respect by compelling comprehensive set others of policies that govern every 3. Love/Belonging - Friendship. Family, sexual aspect of nursing practice intimacy from patient admissions to 4. Safety - Security of body, of employment, of discharge procedures with resources of morality, of the family, of health, & strict adherence required. of property (remember the word strict. 5. Physiological at the bottom - Breathing, ○ According to Fayol: When a food, water, sex, sleep, homeostasis & manager under Fayol's model might excretion develop a more flexible reporting - Maslow theory suggests that individuals have process that allows for immediate five levels of needs ranging from Physical action to be taken on critical incidents needs to Self-Actualization. 8 | PRELIMS NCMB419  - Example: In meeting the basic needs, the C. Douglas Mcgregor physiological & safety needs of the client the - Theory X and Y hospital ensures that the nursing staff has One’s style of management is access to a safe working environment (fair dependent on one’s philosophy of wages, job security, & this includes providing humans. proper PPE especially if they are assigned in a - Theory X communicable ward this is work. Adequate Emphasis on goal of the organization staffing means and nurses for environments Workers must be directed, controlled, which are essential for nurses to perform their coerced & threatened duties effectively. ○ Like an authoritarian Example: In fostering growth esteem management style & self-actualization means for ○ Examples: A nurse manager example. The nurse manager who subscribes to theory x, encourages professional development they believe that nurses are by offering opportunities for advanced inherently unmotivated & education, certification & leadership needs to be closely roles. By recognizing and rewarding supervised. achievements that the manager helps This manager might implement a strict nurses to achieve esteem & schedule, frequent check-ins, and rigid self-actualization leading to higher policies to ensure that tasks are motivation and job satisfaction. complete. While this can lead to high compliance, it may also decrease their B. Frederick Herzberg satisfaction and creativity - Factors in the job can raise the level of - Theory Y performance & meet the higher order needs Emphasis on goal of the individual - Job-content Workers have self-direction, Factors in the job self-control, responds to rewards for Motivators (achievement, recognition accomplishment of goals etc) - Participative management - Job context style Surrounding environmental factors - Example: A nurse manager Hygiene factors (working conditions who follows during Y believes etc). that nurses are self-motivated - Motivators & capable of taking initiative. Example: Offering opportunities for This manager might professional growth. Recognizing & encourage nurses to rewarding excellent performance and participate in decision making, providing challenging and meaningful taking leadership roles in work. projects & contributing ideas These factors contribute to job for improving patient care. satisfaction and encourage nurses to This approach typically leads go above and beyond their roles. to higher job satisfaction & - Hygiene Factors innovation. Example: Address manager ensures that the work environment is (clean, D. Wiliam Ouchi safe & well organized & also the - Theory Z policies on wages, job security, - Emphasizes the importance of employment working conditions are fair). involvement, long-term employment and strong These factors may not directly organization culture. motivate nurse their absence can lead - In theory z, there is emphasis on teamwork. to dissatisfaction & high turnover - Examples: All other nursing department, implements share governance, nurses or actively involved in decision making, care processes related to a patient care policies 9 | PRELIMS NCMB419  - Japanese Organization 4. Human Relations (“Stresses the Social Lifetime employment Environment”) Non-specialized career paths Focused on the effect individuals have on the Implicit control mechanism success or failure of an organization Collective decision making & Chester Barnard responsibility Mary Parker Follet - US Organization Elton Mayo Short-time employment Kert Lewin Specialized career paths Jacob Moreno Explicit control mechanism Individual decision making & A. Chester Barnard responsibility - Studied functions of executives - Stressed the role of informal organizations E. Robert Blake and Jane Mouton for: - Formulated 9x9 or 81 square managerial grid Aiding communication - Vertical axis: manager’s concern for the Meeting individual’s needs people Maintaining cohesiveness - Horizontal axis: manager’s concern for - Degree of cooperation depends on the production non-financial inducement - 2 critical dimensions of leadership 1. Concern for people B. Mary Parker Follet 2. Concern for production - “Mother of modern Management” - Stressed the importance of coordinating the 5 Basic Styles (Robert Blake and Jane Mouton) psychological & sociological aspects of 1. Impoverished Manager = Pip 🆇 + Prod 🆇 management They are NOT good for people & Organization - social system production. The manager is a lack of Management - social process concern for both people & production Legitimate Power - produced by 2. Country Club Manager = Pip ✔ + Prod 🆇 circular behavior whereby superior and They are thoughtful and friendly in subordinated mutually influence one people but in lack of concern in another production The Law of the situation - dictates 3. Organization Man Manager - Pip + Prod that a person does not take orders ✔🆇 from another person They represent a moderate concern of people & production but NOT AT THE C. Elton Mayo SAME TIME. - “The Hawthorne Studies” 4. Authority-Obedience = Pip 🆇 + Prod ✔ - Lighting had a little effect on production In efficiency in operation but lack of - Work norms had more influence than wage concern of human element incentive They are threatened by People that’s why there’s a high productivity D. Kurt Lewin 5. Team Management = Pip ✔ + Prod ✔ - Group dynamics - groups have personalities There’s an optimal managerial style. of their own These managers integrate their Composite of the member’s concern for people and production. personalities Increase people + high productivity, - Lewin advocated democratic supervision there is a collaborative on the people but it takes more time than E. Jacob Moreno authority-obedience. - Sociometry - analyze group behavior - According to Blake and Mouton, the team - Sociogram - chart pairings of preferences for management leadership style has high people others in high production - Contributed to: Psychodrama 10 | PRELIMS NCMB419  Sociodrama Roleplaying techniques Steps in Management Planning Organizing Staffing Directing (leading) Controlling (evaluating) Power Authority VS Power Sources of Power Leader and Managers Authority Legitimate power to direct others. Power One’s capacity to influence others Sources of Power Expert power - KS Legitimate power - Authority Referent power - Respect (elder) Reward power - Recognize (achievement accreditation) Coercive power - Punishment (demote) Connection power - Interpersonal (connections to other people) Informational power - access to information Leader and Managers Leader ○ Many or may NOT BE officially appointed to the position ○ Have power & authority to enforce decisions only as long as followers are willing to be led ○ Influence others toward goal setting, either formally or informally ○ Are interested in risk taking and exploring new ideas. Manager ○ Are appointed officially to the position ○ Have power and authority to enforce decisions ○ Carry out policies, rules & regulations ○ Maintain an orderly, controlled, rational, and equitable structure. 11 | PRELIMS NCMB419 NURSING LEADERSHIP & MANAGEMENT WEEK 3 | Planning | By: JK & Cheska Planning - “In the absence of clearly defined goals, we up in the routine task by setting our are forced to concentrate on activity and clear goals & objectives. The focus ultimately become enslaved by it" Chuck shifts towards achieving these results Conradt which enhances the overall success of - Emphasized the importance of having clear the organization. goals without well-defined goals. People tend Example: Instead of focusing on the to focus on being busy rather than being number of training sessions conducted productive. This leads to a cycle where activity a nurse manager might plan to becomes an end itself rather than a means to improve care quality by setting specific achieve meaningful outcomes. targets such as reducing infection - Essentially without clear direction, we risk rates. becoming trapped in a loop of constant activity - Forces analytic thinking and evaluation of that doesn’t necessarily lead to progress or alternatives fulfillment. Planning requires nurse leaders to think critically & consider various Planning options before making a decision - Is important and precedes all other Example: When planning staffing management functions. levels, a nurse manager might analyze - It’s defined as deciding in advance: different staffing models to determine “What to do?”, “Who is to do it?”, which one best meets patients needs “How?”, “When?”, “Where?” while staying budget constraint. ○ Without adequate planning, - Establish a framework for decision making the management process fails Awell thought out plan provides a & an organizational needs & structured approach to making objectives can’t be met. decisions, ensuring that choices are Involves a choice aligned with the organization’s Cyclical process mission, vision and goals. Proactive Example: A nurse manager uses a Directs attention to the objectives strategic plan reference when deciding - Planning in nursing & leadership & whether to invest in new medical management involves setting objectives. equipment or hire additional staff. Determining the most appropriate - Orient people to action than reaction actions to achieve those objectives. includes day-to-day and future focused It’s a critical component of leadership managers. as it provides direction in a framework Planning encourages a proactive for decision making and resource approach. allocation. This means that nurse leaders and - Effective planning ensures that nursing managers anticipate future needs and activities align with overall goals of healthcare challenges rather than merely reacting organizations. (enhances patient care, to issues as they arise. promotes efficiency & help in anticipating and Example: A nurse manager develops managing potential challenges). a contingency plan for potential staffing shortages during flu season. Reasons for Planning ○ Ensuring preparedness rather - Increases the chance of success by than scrambling for solutions focusing on results not activities when shortage occurs. Planning helps nursing leaders - Helps avoid crisis management and concentrate on achieving desired provide decision making flexibility outcomes rather than getting caught 12 | PRELIMS NCMB419  By anticipating potential problems & ○ Conduct a thorough assessment of the developing plans to address them, current situation including resources, planning reduces the likelihood of sta , capabilities, & patient needs. crisis. ○ Example: The Nurse will evaluate Example: A hospital develops a current staffing levels and skills mix to disaster preparedness plan which determine if they meet the patient’s includes protocols for various care requirements. emergencies allowing for quick and Prioritization effective responses. - Identify and prioritize tasks based on - Provide a basis for managing their importance & urgency organizational and performance individual - Example: Prioritizing critical patient Planning establishes benchmarks and care activities over administrative performance standards that help tasks during shifts. measures both organizational and Resource Allocation individual progress - Ensure that resources including staff Example: A nurse manager sets equipment budgets are allocated specific performance goals for each efficiently to meet the goals team member such as achieving a - Example: Allocating additional nursing certain patient satisfaction score and sta to high equity units during peak uses these goals to guide performance times evaluations Collaboration and Communication - Increases employee involvement and - Foster communication collaboration improves communication among & team members to ensure Involving the employees in the everyone is aligned with the plan planning process fosters a sense of - Example: There are regular team ownership & encourages open meetings to discuss progress and communication. address other issues Example: A nursing department holds Flexibility and Adaptability regular planning meetings where sta - Be prepared to adjust plans as needed members can contribute ideas and based on changing circumstances or provide feedback. new information ○ Leading to improved - Example: Modifying staffing plans in teamwork and morale. response to an expected increase in - Cost effective patient’s admissions In Planning helps organizations Evaluation and Feedback allocate resources efficiently avoiding - Continuously evaluate e effectiveness unnecessary expenses & optimizing of the plan and seek feedback for budgets improvement Example: Careful planning & nurse - Example: There are regular audits manager identifies ways to reduce and surveys to assess the impact of supply waste, saving the department new protocols on patient outcomes money without compromising patient care. Characteristics of Planning Based on clearly defined objectives Principles for Planning ○ Planning should be rooted in specific Goal Setting well-defined objectives that guide the ○ “SMART” entire process ○ Establish clear measurables & Simple achievable goals because this ○ Effective Planning should be provides direction & framework for straightforward & easy to understand. decision making ○ Simplicity in planning reduces the ○ Example: The goal is to reduce likelihood of confusions & increases patient falls by 20 within 6 months the chance of successful Assessment implementation. 13 | PRELIMS NCMB419  Provides for the proper analysis and classification of action ○ Planning should involve thorough analysis & categorization of actions to ensure that resources are allocated effectively priorities are addressed Flexible ○ Flexibility in planning allows for adjustments in response to changing circumstances because are dynamic & plans must be adaptable to unexpected challenges or opportunities. Balanced ○ Planning should achieve a balance between competing demands such as Vision - The status that the organization wants short-term needs & long-term goals or to attain at a certain time in the future resource allocation across different Mission - Purpose of existence and reason departments. behind organizational structure ○ Balanced plan ensures that no aspect Philosophy - Statements of shared values of care is neglected & that all elements and beliefs work harmoniously. together Goals - Statement of intent derived from the Make use of all available resources purposes of the organization, usually stated ○ Effective planning maximizes the use broadly and generally of all available resources including Objectives - Specific aims, purposes or human, financial and material targets that will have to be accomplished resources. Policies - A guide for decision making in the ○ Characteristics ensure that resources organization are utilized efficiently & that the plan is Procedures - The step-by-step process of realistic & achievable within the performing a specific task constraints of the organization. Rules - States the Do’s and Don’ts in the ○ Types of resources: organization - Man power ○ You SHALL - Money ○ You WILL - Material ○ You MUST Values Stages of Planning 1. Develop the purpose or mission statement, Types of Planning goals, objectives, philosophy. Strategic 2. Collect and analyze data– external and internal Bigpicture & Long-term focused (2-5+years) forces Vision, Mission, Why, Policies & Direction 3. Assess for the strength (opportunities that will Executive-management facilitate effectiveness and achievement of What is the right direction for the company goals and weaknesses (threats that will impede achieving goals and objectives). Strategic Planning 4. Write realistic and general statements of goals Long-term planning 5. Develop a timetable for accomplishing each Complex plans for the next 5 years & focuses objective on the broader goals of the organization 6. Provides guideline for developing operational typically for several years. and functional plans Involves senior leadership & engages top 7. Put plans to work/implement management in setting priorities are allocating 8. Provide for formative evaluation reports before, resources & ensuring that organization is during and after the plan is implemented moving towards its mission and vision. 14 | PRELIMS NCMB419  Example: Developing a plan to improve Because they manage the nursing budget patient safety over the next 5 years & plans new services for the patient and create implementing a new EHR system or expanding retention programs to maintain an effective the healthcare to communities nursing workforce Promotes safety and quality in patient care, Operational represents the nursing executive meetings & Focused On Day-to-day running they work closely with nursing staff to foster a Detail level processes for specific outcomes positive work environment. Execution by teams and managers Are we acting in alignment with strategy? Supervisors Formulate policies, rules and regulations, Operational Planning methods and procedures Short-term planning Coordinates nursing activities Middlemanagement & unit leaders Translate strategies and procedures into Plans for day-to-day operations specific objectives and program ○ It focuses on the activities of the ○ Supervisors in healthcare such as nursing unit or department. clinical supervisors play a crucial role ○ Often responsible for creating in the smooth day-to-day operations of operational plans that align with the healthcare facilities strategic goals of organization Example: Scheduling sta shift, managing daily Head Nurse patient care, ensuring that the resources like Lead Operational planning medications & supplies are available when Schedule daily and weekly plans for the needed. administration of patient care for his or her unit Directly responsible for the actual operation Tactical and production of nursing services Short-term focused (3 months to 2 years) Focused On Specific business department 4 Planning Modes Middle-management 1. Reactive Planning What Activities to be planned in strategic Occurs after a problem exist alignment? Problems are dealt with separately without integration with the whole Tactical Planning organization Bridge between strategic & operational Short term solution rather than long planning term strategy: strategy driven needs It focuses on the specific initiatives or projects Since the unit or hospital is not that contribute to achieving the strategic goals. prepared: They are responding to Usually spans from Months to Years. immediate issues as they arise & Short To Medium Term Handling sudden patient influx during a disaster. Contingency Planning Example: A hospital experiences an Preparing for unexpected events unexpected influx of patients due to It Involves creating plans for unfortunate the local disasters. The nursing staff & circumstances or emergencies management react by quickly Ensures readiness reallocating resources such as This helps the nursing team respond redistributing staff to different units or effectively to crisis such as natural disasters extending chief to manage the sudden pandemics or sudden sta shortages increase in patient load. ○ This is effective but this type of Chief Nurse planning can lead to burn out Leads strategic planning creates policies and & it’s not sustainable. guidelines for maintaining the provision of 2. Inactivism nursing service Prevent change and maintain They are also involved in budget management. conformity 15 | PRELIMS NCMB419  ○ (Don't Want change) 4. Proactive Planning ○ Remaining status quo & Interactive resistance to change ○ Consider the past, present, ○ Refusing to update protocols and future and attempt to plan despite new evidence the future of their organization When changes occur, they occur rather than react to it. slowly and incrementally ○ Anticipating & strategically - It involves minimal planning & preparing for future challenges reluctance to make proactive and opportunities changes. ○ Integrating telehealth services - This approach is often in anticipation demand conservative, aiming to Adaptability preserve existing conditions ○ Is a key requirement rather than adapt to new ○ Example: Hospitals recognize circumstances. the growing importance of Example: A nursing home consistently telehealth & begin integrating follows the same protocols & telemedicine services into procedures year after year. their care delivery model well ○ Even if evidence-based before it becomes widespread practices evolved, the necessity. management might resist - They invest in training updating care protocols for nurses and how to because they believe the use platforms current methods are sufficient developing protocols. even though new research - This proactive suggests better approaches. approach ensures that 3. Preactivism they are well prepared Utilize technology to accelerate for the future of change healthcare delivery. Are future oriented: Preparing for future changes, sometimes with urgency or fear or even fear of future problems. This planning emphasizes the preparation. ○ They overlook the present need yung problems. Example: A healthcare organization anticipates a future shortage of nurses to demographic changes in the aging population. ○ The aggressive response nurse recruitment due to anticipated shortages & investing in advanced technology to reduce the reliance on human labor, possibly neglecting current sta needs or patient care quality. 16 | PRELIMS NCMB419 NURSING LEADERSHIP & MANAGEMENT WEEK 4 | Budget | By: JK & Cheska Budget ○ Example: All budget requests for new - Operational management plan related to medical equipment must be submitted income and expenses for division of time, with cost benefit analysis. The hospital allocated resources necessary to future administration will not approve the expenditures. request unless there is a cost benefit ○ A budget is a crucial tool for nursing analysis. To ensure that purchases is management and planning helping aligned with the overall strategic goals. leaders allocate their resources effectively to meet their organizational Purposes of Budgeting in Nursing Service goals. It outlines an operational To plan the objective, programs, activities management plan related to income & of the nursing service and finance to expenses over a period of time. accomplish them ○ This ensures that the nursing ○ Budget helps in planning the department can function efficiently objectives, the activities of the nursing while meeting its objectives. service. ○ Example: When we plan for the next Prerequisites to Budgeting year, the nursing department budget Sound organizational structure with clear for new staff training programs to line of authority and responsibility improve the patient care quality. ○ We need clear organizational structure To motivate nursing workers through with defined lines of authority and analysis of actual experience responsibility for effective budgeting ○ By analyzing the actual financial because it ensures that everyone performance, budgeting can motivate knows their role in managing and the nursing staff by showing how their spending resources. efforts contribute to the departments ○ The Chief Nurse in the hospital must financial health understand the budgetary needs of ○ Example: When the ICU are always each nursing unit this is to ensures within their budget, so this may be that the nurse managers knows their recognized as a team achievement specific financial responsibilities that helps to boost the morale and Managerial support encourage the team to continue their ○ it must have support of the upper financial discipline. management so that the budgeting To serve as standards can be effective. This includes ○ Budgeting is a benchmark or standard providing necessary resources and against which actual performance can backing for the implementation of be measured, allowing for adjustments budget plans. and improvements. ○ In nursing, if a nurse manager ○ Example: The hospital might identifies the need for additional compare its monthly spending on staffing, they must have the support of medical supplies against the budget to the hospital admin or hospital identify areas where costs can be administration to allocate the reduced without compromising care necessary funds. quality. Formal policies and procedures must be reflected in the budgetary manual Types of Budget ○ Budgeting should be guided by formal Capital Operational policies & procedures since this is the framework, we need consistent and - Long term - Day to day transparent financial management. investments expenses 17 | PRELIMS NCMB419  Petty Cash - Expensive - Example: Accessible cash dedicated for emergencies - Example: real supplies, or unanticipated / unexpected events - property, electrical bill, which means that it’s a small amount of money building water bill kept on hand for minor or emergencies renovations, expenses that cannot for formal budget heavy approval because it will take time. equipment Example: The petty cash can be used to purchase emergency supplies like bandages if Capital Budget there is no supply or the main supply order is This budget covers long term investments delayed. often involving significant expenditures that will benefit the organization over several years. Cost Example: real property, building, renovations, Fixed Cost heavy equipment. ○ Not related to volume, remains ○ But in nursing, the capital budget constant may include - funds for purchasing a ○ Example: Salaries for full-time staff new MRI machine for the radiology are fixed cost because they do not department though it is expensive but fluctuate with the number of patients. this can enhance the diagnostic Variable Cost capabilities of the hospital. ○ Related to volume, and varies It is also included in marketing because if the according to different factors hospital has an MRI, patients in the community ○ The variable cost change in relation to will go there because not all hospitals have the volume of services provided. MRI. ○ Example: The cost of disposable gloves and syringe will increase with a Operational Budget higher patient volume making them Is a Day-to-day expenses in routine functioning variable cost. of the nursing department. Direct Cost Example: Supplies, electricity bill, water bill ○ Related to providing product / services In nursing it is the same, this project can ○ Example: Cost of medications also include - medical supplies and routine administered to patients that’s a direct maintenance of equipment. cost in nursing care. Indirect Cost ○ Incurred in support of providing Personnel/Manpower Petty Cash products or services - Salary of - Accessible cash ○ This supports the provision of services personnel dedicated for but is not directly tied to patient care. emergencies or ○ Example: The costs of maintaining the unanticipated hospital's infrastructure which supports events the electronic health record system. Cost Containment Personnel/Manpower - Cost containment involves strategies to keep A salary of personnel means that this budgetary limits budget - is dedicated to cover the salaries and Cost Monitoring benefits for nursing staff. Focuses on how much will be spent, where, Example: The personnel budget will cover the when, & why wages of the registered nurses, the nursing ○ This focuses on tracking expenditures assistants and other support staff. This should to ensure that they align with the ensure that the hospital can maintain adequate budget. staffing levels. ○ Example: Regularly reviewing the budget for a surgical unit to ensure that spending on supplies does not 18 | PRELIMS NCMB419  exceed that allocated amount. so it is Swot Analysis important to monitor it so that we - Strategic planning tool cannot or do not exceed. - Used to identify and evaluate the Strengths, Cost Management Weaknesses, Opportunities, and Threats What can be done to manage cost associated with a particular situation, project, ○ This refers to the overall strategy to or organization. control cost while maintaining service - Purposes of SWOT Analysis quality. Is to develop a comprehensive ○ Example: Negotiating better rates with understanding of the current supplies for medical equipment to environment, enabling informed manage cost more effectively. (in decision making and strategic planning short, we make tawad/barat sa It helps nurse leaders to capitalize on suppliers) strengths, address weaknesses, seize Cost Incentives opportunities and mitigate threats. Motivation and Rewards ○ Offering motivation or rewards to manage cost effectively. ○ Example: Providing bonuses to nursing staff for reducing waste and staying under budget and supplies. Cost Avoidance 1. Strengths Not buying supplies, technology or Positive attributes within the nursing services not necessarily needed department or organization that ○ We need to avoid unnecessary provide an advantage. expenses by not purchasing supplies Examples: or services that are not essential. ○ Advanced technology and ○ Example: In nursing, we decide not equipment to upgrade to a newer model of ○ Highly skilled and experienced equipment - if the current is still nursing staff. functional and meets the patient 2. Weaknesses means. So the dialysis machine they Areas within the organization that are plenty new models but some need improvement or pose challenges hospitals they don’t upgrade because Examples: their old ones are still functional and ○ Limited access to resources or can still use it outdated equipment Cost Reduction ○ Staff shortages or high Spending less for goods or services turnover rates. ○ We are actively seeking ways to 3. Opportunities spend less without sacrificing service Conditions or trends in the external quality. environment that the nursing ○ Example: Switching to a lower cost department or organization can exploit supplier for non critical items like for growth or improvement. linens to reduce expenses. Examples: Cost Control ○ Partnerships with other Effective use of available resources healthcare organizations or through careful planning, forecasting, educational institutions. reporting, and monitoring ○ Advances in medical - Example: The nurse leaders technology or nursing implement a system where all practices. requests for new supplies are ○ New healthcare policies or reviewed to prevent unnecessary funding opportunities purchases. It’s important to double 4. Threats check items so that we will not buy Challenges or obstacles from the extra supply. external environment that could 19 | PRELIMS NCMB419  negatively impact the organization or strategies and assign responsibilities nursing department. to team members. Examples: Continuous Monitoring: Monitor the ○ Increased competition from effectiveness of implemented other healthcare providers. strategies and make adjustments. ○ Public health crises Swot Analysis in Implementing New Technology in Steps to Conducting a Swot Analysis in Nursing Nursing Leadership Strength 1. Gather Data ○ Adequate budget and support from Internal Assessment: Collect data on hospital administration for technology the nursing department’s resources, upgrades processes, outcomes, & staff ○ Strong team cohesion and high levels feedback. of job satisfaction among nursing staff External Assessment: Analyze Weaknesses external factors such as industry ○ Limited technological expertise among trends, regulatory changes, economic the current nursing staff. conditions, and technological ○ Limited availability of specialized advancements. nurses for critical care units. 2. Identify Strengths, Weaknesses, Opportunities Opportunities & Threats ○ Advances in healthcare technology Brainstorming Sessions: Engage that improve patient outcomes. nursing leaders, staff, stakeholders in ○ Growing interest in nursing carers identifying the organization’s SWOT among students provides an Categorization: Organize the opportunity for recruitment identified factors into the four SWOT Threats categories, ensuring a clear and ○ Resistance to change among staff and comprehensive list. potential disruptions during the 3. Analyze and Prioritize transition. Evaluation: Assess the impact and ○ Increasing competition for skilled significance of each factor nurses from other healthcare Prioritization: Rank the factors based organizations on their potential impact on the nursing department’s goals & objectives Benefits of Swot Analysis 4. Develop Strategies Enhanced Decision-Making Leveraging Strengths: We need to ○ Provides structured framework formulate strategies and capitalize on improvisations. nursing department strengths to Strategic Focus achieve its moments. ○ Helps nursing leaders focus on key Addressing Weaknesses: To areas that will have a significant address the medications ready to impact on the department or develop actions and to improve organization. religion and divide witness Proactive Management Exploiting Opportunities: To identify ○ Enables nursing leaders to anticipate in personal that align with and address potential challenges organizations and discrimination before they become critical conscious Mitigating Threats: Creating Resource Optimization contingency immigrants or some ○ Assessed in the effective allocation & cognitive pressure to minimize the utilization of resources based on impact. identified strengths & weaknesses 5. Implementation and Monitoring Team Engagement Action Plans: Translate the SWOT ○ Staff stakeholders in planning process, Analysis findings into actionable fostering sense of ownership and collaboration 20 | PRELIMS NCMB419 NURSING LEADERSHIP & MANAGEMENT WEEK 5 | Organizing | By: JK & Cheska Organizing to one nurse and then the other nurse - Is the second phase of the management will monitor patients on the ward. So process.