Nursing Leadership and Management Past Paper PDF

lOMoARcPSD|8465916 LM- Midterm Period - none Nursing Leadership and Management (Medical Colleges of Northern Philippines) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university...

lOMoARcPSD|8465916 LM- Midterm Period - none Nursing Leadership and Management (Medical Colleges of Northern Philippines) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Christian James Mata ([email protected])  lOMoARcPSD|8465916 MIDTERM PERIOD Specific Instructions in the completion of each Chapter: 1. Set your learning goals. Read and understand the Intended Learning Outcomes of each chapter. This shall serve as your checklist of acquired knowledge and skills after completing the entire chapter, likewise, the basis of the teacher in the formulation of the summative evaluation given at the end of each chapter. 2. Lecture notes are provided for you. BE SURE NOT TO SKIP the lecture. Read and understand before answering the activities. You can take note those concepts that are not clear to you and refer to your subject teacher during the specified consultation hours. 3. Read the teacher’s insight and open video links provided to supplement the lecture notes. 4. As you go on, you will encounter exercises that will test your knowledge and understanding as well as your critical thinking. 5. Compile you outputs in your Learning Portfolio to be submitted on the date set by your teacher. 6. Should you have any queries or clarifications with the topics, please contact your subject teacher during consultation hours (please refer to the preliminaries of this material). Intended Learning Outcomes: At the end of the lesson, students will be able to: 1. define, differentiate, and enumerate the different management functions and apply its importance in the different fields and areas of nursing as nurse manager and leader. 2. Discuss the purpose and modes of Planning. 3. Discuss the components of organization chart. 4. Explain the different modalities of care in organizing patient care. 5. Identify the sequential steps in staffing. 6. Explain the manager’s responsibilities in meeting staffing needs. 7. Demonstrate how to make a sample schedule of staff in the clinical area. 8. Identify different leadership styles, time management and conflict management. 9. Identify communication techniques used in management. 10. Differentiate the motivation theories. 11. Discuss the different types of budgeting and costing in nursing service. 12. Explain the importance of Performance evaluation/appraisal. 13. Identify the process of Staff development and quality improvement. Let’s Begin! ORGANIZING defined: - A process of forming a system into an organic whole, giving it an orderly structure, framing and making arrangements for its working order - A process where personnel job descriptions, qualifications, and functions are distinctly defined and specified for work efficiency in the organization - Grouping of activities for the purpose of achieving objectives - Means of coordinating appropriate activities with other units, horizontally and vertically, that are responsible for accomplishing organizational objectives. ORGANIZATION defined: - Is an organized body, system or society where members harmoniously work together to achieve organizational goals CHARACTERISTICS OF AN ORGANIZATION: - These 6 categories interact with one another in making an organization work productively. 1. GOAL - all organization have specific purpose or goal 2. PEOPLE – organization consist of people who do not come and go. Instead, people who are grouped and work together in a distinct way 3. STRUCTURE – this defines and limits the behavior of the organizational members. 4. CULTURE – the personality of the organization and is reflective of the values, symbols, rituals, myths, and work practices that are common to every organizational member. 5. JOB – the kind of job that every employee performs plays a very significant part in influencing behavior at work Downloaded by Christian James Mata ([email protected])  lOMoARcPSD|8465916 6. SUPERVISION – management personnel who are responsible for establishing work environment. Creating positive work environment by them leads to improved performance and job satisfaction. ORGANIZATIONAL THEORY: MAX WEBER – father of organizational theory. - generally acknowledged to have developed the most comprehensive classic formulation on the characteristics of bureaucracy. ELEMENTS OF ORGANIZING: 1. Setting – up Organizational Structure – It is the process of developing or changing the mission, philosophy, vision, values and objective. This should be based on results of research since new theory arises that the organizational structure affects decision making process. 2. Staffing and Scheduling - It is an orderly, systematic process, based upon sound rationale, applied to number and kind of nursing personnel required to provide nursing care of a predetermined standard to a group of patients in a particular setting. 3. Developing job descriptions - A contract that should include the job’s functions and obligations and specify the person to whom the employee is responsible. STEPS IN ORGANIZING: ( Koontz,1986) 1. Establishing enterprise objectives 2. Formulating supporting objectives, policies and plans 3. Identifying and classifying activities necessary to accomplish the objectives of the enterprise 4. Grouping the activities in the light of the human and material resources available 5. Delegating the head of each group the authority necessary to perform the activities 6. Tying the group horizontally and vertically, through authority relationships and information flows PRINCIPLES OF ORGANIZING: 1. UNITY OF COMMAND – Indicates that although an employee may interact with many different individuals in the course of his work, he should be responsible to only one supervisor, whose direction can be regarded as FINAL. 2. SCALAR PRINCIPLE/CHAIN OF COMMAND - Suggest that there must be a clear line of authority running step by step from the highest to lowest level of organization. 3. SPAN OF CONTROL - The number of people directly reporting to any one manager represents that manager’s span of control and determines the number of interactions expected of him or her 4. HOMOGENOUS ASSIGNMENT OR DEPARTMENTATION-It is the process of forming employees into groups to accomplish specific organizational goals. 5. EXCEPTION PRINCIPLE - also known as management by exception - closely related to parity principle - the exception principle states that managers should concentrate their efforts on matters that deviate significantly from the normal and let subordinates handle routine matters. 6. PRINCIPLE OF CONTINUING RESPONSIBILITY – when a manager delegates a function to a subordinate, the manager’s responsibility for that function is in no way diminished. 7. CENTRALITY – workers who interact with the greatest number of other workers receive greatest amount of work-related information and become most powerful in organization structure 8. SPECIALIZATION – each person should perform a single leading function 9. PRINCIPLE OF REQUISITE AUTHORITY/DECENTRATLIZATION OR PROPER DELEGATION OF AUTHORITY - when responsibility for a particular task is delegated to a subordinate, that subordinate must also be given authority over resources needed for task accomplishment ORGANIZATIONAL CONCEPTS: 1. ROLE – set of behaviors and attitudes expected of a person by those with whom he or she interacts 2. POWER – ability to influence another to behave in accord with one’s wishes > REWARD- ability to provide rewards to another Downloaded by Christian James Mata ([email protected])  lOMoARcPSD|8465916 > COERCIVE POWER- ability to apply punishment to another > REFERENT POWER – person’s ability to inspire admiration, so that others identify with the individual, adopting similar behavior and attitudes > EXPERT POWER – ability to convince others that one possesses a high degree of knowledge and skill in a specialty area. > LEGITIMATE POWER - is given to a manager by the organization because of the manager’s position in the hierarchy. 3. STATUS – the rank a group confers on a person in accord with the group’s estimation of the person’s value and significance to group goals. 4. RESPONSIBILITY – the obligation to account for one’s conduct with respect to an assigned task 5. AUTHORITY – person’s right to make decisions and take actions without approval by higher administration. 6. CENTRALITY – refers to the fact that some positions are so located in the organization’s structure that the incumbent communicates frequently with many other workers. 7. COMMUNCATION- consists of the transmission of information and opinion between persons. LEVELS OF MANAGERS: TOP-LEVEL MANAGERS – look at the organization as a whole, coordinating internal and external influences, and generally make decisions with few guidelines or structures. - PRIMARY PLANNING FOCUS: strategic - COMMUNICATION FLOW: more often top down but receives subordinate feedback both directly and via middle-level managers EXAMPLES: Chief Operating Officer (COO), Chief Executive Officer (CEO) or President, VP for Nursing or Patient-Care Services, Nurse Administrator, Director of Nursing, Chief Nurse, Assistant Administrator of Patient-Care Services MIDDLE- LEVEL MANAGERS – coordinate the efforts of lower levels of the hierarchy and are the channel between lower and top-level managers. - focus is on integrating unit level day-to-day needs with organizational needs - PRIMARY PLANNING FOCUS: combination of long and short-ranged planning - COMMUNICATION FLOW: upward and downward with great centrality EXAMPLES: Nursing Supervisors, Nurse-Managers, Head Nurses, Unit Managers. Chief Nurse Officer (CNO) or Director FIRST-LEVEL MANAGERS – are concerned with their specific unit’s work flow they deal with immediate problems in the unit’s daily operations, with organizational needs and with personal needs of employees - focus primarily on day-to-day needs at unit level. - PRIMARY PLANNING FOCUS: short range/operational planning - COMMUNICATION FLOW: more often upward, generally relies on middle level managers to transmit communication to top level managers EXAMOLES: Primary care nurse, Team leaders, Charge nurses, Registered nurses ORGANIZATION CHART: - is the picture of an organization’s structure - can help identify roles and their expectations - defines formal relationships within the institution FIVE MAJOR CHARACTERISTICS OF AN ORGANIZATIONAL CHART  DIVISION OF WORK – each box represents the individual sub unit responsible for a given task of the organization’s work load  CHAIN OF COMMAND – lines indicate who reports to whom and by what authority  TYPE OF WORK TO BE PERFORMED – indicated by labels or descriptions for boxes  GROUPING OF WORK SEGMENTS- shown by the clusters of work groups (departments or single units)  LEVELS OF MANAGEMENT – indicate individual and entire management hierarchy *HIERARCHY refers to a body of persons or things organized or classified in pyramidal fashion according to rank, capacity or authority assigned to vertical levels with offices ranked in grades, orders or classes, one above the other. Downloaded by Christian James Mata ([email protected])  lOMoARcPSD|8465916 ORGANIZATIONAL CHART:  BOXES – represent individuals in an organization or may indicate entire departments  VERTICAL LINES – Referred to as LINES OF AUTHORITY and ACCOUNTABILITY a. LINES of AUTHORITY – represent the responsibility of individuals; it is identified by going downward on the chart b. LINES of ACCOUNTABILITY – represent a responsibility to report to another person; same lines that represent authority when moving down the chart represent accountability when moving up the chart NOTE: Taken together, the vertical lines demonstrate the CHAIN of COMMAND c. HORIZONTAL LINES – connect individuals who are at the same level in the organization and have official relationships - these individuals are required to work together but none has the authority over the others d. DOTTED LINES – represent communication relationships in which neither individual has direct authority or accountability to the other ORGANIZATIONAL STRUCTURE - Refers to the way a group is formed, its lines of communication, and its mean for channeling authority and making decisions TWO MAJOR TYPES: 1. INFORMAL STRUCTURE - unplanned and covert (hidden) - generally social with blurred or shifting lines of authority and accountability - consists of unofficial personal and social relationships among the members that influence work effectiveness - people with little or no formal status may gain recognition - uses grapevine communication - information may or may not be accurate 2. FORMAL STRUCTURE - planned and made publicly/visible - provides framework for defining managerial authority, responsibility and accountability - roles and functions are defined - describes positions, the responsibilities of those occupying the positions and the working relationships among the various units or departments TYPES OF ORGANIZATIONAL STRUCTURES: LINE STRUCTURE/LINE ORGANIZATIONS/BUREAUCRATIC ORGANIZATIONAL DESIGN - The traditional employer-employee authority relationship that emanates from the top of the organization to the workers’ population( Chain of Command) - Authority and responsibility are clearly defined Downloaded by Christian James Mata ([email protected])  lOMoARcPSD|8465916 LINE AND STAFF ORGANIZATION - is the authority in positions created to support, assist, recommend and generally reduces the supervisor’s informational responsibilities - purely advisory to the line structure with no authority to put recommendations into actions - this pattern develops when a simple line organization is altered to provide management specialists to support the chief executive - originated as a pure line organization to which staff specialists were later attached to improve management functions. LINE AUTHORITY - The traditional employer-employee authority relationship that emanates from the top of the organization to the worker population( Chain of Command) STAFF AUTHORITY - is the authority in positions created to support, assist, recommend and generally reduces the supervisor’s informational responsibilities Downloaded by Christian James Mata ([email protected])  lOMoARcPSD|8465916 AD HOC DESIGN  Modification of the bureaucratic structure and is sometimes used on a temporary basis to facilitate completion of a project within a formal line organization  Means of overcoming the inflexibility of line structure and serves as a way for professionals to handle the increasingly large amount of available information  Use a project team or task approach and are usually disbanded after a project is completed  A project team or task force is a group of diverse specialist who are temporarily joined to perform a non routine task of complex nature and critical importance to the agency MATRIX STRUCTURE - A variation of the line-and-staff organizational structure is the matrix structure - Has a formal and horizontal chain of command - The chain of command is different in that an employee can report to one or more managers, but one manager typically has more authority over the employee than the other manager(s) - The most complex of the different organizational structures - Designed to focus on both the product(end result of the function) and function(described as all the tasks required to produce the product) CENTRALIZATION VS DECENTRALIZATION CENTRALIZATION – both major and minor decisions are made by a core of top-level executives/managers at the top of the hierarchy. - formal approval of the chief executive is needed for all but the most complicated decisions - highly formalized, bureaucratic, routine organization Downloaded by Christian James Mata ([email protected])  lOMoARcPSD|8465916 DECENTRALIZATION – Highly flexible, informal organization - increases the motivation and goal- oriented behavior of local managers - Diffuses decision making throughout the organization and allows problems to be solved by the lowest practical managerial level - task performance is improved by clarifying and defining the jobs of people and setting up appropriate and definite relationships among these jobs STAFFING – refers to the process of determining and providing the acceptable number and mix of nursing personnel to produce the desired level of care to satisfy the patient’s demand for care (Rowland and Rowland, 1992). - Staffing is a complex process. Planning is required on the part of the nurse manager as regards staffing. Every staffing plan must be suited to the needs of the hospital. The nurse manager should remember that each staffing plan cannot just be done by a simple worker/patient ratio or formula. - West (1980) stipulated that the cardinal rule for forecasting staffing requirements is to base staffing projections on past staffing history – where data can be sourced from the patient classification reports and census reports. STAFFING METHODOLOGY Nursing staffing methodology should satisfy the following criteria: 1. It should be observed in an orderly manner. 2. It should follow a systematic process. 3. It should be based upon a sound rationale. 4. It should be applied to determine the number and kind of nursing personnel required to provide a nursing care of a predetermined standard to a group of patients in a particular setting (Aydelotte, Ibid.). MODALITIES OF NURSING CARE/PATIENT ASSIGNMENT SYSTEM: A. CASE NURSING OR TOTAL NURSING CARE-one nurse is assigned to one patient for the delivery of total care. The nurse is accountable for his or her own actions. Downloaded by Christian James Mata ([email protected])  lOMoARcPSD|8465916 B. FUNCTIONAL NURSING – this kind of nursing modality is task oriented in which a particular nursing function is assigned to each worker.It fragments the care of patients to task only. C. TEAM NURSING – similar to the functional nursing method but provides care on a larger scale. D. PRIMARY NURSING – assigns patients to a primary RN who takes responsibility for their care throughout the hospital stay. E. CASE MANAGEMENT – focuses on the administrative issues on health care, rather than the actual delivery of health care. F. PATIENT CLASASIFICATION SYSTEM – is a method for grouping patients according to the amount and complexity of their nursing care requirements. Level 1 – self/minimal care Level 2 – moderate/intermediate care Level 3 – total/intensive care Level 4 – highly specialized/critical care SCHEDULING – a schedule is defined as a time table indicating planned work days and shifts of nursing personnel. A schedule indicates the working days and off-days to the nursing personnel in order to assure adequate patient care and achieve a desirable distribution of duties. TYPES: 1. Centralized scheduling - In this type of scheduling, it is the Chief Nurse or her designate that usually does the assignment of the nursing personnel to the various hospital areas which includes the shift of duties and off duties. 2. Decentralized scheduling – In this type of scheduling, it is the Chief Nurse or her designate that usually does the assignment of the nursing personnel to the various nursing area. Arrangement of shifts of duty and off duties are done by the Supervising Nurse or Head or Senior Nurse of the particular units or areas. 3. Cyclic scheduling – This type of scheduling observes an established basic time pattern for a certain number of weeks and is repeated thereafter. It conforms to the requirements of fair distribution of hours of work and time off for staff. DIRECTING - Is getting the work done through others - In nursing, is giving orders and directions to others to attain quality patient care - Issuance of assignments, orders and instructions that help the nursing personnel understand what is expected from them. - Leadership, motivation, communication, delegation and supervision characterize the directing function of a nurse manager - a management function - Success in it is dependent on several factors, the most important of which are:  Leadership,  delegation,  supervision,  motivation,  and communication Downloaded by Christian James Mata ([email protected])  lOMoARcPSD|8465916 SUMMARY OF LEADERSHIP THEORIES: THEORIES OF LEADERSHIP: GREAT MAN THEORY (aristotelian philosophy) - the premise is that leaders are born - only a few people possess characteristics that make them great - it suggests that leadership cannot be developed. TRAIT THEORY - Suggest that for a person to become a leader, he must have a certain innate or inherited traits. - Later studies revealed however that traits can be learned or experienced - Trait theory has the basic assumption that leaders are born, not made. - Research were able to identify some traits that are common to good leaders LEADERSHIP TRAITS 1. Leaders need to be more intelligent than the group they lead 2. Leaders must possess initiative. 3. Creativity is an asset. New solutions to problems and ideas or new ways of increasing production. 4. emotional maturity with integrity-a sense of purpose and direction, persistence, dependability and objectivity 5. communication skills are important (verbal and written) 6. persuasion often is used by leaders to gain the consent of the followers. 7. leaders need to be perceptive. distinguish their allies from their opponents) 8. Leaders participate in social activities. BEHAVIORAL THEORY - Highlights the importance of understanding human behavior - Human behavior are complex and leaders must have a good academic preparation in behavioral sciences LEADERSHIP STYLES by Kurt Lewin: 1. AUTOCRATIC – leader focused; strong control, gives orders, does decision making, leader does planning, directive, fosters dependency - Leader solves all problems - Leader dominates the group and commands rather than make suggestions or seeks input BEHAVIORS OF AUTHORITARIAN LEADER: - Strong control is maintained over the group Downloaded by Christian James Mata ([email protected])  lOMoARcPSD|8465916 - Others are motivated by coercion - Others are directed with commands - Communication flows downward - Decision making does not involve others - Emphasis is on difference in status (