September 18, 2022

NURSING LEADERSHIP
- Process whereby a nurse influences one or more persons to achieve specific goals in providing
nursing care for one or more patients.

NURSING MANAGEMENT
- Process of working through the nursing staff personnel or members to provide care, cure, and
comfort to the patient

DIFFERENCES BETWEEN LEADERS AND MANAGER

LEADER MANAGER

APPOINTMENT May or may not have an official Officially appointed

appointment

POWER As long as the 67890 followers Have power and authority to enforce
are willing to follow a decision
5 TYPES OF POWER
1. Legitimate Power-
obtained through
demonstrating you have
the skills required for the
role
2. Reward power- means
having the capacity to
offer rewards or benefits in
exchange for carrying out
a task or achieving a result
3. Expert power- comes from
having both deep technical
knowledge and extensive
experience in your field of
expertise
4. Referent power- through
qualities that inspire trust
and respect in their
colleagues- honesty and
integrity; has excellent
interpersonal skills
5. Coercive power - using
threats to force people to
do your will

RELATIONSHIP In intuitive and empathetic Relate to people according to rule

manner

REWARD Rewarded from personal Fulfill organizational mission

achievement

POSITION May or may not be successful Managers as long appointment

holds
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RULES Interested in risk-taking and Carry out predetermined policies

exploring new ideas rules and regulations

OTHERS Influence others toward goal Maintain an orderly, controlled

setting national equitable structure

SCIENTIFIC MANAGEMENT
● FREDERICK W. TAYLOR
- Proposed set of techniques to increase the efficiency and productivity of each worker
- Meaning nurses needs machines to become efficient

FAYOL’S MANAGEMENT THEORY

● HENRY FAYOL
- Was called the father of modern management theory or management process
- 14 principle management
1. Division of labor- according to their knowledge and expertise
2. Authority- managers need to be able to give orders so that they can get things
done (as guidance)
3. Discipline- members in the organization must respect the rules and organization
that govern them → this is a core value
4. Unity of command- each employee must receive his/her instructions about a
particular operation from one person
5. Unity of direction- operations within the organization with the same objectives
should be directed with only one plan
6. Subordination of individual interest to a common goal- in any undertaking the
interest of the employees should not take precedence over the interest of the
organization as a whole; common goal rather than the individual interest
7. Remuneration (salary) - compensation for work should be fair to employees and
employers
8. Centralization- neutral management
9. Scalar Chain- refers to the hierarchy steps that should be from the top to the
lowest. It is important to know who to address
10. Order- well-defined work order to have a favorable work culture; job description
11. Equity- employees should be treated equally
12. Stability- job security; it is the duty of the management to offer job security
13. Initiative- management should support and encourage the employees to take the
initiative (employees become more productive)
14. Esprit de Corps- team spirit; united

BUREAUCRATIC ORGANIZATIONAL THEORY

● MAX WEBER- contributed to the development of a classical approach to organizational design

BEHAVIORAL SCHOOL
● ELTON MAYO- “Hawthorne Effect- individual reacts differently when being observed”

MOTIVATIONAL THEORY
● DOUGLAS McGREGOR- Developed the theory X (inherently lazy) and theory Y (loves to work)
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- Theory X: to exercise strict control over his subordinate to ensure that the work is carried
out properly; management: be strict
- Theory Y- to provide opportunities for the subordinates to be creative and productive and
to encourage growth and provide guidance; management: give opportunities

LEADERSHIP THEORIES
I. The Great Man Theory- leaders are born not made
II. Trait Theory- born with a leader's characteristic; by nature
III. Situational Theory- leader depends on the situation
IV. Contingency Theory- depends on three things: task structure, position power, relationship
- Task structure (leader that acts based on their ability; kung saan marunong sya→ will
become successful)
- Position power- ability to control because of one’s position
- Relationship- a leader with charisma; people person
V. Path-Goal Theory- focus is on the achievement of the goals; dedicated to finishing the work only

A. PLANNING- forecasting of events, making decisions, setting goals, setting of priorities, developing
policies and setting standard
> TYPES OF PLANNING
1. Strategic planning- long-range goals or long-term goals
2. Operational planning- deals with day-to-day maintenance of activity

MISSION- reason for the organization’s existence

- states the services the organization will provide

PHILOSOPHY- reflects the values and beliefs of the organization

OBJECTIVE-
> goals- what you want to achieve
- larger time framed
- may not be measured
> objectives- how are you going to achieve the goal
- short time framed
- measurable; specific

TYPES OF BUDGET
1. Direct cost: directly related to patient care within a manager's unit (example: salary, supplies)
2. Indirect cost: not explicitly related but is necessary to support care (example: water, electricity,
maintenance)
3. Fixed Expenses- don’t vary in volume (rent, monthly salary)
4. Variable expenses- increase or decrease depending on the number of patients (example: cost of
supplies used in the OR; patient meals; laundry of linens)
5. Controllable cost- controlled and varied by managers (example: staffing pattern and mix- means
RN: non RNs)
6. Uncontrolled cost- equipment depreciation (example: staff overtime in response to an emergency)
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B. ORGANIZING - grouping of activities to achieve objectives

- Organization: to accomplish the goals and objectives of the organization efficiently human and
material resources are essential

TYPES OF ORGANIZATIONAL STRUCTURE

INFORMAL FORMAL

- Consist of personal and social - Describes the positions, the

relationships among members of the responsibilities of those occupying the
organization positions, and the working
- Meets the needs of individual with relationships among the various units
similar backgrounds or departments
- Example: PNA

TYPES OF ORGANIZATION CLASSIFIED BY NATURE OF STRUCTURE

1. Line organization- simplest and the most direct type in which position has general authority over
the lower positions in the hierarchy; with a boss. example: president- vice president
2. Informal organization- refers to horizontal relationships; same level. example: dean of engr. -
dean of nursing
3. Staff organization- purely advisory example: dean- assistant dean- CI- (guidance councilor)-----
student nurses
4. Functional organization- each unit is responsible for a given part of the org

VERTICAL CHART/ TALL STRUCTURE- a type of organizational chart that defines the relationship
between among the different level in the organization
HORIZONTAL/ FLAT CHART- Depcits the manager at the top with a wide span of control
- communication in this structure is direct simple and fast with minimal
distortions of the message since the distance between the top and lower level is shorter

PRINCIPLES OF ORGANIZATION
1. Communication- top to bottom
> 4 Levels of communication
a. Downward communication- superior to subordinates (example: memorandum)
b. Upward communication- (example: incident report, resignation letter)
c. Diagonal communication- to other offices
d. Horizontal communication- same level
2. Unity of command
3. Span of control- ratio distribution
- above supervisory position 1:6; below supervisory like the head nurse 1:8
4. Specialization

C. STAFFING- process of determining and providing the acceptable number and mix of nursing personnel
to produce a desired level of care and to meet the patients demand

> Process:
1. Recruitment- enlisting of personnel
2. Selection- evaluation of job candidates
3. Indoctrination- orientation
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4. Training and development

5. Transfer and separation- assignment to a specific unit

4 NURSING CARE DELIVERY SYSTEM

PROS CONS

CASE METHOD Total patient care Different nurses, different shifts

- oldest method of care and different days;

This system is not allowed to

patients with Alzheimer's; autism

FUNCTIONAL SYSTEM Efficiency Nurses do managerial work;

- used when the patient and nurses’ aides do patient
nursing aid is many, few RNs
- tasks are divided

TEAM NURSING Team effort; frees patient care Time needed to coordinate
- nurses are divided into groups coordinator to manage the unit; delegate work;
nursing care plan example: different wings in the
ward

PRIMARY NURSING RNs give total patient care; Confines nurse’s talents to a
- Like nurses in the ICU primary nurs has 24 hr limited number of patients;
responsibility; accountability in associate nurse may change
place care plan without discussing
with primary nurse
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DISTRIBUTION OF SHIFTS
- MORNING: 45% (assign more personnel because of task demands in the morning)
- AFTERNOON: 37%
- NIGHT: 18%

WORKING HOURS
- Total working hours per year for nurses working 40 hrs per week= 1,704
- Total working hours per year for nurses working 48 hours per week = 2120
- RA 5901- hospital with a bed capacity of more than 100- RNs will work 40 hrs a week (5 days)
- below than 100-bed capacity- RNs will work 48hrs a week (6 days)

COMMON ERRORS
1. Halo error- one trait to influence the evaluation of one trait
2. Horns error- the evaluator is a perfectionist

LEADERSHIP STYLES
1. Authoritarian or autocratic- high concerns for task accomplishment but low concern for those who
perform these tasks
2. Democratic- people-oriented focuses on human aspects and builds effective teamwork
3. Permissive or Laizzez- faire- leaders appointed as manager; leaves workers without direction
supervision or coordination