Seminar on

DIRECTING IN
NURSING SERVICE
AND EDUCATION

Submitted to

Submitted by

Mrs.Thankamany V K

Ms. Chinchu M

Asso.Professor

II Year MSc Nursing

Govt.College of Nursing

Govt.College of Nursing

Alappuzha

Alappuzha

INTRODUCTION

Directing is the heart of the management process and is its third function to
achieve the organizational goal. It helps the nursing managers to supervise and
control the activities of nursing staff working under them. In order to maintain
healthy working environment, proper directions plays an important role.
Directing is said to be a process in which the managers instruct, guide and
oversee the performance of the workers to achieve predetermined goals. Directing
is said to be the heart of management process. Planning, organizing, staffing have
got no importance if direction function does not take place.
Directing

is

influencing

people's

behavior

through

motivation,

communication, group dynamics, leadership and discipline. Managers give this

function a variety of names. Higgins calls it leading. Other labels are: influencing,
coaching, motivating, interpersonal relations, and human relations.
MEANING OF DIRECTION
Directing or direction means issuing of instructions to the subordinates,
supervising them, motivating them, and providing leadership to contribute to the
best of their ability for the achievement of nursing organizational goals. It is also
known as actuation.
DEFINITION
Direction is a complex function that includes all those activities which are
designed to encourage subordinates to work effectively and efficiently.
-Koontz and ODonnell
Directing is what has to be done and in what manner through dictating the
procedures and policies for accomplishing performance standards
-Earnest Dale
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It is the directing style where in managers tell their personnel what to do,
how to do it and when to have it completed by. They assign roles and
responsibilities, set standards, and define expectations.
Directing is the fourth phase of the management process. This phase could
also be referred as coordinating, or activating. It is the action phase of
management, requiring the leadership and management skills necessary to
accomplish the goals of the organization
It is the issuance of orders, assignments and directions that enable the
nursing personnel understand what are expected of them. Directing includes
supervision and guidance so that in doing their job well, nurses can maximally
contribute to the organizations goal in general and into nursing service objective
in particular.
PURPOSE
The purpose of directing is to channel the behavior of all personnel to
accomplish the organization's mission and objectives while simultaneously
helping them accomplish their own career objectives
PHILOSOPHY OF DIRECTING
Directing initiates action and it is from here actual work starts. Direction is
said to be consisting of human factors. In simple words, it can be described as
providing guidance to workers is doing work. In field of management, direction is
said to be all those activities which are designed to encourage the subordinates to
work effectively and efficiently. According to Human, Directing consists of
process or technique by which instruction can be issued and operations can be
carried out as originally planned Therefore, Directing is the function of guiding,
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inspiring, overseeing and instructing people towards accomplishment of

organizational goals
Direction represents one of the essentials functions of management
because it deals with human relations. Direction is also, infrequently and by
some, labeled as actuating. Once the organizational plans have been laid down,
the structure being designed and competent people brought in to fill various
positions in organization. Direction is the managerial function of guiding,
motivating, leading, supervising the subordinates to accomplish desired
objectives. Acquiring physical and human assets will not suffice; what is more
important is that people must be directed toward organizational goals. Without
proper direction and supervision employees become inactive, dull and inefficient
and consequently the physical assets like machinery and plant will be put to
ineffective use.
BASIC CONCEPTS ABOUT DIRECTING

Direction consists of the process and techniques utilizing in issuing

instruction and making certain that operations are carried out as originally
planned.

Direction is a complex function that includes all those activities which are
designed to which encourage subordinates to work effectively and efficiently in
both short and long run.

Direction is telling people what to do and seeing that they do it to the best
of their ability.

Directing deals with the steps a manager takes to get subordinates and
others to carry out plans.

Direction provides link between different functions in an organization.

DIRECTING FUNCTION OF MANAGEMENT

Directing

is

influencing

people's

behavior

through

motivation,

communication, group dynamics, leadership and discipline. The purpose of

directing is to channel the behavior of all personnel to accomplish the
organization's mission and objectives while simultaneously helping them
accomplish their own career objectives.
Managers give this function a variety of names. Higgins calls it leading.
Other labels are: influencing, coaching, motivating, interpersonal relations,
and human relations.
The directing function gives the manager an active rather than a passive role
in employee performance, conduct and accomplishments. Managers
accomplish their objectives through people. In blaming others for her or his
human resource problems, a manager is denying the management
responsibilities inherent in the directing function.
The directing function gives managers a second responsibility: helping
people in the organization accomplish their individual career goals.
Organizations do not succeed while their people are failing. Helping people
in the organization with career planning and professional development is an
integral part of the directing function.
In Management Excel, the directing function in Managing for Success has
included: motivation, communication, performance appraisal, discipline and
conflict management. Several Management Excel teams have offered

situational leadership as an advanced course for Managing for Success

graduates. Management Excel team leader in-services have included group
dynamics and team building.
DIRECTION HAS GOT FOLLOWING CHARACTERISTICS
1. Pervasive Function - Directing is required at all levels of organization.
Every manager provides guidance and inspiration to his subordinates.
2. Continuous Activity - Direction is a continuous activity as it continuous
throughout the life of organization.
3. Human Factor - Directing function is related to subordinates and therefore
it is related to human factor. Since human factor is complex and behaviour is
unpredictable, direction function becomes important.
4. Creative Activity - Direction function helps in converting plans into
performance. Without this function, people become inactive and physical
resources are meaningless.
5. Executive Function - Direction function is carried out by all managers and
executives at all levels throughout the working of an enterprise, a
subordinate receives instructions from his superior only.
6. Delegate Function - Direction is supposed to be a function dealing with
human beings. Human behaviour is unpredictable by nature and
conditioning the peoples behaviour towards the goals of the enterprise is
what the executive does in this function. Therefore, it is termed as having
delicacy in it to tackle human behaviour.
DIRECTING STYLE

Managers tell people what to do, how to do it and when to have it completed by.
They assign roles and responsibilities, set standards, and define expectations.

Communications - It is one way. The manager speaks, employees listen and

react. The only feedback managers ask for is - "Do you understand what
needs to be done?"

Goal-Setting - The manager establishes short-term goals with specific

deadlines.

Decision-Making - The manager makes most if not all decisions. When

problems arise the manager evaluates options, makes decisions and directs
employees as to what actions to take.

Providing Feedback - The manager provides candid, detailed instructions

as to what changes the employee needs to make.

Rewards and Recognition - Managers reward and recognize people for

following directions.

Points to Remember When Using the Directing Style

Organize your thoughts before you begin to speak.

Start with the big picture, and then discuss the details.
Make sure your directions are clear and specific.
If possible show employees the desired output. Take the mystery and guess

work out of what you want.

Assign due dates.
Provide written instructions if the directions are complex or lengthy.
Get feedback -test the transfer. Ask the employee to explain in his or her
own words what you want done.
ELEMENTS OF DIRECTING

The directing functions of the manager include the following:

1.
2.
3.
4.
5.
6.

Delegation
Supervision
Leadership
Motivation
Communication
Coordination

A. DELEGATION:
Delegation (also called deputation) is the assignment of authority and
responsibility to another person (normally from a manager to a subordinate) to
carry out specific activities. However the person who delegated the work remains
accountable for the outcome of the delegate work.
It allows a subordinate to make decisions, i.e. it is a shift of decision-making
authority from one organizational level to a lower one.
Delegation, if properly done, is not abdication. The opposite of effective
delegation is micromanagement, where a manager provides too much input,
direction, and review of delegated work.
Delegation is a vital skill for team leaders. Genuine delegation leads to a
team owning its success and increasing its capacity for achievement. Yet
letting go of control can be hard.
FIVE TIPS FOR DELEGATION
1. Provide Context

It is essential to be clear about what is required, and why it is important.

Framing the delegated work within the broader context energises recipients.
They're clear how the work you are delegating contributes to the overall success
of the team. Recipients should also be clear how their tasks help the team
achieve the vision or success criteria.
2. Delegate Authority and Responsibility
Delegation of the responsibility to complete a task is relatively easy. Delegating
the necessary authority is less so. Delegation of authority requires confidence in
the individual, since the leader is relinquishing some control over team
activities. Yet without the necessary authority and room for decision making,
people are not empowered to complete the tasks they have been given. This is
particularly vital in a voluntary organisation. Jethro advised Moses to set up an
organisation with both responsibility and authority (Exodus 18:13-26).

3. Support don't Abdicate

Delegation does not mean complete withdrawal. Particularly in the early stages,
people need support and encouragement to take on additional responsibility.
They may need skill training, or encouraging feedback as they stretch
themselves in previously untested areas. Prayer support is equally important.
Abdication can leave the delegated person feeling that if anything goes wrong
they are left isolated.

4. Only Delegate When Appropriate

Check that the recipients of the delegation have the necessary skills,
information, authority and capability to carry out the delegated responsibilities.
If not, then the work will not get done and the individual concerned may lose
motivation.
5. Look at Team and Sub-team Structure.
Map out what is delegated to the various individuals and sub-teams on your
team. Check for consistency and overlaps, and ensure that there is clear
communication within the team as to who has responsibility for which areas.
This is even more important within a team setting than in a traditional one-toone, manager to subordinate, relationship.
ELEMENTS
1. Responsibility entails an obligation to fulfil the work assigned to a certain
position.
2. Authority - deciding what must be done to achieve the purpose, functions to
be performed, which will carry them out and the authority and
responsibilities they will have to accomplish the tasks.
3. Accountability process of establishing an obligation to perform the work
and to make a decision within the set limits.
BASIC PRINCIPLES
10

1. A clear outline of duties, responsibilities and relationship should be

established.
2. Authority should be delegated within specially defined limits to avoid
stepping to others right.
3. Defining objective and suitable measure for determining performance. The
most effective measure is based on performance standards which are
checked against objectives, programs, schedules and budgets.
4. Delegated responsibility must be accompanied with corresponding authority.
5. Every supervisor is held completely accountable for the methods and results
of the work assigned to him.
ADVANTAGES OF DELEGATION
1. Freeing the supervisors from routine task.
2. Send message to employees that supervisors has confidence in their ability.
3. It is a powerful motivation tool.
4. It is a training tool for those who has leadership potentials.
BARRIERS TO DELEGATION
a. Belief in the fallacy if you want it done right, do it yourself
b. Lack of confidence and trust in workers.
c. Vague job definition or information
d. Fear of competition
e. Lack of control
f. Poor examples set by the managers who dont delegate
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B. SUPERVISION
Origin
Supervise comes from the word supervide which means to oversee or view
directly
Meaning:
It means personally observing a function or activity, providing leadership in
the process of nursing care, delegating functions or activities while retaining the
accountability, evaluating and ensuring that the nursing care provided is adequate
and delivered appropriately.

Main goal:
To attain quality care for each patient and to develop the potentials of
workers for an effective and efficient performance.
ESSENTIALS IN SUPERVISION
Administration
Clinical competence
Democratic management
GOOD SUPERVISION MEANS
A supervisor

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 Can produce attitudes which are both positive and negative in

character.
Produces positive attitudes when are positive when an employee is
conscious of the benefits to himself which he attributes to the
influence of the supervisor.
Produces negative attitude when the reaction of workers is resistance
to discipline or actual fear of demotion or discharge.

PRINCIPLES OF SUPERVISION
Good supervision is focused on improving the staffs work rather than on

upgrading himself/herself.
Good supervision is based on predetermined individual needs.
Good supervision is planned cooperatively.
Good supervision employs democratic methods.
Good supervision stimulates the staff to continue self improvement.
Good supervision respects the individuality of the staff member.
Good supervision helps create a social, psychological and physical
atmosphere where the individual is free to function at her own level.

SUPERVISORY TECHNIQUES

Orientation
Efficient assignments, rotation and follow-up.
Guidance
Evaluation

Techniques in Supervision
Observation of the worker while making the rounds
Spot checking of charts through nursing audits

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 Asking the patients about the care they receive

Looking into the general condition of the units
Getting feedback from co-workers or other supervisors or relatives
Asking questions discretely to find out the problems they encounter in the wards
Drawing out suggestions from the workers for improvement of their work or
work situation.
LEADERSHIP:
LEADERSHIP THEORIES
Many believe that the critical factor needed to maximize human resources is
leadership. A more in-depth understanding of leadership can be gleaned from a
review of leadership theories.
The Great Man Theory
Trait or Attribute Theory
Behavioral theories
Situational and Contingency Theories
Path-Goal Theory
Charismatic Theory
Interactional Leadership theories
Transformational leadership theory
The authoritarian leader is characterized by the following behaviors:

Strong control is maintained over the work group.

Others are motivated by coercion.

Others are directed with commands.

Communications flows downward.

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Decision making does not involve others.

Emphasize is on difference in status (I and you).

Criticism is punitive

The democratic leader exhibits the following behaviors:

Less control is maintained.

Economic and ego awards are used to motivate.

Others are directed through suggestions and guidance.

Communication flows up and down.

Decision making involves others.

Emphasis is on we rather than I and you

Criticism is constructive.
.

The Laissez-faire is characterized by the following behaviors:

Is permissive, with little or no control

Motivates by support when requested by the group or individuals.

Provides little or no direction.

Uses upward and downward communication between members of the group.

Disperses decision making through out the group.

Places emphasize on the group.

Does not criticize.

Attributes for Effective Leader

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 Honesty
Responsibility
Confidence
Enthusiasm
Reliability
Patience
Decisiveness
Determination
Loyalty
Courage
Leadership Styles
I. Authoritarian leadership
Characteristics:
1.
2.
3.
4.
5.
6.
7.

Strong control is maintained over the workgroup

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 ( I and You)
Criticism is punitive

II. Democratic leadership (participative leadership)

Characteristics:
1.
2.
3.
4.
5.

Less control is maintained

Economic and ego awards are used to motivate
Others are directed through suggestion and guidance
Communication flows up and down
Decision making involves others
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6. Emphasis is on we rather than I and you

7. Criticism is constructive
III. Situational Leadership
In this approach, the leader behaves according to a given situation which may
vary from one setting to the other.
Contingency Style of Leadership one in which the leader matches the
situation and its needs
Fiedler and Chemers state that in the work situation, the managers leadership
style and expectation, and the followers characteristics and expectations blend
together and form a productive combination
Leader by Force dominates by force and fear; he/she is ruthless in suppressing
opposition; he/she does not reign long; this type of leadership contains within
itself the seeds of self-destruction; examples are Hitler and Idi Amin
IV.Laissez-faire Leadership (permissive leadership)
Also referred to as delegating approach
Little or no direction is provided
Coworkers develop their own goals, make their own decisions, and take
responsibility for their own management
Managers concentrate on providing maximum support and freedom for
coworkers
Decision making is dispersed throughout the group
COMMUNICATION:
Meaning:
The word communication comes from the Latin word communis, meaning
commonness. Communication is a two-way process by which information
exchanged between or among individuals through a common system of symbols,
signs and behavior.

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Definition:
Communication is the process to impart information from a sender to a
receiver with the use of a medium. Communication requires that all parties have an
area of communicative commonality. Chitty (2001) defines communication as the
complex exchange of thoughts, ideas, or information on at least two levels: verbal
and nonverbal.
Verbal Communication- the transmission of ideas, opinions, feelings, emotions or
attitudes through the use of words. Ex: comments, question, reactions
Nonverbal Communication- refers to the sending of messages to another person
utilizing methods or means other then words. Ex: facial expression, gesture, eye
contact
.
COMMUNICATION PROCESS
As a process, communication is dynamic, adaptive, and continuous.
Communication helps us to develop to be unique persons, relating and cooperating
with others.
An internal and an external climate also exist in communication. The
internal climate includes the values, feelings, temperament, and stress levels of the
sender and the receiver. Weather conditions, temperature, timing, and the
organizational climate itself are parts of the external climate. The external climate
also includes status, power, and authority as barriers to manager-subordinate
communication.
Internal climate External climate

Sender

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Message

Written

Internal

External

Receiver

Non-verbal
Verbal
Both sender and the receiver must be sensitive to the internal and external
climate, because the perception of the message is altered greatly depending on the
climate that existed at the time the message was sent or received. Example, an
insecure manager who is called to meet with superiors during a period of stringent
layoffs will probably view the message with more trepidation than a manger who is
secure in his or her role.
In assessing the internal climate, remember that the human mind perceives
only what it expects to perceive. The unexpected is generally ignored or
misunderstood. In other words, receivers cannot communicate if the message is
incompatible with their expectations. Therefore, effective communication requires
the sender to determine what receivers see and hear.
TYPES OF COMMUNICATION
Mainly, there are three types of communication: spoken words, written
words, and physical expression or significant gestures.
Verbal communication involves spoken words. The speaker must be able to
speak slowly, enunciating the words clearly. Choose words that can be clearly
understood instead of using too technical ones. Only relevant information should

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be conveyed to prevent confusion. It ascertains immediate response when time is

short.
Written communication must be clear, correct, complete and concise. This
should be written in words that are clearly understood by the reader. Written
communication comes in the form of memoranda, hospital orders, documentation,
records and reports, policies, procedures, and the like. Ambiguous terms should be
voided to prevent misunderstanding.
Non-verbal communication is transmission of message without the use of
words. People oftentimes unconsciously use facial expressions, gestures, touch,
body language, or vocal tones.
LINES OF COMMUNICATION
Communication is described as a two-way process, yet in an organization, it
is four-dimensional.
Downward Communication
Upward Communication.
Horizontal Communication
Outward Communication
MOTIVATION:
STRATEGIES IN CREATING MOTIVATING CLIMATE
Have clear expectations for workers, and communicate these expectations
effectively.
Be fair and consistent when dealing with all employees.
Be a firm decision maker using an appropriate decision-making style.
Develop the concept of teamwork.

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 Integrate the staffs needs and wants with the organizations interest and
purpose.
Know the uniqueness of each employee.
Remove traditional blocks between the employee and the work to be done.
Provide experiences that challenge the employee and allow opportunities for
growth.
When appropriate, request participation and input from all subordinates in
decision making.
Be certain that employees understand the reason behind decisions and
actions.
Reward desirable behavior; be consistent in how you handle undesirable
behavior.
Let employees exercise individual judgment as much as possible.
Create a trustful and helping relationship with employees.
Let employees exercise as much control as possible over their work
environment.
Be a role model for employees.
COORDINATION
Functions:
Unites personnel and services to a common objective.
Prevents overlapping of functions, enhances good working relationship and
work schedules are finished on time.
Enhances collaborative efforts resulting in efficient, smooth and harmonious
flow of work
Convey clearly defined polices, standard operating procedures, policies and
guidelines using the proper channels of communication.

CONCLUSION
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It is necessary for the nursing personnel who are working in the education as
well as in hospitals. Directing is influencing people's behavior through motivation,
communication, group dynamics, leadership and discipline. Managers give this
function a variety of names.
REFERENCES
1. JogindraVati, Principles and practice of nursing management and
administration; Jaypee brothers medical publishers (P) ltd: New Delhi.
2. Basavanthappa BT. Nursing administration, 2nd edition (2009);
Jaypeebrothers medical publishers (P) ltd: New Delhi.
3. Sakharkar BM. Principles of hospital administration and planning, 2 nd
edition (2009); Jaypee brothers medical publishers (P) ltd: New Delhi.
4. Thomas Kochuthresiamma. Nursing administration; Jaypee brothers
medical publishers (P) ltd: New Delhi.

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