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Nursing Management: MR - Sivanathan NT
Nursing Management: MR - Sivanathan NT
Nursing Management: MR - Sivanathan NT
MR.SIVANATHAN NT.MSN.(CHN),MBA(HM),
MAHARASHTRA INSTITUTE OF NURSING SCIENCE,
MIMSR MEDICAL COLLEGE ,
LATUR/MAHARASHTRA
UNIT-I
Introduction to Management in Nursing
Definition
It is the process of planning, organizing, leading and controlling the work
of organization members and of using all available organizational resources
to reach stated organizational goals.
Management is the art of getting things done through people. It is the
process of reaching organizational goals by working with and through people
and other organizational resources
2
Nursing management consists of the performance of the leadership
functions of governance (Action of organization) and decision-making
within organizations. It includes processes common to all management like
planning, organizing, staffing, directing and controlling
Management may be defined as the art of securing maximum results
with a minimum of effort so as to secure maximum prosperity and
happiness for both employer (A Person or Organization) and employee
(worker) and give the public the best possible service.
3
Definition Of Manager
▰ Manager
▰ Is a Person who controls and manipulates resources and expenditures,
to meet the organizational goals?
OR
▰ The Definition of a manager is a person responsible for supervising
and motivating employees and for directing the progress of an
organization.
4
“
DIFERENCE BETWEEN ADMINISTERATION
& MANAGEMENT
5
BASIC OF
DIFFERENCE ADMINISTERATION MANAGEMENT
Its Concerned about the determination of Its Puts in to action the polices
NATURE OF WORK objectivise and major policies of an and plans laid down by the
organization administration
TYPE OF FUNCATION Its Determinative function Its An executive function
Its take major decisions of an enterprise as Its take decisions within the
SCOPE a whole framework set by the
administration
LEVEL OF Its top level Authority Its Middle level authority
AUTHORITY
Its consists of owners who invest capital in It’s a group of managerial
NATURE OF STATUS and receive profit from on organization personal who use their
specialized knowledge to fulfil the
6
objective of an organization
Its popular with government, Its used in business
NATURE OF USAGES educational institutes, enterprises
religious organizations
Its decision are influenced by Its decisions are influenced by
DECISION MAKING public opinion, government the value, opinion, and beliefs of
polices, social and religious the managers
factors
Planning and Organizing Motivation and controlling
MAIN FUNCTIIONS functions are involved in it. functions are involved in it
Its need administrative rather Its require technical activities
ABILITIES then technical abilities
7
HISTORY OF NURSING IN INDIA
HISTORY OF NURSING IN INDIA
The nurses were usually young men, and only in special cases, women were
taken for conducting childbirth. The progress of nursing in India was obstructed by
the low state of women, the caste system, illiteracy
Military nursing was the earliest type of nursing. In 1664 the East India Company
started a hospital for soldiers in a house at Fort St.George, Madras
The first sisters were sent from St.Thomas Hospital, London to this military
hospital. In 1797 a Lying - in Hospital (maternity) for Madras.
In 1854 the Government sanctioned a training school for midwives in Madras.
9
Continued…..
▰ Florence Nightingale was the first woman to have great influence over nursing in
India and had a close knowledge of Indian conditions, especially army. She was
interested in the nursing service for the civilian population, though her first interest
was the welfare of the army in India.
▰ St Stephens Hospital at Delhi was the first one to begin training the Indian girls as
nurses in 1867. In 1871, the first School of Nursing was started in Government
General Hospital, Madras with 6 months Diploma Midwives program with four
midwife students.
▰ Between 1890 and 1900, many schools, under either missions or government,
were started in various parts of India.
10
Continued…..
▰ In 1908, the trained nurses association of India was formed
▰ In 1926, Madras State formed the first registration council to provide basic
standards in education and training.
▰ The first four year basic Bachelor Degree program were established in 1946 at
the RAK college of nursing in Delhi and Vellore.
▰ In 1947, after the independence, the community development programme and the
expansion of hospital service created a large demand for nurses, auxiliary nurse
midwives, health visitors, midwives, nursing tutors and nursing administrators.
11
Continued…..
▰ The Indian Nursing Council was passed by our ordinance on December 31st 1947.
The council was constituted in 1949.
▰ The development of Nursing in India was greatly influenced by the Christian
missionaries, World War, British rule and by the International agencies such as
W.H.O. UNICEF, Red Cross, UNSAID etc.
▰ The first master’s degree course, a two-year postgraduate program was begun in
1960 at the College of Nursing, Delhi. The associations such as International
Council of Nurses, the nurses auxiliary of the CMA of India, T.N.A.I. Indian
Nursing council and State level Registration Council are closely connected with
promotion and the upliftment of the nursing profession.
12
CONCEPT OF NURSING
MANAGEMENT
THE CONCEPT OF MANAGEMENT.
▰ The concept (an Obstract idea) of management is not fixed. It has changing
according to time and circumstances. The concept of management has been used
in integration and authority etc.
Different authors on management have given different concepts of management.
The main concepts of management are as follows:
▰ I. Functional Concept:
▰ II.Leadership and Decision-Making Concept:
▰ III.Productivity Concept
IV.Universality Concept: 14
▰
I. Functional Concept:
▰ According to this concept 'management is what a manager does’.
The functional concept as given by some of the authors is given below
▰ Henry Fayol, "To manage is to forecast (Predict or Estimate), and plan, to
organize, to command, to coordinate and to control.“
▰ James L. Lundy, “Management is principally the task of planning, coordinating,
motivating and controlling the effort of others towards a specific objective.
▰ George R. Terry, "Management is a distinct (recognizable or Clear) process
consisting of planning, organizing, activating and controlling performed to
determine and accomplish (Fulfill) the objective by the use of human beings and
other resources." 15
II.Leadership and Decision-Making Concept:
▰ According to this concept, "management is an art and science of decision-making
and leadership." Most of the time of managers is consumed in taking decisions.
Achievement of objects depends on the quality of decisions.
▰ Similarly, production and productivity both can be increased by efficient leadership
only. Leadership provides efficiency, coordination and continuity in an organization.
▰ Leadership and decision-making concept as given by some authors is given
below:
▰
16
Continued….
▰ Donald J. Clough, "Management is the art and science of decision-making and
leadership".
▰ Ralph, C. Davix, "Management is the function of executive leadership anywhere."
▰ Association of Mechanical Engineers, U.S.A., "Management is the art and
science of preparing, organizing and directing human efforts applied to control the
forces and utilize the materials of nature for the benefit to man."
▰ F.W. Taylor, "Management implies substitution of exact scientific investigation
and knowledge for the old individual judgment or opinion, in all matters in the
establishment." 17
III.Productivity Concept
▰ According to this concept, "management is an art of
increasing productivity."
▰ Economists treat management as an important factor of
production. According to them, "Management is also a factor
of production like land, labor, capital and enterprise
18
Continued…
▰ Jon, F. Mee, "Management may be defined as the art of securing maximum
prosperity with a minimum of effort so as to secure maximum prosperity and
happiness for both employer and employee and give the public the best possible
service."
▰ F. W. Taylor, "Management is the art of knowing what you want to do in the best
and cheapest way."
▰ Marry Cushing Niles, "Good management achieves a social objectives with the
best use of human and material energy and time and with satisfaction of the
participants and the public.
19
IV.Universality Concept:
▰ According to this concept, "Management is universal".
Management is universal in the sense that it is applicable
anywhere whether social, religious or business and industrial.
20
Continued….
▰ Henry Fayol, "Management is an universal activity which is equally applicable in
all types of organization whether social, religious or business and industrial".
▰ Megginson, "Management is management, whether it is in Lisbon, or in London
or in Los Angeles."
▰ Theo Haimann, "Management principles are universal. It may be applied to any
kind of enterprises, where the human efforts are coordinated."
21
Continued…..
▰ The Indian Nursing Council was passed by our ordinance on December 31st 1947.
The council was constituted in 1949.
▰ The development of Nursing in India was greatly influenced by the Christian
missionaries, World War, British rule and by the International agencies such as
W.H.O. UNICEF, Red Cross, UNSAID etc.
▰ The first master’s degree course, a two-year postgraduate program was begun in
1960 at the College of Nursing, Delhi. The associations such as International
Council of Nurses, the nurses auxiliary of the CMA of India, T.N.A.I. Indian
Nursing council and State level Registration Council are closely connected with
promotion and the upliftment of the nursing profession.
22
NURSING MANAGEMENT THEORY
NURSING MANAGEMENT THEORY
DEFINITION-
▰ Management theories are the set of general rules that guide
the managers to manage an organization.
▰ Theories are an explanation to assist employees to
effectively relate to the organization goals and implement
effective means to achieve the same.
▰ The study in the development of Management theories can
be useful to nursing leaders in creating their own
management style. 24
▰ They could be categorized into four main focuses.
▰ 1. Scientific Management Theory. (Taylor)
▰ 2 . Administrative & Management Theory. (Hendry Fayal -
1841-1925)
▰ 3. Human Relations Theory. (Elton Mayo )
▰ 4. Behavioral Science Theory.(Douglas McGregor)
25
1. Scientific Management Theory. (Taylor)
Frederick W. Taylor’s
▰ Taylor is the Father of Scientific Management
▰ Machine Model – viewed man as a means of production (economic
man model)
▰ Productivity at the level of the worker (skills, physical attributes)
▰ His management said reduced wasted efforts, set standards for
performance, encourage specialization and, stress the selection of
qualified workers who could be developed for a particular job.
26
Continued..
Basic Principles of the Machine Model
▻ Division of labor and specialization
▻ Unity of command and centralization of decision-
making
▻ One way authority
▻ Narrow span of control (the area of activity and no of
functions, people or things ,)
27
2. Administrative & Management Theory. Hendry Fayal
(1841-1925)
▰ Henry Fayol(1841-1925)
Treated administration as a process as opposed to the prevailing practice where in
administration is under control of specialists.
▰ According to Fayol, administrative management was concerned or focused on the formal
organization structure and the delineation of the basic processes of general management:
▻ Planning – examining the future and drawing up the plan of action
▻ Organizing – building up the structure, material, human resources of the undertaking
▻ Command – maintaining activity among the personnel
▻ Coordination – binding together
▻ Control – conformity
▻ 14 Principles Of Management (A DISCUSS OUR DUE) 28
Continued…
▰ Luther Gullick and Lyndall Urwick (1937) incorporated (Formed in to
legal Corporation)Fayol’s theory into American administration – “Duties
of an administrator”
▰ Planning
▰ Organizing
▰ Staffing
▰ Directing
▰ Coordinating
▰ Reporting
▰ Budgeting 29
3. Human Relations Theory. (Elton Mayo )
▰ Elton Mayo, one of fathers of human relations movement
▰ Basic principles of human relations from Mayo and
Hawthorne experiments:
a. Social norms and supervision
b. The group or democratic administration
c. Rewards and sanctions
30
Continued. Hawthorne
Studies
▰ Conducted by Western Electric industrial engineers to
examine the effect of various illumination levels on
workers productivity
▰ Mayo concluded that behavior and sentiments were
closely related, that group influences significantly affected
individual behavior, that group standards established
individual worker’s output, and that money was less a
factor in determining output than group standards
31
4. Behavioral Science (Douglas McGregor-1932)
Proposed by Douglas McGregor
▰ Theory X: essentially negative view of people- little ambition, dislike
work, avoids responsibility, and needs to be closely directed to work
effectively
▰ Theory Y: positive view – people can exercise self- direction, accept
responsibility and consider work to be as natural as rest or play
▰ Theory Y assumptions best captured true nature of workers and
should guide management practice.
32
FUNCTIONS OF MANAGEMENT
FUNCATIONS OF NURSING MANAGEMENT
Whereas Luther Gullick has given a keyword
▰ POSDCORB where
▰ P stands for Planning,
▰ O for Organizing,
▰ S for Staffing,
▰ D for Directing,
▰ Co for Co-ordination,
▰ R for reporting
▰ B for Budgeting.
34
1.PLANNING
▰ Planning is deciding in advance –
▰ What to do,
▰ When to do & how to do.
▰ It bridges the gap from where we are & where we want to be.
▰ A Plan is a future course of actions.
35
2.ORGANIZING
To organize a business is to provide it with everything useful or its
functioning i.e. raw material, tools, capital and personnel’s.
Organizing as a process involves:
Identification of activities.
Classification of grouping of activities.
Assignment of duties.
Delegation of authority and creation of responsibility.
Coordinating authority and responsibility relationships. 36
3.STAFFING
Managerial function of staffing involves manning the organization
structure through proper and effective selection, appraisal & development
of personnel to fill the roles designed in the structure.
Staffing involves:
Manpower Planning.
Recruitment, Selection & Placement.
Training & Development.
Remuneration.
Performance Appraisal.
Promotions & Transfer. 37
4.DIRECTING
Direction is that inter-personnel aspect of management which deals
directly with influencing, guiding, supervising, motivating sub-ordinates for
the achievement of organizational goals.
Direction has following elements:
Supervision
Motivation
Leadership
Communication
38
5.COORDINATION
Coordinating helps the organization to follow methods to work efficiently
for achievement of organizational purposes.
Managers are required to create coordination in the team to get the task
completed on the desired time.
Coordination has following elements:
Easy functioning
No conflicts
Team spirit
39
6.RECORDS & REPORTING
Reporting is keeping those to whom the executive is responsible
informed as to what is going on, which thus includes keeping himself and
his subordinates informed through records, research and inspections.
In simpler words, it is the process of creating the report and
mentioning the higher authorities regarding the progress and process
followed, and the teammates or group about the information they need to
know to lead the project.
40
7.BUDGETING
Budgeting is the step followed by the manager to perform all budget
related processes in the form of planning, accounting and control.
All the resources which are used by the team are valuable to the
company, and therefore the team is accountable to higher authorities
regarding the use of resources which is informed to them by the manager.
41
HENDRY FAYOL’ 14
PRINCIPLES OF MANAGEMENT
“
42
Easy Remember Principles
▰ A. Discuss Our Due
▰ A- Authority
▰ D-Directing
▰ S-Subordination Of Individual Interests
▰ C-Centralization
▰ U-Unity Of Command
▰ S-Scalar Chain
▰ S-Stability Of Tenure Personal
▰ O-Order
▰ U-Unity
▰ R-Remuneration
▰ D-Discipline
▰ U-Unity (Espirit De Corps)
▰ E-Equity 43
INTRODUCTION
Biography
▰ • Henri Fayol was born in 1841 in Istanbul.
▰ • He became engineer at an age of 19 and joined a mining company
▰ • He became director of mining company in 1888 which had more than
1,000 workers.
▰ • In 1916, he published "14 Principles of Management" in the book
"Administration Industrielle et Générale."
▰ • He is known as “Father of Modern Management Theories”
44
A. DISCUSS OUR DUE
1.AUTHORITY:
▰ The power and responsibility to give orders should reside
with only a few people and should not be diluted.
▰ One of the common errors of large companies is that the
management comprises of too many people, thereby
creating conflicts. When a few hand selected people have
the power to vote, then this authority is carried down the
chain and the process gets implemented.
45
2.DIVISION OF WORK:
▰ Applicable for firms which have many employees as well as
few employees, the principle of division of work says, that
the work should be divided between all people who are
capable of doing it and should not be overloaded to
a concentrated few.
▰ It should not be diluted by giving the same work to many
people. This ensures proper utilization of labour and keeps
them focused and productive.
46
3.INITIATIVE
Henri Fayol argued that with this management principle
employees should be allowed to express new ideas. This
encourages interest and involvement and creates added value
for the company. Employee initiatives are a source of strength
for the organization according to Henri Fayol. This encourages
the employees to be involved and interested.
47
4.SUBORDINATION OF INDIVIDUAL INTERESTS
To control people, you have to understand their interests first.
And in the end, you have to ensure that the interest of the
company lies above the interest of the individual. Many a time,
a person is removed from the company when he is moon
lighting or doing his own sideline jobs. This is because the
company wants to ensure, that the person who is working in
the company is giving his 100% to the company.
48
5.CENTRALIZATION
▰ Centralization (organization under a single authority) is the amount of control
that is lying with people in an organization. If there are select group of people
who have control (for example – in large corporates), then this is known as
centralization.
▰ On the other hand, if there are a higher percentage of people in the
organization having control (for example – in small businesses), then this is
known as decentralization.
▰ Centralization implies the concentration of decision making authority at
the top management (executive board).
▰ Sharing of authorities for the decision-making process with lower levels
(middle and lower management), is referred to as decentralization 49
6.UNITY OF COMMAND
▰ The employees must receive command from only one
manager. A employee receiving command from many
manager lead to chaos and is answerable to none.
50
7.SCALAR CHAIN
▰ Every organization should have an hierarchy (ranking,
grading) and every employee must know where they stand
and what authority and responsibility they posses.
51
8.STABILITY OF TENURE (Holding) OF PERSONNEL
▰ Employees who are specialized in their job must be retained
in order to avoid recruitment cost and hiring new employees
lead to decrease in efficiency as new recruitment is closely
related to high product rejection. This also provide
employees with confidence of job safety to increase
dedication to work.
52
9.ORDER
▰ Everything in organization must be placed in proper manner
to ensure every employee knows what, when and where
they have to do in order to increase efficiency of firm.
53
10.UNITY OF DIRECTION
▰ The whole organization should be working to achieve same
objective and in same way. People with the same task
should be working under the direction of one manager,
using one plan. This will ensure that action is properly
coordinated.
54
11.REMUNERATION
▰ Employee satisfaction depends on fair remuneration for
everyone.
▰ This includes financial and non-financial compensation i.e.
cost of living, supply of qualified personnel, condition of job
must be considered while determine salary of employee.
55
12.DISCIPLINE
▰ Discipline must be upheld in any organization to make it
successful because to make an organization successful
common effort of all employee is required.
56
13.UNITY (ESPIRIT DE CORPS)
▰ Management should encourage harmony and general
good feelings among employees
57
14.EQUITY (Value or Worth)
▰ All employees should be treated as equally as possible.
58
ROLE OF NURSE AS A MANAGER
I. Ward Management
▰ • Organizes, directs and supervises the nursing services
▰ • Coordinates assignments of staff.
▰ • Establishes the general pattern of delegation of
responsibilities and authority.
▰ • Formulates standing orders for the nursing care.
▰ • Ensures appropriate allocation of duties and responsibilities to
all nursing staff 59
Continue…
▰ • Formulates nursing policies to ensure quality patient care
and adequate attention at all times.
▰ • Responsible for efficient functioning of the nursing staff. •
▰ Evaluates the personal performance of the nursing staff.
60
II.Discipline
▰ • Ensure that a standard of discipline of nursing staff is high
at all times.
▰ • Maintain good order and discipline in wards / departments.
▰ • Makes daily rounds of the hospital wards / departments and
also seriously ill patients.
▰ • Brings immediately to the notice of the authority all matters
concerning neglect of duty, insubordination either by nursing
staff, patients or visitors or any un-towards incident. 61
III.Public Relations
▰ • Promotes and maintains harmonious and effective
relationship with the various administrative departments of the
hospital and related community agencies.
▰ • Maintain cordial relationships with the patients and their
families.
62
IV.Office Duties
▰ • Scrutinizes the reports and returns and submits in
accordance with existing orders.
V.Confidential Reports
▰ • Initiates the confidential reports of nursing staff on due
dates.
▰ • Responsible for the nursing budget.
63
VI. Education
• Carries out in-service training for all categories of nursing
staff and paramedical personnel and keeps the records of
such trainings.
• Conduct various update courses based on the needs.
• Encourages the personnel to participate in the continuing
education program.
64
VII.Staff Welfare
▰ • Responsible for health and welfare of nursing staff.
▰ • Ensures annual and periodical health examination and maintenance of
health records.
VIII.Conferences
▰ • Responsible for organizing and conducting staff meeting of the nursing
staff once in three months.
▰ • Holds conference in nursing care problems and discuss policies as
regards to working conditions, working hrs and other facilities. 65
IX.Supervision
▰ • Supervises nursing care given to the patients and all
nursing activities within the nursing unit.
▰ • Supervises the work of all paramedical staff of the hospital.
X.Records and Reports
▰ • Maintains various records such as duty roster nursing staff,
day off book, personal bio-data, leave plan, staff conference
book, courses file etc.
66
Problems & Challenges
▰ ♠ Lack of adequate training.
▰ ♠ Problem of personnel management.
▰ ♠ Inadequate number of nursing staff.
▰ ♠ Shortage of trained manpower.
▰ ♠ Poor role model.
▰ ♠ No research scope.
▰ ♠ Lack of motivation.
▰ ♠ No involvement in planning. 67
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THANKS!
Any questions?
You can find me at
sivanathan111@gmail.com
9881390000,9092707111
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