NURSING MANAGEMENT

 choosing the right person and giving them the appropriate task for the purpose of achieving their
goal/objective in achieving total care

Henry Fayol’s Principle of Management

 Unity of Command – one leader, one command
 Unity of Direction – one group should always have one goal
 Remuneration of Personnel – patient first policy
 Esprit de corps – team spirit
 Command responsibility/Respondeat Superior – let the superior answer the fault of his subordinates
even harm or death
 Balance between centralization and decentralization
 Security tenure
 Delegation of responsibility

Frederick Taylor’s Scientific Management Theory

Elements
 choosing the appropriate person (TAO)
 choosing the appropriate team
 choosing the appropriate training
 choosing the appropriate tools

Human Relations theory

 the be a good manager, there should be a good interpersonal relationship between the leader and
follower
 
Douglas Mc Gregor’s Motivational theory
Theory X
 Negative workers
 negligence, inefficient, ineffective workers
Theory Y
 Positive workers
 diligent, effective, efficient worker
 theory X should be given focus because they are prone to negligence and malpractice.

Max Weber’s Bureaucratic/ authoritarian Theory

 whoever is on the top would perform the management function
 centralized

Elton Mayto’s Behavioral Theory

 overtime pay, rest day, day off
 provide physical needs of the workers
 Hawthorne’s Effect
 If workers knows they are observed they become more efficient
5 steps in Management Process

1. PLANNING
 looking ahead of time.
 Formulating future goals/objective

Types of plan
 Standard/Operational Plan (NCP)
 plans for everyday or ordinary activities
 Strategic/Contingency Plan
 plan used during sudden or acute crisis
 Long-range/future Plan
 plans which you can’t evaluated immediately.
 Usually last months or yrs.
 Used for chronic pt which requires longer period of care.

Stages of Planning Process

 Mission – present reason when established your organization
 Vision - statement of your future purpose of your future organization
 Philosophy – set of values and beliefs of your organization
 Goal – general statement of your purpose
 Objectives – more specific statement of your purpose
 Policies – set of rules and regulations in your organization
 Procedures
 Budgeting – proper allocation of your resources
3 types :
 Personnel
 Compensation for salaries of workers
 Operational
 everyday use of equipment and facilities (gloves, water, electricity)
 Capital
 long term use equipment (MRI, CT Scan, hospital beds, hospital buildings)

2. ORGANIZING
4 stages
i. Organize your team RN Subordinates

 Duties of the RN
 Only assessment can perform the nurse
 Only the nurse can perform HT
 Only the nurse should explain the procedure to the patient
 Preparation, administration, treatment of drugs to the patient
 The nurse can only perform evaluation
 The nurse can only do judgment
 ii. Delegate Task

 They can only delegate to subordinates the Routinary task (standard, unchanging
procedure) eg. monitoring of I&O, bathing, ambulating, toileting, shampooing,
transporting, feeding, clothing, wiping

 Stable patient - predictable outcome (eg. postmortem care with direct supervision of the
nurse only)

 Supervision – need guidance

iii. Staff Schedule/ Staffing

 Schedules (How many hours)
 Traditional – 8hrs a day/40hrs/wk
 Ten hour shift/4 days a week
 Baylor plan – it consist of two shifting nurses
 traditional – mon-fri 8hrs
 2nd shift – 12hr shift during weekends
 Part-time work – fewer working hours per day and may choose the day or work. Less
than 8hrs job
 On – call – during shortage of nurses/staff but increase in the number of patients.

iv. Methods of Nursing care Delivery

Different Methods
 Primary – 24hrs a day
 Primary nurse is the only nurse who is responsible to make a care plan of the patient
from the moment of admission till the moment of discharge. (eg. private duty nurse or
special nurse)

 Functional Method
 DOH format/government hospitals
 Assign nurse :
 Duty/task
 One nurse, one task
 Highly recommended during a period of shortage of nurses and budget
 poorest method of delivery because communication is hindered

 Case Method/Case Nursing

 provide total care within your shift. Used in ICU department
 C – Case Method
 T – total care to the patient
 O – one is to one ratio
 3. Directing/Delegation stage
 a job or a task is done or performed by another perform for you
 What you cannot delegate:
a. you cannot delegate total control of the procedure
b. you can’t delegate discipline of subordinates or staff members.
c. Confidential task
d. Technical task
e. Medical task performing surgical procedure is done by the doc not the nurse

4. Coordination/Collaboration
 the nurse needs to collaborate to other members of the health care team.

 Multi-interdisciplinary approach – to be able to provide holistic approach to the patient.

Types of Collaboration
i. Interpersonal/Intradepartmental

 One patient, one unit.

 Collaboration between one nurse to another healthcare team in one unit/department

 Eg. MI patient - nurse, dietary, specialized in cardio

ii. Interdepartmental

 4 units in one hospital.

 Coordination of the patients care between 2-more units/departments but still under one
same hospital or institution

 Eg. patient due for appendectomy is transferred to the OR

iii. Inter Agency/Institutional

 Coordination of patient’s care between 2 or more hospitals/health care institution for

the benefit of the patient

 Eg. lying – in due for C/S and was transferred to a hospital

 5. Evaluation/Controlling
 stage wherein you determine whether or not your plans for your patient is met or achieved

Methods of evaluating staff performance

i. Checklist

 it is being evaluated higher than you. (eg. nurse manager/supervisor or head nurse)

ii. Nursing rounds

 it is being evaluated higher than you. (eg. Nurse manager/supervisor or head nurse)

 Psychiatric ward is not done by nursing rounds

iii. Peer review

 same rank or level is being evaluated you

 poor method

iv. Performance appraisal

 the patient evaluates you

 best method in evaluation

Proper Compensation of workers

 RA 7305 (Magna Carta Law) – salary grade 50 P13,000/month

 Overtime pay – additional of 25%/hr

 Night Differential – additional of 10%/hr

 Legal holiday – x 2

 Philhealth - Benefit of worker both related and non-related work (aesthetic, dental and
cosmetics are not included)

 Maternity leave – 60days leave is NSD, 78days if CS only to first 4 pregnancy only to legitimate
spouse

 Paternity leave – 7day/1week leave

 Senior Citizen’s Act – 20% discount