Directing

Outlines:
 Introduction
 Definition of directing
 Directing function
 Importance of directing
 Benefits of directing
 Characteristics of directing
 Elements of directing
 Communication(Organizational communication lecture)
 Delegation of authority
 Supervision (Supervision lecture)
 Leadership (Leadership styles & theories lecture)
 Motivation
 Coordination
 Time management
 Conflict management
 Negotiation
 Collaboration
 References

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 Directing
Introduction
Directing or Direction function is said to be the heart of
management of process and therefore, is the central point around which
accomplishment of goals take place. A few philosophers call Direction as
“Life spark of an enterprise”. It is also called as on actuating function of
management because it is through direction that the operation of an
enterprise actually starts.

Definition of directing:
Directing refers to instructing, guiding, communicating and
inspiring people, so that objectives can be achieved. It is the process of
telling people what to do and seeing that they do it in the best possible
manner.

Directing is the fourth element of the management process. It refers

to a continuous task of making contacts with subordinates, training them,
giving them orders, leading and motivating them.

Directing function:
1. Telling people what is to be done and explaining to them how to do it;
2. Issuing instructions and orders to subordinates to carry out their
assignments as scheduled;
3. Supervising their activities;
4. Inspiring them to meet the mangers expectation and contribute
towards the achievement of organizational objectives; and
5. Providing leadership.

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Importance of directing:
In the absence of directing function, subordinates will have no idea
as to what to do. They will probably not be inspired to complete the job
Satisfactorily. Directing is the heart of administration and useful in many
ways such as the following:

1. It guides and instructs the subordinates to complete the given task.

2. It is through directing that managers motivate subordinates to
complete the work satisfactorily. In addition, strive to do those best.
3. Directing involves supervision, which is essential to make sure that
work is performed according to the orders and instructions.
4. Different people perform different activities in the organization. All
the activities are interrelated. In order to co-ordinate, the activities
carried out in different parts and to ensure that they are performed
well, directing is important. It helps to unify the activities.
5. Directing involve leadership which essentially help in creating
appropriate work environment and build up team spirit.

Benefits of directing:
1. It Initiates actions - Directions is the function which is the starting
point of the work performance of subordinates. It is from this function
the action takes placing, subordinates understand their jobs and do
according to the instructions laid.

2. It Ingrates efforts - Through direction, the superiors are able to

guide, inspire and instruct the subordinates to work. For this, efforts of
every individual towards accomplishment of goals are required. It is
through direction the efforts of every department can be related and

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 integrated with others. This can be done through persuasive leadership
and effective communication. Integration of efforts brings
effectiveness and stability in a concern.

3. Means of motivation - Direction function helps in achievement of

goals. A manager makes use of the element of motivation here to
improve the performances of subordinates.

4. It Provides stability - Stability and balance in concern becomes

very important for long-term sun survival in the market. This can be
brought upon by the managers with the help of four tools or elements
of direction function - judicious blend of persuasive leadership,
effective communication, strict supervision and efficient motivation.
Stability is very important since that is an index of growth of an
enterprise. Therefore a manager can use of all the four traits in him so
that performance standards can be maintained.

5. Coping up with the changes - It is a human behavior that human

beings show resistance to change. Adaptability with changing
environment helps in sustaining planned growth and becoming a
market leader. It is directing function, which is of use to meet with
changes in environment, both internal as external. Effective
communication helps in coping up with the changes. It is the role of
manager here to communicate the nature and contents of changes very
clearly to the subordinates.

6. Efficient utilization of resources - Direction finance helps in

clarifying the role of every subordinate towards his work. The
resources can be utilized properly only when less of wastages,

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 duplication of efforts, overlapping of performances, etc. Through
direction, the role of subordinates become clear as manager makes use
of his supervisory, the guidance, the instructions and motivation skill
to inspire the subordinates. This helps in maximum possible utilization
of resources of men, machine, materials and money, which helps in
reducing costs and increasing profits.

Characteristics of directing:
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 behavior 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 behavior is unpredictable by nature and
conditioning the people’s behavior towards the goals of the enterprise

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 is what the executive does in this function. Therefore, it is termed as
having delicacy in it to tackle human behavior.

Elements of directing:
Swansburg, (1999) stated that elements of directing classified
into:
1. Leadership
2. Motivation.

Another author according to Joseph Massie,

 Issuing of orders that are clear, complete and within the capabilities of
subordinates to accomplish.
 Continuous training activity in which subordinates are instructed to carry
out the particular assignment in the existing situation.
 Motivation of subordinates to try to meet the expectations of the
manager.
 Maintaining discipline and rewarding those who perform properly.

Another author Chitty, (2001) classified element of directing

into:
1. Communication
2. Delegation of authority.
3. Supervision
4. Leadership
5. Motivation.
6. Coordination.

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According to Marquis and Huston (1992), components of
directing phase are:
1. Creating a motivating climate.
2. Managing time resources.
3. Establishing organizational communication.
4. Managing conflict.
5. Facilitating collaboration.
6. Negotiating
7. Complying with union and legal constrains affecting management.

1.Communication:
Communication is a basic organizational function.

Definition of communication
Communication: Is the process by which a person transmits
information or messages to other persons? In an organization, supervisors
transmit information to subordinates

Communication: is two-way process concerned with convoying a

message or an idea between two or more individuals. One person is the
sender and one is the receiver of the message. The roles may become
reversed at any time,

Basic elements of communication:

1. Referent: Is the stimulus that initiates and motivate one person to
communicate with others ex, idea, message and perception.
2. Sender: Is the person how encodes and delivers the message.

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 "Encoder"
3. Message: Is the content of communication, as idea, information or
feeling. It may be verbal or non- verbal.
4. Medium: "channel" Is the method by which the message is sent: as
auditory, visual or tactile medium
5. Receiver: Is the person who receives and interprets meaning of the
message.
6. Feedback: Is the message response returned by the receiver, it
indicates whether the meaning of sender message was understood. It
may be positive or

Importance of communication:
1. Communication helps employees to understand their role clearly and
perform effectively.
2. Communication improves managerial efficiency and ensures
cooperation of the staff
3. Effective communication help in molding attitudes and building up
employees morals
4. It helps in achieving co-ordination and mutual understanding, which in
turn, leads to industrial harmony and increased productivity.

Kinds of communication:
There are two basic types of communication:

1. Formal communication "the official":

o This type is established by management and formally pictured in the

charts of the organization.

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 o It is a line of communication for the transmission of official message
and information within or outside the organization.

2. Informal communication

This type of communication is built around the social relationship

of the members of the organization, i.e. arises on account of the nature desire
of the people to communicate with each other.

Types of communication :
A. Verbal communication
B. Non verbale communication

A. Verbal communication:

The need for the manager / leader to accurately and reliably send and
receive verbal messages is critical for effectiveness. Verbal messages that
are vague or unclear promote confusion and poor job performance.

Effective verbal communication:

1. Brief: Use the fewest words that send the message. Keep it short,
simple and to the point. Using too many words can mud messages and
confuse the receiver.
2. Clear: Speak slowly and clearly. Repeat important points. Use words
that are simple enough .to be understood.
3. Paced appropriately: The speed with which a message is
delivered has an impact on the communication. A message that is sent
too rapidly increases anxieties in the receiver. Awkward pauses or the

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 use of too much or too little silence can convey messages other than
what was intended.
4. Effective toned: The tone of a person's voice can have a strong
influence on the message being sent. Vocal tones can also indicate
one's emotional state. To send an effective message, the tone of voice
must match the words that are sent.
5. Relevant: Communications that are important have more impact. If
the message has little relevance or importance it will be casually
received and soon forgotten.
6. Well-timed: In order to be received fully, verbal messages need to
send at advantageous times, for example: messages that are personal or
related to performance need to be times so that they can be sent in
private, with time for discussion. Communications that praise a staff
member should be sent in public. Thus, encouraging recognition and
worth. A good rule of thumb for timing messages: "Praise in public;
criticize in private."

B. Nonverbal communication:

These messages are considered to be a more accurate description of

emotions than verbal messages. It is easier for us to control our words and
speech than the non-verbal messages we send.

Techniques for developing effective nonverbal communication focus

on the use of personal appearance, body language, distance and territory,
attending behaviors and touch.

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 1. Personal appearance: One's personal appearance is the
combination of one's physical characteristics, style of dress, hygiene,
etc. it is a mixture that creates an impression.
2. Body language: The sending and receiving of nonverbal messages
through the use of bodily movements and facial expressions is
referred to as body language. These messages sometimes have a
greater impact on communication than the verbal messages.
3. Distance and territory: The more private or personal the
communication, the closer the distance between people.
4. Attending behavior: These are a combination of behaviors that
indicate if and how the receiver is listening to the speaker. They
include eye contact, focusing on the speaker's message, and attentive
listening techniques.
5. Touch: Touch is a powerful tool that conveys both positive and
negative expressions. Its interpretation depends on the cultural
background and emotional state or mood of the people and the nature
of the relationship or interaction. Awareness of space and territory is
essential when communicating with touch.

Channels of communication in the organization:

There are four channels of managerial communication (Figure 2):

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 2. Upward communication.
3. Horizontal communication.
4. Diagonal communication.

1. Downward communication:

When superiors issue orders and instructions to subordinates. Or it

flows from people at higher level to those at lower level. I.e. from the
superior to subordinate or from manager to assistant manager in the
organizational hierarchy.

o The types of downward oral communication include instructions,

speeches, meetings, use of telephone.
o Examples of written downward communication are letters, handbooks,
Pamphlets, policy statements and procedures.
o This downward communication helps to tie the different levels of
organizational hierarchy together and is the instrument by which an
executive puts his/her delegated authority to effective use.

2. Upward communication:

It passes from subordinates to superior, i.e. "continues up the

organizational hierarchy."

Upward communication provides a means for motivating and

satisfying Personnel by allowing employee input.

3. Horizontal flow communication:

Is one that takes placing directly people on the same or similar

organizational level. It is most frequently used to coordinate activities.

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 2.Delegation of authority
Delegation of authority: It is the process of assigning work from a
supervisor to subordinates and giving them power, authority and
responsibility to accomplish the assigned work.

Delegation of authority: is the process of authorizing a subordinate or

peer to perform some portion of one's official job duties.

Main principles of delegation:

 Responsibility cannot be delegated.
 Authority and responsibility should be in equal proportion.

Five rights of effective delegation:

1. Right task:-One that is delegable for a specific patient.
2. Right circumstances: - patient setting, available resources, and
other relevant factors considered.
3. Right person:-Right person is delegating the right task to the right
person.
4. Right direction/communication: - Clear, concise description of
the task, including its objective, limits and expectations.
5. Right supervision:-Appropriate monitoring, evaluation,
intervention, as needed, and feedback.

The purpose of delegation:

1- Cost saving: The easiest and most efficient way to save on cost is to
use resources properly by ensuring that the right person is doing the
right work at the right time.

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 2- Time saving: Time will be conserved if the manager allocates
activities to the proper staff member. Time will be best used by
professional staff when nonprofessional personnel assist them in
completing some of the necessary tasks.

3- Professional growth for employees: Increasing the self-esteem of

employees is an important reason to use the process of delegation.
Personal and professional growth is expected as personnel experience
the development of their talents and abilities by taking pride in the
results of their efforts. This comes about in response to the decisions
they have made.

4- Professional growth of the manager: Effective and successful

delegation centers around effective manager and staff relationships. In
facilitating the staff's growth, the manager is truly fulfilling a manager
responsibility of the manager's role.

The process of delegation:

The delegator or nurse manager makes relatively few decisions alone
but frames orders in broad, general terms, allowing the subordinate to work
out the details of the work. The delegator or manager does the following:

 Sets goals.

 Tell subordinates what is to be accomplished.

 Fixes the limits within which the subordinates can work in accord with
job description and job assignment.

 Allows employees to decide how to achieve goals.

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Guidelines for effective delegation:-
1. Start delegating by the simple, routine tasks, then progress to
more skilled.

2. Give specific guidelines on what the task entails (Be very

specific).

3. Ascertain that the employee to whom you are delegating has the
ability to do the task.

4. Explain why the task needs to be done.

5. Make yourself available to answer any questions at the outset

and throughout the period of the task.

6. Ask for feedback from the employee, as what did they enjoy
about the assignment? What did they find difficult?

7. Accept that the job might not be done in the same way that you
would do it.

8. Reward if appropriate.

Barriers to successful delegation:

(1)Barriers related to the delegator:-
1.Preference for operating by oneself

2.Demand that everyone know all the details.

3.“I can do it better myself” fallacy

4.Lack of experience in the job or in delegating

5.Insecurity

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 6.Fear of being disliked

7.Refusal to allow mistakes

8.Lack of confidence in subordinates

9.Perfectionism, leading to excess control

10.Lack of organizational skill in balancing workloads

11.Failure to delegate authority commensurate with responsibility

12.Uncertainty over tasks and inability to explain

13.Failure to establish effective controls and to follow up.

14.Disinclination to develop subordinates.

(2)Barriers related to the delegate:

1. Lack of experience

2. Lack of competence

3. Avoidance of responsibility

4. Overdependence on the poss.

5. Disorganization

6. Overload of work

7. Decision-making is a hard mental work, and people seek ways of

avoiding it.

8. Fear of criticism for mistakes.

9. Positive incentives may be inadequate, (e.g. pay rate, opportunity

for promotion, unproved status).

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(3)Barriers related to the situation/environment
1. One-person-show policy

2. No toleration of mistakes

3. Criticality of decisions

4. Urgency, leaving no time to explain (crisis management)

5. Understaffing.

3.Supervision
Definition of supervision
Supervision is defined as a cooperative relationship between a leader
and one or more persons to accomplish a particular purpose.

Objectives of supervision:
1. To persist in the delivery of high quality of health care services.

2. To assist and to help in the development of staff to their highest

potential.

3. To interpret the policies, objective, needs etc.

4. To plan services cooperatively and to develop coordination to avoid

overlapping

5. To develop standards of service and method of evaluation of personnel

and services.

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Purpose of supervision:
1. To provide suitable working conditions.

2. To cultivates a spirit of cooperation between employees

3. To maintain maximum standard and ensure optimum professional

efficiency in relation to achievement of the organizational goals.

4. Is orientation, training and guidance the individuals based upon their

needs and development of new skills.

5. Is concerned with the planning, execution and evaluation of the work to

be done.

Principles of good supervision:

1. Good Supervision strives to make the ward a good learning situation.

2. Good supervision gives autonomy to workers depending on their

competency, personality and commitment

3. Good supervision creates an atmosphere of cordiality and trust.

4. Good supervision is well planned, objectives, methods of supervision

and criteria for judging.

5. Good supervision helps the individual nurse set up objectives.

6. Good supervision helps the nurse to make a pattern for analysis and
to analyze continuously her success in reaching her objectives.

7. Good supervision considers the strengths and weaknesses of

employees.

8. Good supervision respects the individuality of the staff members.

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Functions of supervision:
1. Orientation of newly posted staff

2. Assessment of the workload of individuals and groups

3. Arranging for the flow of materials

4. Coordination of efforts

5. Promotion of effectiveness of workers and social contact.

6. Helping the individuals to cope

7. Facilitating the flow of communication.

8. Raising the level of motivation Establishment of control

9. Development of confidence

10. Emphasis on achievement.

Types of supervision:
 Critical friendship. The supervisor acts as a friend and guides the
supervisee.

 Mentoring. The supervisor acts as a role model for the supervisee.

 Monitoring. The supervisor checks on progress and any problems as

well as advising on solutions.

 Advisory. The supervisor assumes a relatively superior position in

terms of knowledge and skills

 Clinical supervision. In this situation, the supervisor and

supervisee engage in face-to-face interaction that is primarily based on
the observation of performance and an emphasis on collegiality.
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  Hard accountability. In this case, the supervisor performs the
traditional inspector's role, demanding strict accountability from the
supervisee.

The supervision process:

1. Assessment of patient's needs for improvement in the quality of care
given.

2. Assessment of needs of individual staff members for improvement in

the light of the objectives of patient care.

3. Establish objectives for the desired quality of care and individual staff
members' objective.

4. Planning methods for meeting objectives and achieving personal

improvement.

5. Carrying out the plan through direction, guidance, teaching, etc…

6. Evaluation of results and making new plans.

7. Continuous evaluation of the effects of staff effort on the quality of

care given

Methods of supervision:
1. Cooperative determination of staff member's needs:
The nurse manager must be aware of needs of nurses and given them
opportunity to discuss their shortcomings and request assistance, without
fear or embarrassment or criticism, to say they need help. Each nurse should
be helped from her nurse in planning ways to improve her ability in
providing patient care.

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2- Cooperative planning for supervision:
The amount and type of assistance required depends on the ability and
experience of the staff member.

 If the nurse has an understanding of scientific principles, is skilled in

the use of her hands, and in organization of assignment; there should be
a conference with the head nurse, before the starts to care for the
patient.

 When the nurse is new or young in experience, the head nurse might
plan to have a competent nurse with the inexperienced nurse to care for
a patient with difficult problems

3- Observation:
Is an important and essential method of supervision, it is carried out
continuously while the nurse is performing her work; while care is provided
to patient, during patient round, during giving and receiving report and after
all the care has been given.

4. Supervision at bedside:
The head nurse must assist members at the bedside for the safety and
welfare of the patient or for the learning of the individual.

The supervisor's responsibilities:

1) Responsibilities towards subordinates:
The supervisor must get to know the subordinates as individual
human beings, through using the person's name, a respectful tone of voice,

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personalized greeting and asking about their subordinate's health and well-
being.

1. Finds workers who are well equipped to handle their duties.

2. Supports them when they act under given orders or with permission
3. Providing them with constructive criticism and adequate instructions,
training and evaluation.

2) Responsibilities towards peers:

Supervisors' responsibilities to their peers include:

1. Know and understand each of them as individuals.

2. Approach and cooperate with each of them as individuals.
3. Provides needed help to enable peers achieve the satisfaction they desire
from their job.
4. Foster a spirit of cooperation and teamwork

3) Responsibilities towards superior:

The supervisor's responsibilities to the superiors,

1. Promote the organizational goals

2. Operate within the budget and respecting organization's policy.
3. Transmit information about problems along with recommendations for
solving them.
4. Strive for efficiency whenever and wherever possible.
5. Prepare records and reports on time and in the proper form.
6. Uses the organization's resources effectively.

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 4. Leadership
Definition of leadership
Leadership: Is the ability to influence the behavior of others in order
to accomplish the task of a group or to achieve the goal of a group, while at
the same time maintaining the integrity and morale of the group.

Leadership: Is the act of guiding or influencing people to achieve

desired outcomes; occurs any time a persona attempts to influence the
beliefs, opinions or behaviors of individual or group.

Importance of leadership:
1. Leadership improves the performance of the employees. Leader can
motivate the followers to work and thereby increase their performance
level

2. With continuous support and guidance, leaders are able to build

confidence among the followers, thereby increasing speed and
accuracy and decreasing wastage.

3. With friendly and cooperative efforts, the leader is able to build

employees morale, which in turn contribute to higher productivity.

Types of leaders:
A.Formal leader
When practiced by nurse with legitimate authority described in an
approved position. (E.g. nurse, supervisor, case manager, coordinator).

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B.Informal leader:
It is exercised by the person who has no official or appointed
authority to act but is able to persuade and influence the others.

5. Motivation
Motivation is one of the important elements of directing. Issuance of
proper instructions or orders does not necessarily ensure that they will be
properly carried out. It requires manager to inspire or induce the employees
to act and get the expected result.

Definition of motivation
Motivation refers to wishes, desires, impulses that stimulate or
activate person to do thing

Motivation is an inner impulse or internal forces that initiate and

direct the individual to act in certain manner to satisfy need.

Motivation may be:

1-Intrinsic: Comes from within the individual driving him or her to be
productive. It might include such things as desire to be liked, desire for
recognition, or need to achieve. To be intrinsically motivated at work, the
worker must value job performance and productivity. The intrinsic
motivation to achieve is directly related to person's level of aspiration.
Culture background also has an impact on intrinsic motivation.

2-Extrinsic: Extrinsic motivation is enhanced by the job environment or

external rewards. The reward occurs after the work has been completed. If
they come from outside the person. It might include desire to make

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 money, work in a rich environment, or drive an expensive care. it is the
extrinsic motivators that involve effective use of communication skills.

Organization must provide acclimate that stimulates both extrinsic

and intrinsic drives.

Importance of motivation:
1. With proper motivation, there can be maximum utilization of the
factors of production like men, money, material etc.

2. If employees are motivated it will reduce employee turnover and

absenteeism.

3. Motivation fosters a sense of belongingness among the employees

towards the organization and also improves their morale.

4. Motivation helps in reducing the number of complaints and grievances.

The wastage and accident rate also come down.

5. With proper motivational techniques management can attract

competent and best quality employees.

6. Increase interpersonal relationship between manager and employee.

7. Improve job satisfaction.

8. Increase self –esteem and creativity.

9. Improve communication between people.

10. Improve performance and productivity.

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Factors that influence motivation:
1-Persnnal factors:-
Personal attributes of the learner such as developmental stage, age,
gender, emotional readiness, values and beliefs, cognitive ability,
educational level, actual or perceived state of health, need for Power, need
for achievement and support system.

2-Work factors:-
Work environment, accessibility and availability of human and
material resources, and different types of behavioral rewards influence the
motivational level of the individual, job design, satisfies, signify and give
value to employees encouraging them to perform well and positively work
environment is favorable which is made by democratic leadership style, peer
group interaction.

1-The right leadership climate :

The right leadership climate in which the personnel will adopt the
organization goals as their own and work towards them and this depends on
the supervisory climate. The supervisor should use his / her authority,
influence and control, to increase personnel satisfaction on the job.

3-Satisfication of social and personal needs

What employees express basically is satisfaction of social need (to be
a part of a satisfying organization and work group), and of personal needs
(self-respect, recognition, creativeness, achievement, reasonable freedom
and human dignity).

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3-Organizational objectives
Employees will commit themselves to objectives in the achievement
of which they find rewards.

Types of motivation:
a. Negatives and positive motivation
b. Financial and non- financial motivation

1- Negatives and positive motivation:

 Negatives motivation: is based on force of fear
 Positive motivation: is based on reward

2- Financial and non- financial motivation

 Financial motivators are those, which are associated directly or

indirectly with money
 Non- financial motivators:
1. Delegation of authority: The accomplishment of goals is most
effective when workers are given authority to make decisions.

2. Competition: A manager can create an atmosphere of healthy

competition among the subordinates through gaining status or social
prestige.

3. Participation: Participation of employees in decision-making and

policy formulation widely recognized as an important organizational
motivator

4. Job satisfaction: Is based on job factors such as promotion, pay

raise, recognition and responsibility

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 5. Feeling of accomplishment: The manager provides information,
permitting the employees to set their own goals and given opportunity
to grow on the job

6. Responsibility: People can also be motivated by assigning them

higher responsibilities

Characteristics of sound motivation systems:

1. To be a permanent feature of an organization
2. Well understood by all employees
3. Equitable
4. Flexible
5. Comprehensive and competitive
6. Based on proper standards
7. Productive
8. Directly related to efforts

Measures to facilitate nurses' motivation

1. Act as a role model

2. Develop and maintain good personal relationships

3. Post each nurse where she can work best

4. Use a participation style of leadership

5. Guide , encourage and support continuously

6. Reward good work

7. Build teamwork (team spirit)

8. Provide continuing education

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 6. Coordination

Coordination is an important function of a nurse manager; the main

aim of coordination is to secure and maintain a unified action throughout the
organization.

Definition of coordination
Creating a harmony among all activities and personnel to facilitate the
work, and success of the unit and organization.

Why coordination is used?

1. Coordination is used in order to achieve the hospital objectives in the
most economical ways.
2. Coordination help in achieving high quality nursing care.
3. Coordination helps in avoiding the unnecessary wastes or over use of
nurses, time, effort or equipment and supplies.

Methods for achieving coordination:

1-Plans and rules: in the form of standard procedures to be used by
different categories of nursing personnel in the solution of the common
problems they face in their daily work. For example, the annual leave plan,
rotation…etc.

2-Vertical channel of authority: using communication through the

line of authority for example, when the staff nurses face a problem in her
work, she can seek the help of the head nurse. The later can refer to the
supervisor until a superior having authority and power to decide appropriate
solution to the problem is reached.

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3-Scheduled meeting: a fixed scheduled for meeting between heads of
different departments to solve interdepartmental problems. for example, the
monthly meeting of the hospital governing broad to discuss and solve
problems of patient care.

4-Itermediaries: for example, the coordinator or the program

representative whose position in the hierarchy is just above the department
head and below the hospital administrator. The main job intermediaries are
to create interdepartmental coordination.

Strategies for an effective coordination:

Coordination can be effectively achieved through the following strategies:

1. Clearly defined and understood objectives:

For an effective coordination, every individual and each department
understands the overall organizational objectives, because the unified efforts
for coordination between two departments cannot be achieved without a
common purpose.

2. Clear line of authority and responsibility:

An effective coordination will be achieved smoothly if there is a clear
line of authority and responsibility.

3. Proper organizational structure:

A proper organizational structure will enhance an effective
coordination, i.e. departments must be grouped in such a way that work
moves smoothly from one phase to another.

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4. Effective channel of communication:
Coordination requires frequent information exchange between the
manager and his/her subordinates. The usual methods of transmitting
information within the work group are:

o Face to face communication.

o Memoranda: which are brief, informal, written communications to
transmit essential information to employees.
o Posters; which are useful in communicating brief, operational
information, such as notification of group meetings, and educational
offerings:
o Committee: This is a group of people chosen to deal with a particular
topic or problem.

5. Policies and procedures:

Policies serve as a basis for future decisions and actions, they help
coordinating plans, controlling performance, and increasing consistency of
actions, thus the managers could make similar decisions when facing similar
situations.

6. Proper timings:
To be effective, it is important for the coordination activities to be
performed at the proper time.

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 7.Time management
Time is the number of second, minutes, hours, or days available to the
nurse leader to accomplish a given task. Time management is based on
principles and consists of a variety of techniques that facilitate the best use
of time.

Principles of time management:

1-Communicating: Effective use of communication skills is an
important tool to provide complete and appropriate information. Appropriate
information guides correct action. Errors can lead to wasted time and the
useless expenditure of energy.

2-Planning: Planning is critical for the effective use of time. Planning

charts the course of action, outlining task in order of importance. Every
minute spent in planning saves time in the execution of activities.

3-Deligating: Delegating the work of the department to others is not only

a part of management but also a strategy for time management. Delegation is
used by nurse leader as a way to insure that the work of the organization is
completed on schedule.

4-Prioritizing goals: Prioritizing involves ordering goals, tasks, and

responsibilities from the most important to the least important. This process
involve knowledge about the leader's role and the nature of the work to be
completed. Spending time thinking through how best to meet goals is time
well spent. It is far more efficient to spend time planning for problems than
to spend time correcting them.

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Benefits of time management:
1. Gain a sense of control over your time. Effective time management
enables you to gain control over your time. The goal is not control for
the sake of control, but in order to become more effective, reduce your
stress, increase your self-esteem and gain a sense of inner peace.

2. Increase your productivity. Effective time management increases

your productivity allowing you to accomplish more with less effort.
Improving your productivity is not about “doing more in less time,” it
is really about accomplishing more by working less.

3. Achieve your goals. Effective time management helps you accomplish

your important goals by guiding you to direct and focus the
appropriate amount of time and energy towards their achievement.
You cannot hope to achieve any level of success in your personal or
professional life without devoting some of your valuable time and
effort to your goals.

4. Find Fulfillment People are beginning to realize that achievement

does not automatically lead to fulfillment. Effective time
management can lead to fulfillment by helping you realize what is
truly important, rewarding, and valuable in your life and making sure
that you set your goals and priorities accordingly.

5. Find balance. Effective time management enables you to lead a more

balanced life by helping you find the time and energy to devote to all
the important areas of your life.

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Time management skills:
1. Analyze your time for an average week.

2. Plan your workday at the end of the preceding day

3. Know your peak energy time. Do the difficult work then.

4. Being with the most important job.

5. Start the day by reviewing what you will be doing.

6. Do not waste time at work by doing too much socializing.

7. Give yourself time each day to think, plan, and create.

8. Organize the necessary tools to complete a task.

9. Consolidate similar task or work.

10. Eliminate unnecessary work.

11. Delegate work that should be and can be done by others.

12. Break big tasks into smaller pieces.

Barriers to effective time management:

1-Habit: People are creatures of habit. Habits are comfortable ways of
behaving because they do not require conscious thought. Habits are also
very difficult to change. The nurse leader needs to be mindful of negative
habits, particularly procrastination, and make time more productive.

2-Work expansion: Time frames attached to work will provide realistic

guidelines. Work expansion often evident in meeting, especially routine
meeting, which seem to drag on without end. The nurse leader may find it

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helpful to appoint a timekeeper to assist the group in keeping to the timed
agenda.

3-Excessive supervision: Providing too much supervision to a

competent professional can present interpersonal as well as time problems.
Micromanagers waste their own time and create time management problems
for the people they supervise. The nurse leader must be mindful of what
employee is to accomplish and how much supervision is necessary.

4-Underdelegation: The nurse leader who does not delegate

appropriately ends up with more work than necessary.

5-Technology invasion: Cell phones and personal computers can be

wonderful tools for efficiency, but they can also be distractions.

6-Losing sight of objectives: The nurse leader who loses sight of the
work that has to be accomplished will surely waste time. Periodically
reviewing which objectives are to be met and how they can best be met
offers a productive use of time.

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 8.Conflict management
Conflict is the dissension that occurs when two or more individuals
with different values, interest, goals, or needs view things from dissimilar
perspectives.

Conflict is a situation that exists when there are differences of

opinion or opposing points of view among persons, groups, or organizations.

Causes of conflict:
1. Dissimilar knowledge, skills, values, interests.
2. Rivalry for reward.
3. Unworkable organization structure.
4. Change when people are not prepared for change.
5. poor communication systems
6. Inadequately defined organizational structure.
7. Too many rules and regulations.
8. Unclear expectations.
9. Operational or staffing changes.

Types of conflict:

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 1. Intrapersonal conflict: Occurs within an individual in situations
in which we must choose between two alternatives.

2. Interpersonal conflict: Occurs between two or more individuals

Occurs when we realize that everybody does not see the world in
exactly the same way.

3. Organizational conflict: Occurs when there is discord, as when

there is dissonance between Policies, and procedures, some
organizational conflict is related to hierarchical structure and role
differentiation among employees.

*Inter organizational: Occurs between organizations

*Intra organizational: Occurs within an organization

4. Inter group: Occurs between two or more groups

5. Intra group: Occurs within a group.

Stages of conflict (conflict process):

1. Latent (antecedents) conditions: - Conditions such as short
staffing and rapid changes are examples of attendants' conditions in
latent conflict, the conditions are ripe for conflict, although no conflict
has actually occurred and may never occur.

2. Perceived conflict: - Also, called substantive conflict, this form is

intellectualized and often involves issues and roles. It is recognized
logically and impersonally by the individual as occurring. Sometimes
an individual can resolve conflict at this stage before it is internalized
or felt.

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 3. Felt conflict: - Felt conflict is emotionalized and these emotions
include hostility, fear, mistrust, and anger. This is also referred to as
affective conflict.

It is possible for an individual to perceive conflict and not feel

it, that is, there is no emotions attached to the conflict, and the
individual views it only as a problem to be solved. In addition,
possible is for someone to feel the conflict, but not perceive the
problem, that is, they are unable to identify the cause of the felt
conflict.

4. The manifest conflict: - Action is taken. The action may be to

withdraw, compete, debate, or seek conflict resolution.

5. Conflict resolution:-Implies a solution that satisfies all parties

involved in the conflict the optimal goal, then, in conflict resolution is
to create a win – win solution for everyone involved.

6. Conflict aftermath:-This aftermath may be significant than the

original conflict if the conflict has not been handled in a constructive
manner.

Conflict management approaches:

1. Competing/ Forcing. (Win – lose strategy).
A nurse manager as supervisor can exert position power at a
subordinate’s expense. This enforces the rule of discipline .assertive
position that fosters competition rather than commitment to conflict
resolution on the part of the subordinate.

2. Avoidance (Ignoring) or withdrawal (lose – lose strategy).

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 Avoidance is a strategy that allows conflicting parties to cool down
and to gather information. The nurse involved in a conflict can sidestep
the issue by saying, “let’s both take time to think about this and set a date
for a future talk”.

It can be used when the issue is not critical or when the potential
damage of immediate confrontation outweighs the benefits.

3. Collaborating /Assertive and cooperative (win – win strategy).

o This method encourages the individuals involved in the conflict to
work toward common goals

o It is considered a win – win situation and is usually the best one,

especially when this issue is one requiring consensus. This approach
has the drawback of being more time consuming, thus decisions may
be delayed

o It requires that all participants come to the discussion table willing to

examine issues thoughtfully and work in a task – oriented fashion to
solve the problem.

o It requires a commitment on the part of all persons to be supportive

and considerate of one another, to listen to one another, and try to
understand the other person’s point of view. It demands awareness
and sensitivity and open and honest discussion.

The process would, for example, breakdown if one of the individuals

was approaching the problem from a competitive stance.

4. Compromising (win /lose – win / lose strategy)

This method involves give and take. It minimizes the losses for all

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 parties while providing some gains for each.

It is considered a win – lose strategy for each individual, because

each gains something but at the same time gives up something. It is an
appropriate approach to conflict when the goals of both sides seem
incompatible, when the conflict has time constraints.

5-Accommodating (smoothing) /cooperating (lose –win strategy)

Is a strategy being employed when one individual gives in to the
wishes of another to preserve harmony or build up social credits? It is
often seen in situations in which one individual has more power than the
other. It is an appropriate approach if you are wrong and the other
individual is right, if the issue is unimportant to you, or if you can gain
more lately by giving in on this situation.

Role of nurse's manager in conflict resolution:

1- Is self- aware and consciously works to resolve intrapersonal conflict.

2- Addresses conflict as soon as it is perceived and before it becomes felt

or manifest.

3- Seeks a win- win solution to conflict whenever feasible.

4- Assist subordinates in identifying alternative conflict resolutions

5- Recognizes and accepts the individual differences of staff.

6- Open channels of communication.

7- Creates a work environment that minimizes the antecedent conditions

for conflict.

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 8- When appropriate, formally facilities conflict resolution involving
subordinates.

9- Pursues alternative dispute resolution when conflicts cannot be

resolved.

9. Negotiation
Definition of negotiation:
Negotiation: It is a process by which the involved parties or group
resolve matters of dispute by holding discussions and coming to an
agreement which can be mutually agreed by them.

Negotiation: is most creative form is similar to collaboration and its

most poorly managed form may resemble a competing approach and used as
a conflict resolution strategy.

:Before negotiation
1. Be prepared mentally by having done you’re your homework.
2. Determine your starting points.
3. Look for hidden agendas, both your own and the parties with whom
you are negotiating.

During negotiation:
1. Maintain composure.
2. Role model good communication skills (speaking and listening)
assertiveness and flexibility.

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 3. Avoid using destructive negotiation techniques, but are prepared to
counter them they are used against you.

After negotiation:
1. Restate what has been agreed upon, both verbally and in writing.
2. Recognize and thank all participants for their contribution to a
successful negotiation.

Objectives of negotiation:
1. To achieve a framework that facilitates the work.
2. To arrive at a mutually acceptable agreement.
3. To set a positive tone for the on-going institution/sponsor relationship.
4. To negotiate a contract that is consistent with the institution’s policies
and procedures.

Remember: a contract is “binding” agreement and your institution

has a legal obligation to perform.

Elements of successful negotiation:

1-Preparation
Preparation is the single most important element to a successful
outcome. Preparation includes identifying the intended goal as well as
setting limits to achieve that goal.

2-Effective communication skills

Effective communication plays a fundamental role in any interaction
and is essential to successful negotiations. Effective communication skills
include the ability to listen and understand the intended message of the

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sender, clearly expressing your own thoughts and ideas in a way that is
easily followed and understood by others, and finally, accurately interpreting
the messages expressed through body language.

3-Emotional control
Emotional control can play a pivotal role in successful negotiations.
The higher the perceived stakes in a negotiating process, the greater the
chance that emotions will play an important role in the final outcome.
Techniques to enhance emotional well-being become an important asset to
insure an optimal outcome.

4-Closing the deal

Final negotiations resulting in achieving the defined objective – or
‘closing the deal’ relies on the negotiator’s ability to recognize that all
elements of the goals have been achieved and all that remains is to finalize
the process to implement those goals.

10. Collaboration
Definition of collaboration:
Collaboration: Is a cooperative effort that focuses on a win-win strategy

Collaboration: Is effective method of transferring 'know how' among

individuals, therefore critical to creating and sustaining a competitive
advantage. (A key of knowledge management

Barriers to effective collaboration.

1. Staff not willing to interact or have any other barriers to interaction.

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 2. Lack of understanding about the roles and responsibilities of others.

3. Lack of respect for what others contribute interferes with effective

collaboration.

4. Some staff will (not play fairly).

5. Poor communication skills.

Skills to achieving effective collaboration:

1. Communication skills are critical
2. Staff also need to be aware of their own feelings (emotional
intelligence)
3. Staff needs to be able to make decision to solve problems effectively.
4. Effective coordination is important when collaborating with others.
5. Staff needs to develop negotiation skills to be used in resolving
difficult conflicts.
6. Assessment skills are also required, as information needs to be
collected and analyzed as relationships move toward greater
collaboration.

References
 Swans burg, R, c (1999), introductory management and leadership for
nurses (the directing leading process), chapter (17) 2nd edition.
 Bessie L, (2009), Leadership roles and management function in nursing,
chapter (21)6 the ed, unit VI, by Lippincott com

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 Marquis L & Huston J (2009), Leadership Roles and Management
Functions in Nursing, 6th edition chapter 21, unit VI, Pages 487, 488,
&489 by Lippincott Williams& Wilkins Inc.
 Tomey. A (2009), Guide to Nursing Management and Leadership 8th
edition chapter six Page147, 148,152and 153. By Mosby, Inc.
 http://www.kgsepg.com/project-id/10265-5directing
 http://www.answers.com/topic/time-management#ixzz1IMP5bW.
 http://www www.time-management-guide.com/time-management-
skills.html

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