NURSING LEADERSHIP AND MANAGEMENT

DIRECTING: 3RD STEP IN THE

NURSING MANAGEMENT
FUNCTION/PROCESS
MODULE 9
Peter Arnold T. Tubayan, RN, MAN
Instructor
OVERVIEW/INTRODUCTION:
■ After planning and organizing, the next crucial task the manager must now face
is directing. It is through directing that the manager encourages her personnel
to accomplish their assigned tasks towards achieving the objectives that were
laid down for the organization while planning and organizing the operations.

■ Directing goes beyond giving orders and instructions, it is the final major step
taken by the nurse manager to ensure that the organization’s goals are
accomplished. To do this, the manager must ensure that the work is assigned
properly and the right person is assigned for each task to accomplish the goals
of the organization. To be able to perform well, the employee must, in addition to
the skills required, have a genuine interest in the task that needs to be
accomplished, especially if the task is a difficult one that require sustained
effort over a period of time.
OVERVIEW/INTRODUCTION:

■ Furthermore, it is important that the employees chosen by the manager are able
to get along harmoniously because directing employees invariably depend on
the relationships existing among them. This is of particular importance in a
nursing care environment where continued interaction among the various
employees in the system is inevitable and in fact necessary for the organization
to function properly.
LEARNING OUTCOMES:
At the end of the module, students should be able to:
1. Explain the meaning of directing in relation to nursing leadership and
management.
2. Analyze the characteristics of good directing, elements of directing and the role
of the nurse in the implementation process.
3. Discuss the tools of directing, reasons of conflicts, its types and resolutions.
4. Explain the value of critical thinking skills and the different levels of
communication.
5. Apply the concepts and principles of directing in a given situation in nursing
practice.
DIRECTING
DIRECTING
■ It is the act of issuing of orders, assignments, instructions to accomplish the
organization’s goals and objectives.
■ It involves the process of getting the organization’s work done. It entails
explaining what is to be done, to whom and by whom, at what time, how and
why it is to be done.
■ All directions must be consistent with the departmental policies to help the
personnel perform their duties safely and efficiently.
■ ARA and leadership styles are ultimately related to the manager’s ability to
direct.
Characteristics of Good Directions:
1. It must be clear, concise, consistent and complete.
2. Apart from being understandable, the person giving directions must explain the rationale well
and make certain that it is understood.
3. The words used in giving directions indicate their importance.
– “must”, “shall” and “will” – indicate that the directions are mandatory
– “may” – denotes that the action is recommended
– “should” – places directive between mandatory and recommended action
4. The person giving directions must speak distinctly and slowly. Directions must come across as
requests not commands using a specific tone and set of words. Manager should give directions
in logical manner and prioritize the tasks directed to be done by importance and time.
5. It is important to:
– Avoid giving too many directions at one time
– Personalize directions
– Always check to make sure directions have been followed
– Provide feedback for actions done
TOOLS IN DIRECTING
1. Nursing Care Plan
■ Outlines the nursing care to be provided to a patient.
■ It is a set of actions the nurse will implement to resolve patient problems identified by assessment.
■ It guides in the ongoing provision of nursing care and assists in the evaluation of the care.
Characteristics of the Nursing Care Plan:
■ It is primarily concerned with patient needs and problems.
■ It focuses on nursing actions which are designed to solve or minimize the patients’ existing problem
and prevent potential risks.
■ It is a product of a deliberate systematic process based on scientific principles and standards of
nursing practice.
■ It relates to the future actions and interactions.
■ It is based upon identifiable health and nursing problems.
■ Its focus is holistic. Considering all aspects of care, be it physical, emotional, psychological,
sociological or spiritual among others.
■ It aims to meet all the needs of the patients or service user in terms of promotive, curative,
rehabilitative and restorative process of care.
1. Nursing Care Plan
Elements of the Nursing Care Plan:
■ NANDA nursing diagnosis with related factors
■ Subjective and objective data that support the diagnosis
■ Specified outcome goals and objectives to be achieved including deadlines
■ Nursing intervention
Tools in Directing

2. Policies
3. Standards
4. Standard operating procedures
5. Rules and regulations
ELEMENTS OF
DIRECTING
1. Delegation
■ It is the act of assigning to someone else a portion of the work to be done with
corresponding ARA.
■ An assignment is a task done without authority, while delegation is a task done
with ARA.
■ It is a skill to be learned and mastered, beginning with learning what cannot be
delegated and what will be delegated and to whom should it be delegated.
■ The person delegated to do the tasks remains accountable. It encourages
subordinates to make decisions and create changes as deemed necessary.
1. Delegation
■ What cannot be delegated?
– Overall ARA
– Final evaluation of staff performance
– Correcting and disciplining the staff
– Activities which the nurse to whom the task is delegated and does not know
how or does not want to do
– Licensed personnel responsibilities to non-licensed staff
– Delegated task must be based on policies, job description, scope and
capabilities of workers.
1. Delegation
■ Why is there a need to delegate?
– Save money and time
– Helps building skills of subordinates
– Motivate people to perform higher level tasks
– Train people to prepare for greater responsibilities
– Allow next in line staff to do the job in the absence of the manager
– Groom successors since nobody is indispensable.
1. Delegation
Why managers do not want to delegate?
■ Mistakes in delegation can be costly.
■ Failure to delegate wisely increases management costs and contributes to personnel
dissatisfaction.
■ Failure of the employee to do the right thing may cause emotional and psychological
burden on the staff thereby creating fear in accepting delegated tasks.
■ Fear of losing control of the staff.
■ Fear of failing to get others to do the work.
■ Fear of criticism.
– The manager who enjoys the personal satisfaction gained from doing the work
herself will likewise not be inclined to delegate the work.
– This refers to micromanagement where the manager provides too much inputs
and performs the tasks personally.
1. Delegation
Common Delegating Errors:
1. Underdelegating
– The manager’s assumption that delegation may be interpreted as the lack of
ability on his part to do the job  the manager do the job by himself
– Manager has trust issues and thus lacks trust in his subordinates. He is insecure
and fears that subordinates will resent the work delegated to them.
– The manager lacks experience in the job, thus, there is the excessive need to
control and be perfect.
2. Overdelegating
– Unnecessarily burdens the subordinates with tasks that are either
inconsequential or irrelevant to the delivery of the goal.
– The culprit is poor management of time and insecurity in the part of the nurse
manager in the ability to perform tasks.
1. Delegation
Common Delegating Errors:
3. Improper Delegating
– Manager should be able to determine the talents and capabilities of his
subordinates.
– Delegation of tasks and responsibilities beyond which the person cannot
perform properly is improper delegation.
4. Reverse Delegation
– Delegating tasks from lower to higher position which reflects weak
management skills and ARA.
2. Supervision

■ It is the process of guiding and directing the work to be done.

■ It entails motivating and encouraging the staff to participate in activities to
meet goals and objectives and personal development and in helping the staff to
do the work better.
2. Supervision
Principles of Good Supervision:
■ To most workers, the supervisor is presumed as “the management” because of
his constant presence and close association to them.
■ The supervisor is in a position to exert strong influence in motivating individuals
under his supervisory jurisdiction.
■ The supervisor can incite to employees ideas and emotions which may affect
their morale and operational efficiency.
■ A supervisor:
– Can produce attitudes which are both positive and negative in character
– Produces positive attitudes when employee is conscious of the benefits of
it and attributes to the influence of the supervisor.
– Produces negative attitude when the reaction of workers is resistance to
discipline and change or actual fear of demotion or discharge.
2. Supervision
Principles of Good Supervision:
Principles of good supervision for supervisors and managers to remember?
■ Focused on the improvement of work rather than upgrading the worker
■ Based on line of authority, organizational philosophy, vision and mission, job
description, policies and standards, the needs of the individuals
■ Focuses on development of the three areas of skill:
1. Conceptual – enhance knowledge through adequate information and
feedback
2. Technical – refinement of skills through in-service trainings and seminars
3. Interpersonal – develop communication skills through constant dialogues
and conferences
2. Supervision
Principles of Good Supervision:
■ Cooperatively planned by both management and staff and accepts both
challenge and change
■ Uses democratic process to facilitate:
– Effective communication
– Continuous improvement of staff
– Respect for the individuality of each staff member
– Bring about harmonious relationship and a conducive social, psychological
and physical atmosphere
■ Ultimate goal of good supervision is to provide safe, effective quality care.
2. Supervision
Responsibilities of Supervisors:
■ Duty to teach and motivate the staff
■ Facilitate the staff work performance
■ Delegate work responsibilities and be available for consultation
■ Perform assessment and evaluation of work performance
■ Monitor staff environmental conditions
■ Supervise performance of staff
3. Staff Development

■ It is a planned experience to help employees perform effectively and efficiently,

and to enrich their competence in practice, education, administration and
research.
■ It is retraining the employees for improvement and advancement of
performance in the areas of knowledge, skills and attitude (KSA).
3. Staff Development
Functions of Staff Development:
■ Maintain staff efficiency and effectiveness – staff work performance is based on
goals and objectives.
■ Create quality employees – serve the needs of the clients and the organization;
assume greater responsibility; help motivate others to perform better; and can
cope up with crisis and change.
■ Meet the staff’s needs and address their problems – such as deficiencies in KSA.
■ Motivate and improve their self-confidence, knowledge and skills  strengthen
staff capabilities, performance, boost confidence and productivity
■ Help prepare staff for greater responsibilities – the staff must participate in
planning, orientation, continuing education, in-service, patient education, advisory
and research.
3. Staff Development
In-service Training and Continuing Education
■ In-service training – is education for employees to help them develop their skills
in a specific discipline or occupation
■ Continuing education – is a specific learning activity or program characterized
by issuance of certificate or continuing education units (CEU).
■ The Board of Nursing encourages continuing education requirements on
members who hold licenses to practice to expand knowledge base and stay up-
to-date on new trends and development.
 IN-SERVICE TRAINING CONTINUING EDUCATION
Scope Training Professional and personal growth and
Skills enhancement development that relates to
professional and organizational
development
Purpose To orient towards improving performance of staff Strengthen knowledge, skills and
and conforming to organizational needs attitude personally and professionally
To meet high performance level needs
of staff
Objectives Improved patient care through upgrading of Promote development of KSA for
services rendered enhancement of nursing practice
Nature Less formal Formal seminar-workshop
Learning Planned and incidental Planned, structured learning
Experience
Duration Shorter Longer
Setting Within the agency Within/outside the agency
Cost Shouldered by the agency Paid by the individual nurse
Responsibility Agency Individual nurse
Examples Learning experience to introduce staff to new College or university coursework, short
cardiac monitor, demonstration of new equipment, courses, conferences, workshops, post-
procedure reviews, teaching strategies, teaching graduate course
assessment and demonstration
4. Coordination

■ Activity that links the different components of an organization and leads toward
goal achievement.
■ It creates harmony on all activities to facilitate success of work. In a well-
coordinated organization, everything has been delegated to guard against
leaving loose ends.
5. Collaboration

■ The manager and the health care staff together with the other members of the
health care team all participate in the decision making process.
■ Join forces with other as the medical group or larger group, another health care
team or one fulfilling a different role for a purpose.
6. Communication
■ Ensures common understanding via various routes. It is a process by which a
message is sent, received and understood as intended.
■ The goal of proper communication is to narrow the gap between the intended
and the received message.
■ Nurses have to frequently communicate directions and these directions have to
be reasonable and understandable so that subordinates are likely to comply.
■ Communications are more than trying to make people understand, it aims to
changing people’s behavior.
6. Communication
■ Good communication involves: verbal and non-verbal cues.
■ Nurse manager must know:
– The question to ask
– How to formulate directions and any information to give her subordinates
– Learn to listen
– Evaluate understanding of subordinates
■ Ways of Communication:
– Informal talks/ informal staff meeting
– Planned appointments/ planned conferences
– Telephone calls, bulletin board notices, emails
– Memorandum, mass meetings, general assembly
– Letters, reports, posters, visual aids, online chats, social medias
6. Communication
Barriers to Effective Communication:
■ Physical Barriers – environmental factors that prevent or reduce opportunities
for communication. Ex. Distance, noise
■ Psychosocial Barriers – blocks or inhibitors to communication that rise from the
judgements, emotions and social values of people. Ex. Stress, trust, fear,
defensiveness
■ Semantics – words, figures, symbols, penmanship, interpretation of messages
through signs and symbols.
■ Interpretation – defects in communication skills of verbalizing, listening, writing,
reading and understanding.
 6. Communication
Different Kinds of Directional Flow of
Communication among Members of the
Organization:
■ Upward Communication – proceeds from
the subordinates to the superiors
■ Horizontal Communication – takes place
among peers/ members of the team
■ Outward Communication – proceeds from
the team to the patient’s family,
community workers, outside stakeholders
■ Downward Vertical Communication –
proceeds from an authority or manager to
his subordinates
■ Diagonal Communication – flows
throughout different hierarchical levels.
6. Communication
Management Levels in Nursing Service:
1. Top Level – director and administrator of nursing services
2. Middle Level –nurse supervisors and area managers
3. First Line Managers – head nurses, unit managers, senior staff nurses
4. Operating Level – staff nurses, nursing aides/ attendants
7. Evaluation

■ A desired result of any employee behavior is effective job performance.

■ An important role of the manager is to determine performance in advance and
state desired outcome of what has been done.
■ The purpose of evaluation is to determine how far or how many of the
organization’s objectives were accomplished.
7. Evaluation
Purposes of Evaluation:
■ Provide constructive feedback
■ Determine progress and worthiness of individual nurse for greater
responsibilities
■ Serve as basis for promotion and increase in salary or other similar awards.
■ Recognize and further develop strengths
■ Minimize weaknesses of the staff
■ Provide security for patients, personnel, agency and the community
■ Develop a fair employment practice and performance appraisal process that is
in accordance with the law.
7. Evaluation
Different Types of Evaluation:
■ Outcome or Product Evaluation –which takes note of the response of patients
after care or service is done.
■ Process Evaluation – nursing actions are examined, to determine if client goals
have been met or not met.
■ Structure Evaluation – to obtain feedback on the systems in terms of financial
and material resources, nursing personnel, policies and procedures.
 7. Evaluation
Legally Sound Performance Evaluation
■ It has often happened that employees have sued their organizations over employment decisions based on
questionable performance appraisal results.
■ Several Steps to assure that an appraisal system is non-discrimantory:
a) It should be in writing and carried out at least once a year.
b) The information should be shared with the employee.
c) The employee should have the opportunity to respond in writing to the appraisal, and in this
connection a mechanism to appeal or question the results of the appraisal.
d) The manager should have adequate opportunity to either directly observe the employee’s job
performance during the evaluation period, or in the event of inadequate contact, be able to gather
information from other sources.
e) Anecdotal notes on the performance should be kept throughout the evaluation period. These notes
should shared with the employee during the course of the appraisal period.
f) The evaluator should be trained to carry out the appraisal process:
■ What constitutes reasonable job performance
■ How complete the form
■ How to carry out the feedback interview
CONFLICT
Conflict
■ It is a natural, inevitable condition in organizations and is often a prerequisite to
change in people and organizations.
■ It is a consequence of real or perceived differences in goals, values, ideas,
attitudes, beliefs, feelings and actions.
■ These can occur on several levels:
1. Intrapersonal or within one individual
2. Interpersonal or within two or more individuals
3. Intragroup or within one group
4. Intergroup or between two or more groups
– These different types of conflict may cause organizational dysfunction.
Conflict

Positive and Negative Results of Conflict:

■ Provide greater sensitivity to an issue which stimulates the interest and curiosity
of others.
■ Increase creativity by acting as a stimulus for developing new ideas or
identifying methods for solving problems.
■ Help people recognize the legitimate differences within an organization.
■ Powerful motivator to improve performance and effectiveness
■ Make parties aware of costs versus benefits of a particular service or technique.
Conflict
Two Main Types of Conflict:
. 1. Competitive Conflict
• Occurs when two or more groups attempt the same goal and only one group
can attain it
• It is defined by a victory for one side and a loss for the other. The process by
which such conflict is resolved is determined by a set of rules.
2. Disruptive Conflict
• Takes place in an environment filled with fear, anger and stress.
• There is no mutually acceptable set of rules and the goal of each party is the
elimination of its opponent.
Conflict
Conflict Resolution
■ Dominance and Suppression – the use of win-lose strategy is a method that
represses rather than settles conflict, creating a win-lose situation in which the loser
is left feeling angry antagonistic.
■ Restriction – is an autocratic, coercive style that often leads to an indirect and
destructive expression of conflict.
■ Smoothing Behavior – is a more diplomatic way of suppressing conflict wherein one
persuades the opponent to give in to the other side.
■ Avoidance Behavior – creates a situation in which there seems to be differences
existing between one another. An individual withdraws or walk away from the source
of conflict.
■ Majority Rule – resolves conflict by majority vote.
■ Compromise or Consensus Strategy – is a method where each side agrees upon
solutions that meet everyone’s needs.
Conflict
Conflict Resolution
■ Integrative Problem-solving – is a constructive process in which the parties
involved recognize that conflict exists and openly try to solve the problem.
■ Win-win Strategy – focuses on goals and attempts to meet the needs of both
parties.
■ Lose-lose Strategy – is one in which neither side wins, the settlement reached is
unsatisfactory to both sides.
■ Confrontation – is regarded as the most effective means of resolving conflict in
which it is brought out in the open and attempts are made to resolve it through
knowledge and reasons.
■ Negotiation – is a technique where conflicting parties give and take on various
issues and arrange solutions that may offer best for both parties.
Conflict
Ten Commandments for Negotiators:
1. Clarify the common purpose
2. Keep the discussion relevant
3. Get agreement on terminology
4. Avoid abstract principles, concentrate on facts
5. Look for potential trade-offs
6. Listen
7. Avoid debating tactics, use persuasive tactics
8. Keep in mind the personal element
9. Use logic judiciously
10. Look for solutions that satisfy the other person’s real interests
 CRITICAL THINKING
PROCESSES IN
PROBLEM SOLVING AND
DECISION MAKING
Critical Thinking
■ Nurses constantly face numerous alternatives to solve
problems and make decisions. These are part of the
usual nursing care activities and are not easy tasks.
■ Developing critical thinking, problem solving, and
decision making skills enables nurses to see all sides of
an issue, look for creative alternatives and approaches
to problems and make well-thought decisions. The
effect is a stronger organization and more competent
leader and manager.
■ Critical Thinking – is a cognitive process of examining
underlying assumptions, interpreting and evaluating
arguments, exploring and analysing alternatives thereby
developing a reflective criticism for the purpose of
reaching a justifiable reasoned conclusion and correct
judgement.
Critical Thinking
Critical Thinking Competencies:
1. General Critical Thinking Competencies – includes scientific method, problem-
solving and decision making processes.
2. Specific Critical Thinking Competencies in Clinical Situations – includes clinical
situations such as diagnostic reasoning, clinical inference and clinical decision
making.
3. Specific Critical Thinking Competencies in Nursing – are used in making
nursing decisions. This includes use of the nursing process in starting nursing
diagnosis and formulating treatment plan.
Critical Thinking
■ It is higher-level cognitive process that includes creativity, problem-solving and
decision making.
Critical Thinking
■ Five Suggested Questions when Examining Problem or Making a Decision:
1. What do you know about the current issues?
2. How are evidences interpreted?
3. How are the arguments to be evaluated?
4. What are possible alternatives? And why?
5. What is the best alternative?
■ Learning to be a critical thinker requires commitment but the skills can be
learned over time.
Critical Thinking
■ Characteristics of an Expert Critical Thinker:
– Outcome-directed or goal-oriented
– Open to new ideas or out-of-the-box thinker
– Flexible and adaptable
– Willing to change and accepts challenges
– Innovative in ideas which result in new direction
– Creative and conduct researches for new interventions
– Analytical and reflective thinker
– Communicator and expressive of ideas and concerns
– Assertive, can influence people of thoughts and ideas
– Persistent with barriers and persevering
– Caring, warm and friendly
– Energetic and has the capacity to act consistent with norms
– Risk-taker, trying all possible outcomes
– Knowledgeable, rational and reasonable
– Intuitive or have clinical insights
■ All can be honed and developed over time. These can be cultivated as long as one believes it is
possible (commitment).
DECISION MAKING
Decision Making
■ Nurses make decisions of varying importance every day, so the idea that
decision making can be rather sophisticated art. Studies have shown that most
people are much poorer at decision making than they think. An understanding
of what decision making involves together with a few effective techniques will
help produce a better decision at work.
■ Decision Making – is the process of identifying and choosing a particular course
of action from among several possible choices. It is influenced by the values
and preferences of the decision maker.
■ The decision is based on information gathered by the decision-maker.
Decision Making
Decision-making is an end-point of critical thinking which leads to problem solution using
the following steps:
1. Define the problem
2. Assess all options
3. Weigh all options against a set of criteria or standards
4. Test possible options
5. Consider consequences of the decision
6. Make a final decision
■ When making a clinical decision, the nursing process is used for the nurse to determine
actions that will help move the client toward achievement of the expected outcome.
■ Nurse Managers exercise clinical judgement viewed within the context of the
management process involving client care, manpower resources, and hospital
resources.
Decision Making
Kinds of Decisions:
■ Whether Decisions – these are decisions in which the answer is the decision “whether” to take
an action or not. The answer is either a Yes or a No. selection is made after weighing the pros
and cons. Ex. Should I look for another job? Whether I should go to college or not.
■ Which Decisions – is the process of choosing from among several alternatives and options
which are measured based on pre-defined criteria. There are number of tools and processes
available to help in evaluating the options in “which” type decisions. Criteria Table and
Weighted Criteria Table are useful tools. Ex. Which of the three job offers should I accept?
Which career should I choose?
■ Contingent Decisions – are decisions that have been made but put on hold until some
conditions are met or pending the occurrence of certain events like time, energy, price,
availability, opportunity and encouragement. The decision can be more powerful because it is
“pre-decided” what he will do in the event those events occur. There is sufficient time to
carefully consider the decision and eliminate risk of poor decisions. Ex. Military – how to
respond in the event of enemy attack; medicine – how the medical staff should respond in
case of code blue; buy the car if I can get the right price; write an article if it will fit to my
schedule
Decision Making Models
Decision making is the hardest task a manager has to face. Depending on the situation,
the manager will come to the following models:
1. Win-win – it is characterized by mutual willingness in the group to come up with
solutions that are acceptable to all. It is based in part on everyone’s preferred
solution to combine the self-interest and purposes of the people in the group, and to
negotiate solutions that are acceptable to all. Ex. Manager decides to accept student
nurses in the unit. The workload of the RNs will be lighter, student nurses will
improve and advance their learning.
2. Win-lose – some interests or groups are advanced at the expense of others. Ex.
Three new infusion pumps procured that is intended for the two units. Manager
decides to given one to the other unit and two for the other unit since the other has
more patients than the other. Manager decides to stop students’ RLE to hospital due
to pandemic. Win – prevention of virus contamination; lose – students’ RLE altered.
Decision Making Models
Decision making is the hardest task a manager has to face. Depending on the situation,
the manager will come to the following models:
3. Disagreement and Collaboration – decisions resulting in the following elements are
made when conflicts and disagreements are openly explored using collaboration and
cooperation:
– High quality decisions
– Creative decisions
– Decisions that are understood
– Decisions that are accepted and owned
4. Solution-shaping – is focused on how to modify or amend an unpopular proposed
solution rather than attempt to pressure people into changing their minds about the
solution.
Tools in Decision Making
1. Probability Theory
– Devised to address the presence of risk or uncertainty in a decision-making
situation by looking for predictable patterns based on historical data,
thereby reducing the uncertainty.
– When there is limited historical precedent, it becomes hard to apply the
theory and the risks remain unchecked.
Tools in Decision Making
2. Decision Trees
■ Is more graphic in nature, enables the
planner to visualize alternative courses of
action taking into account all factors
involved like risks, information needs and
outcomes for a problem over time.
■ The graphic is essentially a tree-shaped
diagram:
1. Primary decision
2. Numbers of alternatives
3. Possible alternative outcome
■ It gives the manager a forecast of the
possible result of his choices and enables
to make a cost-benefit analysis of each
alternative,
■ It is a technique for determining overall
risk associated with series of related risks.
Tools in Decision Making
3. Queuing Theory
■ Problems are addressed one after another and after having determined the
“best balance” of factors related to service. It is mathematical study of waiting
lines.
■ It is a powerful tool that helps hospitals and clinics to uncork chronic battleneck
in the flow of patients in the ER, OPD, etc.
■ Three Queuing Disciplines:
1. First In First Out (FIFO) – patients are served according to their order of
arrival.
2. Last In First Out (LIFO) – the last patient to arrive on the queue is the one
who is actually serviced first.
3. Processor Sharing (PS) – patients are serviced equally. Ex. Clients
experienced same amount of delay.
Tools in Decision Making
4. Linear Programming
■ Uses matrix algebra or linear mathematical equations to determine the best
way to use limited resources to achieve maximum results.
TEAM BUILDING
Team Building

■ Team – is a group of people brought together for the purpose of sharing and
applying their individual skills toward the achievement of goals.
■ Team Building – is where the members of this team works together toward
achieving goals faster and more productively. It focuses on both the task and
relationship aspect of group performance to maximize efficiency and
productivity.
Team Building
Characteristics of an Effective Team:
■ Has defined goals, as basis to work with
■ Work cooperatively and collaboratively with other team members towards
achieving the goals
■ Has agreed goals that reflect members’ needs and values
■ Has good definition of its members’ roles
■ Team should be adaptable
■ Role flexibility and willingness of the other members to help share
Team Building
Task Roles of the Group Members:
1. Initiator-contributor – one who redefines problems and offers solutions, clarifies
objectives, suggests agenda items and maintains time limits.
2. Information Seeker – one who collects the data for the group
3. Information Giver – provides information given by sharing experiences and
making inferences.
4. Opinion Seeker – clarify issues, viewpoints that defines or reflect the values of
other members’ suggestions.
5. Opinion Giver – conveys to group members what their pertinent values should
be.
6. Elaborator – predicts outcomes and provides illustrations or expands
suggestions, clarifying how they could work.
7. Coordinator – links ideas or suggestions offered by others
8. Orienter – summarizes the group’s discussions and actions.
Team Building
Task Roles of the Group Members:
9. Evaluator Critic – appraises the quantity and quality of the group’s accomplishments
against set standards.
10. Energizer – motivates group to accomplish, qualitatively and quantitatively, the group’s
goals.
11. Procedural Technician – supports group activity by arranging the environment and
providing necessary tools.
12. Recorder – documents the group’s actions and achievements.
■ Group tend to become more cohesive when the team members:
– Are motivated by the same goals and tasks
– Must interact to achieve their goals and tasks
– Work in proximity to each other (same unit/ same shift)
– Have specific needs that can be satisfied by involvement in the group
ASSESSMENT/S
TASKS/ ACTIVITIES/ EXERCISES
Task for You!
Essay. Read and analyze each situation given below and answer the questions after each item.
Recall during your Related Learning Experience in the hospital with the nursing leaders or managers
or interview a nursing leader or manager.
1. What are the characteristics of good directions?
– Describe how a nurse manager carried out her task in directing.
– Record all activities of nurse manager dealing with all the elements of directing.
2. What are the different levels of communication?
– Present the flow of communication in the nursing service.
– Trace the area of authority, responsibility and accountability.
3. Name some forms of communication employed by management. Which is most effective? Do a
research on non-verbal communication, discuss your findings.
4. What should a manager do to ensure that his message is understood and reach his subordinates?
Explain.
5. The grapevine is the mode of communication in the informal organization. How useful it is to
managers?
GRADED QUIZ

■ Via Canvas LMS

RESOURCES:

Clark, C. (2009). Creative nursing leadership and management.

Sudbury. Massachusetts: Jones and Bartlett Publishers.
Finkelman, a. (2012). Leadership and Management for Nurses: Core
Competencies for Quality Care. 2nd ed. Boston: Pearson, Prentice
Hall, Inc.
Grohar-Murray, M. (2011). Leadership and Management in Nursing.
4th ed. Boston, Massachusetts: Pearson Inc.
Hogan, M. A. and Nikitas, D. (2009). Nursing Leadership and
Management. New Jersey: Pearson Prentice Hall.