Transcript
Preparing Nurses as Nurse Managers
By
Nhelia B. Perez RN MSN
In Ancient Japan, when a new student seeks
admission to study at a monastery, he is
required to have an audience with the
master, a sort of pre-entrance interview if you
will.
One day, an intelligent student, appeared before the master for such a session. As they sat
together, the young man started to impress the master with his knowledge and
accomplishments.
When the master offered tea to him, he continued to speak without acknowledging the master; so absorbed was he in his own
cleverness.
Blah blah blah blah blah blah
All of a sudden, he jumped up, reacting to the hot tea
flooding over the tabletop and dripping onto his legs.
“Master!” he shouted. “The cup is overflowing!”
The master continued pouring the tea, spilling it on the floor. Then he
replied, “So are you. Please come back when you are empty and in
need of my teaching.”
Think of your brain as the cup in the story. If you’ll fill it up with your ego, you’ll never get
more knowledge in.
Keep your mind humble and open to new ideas. You’ll learn much more in the process, and continue to develop as a human being.
As Ray Kroc, As Ray Kroc, founder of Mc founder of Mc Donald’s once Donald’s once
said, “When you said, “When you are green, you are green, you will grow; but will grow; but
when you ripen, when you ripen, you will rot and you will rot and
fall.” fall.”
• Taking place without a structured organization, like the nursing service;
• Directed towards the attainment of aims and objectives;
• Achieved through the efforts of other people, &
• Using system and procedures
…PROCESS
It is a series of systematic, sequential or instances of
overlapping steps directed toward the achievement of organizational goals and objectives; an effective
integration of the efforts of members of a purposeful group.
… PROFESSION
… SCIENCE
… AN ART
… A CLASS OF PEOPLE
Principles of Management
Division of Work
Authority
Discipline
Unity of Command
Principles of Management
Unity of Direction
Subordination of individual interests to the general
interestRemuneration
Centralization
Scalar chain
Principles of Management
Order Equity
Stability of Tenure
Initiative
Esprit de Corps
The ultimate test of management is:
THEORIES OF MANAGEMENT
SCIENTIFIC MANAGEMENT THEORY
Developed by Frederick Taylor
Viewed workers as inefficient
Management is characterized and guided by the application of scientific
approaches to solve managerial problems in business and industry.
PRINCIPLES OF SCIENTIFIC MANAGEMENT
• Developed a science for each component of work
• Scientifically select and train workers
• Actively cooperates with workers
• Divide work equally between workers and management
General Administrative Theory
• Developed by Henry Fayol
• Described management as universal set of activities
• Focuses on division of labor, clear hierarchy, rules and impersonal relations
Human Relations
• Idea surfaced in early 2oth century
• Focused on the notion that work is done by people
• Need to focus on human element
• Maslow and Motivation and Theory X and Y
Bureaucracy
Coined by Wax Weber
Highly structure form of administration and usually includes no participation by the governed.
Work within the principle of chain of command, unity of command, span
of control, and specialization.
Advantages of Bureaucratic Management• Competent and responsible employees are produced.• Employees perform by uniform rules and conventions• Employees are accountable to one manager who is an
authority.• They maintain social distance with supervisors and
clients.• Favoritism is reduced and impersonality is promoted.• Rewards and other incentives are provided to employees
based on technical qualifications, seniority and achievement.
Disadvantages of Bureaucratic Management
•Complaints about red tape are frequently heard and experienced.
•Procedural delays are observable
•General frustrations among employees and clients are inevitable.
Characteristics of Bureaucracy
•FORMALITY
•LOW AUTONOMY
•A CLIMATE OF RULES AND CONVENTIONALITY
•DIVISION OF LABOR
•SPECIALIZATION
•STANDARDIZED PROCEDURES
•WRITTEN SPECIFICATION
•MEMORANDA AND MINUTES
•CENTRALIZATIONS
•CONTROLS
•EMPHASIS ON HIGH LEVEL OF EFFICIENCY AND PRODUCTION.
HUMAN RELATIONS
Integration of people into a work situation in a way that motivates them to work productively.
Signifies the individual worker as the source of control.
Conceptualized by Levey and Loomba in 1984
THEORY OF MOTIVATION - Hygiene
Written by Herzberg
Aimed at giving a sound foundation to the more humanistic schools.
Motivational factors are necessary so that employees would perform adequately on the job.
Theory X and Theory Y
Coined by Mc Gregor
Theory X – the traditional view on direction and control
Theory Y – the integration of individual and operational goals.
Theory of X Manager assumes:
… the average person has an inherent dislike for work and will avoid it if possible
… must be coerced, controlled, directed, and threatened with punishment to get the work done
… prefers to be directed, wishes to avoid responsibility, has relatively little ambition and wants security above all.
Theory Y Manager assumes:
•The expenditure of physical and mental effort in work is as natural as play or rest.
•External control and the threat of punishment are not the only means for bringing about effort toward organizational objectives.
•Commitment to objectives is a function of the rewards associated with their achievement.
•The average human being learns under proper conditions, not only to accept but to seek responsibility.
•The capacity to exercise a relatively high degree of imagination, ingenuity and creativity in the solutions of organizational problems is widely, not narrowly distributed in the population.
•Under the conditions of modern industrial life, the intellectual potentialities of the average human being are only partially utilized.
THEORY M FOR MANAGEMENT
• Allen (1973) believe that most managers avoid extremes in their belief in people.
• People are motivated to work by highly complex factors that may be biological, psychological, social, or economic; to name only a few possibilities.
• Some people dislike responsibility and prefer to be led; others are ambitious and want to be leaders; the majority fall somewhere in between.
Theory Z
• Participative Management Model• Spearheaded by Ouichi in 1978• Characteristics
* long-term (lifetime) employment* slowed down rates of evaluation and promotion.* more implicit and less formalized control systems;* personal concern for the employee* cross functional rotation;* some degree of participative consensual decision making, and* emphasis on individual responsibility.
TQM (Total Quality Management)
• Introduced by Deming
• Key to quality is reducing variations.
• Everyone gets involve with quality
• Get it right first time
• Consumer is the most important part of the production line.
ROLE OF MANAGERS
• Interpersonal
• Informational
• Decisional
You are the nurse-manager in the Medical Unit. A 16 year old patient diagnosed with IDDM was admitted due to
uncontrolled increase in blood sugar. The staff found him to be a cooperative patient. However, being a member of a
large clan, members of his family often come and visit him and bringing him foods he should not eat.
The nursing staff came to you on two occasions complaining of the family’s non-compliance to hospital visits and
unauthorized food.
Yesterday, the family members came to you and complained about hospital visitor policies and what they took to be
rudeness of two different staff members. You spent time talking and explaining to them and when they left, they
seem to be agreeable and understanding.
Last night, a staff nurse informed the family that only two (2) family members can stay and if they won’t follows the
orders, the nurse will call for hospital security.
This morning, the patient’s parents have suggested that they will take him home if this is not resolves. The patient’s
blood sugar is still uncontrolled.
Develop a plan of action to solve this problem. First, select three
desired objectives for solving the problem then proceed to
determine what would you do that would enable you to meet your
objectives.
Manpower
Machine
Materials
Money
Moment
Feedback
Survey
Interview
Reading
Research
Education
The Process of Management using a system approach
INPUT MANAGEMENT PROCESS OUTPUT
Efficiency
Client Satisfaction
Business
Owner Satisfaction
PLANNING ORGANIZING DIRECTING CONTROLLING
1. Planning
2. Organizing
3. Directing
4. Coordination
5. Control
The Managerial Activity is divided into five (5) Elements
of Management
• Sincerity
• Simplicity
• Prudence
• Justice
• Understanding & Open-mindedness • Serenity • Staidness • Cheerfulness • Caring
* Do things right * Are interested in efficiency * Administer * Maintain * Focus on systems and structure
* Do the right thing * Are interested in effectiveness * Innovate * Develop * Focus on people
* Rely on control
* Organize and staff
* Emphasize tactics,
structure and systems
* Have a short term view
* Ask how and when
* Accept the status quo
* Rely on trust
* Align people with a direction *
* Emphasize philosophy, core
values,
and shared goals
* Have a long term view
* Ask what and why
* Challenge the status quo
* Focus on the present
* Have their eyes on the bottom line * Develop detailed steps and timetable* Seek predictability and order * Avoid risks
* Focus on the future * Have their eyes on the horizon line * Develops vision and and strategies * Seek change * Take risks
* Motivate people to comply
with standards
* Use position-to-position
(superior-to- subordinate)
influence
* Require others to
comply
* Operate within organizational
rules, regulations, policies
and procedures
* Are given a position
* Inspire people to change
* Use person-to-person
influence
* Inspire others to follow
* Operate outside of
organizational rules,
regulations, policies and
procedures
* Take initiative to lead
Proportion of Management Effort Devoted to the five (5) functions of management
TOP
MIDDLE
FIRST-LINE
P O D S C
P O D S C
P 0 D S C
MANAGEMENT
LEVELS
Continuum of Managers Decision Making Authority
Use of Authority
By the Manager Area of Freedom
For Subordinates
Managers make
decisions and
announces it
Managers sells
decision
Managers present
ideas and invite
question
Managers present tentative decisions subject to questions
Managers present
problems, gets
suggestions and get
decisions
Managers define limits; ask group to make decisions
Manager permits
subordinates to function
within limits defined by superior
1 2 3 4 5 6 7
Autocratic Consultative Participative Democratic Laissez-faire
CHANGE FOR
INDIVIDUAL ORGANIZATION
PRODUCTIVITY
SOCIAL TRANSFORMATION
SELF
Values
Personalizing
Humanizing
Concepts
TheoriesSkills
Techniques
Person
Orientedness
Awareness of Purpose
SILR
COMMUNIC
ATION
COMMUNICATION
STRATEGIES
Benefits
Concern for soft stuff
Positive Outlook
Innovation as an
Interest
Management by wandering
around
Reflecting & Mirroring
Participative Management
Advocating Values
Visibility of Top Mgt
Counselling
Quality Circle
Closing Isolation
gaps
Team buildin
g
Synergistic Management
Being ethically
moral
Pssst…
Do you want to hear a
story?
The Japanese have always loved fresh fish. But the waters close to Japan have not held fish for
decades. So to feed the population, fishing boats got bigger and went farther than ever.
The farther the fisherman went, the longer it took to bring in the fish. If the return trip took more than a few days, the fish were not fresh. The Japanese
did not like the taste.
To solve this problem, fishing companies installed freezers on their boats. They would catch fish & freeze
them at sea. Freezers allowed the boats to go farther & stay longer.
However, the Japanese could taste the difference between fresh & frozen fish &
they did not like frozen fish. So prices were low for these fishes. This is not fresh
fish!
So fishing companies installed fish tanks. They would catch the fish & stuff them in the tanks, fin to fin. After a little thrashing around, the fish stopped moving. They
were tired & dull, but still alive. Unfortunately, the Japanese could still
taste the difference.
Because the fish did not move for days, they lost their fresh-fish taste. The Japanese preferred the lively
taste of fresh fish, not sluggish fish. that does not taste like fresh fish
So factories solve this problem…
To keep the fish tasting fresh, Japanese fishing companies still put
the fishes in tanks, but now they add a shark to each tank. The shark eats a
few fishes, but most of the fishes arrive in a very lively state. The fishes
are C H ALLE N G E D .
Instead of avoiding challenges, jump into them.
Beat the heck out of them. Enjoy the game. If your challenges are too large or too numerous-
DON’T GIVE UP!
Failing makes you tired. Instead, reorganize. Find more determination, more knowledge, more help. If you
have met your goals, set bigger goals.
Don’t create success and lie in it. You have resources, skills & abilities to make a
difference.
The benefits of a CHALLENGE- the more intelligent, persistent & competent you are, the more you enjoy a good problem. If your challenges are the correct sizes, and if you
are steadily conquering those challenges, you are happy. You think of your challenges & get
energized. You are excited to try new solutions. You have fun. . . You are ALIVE!
As soon as you reach your goals, such as finding a wonderful mate, starting a successful company, paying off a debt or whatever, you might lose your passion. You don’t need to work so hard so you
relax. You experience the same problem as lottery winners who waste their money, wealthy heirs
who never grow up & bore homemakers who get addicted to prescription drugs.
It was observed by L. Ron Hubbard in the early 1950s, “Man thrives, oddly enough, only in the presence of a
challenging environment.”
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