Directing

Directing

Definition

• What is said about directing:– The heart of the management process– The most humane function of management

• The process in which the managers instruct, guide, and oversee the performance of the workers to achieve predetermined goals.

• The issuance of orders, assignments, and instructions that enable the nursing personnel to understand what are expected of them.

Directing

• Also referred to as coordinating or activating• The “doing” phase of management requiring

leadership and management skills necessary to accomplish the goals of the organization

Major Elements of Directing

• Delegating• Motivating• Leading/Supervising• Communicating

Delegation

Definition

• Delegating is the process by which a manager assigns specific tasks/duties to workers with commensurate authority to perform the job. The worker in return assumes responsibility for its satisfactory performance and is held accountable for its results.

Reasons for Delegating

• Assigning routine tasks.• Assigning tasks for which the nurse manager

does not have time.• Problem solving.• Changes in the nurse manager’s own job

emphasis.• Capability building.

Aspects of Delegation

• Responsibility• Authority• Accountability

Principles in Delegation

• Select the right person to whom the job is to be delegated

• Delegate both interesting and uninteresting tasks.• Provide subordinates with enough time to learn. • Delegate gradually.• Delegate in advance.• Consult before delegating.• Avoid gaps and overlaps.

Delegation Process

– Defining the task,– Determining to whom to delegate,– Providing clear communication about expectations

regarding the task,– Reaching mutual agreement about the task at hand,

and– Monitoring and evaluating the results and providing

feedback to the individual regarding his or her performance.

What cannot be delegated

• Overall responsibility, authority and accountability for satisfactory completion of all activities in the unit

• Authority to sign one’s name is never delegated. • Evaluating the staff and/or taking necessary

corrective or disciplinary action.• Responsibility for maintaining morale • Jobs that are too technical and those that involve

trust and confidence.

Creating a Motivating Climate

Motivation

Creating a Motivating Climate

• The amount and quality of work accomplished by managers directly reflect their motivation and that of their subordinates

• Motivation:– The force within an individual that influences or

directs behavior– Involves the action people take to satisfy unmet

needs

Intrinsic vs. Extrinsic Motivation

• Intrinsic Motivation – comes from within the person driving him/her to be productive – Shaped by ones values, experiences, social background, peers,

parents/family, and culture• Extrinsic Motivation

– Enhanced by the work environment and occur after the work has been completed; an effect of the culture and values of the organization

• People are always motivated to some extent because of constant needs and wants but because human beings are unique, they are motivated differently

Motivational Theories

• Maslow’s Theory of Human Motivation– Physiologic– Security/Safety– Social/Love– Esteem– Self-ActualizationPeople are complex beings that have many needs motivating them at any one time

• Herzberg’s Motivators and Hygiene Factors or the Two Factor Theory

Motivators Hygiene/Maintenance Factors

Achievement Salary

Recognition Supervision

Work Job Security

Responsibility Positive working conditions

Advancement Personal life

Possibility for growth Interpersonal relationships and peersCompany policy

Status

• Herzberg:– Employees can be motivated by the work itself– There is an internal or personal need to meet

organizational goals– Hygiene factors keep employees from being

dissatisfied but do not act as real motivators– Dissatisfaction may not be satisfaction– The motivating climate must actively include the

employee

• Skinner – operant conditioning and behavior modification– People could be conditioned to behave in a certain

way based on a consistent reward or punishment system

• Vroom’s Expectancy Model– A person’s expectations about his or her

environment or a certain event will influence behavior

– People make conscious decisions in anticipation of reward

• McClelland – Three basic needs– Achievement-oriented – transforms ideas into

action, taking risks when necessary– Affiliation-oriented – focus their energies on families

and friends– Power-oriented – motivated by the power that can

be gained as a result of a specific action• Gellermann– Stretching – assigning tasks that are more difficult

than what the person is used to doing to help the employee grow

– Participation- actively drawing employees into decisions affecting their work

• McGregorTheory X Theory Y

Avoid work if possible Like and enjoy work

Dislike work Are self-directed

Must be directed Seek responsibility

Have little ambition Imaginative and creative

Avoid responsibility Have underutilized intellectual capacity

Need threats to be motivated Need only general supervision

Need close supervision Are encouraged to participate in problem solving

Are motivated by rewards and punishment

• McConnell – positive reinforcement– Must be specific or relevant to a particular

performance– Occur close to the event as possible– Reinforce any improvement not just excellence– Rewards should be intermittent– Reinforcement of new behaviors should be

continuous

• Manion – joyful people positively affect relationships and make the workplace more appealing. Pathways to find joy in work:– Connection pathway – based on relationships– Love of work pathway – strong connection and

identification with the work result in excitement and enthusiasm

– Achievement pathway – achievements, accomplishments and positive work outcomes

– Recognition pathway – could be attained through patient’s gratitude, patient’s families, appreciation or praise or thanks from colleagues or the organization

Communication

Definition

• The exchange of thoughts, messages or information by speech, signals, writing, or behavior

• Maybe verbal or non-verbal• Communication begins the moment that two

or more people become aware of each other’s presence

Communication Process

Internal Climate

External Climate

SENDER

MESSAGE

RECEIVER

InternalClimate

ExternalClimate

Written

Nonverbal

Verbal

Variables affecting organizational communication

• Formal organizational structure• Gender• Differences in power• Differences in status

Channels of communication

• Downward• Horizontal• Diagonal• Grapevine

Modes of communication used most frequently by managers

• Written• Face-to-face• Non-verbal• Telephone

Memos• Short and concise• Focus on the recipients’ needs• Use simple language• Review the message and revise as needed• Use spelling and grammar checks• Address the reader by his/her correct name/title• Include a subject line to summarize the purpose of the memo• Include bullets or headings to emphasize key points• Do not include salutations or complimentary closings• Use the first paragraph to express the context or purpose of the memo

and to introduce the problem• Add a conclusion to summarize the memo and to address attachments

Elements of non-verbal communication

• Space/proxemics• Environment• Appearance• Eye contact• Posture• Gestures• Facial expression and timing• Vocal expression

Assertiveness

• Misconceptions– All communication is either assertive or passive– Those who communicate or behave assertively get

everything they want– Unfeminine– Assertive and aggressive are synonymous

• Assertive communication is not rude or insensitive behavior; rather, it is having an informed voice that insists on being heard

Techniques for assertiveness

• Reflect• Repeat the assertive message• Point out implicit assumptions• Restate the message by using assertive

language• Question the aggressive the behavior

Group communication process

• Forming -- introductions• Storming – competition and identity

establishment• Norming -- establishing rules and designs for

work• Performing – getting the work done• Termination or closure – summarize, express

feelings, and come to closure

Group task roles

• Initiator• Information seeker• Information giver• Opinion seeker• Elaborator• Coordinator• Orienter• Evaluator• Energizer• Procedural technician• recorder

Group building/maintenance roles

• Encourager• Harmonizer• Compromiser• Gatekeeper• Standard setter• Group commentator• follower

Individual roles

• Aggressor• Blocker• Recognition seeker• Self-confessor• Playboy• Dominator• Help seeker• Special interest pleader

confidentiality

• Breached legally only when one provider must share information about a patient so that another provider can assume care

Supervision

Definition

– Provision of guidance and direction, evaluation and follow-up to an employee who has been delegated with a task

– It is concerned with people, the work area working conditions and the work itself

Purpose

• to inspect, evaluate and improve work performance

• to provide suitable working conditions of the staff

• to orient, train and guide the individual staff member

Principles

• Good Supervision is focused on improvement of the work than on upgrading the worker

• Is based on the needs of individuals that have been cooperatively determined.

• Is cooperatively planned.• Employs democratic methods• Stimulates the staff to improve continuously• Respect the individuality of staff member• Helps create a social, psychological and physical

atmosphere in which the individual is free to function on his or her own top level.

Managing Conflict

Definition

• Conflict is the internal or external discord that results from differences in ideas, values, or feelings between two or more people.

• Conflict can be defined as an expressed struggle between at least two interdependent parties who perceive that incompatible goals, scarce resources, or interference from others are preventing them from achieving their goals (Wilmot & Hocker,.

• Too little conflict results in organizational stasis, too much, leads to reduced organizational effectiveness with eventual immobilization of employees.

Sources of Organizational Conflict

• Different values, beliefs, backgrounds, and goals

• Inadequately defined organizational structure• Unclear expectations• Individual or group conflicts of interest• Operational or staffing changes• Diversity in gender, culture or age

Categories of Conflict

• Relationship-based:– Intergroup conflict – occurs between two or more

groups of people, departments, or organizations.– Intrapersonal conflict – occurs within the person –

internal struggle to clarify contradictory values or wants

– Interpersonal conflict – “horizontal violence” or “bullying” happens between two or more people with differing values, goals, and beliefs.

Categories of Conflict…

• Value Conflicts• Data Conflicts• Interest conflicts• Structural Conflicts

Types of Organizational Conflicts• Goal conflict occurs when preferred goals are incompatible,

such as in the situation between the director of respiratory care and the nursing director of the ICU

• Affective conflict occurs when feelings or emotions are incompatible.

• Cognitive conflict occurs when ideas or opinions are believed to be incompatible.

• Vertical conflict occurs between levels of authority when superiors try to exert their authority over subordinates.

• Role conflict occurs when there is inconsistency or misunderstanding about the way a job should be performed.

• Line-staff conflict occurs when line managers believe that staff members use their technical knowledge to intrude on the line manager’s area of legitimate authority

The Conflict Process

• Latent conflict – conditions are ripe for conflict but has not or will never occur

• Perceived/Substantive conflict – there is recognition of values/roles conflict but it is intellectualized – logical and impersonal

• Felt/Affective conflict – conflict is emotionalized (hostility, fear, mistrust, anger)

• Manifest/Overt conflict – action is taken, e.g. withdraw, compete, debate or seek conflict resolution

• Conflict aftermath – may be positive or negative

LATENT CONFLICT

FELT CONFLICT PERCEIVED CONFLICT

MANIFEST CONFLICT

CONFLICT RESOLUTION

CONFLICT AFTERMATH

Conflict Management

• Optimal goal – create a win-win solution for all involved

• Compromising – each party gives up something it wants (lose-lose situation)– Advisable if both parties are willing to give up something of

equal value• Competing – one party pursues what it wants at the

expense of the other (win-lose)– When a quick or unpopular decision has to be made– When one party has more information or knowledge about

a situation than the other

Conflict Management…

• Cooperating/Accommodating – one party sacrifices and allows one party to win (win-lose)– The cooperating party usually collects IOUs from the

other party that can be used at a latter date– Appropriate if the item of conflict is not of high

value to the person accommodating• Smoothing – one party compliments the other

party or focuses on agreements rather than differences

Conflict Management…

• Avoiding – parties involved are aware of a conflict but choose not to acknowledge or attempt to resolve it – Indicated in trivial disagreements when the cost of

dealing with the conflict exceeds the benefits of solving it

• Collaborating – all parties set aside their original goals and work together to establish a superordinate or priority common goal (win-win)

Conflict Management…

• Strategies:– Confrontation – face-to-face meeting of involved parties– Third-party consultation – managers act as neutral party

to help others resolve conflict constructively– Behavior change – reserved for serious cases; educational

modes, training development or sensitivity training– Responsibility Charting – for elementary jurisdictional

conflicts– Structure change – transferring or discharging people– Soothing one party – when the parties are so enraged –

waiting a few days

Conflict Management…

• Processes:– Negotiation

• Bottom line – the very least a person will settle• Trade offs – secondary gains, often future-oriented• Hidden agenda – covert intention of the negotiation

– Alternative Dispute Resolution• Mediation – uses a neutral third party• Arbitration – with an individual who makes final decision• Guidance from ombudspersons – with official title from the

organization

– Consensus Seeking – reaching an agreement which all parties can support even if it does not represent everyone’s first priorities.

Management of Change

Elements of Change

• Change means to be different, to cause to be different or to alter

• Maybe personal or organizational, occur suddenly or incrementally, planned or unplanned, initiated in response to internal or external stimuli

• Change Agent – one who generates ideas, introduces innovation, and works to bring about the desired change

Assumptions Regarding Change

• Change of any kind represents loss.• The more consistent the change goal is with the

individual’s personal values and beliefs, the more likely the change is to be accepted

• Those who actively participate in the change feel accountable for the outcome.

• With each successive change in a series of changes, individual’s psychological adjustment to the change occurs more slowly.

• Power is important to the change process

Strategies for Leading Planned Change

• Rational-Empirical – assumes that people are rational beings and will adopt a change if it is justified and in their self-interest

• Normative-Re-educative – requires a change in attitude, values, and/or relationships; assumes that group norms are used to socialize individuals

• Power-coercive – based on power, authority and control; political or economic power is often used to bring about change

Barriers to Change=StrategiesBarrier Strategy

Desire to remain in comfort zone Rational-Empirical

Inadequate access to information Rational-Empirical

Lack of shared vision Normative-re-educative

Lack of adequate planning Rational-Empirical

Lack of trust Both rational-empirical and normative-re-educative

Resistance to change Normative-re-educative

Fear that power, relationships or control will be lost

Normative-re-educative

Change Theories

• Kurt Lewin’s Force Field Analysis– Change strategies should aim at increasing the

driving forces and decreasing the restraining forces. – Three phases of change:• Unfreezing – loosen the forces maintaining the status quo• Moving – identify, plan, and implement strategies to

bring about the change• Refreezing – reinforce new patterns of behavior brought

about by the change

• Lippitt’s Phases of Change– Diagnosis of the Problem– Assessment of the Motivation and Capacity for

Change– Assessment of the change agent’s motivation and

resources– Selection of progressive change objectives– Implement the Plan– Maintenance of the change– Termination of the helping relationship

• Learning Organizations Theory– Based on the systems theory– A learning organization is where people at all

levels are collectively and continuously working together to improve what they do.

– A learning organization develops the capacity to recreate itself in response to change

Senge’s 5 disciplines to master:• Discipline 1: Personal mastery -- Developing and

clarifying a personal vision • Discipline 2: Mental models -- Building an internal

picture of the world; the lens through which the world is viewed

• Discipline 3: Building shared vision -- Translating personal vision into a collective vision and developing a culture of common caring

• Discipline 4: Team learning -- Fostering shared, participative decision making

• Discipline 5: Systems thinking -- Shifting from fragmentation to holism

• Chaos Theory– Chaos actually has an order– The challenge is to disturb the system in a manner

that will push the system in the direction of a desired outcome.