NURSING MANAGEMENT Lectures

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

Frederick Taylor’s Scientific Management Theory
 Elements
o choosing the appropriate person (TAO)
o choosing the appropriate team
o choosing the appropriate training
o choosing the appropriate tools

Human Relations theory
 the be a good manager, there should be a good interpersonal relationship between the leader and follower

Douglas Mc Gregor’s Motivational theory
 Theory X
o Negative workers
o negligence, inefficient, ineffective workers
 Theory Y
o Positive workers
o diligent, effective, efficient worker
 theory X should be given focus because they are prone to negligence and malpractice.

Max Weber’s Bureaucratic/ authoritarian Theory
 whoever is on the top would perform the management function
 centralized

Elton Mayto’s Behavioral Theory
 overtime pay, rest day, day off
 provide physical needs of the workers
 Hawthorne’s Effect
o If workers knows they are observed they become more efficient

Henry Fayol’s Principle of Management
 Unity of Command – one leader, one command
 Unity of Direction – one group should always have one goal
 Remuneration of Personnel – patient first policy
 Esprit de corps – team spirit
 Command responsibility/Respondeat Superior – let the superior answer the fault of his subordinates even harm or death
 Balance between centralization and decentralization
 Security tenure
 Delegation of responsibility
 Proper Compensation of workers
o RA 7305 (Magna Carta Law) – salary grade 50 P13,000/month
o Overtime pay – additional of 25%/hr
o Night Differential – additional of 10%/hr
o Legal holiday – x 2
o Philhealth - Benefit of worker both related and non-related work (aesthetic, dental and cosmetics are not included)
o Maternity leave – 60days leave is NSD, 78days if CS only to first 4 pregnancy only to legitimate spouse
o Paternity leave – 7day/1week leave
o Senior Citizen’s Act – 20% discount

5 steps in Management Process
 Planning stage
o looking ahead of time.
o Formulating future goals/objective
o Types of plan
 Standard/Operational Plan (NCP)
• plans for everyday or ordinary activities
 Strategic/Contingency Plan
• plan used during sudden or acute crisis
 Long-range/future Plan
• plans which you can’t evaluated immediately.
• Usually last months or yrs.
• Used for chronic pt which requires longer period of care.
o Stages of Planning Process
 Mission – present reason when established your organization
 Vision - statement of your future purpose of your future organization
 Philosophy – set of values and beliefs of your organization
 Goal – general statement of your purpose
 Objectives – more specific statement of your purpose
 Policies – set of rules and regulations in your organization
 Procedures
• Budgeting – proper allocation of your resources
o 3 types
 Personnel
• Compensation for salaries of workers
 Operational
• everyday use of equipment and facilities (gloves, water, electricity)
 Capital
• long term use equipment (MRI, CT Scan, hospital beds, hospital buildings)
 Organizing
o 4 stages
 Organize your team RN Subordinates
• Duties of the RN
• Only assessment can perform the nurse
• Only the nurse can perform HT
• Only the nurse should explain the procedure to the patient
• Preparation, administration, treatment of drugs to the patient
• The nurse can only perform evaluation
• The nurse can only do judgment
 Delegate Task
• They can only delegate to subordinates the Routinary task (standard, unchanging procedure) eg. monitoring of I&O, bathing, ambulating, toileting, shampooing, transporting, feeding, clothing, wiping
• Stable patient - predictable outcome (eg. postmortem care with direct supervision of the nurse only)
• Supervision – need guidance
 Staff Schedule/ Staffing
• Schedules (How many hours)
o Traditional – 8hrs a day/40hrs/wk
o Ten hour shift/4 days a week
o Baylor plan – it consist of two shifting nurses
 traditional – mon-fri 8hrs
 2nd shift – 12hr shift during weekends
o Part-time work – fewer working hours per day and may choose the day or work. Less than 8hrs job
o On – call – during shortage of nurses/staff but increase in the number of patients.
 Methods of Nursing care Delivery
• Different Methods
o Primary – 24hrs a day
 Primary nurse is the only nurse who is responsible to make a care plan of the patient from the moment of admission till the moment of discharge. (eg. private duty nurse or special nurse)
o Functional Method
 DOH format/government hospitals
 Assign nurse :
• Duty/task
• One nurse, one task
• Highly recommended during a period of shortage of nurses and budget
 poorest method of delivery because communication is hindered
o Case Method/Case Nursing
 provide total care within your shift. Used in ICU department
 C – Case Method
 T – total care to the patient
 O – one is to one ratio
 Directing/Delegation stage
o a job or a task is done or performed by another perform for you
o What you cannot delegate:
 you cannot delegate total control of the procedure
 you can’t delegate discipline of subordinates or staff members.
 Confidential task
 Technical task
 Medical task performing surgical procedure is done by the doc not the nurse
 Coordination/Collaboration
o the nurse needs to collaborate to other members of the health care team.
o Multi-interdisciplinary approach – to be able to provide holistic approach to the patient.
o Types of Collaboration
 Interpersonal/Intradepartmental
• One patient, one unit.
• Collaboration between one nurse to another healthcare team in one unit/department
• Eg. MI patient - nurse, dietary, specialized in cardio
 Interdepartmental
• 4 units in one hospital.
• Coordination of the patients care between 2-more units/departments but still under one same hospital or institution
• Eg. patient due for appendectomy is transferred to the OR
 Inter Agency/Institutional
• Coordination of patient’s care between 2 or more hospitals/health care institution for the benefit of the patient
• Eg. lying – in due for C/S and was transferred to a hospital
 Evaluation/Controlling
o stage wherein you determine whether or not your plans for your patient is met or achieved
o Methods of evaluating staff performance
 Checklist
• it is being evaluated higher than you. (eg. nurse manager/supervisor or head nurse)
 Nursing rounds
• it is being evaluated higher than you. (eg. Nurse manager/supervisor or head nurse)
• Psychiatric ward is not done by nursing rounds
 Peer review
• same rank or level is being evaluated you
• poor method
 Performance appraisal
• the patient evaluates you
• best method in evaluation