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.
<ul><li>As Ray Kroc, founder of Mc Donald’s once said, “When you are green, you will grow; but when you ripen, you will rot and fall.” </li></ul>
<ul><li>Taking place without a structured organization, like the nursing service; </li></ul><ul><li>Directed towards the attainment of aims and objectives; </li></ul><ul><li>Achieved through the efforts of other people, & </li></ul><ul><li>Using system and procedures </li></ul>Management is regarded as:
… 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 interest Remuneration Centralization Scalar chain
Principles of Management Order Equity Stability of Tenure Initiative Esprit de Corps
The ultimate test of management is: Achievement Performance &
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 <ul><li>Developed a science for each component of work </li></ul><ul><li>Scientifically select and train workers </li></ul><ul><li>Actively cooperates with workers </li></ul><ul><li>Divide work equally between workers and management </li></ul>
General Administrative Theory <ul><li>Developed by Henry Fayol </li></ul><ul><li>Described management as universal set of activities </li></ul><ul><li>Focuses on division of labor, clear hierarchy, rules and impersonal relations </li></ul>
Human Relations <ul><li>Idea surfaced in early 2oth century </li></ul><ul><li>Focused on the notion that work is done by people </li></ul><ul><li>Need to focus on human element </li></ul><ul><li>Maslow and Motivation and Theory X and Y </li></ul>
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 <ul><li>Competent and responsible employees are produced. </li></ul><ul><li>Employees perform by uniform rules and conventions </li></ul><ul><li>Employees are accountable to one manager who is an authority. </li></ul><ul><li>They maintain social distance with supervisors and clients. </li></ul><ul><li>Favoritism is reduced and impersonality is promoted. </li></ul><ul><li>Rewards and other incentives are provided to employees based on technical qualifications, seniority and achievement. </li></ul>
Disadvantages of Bureaucratic Management <ul><li>Complaints about red tape are frequently heard and experienced. </li></ul><ul><li>Procedural delays are observable </li></ul><ul><li>General frustrations among employees and clients are inevitable. </li></ul>
Characteristics of Bureaucracy <ul><li>FORMALITY </li></ul><ul><li>LOW AUTONOMY </li></ul><ul><li>A CLIMATE OF RULES AND CONVENTIONALITY </li></ul><ul><li>DIVISION OF LABOR </li></ul><ul><li>SPECIALIZATION </li></ul><ul><li>STANDARDIZED PROCEDURES </li></ul><ul><li>WRITTEN SPECIFICATION </li></ul><ul><li>MEMORANDA AND MINUTES </li></ul><ul><li>CENTRALIZATIONS </li></ul><ul><li>CONTROLS </li></ul><ul><li>EMPHASIS ON HIGH LEVEL OF EFFICIENCY AND PRODUCTION. </li></ul>
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: <ul><li>The expenditure of physical and mental effort in work is as natural as play or rest. </li></ul><ul><li>External control and the threat of punishment are not the only means for bringing about effort toward organizational objectives. </li></ul><ul><li>Commitment to objectives is a function of the rewards associated with their achievement. </li></ul><ul><li>The average human being learns under proper conditions, not only to accept but to seek responsibility. </li></ul><ul><li>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. </li></ul><ul><li>Under the conditions of modern industrial life, the intellectual potentialities of the average human being are only partially utilized. </li></ul>
THEORY M FOR MANAGEMENT <ul><li>Allen (1973) believe that most managers avoid extremes in their belief in people. </li></ul><ul><li>People are motivated to work by highly complex factors that may be biological, psychological, social, or economic; to name only a few possibilities. </li></ul><ul><li>Some people dislike responsibility and prefer to be led; others are ambitious and want to be leaders; the majority fall somewhere in between. </li></ul>
Theory Z <ul><li>Participative Management Model </li></ul><ul><li>Spearheaded by Ouichi in 1978 </li></ul><ul><li>Characteristics </li></ul><ul><li>* long-term (lifetime) employment </li></ul><ul><li>* slowed down rates of evaluation and promotion. </li></ul><ul><li>* more implicit and less formalized control systems; </li></ul><ul><li>* personal concern for the employee </li></ul><ul><li>* cross functional rotation; </li></ul><ul><li>* some degree of participative consensual decision making, and </li></ul><ul><li>* emphasis on individual responsibility. </li></ul>
TQM (Total Quality Management) <ul><li>Introduced by Deming </li></ul><ul><li>Key to quality is reducing variations. </li></ul><ul><li>Everyone gets involve with quality </li></ul><ul><li>Get it right first time </li></ul><ul><li>Consumer is the most important part of the production line. </li></ul>
ROLE OF MANAGERS <ul><li>Interpersonal </li></ul><ul><li>Informational </li></ul><ul><li>Decisional </li></ul>
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 CONTROLLING DIRECTING ORGANIZING PLANNING
<ul><li>Planning </li></ul><ul><li>2. Organizing </li></ul><ul><li>3. Directing </li></ul><ul><li>4. Coordination </li></ul><ul><li>5. Control </li></ul>The Managerial Activity is divided into five (5) Elements of Management
* Do things right * Are interested in efficiency * Administer * Maintain * Focus on systems and structure Managers Leaders * 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 Managers Leaders
* 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 Managers Leaders
* 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 Managers Leaders
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 Theories Skills Techniques Person Orientedness Awareness of Purpose SILR COMMUNICATION 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 building Synergistic Management Being ethically moral
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
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.”