directing and leading and providing direction to lead

2. ---Part I---
Activities Related to the Directing Functions
Elements of Directing
1. Delegation
1.1. Principles of Delegation
1.2. Reasons for Delegation
1.3. Management by Objectives
1.4. Effective Delegation
1.5. Nursing Care Assignment
1.6. Utilization of Policies and Procedures

3. ---Part II---
2. Supervision of Personnel (Principles and Techniques)
3. Motivation
3.1. Theories of Motivation (Content and
Process Theories)
3.2. Use of Motivation Theories to Nursing
Administration
4. Coordination of Services
5. Communication
5.1. Principles of Effective Communication
5.2. Lines of Communications

4. ---Part III---
6. Staff Development
7. Decision-making
8. Benchmarking (Standards of Evaluating the Directing
Function)
9. Conflict Management
9.1. Characteristics of Conflict
9.2. Assessing Conflict
9.3. Sources/Causes and Types of Conflict
9.4. Conflict Management – What to Consider
9.5. Techniques/Skills for Managing Conflicts

5. ●Definitions of Directing●
Directing is known as the act of issuing of
orders, assignments, and instructions to
accomplish the organization’s goals and
objectives. It involves the process of
getting the organization’s work done. It
entails explaining what it is to be done,
to and by whom, at what time, how and
why the task should be done.

6. Directing is a function of management often
performed by top level management in order to
achieve organizational goals. It is a very important
and necessary function of management. Directing
consists of the processes and techniques utilized in
issuing instructions and making certain that
operations are carried as originally planned.
●Definitions of Directing●

7. Directing involves determining the course,
giving order and instruction and providing
dynamic leadership. (Marshall)
●Definitions of Directing●

8. ●Activities Related to the Directing Functions●
-telling people what is to be done and explaining
how to do it
-issuing instructions and orders to subordinates
-inspiring them to contribute towards the
achievement of objectives
-supervising their activities
-providing leadership and motivation

10. ELEMENTS
OF
DIRECTING

11. ELEMENTS OF DIRECTING
• Supervision
• Motivation
• Leadership
• Communication
• Order giving

12. ●Delegation●
-the act of assigning to someone
else a portion of the work to be
done with corresponding
authority, responsibility and
accountability
-a skill to be learned and
mastered beginning with learning
what cannot be delegated and
what will be delegated to whom

13. ●Reasons for Delegation●
For the nurse manager
1. To free up time for
planning and organizing.
2. To help the nurse
manager learn how to
properly and effectively
manage and develop
employees.

14. 3. To keep the nurse
manager from ‘spreading
him/herself too thin’.
4. Delegation encourages
open communication and
trust.
5. It can show the nurse
manager a better way of
handling people and
resources.

15. For the subordinates
6. Delegation motivates and
builds morale.
7. Delegation encourages and
stimulates creativity and
initiative.
8. Delegation helps develop the
skills of subordinates
9. Delegation allows the
subordinates to contribute
significantly to team success.

16. For the organization
10. Delegation benefits
the team, the department,
and the organization.

17. ●Principles of Delegation●

18. Principles of directig
• Harmony of objectives
• unity of command
• appropriate techniques
• direct supervision
• effective leadership
• understanding and comprehension
• effective communication

19. • use of informal communication
• utilization of maximum individual efforts
• clear orders
• follow up

20. Principle of Result Expected
Suggests that:
-every nurse manager before delegating the
powers to the subordinate should be able to
clearly define the goals as well as results
expected from them
-goals and targets should be completely and
clearly defined and the standards of
performance should also be notified clearly

21. Principle of Parity of Authority and
Responsibility
-the nurse manager should keep a
balance between authority and
responsibility - both of them should
go hand in hand
- if a subordinate is given a
responsibility to perform a task, at the
same time he should be given enough
independence and power to carry out
that task effectively

22. Principle of absolute responsibility
-responsibility is fixed; authority can
be delegated but responsibility
cannot
-the nurse manager is always
responsible to his superior for
carrying out his task by delegating the
powers
-every nurse manager is responsible
for the act of his/her subordinate and
is also accountable to his/her superior

23. Principle
of
Authority level
-suggests that a nurse manager should exercise his
authority within the jurisdiction / framework given
-before a nurse manager takes any important
decision, he should make sure that he has the
authority to do so
-emphasizes the degree of authority and the level
up to which it has to be maintained

24. ●Delegation: Additional Information●

25. What cannot be delegated?
• Overall ARA
• Final evaluation of staff
performance
• Correcting and disciplining
staff
• Activities which the nurse to
whom the task is delegated
does not want to do because it
is unpleasant

26. Delegated tasks must
be based on
• Policies
• Job Description
• Capabilities of Workers

27. 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.
• Fear on the part of the director, of
her own ability to delegate.
• Fear of losing control of the staff.
• Fear of failing to get others do the
work.
• Fear of criticism.

28. Common Delegation Errors
Underdelegating
• manager’s false assumption: delegation
may be interpreted as the lack of ability on
his or her part to do the job correctly or
completely
• nurse manager manifests his desire to do
the job by himself due to fear that
subordinates will resent the work
delegated to them
• occurs when the nurse manager lacks
experience in the job

29. Overdelegating
• unnecessarily burdens the
subordinates with tasks that are
either inconsequential or irrelevant
to the delivery of the goal; culprit is
usually poor management of time
and insecurity on the part of the
nurse manager in her inability to
perform tasks
Common Delegation Errors

30. Improper delegating
• delegation of tasks and
responsibilities beyond
which the person
cannot perform
properly
Common Delegation Errors

32. SUPERVISION
• It is the central to the process of learning and
to the scope of professional practice and
should be seen as a means of encouraging self
assessment and analytical and reflective skills
---- Department of Health

33. Objectives of supervision
• To see that work or task is being done in the
expected manner
• To promote continuing improvement in the
performance of nurses
• To motivate the staff
• To guide the individuals according to their
needs
• To evaluate the quality of nursing care

34. Principles of Supervision
• The subordinate must always understand
clearly what is expected of them
• It should be well planned
• Create safe and healthful environmemt to the
subordinates
• Superviosion should be participatory and
democratic in nature

35. • Recognition should be given to good work
• They should be helped to set up and attain
objectives
• It should ensure staff development and create
good work

36. Procedural steps for Supervision
• Preparation Phase
• Actual Supervision
• Follow up of supervision

37. Methods
• Direct Methods
• Indirect Methods

38. Tools of supervision
• Observation checklist
• Rating Scale

39. FUNCTIONS OF SUPERVISION
• Normative function
• Formative function
• Supportive function

40. Qualities of a supervisor
• Interpersonal and professional skill
• Fairness
• Intiative
• Tactful
• Emotionally mature
• Teaching abilities
• Positive attitude

41. Guidance
• Guidance involves giving personal help which
is designed to assist a person in deciding
where he wants to go,how to accomplish goals
and solving problems

42. Elements of guidance
• Focus on individual not on problem
• Based on interest and abilities
• self development
• Adjustable
• Sucess and happiness

43. PURPOSE
• Understanding
• helping in making adjustment
• improve activities
• development personal abilities

44. types
• Educational guidance
• Personal guidance
• Recreational guidance

45. Problems
• Lack confidentiality
• Frustation
• Poor environment
• Lack of skills
• Patience

46. INTER PROFESSIONAL
COLLABORATION
According to the World Health Organization
(WHO), interprofessional collaboration occurs
when “multiple health workers from different
professional backgrounds work together with
patients, families, caregivers and communities
to deliver the highest quality of care across
settings.”

47. • Interprofessional collaboration trains different
disciplines to learn how to work together and to
recognize the value of different skillsets, efforts
that enhance the workplace. One study found a
collaborative work environment to improve conflict
management, confidence, and innovation, while
lowering emotional exhaustion. This benefits
healthcare workers by reducing workload and
increasing job satisfaction

48. • Interprofessional collaboration promotes
better communication between healthcare
workers and therefore quickens decision-
making in high-stress clinical environments.
Such collaboration fosters respect for the
contributions of all disciplines

49. • Nurses not only improve patient care — they also
facilitate processes in healthcare. Nurses contribute
to the development, implementation, and
improvement of telenursing and electronic health
records (EHRs). They work with information
technologists, vendors, and nurse informaticists to
help develop accurate EHRs. The collaboration of
nurses with multiple disciplines improves efficiency
for all parties.

50. • Interprofessional collaboration can improve patient
outcomes by reducing adverse drug reactions,
preventing emergency hospitalizations, decreasing
morbidity and mortality rates, and optimizing
medication dosages. When members of a healthcare
team work together, patient outcomes improve by
decreasing medical errors and preventable
complications.

52. ●Management by Objectives●
Management by
Objectives works if you
first think through your
objectives. Ninety
percent of the time you
haven’t. (Drucker)

53. A process whereby the superior and
subordinate managers of an
organization jointly identify its common
goals, define each individual’s major
areas of responsibility in terms of the
results expected of him and use these
measures as guides for operating the
unit and assessing the contribution of
each of its members. (George Odiorne)
●Management by Objectives●

54. MBO is a system for making
organizational structures work, of
bringing about vitality and personal
involvement in the hierarchy by means of
statements of what is expected from
everyone involved and measurement of
what is actually achieved. It stresses
ability and achievement rather than
personality. (Odiorne)
●Management by Objectives●

55. • allows the individual nurse to contribute to
the common goal of the enterprise
• nurse managers focus on the business goals
• MBO promotes high standards, focusing on
the job and not on the manager
• Nurse managers know what to expect of
employees
• Just like their nurse managers, nursing staff
should know for what they will be held
accountable.
●Management by Objectives●

56. • spells out the results expected of
the clinical nursing unit itself and
in relation to other units
• emphasizes teamwork and team
results
• includes short and long-term
objectives as well as tangible and
intangible objectives
●Management by Objectives●

57. • allows people to control their own
performance and measure
themselves
• nurse managers will assume that
clinical nurses want to be
responsible, want to contribute,
want to achieve, and have the
strength and desire to do so.
●Management by Objectives●

58. TEAM MANAGEMENT
• A team is small number of people with
complementary skills who are committed to a
common purpose,performance goals and
approach for which they hold themselves
mutually accountable
DK SMITH 1993

59. IMPORTANCE
• To improve productivity
• To make work meaningful
• To give nurse employees a sense of unity and
belongingness

60. Types of team
• Task force
• Problem solving teams
• Self managed work teams
• Commitees
• Work group
• Quality circle

61. Characteristics
• T- TOGETHER
• E- EVERYONE
• A-ACHIEVES
• M-MORE

62. Stages of team development
• Forming
• Storming
• Norming
• Performing

63. FACTORS INFLUENCING EFFECTIVENESS OF
TEAM
• People related factors
• Organization related factors
• Task related factors

64. ●NURSING CARE ASSIGNMENT ●

65. ●Nursing Care Assignment●
Nursing Care Assignment is the allocation of
clients or client care responsibilities or
interventions that are within the nurse’s scope
of practice and/or scope of employment. It
describes the distribution of work that each staff
member is to accomplish (NCSBN, 2005).

66. It is a dynamic process in which decisions
are evaluated and adjusted as the
healthcare team works together to meet
the changing needs of clients. Nurses
determine assignments according to:

67. •the client’s condition (complexity, variability
and acuity)
•the scope of practice of the health provider’s
profession
•the individual scope/competence of the
individual performing the intervention
•the scope of employment/agency policy
•context of practice

68. • When client care or a client intervention is
assigned to an RN they may perform the
assignment autonomously as they are
accountable for their own decisions and
actions.

69. Types of Nursing Care Assignment
A nurse determines the most appropriate care
provider to be ‘assigned’ to a particular client
and is accountable for that decision. When
clients are ‘assigned’ to a particular nurse or
unregulated care provider, the accountability for
the client care resides with the individual
assigned to the client.

70. Nursing care assignment to unregulated care providers
Assignment is appropriate when the assigned
task falls within the of role description and
training. The nurse manager is responsible and
accountable for developing job/role descriptions
that clearly outline the tasks that can be
assigned to a RN in an organization.

71. Prior to assigning a client or an intervention,
consideration should be given to the individual
competencies of the UCP.
If the task is within the role description but the UCP has
not yet performed the task, the nurse manager would
need to consider the appropriateness of the
assignment. The UCP may have had past training in
tasks but if the task is not included in the UCP role
description, the task could not be assigned to the UCP.
Regardless of the assignment, the nurse assigning the
task to the UCP is always responsible and accountable
for providing appropriate supervision and feedback to
the UCP.

72. Rotations
• In nursing services and education rotation
recurrent posting of vrious groups of nurses or
nursing students belonging to different areas
or classes in specific nursing fields
• Example: different wards

73. TYPES OF ROTATION
• Master rotation plan
• Individual rotation plan
• Clinical rotation plan

74. MASTER ROTATION
• It must be prepared in advance
• For preparing the master rotation plan read
guidelies and syllabus

75. INDIVIDUAL ROTATION PLAN
• This plan is made to individual
• Each student is posted in their perspective
areas

76. CLINICAL ROTATION PLAN
• Clinical rotation plan is also necessary for
practical point of view

77. Nursing rotation
• Rotation of nursing staff is necessary for
moving workers from one department to
another to increase their qualities in all areas
• It is designed for newly qualified nurses to
gain experience in different units or specialties

78. Purpose
• Skill development
• Career Exploration
• Preventing burnout
• Enhanced knowledge and expertise
• Improve patient care
• Increased job satisfication

79. OBJECTIVES
• Reduces the monotomy of the job
• Succession planning
• Establish right employee job fit
• Testing employee skills
• Develop a wider range of work experience
• Clear purpose

80. BENEFITS
• Helps employer explore the hidden talent
• Identifies knowledge,skill,attitude
• Employee replacement
• High satisfication
• Develops interest

81. Disadvantage
• Time consuming
• Time acquaint
• Stress and anxiety
• Waste of efforts

82. • Discipline refers to regulations or condition
imposed on employees by management in
order to correct or prevent behavior which are
counter-productive to the organization.
• Discipline is a control mechanism employed to
ensure compliance with organizational
objectives. It is used to control those who
deviate from performance and behavioral
standards.

83. PURPOSE
To control and manage disorderly or
unsatisfactory conduct of employees.
Protect other employees who are committing
their talents, time, and efforts to the
organization.

84. • Provide code of conduct for the guidance of
the group.
• To create an atmosphere of respect for human
personality and human relations.

85. • To improve the employee morale and to
increase the productivity which is the ultimate
goal of any organization.

86. PRINCIPLES
• There should be sound standards of conduct,
codes, and norms in the organization.
• Employee should be aware of standard of
conduct, codes, and norms
• The standard of conduct, codes, and norms
should be implemented properly and it should
be reviewed periodically

87. DISCIPLINE
• Verbal command is done for minor disciplinary
problems.
• Most often there is modification of behavior
by verbal command

88. TYPES OF DISCIPLINE
• POSITIVE DISCIPLINE
• NEGATIVE DISCIPLINE

89. DISCIPLINARY MEASURES FOR EMPLOYEES
• Unsatisfactory job performance
• Grossly insufficient
• Job performance
• Unacceptable personal conduct

90. Progressive disciplinary process
• Verbal command
• Written repridement
• Suspension from work
• Demotion
• Disciplinary termination or dismissals
• Penalties for misconduct

91. Role of nurse manager in disciplinary action
• Expectations should be made clear to the
subordinates.
• Manager should develop positive attitude
towards the employee

92. • Establish trust with the staff nurses and accept
their potentialities.
• Generate positive work culture in the
department.
• Encourage open subordinates. communication
with the subordinates

93. • Formulate rules and policies which are
available to all employees.
• Carefully keep record of employees behavior.
• Investigate carefully regarding the concerned
matter and collect all relevant facts.

94. • Take corrective and constructive action.
• Allow employees feedback in the disciplinary
process

95. Leadership in Management
• Leadership can be defined as having the ability
to motivate and inspire others to achive
objectives as a group
• Leaders create implement plans that create
and maintain competitive edge

96. IMPORTANCE
• Inspiration
• Empowers
• Engages employees to bring their best to solve
problem