reviewer nursing NCM leadershgip

1. NCM 119 6TH EXAMINATION COVERAGE

2. DIRECTING / LEADING
Delegation is the assignment
of authority and responsibility
to another person to carry out
specific activities

3. Note:
• the nurse must consider the education and competence of the
ancillary nursing staff when delegating a task.
• A nurse must match the team members skills and abilities.
• Supervising and guiding the members
• Must delegate the task efficiently
• Accountability is the nurse role over subordinates
• Make sure to assess the task if done safely and competently
• Perform evaluation and re-evaluation if task done correctly

4. ACCOUNTABILITY vs RESPONSIBILITY

5. ACCOUNTABILITY AT THE WORKPLACE
One of the characteristics of a
successful and influential leader
in the workplace is
accountability.
It is described as accepting
responsibility for ensuring that
responsibilities are met. This
means that before making
commitments, leaders must have
a clear understanding of what is
expected of them.

6. CONSEQUENCES OF LEADERS WHO LACK ACCOUNTABILITY
• The organization may suffer costs
• Business risk their customer
service
• Employee motivation can also
dwindle

7. Benefit of delegation
• Professional growth and skill development
• Efficient distribution of tasks
• Improved patient outcomes of care

8. POWER and AUTHORITY
POWER
• The ability to efficiently and
effectively exercise authority and
control through personal,
organizational, and social strength
• is the ability to impose the will of
one person or group to bring
certain behaviors in other groups
or persons

9. POWER and AUTHORITY
Sources of POWER
• Legitimate Power
• Reward Power
• Coercive Power
• Expert Power
• Information Power
• Referent Power

10. Steps in delegating
• Assess the responsibility
• Determine the appropriateness of task assigned to subordinate
• Supervise and guide
• Evaluate and re-evaluate the task
• Note: if delegating is done poorly the task may be not completed.

11. According to maslow: he proposed that motivation is the result of
person’s attempt at fulfilling five basic needs.
-physiologic
-safety
-love and belongingness
-self esteem
-salf- actualization

12. POWER and AUTHORITY
Authority
represents the right to
expect or secure
compliance; authority is
backed by legitimacy.

13. DELEGATION versus ASSIGNMENT
Assignment
• defined as the distribution of nursing
care among providers based on the
scope of practice, in the case of
RNs and LPNs, and the job
description of UCPs.
• Assignment occurs at the beginning
of a shift and as required throughout
the workday, as patients' health
condition and needs change

14. DELEGATION versus ASSIGNMENT
Delegation
• is the decision to transfer an
intervention that is within the scope of
practice of one health care
professional (delegator) who has the
authority to perform the intervention,
to another health care team member
(delegatee) for whom this intervention
is outside her/ his scope of practice or
job description

15. DELEGATION versus ASSIGNMENT
Delegation
• The core nursing process cannot be
delegated, only interventions can be
delegated.
• RNs cannot delegate nursing
activities that compromise the core
of the nursing process and require
specialized knowledge, judgement,
and/or skill.

16. DELEGATION versus DUMPING
Dumping
• the process of
delegating something
to someone else that
you don’t want to deal
with.

17. STEPS AND BENEFITS OF DELEGATION IN NURSING
FIVE DELEGATION RIGHTS BY
NCSBN:
• Right Task
• Right Circumstances
• Right Person
• Right Direction and Communication
• Right Supervision and Evaluation

18. STEPS AND BENEFITS OF DELEGATION IN NURSING
Benefits of Delegation
• Building skills in delegates
• Allowing nurses to focus on more
challenging tasks
• Creating strong working relationships and
motivating teamwork
• Promoting the most effective utilization of
staff
• Improving resident and family satisfaction
• Discovering potential in other employees

19. DELEGATING ERRORS
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

20. DELEGATING ERRORS
Common Delegation Errors
• Underdelegating
• Overdelegating
• Improper Delegating

21. DELEGATING ERRORS
Common Delegation Errors
• Underdelegating
• Overdelegating
• Improper Delegating

22. MOTIVATIONAL THEORIES

23. DECISION MAKING / SCIENTIFIC DECISION MAKING
• Modern management relies heavily on
decision-making. Essentially, the primary
function of management is to make rational
or sound decisions
• ensure that organizational or business
goals are met, decisions are made at all
levels of management
• decisions are one of the core functional
values that every organization adopts and
implements in order to ensure optimal
growth and drivability in terms of services
and or products provided.

24. CONFLICT MANAGEMENT
• A conflict occurs when two people hold
opposing viewpoints.
• Conflict is defined as a clash between
people caused by differences in their
thought processes, attitudes,
understanding, interests, needs, and
sometimes even perceptions

25. CONFLICT MANAGEMENT
Phases of Conflict
• Prelude to Conflict
• Triggering Event
• Initiation Phase
• Differentiation Phase
• Resolution Phase

26. CONFLICT MANAGEMENT
CONFLICT MANAGEMENT
SKILLS
• Effective Communication Skills
Listening Skills
• Discussion
• Patience
Impartial
• Never Criticize
• Positive Attitude

27. TIME MANAGEMENT
• refers to managing time
effectively so that the right time
is allocated to the right activity.
• refers to making the best use
of time as time is always
limited.
• Effective time management
allows individuals to assign
specific time slots to activities
as per their importance.

28. TIME MANAGEMENT
Time Management includes:
i. Effective Planning
ii. Setting goals and objectives
iii. Setting deadlines
iv. Delegation of responsibilities
v. Prioritizing activities as per
their importance
vi. Spending the right time on
the right activity

29. TIME MANAGEMENT
For Effective Time
Management, one needs to be:
• Organized
• Don’t misuse time
• Be Focused

30. SUPERVISION
Supervision the process of
guiding and directing the work to
be done. It entails motivating and
encouraging the staff to
participate in activities to meet
goals and objectives and personal
development, and in helping the
staff to do their work better.

31. PRINCIPLES OF SUPERVISION
A Supervisor should:
a. Can produce attitudes which are
both positive and negative in
character;
b. Produce positives attitudes when are
positive when an employee is
conscious of the benefits to himself
which he attributes to the influence
of the supervisor; and
c. Produce negative attitude when the
reaction of workers is resistance to
discipline or actual fear of demotion
or discharge.

32. PRINCIPLES OF SUPERVISION
The following are some principles of good
supervision for supervisors and managers in general
to remember:
a. Good supervision is focused on the improvement
of work rather than upgrading the worker.
b. It is based on lines of authority, organizational
philosophy, vision/mission, the job description,
policies and standards, the needs of the
individual.
c. Focuses on the three areas of skill: conceptual,
technical, and interpersonal.
d. It is cooperatively planned, and accepts both
challenge and change.

33. PRINCIPLES OF SUPERVISION
e. It uses a democratic process to facilitate:
∙ Effective communication;
∙ Continuous improvement of staff;
∙ Respect for the individuality of each staff
member; and
∙ Bring about a harmonious relationship and
a conducive social, psychological, and
physical atmosphere
f. The ultimate goal of good supervision is to
provide safe, effective, quality care.

34. PRINCIPLES OF SUPERVISION
e. It uses a democratic process to facilitate:
∙ Effective communication;
∙ Continuous improvement of staff;
∙ Respect for the individuality of each staff
member; and
∙ Bring about a harmonious relationship and
a conducive social, psychological, and
physical atmosphere
f. The ultimate goal of good supervision is to
provide safe, effective, quality care.

35. Controlling

36. Controlling
• Controlling is the use of formal
authority to assure the achievement
of goals and objectives.
• Here, performance is measured and
corrective action is taken to ensure
the accomplishment of
organizational goals.
• It also involves assisting, regulating,
monitoring, and evaluating
individual and group performance.

37. Functions of Controlling
Control serves both as:
• means and an end,
• promotes effective use of
resources,
• provides professional
reinforcements, maintains
activity and expectations.

38. Principles of Controlling
There must be:
1. A Critical Few
2. A defined Point of Control
3. Self – control or Discipline,

39. Kinds of Controlling
The types of formal control
that the manager can use may
be grouped into:
• Pre-action Control
• Post-action Control

40. Types of Controlling
Control are most effective
when they are applied at key
places. Supervisors can
implement controls before
the process begins
(feedforward), during the
process (concurrent), or after
it ceases (feedback).

41. 1. Control systems must be
designed appropriately to be
effective.
2. When control standards are
inflexible or unrealistic,
employees cannot focus on the
organization’s goals.
3. Control systems must prevent,
not cause, the problems they
were designed to detect.
Characteristics of Effective Controls

42. a. Nursing Rounds
b. Quality Assurance
c. Nursing Audit
d. Benchmarking
e. Continuous Quality Improvement
f. Variance Report
g. Accreditation
Evaluation Mechanism

43. Discipline is a control
mechanism employed to
ensure compliance with the
organizational objectives. It is
used to control those who
deviate from performance
and behavioral standards
Discipline

44. • To make the organizational climate
adhere to the organizational goals
• To impart an element of uniformity
despite several differences in
informal behaviors and other
related changes in an organization
• To develop a spirit of tolerance and
a desire to make adjustments.
Objectives of Discipline in the Organization

45. • To give and seek direction and
responsibility
• To create an atmosphere of
respect for the human
personality and human relations.
• To increase the working
efficiency and moral among the
employees.
• To improve the productivity
Objectives of Discipline in the Organization

46. • Self Controlled discipline –
employee brings her or his
behaviour in to agreement with
the organizations official
behavioural code
• Enforced Discipline – action
being enforced by the
organization and employee
compliance with organization’s
rules and regulations.
Types of Discipline

47. Aspects of Discipline
Positive Aspects Negative Aspects
∙ Employees believe and
support to discipline
∙ Adhere to the rules,
regulations, and desired
standards of performance
∙ Positive support and
reinforcement is being
imparted.
∙ Employees doesn’t believe
in support the discipline
∙ Forces and constraints in
obeying the rules and
regulations is being made
∙ Often termed as punitive
approach

48. ∙ All the rules should be framed in
cooperation and collaboration with the
representatives of employees.
∙ All the rules should be appraised at
frequent and regular interval to ensure
that they are, and continue to be,
appropriate, sensible and useful.
∙ Rules should vary with changes in
working conditions of employees.
Principles for Effective Discipline

49. ∙ Rules should uniformly
enforced if they are to be
effective.
∙ Penalties should be clearly
stated.
∙ A disciplinary policy should be
preventive rather than punitive.
Principles for Effective Discipline

50. ∙ If violations of a particular rule are
fairly frequent, the circumstances
surrounding them should be carefully
investigated and studied in order to
discover the causes of such
violations.
∙ Definite and precise provisions for
appeal and review of all disciplinary
actions should be expressly
mentioned in the employee’s
handbook or collective agreements.
Principles for Effective Discipline

51. Approaches to Discipline
Human
Relation
Approach
Employees are helped to correct his deviant behaviors
Human
Resource
Approach
Act of indiscipline as failure in development,
maintenance or utilization of resources
Group
Discipline
Approach
Group norms as the standards of discipline
Autocratic
Approach
Rules and disciplines are set and regulated by the leader
/ supervisor

52. Guidelines for Effective Discipline
1. Get the facts before acting
2. Do not act while you are angry
3. Do not suddenly tighten your
enforcement rules
4. Do not apply penalties
inconsistently

53. Guidelines for Effective Discipline
5. Discipline in private
6. Make the offenses clear. Specify
the accepted behaviour
7. Get the other side of the story

54. Guidelines for Effective Discipline
8. Do not let the disciplining
become personal.
9. Do not back down when you are
right
10. Inform the HRD and
Administration of the outcome and
other pertinent details

55. Self Discipline
∙ The ability to regulate ones conduct by principle and sound judgement, rather
than by impulse, desire, or social custom.
∙ Self discipline can be considered a type of selective training, creating new
habits of thought, action, and speech toward improving yourself and reaching
goals.
∙ Five pillars of self discipline
∙ Acceptance
∙ Willpower
∙ Hardwork
∙ Industry
∙ Persistence

56. Essentials to be Self Disciplined
∙ Get yourself organized
∙ Don’t constantly seek to be entertained
∙ Be on time
∙ Keep your word
∙ Do the most difficult tasks first
∙ Finish what you start
∙ Accept correction
∙ Practice self denial
∙ Welcome responsibility

57. Indiscipline
∙ Disorderliness, insubordination, and
not following the rules and regulation
of an organization
∙ Features:
∙ Change in the normal behavior
∙ Absenteeism, apathy, go-slow at
work, increase in number and
severity of grievances
∙ Persistent and continuous
demand for overtime allowance,
and lack of concern for
performance

58. Causes of Indiscipline
∙ Non – placement of the right person
on the right job
∙ Undesirable behavour of senior
officials
∙ Faulty evaluation of persons and
situations by executives leads of
favoritism
∙ Lack if upward communication

59. Causes of Indiscipline
∙ Leadership which is weak, flexible,
incompetent, and distrustful
∙ Defective supervision
∙ Lack of properly drawn rules and
regulations
∙ Workers’ personal problems, their
fears, apprehensions, hopes and
aspirations; and their lack of
confidence in and their inability to
adjust with their superior and equals.

60. Causes of Indiscipline
∙ Worker’s reaction to rigidity and
multiplicity of rules and their
improper interpretation
∙ Intolerably bad working conditions
∙ Personality characteristics
∙ Absence of enlightened,
sympathetic, and scientific
management
∙ Errors of judgement on the part of
the supervisor or the top
management

61. Causes of Indiscipline
∙ Discrimination based on caste,
colour, creed, sex, language,
and place in matters of
selection, promotion, transfer,
placement, and discrimination
in imposing penalties and
handling out rewards

62. Collective Bargaining for Nurses
• Collective bargaining is a process between
employers and employees to reach an
agreement regarding the rights and duties
of people at work.
• Collective bargaining is an agreement
between a single employer or an association
of employers on the one hand and a labour
union on the other, which regulates the
terms and conditions of employment.

63. Objectives of CBA
• To provide an opportunity to the
workers, to voice their problems on
issues related to employment.
• To facilitate reaching a solution that is
acceptable to all the parties involves.
• To resolve all conflicts and disputes in a
mutually agreeable manner.
• To prevent any conflict/disputes in the
future through mutually signed
contracts.

64. Objectives of CBA
• To develop a conductive atmosphere to
foster good organization relations.
• To provide stable and peaceful
organization (hospital) relations.
• To enhance the productivity of the
organization by preventing strikes lock –
out etc.

65. Characteristics of CBA
• Collective
• Strength
• Voluntary
• Formal
• Flexible
• Improvement
• Representation
• Dynamic
• Continuous
• Bipartate Process

66. Types of Collective Bargaining Agreement
• Conjunctive or Distributive
Bargaining
• Cooperative or Integrative
Bargaining
• Productivity Bargaining

67. Five Core Steps for CBA Process
1. Prepare
2. Discuss
3. Propose
4. Bargain
5. Settlement

68. Advantages of CBA
∙ Contract to guide standards.
∙ Participation in decision making process.
∙ All union members and management must confirm to terms of contract
without exception
∙ Process exists to question manager’s authority if member feels something
was done unjustly
∙ Nurses gain control of practice
∙ Improve professional relationships
∙ Protect patients from inadequate and unsafe care.
∙ Ensure that nurses have fair pay, good benefits, and safe working conditions.
∙ Provide power.

69. Disadvantages of CBA
• Reduced individuality
• Other union members may
outvote one’s decisions.
• Disputes are not handled
with individual and
management only; less room
for professional judgement.
• Must pay union dues even if
one does not support
unionization.