Wednesday, July 1, 2009

MSN: Nursing administration

Subject: Nursing Service Administration
Instructor: Vivian Dedace RN MAN
By: Cabalsa, Medel O.
Lagar, Daisie M.

Management Concepts
Management comprises planning, organizing, staffing, leading or directing, and controlling an organization (a group of one or more people or entities) or effort for the purpose of accomplishing a goal. Resourcing encompasses the deployment and manipulation of human resources, financial resources, technological resources, and natural resources.
Nursing management is performing leadership functions of governance and decision-making within organizations employing nurses. It includes processes common to all management like planning, organizing, staffing, directing and controlling. A good nurse manager should be open to anything in the environment and be sensitive to the needs of the staff under her/his management. It is common for RNs to seek additional education to earn a Master of Science in Nursing or Doctor of Nursing Science to prepare for leadership roles within nursing. Management positions increasingly require candidates to hold an advanced degree in nursing.
Theories of management
Scientific management (also called Taylorism or the Taylor system) is a theory of management that analyzes and synthesizes workflows, with the objective of improving labour productivity. The core ideas of the theory were developed by Frederick Winslow Taylor in the 1880s and 1890s, and were first published in his monographs, Shop Management (1905) and The Principles of Scientific Management (1911).[1] Taylor believed that decisions based upon tradition and rules of thumb should be replaced by precise procedures developed after careful study of an individual at work. Its application is contingent on a high level of managerial control over employee work practices.
Taylorism is a variation on the theme of efficiency; it is a late-19th-and-early-20th-century instance of the larger recurring theme in human life of increasing efficiency, decreasing waste, and using empirical methods to decide what matters, rather than uncritically accepting pre-existing ideas of what matters. Thus it is a chapter in the larger narrative that also includes, for example, the folk wisdom of thrift, time and motion study, Fordism, and lean manufacturing. It overlapped considerably with the Efficiency Movement, which was the broader cultural echo of scientific management's impact on business managers specifically.
Uncertainty management theory :Gudykunst’s first model of Anxiety/Uncertainty management theory was a fusion of the aforementioned URT and Tajfel’s Social Identity Theory, (1978) with a focus on intergroup communication. In 1988 Gudykunst paralleled his research slightly to attempt to explain intercultural adaptation as a result of uncertainty reduction. This version contained 24 axioms and incorporated the works of Stephan and Stephan on anxiety. The key conceptual difference between these two concepts explored by Gudykunst and the existing theory of URT was the intended outcome of the research. The outcome of URT is simply to reduce anxiety and uncertainty. Gudykunst’s intended outcome was for effective communication and cultural adaptation and not solely the reduction of anxiety. The inherent difference is that managing anxiety is to maintain it between minimum and maximum thresholds along a spectrum while reducing anxiety is unidirectional. This realization, along with the introduction of mindfulness as a factor of effective communication, led Gudykunst to finally designate an appropriate name for his research: Anxiety Uncertainty Management Theory (AUM).
Self-Regulation Theory or SRT is a system of conscious personal health management. Although a doctor may give a patient sound medical advice, the theory states that only with self-regulation will the patient appropriately implement that advice. For medical treatment to be effective, the patient needs to be interested in improving one's own health.
SRT consists of several stages. First, the patient deliberately monitors one's own behavior, and evaluates how this behavior affects one's health. If the desired effect is not realized, the patient changes personal behavior. If the desired effect is realized, the patient reinforces the effect by continuing the behavior. (Kanfer 1970;1971;1980
Boreout is a management theory that posits that lack of work, boredom, and consequent lack of satisfaction are a common malaise affecting individuals working in modern organizations, especially in office-based white collar jobs. This theory was first expounded in Diagnosis Boreout, a book by Peter Werder and Philippe Rothlin, two Swiss business consultants.

An absence of meaningful tasks, rather than stress, is the crucial problem for many workers according to Werder and Rothlin. Boreout consists of three elements: boredom, lack of challenge and disinterest. The authors disagree with the common perceptions that a demotivated employee is lazy; instead, they claim that the employee has lost interest in work tasks. Those suffering from boreout are ‘dissatisfied with their professional situation’.[1] They are frustrated by being unable to either contribute to the development of the company or use their skills, knowledge and abilities, or get recognised for their efforts.

Terror management theory (TMT) is a developing area of study within the academic study of psychology. It looks at what researchers claim to be the implicit emotional reactions of people when confronted with the psychological terror of knowing we will eventually die (some believe that awareness of mortality is a trait that is unique to humans). Empirical support for TMT has originated from more than 175 published experiments which have been conducted cross-culturally both nationally and internationally (Solomon, 2004).
The theory was first developed in the late 1980s by Skidmore College psychology professor Sheldon Solomon, University of Arizona psychology professor Jeff Greenberg, and Colorado University at Colorado Springs psychology professor Tom Pyszczynski, who were graduate students at the University of Kansas at the time. The trio were inspired by the theories of Ernest Becker (The Denial of Death, 1973), Otto Rank and Freud, on how potent reminders of one's own ultimate death often provoke a belief in some form of mystical transcendence (heaven, reincarnation, spiritualism, etc.) Terror management theory attempts to provide a rationale for the motivational catalysts of human behavior when life is threatened.
The theory builds from the assumption that the capability of self-reflection and the consciousness of one’s own mortality can be regarded as a continuous source for existential anguish. This "irresolvable paradox" is created from the desire to preserve life and the realization of that impossibility (because life is finite).
Humans are aware of the inevitability of their own death. Culture diminishes this psychological terror by providing meaning, organization and continuity to people's lives. Compliance with cultural values enhances one's feeling of security and self-esteem, provided that the individual is capable of living in accordance with whatever particular cultural standards apply to him or her. The belief in the rightness of the cultural values and standards creates the conviction necessary to live a reasonable and meaningful life. This cultural worldview provides a base of making sense of the world as stable and orderly, a place where one rests their hopes on symbolic immortality (e.g., fame, having children, legacies of wealth or fortune) or literal immortality (e.g., the promise of a life in an afterworld).
Principles of Management
1. Division of Work -
The specialization of the workforce, creating specific personal and professional development within the labour force and therefore increasing productivity; leads to specialization which increases the efficiency of labour. By separating a small part of work, the workers speed and accuracy in its performance increases. This principle is applicable to both technical as well as managerial work.
2. Authority and Responsibility-
The issue of commands followed by responsibility for their consequences. Authority means the right of a superior to give order to his subordinates; responsibility means obligation for performance. This principle suggests that there must be parity between authority and responsibilty.. They are co-existent and go together, and are two sides of the same coin.
3. Discipline-
Discipline refers to obedience, proper conduct in relation to others, respect of authority, etc. It is essential for the smooth functioning of all organizations.
4. Unity of Command -
This principle states that every subordinate should receive orders and be accountable to one and only one superior. If an employee receives orders from more than one superior, it is likely to create confusion and conflict.
Unity of Command also makes it easier to fix responsibility for mistakes.
5. Unity of Direction -
All those working in the same line of activity must understand and pursue the same objectives. All related activities should be put under one group, there should be one plan of action for them, and they should be under the control of one manager.
It seeks to ensure unity of action, focusing of efforts and coordination of strength.
6. Subordination of Individual Interest
The management must put aside personal considerations and put company objectives first. Therefore the interests of goals of the organization must prevail over the personal interests of individuals.
7. Remuneration -
Workers must be paid sufficiently as this is a chief motivation of employees and therefore greatly influences productivity. The quantum and methods of remuneration payable should be fair, reasonable and rewarding of effort.
8. The Degree of Centralization -
The amount of power wielded with the central management depends on company size. Centralization implies the concentration of decision making authority at the top management. Sharing of authority with lower levels is called decentralization. The organization should strive to achieve a proper balance.
9. Scalar Chain -
Scalar Chain refers to the chain of superiors ranging from top management to the lowest rank. The principle suggests that there should be a clear line of authority from top to bottom linking all managers at all levels. It is considered a chain of command. It involves a concept called a "gang plank" using which a subordinate may contact a superior or his superior in case of an emergency,defying the hierarchy of control.However the imediate superiors must be informed about the matter
10. Order -
Social order ensures the fluid operation of a company through authoritative procedure. Material order ensures safety and efficiency in the workplace.
11. Equity -
Employees must be treated kindly, and justice must be enacted to ensure a just workplace. Managers should be fair and impartial when dealing with employees.
12. Stability of Tenure of Personnel -
The period of service should not be too short and employees should not be moved from positions frequently. An employee cannot render useful service if he is removed before he becomes accustomed to the work assigned to him.
13. Initiative -
Using the initiative of employees can add strength and new ideas to an organization. Initiative on the part of employees is a source of strength for the organization because it provides new and better ideas. Employees are likely to take greater interest in the functioning of the organization.
14. Esprit de Corps -
This refers to the need of managers to ensure and develop morale in the workplace; individually and communally. Team spirit helps develop an atmosphere of mutual trust and understanding.
These can be used to initiate and aid the processes of change, organization, decision making, skill management and the overall view of the management function.
Fayol also divided the management function into five key roles:
• To organise
• To plan and forecast (Prevoyance)
• To command
• To control
• To coordinate
Managerial Roles
(Chris van Overveen - Senior Consultant Trimitra Consultants)

To meet the many demands of performing their functions, managers assume multiple roles. A role is an organized set of behaviors. Henry Mintzberg has identified ten roles common to the work of all managers. The ten roles are divided into three groups: interpersonal, informational, and decisional.

The informational roles link all managerial work together. The interpersonal roles ensure that information is provided. The decisional roles make significant use of the information.

The performance of managerial roles and the requirements of these roles can be played at different times by the same manager and to different degrees depending on the level and function of management. The ten roles are described individually, but they form an integrated whole.

The three interpersonal roles are primarily concerned with interpersonal relationships.

In the figurehead role, the manager represents the organization in all matters of formality. The top level manager represents the company legally and socially to those outside of the organization. The supervisor represents the work group to higher management and higher management to the work group.

In the liaison role, the manger interacts with peers and people outside the organization. The top level manager uses the liaison role to gain favors and information, while the supervisor uses it to maintain the routine flow of work.

The leader role defines the relationships between the manger and employees.
The direct relationships with people in the interpersonal roles place the manager in a unique position to get information.

Thus, the three informational roles are primarily concerned with the information aspects of managerial work. In the monitor role, the manager receives and collects information. In the role of disseminator, the manager transmits special information into the organization. The top level manager receives and transmits more information from people outside the organization than the supervisor.

In the role of spokesperson, the manager disseminates the organization's information into its environment. Thus, the top level manager is seen as an industry expert, while the supervisor is seen as a unit or departmental expert.
The unique access to information places the manager at the center of organizational decision making.

There are four decisional roles. In the entrepreneur role, the manager initiates change. In the disturbance handler role, the manger deals with threats to the organization. In the resource allocator role, the manager chooses where the organization will expend its efforts. In the negotiator role, the manager negotiates on behalf of the organization. The top level manager makes the decisions about the organization as a whole, while the supervisor makes decisions about his or her particular work unit.

The supervisor performs these managerial roles but with different emphasis than higher managers. Supervisory management is more focused and short-term in outlook.

Thus, the figurehead role becomes less significant and the disturbance handler and negotiator roles increase in importance for the supervisor.

Since leadership permeates all activities, the leader role is among the most important of all roles at all levels of management.

Masterals : Nursing Management

MANAGEMENT ARTICLES

Managerial Roles
(Chris van Overveen - Senior Consultant Trimitra Consultants)

To meet the many demands of performing their functions, managers assume multiple roles. A role is an organized set of behaviors. Henry Mintzberg has identified ten roles common to the work of all managers. The ten roles are divided into three groups: interpersonal, informational, and decisional.

The informational roles link all managerial work together. The interpersonal roles ensure that information is provided. The decisional roles make significant use of the information.

The performance of managerial roles and the requirements of these roles can be played at different times by the same manager and to different degrees depending on the level and function of management. The ten roles are described individually, but they form an integrated whole.

The three interpersonal roles are primarily concerned with interpersonal relationships.

In the figurehead role, the manager represents the organization in all matters of formality. The top level manager represents the company legally and socially to those outside of the organization. The supervisor represents the work group to higher management and higher management to the work group.

In the liaison role, the manger interacts with peers and people outside the organization. The top level manager uses the liaison role to gain favors and information, while the supervisor uses it to maintain the routine flow of work.

The leader role defines the relationships between the manger and employees.
The direct relationships with people in the interpersonal roles place the manager in a unique position to get information.

Thus, the three informational roles are primarily concerned with the information aspects of managerial work. In the monitor role, the manager receives and collects information. In the role of disseminator, the manager transmits special information into the organization. The top level manager receives and transmits more information from people outside the organization than the supervisor.

In the role of spokesperson, the manager disseminates the organization's information into its environment. Thus, the top level manager is seen as an industry expert, while the supervisor is seen as a unit or departmental expert.
The unique access to information places the manager at the center of organizational decision making.

There are four decisional roles. In the entrepreneur role, the manager initiates change. In the disturbance handler role, the manger deals with threats to the organization. In the resource allocator role, the manager chooses where the organization will expend its efforts. In the negotiator role, the manager negotiates on behalf of the organization. The top level manager makes the decisions about the organization as a whole, while the supervisor makes decisions about his or her particular work unit.

The supervior performs these managerial roles but with different emphasis than higher managers. Supervisory management is more focused and short-term in outlook.

Thus, the figurehead role becomes less significant and the disturbance handler and negotiator roles increase in importance for the supervisor.

Since leadership permeates all activities, the leader role is among the most important of all roles at all levels of management.


The Principles of management [edit]
Management principles are statements of fundamental truth. These principles serve as guidelines for decisions and actions of managers. They are derived through observation and analysis of events which managers have to face in practice.
1. Division of Work -
The specialization of the workforce, creating specific personal and professional development within the labour force and therefore increasing productivity; leads to specialization which increases the efficiency of labour. By separating a small part of work, the workers speed and accuracy in its performance increases. This principle is applicable to both technical as well as managerial work.
2. Authority and Responsibility-
The issue of commands followed by responsibility for their consequences. Authority means the right of a superior to give order to his subordinates; responsibility means obligation for performance. This principle suggests that there must be parity between authority and responsibilty.. They are co-existent and go together, and are two sides of the same coin.
3. Discipline-
Discipline refers to obedience, proper conduct in relation to others, respect of authority, etc. It is essential for the smooth functioning of all organizations.
4. Unity of Command -
This principle states that every subordinate should receive orders and be accountable to one and only one superior. If an employee receives orders from more than one superior, it is likely to create confusion and conflict.
Unity of Command also makes it easier to fix responsibility for mistakes.
5. Unity of Direction -
All those working in the same line of activity must understand and pursue the same objectives. All related activities should be put under one group, there should be one plan of action for them, and they should be under the control of one manager.
It seeks to ensure unity of action, focusing of efforts and coordination of strength.
6. Subordination of Individual Interest
The management must put aside personal considerations and put company objectives first. Therefore the interests of goals of the organization must prevail over the personal interests of individuals.
7. Remuneration -
Workers must be paid sufficiently as this is a chief motivation of employees and therefore greatly influences productivity. The quantum and methods of remuneration payable should be fair, reasonable and rewarding of effort.
8. The Degree of Centralization -
The amount of power wielded with the central management depends on company size. Centralization implies the concentration of decision making authority at the top management. Sharing of authority with lower levels is called decentralization. The organization should strive to achieve a proper balance.
9. Scalar Chain -
Scalar Chain refers to the chain of superiors ranging from top management to the lowest rank. The principle suggests that there should be a clear line of authority from top to bottom linking all managers at all levels. It is considered a chain of command. It involves a concept called a "gang plank" using which a subordinate may contact a superior or his superior in case of an emergency,defying the hierarchy of control.However the imediate superiors must be informed about the matter
10. Order -
Social order ensures the fluid operation of a company through authoritative procedure. Material order ensures safety and efficiency in the workplace.
11. Equity -
Employees must be treated kindly, and justice must be enacted to ensure a just workplace. Managers should be fair and impartial when dealing with employees.
12. Stability of Tenure of Personnel -
The period of service should not be too short and employees should not be moved from positions frequently. An employee cannot render useful service if he is removed before he becomes accustomed to the work assigned to him.
13. Initiative -
Using the initiative of employees can add strength and new ideas to an organization. Initiative on the part of employees is a source of strength for the organization because it provides new and better ideas. Employees are likely to take greater interest in the functioning of the organization.
14. Esprit de Corps -
This refers to the need of managers to ensure and develop morale in the workplace; individually and communally. Team spirit helps develop an atmosphere of mutual trust and understanding.
These can be used to initiate and aid the processes of change, organization, decision making, skill management and the overall view of the management function.
Fayol also divided the management function into five key roles:
• To organise
• To plan and forecast (Prevoyance)
• To command
• To control
• To coordinate
Management comprises planning, organizing, staffing, leading or directing, and controlling an organization (a group of one or more people or entities) or effort for the purpose of accomplishing a goal. Resourcing encompasses the deployment and manipulation of human resources, financial resources, technological resources, and natural resources.
Management can also refer to the person or people who perform the act(s) of management.
Nursing management is performing leadership functions of governance and decision-making within organizations employing nurses. It includes processes common to all management like planning, organizing, staffing, directing and controlling. A good nurse manager should be open to anything in the environment and be sensitive to the needs of the staff under her/his management.
It is common for RNs to seek additional education to earn a Master of Science in Nursing or Doctor of Nursing Science to prepare for leadership roles within nursing. Management positions increasingly require candidates to hold an advanced degree in nursing.
Theories of management

Terror management theory (TMT) is a developing area of study within the academic study of psychology. It looks at what researchers claim to be the implicit emotional reactions of people when confronted with the psychological terror of knowing we will eventually die (some believe that awareness of mortality is a trait that is unique to humans). Empirical support for TMT has originated from more than 175 published experiments which have been conducted cross-culturally both nationally and internationally (Solomon, 2004).
The theory was first developed in the late 1980s by Skidmore College psychology professor Sheldon Solomon, University of Arizona psychology professor Jeff Greenberg, and Colorado University at Colorado Springs psychology professor Tom Pyszczynski, who were graduate students at the University of Kansas at the time. The trio were inspired by the theories of Ernest Becker (The Denial of Death, 1973), Otto Rank and Freud, on how potent reminders of one's own ultimate death often provoke a belief in some form of mystical transcendence (heaven, reincarnation, spiritualism, etc.) Terror management theory attempts to provide a rationale for the motivational catalysts of human behavior when life is threatened.
The theory builds from the assumption that the capability of self-reflection and the consciousness of one’s own mortality can be regarded as a continuous source for existential anguish. This "irresolvable paradox" is created from the desire to preserve life and the realization of that impossibility (because life is finite).
Humans are aware of the inevitability of their own death. Culture diminishes this psychological terror by providing meaning, organization and continuity to people's lives. Compliance with cultural values enhances one's feeling of security and self-esteem, provided that the individual is capable of living in accordance with whatever particular cultural standards apply to him or her. The belief in the rightness of the cultural values and standards creates the conviction necessary to live a reasonable and meaningful life. This cultural worldview provides a base of making sense of the world as stable and orderly, a place where one rests their hopes on symbolic immortality (e.g., fame, having children, legacies of wealth or fortune) or literal immortality (e.g., the promise of a life in an afterworld).
Scientific management (also called Taylorism or the Taylor system) is a theory of management that analyzes and synthesizes workflows, with the objective of improving labour productivity. The core ideas of the theory were developed by Frederick Winslow Taylor in the 1880s and 1890s, and were first published in his monographs, Shop Management (1905) and The Principles of Scientific Management (1911).[1] Taylor believed that decisions based upon tradition and rules of thumb should be replaced by precise procedures developed after careful study of an individual at work. Its application is contingent on a high level of managerial control over employee work practices.
Taylorism is a variation on the theme of efficiency; it is a late-19th-and-early-20th-century instance of the larger recurring theme in human life of increasing efficiency, decreasing waste, and using empirical methods to decide what matters, rather than uncritically accepting pre-existing ideas of what matters. Thus it is a chapter in the larger narrative that also includes, for example, the folk wisdom of thrift, time and motion study, Fordism, and lean manufacturing. It overlapped considerably with the Efficiency Movement, which was the broader cultural echo of scientific management's impact on business managers specifically.
Theory Z is the name applied to two competing management theories. One was developed by Abraham H. Maslow in his book Maslow on Management and the other is Dr. William Ouchi's so-called "Japanese Management" style popularized during the Asian economic boom of the 1980s.[1] In contrast Theory X, which stated that workers inherently dislike and avoid work and must be driven to it, and Theory Y, which stated that work is natural and can be a source of satisfaction when aimed at higher order human psychological needs, Theory Z focused on increasing employee loyalty to the company by providing a job for life with a strong focus on the well-being of the employee, both on and off the job. According to Ouchi, Theory Z management tends to promote stable employment, high productivity, and high employee morale and satisfaction.
Ironically, "Japanese Management" and Theory Z itself were based on Dr. W. Edwards Deming's famous "14 points". Deming, an American scholar whose management and motivation theories were rejected in the United States, went on to help lay the foundation of Japanese organizational development during their expansion in the world economy in the 1980s. Deming's theories are summarized in his two books, Out of the Crisis and The New Economics, in which he spells out his "System of Profound Knowledge". He was a frequent advisor to Japanese business and government leaders, and eventually became a revered counselor. Deming was awarded the Second Order of the Sacred Treasure by the former Emperor Hirohito, and American businesses ultimately tried unsuccessfully to use his "Japanese" approach to improve their competitive position.
Boreout is a management theory that posits that lack of work, boredom, and consequent lack of satisfaction are a common malaise affecting individuals working in modern organizations, especially in office-based white collar jobs. This theory was first expounded in Diagnosis Boreout, a book by Peter Werder and Philippe Rothlin, two Swiss business consultants.

An absence of meaningful tasks, rather than stress, is the crucial problem for many workers according to Werder and Rothlin. Boreout consists of three elements: boredom, lack of challenge and disinterest. The authors disagree with the common perceptions that a demotivated employee is lazy; instead, they claim that the employee has lost interest in work tasks. Those suffering from boreout are ‘dissatisfied with their professional situation’.[1] They are frustrated by being unable to either contribute to the development of the company or use their skills, knowledge and abilities, or get recognised for their efforts.
Self-Regulation Theory or SRT is a system of conscious personal health management. Although a doctor may give a patient sound medical advice, the theory states that only with self-regulation will the patient appropriately implement that advice. For medical treatment to be effective, the patient needs to be interested in improving one's own health.
SRT consists of several stages. First, the patient deliberately monitors one's own behavior, and evaluates how this behavior affects one's health. If the desired effect is not realized, the patient changes personal behavior. If the desired effect is realized, the patient reinforces the effect by continuing the behavior. (Kanfer 1970;1971;1980)
Another approach is for the patient to realize a personal health issue and understand the factors involved in that issue. The patient must decide upon an action plan for resolving the health issue. The patient will need to deliberately monitor the results in order to appraise the effects, checking for any necessary changes in the action plan. (Leventhal & Nerenz 1984)
Anxiety/Uncertainty Management (AUM) is a theory developed by Dr. William B. Gudykunst in an attempt to define what makes up effective communication. Gudykunst’s research began in 1985 using existing theories as a starting point. Specifically, the existing research of Uncertainty reduction theory (URT) done by Berger and Calabrese (1974) provided the framework for Gudykunst to take the next steps. Like most theories on communication, AUM has undergone several modifications over the years as new research comes to light.
Development of Anxiety/Uncertainty Management as a Theory
Gudykunst’s first model of Anxiety/Uncertainty management theory was a fusion of the aforementioned URT and Tajfel’s Social Identity Theory, (1978) with a focus on intergroup communication. In 1988 Gudykunst paralleled his research slightly to attempt to explain intercultural adaptation as a result of uncertainty reduction. This version contained 24 axioms and incorporated the works of Stephan and Stephan on anxiety. The key conceptual difference between these two concepts explored by Gudykunst and the existing theory of URT was the intended outcome of the research. The outcome of URT is simply to reduce anxiety and uncertainty. Gudykunst’s intended outcome was for effective communication and cultural adaptation and not solely the reduction of anxiety. The inherent difference is that managing anxiety is to maintain it between minimum and maximum thresholds along a spectrum while reducing anxiety is unidirectional. This realization, along with the introduction of mindfulness as a factor of effective communication, led Gudykunst to finally designate an appropriate name for his research: Anxiety Uncertainty Management Theory (AUM).
The purpose of the first iteration of AUM was to be a practical application with a high degree of utility. The format of AUM includes numerous axioms, which in turn converge on one another moving in the direction of effective communication. (See Figure X). The specific number of axioms has varied over the last fifteen years according to updated research in the field of cross-cultural communication.