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y NURSING MANAGEMENT
Concept, types, principles and techniques, Vision and Mission Statements, Philosophy, aims
and objective, current trends and issues in Nursing Administration, Theories and models,
Application to Nursing service and education

Management is the act of doing things through & with people in organised group. Health
management is to make health care available to every family in an area.

DEFINITION OF MANAGEMENT:

“Management is the act of doing things through & with the people in formally organised
group.”

CHARACTERISTIC OF MANAGEMENT:

1.
2.
3.
4.
5.
6.
7.
Koontz

Management is “working with human financial & physical resources to achieve

organisational objectives by performing the planning, organising, leading & controlling
function.” Meggression & mosby

Management is a problem solving process of effectively achieving organisational objectives

through the efficient use of scarce resources in a changing environment. Keritner

Management has been defined differently by different writers. Some defined it as a

“technique of getting things done while others as a process of planning, organising, staffing
& controlling.” By analysis the various concepts we can say that management is based on
economic resources, goal decided, distinct process, system of process authority, unifying
force, multidisplinary subject & universal activity.

Management is concerned with getting the work done.

Efficient & effective utilisation

Achievement Goal

It is a process of unification. It brings men, material, money & machine together.

It leads to proper utilisation of resources men, material, and money.
It is a social process as it belongs to social organisations.
It aims at securing maximum results with minimum efforts & cost effective.
It is an activity related to human & extra human means of production.
It is universal process. It exists where there is social organisation.

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 8. It is purposive as it has objectives to be achieved.
9. It is based on social sciences that are its tools & concepts belong to social science.
10. It is concerned with good human relations.

TYPES OF MANAGEMENT:

Management of two types:

1. Top management.
2. Middle management.

Top level management comprises political & administrative personnel. In India minister of
family welfare, joint secretery, secratory of health department.

Functions:

 it performs management functions:

 It gives direction & control in the organisation.
 It prepares notes, reports & information required for the press, public & legislature.
 It provides, he legislative information asked by it through interpretation, short notice
question & its committee.
 It gathers information which the minister required for pressure group, party news, and
constituency such information appears in the form of reports or circular.
 It also has to supply information about legal matters which are pending in the low
courts.
 It serves as a coordinating body inter & intra department agencies.
 It serves as link between cabinet & civil services.
 It coordinates activities of various department, boards & divisions.
 It has to assimilate activity & energy of various technical agencies in to general
administrative to the state.
 It also shares with political heads the thinking, planning & function.

Middle management:

 it is progressive & operational planning.

 Control & direction of operations.
 Skilful supervision.
 Eliciting public co-operation.

Middle manager qualities:

 Vocational specialist.
 Knowledge of rule.
 Skilful supervisor.
 Have a good experience.

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CONCEPTS OF MANAGEMENT:

Introduction:

In order to satisfy his/ her wants a person has to perform numerous activities. An individual
alone can’t perform all necessary activities. Therefore human beings gain or co-operate
together in the form of groups or organisation. Different concepts of management are given
by different writers. Raymond Gi Leon his famous book has written “manage more by doing
less” which explain the following concepts for effective management.

a) Management by communication: manager spend 90% of his time in

communication only. Communication determines the effectiveness of the
management. Communication is a continuous, coordinate process of telling, listening
& understanding. According to this concept the success of management depends
upon the successful communication.
b) Management by system: this refers to:
 Recognising he problems, analysis it & defining the objectives.
 Collection & analysis of necessary data.
 Finding out various possible alternatives.
 Reviewing & evaluating each alternative.
 Testing the conclusion if possible.
 Selecting the best alternatives.
 Reviewing the results & taking corrective actions if necessary
c) Management by results: this concept states that the end results are significant.
Development or progress can be evaluated by looking the end results. Management is
result oriented.
d) Management by participation: the concept takes workers in confidence. Workrers
are provided opportunity in decision making process. It also involves the doctrine of
trusteeship. This concept helps in creating a sense of involvement among the
workers.
e) Management by motivation: motivation is considered as the dynamic aspects.
Management distinct from that of mechanical one. The problem of motivation is its
action in its executive form. It is among the chief tasks of the general manager.
f) Management by exception: it is a special skill of managing by attending only to
exceptionally important matters & are handled by the lower level officers.
g) Management by objectives: it is dynamic system which seeks to integrate the
company’s need to clarify & achieve its profit & growth goals with the manager’s
need to contribute & develop himself. It is demanding & rewarding style of managing
a business.

According to prof. redder it is established of effectiveness, standards for managerial positions

& the periodic conversion of those in to measurable time bound objectives linked vertically &
horizontally & with future planning.

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M.B.O: M.B.O is a comprehensive managerial system that indicate many key managerial
activity in a systematic manner & i.e. consciously directed toward the effective & efficient
achievement of organisational & individual activities.

Definition: M.B.O is demanding & rewarding style of managing a business. HUMBLE.

M.B.O as a process where by superior & subordinate manager of an organisation jointly

defines its common goals, define each individual major area of responsibility in terms of
result expected of him & use these measures as guide for operating the unit & assessing the
contribution of each its members. ODIORNE.

Significance of M.B.O:

1. Key to effective planning/ organised approach.

2. Encourage consistency in managerial end, planning & decision making.
3. Planning is meaning less if it is not related to objectives.
4. End point of planing.
5. Give direction to managerial & other activities.
6. Purchasing, marketing, financing, production all are directed towards objectives.
7. Necessary for the survival of any business.
8. Well planned objective will help in achieving effective planning, communication &
coordination.
9. M.B.O lays great emphasis on development & utilisation of human resources.
10. Problem area identified well by M.B.O.

Characteristics & features of M.B.O.

 Highly objective technique.

 Superior, subordinate participates & interacts.
 Superior subordinate joint in setting the goal.
 Superior subordinate mutually devise methodology.
 Superior subordinate are helping hand.
 Periodical progress reviewed for predetermined goals.
 Result oriented system of information by M.B.O.

M.B.O process:

1. Setting up of objectives.
2. Developing the action plan:
 Overall objectives of subordinate’s job.
 Key result he must achieve to fulfil objectives.
 Long term & short term priority of task & adhere to it.
 Scope & extent of assistancy he may expect from the seniors & others.
 Nature of information & report he will receive to carry of self evaluation.
3. Establish check points:
Periodically standard of performance for evaluating the progress should made.

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 4. Review of performance: annually or biannually.

Objectives M.B.O:

1. Obtaining a certain rate of profit & return.

2. Emphasizing research & develop a continue process of product.
3. Develop public stock ownership.
4. Distributing products in foreign market.
5. Ensuring competitive prices for superior product.
6. Achieving a dominant position in industry.
7. Adhering to the values in which it operates.

Overall objectives:

o Attracting highly qualified students.

o Offering basic training & liberal art success as well as in certain professional fields.
o Attracting highly regarded professors.
o Discovering & organising new research.

Advantage by M.B.O:

 Better planning.
 Better organisation.
 Self control.
 Higher productivity.
 Better appraisal for performance.
 Executive.

Limitation of M.B.O:

 Hesitation.
 Poor planning.
 Lack of training.
 Limited applications.
 Inflexibility.
 Costly process.

GENERAL MODEL OF MBO

Ends- means chain of organizational objectives:

MEANS OVERALL OBJECTIVES ENDS

DIVISIONAL OBJECTIVES

DEPARTMENTAL OBJECTIVES

INDIVIDUAL ONJECTIVES

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STEPS IN MBO:

1. Establish organisational goal, long term & short term.

2. To establish long term & short term goal.

According to Dr. C.B. Gupta: concepts of management are:

1. Management as an economic resources: management is a vital factor of production.

An girepreneur establishes as its owner. But it is management that transforms the
various resources in to a productive quantity. The inputs of labour, capital & materials
do not by themselves ensures growth. But management that co-ordinates various
factors of production.
2. It is factor of production, management can be made efficient through the training &
development of managers. Objectives for each manager, clarifying the key performer
standards.
3. Review of the periodic performance.
4. Encouraging the managers to accept responsibility.

Benefits of MBO:

1) The need for planning will be recognised.

2) It provides for objectives & accountability for performances.
3) It encourages participative management.
4) It helps in job enrichment.
5) It provides for a good feedback system.

2. Management as a team: as a team, management consists of all personnel having

managerial responsibility. Managers occupy positions at different levels of authority but
perform the basic functions. Top level managers have greater authority than middle level
managers. In this way of system of authority created in every organisation.

The management group consists of different types of managers that is professional managers,
top managers etc.

3. Management as an academic discipline: management implies a branch of knowledge. It

comprises management theories & principles, for tackling managerial problems.management
have become a very popular subject of study.

4. Management as a process: it involves organising, directing & controlling human efforts

to accomplish predetermined goals management process refers to series of elements. There
are:

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 a) Defining the aims or objectives of the organisation.
b) Formulating policies, procedures, programmes etc.
c) Bringing together men, money, material & machinery & other factors.
d) Assigning work or duties to people & defining their authority & responsibility.
e) Guiding & inspiring people to perform the assigned tasks as planned.
f) Exercising the control over the performance of people. This concept of management
is the simplest & the most pragmatic it also highlights the universal nature of
management.

5. Management as a human process: this concept was evolved by the behaviour scientist to
recognise the role of human factor in the industry. According to this concept manager get the
things done through the people. Therefore they focus the study of the individual, his
psychology, motives & needs, the informal groups & group dynamics. So the act of
management is getting the things done through or with people in formally organised groups.

6. Management is concerned with ideas, things and people: management is a creative

process. In these process ideas, things & people are vital inputs. Management concerned with
ideas, things & people in following ways.

Management of ideas: it is very crucial for economic & social growth. It is the job of
management is to generate, organise & articulate creative ideas & transform there in to
operating results. Management of ideas involves intellectual, creative & innovative processes.

Management of things: it refers to mobilisation & allocation of material, machinery,

technology & other facilities to connect ideas in to results & performance. it is conversion of
resources in to outputs efficiently & effectively.

Management of people: refers to procurement, development, maintenance & integration of

human beings working in the organisation. it is most important task of the managers.
Management must understand the needs, aspiration & values of the people.

7. Management is the effective utilisation of the human & material resources to achieve
the objectives of the organisation or enterprises.

Objectives of enterprises:

Profit, safety, growth & fulfilment of responsibility.

Human & material resources:

It is manager’s responsibility to utilise human & resources efficiently. It reduce the cost per
unit.

MANAGEMENT THEORIES

1. CLASSICAL SCHOOL: it is oldest sool of management thought. The classical

theorists concentrated on organizational, structure and the achievement of

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 organizational goals. It has also developed certain principles that hold good even
today.
According to Luther Gulick organization is the formal structure of authority
through which work sub- division are arranged, defined and co-ordinated for the
defined objective. Organizations in the public health administration has a hierarchical
line of authority. Hierarchy is grading of several successive steps or levels is
immediately subordinate to the next higher one, and one to the higher steps right to
the top. This line of authority helps to clarify, define the relative position and
responsibilities of each post in the Organization. All the employees have separate
function but all function towards the achievement of a common goal. The classical
thought can be studied under three streams.
a) Scientific management.
b) Administration management or management process
c) Bureaucracy
a. Scientific management: under scientific management every single subject becomes
the question for scientific investigation. The use of observation, measurement,
experimentation, analysis, rationality and reasoning are all the instrument, fr
developing managerial systems. The basic components are:
 Determination of standards of performance.
 Functional foremanship.
 Responsibilities of management.

b. management process school: it regards management as the process of getting things done
with though people as individual and as members of work group. It uses the managerial
experiences as the basis for developing certain principle which can be futher use can study
and research of aagement as well as for improving the practice of management.

When it in community health nursing administration than more importance is given to the
community participation. The healthcare is given according to the needs of the peole in which
health is attained by the people and through the people.

c. Bureaucratic`throry school: Max Weber given this theory of organization and

management it refers to “ certain characteristics of organizational design”. It is
characteristics:

 Assignments of activities of individual as fixed duties.

 A hierarchy of authority and chain of command running throughout organization.
 Administration through well defined rule.
 Decision making on rational and objective criteria.
 Employment and promotion based on competency.

It is centralized approach

Power of decision on the top level so that the lower ones have to refer most problem to
the head of department through proper channel.

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 2. NEO CLASSICAL SCHOOL: it removes the deficiency of classical schools and
suggested the improvement for good human relations of the organization. This is also
known by human relations school.it emphasis human dimension of management as a
counter point against the impersonality of classical theory. Thus its findings leads to the
development of new hypothesis that is:

 Motivation to work
 Moral and productivity
 Social relations among the worker and supervisor.
 Incentives for e.g. femal health workers receive incentive in the community
services

This school of thought view organization as asocial system of interpersonal and

intergrop relationships. They focus on the people as a part of management and
consider man as a uniqe social and psychological being . they emphasise to create the
conducive environment to full fill social and psychological need of people.

3. BEHAVIOURAL SCIENCE SCHOOL: it believes that it is difficut to

understand the socialogy of a group separate from the psychology of the individuals
comprising itand the anthropology of the culture with in which it exists. Thus the
behaviour science is transactional and they concerned with all aspects relevant aspects
of human behaviour approach are as follows:

 Management is the process of getting the things done by people, so, managers
should understand human behaviour.
 Stress should be given on the productivity through motivation & good human
relationship.
 Motivation, leadership, communication, participative management & group
dynamics are central core of this approach.

4. MODERN SCHOOL: this school define organisation as a system & also consider the
impact of environment on the effectiveness of the organisation. It is decentralised approach in
which the lower levels are allowed the discussion to decide most of the matters which come
up. As a result two approaches have come

1. System approach.
2. Contingency approach.

The system approach: in this system organisation is viewed as an organic & open system,
which is intersetting & interdependent parts called subsystems. Organisations are organic
system which must satisfy the conditions for the survival.

1) Organisation should be stable & its various parts should be in the balance with one
another.
2) It should grow & nurture like other entities.
 It should adapt to environmental changes.

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  It is characterised by homeostatic tendency of maintaining equilibrium by
constant adjustment in response to change in environment.
 Community as a system.
 Closed or open system.

The community health nurse must use a systematic approach to determine how healthy a
community is and what are its health needs.

COMPONENT OF THE SYSTEM MODEL:-

1) Boundaries: - factors that separate a community from its environment and maintain
the integrity of the community. The boundary of a system maintain the integrity of the
community. The boundaries of a system can be permeable or impermeable. A very
closed rigid system is resistant to change whereas an open system is more receptive to
change and help the health care delivery system.
2) Goals: - the goals are focused on maximising the well being of its members
promoting the survival and meeting the needs of community members.
3) Set factors: - the physical and the psychosocial characteristics of the community that
affect behaviour. Physical characteristics include
- Length of time the community has been in existence.
- Pertinent demographic data.
- Physical features of the community.
Psychosocial characteristics that affect emotional tones of the community includes:-
- Religion.
- Socio economic class.
- Education.
- Occupation.
- Marital status.
4) Inputs: - inputs may be either resources or demand on the community and may be
imperative or voluntary. The input can be grouped under the following categories:-
- Money.
- Facilities.
- Human services.
- Health information.
- Legislation
- Values of supra system.
Internal functioning of the community divided into four functional sub systems:-
- Economy.
- Polity.
- Communication.
- Values.
The categories of the economy include human services, money, facilities, equipments
and goals and education. Co- ordination control and direction of activities are required

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 to maintain the community and attain goals. The polity subsystem provides
organizational structure, leadership, decision making and social control to its
members. The goal of the community sub system is to provide identity and support to
its members. It includes verbal and non verbal communication. The goals of the value
subsystem are to provide guidelines for the behaviour. The pattern of behaviour that
examined includes tradition, presence of identifiable sub groups, aesthetic
environments, health and homogeneity of the group.
5) Outputs: - the health status of the community includes:- 2 interrelated factors such as
people and environment. The people factor includes trends in mortality and morbidity,
risky behaviour, prevalence of pre symptomatic illness, level of social functioning and
disabilities and impairments. Environmental factors includes physical and social
environment.
6) Feedback: - the information that is returned to the system regarding its functioning. It
can be internal or external.
(b)The contingency theory school- this school aim at integration theory with
practice in a system’s framework. Its approach is approach where the behaviour of
one subsystem is dependent on its environment relationships to other units or sub
units. They have some control over the consequences desired by that subunit. Thus,
behaviour within an organization is contingent situation and manger wants to change
the behaviour of any part of the organization. He must attempt to change the parts of
its environment which has influenced it to bring any change we have to consider the
whole system. Different action should be taken in different setup.

PRINCIPLES OF MANAGEMENT:-

According to TAYLOR:-
TAYLOR has defined the basic purpose of management as the art of knowing exactly
what you want to do and then see that they are in the best and cheapest way. Since
Taylor has put the problem of managing in a scientific way he is often called
FATHER OF SCIENTIFIC MANAGEMENT.
1) Replacing the rule of thumb with Science:- Taylor has emphasized that in
scientific management organised knowledge should be applied which will
replace rule of thumb with the use of experience, aptitude, physical strength
etc a worker should be given work for which he is physically and technically
most suitable. Apart from selection proper emphasis should be given on the
training of the workers, which make them more efficient and effective.
2) Financial incentives: - it can motivate workers to put in their maximum
efforts.
3) Job analysis: - it is undertaken to find out of best way of doing something.
The best way of doing a job is one which require less time and cost. Time
study involves the determination of the time and movement taken to complete
the task which takes minimum time is the best one. Motion study involves
unnecessary movement in doing a job. Fatigue study shows the amount and
frequency of rest required in completing the work.

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 4) Maximum outputs: - this involves continuos increase in production and
productivity.
5) Separation of planning and doing: - separation of planning aspect from
actual doing the work. Before Taylor’s scientific management a worker used
to plan how he had to work and what instrument were necessary for that. The
supervisor was in charge of worker’s performance. This was creating lot of
problem and Taylor emphasised that planning to be left with the supervisor
and worker should emphasise only on the operational work.

FAYOL’S PRINCIPLES

Father of modern operational management theory. Fayol looked at problems of an

organization from op management point of view. He found that activities of an industrial
organization could be divided into 6 groups: managerial, A/C, security, financial, commercial
and technical.

General principles of management:

1) Division of work: he has advocated division of work to take the advantages of

specialisation.
2) Authority and responsibility: he finds authority as a continuation of official &
personnel factors. Official authority is derived from the manager position & personnel
authority is derived from the personnel qualities such as intelligence, experience, past
services.
3) Disciplines: The entire person serving in an organisation should be disciplined.
Discipline may be 2 types:
-self imposed Discipline.
-command Discipline.
Self imposed Discipline comes from within the individual & is in the
nature of spontaneous response to a skilful nature.
Command Discipline stem from a recognised deterrent to secure
compliance with the desired action.
4) Unity of command: it means the person shuld get orders & instructions from only
one superior. The more complete an individual has a reporting relationship to single
superior, the less is the problem of conflict in instructions & greater is the feeling of
personal responsibility of the result.
5) Unity of direction: each group of activities with same objectives must go from one
head & plan. Unity of direction is different from unity of command in sense that the
former is concerned with functioning of organisation in respect of its grouping of
activities or planning. The latter is concerned with personnel at all levels in
organisation in terms of reporting relationship.
6) Subordination of individual to general interest: individual interest must be
subordinated to general interest when there is conflict between two.
7) Remuneration of personnel: Remuneration of employ should be fair & provide
maximum possible satisfaction to employee.

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 8) Centralisation: everything which has gone to increase the importance of
subordinates’ role is decentralise. Everything which goes to reduce, is centralisation is
small firms, centralisation is the natural der but in large firms, a series intermediators
are used.
9) Scalar chain: there should be a scalar chain of authority & communication from
highest to the lowest. It suggests that each communication going up or coming down
must flow through each position in line of authority.
10) Order: this is a principle related to arrangement of things & people in order. There
should be a place for everything & everything should be in its place.
11) Equity: it is a combination of justice & kindness. Equity in treatment & behaviour is
liked by everyone & it bring loyality & devotion from the subordinate.
12) Stability of tenure of personnel: the employ should not be removed with a short
time; there should be a reasonable security of jobs. Stability of tenure is essential to
get an employ to get accustomed new work & succeeding in doing it well.
13) Initiative: within the limits of authority & discipline, manager should encourage their
employees to take intiative. Intiative is concerned with thinking out about execution
of plan. Intiative increases zeal & energyon the part of human beings.
14) Espirit de crops: this is the principle of “ union is strength & extension unity of
command for establishing teamwork. The erring employees should be set right oral
direction & not by demanding written explaination.

TECHNIQUES OF MANAGEMENT

Management techniques are essential ways of doing things, methods of accomplishing a

given results. Various techniques are used for organisational development:

1. Behaviour techniques.
 Sensitivity training.
 Management by objectives(M.B.O)
2. Non Behaviour techniques.
 Organisational design
 Work design.
 Job enrichment.
3. Miscellaneous techniques.
 Survey feedback.
 Process consultation.
 Team building.
1. Behaviour techniques: these techniques are designed to change the behaviour of
individual or group. These include:
 Sensitivity training.
 Management by objectives(M.B.O)

Sensitivity training (T- group): Manager Behaviour is nit how he behaves, thinks, but how
others view his behaviour. The sensitivity training have the objective of expanding a person’s

13
the understanding how his behaviour affects others & his reaction to the behaviour of others.
In this approach, participants are encouraged to undertake considerable self examination.
Sensitivity training represents valuable psychological experience & a highly effective
approach for a study of interpersonal relationships. The T- group training of major category
of sensitivity training & consists of an unstructured group 8-10 people with no leader, no
agenda, no stated goal. The group is expected to develop interactions in whatever ways its
member like. The emphasis is on “here & now” & a “face to face” interaction.some of the
benefits of t- group training is:

i. Participant learns about themselves, their weaknesses & strengths & emotions.
ii. It develops insight.
iii. Help to understand group processes, inter-member relations.
iv. Help to asses one’s values & goals as a result of analysis of direct experience.

Management by objectives (M.B.O):

It is a dynamic system which integrates the institution needs achieve its goals for profit &
growth with the manager’s need to contribute.

Grid development: it is based on Blake & Mounton’s model of ledership called the
managerial grid. Their model depicts two prevailing concerns found in all organisation-
concern for productivity & people.

In grid organisational development, changed agent use a questionnaire to determine the

existing style of managers, help them to re-examine their own style & work towards
maximum effectiveness. A grid organisation development programme has six phases:

a) Training: Key manager learn about grid concepts, & how they are applied in a week
long seminar. They asses their own managerial styles & work for improving such
skills as team development, group problem solving & communication. After
appropriate instructions, these key managers will work to implement the grid
programme throughout organisation.
b) Team development: the team managers bring their new understanding of managerial
grid concepts to the work situation. Emphasis is placed on improving both manager
subordinate relationship & team effectiveness, so that team operate on 9,9 grid level.
c) Inter group development: it focuses on the relationship organisation work groups to
improve cooperation & coordination. Inter group tensions are dealt with openly &
joint problem solving procedures are developed.
d) Organisational goal setting: Top managers set goal to be tested, evaluated & refined
managers & subordinates, working together throughout the organisation.
e) Goal attainment: organisation member seek to make the ideal model of reality, each
sub unit examine how their activities should be carried out in order to achieve
excellence,& they proceed to take whatever corrective action are necessary.
f) Stabilisation: eventually the result of all the phases are evaluated to determine, which
area of organisation still need improvement or alternation
2. Non-behaviour techniques:

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These techniques are much more structured than behaviour techniques. These include:

 Organisational design: organisational structure may be changed to make it more

efficient by re defining the flow of authority. There can also be change in the
functional responsibility. Organisational often reflects the personal desire, needs &
values of the chief executive, changing structure, therefore, may create resistance
& concern because people are worried about their power or status or how the
change will affect their work groups.
 Work design: it is a broad term meaning the process of defining tasks & jobs to
achieve both organisational & employee goals. It most, therefore in to account the
nature of the organisational structure, the information flow & decision processes,
the difference among employees & the reward system. Within the broad scope of
work design is the design of individual jobs. Job redesign makes use of job
analysis to redefine a job terms of tasks, behaviours, education, skill relationships
& responsibilities required.
 Job enrichment: It implies increasing the content of a job or deliberate upgrading
of responsibility, scope & challenges in work. “job enrichment is a motivational
technique which emphasis the need for challenging & interesting work”. It
suggests the jobs need to be redesigned. So that intrinsic satisfaction is derived
from doing the job. The job holder given a measure of direction in making
operational decision concerning his job. Inthis sense he gains a feeling of higher
status, influence & power. The term job enrichment should be distinguished from
the term “job enlargement”. Job enlargement attempts to make a job more varied
by removing dullness associated with performing repetitive operations. It involves
a horizontal loading or expansion, i.e. the addition of more task of the same work
or nature. But in job enrichment, the attempt is to build in to job and higher sense
of challenge & importance of achievement. Job enrichment involves vertical
loading of functions & responsibility which requires higher level of skills &
competencies.
3. Miscellaneous techniques:
 Survey feedback: as its title suggests the method used by the consultant is survey
method to asses the situation as it currently is feedback his analysis to the group.
The feedback information is then discussed & worked on by the team members,
who gradually learn to take over from the consultant the process of surveying
what they are doing & feeding back to themselves as an essential aid to their long
term development as a team. The concentrated 2-3 days, activities has its main
objective to create an awareness among team members of what process are going
on with in group situation & then teaches them to build on the positive element in
those processes & reduce the positive elements. In order to do this, a consultant
may use number of structured questions & survey instrument & also arrange the
team members to use sensing, , other feedback methods.
 Process consultation:
 Team building: team building is an attempt to assist the work group in learning,
how to identify, diagnose & solve its own problems. It directly focus on the

15
 identification of the problems related to task performance & lays down concrete
plans for their elimination. A team building programme deals with new problems
on an ongoing basis. It is an effective technique by which members of an
organisational group diagnose hoe they work together & plan changes that will
improve their effectiveness. The work group problems may be related to task or
personality conflicts. The task related issue can be streamlined by changing the
ways things are done, by redirecting the resources to be utilised or re examine the
work processes. The interpersonal relationship within the team can be improved
by creating an environment which is open & trustworthy, where member of the
team work together to achieve set objectives.

ROLE OF A NURSE MANAGER:

 Assignment: assign staff the duties to ensure smooth functioning to achieve goal.
 Coordinator: coordinate the activities by scheduling work assignments, setting
priorities & directing the work of subordinate employees.
 Evaluator: evaluates & verifies the nurses performance, through review of completed
work, assignments, & work techniques. She also evaluate the programmes & nursing
care plans.
 Educator: identify & plan staff development & training needs & ensures that staff
nurses get the training.
 Recorder; she maintains the records, prepares report & composes correspondence
related to work.
 Supervisor: supervise the general nursing services provided by the staff nurses.
 Planner: she develops plan & objectives for her work.
 Assessment: she assesses the patient needs & initiate nursing care

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CURRENT ISSUES & TRENDS IN NURSING:

There are so many issues occurring in the nursing profession which turned as these were
obstacle to provide proper nursing services to the patients & public at large. These problems
can be classified under following headings:

1. Nursing services.
2. Nursing education.
3. Nursing administration.

Nursing services:

Poor working conditions: Nursing Personnel Constitute a major portion of health

manpower. Nursing has permitted in to the entire health care delivery system to assist point
of his or her life cycle within the home, school, workplace, hospital or community at large.
but the present working conditions of nursing personnel is very poor. This may be due to
improper job description, long hours, split duty, Less pay scale allowances, less promotion
opportunity, career development, lack of accommodation, transport facility, etc.

Recruitment: Recruitment of trained nurses should be made by selecting candidates who are
settled & trained in their respective state. Earlier the recruitment method was good. It is
always better to withdraw the selection of nurses by the public service commissions
immediately as it was badly experienced by the locally trained nurses candidates in recent
selection procedure.

Job description: Job descriptions were made by non-nursing persons so it will not suit the
present working pattern of nurses. The clear of nurses of all categories need to drafted &
enforced in to practice.

Lengthy hours of duty & split duty: in most of the states & union territories of duty
schedule is “on duty”, “off duty” & night duty.

Less salary allowances & other incentives

Less promotion opportunities.

Harassment of nurses by others.

Improper supplies in most of the hospital.

NURSING EDUCATION:

Government institution:

 No independent building for school.

 No independent principal for school.

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  Inadequate hostel.
 Shortage of qualified teachers.
 No clinical facilities.
 Inadequate library.
 No transport facility.
 No separate budget for nursing school.
 M.sc. nursing courses not started in the govt. college.

Private institution:

Many private schools are opening in state, but have lot of shortcomings to run the school
&college.

In the same way in nursing administration there is no involvement of nursing personnel in

budgeting, planning, management of hospitals, job description etc.

VISION STATEMENTS

Vision statements reflect the ideal image of the organization in the future. They create a focal
point for strategic planning and are time bound, with most vision statements projected for a
period of 5 to 10 years.  The vision statement communicates both the purpose and values of
the organization. For employees, it gives direction about how they are expected to behave and
inspires them to give their best. Shared with customers, it shapes customers’ understanding of
why they should work with the organization.

Developing a Vision Statement

1.The vision statement includes vivid description of the organization as it effectively

carries out its operations.

2. Developing a vision statement can be quick culture-specific, i.e., participants may

use methods ranging from highly analytical and rational to highly creative and
divergent, e.g., focused discussions, divergent experiences around daydreams, sharing
stories, etc. Therefore, visit with the participants how they might like to arrive at
description of their organizational vision.

3. Developing the vision can be the most enjoyable part of planning, but the part where
time easily gets away from you.

4. Note that originally, the vision was a compelling description of the state and function
of the organization once it had implemented the strategic plan, i.e., a very attractive
image toward which the organization was attracted and guided by the strategic plan.
Recently, the vision has become more of a motivational tool, too often including highly
idealistic phrasing and activities which the organization cannot realistically aspire.

VALUE STATEMENTS

Value statements define the organisation’s basic philosophy, principles and ideals. They also
set the ethical tone for the institution. An organisation’s values are evident in the statements

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that define the organization and the processes used to achieve its mission and vision.

Developing a Values Statement 

1. Values represent the core priorities in the organization’s culture, including what
drives members’ priorities and how they truly act in the organization, etc. Values are
increasingly important in strategic planning. They often drive the intent and direction
for “organic” planners.

2. Developing a values statement can be quick culture-specific, i.e., participants may

use methods ranging from highly analytical and rational to highly creative and
divergent, e.g., focused discussions, divergent experiences around daydreams, sharing
stories, etc. Therefore, visit with the participants how they might like to arrive at
description of their organizational values.

3. Establish four to six core values from which the organization would like to operate.
Consider values of customers, shareholders, employees and the community.

4. Notice any differences between the organization’s preferred values and its true values
(the values actually reflected by members’ behaviours in the organization).

5. Incorporate into the strategic plan, actions to align actual behaviour with preferred
behaviours.

OBJECTIVES

 Objectives are the ends toward which activity is aimed-they are the end results to
ward which activity is aimed.

 “Objectives are goals, aims or purposes that organizations wish over varying periods
of time”-McFarland

 “A managerial objective is the intended goal that prescribes definite scope and
suggests direction to the planning efforts of a manger”-Terry and Franklin

GUIDELINES FOR OBJECTIVE SETTING

Objectives

 Must be clearly specified

 Must be set taking into account the various factors affecting their achievement

 Should be consistent with organizational mission

 Should be rational and realistic rather than idealistic

 Should be achievable but must provide challenge to those responsible for achievement

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  Should start with “to” and be followed by an action verb

 Should be consistent over the period of time

 Should be periodically reviewed

 Should have hierarchy

Organisational objectives

 Should have social sanction

 An organization may have multiple objectives

 Can be changed

NATURE OF OBJECTIVES

 Each organization or group of  individuals have some objectives

 Objectives may be broad or they may be specifically mentioned

 Objectives may be clearly defined

 Objectives have hierarchy.

 Organisational objectives have social sanction, that is, they are created within the
social norms.

 An organisation may have multiple objectives.

  Organisational objectives can be changed

FUNCTIONS OF OBJECTIVES

  To define an organization

  To provide directions for decision making

  To set standards of performance

  To provide a basis for decentralization

  Integrate organization, group and individual

PHILOSOPHY

The statement of philosophy is defined as an explanation of the systems of beliefs that

determine how a mission or a purpose is to be achieved. An organisation’s philosophy states

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the beliefs, concepts and principles of an organization. 

NURSING SERVICE PHILOSOPHY

The nursing service philosophy is a statement of beliefs that flows from and is congruent with
the institution’s philosophy. The belief system of the nursing philosophy should reflect the
nursing  division member’s ideas and ideals for nursing and should be endorsed by others.

COMPONENTS OF NURSING SERVICE PHILOSOPHY

1. NURSING/NURSING PRACTICE

Nursing is a health care service mandated by society; the practice of nursing stems from the
beliefs and ideals of the nursing service department.

In the first area, nursing theory, the task for the nurse manager is to decide whether and how
to incorporate theory. Three different methods may be considered.

 One method is to use an eclectic approach, selecting ideas and constructs from various
nursing theories and incorporating these into the philosophy.

 A second method is to use one theory throughout the philosophy.

 A third approach is to adopt a theory, then attach the entire document describing the
theory to the philosophy and refer to the theory at appropriate places in the
philosophy.

A second set of values related to nursing/nursing practice centre around practice, education
and research.

 Values specific to education are essential content for most departments of nursing.
The beliefs may focus on the need for continuing education off staff members. The
third value related to the concept of nursing practice is research and this includes the
department’s commitment to applying research findings or supporting others in their
research efforts. The beliefs held about the areas of impact of administration will
influence the formation of philosophy. The last content area related to nursing/nursing
practice is nursing‘s role in over all organization.

2. PATIENT/CLIENT

The patient is the main reason for the institution’s existence, examine patient’s rights. Beliefs
concerning patient's rights will be influenced in part by institutional policies and practices .

3.NURSES

Nurses are essential in the day-to –day operations of the hospital organization. They are the
providers of nursing acts which result in quality, care. To keep the organization functioning
smoothly, it is necessary to address values related to and beliefs about nurses. These values

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and beliefs centre around nurses rights, advancement criteria and responsibilities to other
health professionals, as well as professional organizations.

PHILOSOPHY OF NURSING EDUCATION

“Philosophy of nursing education is the written statement of the believes, values, attitudes
and ideas which the faculty as a group agreed upon in relation to the nursing educational
programme such as health, disease, nursing, nurse, nursing profession, education, learner,
society, patient, nursing education and preparation of nurses.”

Philosophy of f nursing education is a perfect combination of nursing and philosophy of

education, more precisely, philosophy of nursing and philosophy of education is the
application of the fundamental belief of nursing and education in the field of nursing. In the
philosophy of education, importance is given to the students. The objectives formulated with
a philosophical basis of education focus on the student life and the all round development.

FACTORS INFLUENCING PHILOSOPHY OF NURSING EDUCATION

 Beliefs and values of faculty members regarding god, man, life, health, disease, nursing etc

 The philosophical values and beliefs of the institution

 The environment where the education takes place

 The student and activities

 Health needs of the society

 The culture and background of the people

 Developments in nursing, medicine and allied fields

 Philosophy of nursing service administration

 The goals and objectives of the health care delivery system

 The disease pattern, the health awareness and health facilities available

 The available resources in terms of man, money and materials

CONCLUSION

Mission, vision, value statements, objectives and philosophy act as a basis for any
organization. So an administrator has to be vigilant while formulating these.

REFERENCES

1. Basavanthappa BT. Nursing Administration. 1st edn. New Delhi: Jaypee Brothers;
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 2000 pp 533-540.

2. Wehrich H, Koontz H. Management A global perspective. 11th edn.New Delhi: Tata

McGraw-Hill Publishing company ltd;2005 .

3. Koontz harload management global.

4. Loveridge Catherine E,cummings nursing management in the new paradigm 1 st

edition published by an aspen publication pp 45- 56.

5. www.google.com.

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 SEMINAR PRESENTATION
ON
NURSING MANAGEMENT
CONCEPT, TYPES, PRINCIPLES AND TECHNIQUES
VISION AND MISSION STATEMENTS
PHILOSOPHY, AIMS AND OBJECTIVE
CURRENT TRENDS AND ISSUES IN NURSING
ADMINISTRATION
THEORIES AND MODELS
APPLICATION TO NURSING SERVICE AND
EDUCATION

EVALUATOR:
MR. GOPALSINGH
LECTURER
PAEDIATRIC NURSING

SUBMITTED BY:
Mrs. Dalbir Kaur
M.sc (N)2ND YEAR.

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