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THE NURSING MANAGEMENT

PROCESS: An Overview
Prof. Jhessie L. Abella, RN,RM, MAN
Course Description:
This course deals with the application of the concepts, principles, theories
and methods of developing nursing leaders and managers in the hospital
and community-based settings. It also includes ethic moral/legal
aspects of health care and nursing practice and the nurses responsibilities
for personal and professional growth.
Course Objective:
At the end of the course, given a group of clients with varied conditions, the student
should be able to:
1. Utilize the nursing process in the care of individuals, families, population group, in hospital
and community settings.
1.1 assesses with client/s his/her/their condition/health status through interview, physical
examination and interpretation of laboratory findings
1.2 identifies actual and at-risk nursing diagnosis
1.3 plans appropriate nursing interventions with client/s and family for identified nursing
diagnosis
1.4 implements plan of care with client/s and family
1.5 evaluates the progress of the clients condition and outcomes of care;

2. Ensure a well organized and accurate documentation and
reporting system;
3. Demonstrate leadership and competence in the performance of
her responsibilities as a beginning nurse practitioner in the
hospital or community setting
4. Observes bioethical principles, core values, and standards of
nursing care while practicing nursing
5. Promote personal and professional growth for self and others

Leadership and Management: An
Overview
God created man in his own image and in doing
so he was tasked to have dominion over all the
things created before Him. It was the solemn
divine decision that emphasized mans place at
the climax of Gods creative work
(Genesis 1:26-27)
Man is tasked to lead: to manage everything, over the earth
and so are the Nurses, who lead and manage people in their
quest for a quality kind of life.


Leadership and Management: An
Overview
Nursing management is based on theories where
concepts are included together with methods, and
principles. Relationship between principle could be
observed and verify to certain degree if translated in to
the art of practice of nursing management.
Concept are not fragmented thoughts, ideas and
general beliefs in relation to nursing management but
rather concepts that can serve as unifying ideas, thus,
forming a foundation for action or discussion.
Principles are known to be those fundamentals truths,
law or doctrines wherein other beliefs or notions are
founded. Principles serve as guided to concept,
thoughts or actions in a work situation.

Leadership and Management: An
Overview
Nurses realize that they have to keep up with the many
changes in the health care system and its delivery of
service to the people. The Nursing Act of 1991 focuses on
three changes in the efforts to improve the peoples health.
From hospital or institutional care, emphasis shifted
to community health delivery;
From emphasis on physical care, efforts are now
directed towards holistic approach to the care of
individuals, families and communities and
From being mere recipients of care, patients,
individuals, families and communities are now active
participants in health care efforts.

Leadership and Management: An
Overview
Definition of Nursing Management:
The management process is universal. For nurses, knowledge
of this process assures them of the smooth functioning of the
units to attain their goal of quality care through the judicious
use of available human and material resources within specified
periods.
Focus on planning, organizing, staffing, directing or leading
and controlling or evaluating all activities of the nursing
system.
Defined as a process of coordinating actions and allocating
resources to achieve organization goals of the healthcare
delivery system

Harbizon and Myerz offer a classic three fold concept to
emphasize the broader scope of management. They observe
that management is:
AN ECONOMIC RESOURCE management is one of the
factors of production together with land, labor and capital.

SYSTEM OF AUTHORITY management first develops with
top individuals determining the course of action for the rank
and file. This is followed by constitutional management which
emphasizes definite and consistent concern for policies and
procedures in dealing with the working group. The trend
toward a democratic and participative approach follows as
employees receive higher education.


AN ELITE CLASS management is a class and
status system. Managers have become an elite
group of brains and educations. Entrance to this
class is based on education and knowledge. The
new managers continue to expand their horizon in
an effort to attain the ultimate in life.


Nursing management is PLANNING
Nursing management is the EFFECTIVE USE OF TIME
Nursing management is DECISION MAKING
MEETING PATIENTS NURSING CARE NEEDS is business of the nurse
managers
Nursing management is the FORMULATION and ACHIEVEMENT of SOCIAL
GOALS
Nursing management is ORGANIZING
Nursing management denotes a FUNCTION, SOCIAL POSITION OR RANK, A
DISCIPLINE AND A FIELD OF STUDY
GENERAL PRINCIPLES OF
NURSING MANAGEMENT

Nursing management denotes a FUNCTION, SOCIAL POSITION OR
RANK, A DISCIPLINE AND A FIELD OF STUDY
Organizational cultures REFLECTS VALUES AND BELIEFS
Nursing management is DIRECTING OR LEADING
A well managed division of nursing MOTIVATES EMPLOYEES TO
PERFORM SATISFACTORILY
Nursing management is EFFICIENT COMMUNICATION
Nursing management is CONTROLLING OR EVALUATION


Managerial development programs are very useful
means of getting qualified managers. According to
Katz, the necessary fundamental skills of a
manager are:


LEVELS OF SKILLS MANAGEMENT IN NURSING
CONCEPTUAL individuals mental ability to coordinate a variety of
interests and activities. Thinks critically and able to conceptualize
how things could be. VISIONARY

INTERPERSONAL individuals preferred ways of using language,
the degrees to which they listens, and their ways on responding to
others.

TECHNICAL- tools, procedures, and techniques that are unique to
the nurse managers specialized situation. Master of the job-viewed
as a source of help. AN EXPERT.




Top
Management
Middle
Management
First-Line
Management
Conceptual Human
Tech-
nical
Conceptual
Con-
ceptual
Human
Human
Technical
Technical
Proportions of Management skills needed at
Different levels of management
Concerned with broad-based, long-
range decisions that affect the entire
organization; therefore, conceptual skill
is most important at that level
Top
Management
First-Line
Management
Focuses basically on her or his group,
Therefore, the need for conceptual skill is
at a minimum
Human Skill
The need to be able to understand and
work with people is important at all levels,
but the first-line managers position places
a premium on human skill requirements
because of the great number of employee
interactions required
A nurse manager performs these
management functions to deliver
health care to patients.

Nurse managers or administrators work at
all levels to put into practice the concepts,
principles and theories of nursing
management.

They manage the organizational environment
to provide a climate optimal to provision of
nursing care by the clinical nurses.

Technical Skills relates to the
proficiency in performing an activity in the
correct manner with the right technique.
Human relationship skills pertain to
dealing with people and how to get along
with them.
Conceptual skills deals with the ability to
see individual matters as they relate to the
total picture and to develop creative ways
of identifying pertinent factors, responding
to the big problems and discarding
irrelevant facts.

Another approach in developing managers is
postulated by Summer in his early work which
emphasize knowledge, attitude and ability
factors.
Knowledge factors refer to ideas, concepts
or principles that can be expressed and are
accepted because they have logical proofs.
Attitude factors relate to those beliefs,
feelings and values that may be based on
emotions and may not be subjected to
conscious verbalization.
Ability factors include skills, art, judgment
and wisdom.

Qualification of Nursing Service
Administrators
Be a registered nurse in the Philippines
Have at least two (2) years of experience in
general nursing service administrators
Possess a degree of bachelor of Science in
Nursing, with at least nine (9) units in managerial
and administration course at the graduate level;
and
Be a member of good standing of the accredited
professional organization of nurse
It is provided, however, that a person occupying the position
of Chief Nurse or Director of Nursing Service shall, in addition
to the foregoing qualification, possess:
Qualification of Nursing Service Administrators
At least five (5) years of experience in a supervisory or
managerial position in nursing; and
A Masters Degree Major in Nursing

As per Memorandum Circular No. 2000-05,series of
2000 of the PRC, BON.
A new trend in hospital nursing is clinical specialization. Nurses train in
a
special field of nursing of their choice. Courses to prepare nurse
desiring
to perfect their clinical opportunities are offered in universities, usually
at the masters level. These nurses must have the experience required
before applying for a position as an expert practitioner.
Qualification of the Chairperson and Members of the Board
The Chairperson and Member of the Board shall, at the times of the
appointment, posses the following requirements.
o A natural born citizen and resident of the Philippines
o A member of a good standing of the accredited professional
organization of nurses
o A registered nurse and holder of a Master Degree in Nursing,
education or other allied medical profession conferred by a college
or university duly recognize by the government. Provided , that the
majority of the Member of the Board shall be holder of a masters
degree in nursing: Provided, further That the Chairperson shall be a
holder of a masters degree in nursing.
o Must have at least ten (10) years of continuous practice of the
profession prior to appointment. Provided, however. That the last
five (5) years of which shall be in the Philippines.
o Must not have been convicted of any offense involving moral
turpitude.
o Membership to the Board shall represent the three areas of nursing,
namely, nursing education, nurisng service and community health.
Qualification of the Faculty and the Dean of the College of Nursing

A member of the faculty in a college of nursing teaching professional courses
must:
Be a registered Nurse in the Philippines
Have at least one (1) year of clinical nursing practice in a field of
specialization
Be a member of good standing in the accredited professional
organization of nurses and
Be a holder of a masters degree in nursing, education, or other allied
medical and health sciences conferred by a college or university duly
recognized by the Government of the RP.


Qualification of the Faculty and the Dean of the College of Nursing

The career ladder in nursing education starts with a Clinical Instructors
position up to the Dean of a College of Nursing. A dean in a College of
Nursing should possess;
Masters Degree in Nursing
Must have at least five (5) years of experience in teaching and
supervision.
Those teaching in Graduate Programs for nurses must possess post-Masters
Degree or Doctoral Degree in Nursing.

Prior to promotion or holding of managerial positions, nurses who have the
potential to become administrators are asked to participate in
managerial staff development program. The organization then will have
a ready pool of managers who are academically and locally trained to
assume managerial roles.


Who Needs Nursing Management?


All types of health-care organizations,
including nursing homes, hospitals, home
health-care agencies, ambulatory care
centers, student infirmaries, and many
others, need nursing management.
Even the nurse working with one client and
family needs management knowledge and
skills to help people work together to
accomplish a common goal.
A primary nurse working with several
clients prioritizes their care to assist time to
improve health or, sometimes, peaceful
death.
THE MANAGEMENT PROCESS

CONTROLLING
assessing/regulating performance
DIRECTING
actuating efforts to accomplish goals
ORGANIZING
establishing formal authority
PLANNING
thinking ahead, making projections to achieve
desired results

Top
Management
Middle
Management
First-Line
Management
P O D S C
P
P
O
O
D
D S
S
C
C
P - Planning
O - Organizing
Amount of Emphasis on Management Function
D - Directing
C - Controlling
S - Staffing
Universality of Management
Scenario:

A nurse manager spent part of the day working on the budget
(Planning) , meet with the staff about changing the patient care
management delivery system from primary care to team nursing
(Organizing), altered the staffing policy to include 12- hour shifts
(staffing), held a meeting to resolve a conflict between nurses and
physicians (Directing), and gave an employee a job performance
evaluation (Controlling).

Not only would the nurse-manager be performing all phases of the
management process, but each function has a planning,
implementing, and controlling phase.