Unit-II

Nursing Management M.sc II year

Content of the chapter
• Concept
• Type
• Principles
• Techniques
• Vision and mission statement
• Philosophy
• Aim and objectives
• Current trends and issue in nursing administration
• Theories and model
• Application to nursing services and education
Learning objectives
• To define nursing management
• To list out types of nursing management
• To discuss the principles of nursing management
• To describe the techniques used for nursing
management
• To state the vision and mission
• To explain the philosophy of nursing management
• To enlist the aim and objectives of nursing management
• To describe the current trends and issues in nursing
administration
• To explain the theories and model used nursing
management .
Introduction to Nursing Management

• Definition “Management is the art of getting

things done through and with people” --- Mary
Parker “Management is defined as the process
by which a co-operative group directs action
towards common goals” --- Joseph Massie
Definition of Administration
• Definition "Administration is the organization &
direction of human and material resources to
achieve desired ends". --- Pfiffner and Presthus.
Definition of Nursing Management
• Definition -Nursing management is defined as
process of planning, organizing, activating and
controlling the managerial function of nursing in
order to determine and accomplish the
objectives of nursing care.
Concept of management
• The word management interpreted by
• A discipline
• A body of individual
• A process
• A profession
• A human resources
• A financial resources
NATURE OF ADMINISTRATION

• 1. It is universal
• 2. It is holistic
• 3. It is intangible
• 4. It is continuous and ongoing process.
• 5. It is goal oriented
• 6. Its is social and human
• 7. It is dynamic
• 8. It is creative or innovative
Type of nursing management
• In order to accomplish this, 5 leadership styles
can be noted and emulated among successful
nurse leaders. These are:
• Transformational
• Democratic
• Laissez-faire
• Autocratic
• Servant
Transformational Leadership

• Transformational leaders use a collaborative leadership

style that leverages a shared vision, encouragement and
inspiration to facilitate change.
• These leaders are often described as extroverted, open to
new experiences, charismatic, secure in their sense of
self, creative and future oriented in vision.
• A transformational leader encourages innovation, and is
tolerant of error.
• In healthcare, transformational leaders are most
successful in situations where the system is in need of
larger changes or overall improvements that can be
directed, encouraged and overseen by a unifying, guiding
force.
• A democratic leader engages in a shared leadership style
Democratic Leadership
in which they use participation of members of the group
to guide decision-making and management.
• Sometimes, this is called participative leadership.
Democratic leaders are often characterized as mutually
respectful, collaborative, encouraging, empowering and
supportive of innovation but only tolerant of error.
• In healthcare, democratic leaders may be best suited for
situations where new relationships are being built
between leadership and a group.
• For instance, in healthcare, when a system or process
improvement is imperative, a democratic leader may
step in to direct a group of assigned nurses to identify
changes to a policy or guideline.
Laissez-faire Leadership

• A laissez-faire leadership style is a facilitative one in

which a leader makes few decisions. Instead, this style of
leader facilitates the group to drive decision-making and
develop solutions to work-related problems with a
“hands-off” approach. This is the opposite of autocratic
leadership.
• Characteristics of laissez-faire leaders are often reported
as “hands off,“ trusting, encouraging and tolerant of
innovation as well as error.
• These leaders must be critical when necessary, but they
allow and encourage the group to make decisions and
develop solutions to work related problems, reserving
the ability to step in and take over for those times when
deemed necessary.
Autocratic Leadership

• Autocratic leadership is a unilateral style in which

the leader delegates to others with rules and orders.
• These leaders are intolerant of innovation and error
and are the opposite of laissez-faire leaders.
• Autocratic leaders are generally characterized as
self-reliant, highly structured, rapid decision-
makers, authoritative and ultimately “the boss.”
• This leadership style may be useful in healthcare
during emergency situations, traumas, or disaster
management when clear, definitive, rapid decisions
and directions benefit all involved.
Servant Leadership

• Finally, servant leadership is defined as a supportive

style in which the leader provides team members with
skills, tools and relationships they need to perform to the
best of their ability.
• Servant leaders are often noted to share power, listen
actively, conceptualize problems, empathize with others
and prioritize others over themselves.
• They are often noted to encourage and support others
through actions and service to meet their needs to do the
job well.
• Servant leaders continually evaluate the needs of the
team in order to provide resources and facilitate work.
Level of Nursing Management
Level Scope of Responsibility Examples

1. Generally make decisions with

the help of ►few guidelines or
CEO, President, V-President, Chief
Top Level Managers structure.
Nursing Officer
2. Coordinates internal and external
influences

1. They conduct day-day operations

Head Nurse, Department Head, Unit
Middle Level Managers with some involvement, long
Supervisor/Manager
term planning and policy making.

1. Concerned with specific unit

workflows. Charge Nurse, Team Leader, Primary
First Level Managers
2. Deals with immediate day-day Nurse, Staff Nurse
problems.
Some modern techniques for nursing
management
Techniques of nursing management
Example of techniques
PRINCIPLES OF ADMINISTRATION

• 1. Division of work
• 2. Authority, responsibility and accountability
• 3. Discipline
• 4. Unity of Command
• 5. Unity of direction
• 6. Subordination of individual interest
• 7. Remuneration of personnel
Continued
• 8. Centralization
• 9. Scalar chain of command
• 10. Order
• 11. Equity
• 12. Stability of tenure of personnel
• 13. Initiative
• 14. Esprit de corps
•Current trends and
issues in nursing
management
Terms used in nursing management
• ADMINISTRATION:- Administration is the activities
of group co-operating to accomplish common goal. In
other words, it is the organization of use man and
materials to accomplish the purpose and administration
is an essential factor is an development of any service.
• TRENDS:- It denote general direction and tendencies
specially of events of opinion.
• NURSING TRENDS:- Refers to direction towards
which the different nursing event have moved or are
moving as well as the opinion in and around nursing that
are found in and about nursing profession.
• ISSUES:- A point or matter of discussion, debate or
dispute or a matter of public concern
THERE ARE DIFFERENT CHANGES IN PROFESSION

• Social Change:-
• a) Nursing profession severs to meet the need to the society
particularly the need related to health and well being.
• b) The changes in society will influence to bring about changes in
nursing profession.
• I)At present , efforts are made by govt. of india to deliver the health
care to the community especially in rural area.
• II) Overall improvement in the education of people with ever
growing awareness about health and health need.
• c)Now women are more educated and take up jobs out of home to
sever and earn.
• d)Advancement of technology- eg:- Automatization,
Industrialization, Urbanization.
• e)After independence, government began to make serious efforts to
meet health need of nation by implementing recommendation of
Bhore committee.
 Changes in other profession :-
• a) Medical profession is fastly changing profession and the era of
specialization and super specialization has come.
• b) Morden health care facility like ICU, ICCU, Renal unit , organ
transplant unit etc.
• c) Biomedical science have for advanced resulting in newer
diagnostic equipment such as scanner, new drugs, monitoring
system in field of health care all over the world.
CHANGES IN NURSING PROFESSION IT SELF IN THE
COUNTRY:-
• a)Trends to take up education leading to bachelor degree in nursing,
master degree as well as doctoral degree.
• b)Trends related to tuition fee e.g.- paid stipends, free hiring,
accomodation, food and uniform but service is expected from the
nurse. c)Trends related to changes in working condition for nurse
• a)Fast growing trends to post basic degree
programmes.
• b)INC promote sharing of ideas and common
interest between member of national
organization.
• c)Exchange of professional literature like
international review, professional journals,
articles etc.
Current issues and trends in nursing
management
 Continued

•Changing Demographics and Increasing Diversity.

•The Technological Explosion.
•Globalization of the World's Economy and Society.
•The Era of the Educated Consumer, Alternative
Therapies and Genomics.
•Quality assurance in nursing care.
•Decentralised approach to care management.
Current trends and issue in nursing
management
Continued
• VI)Evidence based practice:- • IX)Nursing audits:- Audit is
For this nurses should have required to keep the activities on
scientific bend of mind and the right track. It build
dynamic approach to patient knowledge for the profession.
care. • X)Higher education for senior
• VII)Nurse patient ratio:- position in nursing :- Nursing
Adherence to nurse patient ratio leader can guide and monitor
is necessary for providing the nursing team effectively.
quality care. • XI)Independent nurse
• VIII)Conduct of nursing practitioners:-
research:- Having knowledge is
essential for the nursing
profession. This is possible only
through research and
dissemination of research
finding.
ISSUES IN NURSING:-
• I)Renewal of nursing
registration :-
• II)Diploma V/S Degree in
nursing for registration to
practice nursing:-
• III)Specialization in clinical
area:-
• IV)Nursing care standards:-
ISSUES IN NURSING EDUCATION
• Nursing training school multiplied .
• Lack of independent building for school and
college .
• Lack of independent principal for school and
college.
• Inadequate hostel facility for student .
• Shortage of qualified teacher in nursing.
• Inadequate library facilities. Less supply of
A.V. aids.
• Less promotional apportunities for teachers of
both school and college.
• Very less or no stipend for nursing student.
•Theories and models
used in nursing
management
Example of nursing theories and
models
• Application of Nursing Theories
• Application Goal Attainment Theory
• Application Orem's Self-care Deficit Theory
• Application of Suchman’s Stages of Illness Model
• Application of Betty Neuman's Systems Model in Nursing Care
• Application of Roy's Adaptation Model in Nursing Process
• Application of Peplau's Interpersonal theory in Nursing Process
• Application of Health Belief Model in Nursing Practice
• Attachment Theory : John Bowlby
• Attribution Theory
• Betty Neuman’s system model
• Behaviorist Theory
• Biopsychosocial Model
Continued
• Care, Cure and Core: The Three C’s of Lydia Hall
• Comfort Theory by Katharine Kolcaba
• Cybernetics
• Decision Making Models
• Development of Nursing Theories
• Ernestine Wiedenbach's "The Helping Art of Clinical Nursing"
• Epistemology of Nursing
• Erikson's Theory of Psychosocial Development
• From Novice to Expert: Patricia Benner
• Faye Glenn Abdellah's Theory
• Functional Health Patterns by Majory Gorden
• Health Promotion Model
• Health Belief Model
Continued
• Helping and Human Relationships Theory :
Robert R. Carkhuff
• Human Becoming Theory : Rosemarie Rizzo Parse
• Human-To-Human Relationship Model by Joyce
Travelbee
• Grounded Theory in Nursing Research
• Gate Control Theory of Pain
• Germ Theory of Disease
• Hans Selye's Stress Theory
• Harry Stalk Sullivan's Interpersonal Theory
• Introduction to Nursing Theories
• Jean Piaget's Cognitive Development Theory
Continued
• Jean Watson's theory
• Johnson’s behavior system model
• Kurt Lewin's Change Theory
• Laws (Principles) of Learning
• Learned Helplessness Model
• Levin's Four Conservation Principles
• Life Perspective Rhythm Model by Joyce Fitzpatrick
• Martha Roger’s Science of unitary human beings
• Maslow's Theory of Needs
• Modeling and Role Modeling Theory by Erickson, Tomlin & Swain
• McGill Model of Nursing by F. Moyra Allen
• Models of Prevention
• Models of Nursing Care Delivery
• Newman's Health As Expanding Consciousness
Continued
• Nursing Theorists
• Nursing Theories: An Overview
• Nursing Theories and Research
• Orem's Self-Care Deficit Theory
• Orlando's Nursing Process
• Object Relations Theory
• Prochaska and DiClemente's Stages of Change Model
• Psychoanalytic Theory
• Roy's Adaptation Model
• Roper–Logan–Tierney Model of Nursing
• Systems Theory in Nursing
• Stress-Diathesis Model
• Stuart Stress Adaptation Model
• Self-efficacy Theory
• Statistical Theory
Continued
• Statistical Theory
• Theories Based on Interactive Process
• Theories of Florence Nightingale
• Theories Applied in Psychiatric Nursing
• Theories used in Community Health Nursing
• Theories of Intelligence
• Theories of Learning
• Theory of Mind
• Theory of Interpersonal Relations:: Peplau
• Theory of Goal Attainment: Imogene King
• Theory of Chronic Sorrow
• Theory of Cognitive Dissonance by Leon Festinger
• Theory of Moral Development
• Theory of Evolution
• Tidal Model of Mental Health Nursing
• Trajectory Model by Corbin & Strauss
• Transcultural Nursing
• Understanding the works of Nursing Theorists
Application of nursing and services and
nursing education