Leadership and Management

2nd class
Ashmita Sapkota
 Management process
1)Planning: Planning in nursing leadership and management
involves setting goals, developing strategies, and outlining tasks and
schedules to achieve effective patient care and efficient
organizational operations. Planning is deciding in advance what to
do, how to do and who is to do it. Planning bridges the gap between
where we are and where we want to reach.
 Purpose of planning
 Provide direction

Reduce uncertainty

Minimize waste

Goal focus

Sets standard for controlling
 Elements of planning
1) Objectives/purpose
2) Strategies
3) Policies
4) Procedures
5) Rules
6) Programs
7) Budgets
1) Objectives/purpose: Clear statement of what the organization or
team wants to achieve. Provides direction and purpose.
In Nursing: Reduce patient falls by 20% in the next 6 months.
2) Strategies: Broad description of course of action to be taken. A
strategy is the direction and scope of an organization in the long run.
In Nursing: A strategy to improve patient satisfaction scores.
3) Policies: General guidelines that govern action.
In Nursing: Infection control policy, patient confidentiality policy.
4) Procedure: Step by step instructions for carrying out tasks.
In Nursing: Procedure for medication administration or wound
dressing.
5) Rules and Regulations: Instruction that a specific action must or must
not be performed in a given situation to bring uniformity in action.
In Nursing: No smoking in hospital prermises or proper hand hygiene
required before patient contact.
6) Programs and Projects: Coordinated sets of plans and activies to
achieve major goals.
In nursing : orientation program for new nurses, vaccination program.
7) Budget: A financial plan estimating income and expances for a specific
period.
In Nursing: Budget for staffing, supplies or training.
 Planning Cycle:

Step 1: Analysis of Health Situation

Step 2: Establishing objectives and goals

Step 3: Assessment of Resources

Step 4: Fixing Priorities

Step 5: Writing of formulation plan

Step 6: Programming and Implementation

Step 7: Monitoring

Step 8: Evaluation
 SMART approach in planning

S- Specific: The goal should be clear and specific.

M- Measurable: The goal should have criteria to measure progress
and success.

A- Achievable: The goal should be realistic given the available
resources and constraints.

R- Relevant: The goal should align with broader organizational and
healthcare objectives.

T- Time bound: The goal should have a clear deadline or time frame.
 2)Organizing
Definition: Organizing is the process of identifying and grouping the
work to be performed, defining and delegating responsibility and
authority, and establishing relationships for the purpose of enabling
people to work most effectively together in accomplishing objectives.
Basic element of organizing:
a. centralization and decentralization
b. delegation of authority
c. division of work
d. structures
e. departmentalization
 Objectives of Organizing:

To define roles and responsibilities

To establish a clear hierarchy and authority

To ensure efficient resource use

To coordinate activities across departments

To facilitate smooth workflow
 Steps in Organizing Process:
1) Identifying Activities
2) Grouping Activities
3) Assigning Duties
4) Delegating Authority
5) Establishing Coordination
 Importance of Organizing:

Clarifies roles and responsibilities

Improves communication

Enhances productivity and efficiency

Facilitates growth and expansion

Reduces duplication of work
 3)Directing
Directing can be described as a process of leading, motivating,
communicating and coordinating the activities within the organization
to achieve the organizational objectives and goals.
Direction is a function of management performed by top level
management in order to achieve organizational goals.
It is a continuous managerial process that goes on throughout the life
of the organization.
 Objectives of Directing

To motivate employees

To provide clear instructions and guidance

To ensure smooth communication

To foster team spirit and collaboration

To improve efficiency and performance
 Elements of Directing:
1) Leadership
2) Supervision
3) Motivation
4) Communication
Supervision
Supervision is a Latin Word. Super means ‘from the above’ and
vision means ‘to see’. Supervision means overseeing the activities of
others.
Supervision is “Overseeing the subordinates at work with authority
and with an aim to guide the employees, if he is doing wrong.”
Supervisor: Person who is responsible for guiding and motivating the
subordinates toward better performance.
 Purpose of supervision

To deliver high quality health care services.


To assist in the development of staff to their highest potential.
T

To establish the span of control.


To improve the performance of organization
 Process of Supervision

Planning

Implementation

Evaluation
 Objectives of Supervision:

Monitor and evaluate staff performance

Ensure safe and effective patient care

Identify and address training needs

Provide feedback and coaching

Foster a positive work environment

Enhance communication and collaboration

Ensure regulatory and policy compliance
 Types of Supervision:
1) Direct Supervision: Supervisor is physically present and observes the
staff's performance (e.g., during procedures or assessments).

2) Indirect Supervision: Supervisor is not present but provides support,

guidance, or feedback through other means (e.g., review of
documentation, delegation).

3) Clinical Supervision: Structured support focusing on clinical decision-

making, reflection, and professional development.

4) Managerial Supervision: Focuses on performance evaluation, policy

adherence, and administrative oversight.
 Ways of supervision:

Interview

Review of office records and reports

Tools of supervision

Questionnaires

Record and reports

Observation

Checking of personal diary

Checklist

Formats
 Motivation
Motivation means inspiring, stimulating or encouraging the subordinates with zeal to
work.

Positive, negative, monetary, non-monetary incentives may be used for this purpose.

In the context of an organization, it means the process of making
subordinates to act in a desired manner to achieve certain organizational goals.

Motivation is the process of making individual aware of his need and
taking necessary actions to fulfill that need.

Is of two types: Intrinsic and Extrinsic motivation
 Motivational Theories (Brief Overview):

Maslow’s Hierarchy of Needs: People are motivated by five levels of needs:
→ Physiological → Safety → Social → Esteem → Self-actualization

Herzberg’s Two-Factor Theory
Hygiene factors (e.g., salary, work conditions) prevent dissatisfaction
Motivators (e.g., recognition, achievement) promote satisfaction

McClelland’s Theory of Needs
People are motivated by:
→ Need for Achievement
→ Need for Power
→ Need for Affiliation

McGregors Theory X and Theory Y
Theory X: people are lazy and need control
Theory Y: People are self motivated and seek responsibility.
 Communication

The term "communication" is derived from the Latin word "communis"
which means "common".

This stands for the sharing of ideas in common.

Communication is the means used by people in the organization to
exchange information regarding the operations. Interchange of ideas,
facts, and emotions by two or more people with words, letters and
symbols.
 Communication process or elements:

Sender

Encoding

Message

Channel

Receiver

Decoding
 Importance of communication

Communication helps employees to understand their role clearly and
perform effectively.

It helps in achieving co-ordination and mutual understanding which in
turn, leads to industrial harmony and increased productivity.

Communication improves managerial efficiency and ensures
cooperation of the staff.

Effective communication helps in molding attitudes and building up
employees’ morale.

Communication is the means through which delegation and
decentralization of authority is successfully accomplished in an
organization.
 Types of communication

One way and Two way

Vertical and Horizontal

Upward and Downward

Formal and informal

Inter and Intra Communication
 Barriers of Communication:

Physiological Barrier

Environmental Barrier

Psychological Barrier

Semantic Barrier

Cultural Barrier

Social Barrier
 4) Controlling

A process of monitoring performance and taking action to ensure
desired results.

It ensures that the right things happen, in the right ways, and at the
right time.

It is the process of regulating organizational activities so that actual
performance conforms to expected organizational standards & goals.
 Features of Controlling:

Measures actual performance.

Compares actual performance with the planned performance.

Attempts to find out deviations between the actual & the planned
performance and correct these deviations.

Ensures that organizational goals are accomplished with minimum
disruptions.
 Control Process:
Step 1: Establish objectives and standards.

Begins with planning and the establishment of performance objectives.

Performance objectives are defined and the standards for measuring
them are set.

Time standards

Production standards (output)

Cost standards (Input)

Behavior standards
 Step 2: Measure actual performance

Measurements must be accurate enough to spot deviations or
variances between what really occurs and what is most desired.

Without measurement, effective control is not possible.

Should be done in such a way that deviations may be detected in
advance of their occurrence & avoided by appropriate actions.
 Step 3: Compare results with objectives and standards

The comparison of actual performance with desired performance
establishes the need for action

Comparison methods:
Historical comparison
Relative comparison
 Step 4: Take corrective action as needed .

Managers can correct deviations by redrawing their plans or by
modifying their goals.

Changing the duties or reassigning, adding new staff, better selection
& training of staff or firing, changing the process/procedure.
1. Which of the following is the correct order of the management
process?

A. Organizing → Planning → Controlling → Directing

B. Planning → Organizing → Directing → Controlling

C. Directing → Planning → Controlling → Organizing

D. Controlling → Organizing → Planning → Directing

2. What is the primary function of planning in
management?
A. Hiring qualified staff

B. Monitoring daily activities

C. Setting goals and determining how to achieve them

D. Supervising staff behavior

3. Which function of management involves assigning tasks and
allocating resources?

A. Planning

B. Organizing

C. Directing

D. Controlling
4. In nursing management, which function ensures that actual
performance meets expected standards?

A. Planning

B. Organizing

C. Directing

D. Controlling
5. Directing in the management process includes all of the following
EXCEPT:

A. Motivating staff

B. Communicating instructions

C. Setting organizational goals

D. Leading the team

6. Evaluation of nursing care outcomes is part of which
management function?

A. Directing

B. Planning

C. Controlling

D. Organizing
7. Which of the following best describes “organizing” in the
management process?
A. Setting goals for the organization

B. Creating a budget

C. Assigning responsibilities and arranging resources

D. Monitoring employee performance

8. The role of a nurse manager in planning includes:

A. Only implementing hospital policies

B. Writing daily reports

C. Setting goals, objectives, and identifying resources

D. Supervising technical tasks only

9. Which of the following is NOT a key function of the management
process?

A. Supervising

B. Organizing

C. Directing

D. Controlling
10. Motivation, leadership, and communication fall under
which management function?
A. Organizing

B. Controlling

C. Directing

D. Planning