What is Nursing Management?

Nursing Management as a matron, or M.D in a health facility is the art of getting things done through people in order to achieve the facility objectives.

Management is also the systematic process which involves planning, organizing, staffing, leading and controlling the efforts of organizational members and using all other resources to achieve stated organizational objectives.

Management can be defined as the process by which resources are mobilized, combined and coordinated to effectively to achieve organizational objectives.
It is a process that utilizes organizational resources in the most effective and efficient manner, in order to attain stated organizational objectives.

Efficiency and Effectiveness in Nursing Management

Efficiency in management refers to optimal utilization of organization resources with minimal wastage. Nurses hardly waste the facility’s resources. They are known to be good managers.

It is also the relationship between achieving the objectives of the facility and judicious consumption of resources.
Effectiveness refers to attaining specific facility goals that are timely and challenging.

It is also an outcome measure of the interventions that improve peoples health under ordinary circumstances and in ordinary settings.

15 Examples of Nursing Management Skills

• Conflict resolution.
• Mentoring.
• Decision-making.
• Patience.
• Attention.
• Tolerance.
• Kindness.
• Love.
• Professionalism.
• Time management.
• Adaptability.
• Dedication.
• Diligence
• Empathy
• Create a goal.

Management versus Administration

Administration is part of management work but more concerned with execution. In Nursing Management, proper administration is very important. Nurses are the people who manage patients by administering their prescriptions and taking good care of them.

A manager is said to be performing administrative work when he/she is involved in interpreting policies of the organization and putting into plans and having those plans implemented.
At every level of management, managers perform some work which involves execution or “doing” which is one that completes the administrative process.
Therefore administration is the total of planning, organizing, controlling, coordinating and also operating work.

Who is a manager in health facilities?

This is an individual (Nurse) employed by a facility who is responsible and accountable for efficiently accomplishing the goals of the facility.
Nurses as managers focus on coordinating and integrating resources using the functions of planning, organizing, supervising, staffing, evaluating, negotiating, and representing.

Characteristics of a Managing Nurse

Managers have assigned positions within a formal organization.
They have legitimate source of power due to delegated authority that accompanies their position.
They direct willing and unwilling subordinates.
Since managers work in a formal organization, they have a greater formal responsibility and accountability for rationality and control than leaders.
They are also expected to carry out specific functions, and responsibilities.
Managers also manipulate people, the environment, money, time, and other resources to achieve organizational goals
Managers work at various levels in an organization. The number of levels will depend on the size of the organization. Generally three levels of management are used.
Levels of management
managerial levels

1. First level management:

The first level managers are also referred as first line managers they are responsible for supervising the work of non-managerial personnel and the day to day activities of a specific work units or ward.
They are the lowest level. In a hospital, setting these would include, ward In-charge. They are responsible for clinical practice, assigning staff to patients, interfacing with the public, patient care delivery
Personnel development, ensuring compliance with regulatory and professional standards, maintaining discipline and motivating staff to achieve the organizational goals.
First level managers are also responsible for fostering inter-disciplinary, collaborative and strategic planning

2. Middle level Management:

The middle level managers supervise a number of first level managers usually with related specialties or in a given geographical area.
They have a 24hr responsibility for their defined area.
Typically middle level managers act as liaison between upper management and first level managers.
They are responsible for implementing the policies and plans developed by top managers. They also supervise and coordinate the activities of first line managers
A middle level manager maybe referred as a supervisor, director or assistant director. This group constitutes the largest group of managers
3. Upper level management (top managers):

This refers to top executives (such as Chief Nurse,rco) to whom the middle managers report.
They are responsible for establishing organizational goals and strategic plans for the entire organization and operating policies for the entire division
They also ensure integration of work units to achieve the organization mission and buffering the effects of the external environment on workers within the organization.
Top managers are relatively a small group

Management Roles

Interpersonal roles:

• Figure head role: symbolizes the organization or department and performs ceremonial duties
• Leader: determines the Mission and Objectives of the organization and sees that they are accomplished effectively. He hires, trains and motivates employees and encourages them to do better.
• Liaison role: Involves networking with outside organizations, expanding information sources, like conferences, professional meetings etc. Acts as a link between people, groups or organizations within and without the organization

Informational role:

• Monitor: As a monitor, the manager informally seeks information about the organization through internal networks, gossips, and observations. (Get information useful to organization). He/she tours of the organization and holds formal and informal meetings to provide information about the needs of the organization
• Disseminator: A manager is a link in the organization chain of command. He shares information from outside the organization and between work units (sharing information improves job satisfaction).
• Spokes person: The manager shares information with individuals outside the organization, attends meetings, offering continuing education and participates in professional organizations

Decisional Roles:

The Entrepreneur: The manager looks for profitable investments for the organization to improve its performance (start a school of nursing)

• Resource allocator; Managers schedule their own time (work plan). They decide how resources are distributed and with whom he will work most closely with.
• Negotiator: Enters into negotiation with other parties e.g. to enter into a long term relationship with a supplier
• Disturbance handler: Responds to unforeseen circumstances eg. Replacement of sick staff, missing equipment, disease outbreaks (shift staff).

ATTRIBUTES AND QUALITIES OF A MANAGER

• Technical competence
• Social & human skills
• Conceptual ability

Historical Development of Management

Management has been developed through the following periods:

• The classical theories
• Neo classical theories

SCIENTIFIC / CLASSICAL APPROACH

Described management as a science

– focused on formal structure, technical requirements of the organization, and general sets of principles

– Listed duties of a manager

HUMAN RELATIONS APPROACH

– focused on the informal organisation and the psychological & social needs of people at work

Principles of scientific management

1. Observing the workers’ performance through time and motion study to determine the one best way to carry out each task (develop a science for each element of man’s work to maximize organization output)
2. Scientifically selecting the best worker to perform each job, that is the person with characters and abilities needed to carry out job tasks in the most efficient manner.
3. Training the selected worker to perform tasks in the most efficient manner
4. Paying the worker a differential piece rate to motivate them to perform the tasks in prescribed, efficient fashion
5. Appointing a few highly skilled workers to managerial positions and giving each manager responsibility for planning tasks for subordinate workers
6. Appointing a foreman for each aspect of the work and instructing the production worker to report to a different functional foreman for each aspect of the job.

Principles Of Management

1. Specialization or division of labor
   Reduces span of attention or effort for any one person or group.
   Develops practice and familiarity
   Specializing encourages continuous improvement in skills and the development of improvements in methods.
2. Authority
   Rights to give order
   Should be accompanied by responsibility
   The right to give orders and the power to exact obedience.
3. Discipline.
   This is defined as respect for agreements which are directed at achieving obedience. Obedience must prevail throughout the organization as its essential for smooth running of an enterprise.
   outward mark of respect accordance with formal or informal agreement between firm and employees
   No slacking, bending of rules.
4. Unity of command.
   Every subordinate should receive orders and be accountable to only one supervisor. Dual or multiple commands is a perpetual source of conflict. Unity of command avoids conflicting orders and ensures order stability in the organization
   One man, one superior -Each employee has one and only one boss.
5. Unity of direction.
   According to this principle, each ground of activities having the same objective must have one head and one plan.

One head, one person (director) and one plan for a group of activities with one objective. A single mind generates a single plan and all play their part in that plan.

1. Subordination of Individual Interests to general interests.
2. Efforts should be made to reconcile individual interests with common interests. When there is conflict between the two, the interests of organization should prevail over individual interests.
3. Interest of one individual or one group should be subordinate( not prevail over the general good (total workgroup)
4. When at work, only work things should be pursued or thought about.
5. Remuneration of personnel.
6. The amount of remuneration and the methods of payment should be just and fair and should provide the maximum possible satisfaction to both employees and employers pay should be fair to both employees and the firm.
7. Employees receive fair payment for services, not what the company can get away with.
8. Centralization;
9. The degree of concentration of authority should be based upon optimum utilization of all faculties of the personnel.
10. Depending on size of company and quality of managers.
11. Consolidation of management functions.
12. Decisions are made from the top.
13. Scalar Chain (line of authority).
14. There should be a clear line of authority ranging from top to down of the organization. All upward and downward communication should flow through each position of authority along the scalar chain. There should be an unbroken chain of authority extending from top executive to lowest level worker.
15. Formal chain of command running from top to bottom of the organization, like military
16. Order
17. All materials and personnel have a prescribed place, and they must remain there. The right man should be in the right place. A place for everything &everything in its own place, the right man in the right place.
18. All materials and personnel have a prescribed place, and they must remain there.
19. Equity
20. This means that employees should be treated with justice and kindness. Managers should be fair and impartial in their dealings with subordinates Treat every employee with equity &justice.
21. A combination of justice and kindliness towards employees.
22. Equality of treatment (but not necessarily identical treatment)
23. Stability of tenure of personnel.
24. Employees cannot work efficiently unless job security is assured of them.
25. Employees need time to settle into their jobs,
26. This may be lengthy times.
27. Limited turnover of personnel.
28. Lifetime employment for good workers.
29. Initiative.