NLM (prelims)

NURSING AS A PROFESSION (BOTH AN ART & A SCIENCE)

• integrates 4 major areas : administration/management, research, education, & clinical practice

• administration : planning

• research : evidence-based practice

• education : research knowledge 

• clinical practice : bed-side care

LEADERSHIP (ABILITY TO INFLUENCE OTHERS)

one of management’s many function; focusing on people

MANAGEMENT

• universal process of coordinating and supervising personnel and resources to accomplish organizational goals

manager

• person responsible for activities of other people in an organization

economic source

• management as one of production factors with land and capital

system of authority

• management develops with top individuals determining course of action for rank and file 

class & status system

• sociologist's POV → managers became an elite group of brains and education 

leader (supervise & motivate)

• motivates, guides, and supports team to achieve organizational goals

liaison (external relationships)

• builds relationships and coordinates with other departments and stakeholders

figurehead (ceremonial duties)

• represents organization during official events and ceremonies

monitor (gather info.)

• collects, reviews, and analyzes information R/T staff, patients, and organizational performance

disseminator (share info.)

• shares important information with staff to ensure informed staff

spokesperson (represent organization)

• communicates departmental information to higher management or external stakeholders

entrepreneur (initiate change)

• initiatives improvements, innovations, & quality improvement projects

disturbance handler (solve crisis)

• resolves conflicts, crises, and unexpected problems 

resource allocator (allocate resources)

• assigns personnel, budget, equipment, and other resources where they are needed 

negotiator (negotiate agreements)

• negotiates to obtain resources & resolve issues

MANAGEMENT THEORIES

• replace rule of thumbs with scientific methods - traditional trial-and-error methods replaced with scientific, standardized procedures; work should be studied, and time should be allotted for workers to complete their tasks efficiently

FREDERICK TAYLOR (FATHER OF SCIENTIFIC MANAGEMENT)

• controlled observation of worker’s performance through time and motion study 

• scientific selection of the best man or woman to perform each job

• training the selected worker to perform job task

• paying the worker to a differential rate

• appointing few of most highly skilled workers to managerial positions, planning & preparing task of workers

• appointing a foreman for each aspect of the work

FRANK & LILLIAN GILBRETH (FIRST LADY OF MANAGEMEN

emphasized benefits of job simplification and establishing work standards and effects of incentive wage plans and fatigue on work performance

HENRY GANTT

• developed Gantt Chart (timeline that shows the planned activities and when each activity will be done)

• advocates for humanitarian management and concerned with problems of efficiency → contributed to scientific management by refining previous work rather than introducing a new topic

HENRY FAYOL (FATHER OF MANAGEMENT PROCESS SCHOOL)

• studied functions of managers & concluded that management is universal

division of work

• dividing tasks among employees based on their skills to improve efficiency

authority & responsibility

• having the right to give orders and being accountable for decisions 

discipline

• following rules, policies, and organizational standards

unity of command

• receiving orders from only one superior

unity of direction

• activities with the same goal follow one plan and one leader

subordination of individual interest

• putting organizational goals before personal interests

remuneration

• providing fair and appropriate compensation for work

centralization

• concentrating decision-making authority at the appropriate level

scalar chain

• a clear line of authority from the highest to the lowest level

order

• having the right person and resources in right place & right time

equity

• treating employees fairly and respectfully

stability of tenure

• providing employees with job security and stability

initiative

• encouraging employees to suggest ideas and take appropriate action

esprit de corps

• promoting teamwork, unity, and good relationships among employees

3 types of authority

• traditional, charismatic, & rational authority

LYNDALL URWICK

• combined theories of Taylor and Fayol to develop Organizational Theory; popularized the term “span of control and unity of command”

MARY PARKER FOLLETT

• one of first theorist to suggest basic principles, today called participative decision making or participative management 

• managers should have authority with one another, rather than over employees, solution could be easily be found that satisfies employee without dominating each other

ELTON MAYO

• found that if workers give special attention productivity increases, regardless of environmental conditions

JACOB MORENO

• developed system of pairings (Sociometry), believes that people are attracted to, repulsed by or just indifferent towards each other

ABRAHAM MASLOW

• described humans as “wanting” organisms that satisfy their basic needs in a specific sequence

FREDERICK HERZBER

• American psychologist and one of most influential management theorist; developed the Two-Factor Theory of Motivation or Motivation-Hygiene Theory which explains why employees are either satisfied or dissatisfied with their jobs

DOUGLAS MCGREGOR

• American social psychologist and management professor who introduced Theory X and Theory Y in his book (The Human Side of Enterprise (1960))

• Theory X (Douglas McGregor)

• employees dislike work & avoid responsibility

• employees need close supervision 

• motivation comes from punishment & rewards

• leadership style (authoritorian)

• Theory Y  (Douglas McGregor)

• employees enjoy meaningful work & seek responsibility

• employees are self-directed & motivated

• motivation comes from achievement, recognition, & growth

• leadership style (participative & empowering)

Managerial Grid Theory (1964)

• effective leadership depends on balancing concern for people and concern for production (task accomplishment)

WILLIAM BLAKE & JANE MOUTON

• emphasizes that successful leaders achieve organizational goals while caring for needs of their employees

THE GREAT MAN THEORY

• one of earliest leadership theories, proposing that leaders are born, not made; assumes that certain individuals possess innate qualities that naturally make them effective leaders

TRAIT THEORY OF LEADERSHIP

• effective leaders possess specific personal traits that distinguish them from non leaders; recognizes that while some traits may be inherited, many leadership traits can also be learned and developed through education, experience, and training

CHARISMATIC THEORY OF LEADERSHIP

• effective leaders possess charisma (unique personal quality that inspires, influences, and motivates others to willingly follow them)

charismatic leaders

• gain followers because of their confidence, communication skills, vision, and ability to inspire trust and enthusiasm

SITUATIONAL THEORY OF LEADERSHIP

• states that there is no single best leadership style; effective leaders adapt their leadership style according to situation, needs of their followers, and demands of task

CONTINGENCY THEORY (FRED FIELDER, 1960S)

• there is no single best leadership style; leader's effectiveness depends on the match (fit) between leader's natural leadership style and situation

task-oriented leader

• getting the job done, meeting goals, following procedures, deadlines, and productivity

relationship-oriented leader

• focuses on people, trust, teamwork, communication, and staff satisfaction

leader-member relations

• how well leader & employee trust, respect, and cooperate with each other

task structure

• how clear, organized, & standardized the task is 

position power

• how much authority the leader has to reward, discipline, or direct employees

good relations

• trust, respect, cooperation, teamwork, open communication 

poor relations

• conflict, distrust, resistance, poor morale

PATH-GOAL THEORY OF LEADERSHIP (ROBERT HOUSE

• primary role of a leader is to help followers achieve goals by removing obstacles, providing support, and selecting appropriate leadership style 

contingent reward

• leader rewards employees when they meet goals or perform well

management by exception

leader intervenes when employees make mistakes or fail to meet standards

BEHAVIORAL THEORY OF LEADERSHIP (KURT LEWIN)

autocratic (authoritarian)

• leader makes decisions independently with little or no input from followers

autocratic communication style

• one-way (leader → staff) 

autocratic advantages

• fast decision-making, clear chain of command, effective during emergencies, & ensures adherence to protocols 

autocratic disadvantages

• low staff participation, reduce morale and motivation, limits creativity and innovation 

democratic (participative)

• leader involves followers in decision-making while retaining final responsibility

laissez-faire (delegative)

• leader provides minimal supervision and allows employees to make decisions independently

delegative communication style

• minimal supervision (staff-driven communication) 

TRANSFORMATIONAL THEORY OF LEADERSHIP

• states that effective leaders inspire, motivate, and empower followers to achieve extraordinary performance by creating shared vision, fostering innovation, and promoting personal and professional growth

transformational leaders

• encourage followers to exceed expectations because they are inspired by meaningful purpose and  commitment to organizational goals

leadership functions

• creates organizational vision, motivates employees, build teamwork, develop future leaders, inspires change, encourages creativity, & promotes collaboration

management functions

• plans work, organizes resources, assigns responsibilities, supervises employees, controls quality, evaluates performance, & ensure policy compliance

knowledge factors

• ideas, concepts, or principles that’s expressed and accepted because they have logical proofs

attitude factors

• beliefs, feelings, and values that may be used on emotions and may not be subjected to conscious verbalization

planning

• determining organization's philosophy, mission, goals, objectives, policies, procedures, and rules; identifies what needs to be done and how it will be accomplished

organizing

• establishing organizational structure, assigning duties, allocating resources, and determining appropriate patient care delivery system to implement plans effectively

staffing

• recruiting, interviewing, hiring, orienting, scheduling, developing, and retaining qualified personnel to meet organizational needs

directing

• leading, motivating, supervising, communicating, delegating, resolving conflicts, and facilitating teamwork to achieve organizational goals

controlling

monitoring performance, evaluating outcomes, ensuring quality improvement, maintaining legal and ethical standards, and implementing corrective actions when necessary

FUNCTIONS OF LEADERSHIP & MANAGEMENT (P.O.D.C)

• planning : decide what should be done

• organizing : arrange people & resources

• directing : lead, motivate, & communicate

• controlling : evaluate results & correct errors

top management (long term)

• focuses on strategic planning by setting organizational vision, mission, goals, & policies

middle management (medium term)

• focuses on tactical planning by coordinating departments & implementing policies

first-line management (short term)

• focuses on operational planning by supervising employees & operations

respect for autonomy

• respect right of staff and patients to make informed decisions

beneficence (being present)

• act for good and welfare of others

non-abandonment

• do not abandon staff or patients during times of need

veracity

• tell the truth honestly and accurately

fidelity

• keep promises and honor commitments

justice (fairness)

• treat everyone fairly and equitably

NURSING JURISPRUDENCE

• branch of law that studies legal principles, legislation, regulations, and judicial decisions governing nursing education, administration, and professional practice

• constitutional provisions 

• right to health : right to access proper and safe healthcare

• human rights : protect the dignity, freedom, and basic rights 

• patients' rights : protect patients' choices, privacy, safety, and dignity

• nursing legislation 

• philippine nursing act : law that regulates nursing education, practice, and licensure

• related health laws : other laws that guide and protect healthcare practice and patients

• rules and regulations

• prc regulations : rules that govern licensed professionals

• board of nursing resolutions : official rules and guidelines issued for nursing practice

• DOH administrative orders : health policies and procedures issued by DOH

• legal doctrines 

• professional negligence : failure to provide proper standard of nursing care

• malpractice : professional misconduct or negligence that causes harm 

• informed consent : patient's agreement to treatment after receiving enough information

• confidentiality - keeping patients' personal and health information private

administrative policies

• nursing administration : policies for managing nursing services and staff

• hospital regulations : rules that ensure safe and proper hospital operations

• professional standards : expected standards of safe and competent nursing practice

• judicial decisions 

• supreme court decisions affecting nursing practice : court rulings that help interpret laws and guide nursing practice