Chapter 7 Flashcards
the issuance of orders, assignments and instructions that enable the nursing personnel to understand what are expected of them.
Directing
includes supervision and guidance so that in doing a job well, nurses can maximally contribute to the organization’s goals in general and to the nursing service objectives in particular
Directing
A managers important role is to
help subordinates perform in their best of their abilities.
it is the final major step taken by the nurse manager to ensure that the organization’s goals are accomplished.
Directing
The manager must ensure that she has assigned the work properly and that she has gotten the right person for each task that needs to be accomplished.
Directing
To be able to work well, one should have a _______ in the task that needs to be accomplished, especially if the task is a difficult one that may require ______
genuine interest
sustained effort over a period of time
Directing goes beyond
giving orders and instructions
It is also important that the employees chosen by the manager are able to get along______ because directing employees invariably depend on the _______
harmoniously
relationships existing among them
This is of particular relevance in a nursing care environment where continued interaction among the various employees in the system is______ and necessary for the organization to function properly.
inevitable
> is the act of issuing of orders, assignments, instructions to accomplish the organization’s goals and objectives.
Directing
Tools in Directing:
Primary tool:
NCP.
Policies,
standards operating procedure
rules and regulations can also be tools.
Characteristics of good directions:
- Directions must be clear, concise, consistent and complete.
- Explain the rationale well and make sure it is understood.
- The word used indicates their importance ex: must, shall & will. “may” denotes an action. “should” denotes recommendation or mandatory.
- Speak distinctly and slowly. Directions must come across as a request not a command, using specific tone and set of words. Prioritize the task directed to be done by importance and time.
- Avoid giving too many directions at one time.
- Personalize direction and make sure it has been followed.
Directing
> is the act of issuing of orders, assignments, instructions to accomplish the organization’s goals and objectives.
> it involves the process of getting the organization’s work done.
> it entails explaining what is to be done, to and by whom at what time, how and why the task should be done.
> directing must be consistent with departmental policies to help personnel perform their duties safely and efficiently.
Characteristics of the Nursing Care Plan:
- It focuses on actions designed to solve or minimize the exciting problem.
- A product of a deliberate systematic process.
- Relates to the future.
- Based upon the identifiable health and nursing problems.
- Focus is holistic.
- It aims to meet all the needs of the patient’s.
Principles of delegation:
- Select the right person to whom the job is to be delegated.
- Delegate interesting and uninteresting task.
- Provide subordinates with enough time to learn.
- Delegate gradually.
- Delegate in advance.
- Consult before delegating.
- Avoid gaps and overlaps.
it is the act of assigning to someone else a portion of the work to be done with corresponding Authority, Responsibility and Accountability (ARA)
Delegation
What cannot be delegated?
- Overall responsibility, authority & accountability for satisfactory completion of all activities in the unit.
- Authority to sign one’s name is never delegated.
- Evaluating the staff or taking necessary corrective or disciplinary action.
- Responsibility for maintaining morale or the opportunity to say a few words of encouragement to the staff especially the new ones.
- Job that are too technical and those that involves trust and confidence.
This stems from the managers’ false assumption that delegation may be interpreted as the lack of ability on his or her part to do the job correctly or completely.
Under delegating
> An assignment is a task done without authority while a delegation is a task done with ARA
Delegation
Why nurses Manager do not delegate:
- Lack of confidence feels that they only could do the task faster and better.
- Fear of loss of control if some of their duties are delegated.
- Mistakes in delegation can be costly
- Failure to delegate wisely increases management costs and contributes to personnel dissatisfaction.
- Fear on the part of the director, of her own ability to delegate.
- Fear of losing control of the staff.
- Fear of failing to get others to the work.
- Fear of criticism
Common Delegation Errors:
- Under delegating
- Over delegating
- Improper Delegating
It unnecessarily burdens the subordinates with tasks that are either inconsequential or irrelevant to the delivery of the goal
Over delegating
A manager should be able to determine the talents and capacities of his subordinate. Delegation of tasks and responsibilities beyond which the person cannot perform property is
Improper Delegating
> It is a task oriented in which a particular nursing function is assigned to each worker.
Functional nursing
> Best use when there are many patients.
Functional nursing
Disadvantage of functional nursing:
> Fragmentation of nursing care so holistic care is not achieved.
> Nurse accountability & responsibility is diminished.
> Patient cannot identify who their “real nurse” is
> Nurse-patient relationship is not fully developed.
> Evaluation of nursing care is poor.
> It is difficult to find a specific person who can answer the patients/relatives’ questions.
> One nurse is assigned to one client for the delivery of total care.
Total Care/Case Nursing
> Suitable for short-term use.
Functional nursing
Advantages of functional nursing:
> Work is accomplished in a shorter time.
> Worker learns to work fast.
> Gaining skills faster in that particular task.
The duty nurse will be accountable for their own action.
Total Care/Case Nursing
The nurse plans, coordinates, implements, evaluates and document the nursing care during the patients illness.
Total Care/Case Nursing
> A system of care in which a qualified professional nurse leads a group of nurses in
providing nursing needs of a group of patients through participative effort.
Team Nursing
> Assigning of task to team members according to their job description.
Team Nursing
> Responsible for the total care of a small group of patients from admission to discharge.
Primary Nursing
Primary and secondary nurses are free from administrative & housekeeping
responsibility.
Primary Nursing
> Assumes 24 hrs responsibility for nursing care, secondary nurse executes the care
Plan during the afternoon and night shift and on days when the primary nurse is on off
duty.
Primary Nursing
Accountability, authority and autonomy rest with the primary nurse. So he communicates directly with the members of the health care team within the hospital and community.
Primary Nursing
is the process of guiding and directing the work to be done.
Supervision
> It entails motivating and encouraging the staff to participate.
Supervision
To most workers, the supervisor is presumed as ________ because of her constant presence and close association with them.
the management
Principles of Good Supervision:
a. Good supervision is focused on the improvement of work rather than upgrading the worker.
b. It is based on the lines of authority, organizational philosophy, vision/mission; the job description, policies and standards, the needs of the individual.
c. Focuses on the degree areas of skill: conceptual, technical & interpersonal
d. It is cooperatively planned, and accepts both challenge and change.
e. It uses a democratic process.
f. The ultimate goal of good supervision is to provide safe, effective, quality care.
g. It considers the strength & weaknesses of an employee.
h. Stimulates critical thinking and creativity in patient care.
Responsibilities of Supervisors
> Supervisors have the duty to teach and motivate the staff, as well as facilitate their work.
> They should delegate work responsibilities and be available for consultation.
> They should also perform assessment and evaluation of work performance and conditions
Orientation:
> Planned & guided activities of an employee in an organization.
- It has to be done in the conference room or training room.
- Starts with the mission, vision, philosophy and objectives of the nursing service.
- Hospital policies on hiring, promotion, transfer, dismissal, job description & updating of license.
This practice gives the new staff chance to develop their skills and foster the feeling of acceptance, belongingness and confidence in assuming duties &responsibility.
“Shadowing”/”big sister”/”buddy”
They should also perform assessment and evaluation of work performance and conditions
Responsibility of Supervisors
is a planned experience to help employees perform effectively, and to enrich their competence in practice, education, administration and research it is re-training them for better performance in areas of Skills, Knowledge, and Attitude (SKA).
Staff Development
They should delegate work responsibilities and be available for consultation.
Responsibility of Supervisors
have the duty to teach and motivate the staff, as well as facilitate their work.
Responsibility of Supervisors
Introduction to the unit personnel’s, unit policies, nursing standards & procedure.
ORIENTATION:
Tour around the hospital & assigned unit.
Assigning of clients, evaluation of activities, problems are discussed and implementation of solution.
ORIENTATION:
Tour around the hospital & assigned unit.
> Assuming of greater responsibility. Mentors will instill proper values and attitude. Critical thinking to new staff and to take a stand in ethical dilemmas in the unit.
ORIENTATION:
Tour around the hospital & assigned unit.
> Give the staff opportunities to ventilate their frustration over role expectations, value
ORIENTATION:
Tour around the hospital & assigned unit.
Functions and Staff Development:
A. Maintain staff efficiency and effectiveness
B. Create quality employees;
C. Meet the staffs needs and address their problems, such as deficiencies in knowledge , skills and attitude;
D. Motivated them and improve their self – confidence; and
E. Help prepare them for greater responsibilities, e.g. planning, orientation, continuing education, in-service, patient education, advisory and research.
In-service training is education for employees to help them develop their skills in a specific discipline or occupation. In-service training takes place after an individual begins her work responsibilities.
In-service Training and Continuing Education:
This activity links the different components of an organization and leads them toward goal achievement.
Coordination
It creates harmony on all activities to facilitate success of work. In a well-coordinated organization, everything has been delegated to guard against leaving loose ends.
Coordination
Coordination with the Medical services
for clients plan of care.
Coordination with the Administrative service
for repairs, maintenance of equipment, requisitions of supply, monthly inventories.
