CHAPTER 8 Flashcards
DIRECTING
the manager encourages her personnel to accomplish their assigned tasks towards achieving the objectives that were laid down for the organization while planning and organizing the operations.
directing
goes beyond giving orders and instructions; it is the final major step taken by the nurse manager to ensure that the organization’s goal are accomplished.
Directing
The act of issuing of orders assignments instructions to accomplished the organization’s goals and objectives.
Directing
It involves the process of getting the organization’s work done.
Directing
It entails explaining what is to be done, to and by whom at what time, how and why the task should be done.
Directing
Characteristics of Good Directions
- Directions must be clear, concise, consistent and complete.
- Apart from being understandable the person giving directions must explain the rationale well and make certain that it is understood.
-The words used in the directions indicate their importance.
-The person giving directions must speak distinctly and slowly.
indicate that the directions are mandatory.
The word “must”, “shall”, and “will”
denotes that action is recommended.
The word “may”
places the directive somewhere between mandatory and recommended action.
the word “should”
must come across as requests not commands, using a specific tone and set of words.
Directions
In a characteristic of good directions it is important to:
- Avoid giving too many directions at one time,
- Personalized directions,
- Always check to make sure directions have been followed.
Tools in Directing
- Nursing Care Plan
- Policies
- Standards
- Standard operating procedures
- Rules and regulations
Outlines the nursing care to be provided to a patient.
Nursing Care Plan
It is a set of action s the nurse will implement to resolve nursing problems identified by assessment.
Nursing Care Plan
The creation of the plan is an intermediate stage of the nursing process. It guides in the ongoing provision of nursing care and assists in the evaluation of that care.
Nursing Care Plan
Characteristics of Nursing Care Plan
- It focuses on actions which are designed to solve or minimize the
exiting problem. - It is product of a deliberate systematic process.
- It related to the future.
- It I based upon identifiable heath and nursing problem.
- Its focus is holistic.
- It aims to meet all the needs of the patients or service user.
Elements of Directing
- Delegation
- Supervision
- Staff development
- Coordination
- Collaboration
- Communication
- Evaluation
Is the act of assigning to someone else a portion of the work to be done with corresponding authority, responsibility and accountability (ARA).
Delegation
is a task done without authority
Assignment
is a task done with ARA.
delegation
What cannot be delegated
- Final evaluation of staff performance
- Correcting and disciplining staff
- Such activities which the nurse to whom the task is delegated does not know or does not want to do because it is unpleasant.
Five Rights of Delegation
- Right Task
- Right Circumstance
- Person
- Communication
- Supervision
Questions to ask when determining the right task
- Is there potential for harm
- How complex is the task
- What problem-solving is required to carry out the task
- What is the predictability of the outcome
- Patient interaction/ability.
Delegating a task under the right circumstances includes
- Considering the condition of the patient
- An awareness of the staff mix
- Organization documents
- Determines the scope of practice for each position
- Issues standards of care that guide practice
- Policies and procedures (determine what can be done and what - -level of personnel can carry out the task)
Nurse Practice Act
identifies job responsibilities
Job descriptions
each organization has statements that guide practice.
Organization guidelines
Clear and concise communication is imperative from the RN to the delegatee. This communication should include the :
- Task with clear expectations of what is to be done, why it is being done, and when the task should be completed
- Correct patient
- Information that should be reported back to the nurse and when that information should be given to the nurse
- Expected outcome of the task
The RN must provide sufficient follow up including:
- Checking on the progress of the task
- Checking on the outcomes once the task is performed
- Obtaining feedback about the completed task from the delegatee
- Evaluate the effectiveness of the delegation with the delegatee
Why Managers do not want to Delegate?
- 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 do the work.
- Fear of criticism.
- The manager who enjoys the personal satisfaction gained from doing the work himself will likewise not be inclined to delegate the work.
Common Delegation Errors
- Underdelegating
- Overdelegating
- Improper delegating
This stems from the manager’s false assumptions that delegation may be interpreted as the lack of ability on his or her part to do the job correctly and completely.
Under delegating
The manager manifest his desire to do the job by himself.
Under delegating
He has trust issues and thus lacks the trust in his subordinates.
Under delegating
He is insecure that he fears the subordinates will resent the work delegated to them.
Under delegating
This occurs when the manager lacks experience in the job.
Under delegating
It unnecessarily burdens the subordinate with tasks that are either inconsequential or irrelevant to the delivery of the goal.
Over delegating
The culprit is usually poor management of time and insecurity on the part of the nurse manager in her ability to perform tasks.
Over delegating
A manager should be able to determine the talent and capabilities of his subordinates.
Improper Delegating
Delegation of tasks and responsibilities beyond the person cannot perform properly.
Improper Delegating
Is the process of guiding and directing the work to be done.
Supervision
It entails motivating and encouraging the staff to participate in activities to meet goals and objectives and personal development and in helping the staff to do their work better.
Supervision
A supervisor:
- Can produce attitudes which are both positive and negative in character.
- Produces positive attitudes when an employee is conscious of the benefits to himself which he attributes to the influence of the supervisor
- Produces negative attitude when the reaction of workers is resistance to discipline or actual fear of demotion or discharge.
Principles of Good Supervision
- Good supervision is focused in the improvement of work rather than upgrading the worker.
- It is based on the lines of authority organizational philosophy, vision/mission, job description policies and standards, the needs of the individual.
- Focuses on the three areas of skill
- It is cooperatively planned, and accepts both challenge and change.
- It uses a democratic process to facilitate:
the three areas of skill:
- Conceptual
- Technical
- Interpersonal
democratic process
- Effective communication
- Continuous improvement of staff
- Respect for the individuality of each staff member
- Bring about harmonious relationship and a conducive social, psychological and physical atmosphere.
Responsibilities of the Supervisor
- Supervisors have the duty to teach and motivate the staff, as well a 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.
Is a planned experience to help employee perform effectively, and to enrich their competence in practice, education, administration and research.
Staff Development
It is re-training them for better performance in areas of skill, knowledge and attitude.
Staff Development
Functions
- Maintain staff efficiency and effectiveness.
- Create quality employee.
- Meet the staff needs and address their problems such as deficiency in knowledge skills and attitudes.
- Motivate them and improve their self-confidence.
- Help prepare them for greater responsibilities.
is education for employees to help them develop their skills in a specific discipline or occupation.
In service training
It takes place after an individual begins her work responsibilities.
In-service Training and Continuing Education
is a specific learning activity generally characterized by the issuance of a certificate or continuing professional development (CPD) units for the purpose of documenting attendance at a designated seminar or course of instruction.
Continuing education program
study and memorize the in service training and continuing education in the messenger
/
This activity links the different components of an organization and leads them toward goal achievement.
Coordination
This creates harmony on all activities to facilitate success of work.
Coordination
In a well-coordinated organization, everything has been delegated to guard against leaving loose ends.
Coordination
The manager and health care staff together with the other members of the heath care team all participate in the decision making process.
Collaboration
Sometimes they enjoined forces with another as the medical group or larger group, like other health care team or one fulfilling a different roe for this purpose.
Collaboration
It ensures common understanding via various routes.
Communication
It is a process by which a message is sent, received and understood as intended.
Communication
The goal of proper communication is to narrow the gap between the intended and the received message.
Communication
As nurse managers, nurses have to frequently communicate directions and these directions have to be reasonable ad understandable so subordinates are likely to comply.
Communication
Thus, communication are more than trying to make people understand; they aim at changing people’s behavior.
Communication
To achieve good communication a nurse-manager must be aware that communication is not only confined to verbal communication. There are also non-verbal cues which from part of non-verbal communication as to verbal communication which solely involves talking.
Communication
Barriers to Effective Communication
Physical Barriers
Social/psychological Barriers
Semantics
Interpretations
These are environmental factors that prevent or reduce the opportunities for communication.
Ex. Noise, distance
Physical Barriers
They are blocks or inhibitors to communication that rise from the judgments emotions and social values of people.
Ex. Stress, trust, fear
Social/psychological Barriers
These are words figures, symbols, penmanship, interpretation of messages through signs and symbols.
Semantics
These are defects in communication skills of verbalizing, listening writing and reading.
Interpretations
Dimensional Flow of Communication in Nursing Service
- Upward communication
- Horizontal communication
- Outward communication
- Downward vertical communication
- Diagonal communication
Proceed from the subordinates to superiors.
Upward communication
Takes place among the peers and members of the health team.
Horizontal communication
Proceeds from the team to the patient’s family, community workers, friends.
Outward communication
Proceeds from a authority or manager to his subordinates
Downward vertical communication
Flows throughout different hierarchical levels.
Diagonal communication
Management levels in Nursing Service
Top Level
Middle Level
First line Managers
Operating Level
Director and the administrator of nursing services
Top Level
Nurse supervisors
Middle Level
Head nurses, senior staff nurses
First line Managers
Staff nurses, student nurses , nursing attendants
Operating Level
Evaluation Purpose:
- Provide constructive feedback
- Determine progress and worthiness of individual nurse for greater responsibilities
- Serve as basis for promotion ad increase in salary and other similar rewards.
Evaluation is also meant to:
- Recognize and further develop strengths
- Minimize weaknesses
- Provide security for patients, personnel agency and the community
- Develop a fair employment practice and performance appraisal process that is in accordance with the law
Types of Evaluation
- Outcome or product evaluation
- Process evaluation
- Structure evaluation
Which take note of the response of patients after nursing care is done.
Outcome or product evaluation
Nursing actions are examined, to determine if client goals have been met or have not been met.
Process evaluation
The goal is both to obtain feedback on the system such as financial and material resource, nursing personnel, policies and procedures.
Structure evaluation
Is a natural inevitable conditions and is a prerequisite to change people’s behavior.
Conflict
It is a consequence of real or perceived differences in goals, beliefs, values, ideas, feelings, and actions.
Conflict
Conflict can occur on several levels:
- Intrapersonal or within one individual
- Interpersonal or within one or two individuals
- Intra group or within one group
- Intergroup between two or more groups
Positive and Negative Result of Conflict
- Conflict can provide greater sensitivity to an issues which stimulate the interest and curiosity of others.
- Conflict can increase creativity by acting as a stimulus for developing new ideas or identifying methods for solving problems.
- Conflict can help people recognize the legitimate differences within an organization
- Conflict can also be a powerful motivator to improve performance and effectiveness
- Disagreements can make parties aware of costs versus benefits of a particular service or techniques
Types of Conflict
- Competitive Conflict
- Disruptive Conflict
This occurs when two or more groups attempt the same goals and only one group can attain them.
Competitive Conflict
It is defined as a victory for one side and a loss for the other.
Competitive Conflict
This takes place in an environment filed with fear, anger and stress.
Disruptive Conflict
There is no mutually acceptable set of rule and the goal of each party is the elimination of it opponent.
Disruptive Conflict
Conflict Resolution
- Dominance and Suppression or a win-lose strategy
- Restriction
- Smoothing Behaviors
- Avoidance Behavior
- Majority Rule
- Compromise or Consensus Strategy
Is a method that represses rather than settles conflict, creating a win-lose situation in which the loser is left feeling angry and antagonistic.
Dominance and Suppression or a win-lose strategy
is an autocratic coercive style that is often leads to an indirect and destructive expression of conflict.
Restriction
Is a diplomatic way of suppressing conflict wherein one persuades the opponent to give in to the other side.
Smoothing Behaviors
Creates a situation in which there are no differences
Avoidance Behavior
Resolves conflict by majority vote
Majority Rule
Is a method where each side agrees upon that meet everyone’s need.
Compromise or Consensus Strategy
