2. An interpersonal process to effect change on the
behavior of others
Process by which a nurse influence one or more person
to achieve specific goals in the provision of nursing
care in one or more patients
The process of envisioning a new and better world,
communicating that vision to others, motivating others
and enticing them to join in efforts to realize the vision,
thinking in a different way, challenging the status quo,
taking risks, and facilitating change.
3. Often do not have delegated authority but obtain their
power through other means, such as influence
Have a wider variety of roles than managers do
May or may not be a part of the formal organization
Focus on group process, information gathering,
feedback, and empowering others
Emphasize interpersonal relationships
Direct willing followers
Have goals that may or may not reflect those of the
organization.
4. Great Man Theory
◦ Asserts that some people are born to lead, whereas others are
born to be led
◦ This theory assumed that all leaders were men and all were
great (i.e of the noble class).
5. Trait Theory
◦ Assume that some people have certain characteristics or
personality traits that make them better leaders than others
◦ Studies revealed that these leaders possessed multiple
characteristics of commonalities.
6. Charismatic Theory
◦ Possession of a quality that sets one person apart from others:
supernatural, superhuman, endowed with exceptional qualities
or powers
◦ Theses qualities are said to be magnetic, persuasive and
fascinating.
7. Situational Theory
◦ Embodies the idea that the right thing to do depended on the
situation the leader was facing
◦ Involves assessing the nature of the task and the follower‟s
motivation or readiness to learn.
8. Transformational Theory
◦ The true nature of leadership is not the ability to transform
followers to become more self-directed in all they do.
◦ “Look for potential motives in followers, seek to satisfy higher
needs, and engage the full person of the follower”.
9. Behavioral Theory
◦ Also called functional theories theory
◦ Concerned with what a leader does rather than who the leader
is.
10. Autocratic Leadership
◦ Also known as Authoritarian/Directive
◦ Strong control is maintained over the work group
◦ Others are motivated by coercion
◦ Others are directed with commands
◦ Communication flows downward
◦ Decision making does not involve others
◦ Emphasis is on difference in status (“I” and “YOU”
◦ Criticism is punitive .
11. Democratic Leadership
◦ Also called Participative
◦ Less control is maintained
◦ Economic and ego awards are used to motivated
◦ Others are directed through suggestions and guidance
◦ Communication flows up and down
◦ Decision making involves others
◦ Emphasis is on “WE” rather than “I” and “YOU”
◦ Criticism is constructive.
12. Laissez-Faire Leadership
◦ Also called Ultraliberal/Permissive
◦ Permissiveness, with little or no control
◦ Motivation by support when requested by the group or
individuals
◦ Provision of little or no direction
◦ Communication upward and downward flow among members
of the group
◦ Emphasis on the group
◦ Criticism is withheld.
13. Formal or Informal
Formal Leaders
◦ Appointed by organization and given office or legitimate
authority to act
Informal Leaders
◦ Don‟t have official power to direct activities of others
◦ Mostly based on seniority.
14. Reward Power
◦ Based upon the incentives the leader can provide for group
members to influence behavior by granting rewards.
15. Coercive Power
◦ Based in influencing behavior through the negative things a
leader might do to individual group members or the group as a
whole by withholding rewards or applying sanctions
◦ The manager may obtain compliance through threats of
transfer, layoff, demotion, or dismissal.
16. Legitimate Power
◦ Power of position
◦ Authority is called legitimate power
◦ Power gained by a title or official position within an
organization
◦ Legitimate power has inherent in it the ability to create feelings
of obligation or responsibility.
17. Referent Power
◦ The power a person has because others identify with the leader
or with what the leader symbolizes
◦ Also occurs when one gives another person feelings of
personal acceptance or approval
◦ Perception based on personal charisma, the way the leader
talks or acts, the organization to which he or she belongs, or
the people with whom he or she associates.
18. Expert Power
◦ Based upon particular knowledge and skill not possessed by
staff members
◦ Gained through knowledge, expertise, or experience
◦ This type of power is limited to a specialized area.
19. Informational Power
◦ Based upon “who knows what” in an organization and the
degree to which they can control access to that information by
other individuals
◦ Obtained when people have information that others must have
to accomplish their goals.
20. Self Power
◦ Also referred to as feminist power
◦ The power a person gains over his or her own life – and
maintains that this power is a personal power that comes from
maturity, ego, security in relationships, and confidence in one‟s
impulse.
21. UNPLANNED CHANGE vs PLANNED CHANGE
Unplanned Change
◦ Usually haphazard and the results can be unpredictable
◦ Example: Change as a result of natural disaster
Planned Change
◦ Change that results from a well thought-out and deliberate
effort make something happen
◦ Intended, purposive attempt by individual, group and
organization.
22. COVERT vs OVERT
Covert Change
◦ Is hidden or occurs without the individual‟s awareness
Overt Change
◦ Change about which a person is aware.
23. Kurt Lewin
◦ Identified three phases through which the change agent (a
person skilled in the implementation of planned change) must
proceed before a planned change becomes part of the system
and recognize forces which interplay any potential change
Driving forces – factors that encourage or facilitate the change
Restraining forces – factors that obstruct change.
24. Unfreezing
◦ The change agent unfreezes forces that maintain the status quo
◦ People become discontented and aware of a need to change
◦ Necessary because before any change can occur, people must
believe the change is needed
◦ Unfreezing occurs when the change agent convinces members
of the group to change or when guilt, anxiety, or concern can
be elicited.
25. Moving
◦ The change agent identifies, plans, and implements appropriate
strategies, ensuring that driving forces exceed restraining
forces
◦ Because change is such a complex process, change should be
implemented gradually therefore it requires a great deal of
planning and intricate timing.
26. Refreezing
◦ During this stage, the change agent assists in stabilizing the
system change so it becomes integrated into the status quo
◦ If refreezing is incomplete, the change will be ineffective and
the pre-change behaviors will be resumed
◦ Because change needs at least 3 to six months before it will be
accepted part of the system, change should never be attempted
unless the change agent can make a commitment to be
available until the change is complete.
27. Moving
Unfreezing Develop a plan
◦ Gather data Set goals and objectives
◦ Diagnose the problem Identify areas of support and
◦ Decide if change is needed resistance
Include everyone who will
◦ Make others aware of the be affected by the change
need change Set target dates
Develop appropriate
strategies
Refreezing Implement the change
Support others so the Use strategies to overcoming
resistance
change remains.
Evaluate the change
Modify the change, if
necessary
28. Equilibrium
◦ Characterized by high energy and emotional and intellectual balance
Denial
◦ Individual denies reality of the change. Negative changes occur in
physical, cognitive, and emotional functioning
Anger
◦ Energy is manifested by rage, envy, and resentment
Bargaining
◦ In an attempt to eliminate the change, energy is expended by
bargaining
Chaos
◦ Characterized by diffused energy, feelings of powerlessness,
insecurity, loss of identity.
29. Depression
◦ Defense mechanisms are no longer operable. No energy left to
produce results
Resignation
◦ Change accepted passively but without enthusiasm
Openness
◦ Some renewal of energy in implementing new roles or assignments
that have resulted from the change
Readiness
◦ Willful expenditure of energy to explore new event
Reemergence
◦ person again feels empowered and begins initiating projects and
ideas.
30. Innovators
◦ Enthusiastic, energetic people who thrive on change
Early adopters
◦ Open top receive new ideas but are less obsessed to changes
Early majority
◦ “Be not last to start, nor the first by which the new is tried”.
31. Late majority
◦ Skeptical to innovations, frequently express their negative
views
Laggards
◦ Last to adopt an innovation because they are accustomed to
tradition
Rejecters
◦ Openly oppose innovation and actively encourage others to do
so.
32. The tendency for something to resist change even when
a surprisingly large amount of effort is applied.
33. Process of reaching organizational goals by working
with and through people and other organizational
structures
Series of systematic, sequential, or steps directed
towards the achievement of organizational goal
The process of planning, organizing, directing ,
coordinating and influencing the operation of an
organization to obtain desired result and enhanced total
performance.
34. Top Level Managers
◦ Develop goals, strategic plans, company policies, and make
decisions on the direction and make decisions on the direction
of the business
◦ Board of directors, presidents and vice presidents.
35. Middle Level Managers
◦ Accountable to the top management for their department‟s
functions and devote more time to organizational and
directional function
◦ Directors of nursing, supervisory staff, department heads.
36. First Level/Front Line Managers
◦ Focus on controlling and directing, possess the responsibility
of assigning tasks, guiding and supervising employees‟ day to
day activities
◦ Head nurse.
37. Interpersonal
◦ Connects one person to another, as a leader who hires, trains,
encourages
◦ Figurehead
◦ Liaison
◦ Influencer.
38. Informational
◦ Disseminates about existing rules and regulation as the
representative or spokesperson of the organization
◦ Monitor
◦ Disseminator
◦ Spokesperson.
39. Decision Role
◦ A trouble shooter who handles unexpected situations such as
resignation of subordinates, firing and losses clients and
negotiator when conflict arise
◦ Entrepreneur
◦ Disturbance handler
◦ Resource allocator
◦ Negotiator.
40. Technical Skills
◦ Proficiency in performing an activity in the correct manner
with the right techniques
Human relation Skills
◦ Dealing with people and how to get along with them
Conceptual Skills
◦ Ability to see individual matters as they relate to the total
picture and to develop creative ways.
41. Scientific Management
◦ Frederick Winslow Taylor known as the father of scientific
management
◦ Focuses on principles on increasing the productivity of
workers based on managing time, materials, and work
specialization based on scientific manner
◦ Tao – get right person
◦ Training
◦ Tool
◦ Treatment.
42. Behavioral Theories
◦ Elton Mayo known for his HAWTHORNE EFFECT
◦ Believes that increasing employees productivity deals with
overtime pay, rest day, day off
◦ Provides physical needs of workers like rest and recreation.
43. Bureaucratic Management
◦ Max Weber a German sociologist who developed what was
known as the “ideal bureaucracy”
◦ Whoever is on top would perform management functions
◦ Centralized.
44. General Administrative Theory
◦ Henri Fayol believes in certain principles of management
◦ Unity of command
◦ Unity of direction
◦ Subordination
◦ Esprit de corps
◦ Chain of command
◦ Channels of communication
◦ Command responsibility
◦ Security of tenure
◦ Remuneration.
45. Japanese Management Style
◦ The theory Z of William Ouchi who introduced Japanese
management to the western world
◦ He believes in lifetime management, slow evaluation and
promotion, collective decision making, collective
responsibility, and holistic concern for employees.
46. Theory X and Y
◦ Formulated by Douglas McGregor who believes that there two
types of employees
◦ Theory X is the negative worker
◦ Theory Y are positive workers.
47. Motivation-Hygiene Theory
◦ Also called two-factor theory formulated by Frederick
Herzberg
Intrinsic (Motivator) – growth, advancement, responsibility, work
itself, recognition, achievement
Extrinsic (Hygiene) – status, relationship with subordinates,
personal life, work conditions, and administration.
48. Planning
◦ Determining the long-term and short-term objectives (ends) of
the institution or unit and the actions (means) that must be
taken to achieve these objectives
◦ The first and fundamental function of management because all
other management functions are dependent on it
◦ Deciding what is done, when it is done, how it is done and who
is to do it.
49. Long-term Planning
◦ Strategic planning are specified for three to five years
◦ Determine the direction of the organization, allocates resources
and determine time frame
◦ Done by top managers
◦ Involves SWOT analysis (Strength, Weakness, Opportunities,
and Threat).
50. Intermediate Planning
◦ 6 months to 3 years
◦ Done by the middle manager.
51. Short Range
◦ Deals with the day to day maintenance activities
◦ Done by the first level manager.
52. Mission – a brief statement identifying the reason that
an organization exists
Vision – the future aim or function of the organization
Philosophy – states the purpose and delineates the set
of values and beliefs that guide all actions of the
organization
Goals – ends to be accomplished
Objectives – something aimed at or strived for things
done to achieve goal
Rules and regulations – plans that define specific action
or non-action.
53. A plan for all the allocation of resources and a control
for ensuring that results comply with the plans.
54. Capital Budget
◦ Estimates of expenditure for adding, replacing or improving
buildings or equipments for the budget period
◦ Buildings, major equipments.
55. Operating Budget
◦ Also known as recurrent budget which is the estimates of
operating expenses, estimates of operating revenues, and
estimates of activity
◦ Supplies, electricity expenses, water expenses, repairs and
maintenance.
56. Cash Budget
◦ Also referred to as cash-on-hand and petty cash
◦ Budget planned to make adequate funds available as needed
and to use any extra funds.
57. Personnel Budget
◦ Also called labor budget
◦ Budget which estimates the cost of direct labor necessary to
meet the organization‟s objectives
◦ It includes recruitment, hiring, assignment, lay off and
discharge of personnel.
58. Terminologies
◦ Cost Containment – to keep cost within acceptable limits for
volume, inflation, and other acceptable parameters
◦ Cost Awareness – focuses on employees‟ attention on cost
◦ Cost Monitoring – focuses on how much will be spent, where,
when, and why.
59. The act of planning and exercising conscious control
over the amount of time spent on specific activities
◦ TIME IS A NON-RENEWABLE RESOURCE
◦ Set goals
◦ Ranked goals and plan strategies to achieve them
◦ Plan schedule.
60. Principle of Time Management
◦ Effective communication
◦ Ability to plan effectively
◦ Delegation
Efficiency – doing the right task
Effectively – doing the right task correctly.
61. Organizing
◦ Mobilizing human and material resources so that institutional
objectives can be achieved
◦ The arranging of component parts into functioning wholes.
62. An organization is a group of people working together,
under formal and informal rules of behavior, to achieve
a common purpose.
63. An organizational chart provides the „blueprint‟ of
depicting formal relations, functions, and activities
Used to clarify chain of command, span of control,
official communication process, and linkage for all
department personnel.
64. Interconnecting lines
◦ Line – indicates direct authority or command giving
relationship
◦ Broken line – indicates consulting relationship with no
prescribed frequency of the structure to collaborate for
planning or control purpose.
65. Status – rank given to person
Accountability – the internalized responsibility
whereby an individual agrees to be morally for the
consequences of his actions
Responsibility – the obligation to perform the assigned
tasks
Authority – the official power to act
Power – capacity to act or potency to accomplish
something.
66. Unity of Command - there can only be one superior to
avoid confusion
Scalar Principle – flow from higher to lower authority
Departmentalization- grouping of workers with similar
assignment
Span of Control – number of people that can be directly
supervised (4-6)
Decentralization – proper delegation of authority.
67. The management activity that provides for appropriate
and adequate personnel to fulfill the organization‟s
objectives
The nurse manager decides how many and what type of
personnel are required to provide care for patients.
68. Centralized chief nurse– done by the
Decentralized – done by supervisors or head nurse
Cyclical – covers a designated number of weeks and
repeated there on.
69. Patient Care Classification
◦ Level I – (minimal) for discharge/convalescing patient
◦ Level II – (moderate) needs some assistance of activities of
daily living
◦ Level III – (complete) completely dependent; those who need
close attention throughout the shift
◦ Level IV – (specialized) continuous monitoring .
70. Total patient care/case method
◦ The oldest mode of organizing patient care
◦ Nurses assume total responsibility during their time on duty for
meeting all the needs of assigned patients.
71. Primary Nursing/relationship-based nursing
◦ Nursing care directed by a nurse in a 24-hour basis
◦ Increase job satisfaction, improves continuity of care, allows
independent decision making, supports direct nurse-client
communication, encourages discharge planning, improves
quality care
◦ Increase personnel costs, requires properly trained nurses to
carry out system principles.
72. Functional Nursing
◦ Task oriented and very useful in emergency situation
◦ Reduces personnel costs
◦ Fragments nursing care, decreases job satisfaction, decrease
personal contacts with patients, limits continuity of care.
73. Team Nursing
◦ One nurse will lead a group of nurses
◦ Increases job satisfaction, increase cost effectiveness
◦ Decreases personal contact with client, limits continuity of
care.
74. Case Management
◦ Focuses on attainment of outcomes within effective time frame
by a case manager and this is done prior to admission and
spans for about 2-3 weeks discharge
◦ Improves nurse responsiveness to clients changing needs,
improves continuity of care, increase nurse‟s job satisfaction
◦ Increase personnel costs.
75. The study of how people perform and function within a
group structure
The group becomes a unit when it shares a common
goal and acts in union to either achieve or thwart the
accomplishment of the goal
◦ Primary Groups – composed of individuals who interact on
“face-to-face” basis, and the relationships are personal
◦ Secondary Groups – are larger and more impersonal groups
who are organized around formal rules, procedures, policies
and other regulations.
76. Aggressor - expresses disapproval of others‟ values or
feelings through jokes, verbal attacks, envy
Blocker – Persists in expressing negative points of view
and resurrects dead issues
Recognition Seeker – works to focus positive attention
on himself
Playboy – remains uninvolved with everything
Dominator – attempts to control and manipulates the
group
Help Seeker – use expressions of personal insecurity,
confusion, or self-deprecation.
77. Forming – during the initial stage the group forms and
learns the behavior acceptable to the group
Storming – as the group becomes more comfortable
with one another they begin to assert their individual
personalities
Norming – the conflicts that arouse in the previous
stages are addressed and hopefully resolved
Performing – is a stage by which a group begins to
operate as a unit
Adjourning – is a time for a temporary group to wrap
up activities.
78. Stimulate the production and generation of creative
ideas of groups
◦ Generate new ideas about an issue
◦ Welcomes free thinking and facilitate open expression ideas
◦ Withhold any evaluation or criticism of the ideas that are
expressed
◦ Build and improve on ideas already expressed.
79. Directing
◦ The function of the manager that gets work done through
others which involves giving direction, supervising, leading,
motivating, and communicating.
80. Transferring a tasks to a component individual
What Cannot Be Delegated
◦ Overall responsibility, authority, accountability, and
completion of all activities in the unit
◦ Authority to sign one‟s name
◦ Jobs that are too technical
◦ Sterile procedure
◦ Initial and terminal assessment
◦ Unstable patient.
81. Right person
Right task
Right amount of time
Delegate in advance
Delegate gradually
Consult first before delegating
Avoid gaps and overlaps .
82. Decision Making
◦ A choice made between two or more alternatives wherein the
manager chooses the best alternative to reach the
predetermined objective.
83. Ends-Means
◦ Ends – deals with the determination of desired individual or
organizational results to be achieved
◦ Means – decisions deal with strategic or operational programs,
activities that will accomplish desired results.
84. Administrative-Operational
◦ Administrative – decisions made by senior management, which
have significant impact throughout the organization
◦ Operational – generally made by mid level and first line
managers and address day to day operational activities of a
particular organization.
85. Programmed-Non-programmed
◦ Programmed – repetitive and routine in nature
◦ Non-programmed – unique and non-routine.
87. The transfer or information and understanding from
one person to another
◦ Verbal – use of spoken words
◦ Non-verbal – facial expressions, gestures, body language and
touch.
88. Ideation – the idea or thought to be conveyed to an
individual or group
Encoding – the manner in which the message is
conveyed
Transmission – actual expression of the message
Receiving – the manner in which the receiver gets the
message
Decoding – receiver's understanding of the message
Response – or feedback.
89. Elements of communication
◦ Sender – a person or group who wishes to convey a message to
another
◦ Message – that which is being conveyed
◦ Receiver – the listener, observer
◦ Feedback – response, message that the receiver returns to the
sender.
90. Vertical Communication
◦ Downward – information and other types of communication
are sent by superiors to subordinates
◦ Upward – when employees or managers who are subordinate
to top level management send message up through the chain of
command
Horizontal Communication
◦ When people communicate on the same level in the
organization structure
Diagonal Communication
◦ Interactions of different levels in the organization.
91. Formal Communication
◦ Follows the formal line of authority in the organization‟s
hierarchy
Informal Communication
◦ Occurs between people at the same or different levels of the
organizational hierarchy but do not represent formal lines of
authority.
92. Proxemics – the study of distance between people in
their interaction
◦ Intimate – physical contact – 1.5 ft
◦ Personal – 1.5 – 4 ft
◦ Social – 4 – 12 ft
◦ Public – 12 ft and beyond.
93. Assertive
◦ Says directly and clearly what is on your mind based on self-
respect and consideration for other people
Passive
◦ Communicating viewed as being uninvolved or unable to share
thoughts which may be withdrawn, shy or purposely
withholding
Aggressive
◦ Concerned only with the rights of one position and may be
loud, inappropriate, confronting or hostile.
94. Clarify your ideas before communicating to others
Consider the setting, both physical and psychological
Consult with others when necessary to be exact and
objective
Be mindful of the overtones as well as the message itself
Take the advantage to convey something to help, value, or
praise the receiver
Follow up your communication
Be sure your actions support communication
Be an active listener
Give credit for the contributions of others
Be assertive when expressing your views.
95. An expressed struggle between at least two
interdependent parties, who receive incompatible goals,
scarce rewards, and interference from the other party in
achieving their goals.
96. Win-Lose
◦ It is not the optimal way of resolving conflicts because one of
the participants losses
Lose-Lose
◦ The strategy which everyone would like to avoid, lose-lose is
not an intentional choice, but they end up with this outcome
when other strategies fail
Win-Win
◦ Strategy which allows both individuals to feel they have
accomplished all or part of their goal.
97. Intrapersonal
◦ Conflict within an individual
Interpersonal
◦ Those that arise between two individuals
Intragroup
◦ Those that arise from the members of the same group
Intergroup
◦ Those that arise between groups.
98. Methods employed to resolve or suppress a conflict by
all parties‟ agreement or else by the defeat of one party.
99. Avoidance
◦ A style characteristic of individuals who are passive and who
do not want to recognize a conflict
◦ These person generally prefer to ignore conflict situations
rather than confront them directly.
100. Competition
◦ A conflict style characteristic of individuals who are highly
assertive about pursuing their own goals but uncooperative in
assisting others to reach their goals
◦ These individuals attempt to resolve a struggle by controlling
or persuading others in order to achieve their own ends.
101. Accommodation
◦ A conflict style that is unassertive but cooperative
◦ Attends very closely to the needs of others and ignores his or
her own needs
◦ A way for individuals to move away from the uncomfortable
feelings of struggle that conflict inevitably produces.
102. Compromising
◦ Compromise is a positive conflict style because it requires that
individuals attend to others‟ goals as well as their own
◦ Compromise reminds us of the golden rule: “Do unto others as
you would have them do unto you”.
103. Collaborating
◦ The most preferred of the conflict styles, which requires both
assertiveness and cooperation
◦ It involves attending fully to other‟s concerns while not
sacrificing or suppressing one‟s own concern
◦ Although this is the most preferred style, it is still the hardest
to achieve.
104. Conflict Resolution
◦ Smoothing
◦ Other persons are involved trying to “smooth” the conflict to
reduce emotional component of the conflict.
105. Controlling
◦ The regulation of activities in accordance with the plan which
ensures that the tasks to be accomplished is appropriately
executed.
106. Performance Appraisal
◦ A systemic review of an individual employee‟s performance on
the job, which is used to evaluate the effectiveness of his/her
work using:
◦ Rating scales
◦ Checklist
◦ Peer review
◦ Ranking
◦ Patient survey
◦ Management by objective.
107. System Standard
◦ Refers to the instrumentalities like equipment and setting
Process Standard
◦ Refers to the nursing care given to clients
Outcome Standard
◦ Refers to the desired results.
108. A process of continuously improving a system by data
gathering
Total quality management – involvement of all
employees in the improvement of the quality of every
product or service
Benchmarking – comparing your institution with the
best.
109. Quality Assurance
◦ Evaluation of services to make sure that it meets the standard
◦ Nursing audit – review of patients chart
◦ Peer review – evaluation between staff nurses
◦ Quality circle – a group of workers who meet regularly under
the leadership of a supervisor who analyze and solve work
related problems.
110. The manager administers; the leader innovates
The manager maintains; the leader develops
The manager focuses on system and structure; the
leader focuses on people
The manager relies on control; the leader inspires trust
The manager has short-range view; the leader has long-
range perspective
The manager asks how and when; the leader asks what
and why.
111. The manager has his eye on the bottom line, the leader
has his eye on the horizon
The manager accepts the status quo; the leader
challenges it
The manager is the classic good soldier; the leader is
his own person
The manager does things right; the leader does the right
thing.