NURSING MANAGEMENT

ADMINISTRATION
 The word “administer” is derived from Latin word
“ad+ministraire”, means to care for or to look after
people to manage affairs.
 Administraire means “Serve”. The meaning itself
reflect that the administrator regards himself as
servant, not that the master to look after, perform all
the functions. It is a cooperative effort, directed
towards the realization of a consciously laid down
objectives.

ADMINISTRATION
 Definition
 “Administration is the organization and direction of human
and material resources to achieve desired ends.”
- Pfiffner and Presthus
 “Administration has to do with getting things done, with
accomplishment of defined objectives.”
- Luther Gullick
 “Administration is the direction, coordination and control of
many persons to achieve some purposes or objectives.”
- LD White
 “Administration is the activities of groups cooperating to
accomplish common goals.”
- Herbert A Simon

NATURE OF ADMINISTRATION
Universal
Holistic
Intangible
Dynamic
Goal oriented
Continuous
Social and Human
Creative

PHILOSOPHY OF ADMINISTRATION
 Cost effectiveness
 Execution and control of work plans
 Delegation of Responsibility and authority
 Human relations and Good Morale
 Effective communication
 Flexibility in certain situations.

INTRODUCTION TO MANAGEMENT
 Management is a general term which is described in various
ways, with significantly different meaning.
 For eg: sociologist, treated it as a class or group of persons
 Practitioners, a process comprising different activities
 Traditional authors, it is a art of getting things done
 Modern authors, it is a process to achieve certain objectives
through utilization of human and other resources

 Management is commonly termed as functioning with and
through the personnel, individually or in group, to manage
the resources to the maximum to achieve the objectives
 Management techniques are significantly relevant to those
who control the behavior of those under them to
accomplish the goals.

 Four main components of management process:
 framing strategies of planning management
 Systemizing the work process
 Reinforcing or motivating the workers
 Supervising to achieve the goals of the management

CONCEPTS OF MANAGEMENT
 Traditional concept
 It is viewed as an art of getting things done
 Mary Parker Folett defines ‘management is the art of
getting things done through people’
 ‘management consist of getting things done through
others’

MODERN CONCEPT
 Managing not only limited to directing the efforts to
others to accomplish the goals of organization but
also involves creating an environment or climate in
the organization whereby the individuals are
motivated to work efficiently to achieve specific
objectives of organization

 Koontz Harold and Cyril O’Donnell defines
 “ management is the creation and maintenance of an internal
environment in an enterprise where individuals, working in
groups, can perform efficiently and effectively towards the
attainment of group goals.”

 Taking all the emerging concepts in view, the
management can be used in the following four ways:
 management as a discipline
 Management as an activity
 Management as a group of people
 Management a process

 According to these concepts management is viewed in the
direction of people with defined activities towards
organizational objectives.
 Weilrichs and Koontz(1994) stated “management is a process
of designing and maintaining an environment in which the
individuals working together in groups efficiently accomplish
selected aims.”
 The managers are to carry out managerial functions of
planning, organizing, staffing, leading and controlling.

 FINALLY
 Management is the process of achieving its objectives by
utilizing and controlling the group of appointed candidates in
order to complete the management task
 Providing good work environment ensures that the workers
perform well,
 Ultimately, the group performance removes the hurdles and
provides ways for maximizing the skill in attaining the
objectives of the management.

 Management involves a set of activities directed at the
efficient and effective utilization of resources- human,
financial and physical – through planning, organizing,
leading and controlling functions
 It is based on economic resources, goals, processes and
authority

CONCEPTS OF MANAGEMENT
 Raymond Gi Leon in his famous book has written
“manage more by doing less” which explains the
following concepts of management;
 Communication
 System
 Results
 Participation
 Motivation
 Exception
 Objectives

 According to Dr. C.B. Gupta concepts of
management are:
 Management as an economic resource
 Management as a team
 Management as an academic discipline
 Management as a process
 Management as a human process
 Management is concerned with ideas, things and
people
 Management is the effective utilization of human
and material resources to achieve the enterprise
objectives

DEFINITION OF MANAGEMENT
 Management is the art of getting things done
through and with people in formally organized
groups.
Koontz
 Management is the function of getting things done
through people and directing efforts of individuals
towards a common objective.
Theo Haimann

 Management can be defined as the art of applying
the environment principles that underline the
control of men and material in the enterprise under
consideration.
Kimball and Kimball
 “Management may be defined as the art of
securing maximum results with the minimum of
effort so as to secure maximum prosperity and
happiness for both employer and employee and
give the public the best possible service.”
John Mee

DEFINITION OF MANAGEMENT
 Management is a process of designing and maintaining an
environment in which individuals, working together in groups,
efficiently accomplish selected items.
 Management has been defined as the creation and maintenance
of internal environment in an enterprise where individuals
working together in groups, can perform efficiently and towards
the attainment of group goals.
Koontz and O’Donell

NURSING MANAGEMENT PARALLELS NURSING
PROCESS
AAASS
NURSING
PROCESS
ASSESSMENT DIAGNOSIS
PLANNING
IMPLEMENTATION
EVALUATION
PLANNING
ORGANISING
STAFFING
LEADING
CONTROLLING
DATA
GATHERING

NURSING MANAGEMENT- A GENERAL SYSTEM
THEORY

DIFFERENCES IN ADMINISTRATION &
MANAGEMENT
Bases Management Administration
Main focus Getting the work done Formulation of
policies, objectives,
plans, programmes
Function Execution of decisions Decision making
Concern Implementation of policies laid
down by administration
Determination of major
policies
Authority Operational authority to
implement administrative
decisions
Authority to take up
strategic and policy
decisions
Level in
the
organizati
on
Applicable at lower levels of
management
Refers to higher levels
of management
Decision
making
Decision is made who will
execute the policies etc
Determine what is to
be done and when it is

Bases Management Administration
Applicability Applicable in private sector Applicable in
government sector
Directive
activities
Concerned with direction of
human efforts at the operational
level
Not directly concerned
with operational level
officials

ELEMENTS/ FUNCTIONS OF ADMINISTRATION
Professor Luther Gullick (1937) has
summed up the elements of
administration in the word,
“POSDCORB”

 P-PLANNING:
 It refers to working out a broad outline, the things that
need to be done and the methods for doing them to
accomplish the purpose set for the enterprises or of
the purpose in hand.

 Planning is Preparing a blue print.
 It is a continuous , Intellectual process of
determining philosophy ,Objectives, Policies,
procedures and rules and standards, long and short
term projected out comes and fiscal course of
actions and managing planned change. This is the
preliminary and most important step of
management process.

 PLANNING
 According to KOONTZ, “Planning is deciding in
advance – what to do, when to do & how to do. It
bridges the gap from where we are & where we want to
be”.
 A plan is a future course of actions.
 Planning is a process of determining the objectives effort
and devising the means calculated to achieve them.
- Millet

ADVANTAGES OF PLANNING
Planning facilitates management by
objectives
Planning minimizes uncertainties
Planning facilitates co-ordination
Planning improves employee’s morale
Planning helps in achieving economies
Planning facilitates controlling
Planning encourages innovations

 O-ORGANISING:
 It refers to the establishment of the formal structure
of authority through which work of subdivisions are
arranged, defined and coordinated for the defined
objective.
 Building up the structure of authority through which
the entire work to be done is arranged into well
defined subdivisions and coordination's.

 It is establishing the structure to carry out plans.
Determining the most appropriate type of patient care
delivery in a health agency. Or educational programs in
an institution. Grouping the activities to meet its goals,
 Other functions involve;
 working within the structure of an organization and
 understanding and
 using power and authority appropriately.

 ORGANIZING
 Organization is the form of every human
association for the attainment of common
purpose and the process of relating specific
duties or function in a whole.
- J.D.Mooney.

 S-STAFFING:
 The whole personnel function of bringing and training
the staff and maintaining favorable conditions of work
 Appointing suitable persons to the various posts under
the organization and the whole of personnel
management

 STAFFING
 According to Koontz & O’Donell, “Managerial function of
staffing involves managing the organization structure through
proper and effective selection, appraisal &
development of personnel to fill the roles designed and the
structure”.
 Staffing involves:
Manpower planning
Recruitment, selection & placement.
Training & development.
Remuneration.
Performance appraisal.
Promotions & transfer.

 It is a process of assigning competent people to fill
the appropriate nursing roles in a an institution ,
designated for the organizational structure through;
 Recruitment & Selection of staff
 Hiring and Orienting staff ,
 Staff scheduling and
 Staff development activities,.
 staffing often becomes part of organizing. Example
: Appointment of a Dean for the college of nursing,
nursing superintendent for a hospital or a head
nurse for a surgical unit etc.

 D-DIRECTING:
 Continuous task of making decisions and
embodying them in specific and general orders and
instructions and serving as leader of the enterprise.
 Making decisions and issuing orders and
instructions embodying them for the guidance of the
staff.

 Is a process of involving many human resource
management responsibilities such as ;
 Motivating
 Managing a conflict,
 Communicating and
 Facilitating Collaboration and Coordination.

 CO-COORDINATING:
 Interrelating various parts of the work and eliminating
of overlapping and conflict

 CO-ORDINATING
 It is the act of synchronising people and activities
so that they function smoothly in the attainment of
organization objectives.
 Co-ordination is the integrating process in an
orderly pattern of group efforts in an organization
towards the accomplishment of a common objective.
- Terry

 R-REPORTING:
 Keeping himself and his subordinates informed
through records, research and inspection

 REPORTING & RECORDING
 Reports are oral or written exchanges of information
shared between caregivers or workers in a number of
ways.
 A report summarizes the services of the person,
personnel and of the agency.
 Reports are written usually daily, weekly, monthly or
yearly.

 B-BUDGETING:
 Budget is the whole of financial administration.
 Budget is mainly in the form of fiscal planning,
accounting and control.

 BUDGETING
 It is expressed in financial terms and based on expected
income and expenditure. It is the form of fiscal planning,
accounting and controlling of financial resources. It
served as a powerful tool of coordination and negatively
an effective device of eliminating duplicating and
wastage.

FUNCTIONS OF ADMINISTRATION
 Henri Fayol (1925) first identified the functions of
Administration. They are
 Planning
 Organization
 Command
 Coordination
 Control

 These functions are revised and are now taught as
planning, organizing, staffing, directing and
controlling (Kannan)
 These functions appears to be independent, they
are really interactive and make up the management
process.

PLANNING
 Determines
 Mission/ Philosphy
 Goals/ Objectives
 Policies/ Rules
 Procedures
 Scheduled changes
 Fiscal/ budget actions

ORGANIZING
It provides the structure required to execute the plan.
Organizing includes everything needed to:
 Carry out plans
 Assign the duties and activities to specific positions
and people to provide client care
 Group activities to meet goals
 Delegate authority
 Establish horizontal and vertical authority-
responsibility relationships
 Work within the system

STAFFING
 Involves selecting the right person to execute each
planned task. Staffing transforms a plan into action.
It includes
 Recruiting
 Interviewing
 Hiring
 Orientation
 Staff development

DIRECTING
 It includes
 Motivate
 Manage conflict
 Delegate
 Communicate
 Collaborate
 Functions of directing includes giving orders and
instructions, supervising the people at work,
enhancing motivation by creating a willingness in
others to work towards specific objectives etc

CONTROLLING
 It includes
 Performance appraisals
 Fiscal accountability
 Quality control
 Legal and ethical issues
 Professional and collegial control

 Later Luther Gullick (1937) expanded the functions
in the term of POSDCORB
 Planning
 Organizing
 Staffing
 Directing
 Coordinating
 Reporting
 Budgeting

PRINCIPLES OF ADMINISTRATION
 According to Finer, following are the principles of
administration:
 1. Principle of Oneness
 2. Principle of Specialism and the Whole
 3. Principle of Hierarchy and Regimentation
 4. Principle of Morale
 5. Principle of Bureaucracy
 6. Principle of Self Administration.

PRINCIPLE OF ONENESS
 From the apprehension of purpose, from its
absorption, flows directly the oneness of leadership
that gives form to the whole aggregate of people
whose skills are needed for its fulfillment
 Oneness implies that all the personnel are
members.
 The first requirement is that the right of people to
have positions of authority

PRINCIPLE OF SPECIALISM AND THE WHOLE
 In the administration, each one should become an expert.
 The contribution that expertness make to a whole
organization is the sure mastery of part of clinical or
administrative practice, a mastery that others need as an
ingredient of their service, and must take on authority of
the person who is expert.
 Failure to do this means either a loss of effectiveness or
the need to neglect other work in order to immense
oneself in the specialism
 Eg; expert in sweeping, so the expertness of the specialist
is indispensable and must be preserved and encouraged

PRINCIPLE OF HIERARCHY AND REGIMENTATION
 Administration has accepted the idea of hierarchy to
denote authority coming downward from above, but not in
the sense of chastising dogmatic rule.
 When the administrative scientist talk of hierarchy, they
mean not regimentation but the pervasion of whole
organization with a notion of its oneness and fitting
together of all members vertically(downward) in the line of
authority and horizontally(across) of teams and colleagues
in specialist skill.

PRINCIPLE OF MORALE
 Morale is the spirit of active devotion to the persons
working together for a common purpose.
 When it is high, subjective burdens of the work, its hours,
its routines, the patience it demands, the submissions of
personal interesting and values are lightly carried and
there is an easy and cheerful demeanor on the part of
those who take and give order.
 When it is low, the work and purpose lose value and
personality frustrates them. When against, personal
tensions, individual and interpersonal, rise in high and
rebelliously more endangered.
 To buy morale, all aspects of employees are taken into
confidence at all levels

PRINCIPLE OF BUREAUCRACY
 Bureaucracy is diseased administration, the disease
may be defined as deficiency in the spirit that created
its purpose that caused organization to be created,
so that either cooperation has fallen apart or activities
are executed without any interest in the object
originally assigned to them.
 Bureaucracy is administration without purpose, ethos,
oneness or morale; it is the organizational form of
personality equal to the individual person called
‘Hollowmen’.

PRINCIPLE OF SELF ADMINISTRATION
 Administration begins with self in relationship to the
fulfillment of a purpose. The administrator begins
with self administration, the adaptation of his own
stubborn, passive, incompetent or dissentient self
to the purpose, even if no one else is at work with
him on the job
 Every professional worker is obliged to administer
himself/ herself, they must retain their caprices,
harness their energies and abate spiritual and
mental rebellion in their natures for the successful
and most economical mastery of purpose.

ACCORDING TO HENRI FAYOL, PRINCIPLES OF
ADMINISTRATION:

1. DIVISON OF WORK:
 The work in organisation must be divided among
individuals and departments.
 It leads to specialisation.
 improvement in quality, quantity, and reduction in
cost

2. AUTHORITY AND RESPONSIBILITY
 Authority is the right to give orders and obtain
obedience, and responsibility is the corollary of
authority.

3. DISCIPLINE
 Employees must obey and respect the rules that govern the
organization.
 Good discipline is the result of effective leadership,
regulation.

4. UNITY OF COMMAND
 Every employee should
receive orders from only
one superior or behalf of
the superior.
 Every employee should
follow orders from superior
as per the instructions.

5. UNITY OF DIRECTION
 directed by one
manager using one
plan for achievement of
one common goal.
 Particular activity
must be directed with
single plan

6. SUBORDINATION OF INTEREST
 Every employee or a
group
 should work in the
interest
 of the organisation.
 They should not
work for
 their own self interest.

7. REMUNERATION
 All Workers must be
paid a
 fair wage for their
services.
 Value of the
employee.

8. CENTRALISATION
 degree to which
 subordinates are
involved
 in decision making.
 There should be a
central
 power to guide and
take
 decisions.

9. SCALAR CHAIN
 Communications
should
 follow this chain.
 Chain can be broken
as per
 the situation or demand
in
 interest of the
organisation.

10. ORDER
 This principle is
concerned
 with systematic
 arrangement of men,
 machine, material etc.
 There should be a
specific
 place for every
employee
 in an organization.

11. EQUITY
 Managers should be kind and fair to their
subordinates.
 There must not be partiality in transfers,
promotions etc.

12. STABILITY OF TENURE
 Employee should not be temporary for long
period of time.
 Employee should be made permanent so that
they do not leave the organisation

13. INITIATIVE
 Superior must sacrifice his own vanity to encourage
and inspire those under him to show initiative.
 Employees who are allowed to originate and carry out
plans will exert high levels of effort.

14. ESPRIT DE CORPS
 Promoting team spirit will build harmony and unity
within the organization.
 Loyalty, dedication and commitment.

NURSING ADMINISTRATION AND
NURSING MANAGEMENT
 Nursing administration is above nursing
management
 “Nursing Administration is primarily the process
and agency used to establish the nursing
objectives or purposes, which an undertaking or
staffs are to achieve. It also has to plan and to
stabilize, the broad lines or principles that will
govern nursing action. These broad lines are
usually called policies. Whereas the nursing
management is the process and agency through
which execution of nursing policy is planned and
supervised.”
Milward GE

NURSING MANAGEMENT
 Nursing management as ‘the process of working
through nursing staff members to provide care, cure
and comfort to patients’
Gillies DA
 Nursing management is defined as the process of
planning, organizing, activating and controlling the
managerial functions of nursing in order to determine
and accomplish the objectives of nursing care
 Nursing management is the art of getting work done
through and with nursing staff by nurse manager. It is a
cooperative effort aimed at providing high quality care
to the patient

TYPES OF NURSING MANAGEMENT
PERSONNAL
MANAGEMENT
MATERIAL
MANAGEMENT
FINANCIAL
MANAGEMENT

PERSONNAL MANAGEMENT
 It is the part of the management function, which is
primarily concerned with the human relationship within
the organization.
 Elements
 Recruiting employee
 Retaining employee
 Maintaining good interpersonal employee, employer
relationships
 Ensuring that the employees aware of the objectives

 Aims :
 To attract and retain competent professional nurses and
other personnel
 To achieve effective nursing service
 To provide nursing service which contribute to health,
development of efficiency and contentment of the
personnel

MATERIAL MANAGEMENT
 It is an important and integral component of
resource mangement covering both human and
materials management.
 It is concerned with 5M’s
 Men
 Money
 Material
 Machines
 Moral

FINANCIAL MANAGEMENT
 It is concerned with management of money and
expenditure, through raising funds profitably and
ensuring its control
 Importance
 Building and maintaining the infrastructure
 Procuring drugs, supplies and equipment
 Undertaking medical laboratory services, radiographic
services, blood banking services, pharmacy services,
laundry services, CSSD services and so on

 Top level management
 Responsible for planning. It lays down the polices
and programmes for the enterprise. It thus,
provides a framework within which the entire
enterprise works. Top management is responsible
for providing leadership, guidance and supervision.

 The middle order management
 Responsible for executive work at the second tier
which certainly functions as the second order to the
top management.
 The lowest level management
 Like the middle order responsible for the execution
for the plans, polices and programmes. This level is
directly involved in the operation of job while the
middle order management, the second tier, is
indirectly responsible for execution.

SKILLS AND LEVELS OF MANAGEMENT

Board of director
Managing director TOP LEVEL
General manager
Dept manager
Deputy manager MIDDLE LEVEL
Asst manager
Forman
Supervisor firstline LOWER LEVEL
Workers

MANAGEMENT TECHNIQUES
TECHNIQUES
Detection
Evaluation
Improving
performance
Optimising
performance
Specification of a
desired value of
situation or action
Control
Communication
Demonstration

 Detection
 To find out what is happening or discover something,
eg. What is wrong.
 Techniques: Input-output analysis, attitude survey,
production study, activity sampling, critical
examination and break even analysis.

 Evaluation
 To measure or estimate the value of an item
 Techniques: job evaluation, work measurement, work
estimation, performance, appraisal, cost benefit
analysis and network analysis
 Improving performance
 Techniques: management by objective, method study,
value analysis, management by exception

 Optimizing performance
 Techniques: linear programming ergonomics,
operational research
 Specification of a desired value of situation or
action
 Techniques: layout planning for offices and plants
etc
 Control
 Techniques: cost control, credit control, labour
control, inventory control, production control and
budget control

 Communication:
 Techniques: visual aids, suggestion schemes,
report writing, communication theory, information
theory, management information etc
 Demonstration :
 Techniques: programmed learning, job instruction,
management development and training etc