WEL-COMEWEL-COME

1R S Mehta, MSND, CON, BPKIHS

Strengthening Leadership Qualities among Nurse Managers Working in

B. P. Koirala Institute of Health Sciences

Ram Sharan MehtaPrincipal Investigator

2R S Mehta, MSND, CON, BPKIHS

Aims of the Study:

� To offer practicing nursing managers

educational activities that enhances

the cognitive and practical skills the cognitive and practical skills

necessary to strengthening

leadership qualities among the nurse

working in Medical-Surgical Units of

BPKIHS.

3R S Mehta, MSND, CON, BPKIHS

List of Contents: � Nursing service administration

� Nursing Management Process

� Functions and types of management &

LeadershipLeadership

� Supervision and clinical supervision

� Patients Right, Ethical and Legal issues

� Principles of management

� Functions of management

� Nosocomial infection and Universal precaution

4R S Mehta, MSND, CON, BPKIHS

� Basic life support and CPR & Management of

Anaphylaxis

� HIV/AIDS

� Conflict management

� Blood transfusion

� Factors affecting the quality of patient care� Factors affecting the quality of patient care

� Recording, Reporting , Nursing Standard and

Nursing Audit

� Methods of Assignment

� Communication and coordination

� Motivation5R S Mehta, MSND, CON, BPKIHS

� Organization culture and behaviour

� Decision making and problem solving

� Some basic concepts have to learn to live

� Characteristics of organization

� Self management

Peter F Druker Quotes� Peter F Druker Quotes

� Causes of stress in nursing

� Reason for public anger to Nurses

� Emerging trends in Nursing

6R S Mehta, MSND, CON, BPKIHS

Explanation of

the Packagethe Package

R S Mehta, MSND, CON, BPKIHS 7

Nursing Leadership

&

Management

Ram Sharan Mehta

Medical-Surgical Nursing Department

8R S Mehta, MSND, CON, BPKIHS

9R S Mehta, MSND, CON, BPKIHS

� Coordinate the individual efforts to

common goal: e.g.: Dharhara,

Singhdarbar, Tajmahal, Great wall of

china etc.

Concepts:

china

� Approach of management:

productivity, process, decision

making, human relation, and

system approach. R S MEHTA, MSND 10

Nursing Management

� This is defined as the coordination

and integration of nursing resources by

applying the management process applying the management process

to accomplish nursing care and

service goals and objectives

11R S Mehta, MSND, CON, BPKIHS

�FOUNDATIONS &

RESOURCES OF

MANAGEMENTMANAGEMENT

12R S Mehta, MSND, CON, BPKIHS

1.MEN

13R S Mehta, MSND, CON, BPKIHS

2.MONEY

14R S Mehta, MSND, CON, BPKIHS

3. MATERIALS

15R S Mehta, MSND, CON, BPKIHS

4.MACHINES

16R S Mehta, MSND, CON, BPKIHS

5. Time Management

R S Mehta, MSND, CON, BPKIHS 17

� What is the Difference

between a MANAGEMENT

AND LEADERSHIP?

18R S Mehta, MSND, CON, BPKIHS

LEADERSHIP

�To Guide, to go before and

show the way

�Leadership is the art of

developing people

19R S Mehta, MSND, CON, BPKIHS

MANAGEMENT

� Is a process by which cooperative

group directs actions towards

common goals.

� It involves techniques by which

distinguished group of people

coordinates the services of people

20R S Mehta, MSND, CON, BPKIHS

21R S Mehta, MSND, CON, BPKIHS

Why do we have to study MANAGEMENT AND

LEADERSHIP?

� nurses must realize that

they have to keep up with

the many changes in the the many changes in the

health care system and its

delivery of services to the

people

� Nurses believe that leaders

are made and not born!!!!22R S Mehta, MSND, CON, BPKIHS

ROLE OF MANAGERS

�The basic roles performed by

managers as

1. INTERPERSONAL,1. INTERPERSONAL,

2. INFORMATIONAL,

3. DECISIONAL

23R S Mehta, MSND, CON, BPKIHS

1.INTERPERSONAL ROLE

� As a leader who:

�Hires

�Trains�Trains

�Encourages

�Fires

�Remunerates

� Judges

24R S Mehta, MSND, CON, BPKIHS

�As a LIASON officer between

outside contracts such as the

community, suppliers and the

organizationorganization

25R S Mehta, MSND, CON, BPKIHS

2.INFORMATIONAL ROLE�One who monitors information

�Disseminates information from both

external and internal sources

�As a spokesperson or representative �As a spokesperson or representative

of the organization.

�She represents the subordinates to

superiors and the upper management

to the subordinates

26R S Mehta, MSND, CON, BPKIHS

3.DECISIONAL ROLE

�Problem discoverer, a designer to

improve projects that direct and

control change in the organization

�As a Negotiator when conflicts arise

1. PROBLEM SOLVER

2. TROUBLE SHOOTER

3. NEGOTIATOR

27R S Mehta, MSND, CON, BPKIHS

DEVELOPING FUTURE MANAGERS

� Managerial development programs are very

useful means of getting qualified managers.

� The necessary fundamental skills of a

manager are:manager are:

28R S Mehta, MSND, CON, BPKIHS

a. TECHNICAL SKILLS

� Relate to the proficiency in performing an

activity in the correct manner with the right

technique

b. HUMAN RELATIONSHIP SKILLS

� Pertains to dealing with people and how to “Get

Along with them”Along with them”

c. CONCEPTUAL SKILLS

� Deal with the ability to see individual matters as

they relate to the total picture and to develop

creative ways of identifying pertinent factors,

responding to the big problems, and discarding

irrelevant facts29R S Mehta, MSND, CON, BPKIHS

Approach in developing managers

emphasizes:

1.ATTITUDE FACTORS

2. KNOWLEDGE FACTORS

3. ABILITY FACTORS

30R S Mehta, MSND, CON, BPKIHS

a. ATTITUDE FACTORS

� Interest in one’s work

� Confidence in one’s mental competence

� Desire to accept one’s responsibility

31R S Mehta, MSND, CON, BPKIHS

b. KNOWLEDGE FACTORS

> Refers to ideas, concepts or principles

that can be expressed and are accepted

because they have logical proofs

32R S Mehta, MSND, CON, BPKIHS

c. ABILITY FACTORS

33R S Mehta, MSND, CON, BPKIHS

� Include skills, art, judgment and

wisdom

�Nursing Service Administrators are

required to be academically prepared

�Prior to promotion or holding of

managerial positions, nurses who have managerial positions, nurses who have

the potential to become administrators

are asked to participate in managerial

staff development programs

(e.g. Singapore CGH, 2 weeks training)

34R S Mehta, MSND, CON, BPKIHS

LEVELS OF MANAGEMENT

35R S Mehta, MSND, CON, BPKIHS

1. TOP MANAGEMENT

� Overall operations of nursing

services, establishes goals,

objectives, policies and objectives, policies and

strategies

� Chief nurse, Director, Matron

36R S Mehta, MSND, CON, BPKIHS

2. MIDDLE MANAGEMENT

� Coordinator of nursing activities of

several units

� Supervisor, Coordinator

37R S Mehta, MSND, CON, BPKIHS

3. FIRST LEVEL MANAGEMENT

� Responsible for production of

nursing services; act as links

between higher level managers between higher level managers

and non-managers

� Ward Incharge, Head nurse,

Team leader

38R S Mehta, MSND, CON, BPKIHS

LEADERSHIP ROLES

� TOP --------------------------------ADMINISTRATOR

� MIDDLE---------------------------SUPERVISORS

� FIRST LINE-----------------------HEADNURSES/SENIOR

NURSESNURSES

� OPERATIONAL LEVEL----------STAFF NURSES/ ANMs

39R S Mehta, MSND, CON, BPKIHS

Three basic competences

Level ofmanagement

Imanagement

Technical skills Interpersonal skills Conceptual skills

II

III

TYPE OF ORGANIZATIONAL STRUCTURES

1. Bureaucratic� Commonly called line structures or staff

organizations seen in large healthcare facilities

Advantage:

Clearly defines authority and responsibility� Clearly defines authority and responsibility

Disadvantages:

� Transfer workers

� Produces monotony

� Restricts upward communication

41R S Mehta, MSND, CON, BPKIHS

2. Ad hoc� Used on a temporary basis to complete a

particular project (e.g. Kala-azar Project)

� Usually disbanded after a project is completed

Advantage:

Serves as a way for professionals to handle � Serves as a way for professionals to handle

the situations

Disadvantages:

1. Decreases strength in the formal chain of command

2. Decreases employees' loyalty to the parent

organization42R S Mehta, MSND, CON, BPKIHS

3. Matrix� Focuses on both product and function, with

emphasis on the required task and the end-

result of the function (e.g. Car Factory)

Advantages:

1.Centralizes expertise1.Centralizes expertise

2. Less formal rules

3. Fewer levels of hierarchy

Disadvantage:

� Slow decision-making can produce confusion

and frustration43R S Mehta, MSND, CON, BPKIHS

Conflict� Why it is important?

(No two individual has Same Thoughts)

�How to manage it?

R S Mehta, MSND, CON, BPKIHS 44

TYPES OF CONFLICT IN THE

ORGANIZATION

1. Leader and worker2. Among leaders3. Among workers3. Among workers4. Between worker and client 5. Between organization and client6. The third party 7. Between law and process8. Between process and objectives

Conflict resolution:� Avoidance: powerful party, unimportant issues.

� Deforsing: calm down, compromising behaviour.

� Containment: discuss issues, equal power.

� Confrontation: tactic (Clarify Issues)� Confrontation: tactic (Clarify Issues)

� Lose-lose approach: both party lose.

� Win-loss approach: one gain, other loss, bitter and revengeful.

� Win-win approach: focus on goal rather that person

46R S Mehta, MSND, CON, BPKIHS

5 ways to manage conflict

� Avoidance

� Competition (A)

� Accommodation (B)

47

� Accommodation (B)

� Compromise (C)

� Collaboration (D)

R S Mehta, MSND, CON, BPKIHS

Conflict Continuum

I win, you lose (competition—A)

I lose or give in (accommodate—B)

We both get something

(compromise—C)

48

(compromise—C)

We both “win”(collaborate—D)

A B C D

R S Mehta, MSND, CON, BPKIHS

Tips for Managing Workplace

Conflict

� Build good relationships before conflict occurs

� Do not let small problems

49

� Do not let small problems escalate; deal with them as they arise

� Respect differences

R S Mehta, MSND, CON, BPKIHS

� Listen to others’ perspectives on the conflict situation

� Acknowledge about feelings before focussing on facts

� Focus on solving problems, not changing peoplechanging people

� If you can’t resolve the problem, turn to someone who can help

� Remember to adapt your style to the situation and persons involved

R S Mehta, MSND, CON, BPKIHS 50

Role of Leader:� Risk taker

� Influencer

� Change agent

� Good communicator

� Mentor

� Critical thinker

� Good listener

� Forecaster

� Energizer

� Visionary

� Problem solver and

� Role model. 51R S Mehta, MSND, CON, BPKIHS

�Nothing is more dangerous

than an idea when it’s the

only one you have.

– Emile

R S Mehta, MSND, CON, BPKIHS 52

Thank YouThank You

53R S Mehta, MSND, CON, BPKIHS