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ӝ SEMI – FINALS ӝ 1.

SETTING – setting up organizational structure


ORGANIZING - Process of developing or changing the
- Process of forming a system into an organic whole mission, philosophy, vision, values and
- Grouping of activities for the purpose of achieving objective. This should be based on result of
objectives research theory arises that the structure
- Means of coordinating appropriate activities with other affects deciding process.
units horizontally and vertically, that are responsible in2. STAFFING AND SCHEDULING
accomplishing organization. - An orderly, systematic process, based upon
sound rationale, applied to member and kind of
ORGANIZATION nursing personnel required to provide nursing
predetermined standard of the points in a
- An organized body, system or society where members particular setting
are working harmoniously together to achieve3. Developing Job Description
organizational goal. -A contract that should include the job’s function
Characteristics: and obligation and specify the person to whom the
1. GOAL – “produce the highest quality care of patient”. employee is responsible
2. PEOPLE – “the more cohesive the group is, or the
more each employee cooperate with one another in STEPS IN ORGANIZING
the group’s goal 1. Establish objectives
3. STRUCTURE – this defines the limit of behavior or an 2. Formulating supporting objectives, policies, and plans
organization’s members. 3. Identifying and classifying activities necessary to
4. CULTURE – personality of the organization and is accomplish the objectives of the enterprise.
reflective of the values, symbols, rituals, myths and 4. Grouping the activities in thought of the human and
work practices that are common to every material resources available.
organizational member 5. Delegating the head of each group, the authority
5. JOB – “the kind of job that the employee performs necessary to perform the activities
plays a significant part in influencing the kind of work 6. Tying the group horizontally and vertically, through
6. SUPERVISION – “supervisor is responsible for authority and information flows.
establishing the work environment”
-positive work environment lead to improved ORGANIZING PRINCIPLE
performance and job satisfaction
1. UNITY OF COMMAND – indicates he should be
ORGANIZATIONAL THEORY responsible to only one supervisor, whose direction
can be regarded as FINAL
MAX WEBER – father of org. theory
- Generally acknowledged to have developed
the most comprehensive formulation on the 2. SCALAR PRINCIPLE OR CHAIN OF COMMAND
characteristics of BUREAUCRACY. -Suggest that there must be a clear line of authority
running step by step from the highest to lowest
ELEMENTS OF ORGANIZING level of authority
3. SPAN OF CONTROL – the number of people STATUS – the rank a group conforms on a person in accord
directly reporting to only one manager represents with the group’s estimation of the person’s values
that the manager’s span of control and determines REPONSIBILITY – the obligation to account to one’s contact
the number of interaction express of her. with respect to an assigned task
CENTRALITY – fact that some positions are so located in the
4. HOMOGENOUS ASSIGNMENT OF organization structure that the incumbent
DEPARTMENTATION communicates frequently with many other workers
-Process of forming employees into group to accomplish COMMUNICATION – consist of transmission of information
organizational group and opinions
-Departmentation – organized according to function
workers perform
- Specification of jobs. LEVELS OF MANAGER

5. EXCEPTION PRINCIPLE – management by exception 1. TOP – LEVEL MANAGER – lock at the organization as
and closely related to parity principle a whole, coordinating internal and external influences
-Exception Principle – managers should concentrate and generally make decisions with few guidelines or
their efforts on matters that deviates significantly structure
from the normal subordinates handles routine Primary focus – STRATEGIC
Communication Flows – top to down
6. PRINCIPLES OF CONTINUING RESPONSIBILITY
-When a manager delegates a function to a 2. MIDDLE LEVEL
subordinate, the manager’s responsibility for that -Coordinating the
function is in no way diminished. -Serves as a channel between top manager to
lower
7. CENTRALITY – workers who interact with the -Primary planning focus : combination of long
greatest number of other workers receive greatest and short – range planning
amount of work related information and become -Communication Flows : up and downward with
most powerful organization structure great centrality

8. SPECIALIZATION – perform a single leading function 3. FIRST LEVEL MANAGERS – deal with immediate
9. PRINCIPLE OF REQUISITE AUTHORITY problem, work force of the org.
-When responsibility for a particular task is - Focus : day to day needs of the org.
delegated to a subordinating subordinate must also - Primary planning focus : short range or operational
be group over sources needed for an authority planning
accomplishment - Communication : upward
- Generally relies to middle managers
ORGANIZATIONAL CONCEPT to transmit communication to top
level managers
ROLE – set of behavior and attitudes expected of a person by
those with whom he or she interacts ORGANIZATIONAL CHART
POWER – ability to influence - Picture of an organizational structure
- Help identify roles and their expectations
- Defines formal ORGANIZATIONAL STRUCTURE

Characteristics of Org. Chart - Refers the way a group is formed, its type of
1. Division of Work – each box represents the communication and its mean for channeling authority
individual sub – unit responsible for a and making decisions
given task of the organization Factors:
2. Chain of Command – lines individual who reports to 1. Presence of increasing demand and expectation from
whom and by what authority other professional groups and department
3. Type of Work to be performed – indicated labels 2. Transition in the nursing profession, new period of
or description for boxes stress
4. Grouping of Work Segments – shown by the 3. Complexity inserting numerous clinical demands
clusters of work groups (department or because of technological advancement affecting
single unit) patient care
5. Levels of Management – indicate individual and 4. Every increase requirements of governmental,
entire management hierarchy accessibility, educational, institutional and related
Hierarchy – body of person or things agencies
organized or classified pyramidically 5. Critical need for cost containment through operational
according to rank effectiveness in all areas decreasing efficiency or
nurse’s role and delivery management of patient care
 BOXES – represents individual’s in an organization or 6. Seemingly more defined program toward prevention
may indicate entire department rather than core perse in health care.
 VERTICAL LINES – referred to as lines of authority
and accountability 2 MAJOR TYPES
 Lines of Authority – represents the responsibility
of individuals, it is defined by going downward 1. Informal Structure – unplanned; concealed (hidden)
on the chart - Generally social with blurred
 Lines of Accountability – presents responsibility - Consist of unofficial personnel
to report to another person and presents - People with little or no formal status may gain
authority when moving recognition
- Demonstrated CHAIN OF COMMAND
2. Formal Structure
- Highly planned and visible
 HORIZONTAL LINES – connect individual who are at
- Made publicly and provides framework for defining
the same level in the organization and have official
managerial authority
relationship
- These individuals are required to work together but
Types:
none has the authority over the others
1. Line Structure /Line Organization/ Bureaucratic
 DOTTED LINES – represents communication
Organizational Design
relationships in which neither individual has direct
- The traditional employee – employee authority
authority or accountability to others.
relationship that emanates
- Authority and responsibility are clearly defined
2. Line and Staff Organization TRADITIONAL – focus on the function within organization,
- Authority in positions created to support, assist, closely following organization’s customs and
recommend and generally reduces the bureaucratic procedures.
supervisor’s informational responsibilities purely
advisory to the line structure with no authority to VERTICAL CHART OR TALL/ CENTRALIZED STRATEGY
put recommendation into actions - Depicts the chief executive of the top with lines of
- This pattern develops when a simple line is authority following the shown hierarchy
altered to provide management specialists to - Defines the relationship between and among the
support the chief executive. different levels in the org.
3. Functionalized and Staff Organization - Members are given more opportunities to participate
- Staff officers are no longer purely advisory but
with some command authority over line of HORIZONTAL CHART OR FLAT/ DECENTRALIZED
employee - The manager at the top with or wide span of control
- Levels of management is not shown in a flat chart
AD HOC DESIGN – modification of the bureaucratic - Communication in this structure is direct and simple
structure and is sometimes used as a temporarily
basis only. ORGANIZATIONAL CLIMATE
- Means of over forming the flexibility of the structure - Feeling of trust, belongingness, esteem and loyalty are
and serves as a way for professionals part of the climate; values for competence and
accomplishment are part also
MATRIX STRUCTURE – variety of line of staff of - Climate is based on the official policies and procedures
organizational structure of the organization, the behavior of the supervisors,
- Has a forming and horizontal chain of command the informal org., and the feedback provided by the
- Use a chain of command which is different in that org.
of the employee can report to one or more
managers, but one manager typically has more
authority over the employee than the other
manager
- Focus on the product and the function

CENTRALIZATION – both major and minor designs are made


by a core of top – level manager at the top of the
hierarchy
- Formal approval of the chief executive is needed for
all but the most complicated decisions
DECENTRALIZATION – highly flexible, informal organization
- Diffuses decision making
- Task performance is approved by clarifying and
defining the jobs of people and setting up appropriate
and definite relationships among these jobs
 Advertisement in local newspaper, nursing
organization, bulletins, journals, flyers and
newsletter, etc.
 Placement services, nursing conventions

Major Sources of Personnel


 Seeking their first job – the graduates
 Dissatisfied employee
 The unemployed

 3 Underlying Philosophies in Hiring


1. Manager should screen out applicants who do not
fit the agency’s image
STAFFING
2. The manager should try to fit the job to a promising
applicant
- The process of determining and providing the
3. The manager should try to fit the applicant to the
acceptable number and mix of nursing personnel to
job
produce the desired level of care to satisfy patient’s
demand for care
- Selection of a personnel and assignment system and  Interview
the determination of staffing schedule Purpose: to obtain information to give
information, and to determine the applicant
STAFFING METHODOLOGY meets the requirements for the position

- Should be observed in an orderly manner  Topics to Explore


- It should follow a systematic process 1. Education
- Should be based on sound rationale 2. Prior Employment
- Should be applied to determine the number and kind 3. Life Experience
of nursing personnel required to provide nursing care 4. Professional
of a predetermined standard to a group of patients in
a particular setting

 Recruitment and Retention STAFF DEVELOPMENT


- Acquisition of qualified people to the agency
ORIENTATION – the manager introduce the nurse to her
Modes: new job
 Active recruitment - Tour on the facilities
- Description of the organizational structure
 Employee recommendation
- Discussion of the different department function
 Word of mouth
- Presentation of the philosophy, goals and standards
- Interpretation of administration policies
- Explanation of the relation of hospital and community -Staff nurse collectively implement the monthly
- Frequent visits to make feel comfortable work schedule, given the criteria for adequate
- Nurse internship programs for new nurses unit staffing for each 24 hour period by the head
- Near end and probationary period, it is advisable to nurse
make systematic evaluation indication to job
 Assignment for Staffing
CAREER MAPPING 1. Case Method – nurse is assigned for a total
 Curriculum Vitae – listing of educational, professional patient care
and scholarly accomplishment, most commonly -Nurse assume total responsibility for meeting all
used in academic setting the needs of the assigned patient during their
 Resume – a concise listing of educational and time of duty
experience in a few pages -The patient receives holistic and unfragmented
- One on one interview care during nurse’s duty
- Serial interview 2. Functional Nursing
- Group interview - Based on the concept of division of labor between
- Reinter views nurses
-One nurse may be related to get the v/s of all
SCHEDULING patients, the other nurse may be tasked to
- A time table indicating planned work days and shifts of administer all the medications and discharge
nursing personnel -Every one is responsible to the Head Nurse/
- The working days and off – days to the nursing Senior Nurse as the provider for the over all
personnel in order to assure adequate patient care and direction and supervision
achieve desirable schedule of duties 3. Team Nursing
-Professional, technical and auxiliary nursing
 Types of Scheduling personnel are grouped as a team to provide total
1. Centralized Scheduling – chief nurse or care to a selected group of patients
designated personnel will do scheduling -The nurse as a team leader is responsible for
- Relieves the staff nurse as charge nurse knowing the condition and need of all patients
2. Decentralized Scheduling – it is the chief nurse assigned to the team
as the designated that usually does the assignment -Group members given as minor authority as
of the possible when performing assigned tasks,
3. Cyclic Scheduling – observe established basic although responsibility and accountability are
time pattern for a certain member each week and shared by the team collectively
is repeated themselves
- Advantages: fair to all
-Saves time 4. Primary Nursing
-Scheduled leave coverage such as -The primary nurse assumes 24 hours
vacation are more stable responsibility for planning the care of one or more
-Productivity is implied patients from admittance to discharged of the
4. Self Scheduling patients
-Work hours: primary nursing provides total direct
care for the patient Methods to Reach the Goal of the Interview
-Off – duty: care is provided by the associate -Ask only job related questions
nurses who follow the care established by the -Use open – ended questions that require more than a yes or
primary nurse no answer
-Pause a few second after the applicant has seemingly
PREPARE FOR THE INTERVIEW finished before asking the next question
- Managers should “have complete, clear and -Ask questions clearly but do not verbally or nonverbally
understanding of the open position” before the indicate the correct answer
interviewing candidate -Return the topic later in the interview on which the applicant
 Use Team Approach uttered little information initially
- More than one person interview the job applicant -Ask questions one at a time
 Develop a Standard Interview format for each job -Always appear interested in what the applicant say
qualification -Language should be used that is appropriate for the
-The standard interview is advantageous because applicant
it allows the interviewer to be consistent and -A written record should be kept to ensure and serves as a
prevents the interview from becoming side – written document
tracked
 Use seniors to Determine Decision – making Ability Interviewing Tips for the Applicants
 Conduct Multiple Interview -Prepare in advance for the interview
- Candidates should be interviewed more than once on -Obtain copies of the philosophy and organizational chart of
separate days the org. to which you are applying
-Schedule an appointment for the interview
 Provide Training in Effective Interviewing Techniques
-Dress professionally and conservatively
-Training should focus on communication skills and
-Practice responses to potential interview questions in
advice on planning, conducting, and controlling
advance
the interview
-Arrive early on the day of the interview
Suggested Interview Format:
-Greet the interviewer formally and do not sit down before he
-Introduce yourself, and greet the applicant
or she does unless given permission to do so
-Make a brief statement about the organization and available
-Share the interviewers hand upon entering the room and
positions
smile
-Ascertain the position for which the person is applying
-During the interview, sit quietly, be attentive and take notes
-Discuss the information on the application and seek
only if absolutely necessary
clarification
-Do not chew gum, fidget, slouch or play with your hair, keys,
-Discuss employee qualification and proceed with the
or pen
standard interview format
-Ask appropriate questions about the org. or the position
-If the applicant appears qualified, discuss the organization
-Avoid “what can you do for me” approach
and the position further
-Answer questions as confidently and honestly as possible
-Explain the subsequent procedures for hiring such as
-Shake hand to close the interview and thank the interviewer
employment physicals, and hiring date
for the time
-Terminate the interview
-Send a brief, typed thank you note to the interviewer
- To make the employee feel that they are
SELECTION already part of the organization
-Process of choosing from among the applicant based on - Reduce burn – out and help new employee
qualified individual for a particular job or position became independent quickly in their new role
-This process involves verifying the applicant’s Socialization – learn new values, skills, attitude,
qualification, checking his/her work history and and social rules as a result of changes in the
deciding of a good match exists between the type of work they do, the sense of
applicant’s qualifications and the org. expectations responsibility.

PLACEMENT
-Assigning a new applicant to a position
-Proper placement foster personal growth, provide a
motivating climate and maximizes productivity
-Managers who are able to match employee’s strength to
job requirement facilitate unit functioning

 Indoctrination
-Refers to the planned adjustment of an employee to the
organization and their work environment
Seek by:
a. Establish favorable employee attitudes around
the organization
b. Provide the necessary information and
education for success in the position
c. Instill a feeling of belongingness and
acceptance

3 Phases: DIRECTING
i. Induction
ii. Orientation - Is the managerial functions of guiding, motivating,
iii. Socialization leading, supervising

Induction – takes place after the employee has ELEMENTS:


been hired / selected but before performing the job 1. Delegation
role 2. Supervision
-Include all activities that educate the 3. Leadership
employee about the org. and employment 4. Motivation
and personal policies and rules 5. Communication
Orientation – provides information about the 6. Coordination
activities and specific for the position 7. Orientation
DELEGATION 2. Plan
- Is not an option, but a necessary 3. Control and coordinate the work of subordinates
- Is a managerial tool for subordinate accomplishment 4. Emphasized employees solving their own problems
and enrichment 5. Accept delegation as desirable
6. Agree on performance standard
Causes of Underdelagation 7. Assess result
1. Fear that delegation may be interpreted as a lack of 8. Give appropriate rewards
ability to do the job completely or correctly 9. Do not take back delegated task
2. Selfishness
3. Fear that subordinates will resent delegated work Reasons for Delegating
4. Lack of experience in the job or with delegation 1. Assigning routine task
5. Enjoyment of the work
Techniques for Delegating
Causes of Overdelegating 1. Prepare list of duties that can be delegated
1. Poor managers of time who spend to much time trying 2. Rank the duties according to the time required to
to get organized perform them and important to the organization
2. Insecurity in the ability to perform task 3. Delegate one duty at a time

Causes of Improper Delegation UNINTERESTED JOB – can be used to challenge,


1. Wrong time, to the wrong person or for the wrong motivate a person’s performance
reason
2. Beyond the capability of the person or something the 4. Consult before delegates
manager should do 5. Avoid gaps and overlaps
3. Decision making without providing adequate Gaps – job left out; no one taking responsibility
information Overlaps – two or more people in one task

CLEAR COMMUNICATION + DELEGATION


- Define the task clearly Can’t be Delegate
- Delineate end result, time, frame and standards 1. Task of accountability
- Delegate the objective, not the procedure 2. Authority to sign one’s name
- Managers should validate the perception by direct 3. Evaluating of staff performance
observation 4. Responsibility for maintaining or opportunity to say a
few words of encouragement to the staff
*direction must be complete, understandable, and given a 5. Job that are too technical and those involve trust and
logical order confidence
*direction is the function of a manager 6. Power to discipline
7. Duties involving trust and confidence
Ways for Nurses and Nurse Manager Delegate
Successfully Effective Delegating
1. Train 1. Plan ahead
2. Identify necessary skills and levels
3. Select most capable personnel
4. Communicate goal clearly *PURPOSE
5. Empower the delegate  Facilitate work
6. Set deadlines and monitor progress  Effect change
7. Model the role and provide guidelines  Optimize care
8. Evaluate performance  Increase worker satisfaction
 Facilitate coordination
Task that can be Delegated:
 These binds the org. to ensure common understanding
1. Answering phones
2. Cleaning up after procedures
COMMUNICATION PROCESS
3. Patient transportation
4. Ordering supplies; other clerical task  Objective of Communication
5. Stocking procedures and exam rooms  Be understood
6. Assisting with procedures  Get agreement
7. Data collection without analysis  Get something done

Task that Can Not be Delegated: Channels:


1. Any task that would involve nursing judgment or
sophisticated application of the nursing process Downward
2. Initial assessment on new patients - Traditional
3. Assessing pain - Directive
4. Teaching injections - Satisfaction on less for subordinate
5. Evaluating success of treatment - Employee handbooks, reports, job description
6. Interpreting results
7. Establishing plans of care Upward:
8. Identifying needs - Allows employee input
9. Triage - Staff satisfaction very high
10.Counseling and teaching - Supervisor passes up
- Bias and filtering increase as information is passed
COMMUNICATION upward
- This complex exchange of thoughts, ideas or
information at least two levels, verbal or non – verbal Downward Communication
1. Corporate goal plans
*PRINCIPLES: 2. Organization changes
1. A leader or manager must always maintain credibility, 3. Policies, rules and regulation
be honest and base actions on facts and emotions 4. Work system and methods
2. Know what needs to be communicated (who, what, 5. Corporate
where, whom, outcome)
3. Be positive Methods:
4. Be clear and concise, give step by step directions  Face to face communication
indicated  Employee handbooks
 Operating manuals - Understand the structure of the organization and
 Job description sheets recognize who will be affected by the decisiveness
 Bulletin board - Realize that communication is not one way channel
 Letters - Keep communication clear, concise and simple
(SBAR technique: Situation, Background, Assessment,
What should be Communicated Upward: Recommendation)
1. Highlights of their work, achievements and future jobs - Sender should seek feedback regarding accuracy
2. Outlines of unsolved work problems - Use multiple communication method
3. Suggestions for improvement - Don’t overwhelm with necessary information
4. Perception of the workers about their jobs associates
and company THE COMMUNICATION PROCESS
 External Climate
Methods: - Weather climate
 Face to face communication - Timing, temperature, organizational climate, status,
powers, and authority, barriers to managers
 Grievance procedure
 Suggestion systems
 Internal Climate
 Attitudes surveys
- Values, temperament, feelings, stress levels of
 Employee committees sender, and receiver
Lateral Communication
- Horizontal or sideward communication COMMUNICATION MODES
- The communication is between departments on the - Written communication
same level of hierarchy and is most frequently used to - Verbal communication
coordinate activities endorsement, rounds, referral at - Non – verbal communication
same department - Telephone communication
Diagonal Communication Guidelines for Writing Effective Memos
- Occurs between individual or departments that are not
on the same level of hierarchy - Menus should make the main pt. in the beginning
- Only essential information should be included in the
Grapevine Communication memo
- Flows horizontally between people of all levels of the - The menu should be written simply without inflated
hierarchy and usually resolves for people at a time or authoritarians language
- Subjects to error and distortion because of the speed - Headings should be used in the menu to direct the
- Sender has little formal accountability for accuracy of reader to specific issues
organization
*gender is also a significant factor in organization because
 Non – verbal communication clues:
men and women communicates and use language differently
- Space ( Proxemics study of how space a territory
affect communication )
ORGANIZATION COMMUNICATION STRATEGY
- Environment, outward appearance, eye contact,  Virtual Communication
security -Electronic mail, fax, teleconference, pagers,
- Body posture, gesture, facial expression and timing internet, CD – ROM, networked system
- Vocal expression – confidence and clarity  Listening Skills
-Are person spends 70% of his/her time listening
 Verbal Communication skills but only 1/3 of the message are retained
1. Assertive – a way of communication should allow -Good listening skills are so important as good
people express themselves in direct honesty and verbal skills to the messages
appropriate ways that do not infringe (break on -Good listening skills take ongoing effort
another person’s right)
2. Passive – occurs where a person suffers in silence, SUPERVISION
although he/she may feel strongly about the issue - Means personally observing function or activity,
(mono assertive) providing leadership is the process of nursing care,
3. Aggressive - expressing oneself in a direct and delegating functions or activities while retaining the
often hostile manner that infringe on another accountability evaluating and ensuring that the
person’s life nursing care provided is adequate and delivered
- Generally oriented to winning at all costs appropriately
4. Passive Aggressive – an aggressive message - Means to inspect, to guide, evaluate, and improve
presented in a passive way work performance of employee through a criteria
- Limited verbal behavior with incongruent non – against which the quality and quantity of work
verbal behavior production and utilization of time and resources are
made

Supervisory Technique:
Misconception and Myths about Assertiveness  Include observation of the worker while making
 All behavior is either assistive or passive her rounds
 To get what you want all you have to do is to be  Spot checking of charts
assertive  Asking the patients about care they receive
 Being assertive will:  Looking into the general condition of the units
- ↑odds of getting what you want  Getting feedbacks from the co – worker or other
- To be assertive is to be aggressive supervisor or relatives
- Assertiveness is un feminine  Asking questions discretely to find out the
- Assertive communication is wide or insensitive problems they encounter in the words drawing
 Telephone Communication out suggestions from the workers for
- Rapid improvement of their work or work sit
- Allows receiver to clarify message at time it is  Comments and feedbacks
received
 Soft, courteous manner – taken willingly and
-Does not, however allow the receipt of non –
accepted as a challenge to improve
verbal messages for either the sender or
performance
receiver
COORDINATION - Generally used when the issue is more important to
- Enhances collaborative efforts others
- Prevents overlapping of functions, promote good
working relationship and work schedules are ACCOMODATING – one party sacrifices his or her beliefs
accomplished and targeted and wants to allow the other party to win
- Convey clearly defined policies, standards, procedures,
guidelines using proper channels of communication AVOIDANCE
- Results from a low concern for your group’s own
COLLABORATING interests coupled with a low concern for the interest of
- An assertive and cooperative means of conflict others
resolution whereby all parties set aside their original - Outcome: “lose/lose”
goals and work together to establish a communication - Strategy is generally used when the issue is trivial or
priority goal more pressing

COMPROMISING AVOIDING – parties are aware of a conflict but choose not


- This strategic results from a right concern for your to acknowledge it or attempt to resolve it.
groups own interest along with a moderate concern for
the interest of other partners
- This outcome is “win some/loss some”. This strategy
is generally used to achieve temporary solution to
avoid destructive power struggle when time pressure
exist.
- Each party gives up something it wants.

COMPETITION
- Result from high concern for your group / own interest
with less concern for others.
- Outcome is win/lose.
- Includes most attempt at bargaining it is generally
used when basic right are stable or to set a precedent.

COMPETING
- One party pursues what it wants regardless of the
cost to others.

ACCOMODATION
- Results from a low concern of your group’s own
interests combined with a high concern for the interest
of other partners
- Outcome: “lose/win”

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