Vision

An aspirational description of what

an organization would like to achieve
or accomplish in the mid-term or
long-term future. It is intended to
serves as a clear guide for choosing
current and future courses of action

Mission
A written declaration of an
organization's core purpose and
focus that normally remains
unchanged over time.
Serve as filters to separate what is
important from what is not
Clearly state which markets will be
served and how
Communicate a sense of intended
direction to the entire organization.

Philosophy
An academic discipline that exercises
reason and logic in an attempt to
understand reality and answer
fundamental questions about
knowledge, life, morality and human
nature.

Goals and Objectives

Goals are long-term aims that you
want to accomplish.
Objectives are concrete attainments
that can be achieved by following a
certain number of steps.

Measuring Goals and

Objectives
Unfortunately, there is no set way in
which to measure the
accomplishment of your goals.
Objectives can be measured.

Planning
As a basic function of management is a principal duty
of all managers.
A systematic process and requires knowledgeable
activity based on sound managerial theory.
A continuous process
A thinking or mental process of decision making and
forecasting.
Should be based on objectives that should be framed
in terms of making a product or providing a service for
the community
Improves with experience, gives sequence in activity,
and protects a business against undesirable changes.

TYPES OF PLANNING
Strategic Planning
a continuous, systematic process of making risk-taking
decisions today with the greatest possible knowledge
of their effects on the future; organizing efforts
necessary to carry out these decisions and evaluating
results of these decisions against expected outcome
through reliable feedback mechanisms.
is concerned with what nursing should be doing. Its
purpose is to improve allocation of scarce resources,
including time and money, and to manage the agency
for performance.

 Odiorne recommends the following process for

crafting a strategic plan:
Identify the major problems of your organization,
determining where you are headed and where you
want to be.
Examine outside influences that relate to the key
problems of your organization.
List the critical issues
Rank the critical issues according to their importance
to your organization and plan accordingly
Decide the critical issues to all organization managers.
Include time in the budget

How Strategic Planning Can Be Used

to Improve Nursing Management
To provide accountability and monitoring of performance; to
tie merit to performance.
To set up more formal planning programs and require
divisional and unit planning.
To integrate strategic plans with operational and financial
plans.
To improve knowledge of and training in strategic planning.

To increase top management involvement and commitment.

To improve focus on competition, market segments, and
external factors.
To improve communication from top administration and
nursing management.

 To allow better execution of plans.

To be more realistic, and less rationalizing and vacillating.
To improve the development of nursing management
strategies.
To improve the development and communication of
nursing management goals.
To put less emphasis on raw numbers.
To anticipate the future and plan for it.
To develop the annual budget.
To focus on quality outputs that will improve nurse
performance and productivity, decrease losses, and
increase return on equity.

Summary of Phases of Strategic Planning

Process

PHASE 1: The Mission and the Creed

Develop statements that define the work, the aims, and
the character of the division of nursing.

PHASE 2: Data Collection and Analysis

Collect and analyze data about the health-care industry
and nursing.

PHASE 3: Assess Strengths and Weaknesses

Define those factors from the data analysis that
influence the management of the division of nursing.

PHASE 4: Goals and Objectives

Write realistic and general statements of goals.

 PHASE 5: Strategies
Identify untoward conditions that could
develop in achieving each objective.
Define the organization needed for
doing and implementing strategic plans.

PHASE 6: Timetable
Develop a timetable for accomplishing
each objective.
Identify by geographic units as well.

 PHASE 7: Operational and Functional Plans

Provide guidelines or general instructions that lead
the functional and operational nurse managers to
develop action plans to implement the goals and
objectives.

PHASE 8: Implementation
Put the plans to work.

PHASE 9: Evaluation
Provide for formative evaluation reports before,
during, and after the operational plan is implemented
Provide for summative evaluation that is quantified.

Operational Planning
Operational management is the organization
and directing of the delivery of nursing care.
Includes such planning as creating a budget,
creating an effective organizational structure
that encompasses a quality monitoring process,
and directing nurse leaders, an administrative
staff, and new programs.
Operational plans are everyday working
management plans developed from both longrange objectives and the strategic planning
process and short range or tactical plans

 Operational managers develop goals,

objectives, strategies, and targets to
set the strategic plan in motion.
The goal is to plan, assess progress
toward goals and objectives at all
levels, and provide feedback to all
levels of management.

NATURE OF PLANNING

(a) Planning is a mental activity.

(b) Planning is goal-oriented
(c) Planning is forward looking.
(d)Planning is the basic function of
managers at all levels
(e) Planning is the primary function.
(f) Planning is based on facts.

PURPOSES OF PLANNING
1. Planning increases the chances of success by
focusing on results, not on activities.
2. It forces analytic thinking and evaluation of
alternatives, therefore improving decisions.
3. It establishes a framework for decision making
that is consistent with top management
objectives.
4. It orients people to action instead of reaction
5. It includes day-to-day and future-focused
managing.

 6. It helps to avoid crisis management

and provides decision-making
flexibility.
7. It provides a basis for managing
organizational and individual
performance.
8. It increases employee involvement
and improves communication.
9. It is cost-effective.

Fiscal Planning
Is the process of estimating the
capital required and determining its
competition.
process of framing financial policies
in relation to procurement,
investment and administration of
funds of an enterprise.

Importance of Financial
Planning
Adequate funds have to be ensured.
Financial Planning helps in ensuring a
reasonable balance between outflow and
inflow of funds so that stability is maintained.
Financial Planning ensures that the suppliers
of funds are easily investing in companies
which exercise financial planning.
Financial Planning helps in making growth and
expansion programmes which helps in longrun survival of the company.

 Financial Planning reduces

uncertainties with regards to
changing market trends which can be
faced easily through enough funds.
Financial Planning helps in reducing
the uncertainties which can be a
hindrance to growth of the company.
This helps in ensuring stability an d
profitability in concern.

Planned Change
Results from a well thought out and
deliberate effort to make something
happen.
The deliberate application of
knowledge and skills by a leader to
bring about a change.
Successful leadermanagers must be
well grounded in change theories and
be able to apply such theories
appropriately

 Change agenta person skilled in the

theory and implementation of planned
changeto deal appropriately with these
very real human emotions and to connect
and balance all aspects of the
organization that will be affected by that
change.
Initiating and coordinating change
requires well-developed leadership and
management skills.

THE DEVELOPMENT OF CHANGE

THEORY: KURT LEWIN
Lewin (1951) identified three phases
through which the change agent
must proceed before a planned
change becomes part of the system:
Unfreezing
Movement
Refreezing

Unfreezing
Occurs when the change agent convinces
members of the group to change or when
guilt, anxiety, or concern can be elicited.
For effective change to occur, the change
agent needs to have made a thorough
and accurate assessment of the extent of
and interest in change, the nature and
depth of motivation, and the environment
in which the change will occur.

 Because human beings have little

control over many changes in their
lives, the change agent must
remember that people need a
balance between stability and
change in the workplace. Change for
changes sake subjects employees to
unnecessary stress and
manipulation.

Movement
It is when the change agent identifies, plans, and
implements appropriate strategies, ensuring that driving
forces exceed restraining forces.
Because change is such a complex process, it requires a
great deal of planning and intricate timing.
Lewin suggested that this is because change, even at
the psychological level, is a journey rather than a simple
step. This journey may not be that simple and the person
may need to go through several stages of
misunderstanding before they get to the other side
Any change of human behavior, or the perceptions,
attitudes, and values underlying that behavior, takes
time.

Refreezing
During the refreezing phase, the change agent
assists in stabilizing the system change so that it
becomes integrated into the status quo.
The change will be ineffective and the prechange
behaviors will be resumed if refreezing is
incomplete.
The change agent must be supportive and
reinforce the individual adaptive efforts of those
affected by the change
Change needs at least 3 to 6 months before it
will be accepted as part of the system.

LEWINS DRIVING AND

RESTRAINING FORCES
The forces that push the system toward change are
driving forces, whereas the forces that pull the
system away from change are called restraining
forces.
Lewins model suggested that people like feeling
safe, comfortable, and in control of their
environment and that they derive a strong sense of
identity from their environment, including work.
For change to occur then, the balance of driving
and restraining forces must be altered. The driving
forces must be increased or the restraining forces
decreased.

 Creating an imbalance within the

system by increasing the driving
forces or decreasing the restraining
forces is one of the tasks required of
a change agent.

CLASSIC CHANGE
STRATEGIES
RationalEmpirical Strategy
The change agent using this set of strategies assumes
that resistance to change comes from a lack of
knowledge and that humans are rational beings who will
change when given factual information documenting
the need for change.

NormativeReeducative Strategy
Uses group norms and peer pressure to socialize and influence
people so that change will occur.

PowerCoercive Strategy
Features the application of power by legitimate authority, economic sanctions,
or political clout of the change agent
Includes influencing the enactment of new laws and using group power for
strikes or sit-ins.

RESISTANCE: THE EXPECTED

RESPONSE TO CHANGE
Resistance almost always accompanies change
because change alters the balance of a group.
Technological changes encounter less resistance
than changes that are perceived as social or that
are contrary to established customs or norms.
Nursing leaders also must recognize that
subordinates values, educational levels, cultural
and social backgrounds, and experiences with
change (positive or negative) will have a
tremendous impact on the degree of resistance.

 Resistance is recognized as a natural and

expected response to change.
Managers should immerse themselves in
identifying and implementing strategies to
minimize or manage this resistance to change.
It takes a strong leader to step up and engage
when a change effort meets with pushback. If
you can gain perspective by paying attention
to, understanding, and learning from behaviors
you perceive as threatening, you will ultimately
deliver better results

 The leadermanager must remember

that subordinates in an organization
will generally focus more on how a
specific change will affect their
personal lives and status than on
how it will affect the organization.

PLANNED CHANGE AS A
COLLABORATIVE PROCESS
As a rule, anyone who will be affected by a
change should be included in planning it.
When there are organizational shocks, like
layoffs, the astute manager will give people as
much information as they can, about what will
happen to them as individuals, to their work
groups, and to the organization as a whole.
This allows everyone who will be impacted by
a change to prepare to what extent they can
and to suffer less

ORGANIZATIONAL CHANGE ASSOCIATED

WITH NONLINEAR DYNAMICS
Complexity and Complex Adaptive
Systems Change Theory
Complexity science has emerged from the
exploration of the subatomic world and quantum
physics and suggests that the world is complex
as are the individuals who operate within it.
CAS theory, an outgrowth of complexity theory,
suggests that the relationship between elements
or agents within any system is nonlinear and
that these elements are the key player in
changing settings or outcomes.

 Multidimensionality of healthcare
organizations, and the individuals who
work within them, results in significant
challenges for the change agent.
Change agents then must carefully
examine and focus on the relationships
between the elements and be careful
not to look at any one element in
isolation from the others.

 Chaos Theory
Emerged from the early work of
meteorologist Edward Lorenz in the
1960s
Lorenz discovered that even tiny
changes in variables often dramatically
affected outcomes and suggests that
even small changes in conditions can
drastically alter a systems long-term
behavior

INTEGRATING LEADERSHIP ROLES

AND MANAGEMENT FUNCTIONS
IN PLANNED CHANGE

Leadership and management skills are necessary for

successful planned change to occur.
The manager is the mechanic who implements the
planned change.
The leader is the inventor or creator and must
identify trends and changes that may affect their
organizations and units and proactively prepare for
these changes.
The leader is the role model in planned change. He
or she is open and receptive to change and views
change as a challenge and an opportunity for
growth.

TIME MANAGEMENT

 Time management can be defined as

making optimal use of available time.
Barry Izsak, a productivity expert,
suggests, however, that it is not time that
is managed in time management; rather it
is a management of self.
Suggests that there is always enough time
to accomplish priorities if we can identify
them and then do what we know must be
done.

BASIC STEPS OF
TIME MANAGEMENT

 Planning then is essential if an

individual is to manage by efficiency
rather than by crisis and the old
adage fail to planplan to fail is
timeless.
Unfortunately, two mistakes common
to novice managers are
underestimating the importance of a
daily plan and not allowing adequate
time for planning.

The SMART Approach to

Manage Activities
1. Set specific, clear goals to be
accomplished.
2. Record your progress as measurable
progress maintains your interest.
3. Identify the steps needed to
accomplish your goals.
4. Be realistic about your time
constraints and set goals that can be
accomplished within these constraints.
5. Set a time frame and plan for this.

 Planning occurs first in the management process

because the ability to be organized develops from
good planning.
The following suggestions using industrial engineering
principles may assist the staff nurse in planning work
activities:
Gather all the supplies and equipment that will be needed
before starting an activity.
Group activities that are in the same location.
Use time estimates
Document your nursing interventions as soon as possible
after an activity is completed.
Always strive to end the workday on time.

Priority Setting and

Procrastination
Priority setting may well be the key
to good time management.
To procrastinate means to put off
something until a future time, to
postpone, or to delay needlessly.
Often times, it is a barrier to effective
time management

 Procrastination is a difficult problem to solve

because it rarely results from a single cause and
can involve a combination of dysfunctional
attitudes, rationalizations, and resentment.
The key in procrastination is to use it appropriately
and selectively. It is rarely appropriate when it is
done to avoid a task because it is overwhelming or
unpleasant.
Emotional intelligence is an important part of being
able to put aside the negative emotions associated
with doing an unpleasant or overwhelming task

 Before setting do later items aside, the

leadermanager must be sure that large
projects have been broken down into smaller
projects and that a specific timeline and plan
for implementation are in place.
The plan should include short-term,
intermediate, and final deadlines. Likewise,
one cannot ignore items without immediate
time limits forever and must make a definite
time commitment in the near future to
address these requests.

Making Lists
A planning tool.
In prioritizing all the do now items, the manager
may find preparing a written list helpful.
Should not be longer than what can be realistically
accomplished in 1 day.
Lists should allow adequate time for each task and
have blocks of time built in for the unexpected.
Sometimes,items on the list remain
unaccomplished because they are not divided into
steps or tasks that can be completed.

Reprioritizing
Often times ones priorities or list will change
during a day, week, or longer because new
information is received.
No amount of planning can prevent an
occasional crisis.
The individual may need to set aside the
original priorities for the day and reorganize,
communicate, and delegate a new plan
reflecting the new priorities associated with the
unexpected event causing the crisis.

Time Wasters
1. Facebook, My Space, and Twitter have created new
opportunities for communicating in real time to vast
networks of users but somehow increasingly consumes
our time instead of doing more important matters.
2. Socializing with colleagues during the workday and
making personal phone calls can waste signifi cant
amounts of time in a workday but can deter productivity.
3. Managers are generally inundated with paper clutter,
including organizational memos, staffing requests,
quality assurance reports, incident reports, and patient
evaluations.
4. Cluttered workspace.

Personal Time
Management
Managing time is difficult if a person is unsure of his or her
priorities for time management, including personal short-term,
intermediate, and long-term goals.
Goals alone are not enough; a concrete plan with timelines is
needed.
By being self-aware and setting goals accordingly, people
determine how their time will be spent.
When individuals lack this self-awareness, they may find it difficult
to find a balance between time spent on personal and professional
priorities.
Work and personal life should be kept separate whenever
possible, and that nurturing relationships is equally important to
enjoy the quality of life and avoid regrets in future.
Finally, each individual should be cognizant of how he or she
values the time of others.

 Career development is intentional

career planning and should be
viewed as a critical and deliberate
life process involving both the
individual and the employer.
Provides individuals with choices
about career outcomes rather than
leaving it to chance.

CAREER STAGES
Three different career phases or stages among
nurses:
1. Promise is the earliest of the career phases and
typically reflects the fi rst 10 years of nursing
employment.
2. Momentum is the middle career phase and
typically reflects the nurse with 11 to 29 years of
experience.
3. Harvest, commences in late career. Shirey labels
nurses with 30 to 40 years as having prime
experience and nurses with more than 40 years of
experience as being legacy clinicians.

JUSTIFICATIONS FOR CAREER

DEVELOPMENT

Reduced employee attrition.

Equal employment opportunity.
Improved use of personnel.
Improved quality of work life.
Improved competitiveness of the
organization.
Obsolescence avoided and new skills
acquired.
Evidence-based practice promoted

INDIVIDUAL RESPONSIBILITY FOR

CAREER DEVELOPMENT
Career development should begin with an
assessment of self as well as ones work
environment, job analysis, education, training, job
search and acquisition, and work experience.
Career planning in nursing should begin with an
individuals decision about educational entry level
for practice and quickly expand to developing
advanced skills in an area of nursing practice.
Every nurse should proactively develop a career
plan that provides opportunities for new learning,
challenges, and opportunities for career
divergence.

THE ORGANIZATIONS RESPONSIBILITY

FOR CAREER DEVELOPMENT

Integrating needs
Establishing career paths
Disseminating career information
Posting job openings
Assessing employees
Providing challenging assignments
Giving support and encouragement
Developing personnel policies.
Providing education and training

CAREER COACHING
Career coaching involves helping
others to identify professional goals
and career options and then
designing a career plan to achieve
those goals.
Career coaching typically has three
steps:
1. Gathering data
2. Asking what is possible
3. Conducting the coaching session.

EMPLOYEE TRANSFERS
Lateral Transfer
Lateral transfer describes one staff person moving to another
unit, to a position with a similar scope of responsibilities, within
the same organization.

Downward Transfer
Occurs when someone takes a position within the organization
that is below his or her previous level.
In some circumstances, the manager may need to intervene and
use a downward transfer to alleviate temporarily a nurses
overwhelming stress

Inappropriate Transfer
deterrent to successful career development.

PROMOTIONS
Promotions are reassignments to a position of higher
rank.
Include increased status, title changes, more authority,
and greater responsibility.
To avoid negative personnel outcomes from filling
quickly positional openings with little thought of longterm organizational goals, these elements should be
determined:
Whether recruitment will be internal or external
What the promotion and selection criteria will be
The pool of candidates that exists.
Handling rejected candidates.
How employee releases are to be handled.

MANAGEMENT
DEVELOPMENT
Management development is a planned system of
training and developing people so that they acquire the
skills, insights, and attitudes needed to manage people
and their work effectively within the organization.
Many nurses feel that they lack the knowledge and
experience necessary to become a manager.
Support for such management development programs
by the organization should occur in two ways:
First, top-level management must do more than bear the cost
of management development classes.
Second, training outcomes improve if nursing executives are
active in planning and developing a systematic and
integrated program.