Management theories

a. SCIENTIFIC MANAGEMENT
- Frederick W. Taylor, the “father of the scientific management”
- Work should be studied scientifically to determine the method of task performance
that would yield maximum work output with minimum work expenditure.
Four overriding principles of scientific management:
1. Traditional “rule of thumb” means of organizing work must be replaced with
scientific methods
2. A scientific personnel system must be established so that workers can be hired,
trained, and promoted based on their technical competence and abilities.
3. Workers should be able to view how they “fit” into the organization and how
they contribute to overall organizational productivity.
4. The relationship between managers and workers should be cooperative and
interdependent, and the work should be shared equally

b. Bureaucracy
- Max Weber (1922), Theory of Social and Economic Organization advocated
Bureaucracy.
- Need for legalized, formal authority and consistent rules and regulations for personnel
in different positions

c. Management Functions
- Henri Fayol (1925), first identified the
management functions of planning, organization,
command, coordination, and control.

d. Activities of Management
- • Luther Gulick (1937) expanded on Fayol’s management functions in his
introduction of the “Seven Activities of Management” planning, organizing, staffing,
directing, coordinating, reporting, and budgeting.

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Management Processes:

14 Principles of Management

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e. Participative Management
- Mary Parker Follett (1926) was one of the first theorists to suggest participative
decision making or participative management.
- Managers should have authority with, rather than over, employees.

f. Illumination Studies
- Elton Mayo and his Harvard associates (1927-1932), look at the relationship between
light illumination in the factory and productivity

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 - Hawthorne effect indicated that people respond to the fact that they are being studied,
attempting to increase whatever behavior
g. Theory x and Y
- Douglas McGregor (1960), X and Theory Y, posited that managerial attitudes about
employees can be directly correlated with employee satisfaction.

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h. Employee Participation
- Chris Argyris (1964), managerial domination causes workers to become discouraged
and passive.
- If self-esteem and independence needs are not met, employees will become
discouraged and troublesome or may leave the organization.

QUALITIES OF AN EFFECTIVE MANAGER

a. Leadership. All of the people skills of the leader are essential to the effective
manager. They are skills needed to function as a manager.
b. Clinical expertise. It is very difficult to help others develop their skills and evaluate
how well they have done so without possessing clinical expertise oneself. It is
probably not necessary (or even possible) to know everything all other professionals
on the team know, but it is important to be able to assess the effectiveness of their
work in terms of patient outcomes.
c. Business sense. Nurse managers also need to be concerned with the “bottom line,”
with the cost of providing the care that is given, especially in comparison with the
benefit received from that care and the funding available to pay for it, whether from
insurance, Medicare, Medicaid, or out of the patient’s own pocket. This is a complex
task that requires knowledge of budgeting, staffing, and measurement of patient
outcomes.

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BEHAVIORS OF AN EFFECTIVE MANAGER

A. Interpersonal Activities
a. Networking
- Nurse managers are in pivotal positions, especially in inpatient settings where they
have contact with virtually every service of the institution as well as with most people
above and below them in the organizational hierarchy.
- This provides them with many opportunities to influence the status and treatment of
staff nurses and the quality of the care provided to their patients.
b. Conflict negotiation and resolution
- Managers often find themselves resolving conflicts among employees, patients, and
administration.
- The ineffective manager either lets people go unmanaged emotionally or mismanages
feelings in the workplace
c. Employee development
- Providing for the continuing learning and upgrading of the skills of employees is a
managerial responsibility.
d. Coaching
- It is often said that employees are the organization’s most valuable asset (Shirey,
2007). This is one of the ways in which nurse managers can share their experience
and expertise with the rest of the staff.
e. Rewards and punishments
- Managers are in a position to provide specific (e.g.,salary increases, time off) and
general (e.g.,praise,recognition) rewards as well as punishments.

B. Decisional Activities

a. Employee evaluation
- Managers are responsible for conducting formal performance appraisals of their staff
members. Effective managers regularly tell their staff how well they are doing and
where they need improvement
b. Resource allocation
- In decentralized organizations, nurse managers are often given a set amount of money
to run their units or departments and must allocate these resources wisely. This can be
difficult when resources are very limited.
c. Hiring and firing employees
- Nurse managers decide either independently or participate in employment and
termination decisions for their units.

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 d. Planning for the future
- The day-to-day operation of most units is complex and time-consuming, and nurse
managers must also look ahead in order to prepare themselves and their units for
future changes in budgets, organizational priorities, and patient populations.
e. Job analysis and redesign
- In a time of extreme cost sensitivity, nurse managers are often required to analyze and
redesign the work of their units to make them as efficient as possible.

C. Informational Activities

a. Spokesperson
- Nurse managers often speak for administration when relaying information to their
staff members. Likewise, they often speak for staff members when relaying
information to administration.
b. Monitoring
- Nurse managers are also expert “sensors,” picking up early signs of problems before
they grow too big (Shirey,Ebright,& McDaniel,2008).They are expected to monitor
the many and various activities of their units or departments, including the number of
patients seen, average length of stay, infection rates, fall rates, and so forth. They also
monitor the staff (e.g.,absentee rates, tardiness, unproductive time),the budget
(e.g.,money spent, money left to spend in comparison with money needed to operate
the unit),and the costs of procedures and services provided, especially those that are
variable such as medical supplies (Dowless,2007).
c. Public Relations
- Nurse managers share information with their patients, staff members, and employers.
This information may be related to the results of their monitoring efforts, new
developments in health care, policy changes, and so forth.

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 Activity no. 2

1. Why should new graduates decline nursing management positions? At what point do you
think a nurse is ready to assume managerial responsibilities?

2. Which theory, scientific management or human relations, do you believe is most useful
to nurse managers? Explain your choice.

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3. Describe your ideal nurse manager in terms of the person for whom you would most like
to work. Then describe the worst nurse manager you can imagine, and explain why this
person would be very difficult.

4. 5. List 10 behaviors of nurse managers, then rank them from least to most important.
What rationale(s) did you use in ranking them?

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Case Study:
Joe Garcia has been an operating room nurse for 5 years. He was often on call on
Saturday and Sunday but he enjoyed his work and knew that he was good at it. Joe was called to
come in on a busy Saturday afternoon just as his 5-year-old daughter’s birthday party was about
to begin. “Can you find someone else just this once?” he asked the nurse manager who called
him. “I should have let you know in advance that we have an important family event today, but I
just forgot. If you can’t find someone else, call me back, and I’ll come right in.” Joe’s manager
was furious. “I don’t have time to make a dozen calls. If you knew that you wouldn’t want to
come in today, you should not have accepted on-call duty. We pay you to be on-call, and I
expect you to be here in 30 minutes, not one minute later, or there will be consequences.” Joe
decided that he no longer wanted to work in the institution. With his 5 years of operating room
experience, he quickly found another position in an organization that was more supportive of its
staff.
1.What style of leadership and school of management thought seemed to be preferred by Joe
Garcia’s manager?

2.What style of leadership and school of management were preferred by Joe?

3.Which of the listed qualities of leaders and managers did the nurse manager display? Which
behaviors? Which ones did the nurse manager not display?

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4.If you were Joe, what would you have done? If you were the nurse manager, what would you
have done? Why?

5. Who do you think was right, Joe or the nurse manager? Why?

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