DELEGATION

POSITION TASKS THAT CAN BE TASKS THAT CANNOT BE

DELEGATED DELEGATED
CHIEF NURSE to  Directing and  Overall control and
NURSING SUPERVISOR delegating management authority on Nursing
of nursing personnel Service
 Conducting  Leadership and
performance decision-making
improvement activities  Serve as a
 Recruitment of staff spokesperson for
nurses nursing
 Training of staff  Formulation of
members functions and
qualifications of each
nursing position
 Ensure that nursing
standards are upheld
 Maintain regulatory and
compliance approvals
and accreditations
 Participating in cross-
departmental decision
making
 Representing nursing
services at board of
director meetings
 Disciplinary action to
nurse supervisor
 Establishment of goals
and objectives for the
nursing department

NURSING SUPERVISOR  Supervision of staff  Performance

to HEAD NURSE nurses evaluation for head
 Assurance of quality nurses
nursing through  Management of
observing safe and professional personnel
therapeutic nursing care  Scheduling and
in the unit assigning of staff
 Disciplinary action to nurses and attendants
staff nurses  selecting, orienting,
 Maintaining safe and training, assigning,
 clean working scheduling, coaching,
environment counseling, and
 Checking of nursing disciplining employees
supplies inventory and  Recruitment of new
usage reports staff nurses

HEAD NURSE to STAFF  Nursing service  Overall responsibility

NURSE activities for assigned and authority as a
patients Head Nurse
 Planning of the unit’s  Performance
staffing Evaluation for staff
nurses
 Supervision of staff
nurses
 Handling of issues
regarding nursing
service in the unit
 Resolving conflict
between patients and
staff
 Disciplinary action to
staff nurses

STAFF NURSE to  Transport of clients and  Administering

NURSING ATTENDANT specimens to respective medications
units  Activities that require
 Securing and stocking clinical reasoning,
of necessary supplies nursing judgment or
 Provision of non- critical decision making
pharmacological  Documentation of
comfort and pain relief patient care
interventions such as  Filling up hospital
establishing and forms
maintaining an  Securing of consents
environment conducive or waivers
to comfort and providing  Developing plan of
the client with a care for patients
soothing and
therapeutic back rub
 Monitoring and
recording of vital signs,
height, and weight for
stable patients
 Measuring and
 recording of fluid intake
and output
 Assistance with
transfers, range of
motion, feeding, and
ambulation, and bowel
and bladder functions
 Bed making
 Responding to basic
patient needs and
queries with regards to
hospital stay, such as,
regulating air condition
or fan, location of
restrooms or pantry
 Standard and
unchanging nursing
procedures

DIRECTIONS OF COMMUNICATION
 UPWARD COMMUNICATION
Upward communication moves from lower to higher levels within an organization.

- Problems
- Suggestions for improvement
- Performance reports
- Grievance and disputes
- Financial and Accounting information

E.g. Staff nurses giving suggestions to the head nurse and supervisor to the CEO

LATERAL COMMUNICATION
Lateral communication is the flow of messages across individuals and groups on the same level
of an organization.

- Intradeparmental problem solving

- Interdepartmental coordination
- Staff advice to line departments
- Coordinate

E.g.

DOWNWARD COMMUNICATION
Downward communication is managers communicating to their subordinates.

- Implementation of goals and strategies and objectives

- Job instructions and rationale
- Procedures and practices
- Performance feedback

E.g. Staff nurse told the nursing assistant to remove the urine in urine bag every 4 hours
 CONFLICT RESOLUTION

Thomas-Kilmann Conflict Mode Instrument

Thomas-Kilmann based their strategies on the choices people make about how
assertive or cooperative they will be in a conflict. Everyone has a different, preferred approach
to managing conflict in the workplace, understanding these strategies can help move a project
or team forward when a conflict occurs.

Anyone who faces interpersonal conflict in nursing has a variety of options on how to handle it.
In fact, people’s approaches to conflict usually follow one of five routes:

Avoiding: Nurses who rely on avoidance as a conflict resolution strategy choose to avoid the
source of conflict or leave it alone altogether rather than confronting it head on. Avoiding
increases the chances of a group overlooking ideas, which can be harmful in the long run. ‍

‍ ompeting: Nurses whose conflict resolution strategies revolve around competing tend to be
C
overly assertive and preoccupied with “winning” the argument rather than coming to the best
possible solution. ‍
‍
Accommodating: Nurses who choose to use accommodating as their main conflict resolution
strategy are people-pleasers. They’re fine accommodating other ideas even at the expense of
shelving or de-prioritizing their own. This can be helpful when it moves the best solution forward,
but it can also be dangerous because it may lead to a case where an individual withholds valid
convictions or opinions just to “keep the peace.”‍
‍
Collaborating: Nurses who choose collaboration as their conflict resolution strategy incorporate
others’ ideas into their own; while the result may not be as half-and-half as with the
compromising method, the solution still has aspects of everyone’s opinions and input,
increasing group agreement and general satisfaction with the final decision.

Compromising: Instead of adopting a “me vs. you” mentality, nurses approaching interpersonal
conflict resolution from a compromising mentality aim to reach a solution that makes both sides
at least partially happy. By doing so, both sides leave with something they want and are able to
move forward with implementing a solution.‍
Performance Appraisal:

Evaluation Tool
Staff Name: _____________________ Date: _____
___
Performance Rating Scale
5 Standards Met with minor struggles
4 Standards Met with struggles
3 Standards Partially Met
2 Standards Not yet met
1 Requires Further Development

PERFORMANCE 1 2 3 4 5
1. Demonstrates an understanding of primary health care principles and
nursing in general practice
2. Provides nursing care consistent with current nursing and general
practice standards, guidelines, regulations and legislation
3. Seeks advice from other RNs, or health professionals, when faced with
situations outside of their scope of practice.
4. Integrates an understanding of the health and social needs of the Practice
and/or local community into the delivery of nursing care.
5. Practice is consistent with evidence-based guidelines and policies within
the RN scope of practice.
6. Mentors other nurses and health professionals in the application of
specific standards, guidelines, regulations and/or legislation.
7. Ensures Confidentiality in respect to records and interaction
8. Disseminates findings to the doctors
9. Engages with relevant professional nursing and/or general practice
organizations.
10. Plans own continuing professional education based on areas identified
for development.
11. Leads networks of nurses in general practice, facilitating orientation to
general practice and networking and/or mentoring relationships.
12. Develops the nursing role within general practice in collaboration with
other health professionals and consumers
13. Provides collegial support and works in collaboration with other RNs and
the broader general practice team.
14. Accountable and takes responsibility for leading the delivery of nursing
care within the Practice.
15. Demonstrates involvement in leadership activities within nursing and/or
general practice groups at a local level.
16. Articulates an understanding of evidence- based practice and its
application within nursing.
17. Builds and maintains professional and therapeutic relationships with
consumers, their families and/or support person(s)
18. Effectively manages human and physical resources
 19. Participates in the development, implementation and evaluation of
relevant policies and procedures
20. Contributes to quality improvement and research activities to monitor
and improve the standard of care provided in general practice

□ ÷ 100 × 75 + 25 =________

Evaluated By: _______________

Disciplinary Approach

 This approach involves the development and communication of clear rules about
acceptable and unacceptable behavior and reasonable consequences for breaking rules
of the organization.
Types of Disciplinary Approach
Verbal Warning

 Use for work performance issues, behavior problems or incidents when company
policies have been violated. Fields for employee incident are provided along with
communication completed and follow up steps to correct the situation.
Written Warning

 A form that Verdict informing the employees by the manager or from the that their
misconduct is taken seriously and they might not be given a second chance if any other
misconduct takes place from their end.
Suspension

 Suspend an employee due to an investigation of gross misconduct or other serious

disciplinary matter. The right to suspend will usually be set out in employees' contract of
employment or the staff handbook.
Dismissal

 Dismissal is the termination of employment by an employer against the will of the

employee. This decision can be made by an employer for a variety of reasons, ranging
from an economic downturn to performance-related problems on the part of the
employee.
Major and minor Misconduct
Major misconduct

 Major misconduct is an employee's behavior, which is serious enough to potentially

destroy the relationship between an employer and employee. The conduct must be
deliberate or amount to gross negligence, and entitles an employer to dismiss the
employee with immediate effect, without any notice.
Minor misconduct

 Minor misconduct occurs when an employee performs actions in the workplace that are
unacceptable but not criminal. Examples of minor misconduct include poor task
performance, excessive absences, safety violations, failure to follow directions or an
unintentional leakage of information.

Major Offense
Conviction of a crime

 1st offense: Dismissal

Falsification of a document

 1st offense: Dismissal

Dishonesty

 1st offense: Dismissal

Gross Neglect of Duty

 1st offense: Dismissal

Frequent Unauthorized Absences

 1st offense: suspension of 6 months

 2nd offense: dismissal
Disgraceful and Immoral conduct

 1st offense: suspension of 6 months

 2nd offense: dismissal
Refusal to perform official duty

 1st offense: suspension of 6 months

 2nd offense: dismissal
Inefficiency and Incompetence in performance

 1st offense: suspension for 6 months

 2nd offense: dismissal
Physical violence or harassment

 1st offense: suspension for 6 months

 2nd offense: dismissal
Unauthorized possession of drugs, drug paraphernalia or controlled substance while on work
premises

 1st offense: Dismissal

Carrying a firearm or deadly weapon on work premises unless specifically authorized/required in
the performance of duties

 1st offense: suspension for 6 months

 2nd offense: dismissal

Minor offense
Tardiness (30 minutes late for 3 consecutive duties)

 1st offense: Verbal Warning

 2nd offense: Written Warning
 3rd offense: Suspension for 3 days
Not wearing proper uniform

 1st offense: Verbal Warning

 2nd offense: Written Warning
 3rd offense: Suspension for 3 days
 4th offense: Suspension for 7 days
 5th offense: Dismissal
Simple Neglect of Duty

 1st offense: Written Warning

 2nd offense: Suspension for 3 to 30 days (depending on the case)
 3rd offense: Dismissal
Habitual Drunkenness on duty

 1st offense: suspension for 6 months

 2nd offense: dismissal
Failure to perform assigned tasks or duty

 1st offense: Verbal Warning

 2nd offense: Written Warning
 3rd offense: Suspension for 5 days
Violation of Reasonable Rules and Regulations

 1st offense: Written Warning

 2nd offense: Suspension for 3 to 30 days
 3rd offense: Dismissal
Smoking in breach of the company policy

 1st offense: Written Warning

 2nd offense: Suspension for 3 days
 3rd offense: Suspension for 7 days
 4th offense: Dismissal
Abusive Language

 1st offense: Verbal Warning

• 2nd offense: Written Warning

 3rd offense: Suspension for 3 days

Making rude or disrespectful comments to other members of staff

 1st offense: Verbal Warning

 2nd offense: Written Warning
 3rd offense: Suspension for 3 days

Nurses responsibility towards Minor and Major offenses

Nurses are legally required to identify any violation of her fellow

staff or by other healthcare workers. After identifying, the nurse must try to stop the said
inappropriate practice and report it immediately so that necessary disciplinary action can be
done.
PROMOTION

This refers to “advancement in rank and status that is accompanied by increase in

emoluments”.
Promotion is earned by dint of hard work, good conduct and result oriented performance as
reflected in confidential report.
Factors considered for Employees:

 Increase in salary
 Increase in job status
 Additional responsibility and accountability
Assessment of each employee should be based on fair, objective evaluation of the confidential
report for the precedings of almost five years or years equal to the required qualifying service.
Staff Nurse to Head Nurse
Head Nurse: Job requirements and qualifications

 Bachelor's Degree in Nursing (BSN)

 Registered Nurse (RN)
 3-5 years of experience
 Master’s Degree in Nursing
 Monthly Salary (P 34,000.00)
Head Nurse to Nurse Supervisor
Nursing Supervisor: Job requirements and qualifications

 Bachelor's Degree in Nursing (BSN)

 Registered Nurse (RN)
 5 years of experience
 Master’s Degree in Nursing
 Any additional certification in healthcare administration will be considered an advantage
 Certified in Nurse Manager and Leader (CNML)
 Certified in Executive Nursing Practice (CENP)
 Monthly Salary (P 36,000.00)
Nurse Supervisor to Chief Nursing Officer
Chief Nursing Officer: Job requirements and qualifications

 Bachelor's Degree in Nursing (BSN)

 Registered Nurse (RN)
 Masters of Science in Nursing (MSN)
 Masters Degree in Nursing/Masters of Health Administration (MBA)
 More than 5 years of managerial experience
 Monthly salary of (P 61,000.00)