Directing

Directin g

AILYN BRILLO PINEDA, RN

DIRECTING The act of issuing orders, assignments, instructions to accomplish the organization’s goals and objectives. It entails explaining what is to be done, to and by whom, at what time, how and why.

TOOLS IN DIRECTING Nursing Care Plan Policies Standards Standard Operating Procedure Rules and Regulation

ELEMENTS IN DIRECTING 1. 2. 3. 4. 5. 6. 7.

Delegation Supervision Staff Development Coordination Collaboration Communication Evaluation

1. Delegation Getting work done through others. Directing the performance of one or more people to accomplish organizational goals.

Provides learning or Delegation

‘stretching’ opportunities for subordinates. Increases power. Cannot delegate total responsibility. Do not delegate responsibility without authority. Delegate to the right person, at the right time, and for the right reason. Say no when you must.

Nursing management - DIRECTING Principles of Delegation 2. Select the right person to whom the job is to be delegated. 3. Delegate both interesting and uninteresting tasks. 4. Provide subordinates with enough time to learn. 5. Delegate gradually. 6. Delegate in advance. 7. Consult before delegating.

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Aspects of Delegation 1. Responsibility – denotes obligation 2. Authority – the power to make final decisions and give commands. 3. Accountability – refers to liability

Sometimes managers must delegate routine tasks so they are free to handle problems that are

Managers may delegate work if someone else is better prepared or has greater expertise or knowledge

For nurses, delegati on is not an option, but a necessit

Delegation is a managerial tool for subordinate accomplishment and enrichment.

Causes of Underdelegating Fear that delegation may be interpreted as a lack of ability to do the job completely or correctly. A desire to complete the whole job himself or herself. Fear that subordinates will resent delegated work.

Causes of Overdelegating Poor managers of time who spend too much time trying to get organized. Insecurity in

Causes of Improperly Delegating Wrong time, to the wrong person, or for the wrong reason. Beyond the capability of the person or something the manager should do.

Clear Communication + Delegation Define the task clearly. Delineate end results, time frame, standards. Delegate the

If the delegator requires a higher quality than “satisficing,” this must be made clear at the time of the delegation. Not everything that is delegated needs to be handled in a maximizing mode.

Managers should ask the individuals to whom they are delegating if they are capable of completing the delegated task, but should also validate this perception by direct observation.

Monitoring delegated tasks keeps the delegated task before the subordinate and the manager, so that both share

“Never tell people how to do things. Tell them what you want to achieve, and they will surprise you with their ingenuity.”

Patton,

George 1944

Delegation as Function of Professional Nursing RNs at all levels are increasingly expected to make assignments and supervise the work of different levels of employees.

Resistance is a common response by subordinat es to

2. SUPERVISION The process of guiding and directing the work to be done.

PRINCIPLES OF GOOD SUPERVISION 1. 2.

3. 4. 5. 6.

Focused on the improvement of work rather than upgrading the worker. It is based on line of authority, organizational philosophy, vision, mission, job description, policies and standards, the needs of the individual. Focus on the 3 areas of skill: conceptual, technical and interpersonal It is cooperatively planned, and accepts both challenge and change. Uses democratic process. THE ULTIMATE GOAL OF GOOD SUPERVISION IS TO PROVIDE SAFE, EFFECTIVE , QUALITY CARE.

RESPONSIBILITIES OF SUPERVISORS Teach and motivate the staff Delegate work responsibilities Perform ax and evaluation of work performance and condition. Attend consultation.

3. STAFF DEVELOPMENT Staff development is a planned experience to help employees perform effectively , and to enrich their competence in practice, education, administration and research.

FUNCTION OF STAFF DEVELOPMENT To maintain staff efficiency and effectiveness To create quality employees To meet the staff’s needs and address their problems To motivate them and

4. COORDINATION Coordination links he different components of an organization and leads them toward goal achievement.

5. COLLABORATION Collaboration is working together in the decision making process.

6. COMMUNICATION Communicatio n is the process by which a message is sent, received and

Communication The complex exchange of thoughts, ideas, or information on at least two levels: verbal and nonverbal.

Channels of Communicati on Downward 

Upward

Traditional



Primarily directive



Satisfaction less for subordinate



Employee handbook, reports, job descriptions

Allows employee input Staff satisfaction high Supervisor passes up

Horizontal 

To peers and members of the health team.



Outward To patient, family and

Variables Affecting Organizational Communication Spatial distance Different subgroups or subcultures Differing authority and work structures Organizations in a constant state of flux

Gender is also a significant factor in organizational communication because men and women communicate and use language

Organizational Communication Strategies Understand the structure of the organization. Realize that communication is not a one-way channel. Keep communication clear, concise, and simple. Sender should seek feedback regarding accuracy. Use multiple communication methods. Don’t overwhelm with

The Communication Process External Climate  Weather

conditions

 Temperature  Timing  Organizational  Status,

climate

power, and authority as barriers to manager-subordinate communication

Internal Climate Values Feelings Temperament Stress levels of sender and receiver

Communication Modes Written communicati on Verbal communicati on Nonverbal communicati

Grapevine Communication Flows haphazardly between people at all levels of the hierarchy and usually involves 3-4 people at a time. Subject to error and distortion because of the speed at which it passes. Sender has little formal accountability for the accuracy of the

Telephone Communication Rapid. Allows receiver to clarify message at time it is received. Does not, however, allow the receipt of nonverbal messages for

Listening The average person spends 70% of his or her time listening, but only 1/3 of all messages are retained. Good listening skills are as important as good verbal skills to the manager. Good listening skills take ongoing effort.

Non-Verbal Communication Ralph Waldo Emerson stated, “What you are speaks so loudly I cannot hear what you say.” (Rocchiccioli & Tilbury, 1998, p. 147)

Non-Verbal Communication Cues Space Environment Outward appearance Eye contact Body posture Gestures Facial expression

Interpersonal Communication Other interpersonal communication skills Nonverbal communication Assertive communication Listening skills

Assertive Communication A way of communicating that allows people to express themselves in direct, honest, and appropriate ways that do

Passive Communication Occurs when a person suffers in silence, although he or she may feel strongly about the issue.

Aggressive Communication Expressing oneself in a direct and often hostile manner that infringes on another person’s rights. Generally oriented to “winning at all costs.”

Passive-Aggressive Communication An aggressive message presented in a passive way. Limited verbal behavior with incongruent nonverbal behavior.

Virtual Communicat Electronic mail Fax Teleconferences Pagers Internet CD-ROM Networked systems

Stages of Group Work Forming Storming Norming Performin g

Stages of Group Work Forming Storming Norming Performin g

Confidentiality Confidentiality is expected regarding sensitive personal communications between managers and subordinates. All patient records require

BARRIERS TO EFFECTIVE COMMUNICATION Physical Barriers Social/Psychologi cal Barriers Semantics Interpretation

7. EVALUATION

Outcome of what has been done based on job performance.

PURPOSE OF EVALUATION Provide constructive feedback Determine progress and worthiness of individual nurse for greater responsibilities Serve as a basis for promotion and increase in salary or other similar rewards.

Managing Conflict

conflict

The internal or external discord that occurs as a result of differences in ideas, values, or beliefs of

Conflict is about... Person about reactions on a personal, emotional level personal style - selfassessments identifying the styles of

Common Reactions to Conflict Anger Hostility Avoidance Hurt

Personal Styles

Are you right or left-brained?

Are you a Theory X or Theory Y?

Are you someone who… ?

Testing your ‘style’...

Identifying the styles of others… the “Crazymakers” ...

Conflict is about...

Place ❖ The environment in your

workplace ❖ The culture of your workplace ❖ The culture of your department ❖ Organizations are ‘messy’, complex and contradictory things ❖ Using metaphor to understand your workplace

Conflict is about...

Process  Common approaches to

conflict resolution  Reframing the conflict  Disarming ‘tools’  Capitalizing on your style

The Pareto Principle or 80/20 Principle 80% of the conflicts in your life are probably with 20% of the people in your life, and 20% of those conflicts are causing 80% of the negative consequences in your life, so Because you can’t resolve all the conflicts, you have to pick the ones that matter. Concentrate on the 20% that are causing 80% of your problems.

Categories of Conflict Interperson al Intraperson al

Interpersonal Conflict Also known as horizontal violence or bullying.

Conflict Resolution Outcomes Win–Win Win–Lose Lose–Lose

Winning and losing are goals for games, not for conflicts.

The optimal goal in resolving conflict is creating a win–win solution for all involved.

Common Conflict Resolution Strategies Avoiding Compromisin g Competing Accommodati ng Smoothing

Avoiding Parties are aware of a conflict but choose not to acknowledge it or attempt to resolve it.

Compromising Each party gives up something it wants.

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

Accommodating One party sacrifices his or her beliefs and wants to allow the other party

Smoothing An individual attempts to reduce the emotional component of the

Collaborating An assertive and cooperative means of conflict resolution whereby all parties set aside their original goals and work together to establish a supraordinate or

Helpful Tips in Conflict Resolution Focus on the causes of the disagreement and not on personalities. Try to arrive at solutions acceptable to everyone concerned. Get all the information possible.

Helpful Tips in Conflict Resolution (cont.) Listen carefully and don’t prejudge. Don’t belabor how the conflict occurred. Instead, concentrate on what should be done to keep it from recurring. Concentrate on

Three Difficult Personality Types We ALL Have Conflicts With Sherman Tanks: The Attackers Snipers: The Potshot Artists Clams: The Maddening Ones

Negotiation Frequently resembles compromise when used as a conflict negotiation strategy. Emphasis is on accommodating differences between the parties. Each party must consider trade-offs and their bottom line to

Negotiating Strategies Use factual statements. Listen and keep an open mind. Discuss issues and not personalities. Start tough. Handle the unexpected wisely. Deal with the unexpected.

Negotiating Strategies (CONT.) Be honest. Be pleasant and don’t show anger. Don’t give up the ship too early. Try not to use your bottom line. Take a break if necessary.

Negotiation Closure and Follow-Up End on a friendly note. Restate final decision. Hide astonishment at your success. Make the other party feel that they also won. Follow up with a memo.

Types of Alternative Dispute Resolution (ADR) Mediation Fact-finding Arbitration Ombudsperson

Seeking Consensus Always an appropriate goal in resolving conflicts and in negotiation. All parties support, or at least do not oppose, an agreement. Greatest challenge in consensus

Conclusion Conflict is inevitable in any organization, but if successfully managed, it can produce highquality, creative solutions that lead to motivation and progress. The goal, then, should be to create a work environment that uses conflict constructively

Nursing management - CONTROLLING CONTROLLING Controlling or evaluating is an on-going function of management which occurs during planning, organizing, and directing activities. The controlling process opens opportunities for improvement and comparing performance against set standard.

Nursing management - CONTROLLING -

Reasons For Conducting Evaluation 2. Evaluation ensures that quality nursing care is provided. 3. It allows for the setting of sensible objectives and ensures compliance with them. 4. It provides standards for establishing comparisons. 5. It promotes visibility and a means for employees to monitor their own performance. 6. It highlights problems related to quality care and determines the areas that require priority attention. 7. It provides an indication of the costs

Nursing management - CONTROLLING 2.

3. 4.

5.

6. 7.

8.

Principles of Evaluation. The evaluation must be based on the behavioral standards of performance which the position requires. The evaluation should have enough time to observe employee’s behavior. The employee should be given a copy of the job description, performance standards, and evaluation conference. The employee’s performance appraisal should include both satisfactory and unsatisfactory results with specific behavioral instances to exemplify these evaluative comments. Areas needing improvement must be prioritized to help the worker upgrade his/her performance. The evaluation conference should be scheduled and conducted at a convenient time for the rater and the employee. The evaluation report and conference should be

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Characteristics of an Evaluation Tool 2.Should be objective 3.Should be reliable 4.Should be

Nursing management - CONTROLLING PERFORMANCE APPRAISAL Performance appraisal is a control process in which employee’s performance is evaluated against

What Are the Purposes of a Performanc e

Purposes of Performance Appraisal 2.Determine salary standards and merit increases. 3.Select qualified individuals for promotion or transfer. 4.Identify unsatisfactory employees for demotion or termination 5.Make inventories of talents within the institution.

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6. Improve the performance of work groups by examining, improving, correcting interrelationship between members 7. Improve communication between supervisors and employees and reach an understanding on the objectives of the job 8. Establish standards of supervisory performance. 9. Discover the aspirations of

Nursing management - CONTROLLING Methods of Measuring Performance 2. Essay 3. Checklist 4. Ranking 5. Rating Scales 6. Forced-choice Comparison 7. Anecdotal Recording