Textbook of Nursing Management and Services for BSc and Post Basic Nursing Sukhbir Kaur, Jagjit Kaur
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Introduction to Management in NursingUNIT I

What is management? The term management has many connotations, implications and dimensions. Management is not an alien concept to us. We all manage our own likes, and the practice of management is found in very facet of human endeavor. Most tasks in society are not performed in isolation, but rather, people come together as one unit to accomplish certain aims, which they could not otherwise achieve as individuals. Management is a process, a profession and a class of people. Management is both an art and science and now is regarded as resource also with the materials, capital and labor. Management is multidimensional in nature and the body of knowledge derived from a variety of discipline like philosophy, economics, mathematics, political science and behavior sciences. Management is a complex phenomenon involving interpersonal relationship, motivation, morale: and the combination of social biological, physical and political factors. As a process it consists of series of sequential or overlapping activities directed towards achieving organizational objectives. Management does not provide a cookbook solution to all problems. But provide phenomenon that can be measured, relationships that can be represented quantitatively, causal chains whose internal consistency can be logically verified, and conclusions that can be empirically tested.
Every individual is equipped with certain skills, abilities and strengths. When people work together in group, these individual skills and strengths are “pooled” together, in order to maximize the results. Managing group effort has become essential to ensure the coordination of individual efforts; otherwise individuals will be moving in different directions, leading to conflict and confrontations, therefore, management deals with setting, seeking and reaching certain objectives.
 
DEFINITION OF MANAGEMENT
“Management is a process of functions”, and there are five major functions like:
  • to forecast and plan;
  • to organize;
  • to command;
  • to coordinate and
  • to control.
Henri Fayol
“Management is the process of designing and maintaining an environment in which individuals, working together in groups, efficiently accomplish selected aims”.
Harlod and Heinz Weirich
“Management is a distinct process consisting of activities of planning, organizing, actuating and controlling, performed to determine and accomplish stated objectives with the use of human beings and other resources.”
George Terry2
“Management identifies a group of people whose job is to direct the efforts and activities of other people towards common objectives.”
TN Chhabra
Management is defined as the creation and maintenance of internal environment in an enterprise where individuals working together in groups, can perform efficiently and towards the attainment of group goals.
Koontz and O'Donell
“Management is a process that involves the coordination of human and material resources towards the accomplishment of certain objectives.” Therefore, management can be seen as:
  • a process
  • a profession
  • a factor of production
  • a field of study and
  • a group of people that supervise an organization.
The term management can also be used in three alternative ways–
  1. Management as a Discipline: Discipline refers to field of study having well defined concepts and principles, the knowledge of which aids in managing. From this point of view, management can be treated as an art or science.
  2. Management as a group of people: Sometimes, we refer to management as a group of people in which we include all those personnel who perform managerial functions in organizations.
  3. Management as a process: A process can simply defined as systematic method of handling activities. However, the management process can be treated as a complex one which can be referred to as an identifiable flow of information through interrelated stages of analysis directed towards the achievement of an objective or set of objectives.
 
CHARACTERISTICS OF MANAGEMENT
  • Management is a process of organized activities. When a group of people are involved in working towards common objectives, the principles of management are enforced.
  • The group should formulate an objective or a set of objectives towards which group activities are directed.
  • Management involves group activity or working with a group of individuals.
  • Management process involves decision-making at various levels in order to achieve the organizational goals.
  • Management is concerned with proper utilization of resources—the six M's, i.e. men, money, materials, machines, methods and markets, or basic resources to achieve organizational goals.
  • Management involves delegation of responsibility with authority.
  • Management aims at cost effectiveness, i.e. securing maximum results with minimum of effort and cost.
  • Management involves good human relations. Human relations motivate people to function in groups. Motivation, leadership, communication, participative management and group dynamics are the central core of human relations.
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MANAGEMENT CONCEPTS
For any kind of organization to run smoothly in achieving their set goals and objectives they need to implement management concepts. To plan for it, there are four basic management concepts that allow any organization to handle planned, tactical and set decisions. Any organization, whether new or old, whether big or small need to run smoothly and achieve the goals and objectives which it has set forth. Therefore some management concepts need to be overlooked and reasons why management concepts should be followed:
  • To increase managerial efficiency: The establishment of rules, principles and techniques of management increases managerial efficiency as they provide managers the important guidelines as how they should operate and work in different situations.
  • To develop a science of management and to crystallize the nature of management: Lack of understanding of the management concepts. Principles and techniques make it difficult to analyze job and to design programs to train and develop managers. Therefore, it's essential to develop a science of management.
  • To prepare and study research projects: Research work must undertake to expand and improve the horizons of management knowledge if structural frameworks of management theory exist. Major research projects must be pursued every year by the students of management to test various aspect of the validity of management.
  • To acquire social achievement: Broadly speaking, a management function is to coordinate the efforts of the people so that individual objectives may be translated into social achievements.
 
Therefore the Basic Management Concepts are its four Essential Functions
  1. The base function is to: Plan
    It is the foundation area of management. It is the base upon which all the areas of management should be built. Planning requires administration to assess; where the company is presently set, and where it would be in the upcoming. Hence an appropriate course of action is determined and implemented to attain the company's goals and objectives. Planning is unending course of action. Sometimes companies may face sudden change because of certain uncontrollable strategies. It can be said that they are external factors that constantly affect a system both optimistically and pessimistically. Depending on the conditions, a company may have to alter its course of action in accomplishing certain goals. This kind of preparation, arrangement is known as strategic planning. In strategic planning, management analyzes inside and outside factors that may affect the company and so objectives and goals. Thorough study of strengths and weaknesses, opportunities and threats, enables the management to be efficient and practical.
  2. The subsequent function is to: Organize
    The second function of the management is getting prepared, getting organized. Management must organize all its resources well before in hand to put into practice the course of action and to decide that has been planned in the base function. Through this process, management will now determine the inside directorial configuration; establish and maintain relationships, and also assign required resources.
    While determining the inside directorial configuration, management ought to look at the different divisions or departments. They also see to the harmonization of staff, and try to find out the best way to handle the important tasks and expenditure of information within the company. Management determines the division of work according to its need. It also has to decide for suitable departments to handover authority and responsibilities.
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  3. The third function is to: Direct
    Directing is the third function of the management. Working under this function helps the management to control and supervise the actions of the staff. This helps them to assist the staff in achieving the company's goals and also accomplishing their personal or career goals which can be powered by motivation, communication, department dynamics, and department leadership.
    Highly motivated employees generally surpass in their job performance and also play important role in achieving the company's goal that is why managers focus on encouraging their employees. They come about with prize and incentive programs based on job performance and geared in the direction of the employees requirements.
    It is very important to maintain a productive working environment, building positive interpersonal relationships, and problem-solving. And this can be done only with effective communication. Understanding the communication process and working on area that need improvement, help managers to become more effective communicators. The finest technique of finding the areas that requires improvement is to ask themselves and others at regular intervals, how well they are doing. This leads to better relationship and helps the managers for better directing plans.
  4. The final function is to: Control
    Control, the last of four functions of management, includes establishing performance standards which are of course based on the company's objectives. It also involves evaluating and reporting of actual job performance. When these points are studied by the management then it is necessary to compare both the things. This study on comparison of both decides further corrective and preventive actions.
    In an effort of solving performance problems, management should have higher standards. They should straightforwardly speak to the employee or department having problem. On the contrary, if there are inadequate resources or disallow other external factors standards from being attained, management had to lower their standards as per requirement. The controlling processes as in comparison with other three, is unending process or say continuous process. With this management can make out any probable problems. It helps them in taking necessary preventive measures against the consequences. Management can also recognize any further developing problems that need corrective actions.
    Effective and efficient management leads to success, the success where it attains the objectives and goals of the organizations. Of course for achieving the ultimate goal and aim management need to work creatively in problem-solving in all the four functions. Management not only has to see the needs of accomplishing the goals but also has to look into the process that their way is feasible for the company.
 
THEORIES OF MANAGEMENT
There are several theories of management but few has enlightened about management thoughts. Many different contributions of writers and practitioners resulted in different approaches to management and these makeup a “ Management theory jungle”.
 
1. Scientific Management Theory
Frederick W. Taylor (1856 – 1912) an American mechanical engineer who sought to improve industrial efficiency, is acknowledged as “the Father of scientific management”. Taylor was one of the intellectual leaders of the Efficiency movement and his ideas. Taylor's famous work entitled “ Principles of Scientific Management” was published in 1911. His primary concern was to increase productivity through greater efficiency in production and increased pay for workers, through the application of scientific method.5
Taylor's principle emphasized (shown in Fig. 1.1)
  • Replacing rules of thumb with science (organized knowledge).
  • Obtaining harmony in group action, rather than discord.
  • Achieving cooperation of human beings, rather than chaotic individualism.
  • Working for maximum output rather than restricted output.
  • Developing all workers to the fullest extent possible for their own and their company's highest prosperity.
According to Taylor, majority of workers put minimal effort in their work if they knew they could easily get away with it. He referred to this mode as soldering and he attributed this problem with mismanagement of the work at the lowest level of organization. This lack of proper organization manifested itself in a lack of productivity.
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Figure 1.1: Taylor's principles of scientific management
Taylor's methodical approach to determine the “one best way” to perform a job consisted of the following steps:
  • Select a sample of skilled workers and carefully study the job being done.
  • Carefully list each operation including extensive detail on each task being performed.
  • Utilize a stopwatch to time each task being performed. Repeat this step over a period of time to obtain an average of the time it takes to perform each task.
  • Identify and eliminate any unnecessary tasks that are performed to finalize the job.
  • Identify any improvements, tools or techniques that can be adopted to reduce the time in performing the job.
  • Establish new and informed times and pay – rates for the job.
  • Lastly, all workers are trained to perform the job in the “one best way” identified.
Taylor's scientific method to establish work procedures resulted in reduces timeframes to perform jobs and introduced rules and procedures to industrial management. Taylor's method became known as work study and it was embraced by several organizations. It was eventually also applied to office and administrative jobs, e.g. by nursing superintendent and it becomes a precursor to system analysis.6
 
2. Human Relations Theory (1930 – 1970)
Human relations movement refers to those researchers who study the behavior of people in groups and in particular work places. It originated in the 1930s in Hawthorne studies which examine the effect of social relations, motivation and employee satisfaction on factory productivity. The movement viewed workers in term of their psychology and fit with companies, rather than as interchangeable parts. These Hawthorne studies were conducted by George Elton Mayo at Hawthorne plant of Western electric company from 1927 – 1930 after which the human relation theory was introduced. He studied employee's productivity under varying environmental conditions and he found the factors that effect productivity were motivation, counseling, leading and communicating. He also found that employees motivated by relational factors like attention and sense of camaraderie
According to George Elton Mayo “the Hallmark of human relation theories is the primacy given to organizations as human cooperative system rather than mechanical contraptions.”
He stressed the following points:
  • Natural groups to be formed.
  • Upward and two-way communication from worker to chief executive and vice versa.
  • Cohesiveness and good leadership.
  • Communicate goals and ensure effective and coherent decision-making.
  • Relationship between employees and employers not regulated by legal norms but by moral and psychological factors.
    Elton Mayo developed a matrix which he used to illustrate the likelihood that a given team would be successful. His matrix demonstrates the role that varying combination of group norms and team cohesiveness place in team effectiveness. The following are the four combination of Mayo theory: (Fig. 1.2)
  • Groups with low norms and low cohesiveness are ineffective; they have no impact, since none of the members are motivated to excel, according to Mayo's theory.
  • Groups with low norms and high cohesiveness have negative impact, since fellow members encourage negative behaviors (e.g. gangs).
  • Groups with high norms and low cohesiveness have some degree of positive impact through individual member accomplishments.
  • Groups with high norms and high cohesiveness have the greater positive impact, since group members encourage one another to excel.
zoom view
Figure 1.2: Human relation theory
This concept has given rise to soft skill training of employees in order to maintain more compatible relationship.7
 
3. Operational Management Theory
Henri Fayol referred to as “Father of modern management theory” published his observation on the principles of general management in 1916 in French under the title “Administration industrielle at Ge'ne'rale”.
Fayol found the activities of industrial undertaking could be divided into six groups as shown in Fig. 1.3 these groups are:
  1. Technical (production).
  2. Commercial (buying, selling and exchanging).
  3. Financial (search for and optimum use of capital).
  4. Security (protection of property and persons).
  5. Accounting (including statistics) and
  6. Managerial (planning, organization, command, coordination and control).
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Figure 1.3: Activities in an organization
Fayol has also listed fourteen principle of management based upon his theory which are discussed further in the chapter in details.
 
4. Behavioral Science Theory
Hugo Minsterbery acknowledged being “Father of industrial psychology” was trained as a psychologist. In 1910, his interest turned to the application of psychology to industry, where he saw the importance of applying behavioral science to the new scientific management movement.”
In his book entitled “Psychology and industrial efficiency”, first published in 1912, stated his objectives as:
  • How to find people whose mental qualities best fit them for the work they are to do?
  • Under what psychological conditions the greatest and most satisfactory output can be obtained from the work of every person, and
  • How a business can influence workers in such a way as to obtain the best possible results from there?
    Hugo like taylor was interested in the mutuality of interests between managers and workers. His approach was even more strongly aimed at workers. He hoped to reduce their working time, increase their wages and raise their level of life.
 
5. Sociological Theory: Approach to Management
Concurrent to the development of scientific management by Taylor and administrative management by Fayol considerable amount of research was being devoted to observing people as products of group behavior. This is sometimes called the “social man” approach to management. Max Weber, Emile Durkheim and Vilfredo Pareto are generally regarded as “Father's of organization theory or Social system approach to management.”
Weber's analysis of church, government, military and business led him to believe that hierarchy, authority and bureaucracy, lie at the foundation of all social organizations. Emile Durkheim emphasized the idea that groups, by establishing their values and norms, control human conduct in any social organization.
Pareto viewed society as intricate clusters of independent units- that is, as social system with many subsystems. He said that the social system had a tendency to seek equilibrium upon being disturbed by outside or inside forces.
Social attitudes, sentiments function to cause the system to seek equilibrium when disturbed by these forces. According to him it was the task of elite in any society to provide the leadership to maintain the social system.8
 
6. Modern Management Thought
Management Theory Jungle: The variety of approaches to management analysis, the amount of research, and the number of different views have resulted in much confusion as to what management is, what management theory and science is, and how managerial events should be analyzed. Koontz has called these situations as ‘Management Theory Jungle’.
Some approaches to management are discussed below:
  1. The system approach: The systems concepts have broad applicability. Organizations are open system, i.e. systems have boundaries, but they also interact with the external environment. This approach recognize the importance of studying interrelatedness of planning, organizing and controlling in an organization as well as the many subsystems.
  2. Contingency or situational approach: According to this approach, managerial practice depends on circumstances, i.e. a contingency or a situation. Contingency theory recognizes the influence of given solutions or organizational behavior patterns. Managers have long realized that there is no best way to do things, but it can be very complex and difficult to determine all relevant contingency factors and show their relationships.
  3. Operational approach: This approach draws together concepts, principles, techniques and knowledge from other fields and managerial approaches and integrates these approaches with science and theory that is practice. It develops classification systems built around the managerial functions of planning, organizing, staffing, leading and controlling. The operational approach recognizes that there is a central core of knowledge about managing that is pertinent only to the field of management. These approaches draws on and absorbs knowledge from other fields including system theory, decision theory, theories of motivation and leadership, individual and group behavior, social systems and cooperation and communication as well as the application of mathematical analysis and concepts.
 
LEVELS OF MANAGEMENT
zoom view
Figure 1.4: Skills and management levels
 
1. Top Level of Management
It consists of board of directors, chief executive or managing director. The top management is the ultimate source of authority and it manages goals and policies for an enterprise. It devotes more time on planning and coordinating functions.9
The role of the top management can be summarized as follows:
  • Top management lays down the objectives and broad policies of the enterprise.
  • It issues necessary instructions for preparation of department budgets, procedures, schedules, etc.
  • It prepares strategic plans and policies for the enterprise.
  • It appoints the executive for middle level, i.e. departmental managers.
  • It controls and coordinates the activities of all the departments.
  • It is also responsible for maintaining a contact with the outside world.
  • It provides guidance and direction.
  • The top management is also responsible towards the shareholders for the performance of the enterprise.
 
2. Middle Level of Management
The branch managers and departmental managers constitute middle level. They are responsible to the top management for the functioning of their department. They devote more time to organizational and directional functions. In small organization, there is only one layer of middle level of management but in big enterprises, there may be senior and junior middle level management. Their role can be emphasized as:
  • They execute the plans of the organization in accordance with the policies and directives of the top management.
  • They make plans for the subunits of the organization.
  • They participate in employment and training of lower level management.
  • They interpret and explain policies from top level management to lower level.
  • They are responsible for coordinating the activities within the division or department.
  • It also sends important reports and other important data to top level management.
  • They evaluate performance of junior managers.
  • They are also responsible for inspiring lower level managers towards better performance.
 
3. Lower Level of Management
Lower level is also known as supervisory/operative level of management. It consists of supervisors, foreman, section officers, superintendent, etc. According to RC Davis, “Supervisory management refers to those executives whose work has to be largely with personal oversight and direction of operative employees.” In other words, they are concerned with direction and controlling function of management. Their activities include:
  • Assigning of jobs and tasks to various workers.
  • They guide and instruct workers for day to day activities.
  • They are responsible for the quality as well as quantity of production.
  • They are also entrusted with the responsibility of maintaining good relation in the organization.
  • They communicate workers problems, suggestions, and recommendatory appeals, etc. to the higher level and higher level goals and objectives to the workers.
  • They help to solve the grievances of the workers.
  • They supervise and guide the subordinates.
  • They are responsible for providing training to the workers.
  • They arrange necessary materials, machines, tools, etc. for getting the things done.
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  • They prepare periodical reports about the performance of the workers.
  • They ensure discipline in the enterprise.
  • They motivate workers.
  • They are the image builders of the enterprise because they are in direct contact with the workers.
zoom view
Figure 1.5: Levels of management
 
TYPES/STYLES OF MANAGEMENT
  1. Autocratic or authoritarian: In this the complete authority is in one person's hand and no one else can question it. It is also known as totalitarianism or dictatorship. It does forge an atmosphere of discipline in the organization. However, it can at anytime cause dissatisfaction and a lack of ‘creative space’ for the employees. For such management, the employees are just a replaceable resource and not the core of the organization. The manager believes in top - down communication, wherein orders are given by the higher hierarchical levels to the lower ones. The concept of ‘employee satisfaction’ does not hold importance for such manager.
  2. Democratic: In this type, the management allows the employees to voice their opinions. Most common policies and decisions are made, taking into consideration employee opinions. It is also known as participative style. This means that a meeting is held with representative from each hierarchical level, in order to take decision about the smallest company policies, as well as the major ones. “Confidentiality” is not of much substance to such management.
  3. Participative/consultative: In this style, the authority is in the hand of one individual. However, that one individual cares more about the employees than outcomes and profits that means the manager will be more like a parent rather than a boss. This kind of a management believes in top down as well as bottom-up communication.
  4. Laissez-Faire: In this the targets are communicated to the employees however, the employees can go about meeting those targets in whichever way they want. It is very liberal management. However, there is lots of chaos in the delegation of authority and responsibility. Communication is free and more through grapevine.
    The above mentioned management styles are more closely linked to the personality and leadership qualities of a leader manager.
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FUNCTIONS OF MANAGEMENT
 
1. Planning
It is the basic function of management. It deals with chalking out a future course of action and deciding in advance the most appropriate course of actions for achievement of pre-determined goals. According to Koontz, “Planning is deciding in advance—what to do, when to do and how to do? It bridges the gap from where we are and where we want to be.” A plan is a future course of actions. It is an exercise in problem-solving and decision-making. Planning is determination of courses of action to achieve desired goals. Thus, planning is a systematic thinking about ways and means for accomplishment of predetermined goals. Planning is necessary to ensure proper utilization of human and nonhuman resources. It is all pervasive, it is an intellectual activity and it also helps in avoiding confusion, uncertainties, risks, wastages, etc.
 
2. Organizing
It is the process of bringing together physical, financial and human resources and developing productive relationship amongst them for achievement of organizational goals. According to Henry Fayol, “To organize a business is to provide it with everything useful or its functioning, i.e. raw material, tools, capital and personnel's.” To organize a business involves determining and providing human and nonhuman resources to the organizational structure. Organizing as a process involves:
  • Identification of activities.
  • Classification of grouping of activities.
  • Assignment of duties.
  • Delegation of authority and creation of responsibility.
  • Coordinating authority and responsibility relationships.
zoom view
Figure 1.6: Functions of management
 
3. Staffing
It is the function of manning the organization structure and keeping it manned. Staffing has assumed greater importance in the recent years due to advancement of technology, increase in size of business, complexity of human behavior, etc. The main purpose of staffing is to put right man on right job, i.e. square pegs in square holes and round pegs in round holes. According to Kootz and O'Donell, “Managerial function of staffing involves manning the organization structure through proper and effective selection, appraisal and development of personnel to fill the roles designed in the structure.” Staffing involves:
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  • Manpower Planning (estimating man power in terms of searching, choose the person and giving the right place).
  • Recruitment, selection and placement.
  • Training and development.
  • Remuneration.
  • Performance appraisal.
  • Promotions and transfer.
 
4. Directing
It is that part of managerial function which actuates the organizational methods to work efficiently for achievement of organizational purposes. It is considered life-spark of the enterprise which sets it in motion the action of people because planning, organizing and staffing are the mere preparations for doing the work. Direction is that inertpersonnel aspect of management which deals directly with influencing, guiding, supervising, motivating subordinate for the achievement of organizational goals. Direction has following elements:
  • Supervision
  • Motivation
  • Leadership
  • Communication
Supervision implies overseeing the work of subordinates by their superiors. It is the act of watching and directing work and workers.
Motivation means inspiring, stimulating or encouraging the subordinates with zeal to work. Positive, negative, monetary, nonmonetary incentives may be used for this purpose.
Leadership may be defined as a process by which manager guides and influences the work of subordinates in desired direction.
Communication is the process of passing information, experience, opinion, etc. from one person to another. It is a bridge of understanding.
 
5. Controlling
It implies measurement of accomplishment against the standards and correction of deviation if any to ensure achievement of organizational goals. The purpose of controlling is to ensure that everything occurs in conformities with the standards. An efficient system of control helps to predict deviations before they actually occur. According to Theo Haimann, “Controlling is the process of checking whether or not proper progress is being made towards the objectives and goals and acting if necessary, to correct any deviation.” According to Koontz and O'Donell “Controlling is the measurement and correction of performance activities of subordinates in order to make sure that the enterprise objectives and plans desired to obtain them as being accomplished.” Therefore controlling has following steps:
  • Establishment of standard performance.
  • Measurement of actual performance.
  • Comparison of actual performance with the standards and finding out deviation if any.
  • Corrective action.
 
PRINCIPLES OF MANAGEMENT
A principle refers to a fundamental truth. It establishes cause and effect relationship between two or more variables under given situation. They serve as a guide to thought and actions. Therefore, management principles are the statements of fundamental truth based on logic which provides guidelines for managerial decision-making and actions. These principles are derived:
  1. On the basis of observation and analysis, i.e. practical experience of managers.
  2. By conducting experimental studies.
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There are 14 Principles of Management Described by Henri Fayol.
 
1. Division of Labor
  • Henry Fayol has stressed on the specialization of jobs.
  • He recommended that work of all kinds must be divided and subdivided and allotted to various persons according to their expertise in a particular area.
  • Subdivision of work makes it simpler and results in efficiency.
  • It also helps the individual in acquiring speed, accuracy in his performance.
  • Specialization leads to efficiency and economy in spheres of business.
 
2. Parity of Authority and Responsibility
  • Authority and responsibility are coexisting.
  • If authority is given to a person, he should also be made responsible.
  • In a same way, if anyone is made responsible for any job, he should also have concerned authority.
  • Authority refers to the right of superiors to get exactness from their subordinates whereas responsibility means obligation for the performance of the job assigned.
  • There should be a balance between the two, i.e. they must go hand in hand.
  • Authority without responsibility leads to irresponsible behavior whereas responsibility without authority makes the person ineffective.
 
3. Unity of Command
  • A subordinate should receive orders and be accountable to one and only one boss at a time.
  • In other words, a subordinate should not receive instructions from more than one person because:
    • It undermines authority
    • Weakens discipline
    • Divides loyalty
    • Creates confusion
    • Delays and chaos
    • Escaping responsibilities
    • Duplication of work
    • Overlapping of efforts
  • Therefore, dual subordination should be avoided unless and until it is absolutely essential.
  • Unity of command provides the enterprise a disciplined, stable and orderly existence.
  • It creates harmonious relationship between superiors and subordinates.
 
4. Unity of Direction
  • Fayol advocates one head one plan which means that there should be one plan for a group of activities having similar objectives.
  • Related activities should be grouped together. There should be one plan of action for them and they should be under the charge of a particular manager.
  • According to this principle, efforts of all the members of the organization should be directed towards common goal.
  • Without unity of direction, unity of action cannot be achieved.
  • In fact, unity of command is not possible without unity of direction.
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Basis
Unity of command
Unity of direction
Meaning
It implies that a subordinate should receive orders and instructions from only one boss.
It means one head, one plan for a group of activities. having similar objectives.
Nature
It is related to the functioning of personnel's.
It is related to the functioning of departments, or organization as a whole.
Necessity
It is necessary for fixing responsibility of each subordinates.
It is necessary for sound organization.
Advantage
It avoids conflicts, confusion and chaos.
It avoids duplication of efforts and wastage of resources.
Result
It leads to better superior subordinate relationship.
It leads to smooth running of the enterprise.
Therefore it is obvious that they are different from each other but they are dependent on each other, i.e. unity of direction is a prerequisite for unity of command. But it does not automatically comes from the unity of direction.
 
5. Equity
  • Equity means combination of fairness, kindness and justice.
  • The employees should be treated with kindness and equity if devotion is expected of them.
  • It implies that managers should be fair and impartial while dealing with the subordinates.
  • They should give similar treatment to people of similar position.
  • They should not discriminate with respect to age, caste, sex, religion, relation, etc.
  • Equity is essential to create and maintain cordial relations between the managers and subordinate.
  • But equity does not mean total absence of harshness.
  • Fayol was of opinion that, “at times force and harshness might become necessary for the sake of equity.”
 
6. Order
  • This principle is concerned with proper and systematic arrangement of things and people.
  • Arrangement of things is called material order and placement of people is called social order.
  • Material order: There should be safe, appropriate and specific place for every article and every place to be effectively used for specific activity and commodity.
  • Social order: Selection and appointment of most suitable person on the suitable job. There should be a specific place for everyone and everyone should have a specific place so that they can easily be contacted whenever need arises.
 
7. Discipline
  • According to Fayol, “Discipline means sincerity, obedience, respect of authority and observance of rules and regulations of the enterprise.”
  • This principle applies that subordinate should respect their superiors and obey their order.
  • It is an important requisite for smooth running of the enterprise.
  • Discipline is not only required on path of subordinates but also on the part of management.
  • Discipline can be enforced if:
    • There are good superiors at all levels.
    • There are clear and fair agreements with workers.
    • Sanctions (punishments) are judiciously applied.
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8. Initiative
  • Workers should be encouraged to take initiative in the work assigned to them.
  • It means eagerness to initiate actions without being asked to do so.
  • Fayol advised that management should provide opportunity to its employees to suggest ideas, experiences and new method of work.
  • It helps in developing an atmosphere of trust and understanding.
  • People then enjoy working in the organization because it adds to their zeal and energy.
  • To suggest improvement in formulation and implementation of place.
  • They can be encouraged with the help of monetary and nonmonetary incentives.
 
9. Fair Remuneration
  • The quantum and method of remuneration to be paid to the workers should be fair, reasonable, satisfactory and rewarding of the efforts.
  • As far as possible it should accord satisfaction to both employer and the employees.
  • Wages should be determined on the basis of cost of living, work assigned, financial position of the business, wage rate prevailing, etc.
  • Logical and appropriate wage rates and methods of their payment reduce tension and differences between workers and management creates harmonious relationship and pleasing atmosphere of work.
  • Fayol also recommended provision of other benefits such as free education, medical and residential facilities to workers.
 
10. Stability of Tenure
  • Fayol emphasized that employees should not be moved frequently from one job position to another, i.e. the period of service in a job should be fixed.
  • Therefore employees should be appointed after keeping in view principles of recruitment and selection but once they are appointed their services should be served.
  • According to Fayol. “Time is required for an employee to get used to a new work and succeed to doing it well but if he is removed before that he will not be able to render worthwhile services.”
  • As a result, the time, effort and money spent on training the worker will go waste.
  • Stability of job creates team spirit and a sense of belongingness among workers which ultimately increase the quality as well as quantity of work.
 
11. Scalar Chain
  • Fayol defines scalar chain as “The chain of superiors ranging from the ultimate authority to the lowest.”
  • Every orders, instructions, messages, requests, explanation, etc. has to pass through Scalar chain.
  • But, for the sake of convenience and urgency, this path can be cut short and this short cut is known as Gang Plank.
  • A Gang Plank is a temporary arrangement between two different points to facilitate quick and easy communication as explained below:
    zoom view
    Figure 1.7: Gang Plank
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  • In the Fig. 1.7 given, if D has to communicate with G he will first send the communication upwards with the help of C, B to A and then downwards with the help of E and F to G which will take quite sometime and by that time, it may not be worth therefore a gang plank has been developed between the two.
  • Gang Plank clarifies that management principles are not rigid rather they are very flexible. They can be moulded and modified as per the requirements of situations.
 
12. Subordination of Individual Interest to General Interest
  • An organization is much bigger than the individual it constitutes therefore interest of the undertaking should prevail in all circumstances.
  • As far as possible, reconciliation should be achieved between individual and group interests.
  • But in case of conflict, individual must sacrifice for bigger interests.
  • In order to achieve this attitude, it is essential that:
    • Employees should be honest and sincere.
    • Proper and regular supervision of work.
    • Reconciliation of mutual differences and clashes by mutual agreement. For example, for change of location of plant, for change of profit sharing ratio, etc.
 
13. Esprit De’ Corps (can be Achieved through Unity of Command)
  • It refers to team spirit, i.e. harmony in the work groups and mutual understanding among the members.
  • Esprit De’ Corps inspires workers to work harder.
  • Fayol cautioned the managers against dividing the employees into competing groups because it might damage the moral of the workers and interest of the undertaking in the long run.
  • To inculcate Esprit De’ Corps following steps should be undertaken –
    • There should be proper coordination of work at all levels
    • Subordinates should be encouraged to develop informal relations among themselves.
    • Efforts should be made to create enthusiasm and keenness among subordinates so that they can work to the maximum ability.
    • Efficient employees should be rewarded and those who are not up to the mark should be given a chance to improve their performance.
    • Subordinates should be made conscious of that whatever they are doing is of great importance to the business and society.
  • He also cautioned against the more use of Britain communication to the subordinates i.e. face to face communication should be developed. The managers should infuse team spirit and belongingness. There should be no place for misunderstanding. People then enjoy working in the organization and offer their best towards the organization.
 
14. Centralization and Decentralization
  • Centralization means concentration of authority at the top level. In other words, centralization is a situation in which top management retains most of the decision-making authority.
  • Decentralization means disposal of decision-making authority to all the levels of the organization. In other words, sharing authority downwards is decentralization.
  • According to Fayol, “Degree of centralization or decentralization depends on no. of factors like size of business, experience of superiors, dependability and ability of subordinates, etc.
  • Anything which increases the role of subordinate is decentralization and anything which decreases it is centralization.
  • Fayol suggested that absolute centralization or decentralization is not feasible. An organization should strike to achieve a lot between the two.
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Following are the Main Importance of the Principles of Management
  1. Improves Understanding: From the knowledge of principles managers get indication on how to manage an organization. The principles enable managers to decide what should be done to accomplish given tasks and to handle situations which may arise in management. These principles make managers more efficient.
  2. Direction for Training of Managers: Principles of management provide understanding of management process what managers would do to accomplish what. Thus, these are helpful in identifying the areas of management in which existing and future managers should be trained.
  3. Role of Management: Management principles makes the role of managers concrete. Therefore these principles act as ready reference to the managers to check whether their decisions are appropriate. Besides these principles define managerial activities in practical terms. They tell what a manager is expected to do in specific situation.
  4. Guide to Research in Management: The body of management principles indicate lines along which research should be undertaken to make management practical and more effective. The principles guide managers in decision-making and action. The researchers can examine whether the guidelines are useful or not. Anything which makes management research more exact and pointed will help improve management practice.
 
ROLE OF NURSE AS A MANAGER AND MANAGERIAL SKILLS
Henry Mintzberg in “The Nature of Managerial Work” concluded that the manager played some ten different roles, which were as follows:
 
Interpersonal Roles
  • Figurehead: In this role, the manager performed duties of a ceremonial nature such as entertaining high profile nurses to exchange innovative evidence based clinical experiences and health care practices.
  • Leader: As a leader, the manager must motivate nurses and health care team workers and try to reconcile the individual needs and aspirations with the larger goals of the organization.
    zoom view
    Figure 1.8: Role or nurse as a manager
  • Liaison: The manger should cultivate inter and intra departments contacts to collect information relevant to the organization.
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Informational Role
  • Monitor: The manager has to continually scan one's environment for information. She/he the can receive information through personal contacts, and subordinates or it may be unsolicited information.
  • Disseminator: in the role of a disseminator, the manager passes some of the prevailed information to his subordinates, who would otherwise have no access to it.
  • Spokesman: In this role, the manager gives relevant information to the various groups and people who influence the organization. He may advise shareholders about the financial performance of the organization, satisfy the government abiding by the laws, etc.
 
Decision Roles
  • Entrepreneur: The manager is on the look out for new ideas to improve health care continually by adapting it to the changing external environment.
  • Disturbance handler: In this role, the manager has to work like a firefighter and find solutions for unanticipated problems.
  • Resource allocator: In this role, the manager has to delegate authority and also allocate resources so that they are optimally utilized.
  • Negotiator: A manager spends a considerable amount of his time in negotiations. The manager may have to negotiate with supplier, with workers over grievance, etc.
Furthermore, three kinds of skills were identified by Robert L. Katz which are essential for the managerial roles. These are:
  1. Technical skill is the manager understands of the nature of job that people under him will perform. It is his knowledge of and proficiency in activities involving method, process and procedures.
  2. Human skill is the ability to interact effectively with people at all levels. It is the creation of an environment in which people feel secure and free to express their opinions.
  3. Conceptual skill is the ability to see the ‘big picture’ and to take a broad and farsighted view of the organization and its future. This skill enables the manager to recognize the significant elements in a situation, and to understand the relationships among the elements. This skill increases in importance as the manager moves up in organizational hierarchy. Another skill can be added to it is the design skill which is the ability to design a workable solution to the problem. The solution must be viable and feasible in the light of the ground realities of the situation.
 
Nurse as a Manager
  • Nurse Managers are responsible for planning, organizing, and directing health services in their department to ensure that the goals and objectives are performed consistently and that the services provided to the patients is of the highest quality and standard.
  • They select, mentor, motivate, and direct the development and evaluation of the staff nurses. They are responsible for establishing and keeping track of quality improvement indicators and other information that concerns the patient care and services. They ensure that resources are available in order to provide high quality service and the on-time performance that is consistent and qualitative. At times, educational programs are devised specifically health related for the facility's non-professional and professional staff.
  • Nurse as a manager participates, consult and collaborate, with other units and healthcare providers in developing long term plans for health care programs.
  • They are also responsible for developing budget estimates and handle other information pertaining to financial concerns and requirements. They approve and monitor expenditures and purchases to ensure that the budget guidelines are complied to.
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  • They are responsible in the staff maintenance. They assign nurses to particular cases and oversee the patient care to ensure that it remains at a high standard. They are also involved in creating treatment plans for patients. Health team coordination is maintained to keep everyone up to date of the progress in the medical care and health profile of the patient.
 
Management and Administration
According to Theo Haimann, “Administration means overall determination of policies, setting of major objectives, identification of general purposes and laying down of broad programs and projects”. It refers to the activities of higher level and lays down basic principles of the enterprise. According to Newman, “Adminis­­tration means guidance, leadership and control of the efforts of the groups towards some common goals.” Whereas, management involves conceiving, initiating and bringing together the various elements; coordinating, actuating, integrating the diverse organizational components while sustaining the viability of the organization towards some predetermined goals. In other words, it is an art of getting things done through and with the people in formally organized groups.
zoom view
Figure 1.9: Administration and management at various level
 
The Difference between Management and Administration can be summarized under 2 categories
  1. Functions
  2. Usage/Applicability
Difference Between Management and Administration:
On the Basis of Functions
Basis
Management
Administration
Meaning
Management is an art of getting things done through others by directing their efforts towards achievement of predetermined goals.
It is concerned with formulation of broad objectives, plans and policies.
Nature
Management is an executing function.
Administration is a decision-making function.
Process
Management decides who should as it and how should he dot it.
Administration decides what is to be done and when it is to be done?
Function plans
Management is a doing function because managers get work done under their supervision.
Administration is a thinking function because and policies are determined under it.
Skills
Technical and Human skills
Conceptual and Human skills
Level
Middle and lower level function
Top level function
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On the Basis of Usage
Basis
Management
Administration
Applicability
It is applicable to business concerns, i.e. profit-making organization.
It is applicable to nonbusiness concerns, i.e. clubs, schools, hospitals, etc.
Influence
The management decisions are influenced by the values, opinions, beliefs and decisions of the managers.
The administration is influenced by public opinion, govt. policies, religious organizations, customs, etc.
Status
Management constitutes the employees of the organization who are paid remuneration (in the form of salaries and wages).
Administration represents owners of the enterprise who earn return on their capital invested and profits in the form of dividend.
Practically, there is no difference between management and administration. Every manager is concerned with both—administrative management function and operative management function as shown in the Figure 1.9. However, the managers who are higher up in the hierarchy denote more time on administrative function and the lower level denote more time on directing and controlling worker's performance, i.e. management.
 
Summary
  • Management is both art, science and now is regarded as resource also with the materials, capital and labor.
  • Management is the process of designing and maintaining an environment in which individuals, working together in groups, efficiently accomplish in selected aims.
  • Management is concerned with proper utilization of resources — the six M's, i.e. men, money, materials, machines, methods and markets, or basic resources to achieve organizational goals.
  • Planning requires administration to assess where the company is presently set, and where it would be in the upcoming.
  • Management must organize all its resources well before in hand to put into practice the course of action to decide that has been planned in the base function.
  • Control, the last of four functions of management, includes establishing performance standards which are of course based on the company's objectives.
  • Taylor's scientific method to establish work procedures resulted in reduces timeframes to perform jobs and introduced rules and procedures to industrial management.
  • The Hallmark of human relation theories is the primacy given to organizations as human cooperative system rather than mechanical contractions.
  • Max Weber, Emile Durkheim and Vilfredo Pareto are generally regarded as Father's of organization theory or social system approach to management.
  • Levels of management can be divided into top level, middle level and lower level.
  • There are various styles of management but four commonly known are autocratic, democratic, participative and laissez faire.
  • Planning is deciding in advance—What to do, when to do and how to do? It bridges the gap from where we are and where we want to be?
  • Organizing is the process of bringing together physical, financial and human resources and developing productive relationship amongst them for achievement of organizational goals.
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  • Managerial function of staffing involves manning the organization structure through proper and effective selection, appraisal and development of personnel to fill the roles designed in the structure.
  • Direction is that inert—personnel aspect of management which deals directly with influencing, guiding, supervising, motivating subordinate for the achievement of organizational goals.
  • Controlling is the process of checking whether or not proper progress is being made towards the objectives and goals and acting if necessary, to correct any deviation.
  • Subdivision of work makes it simpler and results in efficiency.
  • Authority refers to the right of superiors to get exactness from their subordinates whereas responsibility means obligation for the performance of the job assigned.
  • Unity of command provides the enterprise a disciplined, stable and orderly existence.
  • Unity of direction is a prerequisite for unity of command.
  • Equity is essential to create and maintain cordial relations between the managers and subordinate.
  • Discipline is not only required on path of subordinates but also on the part of management.
  • Stability of job creates team spirit and a sense of belongingness among workers which ultimately increase the quality as well as quantity of work.
  • Spirit De’ Corps inspires workers to work harder.
  • As a leader, the manager must motivate his employees and try to reconcile the individual needs and aspirations with the larger goals of the organization.
  • Nurse Managers are responsible for planning, organizing, and directing health services in their department to ensure that the goals and objectives are performed consistently and that the services provided to the patients is of the highest quality and standard.
  • The managers who are higher-up in the hierarchy denote more time on administrative function and the lower level denote more time on directing and controlling worker's performance, i.e. management.
 
Action Summary
Reread the learning objectives below. Objective type questions are followed by long questions. Answering these questions accurately will help you to retain the most important concepts discussed in this chapter. Check your answer against the answer key at the end of this chapter.
1. The famous 14 principles of management was first defined by:
  1. Elton Mayo
  2. Henri Fayol
  3. Adam Smith.
  4. James Watt
1. b.
2. Scientific management Theory was developed by:
  1. Max Weber
  2. Frederick Taylor
  3. Adam Smith
  4. Rensis Likert
2. b.
3. Which of the following concept is NOT related to Frederick Taylor's theory of modern management:
  1. Management is a true science
  2. The selection of workers is a science
  3. Workers are to be developed and trained
  4. Scientific management is a collaboration of workers and managers
  5. The average human being prefers to be directed, wishes to avoid responsibility, has relatively little ambition, wants security above all.
3.e
4. The famous Hawthorne experiments were conducted by:
  1. Elton Mayo
  2. Max Weber
  3. Henry Ford
  4. FW Taylor
4.a
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5. All levels of management between the supervisory level and the top level of the organization are termed_____________:
  1. Middle managers
  2. First line managers
  3. Supervisors
  4. Foremen
5.a
6. _______________is the process of getting activities completed efficiently and effectively with and through other people:
  1. Leading
  2. Management
  3. Supervision
  4. Controlling
6.b
7. The management process functions consist of____________:
  1. Planing, organizing, staffing and directing
  2. Planning, organizing, leading and directing
  3. Planning, organizing, leading and staffing
  4. Planning, organizing, leading and controlling
7.d
8. Which of the following theorists assumed that any worker's job could be reduced to science:
  1. Mayo
  2. Fayol
  3. Taylor
  4. Gilbreth
8.c
9. The contingency approach emphasizes the viewpoint that what managers do in practice depends overall on:
  1. The worker
  2. The situation
  3. The task
  4. The environment
  5. The manager's personality
9.b
10. The management science approach emerged after:
  1. World War I
  2. Civil War
  3. Korean War
  4. World War II
10.d
 
Issues for Review and Discussion
  1. List five approaches to managing.
  2. Define classical approach to management.
  3. What is scientific management?
  4. List and define Fayol's general principles of management.
  5. Define behavioral approach to management.
  6. What is the significance of studies carried out at Hawthorne works of the western electric company?
  7. Describe the human relations movement?
  8. List and explain three characteristics of situations in which management science applications usually are made.
 
Learning Exercises
  1. Exercise 1.1: Define nursing management as it relates to your job. If you are a student, observe the work of a nurse manager and define management in terms of your observations.
  2. Exercise 1.2: Write short theory of nursing management based on information presented in this chapter. Remember that a theory of nursing management is an accumulation of concepts, methods, and principles that can be or have been observed and verified to some degree and translated into the art or practice of nursing management.