Nursing Management 1

1
Module LBNS 3407

NURSING
MANAGEMENT 1
BSc (Hons) in Nursing

Post Registration
Year 2, Semester 1
LBNS 3407 Nursing Management 1
TABLE OF CONTENTS
Introduction to the Module..2
Module Learning Outcomes ......4
Topics of the Module ...5
Brief Contents of the Module ...................7
Assessment of the Module27
Assessment Guidelines.28
Formative Assessment..........28
Summative Assessment........32
Marking Criteria ..........34
Directed Study Activities .....37
Activity 1: Management presentation.37
Activity 2: Writing a assignment..39
Group Work Sessions40
Session 1: Managerial skills and leadership41
Session 2: Problem-based learning42
References.42
Bibliography..44
Introduction to the Module

This is a seven credit module. The module includes group presentations, group
assignments, lectures, tutorials, practical and independent learning.
This module aims to facilitate nurses to develop managerial skills and apply them
with creative and analytical thinking in managing their wards, as well as using them
to motivate others. The module also aims to prepare the learner to fulfill the
professional practice roles and responsibilities in the practice setting. This includes
concepts of management and leadership, interagency and multi-disciplinary team
working, teaching and facilitating others and lifelong learning to maintain and
develop contemporary skills.
The responsibilities and the skills of qualified nurses, to function as an effective

nurse manager include:
Using leadership skills

Communication skills used when working
Using organizational theories, functions and culture
Critical thinking, self-directed learning in using the managerial skills
This module provides the learners with the basic concepts and principles of
leadership and management in a progressive health care system that fosters a
positive, creative and caring environment. It prepares nurses for assuming
leadership and management roles as first line managers within the social, legal
and economical context of health care system in general and the national health
care system in particular. Theories, processes, tools, and responsibilities of team
leaders will be explored along with their effective application in the clinical setting.
At the end of the module, you will be able to report findings independently and
share them with your other colleagues at a high learning level.
The module activities are directly related to the completion of the module
assignment and the output from the activities will form both the formative and
summative elements.
module leader.
The theory will require a face-to-face contact with the
Module Learning Outcomes
At the end of this module, students should be able to:

1. Discuss the structures and functions of organizations.
2. Discuss various strategies managers use to coordinate materials
and human resources for the accomplishment of organizational
goals.
3. Discuss the role of communication in leadership.
4. Discuss various theories in relation to leadership and management.
5. Discuss types of decision making and communication management.
6. Discuss the importance of budget.
7. Discuss the importance of performance appraisal.
8. Discuss the importance of good team work, depending greatly on
the leadership of the manager.
Topics of the Module

Table 1 below outlines the topic and highlights the subject matter which you need to
learn in order to help you with your written assignments.
ORGANIZATIONAL THEORIES, STRUCTURE, CULTURE AND
FUNCTIONS
TOPIC 1
Various theories of management
Various types of organizational structures
Different levels of management
Formal and informal structures within the organization
Attributes of an effective manager
Management processes commonly used by nurses in

managerial roles
The concepts of strategic planning
LEADERSHIP THEORIES AND STYLES
TOPIC 2
Leadership theories
The styles of Leadership
Types of power used by a leader
The roles of manager & leader
Ways to become a more effective leader
Politics, power, and policy
Different sources of power
The political strategies
HUMAN RESOURCE MANAGEMENT
TOPIC 3
Staffing and scheduling
Staff development
Purpose of performance appraisal
Process of performance appraisal
Components, methods and types of evaluation
RESOURCE AND FINANCIAL MANAGEMENT
TOPIC 4
Budget
Purpose of budgets
Different types of budget
Importance of budget for nurses
Elements of preparing, controlling and monitoring budget
COMMUNICATION IN MANAGEMENT
TOPIC 5
Basic principles of communication
Formal and informal channels of communication in organizations
Factors influencing communication
Role of communication in leadership
CHANGE MANAGEMENT
TOPIC 6
Categories and types of change
Techniques for dealing with resistance
Reflection
PROBLEM SOLVING & DECISION MAKING
TOPIC 7
Stages of problem solving
Types of decision making
Critical thinking in decision making
Models used for decision making
Brief Contents of the Topics

Organizational structure
Organization consists of groups of people coming together for a common purpose.
An organization can be defined as a group of persons with specific responsibilities
who are acting together for the achievement of a specific purpose determined by
the organization (Huber, 2000). Nursing is an integral and major components of the
healthcare organization, with nursing being the largest group of employees within
the healthcare setting. It is essential that nurses know their organization, the
structures within which they function, and be able to relate this to their individual
clinical unit. There are few organizational theories that nurses need to explore in
order to understand the functionality of organizational structures.
(i) Classical theory

The concept of classical theory was the people of an organization will be productive
if they are given a well-defined task to complete. By dividing work into tasks and
requesting employees to complete the same task every day, the theory proposed
that productivity would increase because of the repetition of the task. Results of this
theory have come to be known as the classical principles of organizational design.
It consists of the following components:
Organizational structure
It concerns the arrangement of the work groups within the organization and is
intended to support the organizations survival and success.
Division and specialization of labor
It refers to the work of the organization be divided into tasks and employees be
assigned a specific task to complete.
Chain of command
It refers to the formal line of authority and responsibility within the organization.
Span of control
It refers to the number of employees who report to a manager or a supervisor.
(ii)
Neoclassical theory (humanistic theory)
This theory placed emphasis on cooperation and participation in the workplace

(Sullivan & Decker, 2001). The key factor in this theory is motivation. A motivated
employee will produce better output in the job setting. For example, if employees
are given satisfactory working conditions and have opportunities to socialize with
other employees, job satisfaction will improve and the employee will be more
motivated.
(iii) Systems theory

This theory asserts that systems are a whole and that organizations should be
viewed as a whole, considering the relationships within the structure of the
organization. A system is a complex mix of intertwined elements and work in cycles.
It includes:
Inputs the items being put into the organization to create the product e.g.
resources (employees, patients, materials, money, equipment, etc) imported
from the environment.
Throughputs the processes put into place to assist with the creation of the
outputs e.g. work within the organization (transforms energy and resources to
yield a product).
Outputs e.g. product that exported to the environment.
(iv) Chaos theory

This theory stresses the importance of change within organizations. Change is the
stimulation of the organization and it is constant in healthcare today. Leaders must
constantly assess the organizational environment and determine whether there is
consistency within the structure. Organizational leaders working under this theory
will excel with change and creativity (McGuire, 1999).
(v)
Contingency theory
The concept within this theory is that the organizations structure must match the
working of the environment. The most common aspect of the theory is recognizing
the style of the leader and how this influences the situation. There is no one
leadership style that fits every situation. A good leader will learn how to adapt to
each situation to support the desired outcomes. The organizational structure based
on this theory is flexible and varies based on the needs of the organization and the
leader.
Types of organizational structure

Healthcare providers should be familiar with the types of structure used within their
organization. The structure affects communication patterns, relationships, and
authority within the healthcare setting (Marquis & Huston, 2012). There are few
organizational structures discussed below:
Bureaucracy
The bureaucracy structure, also known as tall or centralized structure, is a
hierarchical structure. Decision making and power are held by a few people
within the top level. Each person who has some power and authority is
responsible for only a few people. There are many layers of departments, and
communication tends to be slow as it travels through this type of a system.
Flat/decentralized structure
The decentralized structure is flat in nature and organizational power is spread
out throughout the structure. There are few layers in the reporting structure, and
managers have a broad span of control. Communication patters are simplifies,
and problems tend to be addressed with ease and efficiency at the level which
they occur. Employees have autonomy and increased job satisfaction within this
type of structure.
Ad hoc / Adhocracy structure
The adhocracy structure of organization is an open, free-form system. This
system has resulted from behavioural research based on job satisfaction and
efficiency. This type of structure is used with specialized teams to complete a
specific task.
Matrix structure
It is a combination of two structures which consisting of the product (output) and
the function that linked into one structure. The structure works to balance the
function and serve the organization into one operational outcome. This structure
implements the use of resources efficiently.
Strategic planning
Strategic planning is a step-by-step process that delineates ongoing group activity.
It is a management tool that helps organizations set long-term goals. It assures that
the individuals working for the organization work together to accomplish set goals
and objectives. The way a strategic plan is developed depends on the nature of the
organizations
leadership,
culture
of
the
organization,
complexity
of
the
organizations environment, size, and the expertise of the planners. The steps for
strategic planning process are:-
Step 1: Assessment of the environment

At any level, the assessment conducted is both external and internal. The external
assessment should include the competition for services in the community. For
internal environment, strategic planners must identify a variety of systems within the
organization e.g. patient care standards, financial resources, information systems,
etc.
Step 2: Mission and vision statement
Mission statements identify why the organization exist and encapsulate the
overriding purpose of the organization. For vision statements, it identifies the future
of the organization and provides the ultimate level the organization aims for.
Step 3: Goal setting
Strategic plan goals are institutional goals that use to oversee the organizations
activities and to conduct environmental assessments.
Step 4: Objectives
Objectives are descriptions of performance or activities. They are statements that
make goals more specific and measurable and give managers the ability to
evaluate goal achievement.
Step 5: Strategies
Strategies are series of actions or behaviours that assist planners in achieving the
objectives. Well-planned strategies provide specific directions to achieve objectives
and link to intended outcomes.
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Step 6: Implementation
All the strategies planned are carried out in this phase and the success in the
implementation of the strategies depends on the involvement of managers who
must monitor all the activities to ensure accomplishment of the objectives.
Step 7: Outcomes
Outcomes are the result that you plan to accomplish. It must be realistic and
achievable. Outcomes help to reflect the effectiveness in meeting the expectations
of the planners.
Step 8: Evaluation
The evaluation determines the organizations progress towards attaining the
identified outcomes. How did the organization respond to the implementation of the
plan? How was productivity achieved? The evaluation is compare outcomes or
results with the objectives.
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Nursing leadership theories and styles

Effective and successful leadership from nurses is crucial to the delivery of high
quality healthcare. There are five identified styles of leadership which are listed and
discussed below.
1. Servant leadership
This term is used to describe leaders who influence and motivate others by building
relationships and developing the skills of individual team members. A servant leader
makes sure the needs of the individual team members are addressed. In this style
of management, the entire team has input into decision making based on the
organizations values and ideals. The characteristic skills of a servant leader
include:
Listening
Foresight
Acceptance
Commitment to the growth of others
Awareness
Building community
Persuasion
2. Transformational leadership
It is based on building relationships and motivating staff members through a shared
vision and mission. Typically leaders have charisma to communicate vision and
confidence to act in a way that inspires others. They also have staff respect and
loyalty by letting the team know they are important, and are masters at helping
people do things by giving encouragement and praise.
3. Democratic leadership
Democratic leader encourages open communication and staff participation in
decisions. Workers are given responsibility, accountability and feedback regarding
their performances. Meanwhile, relationships are important to leader who places a
focus on quality improvement of systems and processes, rather than on mistakes of
individual team members.
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4. Autocratic leadership
This leadership is demonstrated when a leader makes all decision without
considering input from staff. Negative reinforcement and punishment are often used
to enforce rules. Mistakes are not tolerated and blame is placed on individuals
rather than on faulty processes. The positive side of this style is that it works
perfectly in emergencies or chaotic situations where there is little time for
discussion. It is useful when enforcing policies and procedures that protect resident
health and safety.
5. Laissez-faire leadership
It is a style in which the leader provides little or no direction or supervision, and
prefers to take a hands-off approach. Decisions are not made, changes rarely occur
and quality improvement is typically reactive, not proactive. It is often used by new,
inexperienced leaders or by those at the end of their careers who choose not to
address issues.
Therefore, as a nurse leader, it may be necessary to adopt characteristics from a

variety of leadership styles based on the situation. Regardless of the leadership
activity needed, it is important to act with integrity, set realistic goals, communicate
clearly and encourage and inspire others to provide the best of care.
Nursing management
Day-to-day management of services, resources and staff is the bread and butter of
healthcare workers, but this is rarely acknowledged, even by staff. Even though
management skills are valued less than leadership and clinical skills, excellence in
healthcare is needed in both management and leadership components. Nurse
management is pertinent to the nursing field, which deals with the management of
nurses and patients, or both. An efficient nursing manager is able to carry out the
given responsibilities within the given or prescribed timelines with the help of
allotted resources, both financial and personnel, in order to meeting the goals and
objectives of the organization. Rowland and Rowland (1997) defined management
as a five steps process:
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Planning
Organizing
Directing
Coordinating
Controlling
A few major problems in management are listed below:
Shortage of nurses and well-educated nurse managers
Limited participation of nurses in planning and policy making
Lack of recognition
Poor working condition
Inadequate information systems
Little inter-professional collaboration and teamwork
Lack of supportive legislation
Management for nurses

A nurse manager has many varied formal and informal roles which involve team
building, decision making, communication, negotiation, delegation and mentorship.
1. Team builder
A nurse must be able to build a strong team in order to lead and manage effectively.
New management strategies emphasize the importance of self-organizing teams
and the value of group activities. Each individuals participation as a team member
is a requirement. Managers must communicate to all team members their belief in
the ability of the team to work well together. The objective is to help the concerned
individuals assess their own contributions to the team and their expectations of
other team members. It also serves the purpose of empowering each team member
to contribute fully.
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2. Decision makers
Participative and transformational leaders enter into relationships with the
professionals in their organization. They share information, discuss values and
collaborate on decisions. The self-esteem of team members correlates with
involvement with decision making. A wise leader negotiates for the time to make a
well-informed decision and thus avoids the frustration and time associated with
negative outcomes of hasty decision making.
3. Communicator
Personal face-to-face communication is optimal. Managers must make every effort
to stagger their hours in the organization to allow communication on a regular basis.
Both formal and informal communication is important. Managers who make time for
informal communication will have a more accurate understanding of the issues with
which the knowledge workers are dealing; will develop more open, trusting
relationship within the organization; as well as a greater understanding of factors
affecting morale.
4. Negotiator
The first rule of negotiation is to understand the positions of the stakeholders,
including nurses, patients, interdisciplinary professional, community members,
families of patients, unlicensed assistive personnel and administration. The nurse
manager must exhibit excellent negotiation skills. These skills are important in
helping a team arrive at decisions, gaining organizational support for a new plan,
gaining the cooperation of another department or organization, and in many other
facets of the managers role.
5. Delegator
The leader will recognize the wisdom of members of the healthcare team and
support the interconnectedness of team members in the healthcare delivery
system. The manager will foster an environment that supports the notion of
associates (i) being partners in the delivery of health care, (ii) being accountable for
evaluating the outcomes of their interventions, (iii) having the equity in the
organization to make point of service delivery decisions and (iv) feeling a sense of
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ownership in the organization (Wilson & Porter-OGrady, 1999).
6. Mentor
Mentoring relationships can be formal (assigned through an organization) or
informal (simply a handshake agreement between a seasoned leader and an
aspiring one). Mutual respect, goal setting, accountability to each other, and open
dialogue are hallmarks of an effective mentoring relationship. All nurses must have
a responsibility to mentor new members of the profession. The mentoring
relationship must be mutually rewarding and it must involve the opportunity for real
work and stimulating challenges.
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Staffing and scheduling

Staffing
Staffing, according to the Center for American Nurses (The American Nurse, 2006),
refers to job assignments. Job assignments include the following: the volume of
work assigned to individuals, the professional skills required for particular job
assignments, the duration of experience in a particular job category, and work
schedules.
The staffing process is the linear incorporation of the staffing plan, the scheduling
and staffing system, and the scheduling outcomes into a systematic flowing
process. The staffing plan consists of four different elements that must be
addressed.
Healthcare setting
Healthcare facility will determine the accessibility of the nursing staff to the
patient, which has ramifications regarding the work allocation and provision of
the patient care services.
Care delivery model
It composes of four main components: patient needs, patient population
demographics, number of nursing staff numbers; and ratio of nurses serving
various roles and levels.
Patient acuity
It refers to patients being assigned locations in a hospital based on a acuity
system and /or admitting diagnosis.
Nursing staff
The work activity of the nursing staff includes direct care, indirect care, unitrelated, personal time and documentation.
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Scheduling
Once the variables of healthcare setting, care delivery models, patient acuity, and
nursing staff have been determined, the staffing process continues into the
development of the schedule. Scheduling is defined as the process of making the
personnel work assignments for a specific period. Generally, nursing schedules are
communicated to the staff in a manual format or by computer.
Scheduling and staffing models can be centralized, decentralized, or mixed.

Centralized
It is a system whereby a master plan is developed as the top level of the
organization in a centralized location, frequently the central nursing office. This
system offers the opportunity to oversee the entire organizations nursing
services activities.
Decentralized
It is a unit based plan with corresponding schedules managed by the unit nurse
manager.
Mixed
It combines centralized and decentralized to offer a comprehensive overview of
a facility while offering individualization for unit and staff members.
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Financial Management
Budget is a plan that uses numerical data to predict the activities of an organization
over a period of time, and it provides a mechanism for planning and control, as well
as for promoting each units needs and contributions (Carruth, Carruth & Noto,
2000). The objectives of the budget process are:
To provide a written expression, in quantitative terms, of the plans of the
organization.
To provide a basis to evaluate financial performance in relation to the plans of
the organization.
To provide a tool to measure fiscal and outcome compliance with the stated
plan.
To create a sensitivity and heightened awareness of costs relative to resources
used.
Steps in the budget process

Nurses have been expertly educated to use the nursing process. The same type of
process is the most widely used approach to preparing a budget.
1. Assessment
To assess the department and determine what needs to be covered in the
budget to meet the organizations goals, e.g. the nurse manager assesses the
needs of the area for which the budget is being created.
2. Planning
The length of time of the budget must be planned and determined. This time
frame is the budget cycle, e.g. the nurse manager begins the planning process
by reviewing past budget history to determine average supply costs and the
number of patient days or the average daily census for the unit.
3. Implementation
During the implementation phase, the nurse manager must be actively involved
in monitoring and analyzing budget activity to remain within the budgeted
parameters and to avoid inadequate or excess funds at the end of the budget
period.
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4. Evaluation
After the implementation phase, the budget should be reviewed regularly to
determine the level of adherence to the budgeted figures.
Types of budget
i. Operating budget
It is a combination of the revenue and expense budget. It is a forecast of the
revenue that is expected to be earned during the defined budget period and
the expenses incurred to earn the revenue during the same period. The
personnel costs are a significant part of this budget e.g. organizations daily
operating revenue and expenses.
ii. Program budget
It contains all the items that are cost in a particular care delivery program. This
type of budgeting is frequently completed for new programs and expansion of
existing programs of care or services.
iii. Capital budget
It summarizes the anticipated purchases for the fiscal year and usually has a
dollar minimum cost to be included.
iv. Cash budget
The cash budget predicts expected revenues and payments for resource or
cash outflow, e.g. cash outflow is the payment of salaries for work performed.
v. Supply budget
It predicts the use of medical-surgical supply costs based on predicted case
mix of patients for the upcoming fiscal year, e.g. expenses of all supplies that
are utilized on the nursing unit to provide patient care.
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Communication in Management
Effective communication is essential to the well-being of an organization.
Communication is critical to the strategic planning process of any organization, and
it is crucial for attainment of short and long-term organization goals. Good
communication is pivotal to the day-to-day operation of any organization, affecting
patient safety and quality care employee satisfaction, and customer relations and
satisfaction.
Types of organizational communication

Organizational
communication
includes
verbal
and
nonverbal
means
of
communication throughout the organization. Large and complex organizations use

a variety of channels of communication including vertical, horizontal, diagonal and
the grapevine (Marquis and Huston, 2003).
Verbal communication
Both face-to-face and written messages constitute verbal communication. Marquis
and Huston (2003) observe that face-to-face communication is rapid but that fewer
people may receive the information. For example, nurse managers communicate
face-to-face in a variety of formats, including formal meetings, presentations and
work groups.
For written messages, including e-mail, then provide documentation of the message
but may be misinterpreted by the recipients and are time consuming for managers.
People will likely interpret written messages from their own perspectives,
experiences and position in the organization. Therefore, efficient and effective
writing skills are important for nurse managers.
Non-verbal communication
Communication is commonly considered a process, with words as symbols and
language representing a code. Nonverbal communication includes appearance,
tone of voice, gestures, body movements, glances, facial expressions, dress, smell,
proximity and gait. Managers and employees should be aware of their nonverbal
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behaviour and recognize its impact on all communication. Both managers and
employees should monitor their nonverbal behaviours. They may also find it useful
to seek feedback from others to determine if their nonverbal behaviours are
consistent with their verbal message and to determine the impact of their nonverbal
behaviour on the overall impression generated by their communication.
Vertical communication
Vertical communication occurs between superiors and subordinates. It concludes
downward communication and upward communication. Downward communication
is the information sent by supervisors and subordinates. It reflects the hierarchical
structure of the organization and occurs in a variety of ways depending on the
content of the message. Upward communication occurs when employees or
managers who are subordinate to top level management send messages up
through the chain of command. Each employee is expected to respect the chain of
command and submit the communication to an immediate manager.
Horizontal communication
It occurs when managers and others communicate with people on the same level in
the organizational structure, e.g. staff nurses communicate with other staff nurses.
Effective horizontal communication can facilitate coordination between departments
as well as problem solving and decision making.
Diagonal communication
Managers interact with managers, physicians and groups of people in other
departments in the organization who are not on the same level in the hierarchy. This
type of interaction is important to the functioning of the organization and usually
does not occur through formal means.
Grapevine
It is a common vehicle for informal communication in organizations. The grapevine
is the informal and unsanctioned information network within every organization. It is
essentially the rumour mill in an organization. Word is spread from one person to
another outside the formal communication network.
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Change Management
Change is an integral part of any organization, and the process can be
uncomfortable and disturbing to those who are affected. Change means to be
different, to cause to be different or to alter. It may be personal or organizational
and can occur suddenly or incrementally. Unplanned change or reactive change
usually occurs suddenly and in response to some event or set of circumstances.
Change may be initiated in response to internal or external forces. Internal forces

stem from within the organization and it includes organization values and beliefs,
culture and past experiences with change. External forces come from outside the
organization and these can be social influences, economic factors or legislation.
Another factor essential to change is the presence of a change agent. A change
agent is one who generates ideas, introduces the innovation and works to bring
about the desired change (refer to table 2). In either case, the change agent is
responsible for moving those affected by the change through the process and
implementing the change. Their success depends on communication and
consultation style, interpersonal skills and expert power.
Table 2
Roles of the change agent
Visioner
Facilitator
Idea person
Communicator
Challenger
Problem solver
Advisor
Advocate
Objective observer
Coach
Educator
Resource linker
Provider of feedback
Empowerer
Problem finder
(Adapted from Nursing Leadership and Management: theories, processes and practice.
Patronis Jones, 2007)
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Barriers to change
All changes have the potential for both gain and loss. It is important to identify all
the potential barriers to change, to examine them contextually with those affected
by the proposed change, and to develop strategies collectively to reduce or remove
the barriers. Barriers most common to change within the health-care environment
are discussed below.
Desire to remain in the comfort zone
Inadequate access to the information
Lack of shared vision
Lack of adequate planning
Lack of trust
Resistance to change
Poor timing or inadequate time planned
Fear that power, relationships or control will be lost
Practical guide reflection

There are several practical steps you can take to increase your chance for success.
1. Begin by articulating the change vision clearly and concisely.
2. Select the change project team carefully.
3. Identify the formal and informal leaders who can help you implement the change
successfully.
4. Stay alert to political forces, both for and against the change.
5. Develop communication skills. Keep communication lines open.
6. Practice problem-solving skills.
7. Develop conflict resolution skills.
8. Learn to trust yourself and your project team.
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Problem Solving and Decision Making

Critical thinking
Critical thinking is the process that guides scientific reasoning, the nursing process,
problem solving and decision making. The cognitive skills attributed to the critical
thinking process include divergent thinking, reasoning, reflection, creativity,
clarification and basic support (Green, 2000).
Divergent thinking is the ability of an individual to analyze a variety of opinions

and judgments.
Reasoning involves the use of logic and the ability to discriminate between
observation and inference, fact and guessing.
Reflection allows one to deliberate about something, whereas creativity enables
one to produce ideas and alternatives and consider multiple solutions.
Clarification includes identifying similarities, differences and assumptions and
defining terms.
Basic support involves the use of known facts and background knowledge.
Model used for decision making

Decision making is a complex and abstract process. Individuals may have many
different ways of thinking about it. A discussion of various decision making models
can be helpful in explaining and understanding this phenomenon.
Information processing model
In this model, decision making is seen on a continuum and not as an either/or
process (Thompson, 1999). This model consists of two components: short and
long term memory. Short term memory contains the stimuli information
necessary to unlock factual and experimental knowledge that is stored in the
long term memory. The clinician uses a four stage process to make decisions in
this theory:
Gather clinical patient data.
Generate hypotheses or predictions about the issue.
Interpret the data and confirm or refute the hypotheses.
Weigh the pros and cons of each decision alternative.
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Wheelers model
Wheeler (2000) suggests that having choices and knowing the context in which
choices are made are the most important elements of proactive decision
making. Being proactive allow the anticipation of an event and allows one to
generate actions before the event.
Nursing process
Using the nursing process as a guide, the decision making process started by
collecting data and assessing the situation. Leaders make their most successful
decisions when they assess the strengths and weaknesses of the people and
environment.
Types of decision making

1. Routine decision
It can be used to respond to frequently occurring, common, and reasonably welldefined issues. Policies, procedures and established rules can be used to guide
the decision making process. The level of personnel that makes routine
decisions can range from the staff nurse to top administrators.
2. Innovative decision
These decisions are made when the situation or problem is unusual and the
rules and guidelines do not clearly define or dictate a course of action. Nurses
from the bedside to top administration, need to make these kinds of decisions
frequently.
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Assessment of the Module

Completion of both formative and summative pieces of work is required for this
module.
Formative
Formative assessment involves a group presentation and mid-term test.
Summative
The summative assessment requires a written essay as an individual assignment
submitted via LUC learning system.
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Assessment Guidelines
These guidelines are to assist you in developing your work and to enable you to
reflect on what you should be doing. The formative assessment is based on group
presentation and mid-term test; while summative assessment is based on the
individual assignments study, which includes coverage of the module transferable
skills. The important outcome for this module is the completion of the module
learning outcomes. It is important that you demonstrate your understanding of a
range of relevant theories in nursing science, health science and behavioural
science.
Formative Assessment
Guidelines for developing group presentation
Group presentation is a daunting and anxiety-ridden task that is carried out in a
large or small group. Thus, you are going to present to a group of people, who may
be your colleagues or module leaders. The word, nuance, the appearance, the tone
of the voice are all important. The presentations must be well layout and the
presentations should cover the topic that has been given. For example, there can
be presentations on the roles of managers in managing the ward, how they use
leadership in their daily work and how they can communicate with other peers and
create good communications with others. The guidelines should include:-
Stages in planning a presentation

1. Preparations
The students should design their presentations according to the following
presentations:
Objectives
Audience
Venue
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2. Objectives
There should be clear objectives on why the presentations are done and how they
are going to achieve in the presentations. There should be strategic decisions about
the design and the tone of the presentations. Once the objectives have been
developed, there should be balanced arguments where creative approaches have
been looked into:
What do you want your audience to understand?
What actions do you want your audience to take following your presentation?
How can you best design your presentation to meet your objectives?
3. Audience
Students must know who their audiences are, as they have different experiences,
interest and levels of knowledge. The students should always look into what the
audiences already know about the topics and whether there are new materials to
things they might already understand. Students should avoid technical jargons and
explain abstract concepts with clear practical examples.
4. Venue
There should be a venue on where the presentations will be done. A large lecture
theatre might create a formal atmosphere. Students must be able to create the
atmosphere and must know what the visual aids they want to use.
5. Main points
Students should design the presentations and the main points should be defined.
Students should not present more than three main points in ten minutes during
presentations. Students must allow time for adequate introduction and conclusion.
A powerful presentation delivers information in a logical, structured manner,
building on the previous point and avoiding large jumps in sequence. The student
should consider the following points:What are the main points that the students wish to make?
Are the points structured in a logical coherent way?
Do the main points reflect the objectives and take account of the needs of the
audience?
29
6. Choosing the supporting information

The supporting information helps the audience understand, believe in and agree
with the main points. This evidence might take the form of factual data, points of
detail or an explanation of process. It might be presented in imaginative ways using
diagrams, pictures or video segments.
7. Establishing linking statements

The next stage is to develop the linear flow with the presentation. This can be
achieved by using linking statements to show clearly how your main points fit
together. Common linking statements include:
The next stage in our project is to ;
Another important issue of consideration is ;
By following this argument we can now see that .
Linking statements send signals to the audience, highlighting the next point in the
argument, linking to earlier ideas or clarifying the stage the presentations have
reached in the argument overall. This may be of particular importance in a lengthy
presentation where even the most effective presenter has to work hard to keep an
audience involved.
8. Developing an opening
The introduction to the presentation is crucial. It is your first point of contact with the
audience. Students can either capture or lose their audiences interest in a matter of
seconds. Use your introduction to lay a clear foundation for the presentation to
follow. Students should follow the below guidelines when developing the opening:
Introduction
State what the subject is (a title or subject area);
State how this will done (e.g. by comparing test results or reviewing the
supporting literature);
State what is good of the presentation (an informed group, a lively discussion);
30
9. Developing a conclusion
The conclusion is another important stage in the presentation. The following
structure provides a powerful conclusion:
A review of the title or subject area
In this presentation I wanted to explore the relationship between X and Y.;
A summary of the main points
We have discussed the following points;
A summary of the process you have been gone through
By looking at X we have found that Y ;
A conclusion clearly drawn from the main points (this must be supported by the
detail of the presentation)
It is clear that there can be no substantive relationship between X and Y;
A parting statement to stimulate your audiences thoughts (this might be a
question or a bold comment).
10. Reviewing your presentation

Students should have written presentations that make sure the review of the
contents took place. Students should review whether the presentations have met
the objectives, were logically structured and whether the presentation was too long
or too short.
31
Summative Assessment
Guidelines for developing an individual written assignment
Students are expected to do a wide reading of academic and professional literature

to develop your understanding of aspects of the syllabus. The written assignment
should include the following:
Show evidence of wide ranging, current reading of appropriate materials.
Follow a logical process in presenting a case, supported by evidence
Demonstrate critical reflection on theory and practice
Express ideas clearly and fluently, using an easy to read style
Use the APA system of referencing to indicate reading and acknowledge
sources properly.
Students should present a brief introduction to the topic, the appropriateness for
study, determine the focus of investigation and review existing knowledge including
published literature from all relevant areas.
Students must demonstrate
understanding of the topic.
Writing style
All assignments should be written in accurate, easily understood language. Plain
English should be used, but the work should not be informal. Slang and
colloquialisms should be avoided. Any abbreviations or contractions should be
clarified. The reader should always be able to understand what is being
communicated, particularly when persuasive arguments are made.
A confident style of writing demonstrates understanding and knowledge. You

should not lecture or criticize the reader and avoid asking questions where it is
better to demonstrate understanding.
Accurate grammar, spelling and use of language are all important elements of
writing.
All work should be clearly structured so that the content and flow of ideas are
apparent.
32
Sub headings and other presentational devices may be used where appropriate
to clarify the structure.
Students should proof read every assignment very carefully before handing it in.
Grammatical, typographical and spelling errors will be penalized. A spell
checker can be useful when word processing work, but remember this will not
eliminate every problem, such as the correctly spelt word in the wrong context
(i.e., conservation instead of conversation) nor accidentally used plurals.
Make sure that the assignment is of the correct length (2,000 words). Marks will
be deducted if for under or excess of 10% word limit. Word count should be
included at the end of all assignments.
33
Marking Criteria
Table 1 below discusses the criteria for evaluating the group presentation.
Table 1: Marking criteria for group presentations

Criteria
Comments
Introduction of the subjects
Objectives are clearly stated and there are series of

bullet points.
Content
Contents adequacy and relevancy
Organizations of the content and refers back to the main

objectives.
Summary
Logical conclusion
Speaks clearly and communicates in a professional

manner
Presents an overview, logical sequence and summary of

presentation.
Presentation
and power point
The quality of teaching materials is professionally

presented with limited mistakes.
Generates
interest
and
group
discussion
understanding the needs of the audience.
Important ideas were presented clearly
Use of various audio visual to present the ideas
Keeps the presentation within the allocated time.
by
34
Group members demonstrate understanding of the

subjects
Group members work towards the goal.
Group members participate equally in presentations
Group members are confidence in presentation
Use of
Draws lines of databases, books and media
resources
Draws on a range of recent referred journal/books.
Teamwork
35
Table 2 below discusses the criteria for evaluating the written assignment.
Table 2: Marking criteria for group written assignments

Comments
Criteria
Introduction
Comments
State clearly the key issues and introduce the topic well
and clearly
Contents
Clear, concise and well structured
Use appropriate quotations
Original of ideas and expressions
Develops logical arguments and state clearly the relevant

ideas and evidence.
Flows of the assignments developed thoroughly

Organization of
Strong links between paragraphs and sentences making
the assignments
the text logical

Appropriate introduction, developments and conclusions
Style and
presentations
Use correct spelling, punctuation and capitalization

Correct and effective use of English
Legibility
Adequate and appropriate referencing
Text references match the reference in the reference list
Reference list using APA style
Formatting of
Include cover page
assignments
Proper heading, fonts and spacing
Includes page number
Appropriate use of appendix
Referencing
36
Directed Study Activities

This is divided into two activities. Students are required to do group presentations
and written assignments.
Activity one: Present a group presentation on management

This activity forms part of your directed study in general preparation for a career as
a nurse manager or curriculum developer for the nursing faculty.
You should work in a team and identify the topics that require evaluating, and
assessing the current knowledge, skills and attitude of learners. The topics must be
appropriate for the nursing service and updated either from your own experience or
from the set of case notes using a selected format of referencing.
The module leader will provide a format on the presentation of the group
presentation. The learner should include background information on events leading
up to the nursing service users and groups involved with care. The aim is to assess
the examinees with options on the use of management skills and treatment for your
chosen topics given.
Format for the activity one Group presentations
Content
Introduction of the subjects
Objectives are clearly stated and there are series of bullet points
Contents adequacy and relevancy
Organizations of the content and refers back to the main objectives
Summary
Logical conclusion
37
Presentation and power point

Speaks clearly and communicates in a professional manner.
Presents an overview, logical sequence and summary of presentation.
The quality of teaching materials is professionally presented with limited
mistakes.
Generates interest and group discussion by understanding the needs of the
audience.
Important ideas were presented clearly.
Use of various audio visual to present the idea.
Teamwork
Group members demonstrate understanding of the subjects.
Work towards the goal.
Participate equally in presentations.
Use of resources
Draw lines of databases, books and media.
Use of recent referred journal/books.
38
Activity two: Write an essay which related to the issues covered in

this module (small group).
Work independently. This activity forms part of your directed study in preparation
for your career as a nurse manager.
Format for the activity 2 writing an essay based in a group
Introduction
State clearly the key issues and introduce the topic well and clearly
Clear, concise and well structured
Contents
Use appropriate quotations
Original ideas and expressions
Develops logical arguments and state clearly the relevant ideas and evidence.
Organization of the work

Flows of the assignments developed thoroughly
Strong links between paragraphs and sentences making the text logical
Appropriate introduction, developments and conclusions
Style and presentations

Use correct spelling, punctuation and capitalization
Correct and effective use of English
Legibility
39
Group Work Sessions

(Note: This is not a graded work session)
Learning Outcomes
Demonstrate problem solving skills [solution and application] in relation to
practice settings.
Identify your own colleagues or classmates strengths and weaknesses and
verbalize it in group discussions
Purpose and output

The group work activities provide a supportive environment to share and discuss
plans together. You are asked to work in teams to help each other to solve
problems, as this is the norm in clinical practice. Team working is highly valued in
health-care settings and is a skill that employers seek in potential employees. The
output may come as a peer review but might include a better understanding of the
problems and potential solutions.
Problem solutions and applications

In this group work, you will explore solutions to the problems you identified as
weaknesses of your colleagues. However, most problems have multiple causes,
thus they overlap considerably.
Any attempt to solve the problem without first
accurately identifying its root cause is doomed to failure. Having proposed a cause
for the problem and a planned solution, the next step is to set out how you intend to
implement your outline and evaluate the outcome.
40
Group Work: Session one

Discuss on how to apply managerial skills and leadership in the practice settings.
Each of you, as a class, will state the strengths and weaknesses of the topic.
Briefly describe the topic with your group and decide what to do?
Describe what you have identified.
How can these skills be used in upgrading the managerial and leadership skills
in your practice?
Other group members, classmates or colleagues will contribute through discussion

of the problems and sharing their experiences of the problem in clinical practice.
Group Work: Session two

Discuss how to develop a problem-based learning this is done within classmates
of the same group.
Each student will present his or her proposed solution(s) for the weaknesses and
strengths of the topic that have been discussed. You should start to think about what
you might address to help the individual in their future career.
Group members will contribute through discussion of your proposed explanations

and sharing of similar experiences.
41
References
Carruth, A.K., Carruth, P.J., & Noto, E.C. (2000). Nurse managers flex their
budgetary might. Nursing Management, 31(2),1617.
Green, C. (2000). Critical thinking in nursing, Upper Saddle River, NJ: Prentice Hall
Health.
Huber, D. (2000). Leadership and nursing care management (2nd ed.). Philadelphia:
W.B. Saunders.
Marquis, B. L. & Huston, C. S. (2012). Leadership roles and management functions

in nursing: Theory & application (7th ed.). Philadelphia, PA: Lippincott Williams
& Wilkins.
Marquis, B.L., & Huston, C.J. (2003). Leadership roles and management functions
in nursing. Philadelphia: Lippincott Williams & Wilkins.
McGuire, E. (1999). Chaos theory: Learning a new science. Journal of Nursing

Administration, 29(2), 89.
Patronis Jones, R.A. (2007). Nursing leadership and management: theories,

processes and practice. F.A. Davis company: Philadelphia.
Rowland, H.S., & Rowland, B.L. (1997). Nursing administration handbook (4th ed.).
Gaithersburg, MD: Aspen Publications,Inc.
Sullivan, E, & Decker, P. (2001). Effective leadership and management in nursing.

Upper Saddle River, NJ: Prentice Hall.
The American Nurse (2006). A change will do you good. The American Nurse,
38(1), 9.
42
Thompson, C. (1999). A conceptual treadmill: The need for middle ground in

clinical decision making theory in nursing. Journal of Advance Nursing, 30,
12221229.
Wheeler, R. (2000). Being proactive, not reactive. In Fay L. Bower (Ed.) Nurses
taking the lead: Personal qualities of effective leadership. Philadelphia: W.B.
Saunders.
Wilson, C.K., & Porter-OGrady, T. (1999). Leading the revolution in health care
(2nd ed.). Gaithersburg, MD: Aspen Publishers, Inc.
43
Bibliography
Huber, D. (2000). Leadership and nursing care management (2nd ed.). Philadelphia:
W.B. Saunders.
Marquis, B. L. & Huston, C. S. (2012). Leadership roles and management functions

in nursing: Theory & application (7th ed.). Philadelphia, PA: Lippincott Williams
& Wilkins
Patronis Jones, R.A. (2007). Nursing leadership and management: theories,

processes and practice. F.A. Davis company: Philadelphia.
Sullivan, E, & Decker, P. (2001). Effective leadership and management in nursing.

Upper Saddle River, NJ: Prentice Hall.
44

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1

Module LBNS 3407

BSc (Hons) in Nursing

LBNS 3407 Nursing Management 1

LBNS 3407 Nursing Management 1

Introduction to the Module

The responsibilities and the skills of qualified nurses, to function as an effective

Using leadership skills

LBNS 3407 Nursing Management 1

The theory will require a face-to-face contact with the

LBNS 3407 Nursing Management 1

Module Learning Outcomes

At the end of this module, students should be able to:

LBNS 3407 Nursing Management 1

Topics of the Module

Various theories of management

Various types of organizational structures

Different levels of management

Formal and informal structures within the organization

Attributes of an effective manager

Management processes commonly used by nurses in

The concepts of strategic planning

LEADERSHIP THEORIES AND STYLES

The styles of Leadership

Types of power used by a leader

The roles of manager & leader

Ways to become a more effective leader

Politics, power, and policy

Different sources of power

The political strategies

HUMAN RESOURCE MANAGEMENT

Staffing and scheduling

Purpose of performance appraisal

Process of performance appraisal

Components, methods and types of evaluation

LBNS 3407 Nursing Management 1

RESOURCE AND FINANCIAL MANAGEMENT

Different types of budget

Importance of budget for nurses

Elements of preparing, controlling and monitoring budget

Basic principles of communication

Formal and informal channels of communication in organizations

Factors influencing communication

Role of communication in leadership

Categories and types of change

Techniques for dealing with resistance

PROBLEM SOLVING & DECISION MAKING

Stages of problem solving

Types of decision making

Critical thinking in decision making

Models used for decision making

LBNS 3407 Nursing Management 1

Brief Contents of the Topics

(i) Classical theory

LBNS 3407 Nursing Management 1

Neoclassical theory (humanistic theory)

This theory placed emphasis on cooperation and participation in the workplace

(iii) Systems theory

(iv) Chaos theory

LBNS 3407 Nursing Management 1

Types of organizational structure

LBNS 3407 Nursing Management 1

Step 1: Assessment of the environment

LBNS 3407 Nursing Management 1