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INTRODUCTION TO NURSING SERVICE MANAGEMENT


Management is as old as human kind and existed since man has been organized in to communities. Managers influence all phases of our modern organizations. Our society simply could not exist as we know it today or improve its present status without a steady stream of managers to guide its organizations. Peter Drucker makes this same point in stating that effective management is quickly becoming the main resource of developed countries and the most needed resource of developing ones (1).
Essentially, the role of managers is to guide organizations toward goal accomplishment. All organizations exist for some purpose or objective, and mangers have the responsibility for combining and using organizational resources to ensure that the organizations achieve their purposes. Management moves organizations toward these purposes or goals by assigning activities that organization member perform. If these activities are designed effectively, the production of each individual worker represents a contribution to the attainment of organizational goals. Managers strive to encourage individual activity that will lead to reaching organizational goals and to discourage individual activity that hinders organizational goal accomplishment. Management has no meaning apart from its goals (2). Management must keep organizational goals clearly in mind at all times

Definition of management and nursing service administration
Definition of management
Different authorities define management differently but have strong unifying similarities in all the definitions. The term management can be used in several ways. For instance, it can simply refer to the process that managers follow to accomplish organizational goals. The term can be used, however, to refer to a body of knowledge. In this context, management is a cumulative body of information that furnishes insight on how to manage.
Management is the art of getting things done through people. It is the process of reaching organizational goals by working with and through people and other organizational resources. It is the process of planning, organizing, leading and controlling the work of organization members and of using all available organizational resources to reach stated organizational goals. It is the process of directing, coordinating and influencing the operation of an organization to obtain desired result and enhance total performance.

Nursing service administration
Nursing service administration is a coordinated activity, which provides all of the facilities necessary for the rendering of nursing service to clients.
Nursing service administration is the system of activities directed toward the nursing care of clients, and includes the establishment of over-all goals and policies within the aims of the health agency and provision of organization, personnel, and facilities to accomplish this goals in the most effective and economical manner through cooperative efforts of all members of the staff, coordinating the service with other departments of the institution
Nursing service administration is the marshaling of resources to accomplish a purpose.

It is both an art and a science. It is a science in the sense that one may systematically study and analyze the behavior of people as a collective endeavor and, even their individual behavior in relationship to their individual purposes and to draw generalizations from them that are valid guides to foresight and action. It is an art because it requires qualities of dynamic character to make them effective in application.
Nursing service administration is the process of planning, organizing, leading and controlling that encompasses human, material, financial and informational resources in an organizational environment to achieve the predetermined objectives.
Nursing service is the process composed of the set of interrelated social and technical functional activities occurring within a formal organizational setting to accomplish predetermined objectives through utilization of human and other resources.


The primary objective of the role of nursing service administration is the provision for continuous individual, group and community service, including whatever is necessary. In addressing the factors, which determine health, and to bring them back to self-directive activity towards their own health. The subsidiary objectives of this role are the professional activities of administration, including human relations, communications, teaching, research, and personal development, designed to further the primary objective-the optimum nursing care of patients. In this lecture note management and administration are used interchangeably.

Types of managers, managerial skill and roles
Nursing service managers are people who appointed to positions of authority, which enable others to perform their work effectively, who have responsibility for resource utilization and who are accountable for work results and can be proud of their organizations and what they do.

Types of managers
Traditionally classifications of managers are by level in the organizational hierarchy; common nomenclature is:

·        Top level–such as board of directors, Presidents and vice presidents
·        Middle level–such as directors of nursing, supervisory staffs and department heads

·        First line/front line/ or supervisory management– such as head nurses and staffs.

Regardless of level, managers have several common attributes; they are:

·        Formally appointed to positions of authority

·        Charged with directing and enabling others to do their work effectively
·        Responsible for utilizing resources

·        Accountable to superiors for results

The primary differences between levels of managers are the degree of authority and the scope of responsibility and organizational activity at each level. For example, top-level managers such as nursing administrators have authority over and responsibility for the entire organization. Middle level managers such as department heads and heads of services have authority over and responsibility for a specific segment, in contrast to the organization as a whole and act as a liaison between top-level managers and first level managers. First line managers, who generally report to middle level managers have authority over and are responsible for overseeing specific work for a particular group of works.

Managerial Skills
Managers can also be differentiated by the extent to which they use certain skills: conceptual, human relations and technical skills. All managers use human relation skills because they accomplish work through people. Human relations skills include motivation, leadership and communication skills. The degree to which each is used varies with the nature of the position, scope of responsibility, work activity, and number, types and skills of subordinates. Senior managers use disproportionately more conceptual skills in their jobs than do middle level or first line managers. These include recognizing and evaluating multiple complex issues and understanding their relationships, engaging in planning and problem solving that profoundly affect the health service organization, and thinking globally about the organization and its environment. In contrast first line managers tend to use job related technical skills, or skills that involve specialized knowledge.


Managerial roles
All health service managers engage in planning, organizing, staffing, directing, controlling, and decision making to some degree. In addition, they perform other activities related to accomplishing work and organizational objectives that do not readily fall within the functional classification. These roles are defined as the behavior or activities associated with a management position because of its authority and status. Mintzberg's classification identifies:
1.      Interpersonal

2.      Informational and

3.      Decisional roles

Interpersonal role

The three interpersonal roles are

ü  Figurehead: all managers, but especially senior managers, are figureheads because they engage in ceremonial and symbolic activities such as greeting visitors and making speeches at organizational events.
ü  Liaison: involves formal and informal internal and external contacts.
ü  Influencer: includes activities inherent in the directing function, the purpose of which is to motivate and lead.

Informational role

The three informational roles of a manager are

  •          Monitor
  •        Disseminator and
  •       Spokesperson



Decisional Roles

The four decisional roles of a manager are

ü  Entrepreneur

ü  Disturbance handler

ü  Resource allocator and

ü  Negotiator


Health care, health services and health service organizational models
Health care: is the total societal effort, organized or not, whether private or public, that attempts to guarantee, provide, and finance the promotion of health, prevention of diseases, and restoration of health and rehabilitation.
Health service: is the delivery of health care

Health service organizations: Deliveries of health services to clients occur in a variety of organizational settings. Health service organizations can be classified by ownership, profit motive, whether the client is admitted. Historically, hospitals and nursing facilities have been the most common and dominant health service organizations engaged in delivery of health services.

Health Service Organizational Model

Model

      Organizations are open systems

      Composed of inputs, throughput and output


The Benefit of good Management in Health Service organizations
  • High lights priority areas
  • Adopts the service to the needs of a changing situation
  •  Makes use of the most limited resources
  • Improves the standard and quality of services
  • Maintain high staff morale


Learning activities
  1. Briefly discuss management and nursing service administration
  2. List the three levels of management
  3. Discus the four common attributes of managers regardless of their level
  4. Describe the three management skills
  5. Explain the role of managers in an organization
  6. What is health care, health service and health service organization?
  7. Discuss the components of the health service model
  8. What is the benefit of good management for an organization?

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