Management is a universal process used in business, the practice of one’s profession, and even day-to-day personal affairs. It coordinates and supervises personnel (or the self) and available resources effectively and efficiently to accomplish organizational goals. Leadership (arguably a function of management) is the use of the self as an influencer (Leader) of a group to function together to achieve common goals and objectives.
Nursing Management
Management is an old French term meaning “the directing”. Along with the aforementioned definition, it is also used to design and maintain an internal environment in which people work together in groups that can perform effectively and efficiently towards the attainment of group goals. It may be used in running a business, in practicing one’s profession, and even day-to-day interactions.
Venson (2010)
Management is a process by which a cooperative group directs actions towards common goals, involving techniques with which a distinguished group of people coordinates the services of people. It also includes moral and ethical standards in the selection of right ends towards which managers should strive.
Harbinzon and Myers created a Three-Fold Concept to Emphasize the Broader Scope of Management:
- Economic Source: one of the factors of production, together with land, and capital. Industrialization increases, management is substituted by labor and capital. Management of a firm determines, to a large extent, its productivity and profitability.
- System of Authority: management first develops with top individuals determining the course of action for the rank and file. The constitutional management emphasizes definite and consistent concern for policies and procedures in dealing with the working group. A line towards a democratic and participative approach follows as employees receive higher education.
- Class and Status System: from a sociologist’s point of view, managers become an elite group of brains and education. This class is based on education and knowledge. Managers continue to expand their horizons in an effort to attain the ultimate in life or goal.
Theories of Management
Scientific Management Theory
Frederick W. Taylor, the “father of scientific management”, postulated that workers could be taught “one best way to accomplish a task”, and that productivity would increase. He called these principles scientific management. This theory employs four principles:
- Traditional “Rule of Thumb”: work organization must employ scientific methods. Workers must be given an adequate amount of time in accomplishing their task.
- Workers can be hired, trained, and promoted based on their competence and abilities.
- Employees are entitled to receiving financial rewards, and incentives for worked accomplishments because Taylor viewed humans as “economic animals” motivated solely by money.
- Maintain good interpersonal relationships between workers and managements. They should be cooperative and interdependent, with the work shared equally.
Taylor’s system of work improvement utilized the following steps:
- Controlled observation of the worker’s performance through time and motion studies
- Scientific selection of the best workers for each job, and training for the job task.
- Paying the worker to a differential rate
- Appointing a few of the most highly skilled workers as managers to plan and prepare the task of workers.
- Appointing foremen (supervisors) for each aspect of the work.
Gilbreth’s Job Simplification
Frank Gilbreth and Lillian Gilbreth (the “first lady of management”) were among the first to use motion-picture films to analyze worker’s motion. They emphasized the benefits of job simplification and the establishment of work standards, as well as the effects of the incentive wage plans and fatigue on work performance.
Gantt Charting
Created by Henry Gantt, a student of Taylor, a Gantt chart is a timeline for tracking aspects of a project. Gantt advocates for humanitarian management, and is concerned with problems of efficiency. He contributed to scientific management by refining previous work rather than introducing new topics.
Classical Organization Theories
Fayol’s Principles of Management and Management Process
Also read: Management Process Henry Fayol is known as the “father of the management process school”. He studied the functions of the managers and concluded that management is universal. There are fourteen principles of management:
- Division of work
- Authority and Responsibility
- Discipline
- Unity of Command
- Unity of Direction
- Subordination of Individual Interest to General Interest
- Remuneration of Personnel
- Balance of Centralization and Decentralization
- Scalar Chain/Chain of Command
- Order
- Equity
- Stability of Tenure of Personnel
- Initiative
- Esprit de Corps (Team Spirit)
The management process consists of:
- Planning: the determination of philosophy, goals, objectives, policies, procedures, and rules.
- Organizing: establishing the organizational structure to carry out plans, e.g. determining the most appropriate type of patient care delivery.
- Staffing: recruiting, interviewing, hiring, and orienting staff
- Directing: motivating, conflict resolution, delegating, communicating, and collaborating.
- Controlling: performance appraisals, fiscal accountability, quality control, legal and ethical control.
Max Weber’s Types of Authority
The father of organizational management. Webber conceptualized three types of authority:
- Traditional Authority: legitimacy based on long-standing cultural traditions e.g. monarchies.
- Charismatic Authority: authority produced as a by-product of extraordinary personality and charisma.
- Rational Authority: power based on legislature and established rules and regulations.
Lyndall Urwick’s Organizational Theory
She combined the theories of Taylor and Fayol to develop the classic organizational theory. She popularized the term “span of control and unity of command”
Human Relation Management
- Mary Parker Follett (1926) is one of the first theorists to suggest basic principles of what today would be called participative decision making or participative management. She believed that managers should have authority with one another, rather than over employees. She postulates that this leads to better solution-finding and greater employee satisfaction without dominating one or the other.
- Elton Mayo and his Harvard associates conducted a study done at the Hawthorne Works of the Western Electric Company near Chicago, where they found that special attention given to workers results in increased productivity, regardless of environmental conditions. Because of its location, this change in behavior when an individual is aware they are being observed is called the Hawthorne Effect, which is also an important consideration in research.
- Jacob Moreno developed a system of pairings called Sociometry, which states that people are either attracted to, repulsed by, or simply indifferent with other individuals. Often this is done simply by surveying each individual which coworker they would prefer (or not prefer) to work with.
Behavioral Science
- Abraham Maslow developed the Hierarchy of Needs, which states that individuals will only focus on higher level needs when lower level needs are satisfied.
- Physiologic Needs > Safety and Security Needs > Love and Belonging Needs > Self-Esteem Needs > Self-Actualization
- Frederick Herzberg developed the Motivator-Hygiene Theory, a theory that identifies motivators which increase satisfaction and productivity; and hygiene factors which do not produce satisfaction, but is required to avoid dissatisfaction.
- Motivators: achievement, recognition, advancement, creativity, variety, independence, interesting work, responsibility, accomplishment, personal development, interpersonal relationships, status
- Hygiene Factors: salary and benefits, job security, work environment, job policies, supervisory practices, company policies and administration, company reputation
- William Ouchi developed Theory Z, by comparing Japanese organizations to American organizations. It is a blend of both management philosophies.
- Douglas McGregor (1960) theorizes that managerial attitude may be related to employee satisfaction. There are two contrasting theories; Authoritarian (Theory X) and Participative (Theory Y).
- If team members dislike their work and have little motivation, an authoritarian approach may be used. This may involve micromanaging and a “hands-on” position.
- If team members take pride in their work and see it as a challenge, a participative approach may be used. Trust in the members is required.
- William Blake’s Managerial Grid is a graph to allow for managers to determine their management style. The two axes of the graph denote concern for productivity (horizontal) and concern for people (vertical). It is divided into four quadrants, named according to their styles:
- Impoverished Management: A low concern for both productivity and people. It is the most ineffective in meeting people’s needs and generating positive results for the organization. Disharmony and conflict arise.
- Country Club Management: A low concern for productivity, but high concern for people. They trust people to manage themselves, so they may not provide adequate direction and coaching. Productivity may suffer, but they believe happy people will work hard and generate good results for the company.
- Authority-Compliance/Produce-or-Perish Management: A high concern for productivity, but low concern for people. Impressive results may be reached using strict rules and punitive measures, but these adversely affect team morale and motivation, eventually resulting in a decline in quality and timeliness of desired results.
- Middle-of-the-Road Management: A moderate concern for both productivity and people. A lack of prioritization for either aspect may result in ineffectivity.
- Team Management: A high concern for both productivity and people. A positive work environment where people feel respected, seen, and heard is created. The workers are motivated and inspired to give their best effort, and productivity improves. Absenteeism and turnover is also reduced in this management style.
Contemporary Management
- A contemporary approach denotes new, recent, or current approaches in a field of management, e.g. a “contemporary approach in steel manufacturing management” may refer to approaches used by other steel companies in the present day.
- A contingency approach gives way for differences between organizations and situations (contingencies) and thus different approaches to management. It assumes there is no single way to best manage a system. The environment impacts the organization, and managers must be flexible to consider environmental changes. The way the organization and control systems are created depends on the environment. A common aspect of the environment that changes frequently and rapidly is technology. Contingencies include:
- Circumstances in the organization’s external environment
- The internal strengths and weaknesses of the organization
- The values, goals, skills, and attitudes of managers and workers in the organization.
- The types of tasks, resources, and technologies the organization uses.
- A systems approach views an organization as a set of interrelated and interdependent parts arranged in a manner that produces a unified whole. It also follows the principle of “there is no one best way to manage”.
- Closed System: systems that are not influenced by, nor interacts with the environment.
- Open System: systems that interact with their environment.
Levels, Skills, and Roles of a Manager
There are various levels of management:
- Top-Level Manager: an individual who looks at the overall operation of the organization. They coordinate internal and external affairs of the organization; makes major decisions; determines the organization’s vision and vision statement, philosophy, policies, and procedures; and creates goals and allocates resources.
- Middle-Level Manager: coordinates activities of different departments. They receive policies from the top-level manager, and makes specific objectives and programs.
- First-Level Manager: directly acts for the actual production of services, acting as links between higher-level managers and non-managers.
A manager should have these skills according to Robert L. Katz (Katz’s Three Skills):
- Technical Skill: knowledge and proficiency for methods, procedures, and processes.
- Human Skill: ability to work with other people for a harmonious working relationship.
- Conceptual Skill: ability to see the overall picture, identify important elements, and their relationships; identifying pertinent factors; and responding to big problems.
Summer also puts forth the following factors:
- Knowledge Factor: ideas, concepts, or principles that can be expressed and are accepted through logical proofs.
- Attitude Factor: beliefs, feelings, and values that may be used on emotions and may not be subjected to conscious verbalization.
- Ability Factor: skill, art, judgment, and wisdom; abstract factors that can direct one’s thinking to factors that can be developed by the individual manager who takes time to consider them.
Managers take on various roles:
- Interpersonal Role: the manager takes on a position as a:
- Symbol: the leader occupies and consists of such duties e.g. signing papers and documents required by the organization.
- Leader who hires, trains, encourages, fires, remunerates, and judges.
- Liaison Officer between outside contacts e.g. the community, and suppliers
- Informational Role: the manager handles information and its distribution, and acts to:
- Disseminate information from external and internal sources
- Monitor information
- be a Spokesperson or representative of the organization
- Decisional Role: a manager takes on the responsibility of decision making, acting as a:
- Problem Solver/Troubleshooter, handling unexpected situations such as resignation of subordinates or loss of clients.
- Innovator/Entrepreneur to improve projects; directs and controls changes in the organization.
- Negotiator in conflict states.
Nursing Leadership
A job title alone does not make a person a leader. Only a person’s behavior determines if they hold a leadership role. While the manager brings things about, the leader influences and guides. There are various definitions for leadership:
- A process of influence in which the leader influences others towards goal achievement.
- The process of influencing the activities of an organized group in its efforts toward goal setting and goal achievement.
- Leadership is about creating change. It involves establishing a direction, aligning people through empowerment, motivating and inspiring them toward producing useful change and achieving the mission.
- Leadership is the vital ingredient that transforms a crowd into a functioning, useful organization.
In the context of Nursing,
Nursing leadership is the process whereby a nurse influences one or more persons to achieve a specific goal in the provision of quality nursing care.
Theories of Leadership
Great Man Theory
This theory simply states that some people are as leaders, and that great leaders arise when the situation demands it. Leaders display both instrumental (technical) and supportive (socially oriented) leadership behavior. Those who lack the ability to be a “great man” cannot adequately develop the necessary traits for leadership.
Trait Theory
This theory advocates that specific traits create a leader. Identified traits include energy, affection, enthusiasm, ambition, aggressiveness, decisiveness, self-assurance, self-confidence, friendliness, affection, honesty, fairness, loyalty, dependability, technical mastery, and teaching skill. This theory allows for individuals to have both inherent and learned traits, deviating from the Great Man Theory.
Charismatic Theory
This theory attributes leadership to charisma; charm; referent power, an inspirational quality that some leaders possess that makes others feel better in their presence.
Situational Theory
- Degree of interpersonal contact possible
- Time pressures
- Physical environment
- Organizational structure
- Influence of the leader outside the group
- Nature of the organization
Contingency Theory
Created by Fred Fiedler in the 1960s, this theory also states no single leadership style is ideal for every situation. Similar to the Situational Theory, it believes the situation changes the leadership style required based on three aspects:
- Leader-Member Relations: assessed through the Group Atmosphere Scale, a Likert scale from 1 to 8 between the following:
- Friendly, Unfriendly
- Accepting, Rejecting
- Satisfying, Frustrating
- Enthusiastic, Unenthusiastic
- Productive, Non-productive
- Warm, Cold
- Cooperative, Uncooperative
- Supportive, Hostile
- Interesting, Boring
- Successful, Unsuccessful
- Task Structure: graded from high to low based on how easy it is to define and measure a task (high). Four criteria are used to determine the degree of task structure:
- Goal Clarity
- Extent to which a decision can be verified by knowing who is responsible for what
- Multiplicity of Goal Paths
- Specificity of solutions, and number of correct answers
- Position Power: the authority inherent in the leader’s position, including the ability to use rewards and punishment.
Fielder provides some leadership styles to match situations:
- If the leader is disliked, but the task is structured, then utilize a diplomatic leadership style.
- If the leader is liked, but the task is ambiguous, then seek cooperation.
- The accepting, considerate leadership style will probably be the most productive in situations with good relations, structured tasks, and position power is either strong or weak.
- In an emergency, a task-oriented leader would be advisable in a natural disaster, as leader-member relations are not a priority.
- In blue-collar work, a relationship-oriented leader may be more productive as the workers often know what to do; have a highly organized task structure.
Leadership Styles (Hersey and Blanchard)
- Directing Style: a high-task, low-relationship style effective when subordinates are low in motivation and ability.
- Coaching Style: a high-task, high-relationship style effective when subordinates have adequate motivation but low ability.
- Supporting Style: a low-task, high-relationship style effective when subordinates have adequate ability but low motivation.
- Delegating Style: a low-task, low-relationship style effective when subordinates are very high in ability and motivation. Similar to laissez-faire leadership.
Path-Goal Theory
This theory states that people act as they do because they expect their behavior to produce satisfactory results. The leader must take charge and set a path to a goal, allowing workers to be more productive and successful.
Transactional Theory
This theory gives emphasis to written or documented policies, rules, and regulations in influencing a group. The needs of followers are identified and the leader provides rewards to meet those needs in exchange for expected performance. Leaders who utilize a transactional method focus on day-to-day operation.
Transformational Theory
This theory gives emphasis to inspirational, motivational, and optimistic leadership in influencing a group. This promotes employee development, attends to the needs and motives of followers, promotes a change in perception, creativity, and provides intellectual stimulation.
Behavioral Theory
This is a management philosophy that evaluates leaders according to the actions they display in the workplace; to be an effective leader is to learn a certain set of behaviors. This shifted focus away from the traits of the leader to the actions of the leader.
Leadership Styles (Kurt Lewin)
Lewin along with White and Lippitt identified the following common leadership styles:
- Authoritarian Leadership: a leader who uses positional and personal power who is demanding and controlling. They emphasize differences in status and directs or commands others. Criticism is punitive, and communication is vertical. Decisions are made based on their opinion alone.
- Democratic/Participative Leadership: a leader who allows for group governance through collaboration or group efforts. It requires trust and openness, and less control is maintained. Both economic and ego rewards are used to motivate, and emphasis is placed on “we” rather than “I and you”. Criticism is constructive.
- Laissez-Faire Leadership: a “hands-off” approach to leadership, often with poor results. Informal leaders arise in a somewhat-decentralized manner for the group. Leaders are uninvolved, disinterested, withdrawn, and permissive. They do not provide criticism, and allows their subordinates to plan.
Servant Leadership
These leaders are more concerned with the needs of others than themselves, and lead through their service. They foster a service inclination in others that promotes collaboration, teamwork, and collective activism.
Authentic Leader
A leader manager arsenal; in order to lead, leaders must be true to themselves and their values, then act. Authentic or congruent leadership theory differs from the traditionaltransformational leadership theory.
Thought Leader
This applies to a person who is recognized among their peers for innovative ideas and demonstrates the confidence to promote these ideas.
Power
Power is the ability to impose the will of one person or group to bring certain behaviors to other persons or groups. Power may take various forms:
- Rewarding Power: the power to reward workers for their performance; to compensate or remunerate the achievements of the staff e.g. bonuses, awards, promotions
- Coercive Power: the use of fear or duress to gain control; the opposite of rewarding power e.g. reprimands, termination, penalties
- Legitimate Power: power conferred upon a leader based on organizational definitions of authority; power vested upon a leader in relation with their position or rank sanctioned by the institution itself.
- Referent Power: power attained from the ability of the leader to obtain admiration; based on charisma.
- Expert Power: power based on the knowledge, skills, information, and expertise of the leader in the domains they oversee. This gains respect and compliance.
- Information Power: power based on access to knowledge, access to information, and communication avenues (e.g. memos). It is especially powerful when others require pertinent information, such as recent changes in healthcare standards.
- Connection Power: power based on access and familiarity with other influential individuals.