MANAGEMENT

DEFINITION:
There are many definitions of
management but these are the
common ones.
• Management is getting work done through
other people.
• Management is a process of working with
and through people to effectively and
efficiently achieve organizational objectives
utilizing the available resources carefully in
a changing environment.
WHAT DO MANAGERS DO?

They manage 3 M+T+I, which stands for:

 Manpower (currently called Human
resources)
Materials + Equipment
Money (Finance)
Time
Information or ideas
 1) Process:

• A careful itemized number of steps to

follow in carrying out an activity or a task.
• It is also a specialized way of doing things,
usually guided by rules and regulations.
They represent a set of certain policies to be
followed.
 2) Resources:

Available facilities that can be used to achieve

our goals. They are
• Physical: (Buildings, machines, land,
furniture, duty rooster etc.)
• Financial: (Cash money, gifts, donations,
budget allocations, grants, contributions,
levies and others).
• Human: (Skilled and unskilled).
 3) Carefully:

• Systematically, step-by-step efforts to

achieve certain goals and objectives.
 4) a) Effectively:

• To be effective is to emphasize the work

(task oriented)
 b) Efficiently:

To be efficient is to emphasize the

workers welfare (people
oriented)
 5) Goals:

• Broad statements describing the long-term

expectations to be met by the organization.
 6) Objectives:

• Specific and immediate expectations to be

fulfilled.
• Broad goals and aims are divided into
achievable specific objectives. In health,
policies and goals are reduced into
achievable objectives in the
ward/department interaction between health
workers and patients/clients.
 TERMINOLOGIES

A) MANAGER:
Is a person who performs the work of
management not
merely the top executive ( a person who is in-
charge of: overseer, heads, supervise an
organization or business).

B) EFFECTIVENESS:
Is the degree to which an objective is being or
has been
achieved (to produce desired results or doing
the right things).
C) EFFICIENCY:
• Is “reaching ends” by the only necessary
means or by the
• least wasteful ways or means i.e a measure
of the relationship between results obtained
and the efforts put or expected by the
organization (doing things in the right
ways).
D) OBJECTIVE:

The desired end results of any

activity (it is the end towards
which all activities in an
organization are aimed at).
 E) ADMINISTRATION:
Identifies the structure within
which management takes
place and each organization or
institution has got its own
management structure. Each
organization has its own rules
and regulations to function
within.
 F) PRINCIPLE:

• The fundamental truth used as a basis for

reasoning or
• taking action.

• OR
• General law used as a guide to an action or
a decision.
G) POLICY:

• Situation related guidelines, which clarifies

or spells out
• responsibilities and prescribes specific
actions to be taken in the given situation.
H) RESPONSIBILITY:

• An obligation or opportunity to act or to

work or decide
• without having to be closely supervised or
authorized.
I) LEADERSHIP:

An activity of influencing others to co-

operate towards achieving a common goal.

OR
An art of exerting (imposing) one’s
influence upon others so that one is able to
command their respect, confidence and
obedience.
J) DELEGATION:

• A process of assigning duties to be

performed by
• subordinates and conferring to the
subordinates the authority necessary to
carryout the assigned duties.
K) AUTHORITY:

• Legitimate right of a position or office

that requires others to obey.
OR
* The right to act or command the action of
others.
 L) SUPERVISION:

• An act of overseeing what other staff are

doing and
• correcting them appropriately.
M) Accountability:

• A state of being answerable to the delegator

for the quality
• and quantity of the assigned duties.
THE ESSENTIAL NATURE
OF MANAGERIAL WORK
• Management is practiced for the purpose of
achieving organizational objectives.

• Managers, the people in positions of

authority who make decisions to commit
organizational resources, mainly get things
done through people. People are seen as the
key most of all organizational resources.
• Consequently, the manager should pay
special attention to this special resource in
terms of its acquisition, utilization, training
and motivation.

• It should be noted that for the people to be

effective, the manager must secure for them
additional resources in terms of materials,
equipment and money.
Furthermore, for the manager to achieve the
goals they set they must execute the various
functions of management, which include
planning, organizing, staffing, controlling,
co-ordinating, motivating, delegating,
communicating.

Whether the organization’s philosophy is

capitalistic or socialistic, management only
requires efficiency and effectiveness.
Efficiency means being procedural, orderly,
systematic or methodical, while
effectiveness means being result oriented to
achieve targets, standards, objectives and
satisfaction as a measure of productivity.
Specifically, management is
about three factors:

a) Accomplishment of Group Objectives

The manager converts the various
resources, (people, machines, materials, money,
time and space) into useful enterprise.

b) Efficient Running of Organization

This is done by the manager providing appropriate
leadership to those he leads. He/She should
explain the purpose behind organizational goals
and seek to involve the subordinates mentally and
emotionally in the accomplishment of
organizational goals.
c)Sound Organizational Structure
The manager must establish a pattern of
authority (responsibility relationship) and
provide a proper environment for people to
produce.

According to Peter Drucker: The work of

management is to make people productive.
On the other hand, Donnelin, Gibson and
Ivancevich state that there are three types
of world class managers:-
• i) Managing work and organizations
• ii) Managing people
• iii) Managing production and operations.

Managing Work and

Organizations

Managing
Productions and Managing
Organizations People
A) HOW DO MANAGERS
SPEND THEIR TIME

Generally, how a manager spends his/her time

will be determined by the following factors:

• i) The nature of the industry or the

organization.
• ii) The nature of the individual’s style.
• iii) The needs of the moment.
According to studies undertaken by Henry
Mintzberg on Chief Executive, a large
proportion of their time is spent on:-
• Scheduled meetings
• Proportion of activities lasting less than 9
minutes.
• Desk work.
• Unscheduled meetings.
• Proportion of activities lasting longer than
60 minutes.
• Telephone calls
• Tours
• The manager’s days are characterized
by a large number of brief informal
two-person contacts (telephone calls
and unscheduled meetings) and
relatively few scheduled meetings,
which nevertheless take up most of
their time.
B)CHARACTERISTICS OF MANAGEMENT

The salient features which highlight the nature

of management are as follows:-

1. Management is universal – Its

principles are applicable everywhere.
2. Management is purposeful –
Management exists for achievement of
objectives.
3. Management is an integrative
force – Management is about co-ordination
of individual effort into team effort.
4. Management is a social process –
Management is done by people hence concerns
interpersonal relations. The human factor is the
most important element in management.
5. Management is multidisciplinary –
Management has to deal with human behavior
under dynamic conditions.
6. Management is a continuous process.
7. Management is both an art as well as a
science
 THE TASKS AND
CONTRIBUTIONS OF A
MANAGER
Peter Drucker identifies three tasks of a manager:-
i. Fulfilling the specific purposes and mission of the
organization.

ii. Manning work productive and the worker

achieving.
iii. Managing social aspects and social
responsibilities.
Drucker then goes on to identify
five basic operations in the work
of the manager:-
a) Sets Objectives

Determines objectives and the

goals for each area of objective,
and describes what needs to be
done to achieve these
objectives.
b) Organizes

Analysis the activities, decisions and

relations required, classifies and divides
work, creates organization structure, and
selects staff.
c)Motivates and Communicates

Creates a team out of people responsible for

various jobs.
d) Measures

– Establishes targets and measurements of

performance which focus on both the
individual and the organization as a whole.
e) Develops People

Directs, encourages, and trains.

D) LEVELS OF MANAGERS
IN AN ORGANIZATION
Not all managers are equal: In an
organization there normally exist
three distinct levels, making some
managers more equal than others.
These levels of managers are:-
 TOP MANAGERS

These are relatively small group of

executives. This level consists of the Board
of Directors (or their equivalent) and the
Chief Executive Officer (Managing
Director, Executive Director, General
Manager, President, etc).
This level is the ultimate source of
management authority. They engage
extensively in the formulation of strategies.
They must provide leadership, evaluate and
shape the method of organizing, and control
the direction the organization is moving, in
an effort to accomplish goals.
Their specific functions include:

i) Analyzing, evaluating, and dealing with

environmental forces – They meet other
government officials or other executives.
ii) Establishing overall long-term goals and
operating policies of the firm.
iii) Appointment of key personnel.
iv) Reviewing and controlling the firm’s
operations.
v) They work for long hours and spend most of
their times in meetings or telephones.
The top management is accountable to the
shareholders (or their equivalent).
b) MIDDLE LEVEL MANAGERS
The middle level managers are more diverse
in terms of tasks and responsibilities.
Generally, they are responsible for the
efficient and coordinated functioning of
their departments in accordance with the
basic objectives and implementing and
plans laid down by the top management.
• They have supervisory responsibility of
first-line managers and at times non-
management personnel in the organization.
They issue instructions, integrate various
parts of their division, motivate and train
their juniors.
• They supervise and co-ordinate activities of
lowest level managers. They go by titles
such as Departmental or Divisional heads,
hospital matrons, branch managers,
medical superintendent, operations
managers.
 c) SUPERVISORY/FIRST/LOWER
LEVEL MEDICAL

These are situated at the lowest level in the

managerial hierarchy. They are the
operating managers, job implementers who
serves as a link between the workers and
the management.
Their specific functions include:
i)Planning day-to-day production.
ii)Assigning jobs to workers.
iii)Explaining work procedures.
iv) Supervising and controlling workers
(They spend most of their time supervising
subordinates).
v)Maintaining good human relations among
workers.
vi)Maintaining discipline and solving
workers problems.
They go by titles such as “Foreman”, “Supervisor”,
“Superintendent”, or “Sales and Accounts officers”.

First-line management offers the initial entrance into a

management position.

Top Managers

Middle Level Managers

First-Line Or
Supervisory Managers

The Hierarchy of Management

E) THE ATTRIBUTES/SKILLS/QUALITIES
OF A MANAGER

An able and capable manager should possess

the following QUALITIES among others.
- Have an acceptable level of formal
education.
- Having training and competency in
the industry he/she manages.
- Have a good understanding of the
goals/objectives of the organization
- Have an understanding of the top
management view.
- Have vision and foresight.
- Have leadership qualities.
- Understand and appreciate the various
environmental factors.
A good manager should also be hardworking,
target/results-oriented, be morally upright
and with integrity, and understand/apply the
various management functions and the
related principles.
 SKILLS OF AN EFFECTIVE MANAGER

a)Technical Skills:
This is knowledge and proficiency in
activities involving methods, processes and
procedures. It is the ability to work with
tools and apply specific techniques.

Technical skills are prominent at the

operational level – lower level – of
management.
Usually, the people who possess advanced
technical skills are the hands-on people.
However, a good manager should possess
the same skills so that he/she can
competently guide the implementing staff
on how to use the various work tools.
b) Human Skill:

This consists of the ability to work effectively

with others – to win their cooperation and
build effective work teams.

Good interpersonal relations, communication,

delegation and motivation are examples of
human skills. They are reflected in the way
the manager perceives/interacts with the
subordinates, peers, and even superiors.
c) Conceptual Skills:

This is the ability to see the “Big Picture” – to

recognize significant elements in a
situation, and to understand the relationship
among elements.

Good managers must learn to plan long-term.

They must strategize, and have to be
creative and nurture innovative thoughts.
They must be good at interpreting the
factors in the environment.
c) Conceptual Skills Continued
Conceptualizing is most important for the top
management. The skills are important for
formulating long-term plans, making broad
policy decisions, and relating the business
enterprise to its industry and the economy.
It should be noted that the three skills are
interrelated – but the proportion or relative
significance of each skill varies with the
level of management. Equally, the
prominence of a particular skill will vary
according to the nature of the industry.
Generally, technical skills deal with jobs,
human skills with persons, and conceptual
skills with ideas.
THEORIES OF MANAGEMENT
:
THEORY : definition
A properly argued or reasoned out ideas about facts
or events.
OR - An opinion or idea not necessarily based on
reasoning e.g. spare the rod and spoil the
child.
OR - Ideas, beliefs or claims about something or
events which may not be found to be true.

OR - Sets of principles on which a subject of

study or an investigation is based.
 THEORIES OF MANAGEMENT
CONTINUED

Theories refers to the work of leading thinkers

on management - their ideas and
conclusions about how management should
be undertaken.

NB: The main aim of studying the theories

of management is to establish how
managers can achieve effectiveness and
efficiency in their work.
THEORIES OF MANAGEMENT
CONTINUED

Four main approaches have been

identified:
• Classical
• Human Relations
• Systems
• Contingency
A THE CLASSICAL/SCIENTIFIC
THEORY OR MANAGEMENT

The scientific management is associated with

the works and writings of Taylor (1856-
1915) Fayol (1841-1925). Gantt (1861-
1919) and Weber (1864-1920). The
prominent figures felt that managers could
achieve effectiveness and efficiency
through:
a) Use of scientific tools e.g statistics,
mathematics and operational research.
b) Implementing or enforcing the functions of
management i.e, planning, organizing,
directing, controlling, co-ordination.
The classical approach to management grew out of
the need to improve efficiency through efficient
utilization of human and material resources.
• The classical approach provides the basis for
training the managers by identifying the functions
and skills of management.
• It offers a convenient way of acquiring managerial
skills.
• It helps managers to focus attention on division of
work.
• It normally enables to develop structures of the
organization/management e.g departments.
 FREDERIC WINSLOW
TAYLOR (1856-1915)
FW Taylor, a mechanical engineer and the
father of scientific management was born in
Pennsylvania, educated in a steel company
and a paper mill that invented several
industrial tools and conducted research on
methods of training workers for increased
production. He emphasized
ACCOUNTABILITY
functional assignment of tasks:

His scientific management thought dwelt on

economic incentive as motivators. He
encouraged more production of goods by
introducing scientific procedures for
performing work better.
He believed by making more money, he’ll
pay more money to the workers and they
will be motivated to work.
His time and motion studies emphasized
training, job analysis and proper selection
of workers.
He was known in management circles as
“Economic man”. A nurse administrator
would divide tasks so that each nurse is
given a piece to perform for example giving
medication or bathing a patient, the nurse
would then account for his/her performance
task.
 HENRY GANTT (1861-1919)
Henry Gantt, a colleague of Taylor, also was
concerned with problems of efficiency.
He contributed to scientific management by
refining previous work rather than
introducing new concepts.
The Gantt Chart, a forerunner of the PERT
(Program evaluation and Review
Technique) chart, depicts the relationship of
the work planned or completed on one axis
to the amount of time needed or used on the
other.
Gantt also developed a task and bonus
remuneration plan whereby workers
received a guaranteed day’s wage plus a
bonus for production above the standard to
stimulate higher performance.
He recommended that workers are selected
scientifically and provided with detailed
instructions for their task.
He argued for a more humanitarian approach
by management, placing emphasis on
service rather than profit objectives,
recognizing useful non-monetary incentives
such as job security, and encouraging
staff development
 HENRY FAYOL (1841-1925)

This French mining Engineer whose book

“General Industrial Management” was first
established in 1916, is perceived to be the
most influential of all classical writers.

He believed that good management was a

skill that could be taught – that good
management principles were needed to
guide managers. He broke down the key
function of management into five main
aspect that a manager needs to perform.
– Planning – A course of action for the
organization to meet its goals.
– Organizing – To ensure the availability and
co-ordination of the material and human
resources of the organization to put the plans
into effect.
– Commending – To provide direction to
employees.
– Coordination – To ensure that resources and
activities of the organization work together to
achieve the desired goals.
– Controlling – To monitor the plans and ensure
they are being achieved.
Nurse administrators at whatever level of an organization
apply these elements in their work.

Fayol is also well known for his 14 principles of

management.

1. Division of work – i.e specialization, sub-

divided and one person performs the
smaller task productivity goes up as the person gets to
increase his/her ability.
2. Authority and Responsibility: Authority and
responsibility should be equal i.e
the right to give orders and exact obedience and an
obligation to perform duties.
3.Discipline:This help workers develop
obedience, diligence and
respect.
4.Unity of Command: An employee should
receive orders from one supervisor
(superior) only.
5. Unity of Direction: All members of a team
(organization) must pull in the same
direction in terms of pursuing the organizational
goals/objectives. (All operations with the same
objectives should have one manager and one
plan).

6. Subordination of Personal Interests to general

Interest: Individual or group
interests should not supercede those of the
organization.

7. Remuneration: Methods of payment should be

fair. People should be well paid having done a
good job “A good reward for a good day’s work”.
8. Centralization or Decentralization:Managers
must maintain final responsibility but
should delegate certain authority to subordinates.

9. Scalar Chain:A clear line of authority or chain of

command should extend from the highest to the
lowest level of an enterprise. This helps to ensure
an orderly flow of information and supplements
the principle of true command.

10.Order: There should be proper policies, rules and

procedures, regulations to maintain an orderly
situation in the organization.

11.Equity: All employees should be treated with

equity and justice i.e rewards, training
opportunities or promotions.
12. Stability of Tenure of Personnel:
Management should work towards
obtaining long term commitment from staff.
(Employees should have a sense of security
and hope in their jobs).

13. Initiative:Workers should be allowed

to conceive and execute plans in order to
develop their capacity to the fullest and feel
like an active part of the organization.
(Employees should be encouraged to be
creative in their work).
14.Espirit de corps: Harmony and unity
among members of the organization is a
great strength in the organization. (This is a
French word meaning teamwork; that
without members of the organization
working together they are unlikely to
succeed).
 MAX WEBER (1864 – 1920)

Weber, a German sociologist and political

scientist, felt that organizations of the time
were ineffective and unable to solve the
problems of that time.
He advocated “bureaucracy” as the ideal form
of organization for a “complex institution”.
• Weber described a bureaucracy as having a
well-defined hierarchy of authority, division
of work based on specialization, highly
specific rules governing workers duties and
rights, work procedures, interpersonal
relationships and promotion based on
technical competence.
Weber also claimed that bureaucracy was
superior to other forms of organization,
because it provides greater stability,
precision and reliability in controlling
employees.

The disadvantages of Bureaucracy are:

- Excessively long chains of command.
- Slow decision taking
- Discourage individual initiative and
possible failure to identify and remove
incompetent individuals.
NOTE: Resulting from these works of Taylor,
Fayol, Gantt and Weber, management
concepts were developed.
These include span of control, delegation of
authority, coequality of authority and
responsibility and unity of command which
are still applicable in today’s management
especially the nursing organizational
structures where top level
executives/administrators (Director of
Nursing) delegate part of their work domain
to their subordinates and apply the
principles of management by exception
where they only deal with issues which
their subordinates are not able to tackle.
BUREAUCRACY THEORY
OF MANAGEMENT
Meaning stages/centres of control during
service delivery.
Weber described a particular organizational
form which exists to some extent in every
large scale enterprise whether in the
private or public sector. In Weber’s view
the bureaucratic organization was a
logical, rational organization, which was
technically superior to all other forms.
The key elements in the ideal bureaucratic
type of organization are as follows:
The theory recognizes that employees in an
organization will function smoothly if the
following are put in place.

1) They should know where they belong

in the organizational hierarchy i.e what
grade or cadre are you? (a well-
defined hierarchy of legitimate
authority).
2) They should also know their role in
relation to others to avoid role conflict
(a division of labour based on
functional specialization).
3) People also need to know how they
are managed e.g they need to know.
 Policies
 Rules and regulations
 Code of Conduct
 Procedures

(Rules and procedures in writing should exist to deal

with all decisions and situation).

4) They should also know whom they are

answerable to and the channel of
communication (a clear statement of the rights
and duties of personnel).
5) Promotion and selection are based on
technical competence.
6) A continuous organization of functions bound
by rules.
7) Official positions exist in their own rights
and job holders have no rights to a particular
position.
A number of problems and weaknesses have been
identified with the bureaucratic model of which
the following are the most important:

Adaptability and the ability to change are made

more difficult because of standardized rules,
procedures and rigid structures.
 Innovation, creativity and initiative tend to
be discouraged.
Rules tend to become important in their own
right than a means of promoting efficiency.
Control systems are rigid and frequently out of
date.
• Decision making is slow and cumbersome.
 However, in spite of these and
other deficiencies, as
organizations grow in size and/or
complexity the need increases for
some form of systematic
organization, which experience
shows inevitability incorporates a
number of Weber’s bureaucratic
elements.
 HUMAN
RELATIONS/BEHAVIOURAL
• It was developed to challenge the contents
of the Scientific/classical School. It stated
that the Scientific/classical School did not
consider the talents and morale of the
workers and it further says if the manager
does not recognize the talents and the
morale of workers they cannot achieve
effectiveness and efficiency.
 During the 1920’s, the years of
Great depression in America,
greater attention began to be paid
to the social factors at work and
to the behaviour of employees
within an organization – that is,
human relations.
 The turning point in the
development of the human
relations movement came with
the famous HAWTHORNE
experiments at the western
Electric Company in America
(1924-1932) Chicago and the
subsequent publication of the
research findings.
 Among the people who wrote about the
Hawthorne experiments was a Harvard
Professor Elton Mayo.
The results of the Hawthorne experiments did
generate new ideas concerning the importance
of work groups and leadership,
communications, motivation and job design.
They place importance on personnel
management. These experiments are
regarded as one of the most important of all
social science investigations and are
recognized as probably the single most
important foundation of human relations
approach to management and the
development of organizational behaviour.
• Abrahams maslow’s theory
• Douglas McGregor theory X and theory Y
 This theory encourages
creativity and innovation and is
associated with democratic
practices.
 c) SYSTEMS

A system is a collection of parts, or a set of

interrelated activities that operate
interdependently to achieve a common
purpose.

It states that even if you enforce tools and

practice principles of management properly,
you cannot achieve the effectiveness and
efficiency if you do not:
i) Co-ordinate the activities of the
workers within the organization e.g
co-ordination of activities of
different departments.
ii) You cannot achieve effectiveness
and efficiency if you do not
consider the external forces that
affect the organization e.g. the
activities of the competitors.
The principal elements in a
system are:
• Willingness to serve.
• Common purpose
• Communication.

If the above elements were not present and

working interdependently then the
organization will not exist. The emphasis is
on management awareness of:
Characteristics of a System

• It is made up of sub-systems.
• Comprises of components.
• Components are interrelated.
• Without one component the system will not
function.
 D) THE CONTIGENCY
APPROACH
• This theory advocate that it is impossible to
specify a single way of managing the works
best in all situations.
• The contingency approach is an effort to
determine through research which
management practices and techniques are
appropriate in specific situations.
• It is a Situational appropriateness
management. Different situations require
different managerial responses.
• Managers need contingency plans – plans
that are flexible and that can adapt quickly
to change in today’s unstable surroundings.
• The contingency approach has grown in
popularity because it recognizes that there
is no magical formula for managerial
effectiveness.
PRINCIPLES OF
MANAGEMENT
1) MANAGEMENT BY OBJECTIVES:
Definition:
Management by Objectives is a process
whereby the superior (managers) and
subordinates of an organization jointly
identify its common goals, define each
individuals major areas of responsibility
in terms of the results expected of him/her
and use these measures as guides for
operating the units and assessing the
contribution of each of its members.
 Advantages of Management By
Objectives
• It concentrates attention on the main areas where it
is important for the organization to be effective.
• It improves performance standards.
• It leads to a sound organization structure, clarifies
responsibilities, aids delegation and co-ordination.
• It identifies where changes are needed and
seeks continued improvement results.
• It improves appraisal systems and provides
a more equitable procedure for determining
rewards and promotion plans.
• It normally identifies training needs and
provides an environment, which encourages
personal growth and self discipline.
• It improves communication and
interpersonal relationships.
• It encourages motivation to improve
individual performance.
2) MANAGEMENT BY
LEARNING FROM EXPERIENCE

• This principle is applied when management

realizes that there is a gap between
objectives and results (or achievements).
• Management analyses why the observed
results were achieved and why they fell
short of the set objectives.
• Some causes can be easily remedied and
action is taken accordingly. Others cannot
be removed in the short term and are then
called constraints.
• Management learns from this process and
uses what it has learned in its further
decisions for achieving its objectives. This
process is called ‘feedback’ of information
from experience to decision for action.
3) MANAGEMENT BY
DIVISION OF LABOUR
• When work is divided, or distributed among
members of a group and the work is directed and
coordinated, the group becomes a team.
• In a team, and generally when there is
Specialization and division of labour, with each
category of staff exercising its own skills towards
achieving the objectives, management assigns a
balanced proportion of each kind of staff to the
work to be done.
• The team approach is the way in which
management attempts to bring about balance
among the different members of the team and the
work they do.
 4) MANAGEMENT BY
CONVERGENCE OF WORK
• Convergences of work means that the
activities of the various people i.e who do
the work come together in the achievement
of objectives.
• The activities should be designed, assigned
and directed in such a way that they support
each other in moving towards a common
goal. It also implies that working relations
– the way in which the members of a team
interact with one another should contribute
to the success of each activity and thus to
general effectiveness.
In general, health activities are
studied, described and performed
under three main headings.
• Service activities.
• Development activities
• Support activities
 A service activity (e.g
Immunization) usually requires
some preceding development
activity (e.g training immunizers)
and some continuous support
activity (e.g provision of
supplies).
These three kinds of activity need
to be managed so as to bring
about convergence of work,
balance of resources and
harmonious work relations and
ultimately the intended results.
Specific work activities must be
brought into logical relations
with one another.
5) MANAGEMENT BY
SUBSTITUTION OF
RESOURCES
• One particular type of substitution of
resources is labour substitution e.g using
trained auxiliary personnel or volunteers for
tasks formerly undertaken by professionals;
use of generic drugs instead of brand-name
(preparation of drugs which are much more
expensive). Substituting bikes for motor
vehicle transport when petrol sales go up.
 6) MANAGEMENT BY
FUNCTIONS DETERMINE
STRUCTURE
• When work is clearly defined i.e the
function and duties of individual members
of the team are clearly defined and known
to all, the working relations follow.
• In working relations, decisions are made
where and when necessary by the most
suitable person. In a health team, any
member may be called upon to make
decision of one time or another, especially
when the team leader is absent or otherwise
the team would be paralysed.
7) MANAGEMENT BY DELEGATION

• It is the transfer of responsibility and authority to

another person to act on one’s behalf (to entrust a
task to another person who serves as one’s
representative).
• There are many good reasons for delegating.
Sometimes managers must delegate routine tasks
so that they are free to handle problems that are
more complex or require a higher level of
expertise. Managers should also delegate work if
someone else is better prepared or has greater
expertise or knowledge about how to solve a
problem.
 Delegation can be used to
provide learning or stretching
opportunities for subordinates.
Subordinates who are not
delegated enough responsibility
may become bored, non-
productive. Everyone needs to
feel that he or she makes a
difference to the success of the
organization.
The difference maybe small, but
when they are empowered, people
feel that what they do has meaning
and significance. Thus, in
delegating, the leader/manager
contributes to employees personal
and professional development.
8) MANAGEMENT BY EXCEPTION

• Management by exception means two

things.
MANAGEMENT BY
EXCEPTION CONT’D
• Being Selective: Keeping mind available
for critical information on which action will
be required and not becoming overloaded
with routine and unnecessary information.
• Making big decisions first – Prioritizing –
decisions to be made. Being overloaded
with petty decisions may result in more
important ones being neglected (being
postponed until they become unnecessary).
In short, management by exception means
“selectivity in information and priority
indecision”
9) MANAGEMENT BY THE
SHORTEST DECISION –
PATH
• This deals with issue: of Who should make
which decision when and where? Applying
this principle means that decisions are made
as close as possible in time and place to the
object of the decision and those affected by
it. This saves time and work (e.g in
transmitting information) and also ensures
that decisions can take full account of the
circumstances which make the decisions
necessary and in which they are put into
effect.
Functions Of Management

Function: Can be defined as a broad area of

responsibility aimed at achieving a
predetermined objective or a group of
activities with a common purpose.
• Management consists of many functions but
a health team has three main management
functions. Planning, implementation and
evaluation.
These three broad functions of management are sometimes
presented graphically as follows.
Management Cycle/Process

E
 Planning

• Planning is the most basic of all

management functions.
• It is deciding in advance what to do, how
to do it, when to do it and who is to do it.
• Planning closes the gap where the
institution is at a particular point and where
it should be at a desired point in future.
 Implementation

• The implementation function involves the

conversion of the theoretical plans into
action.
• If there is no implementation, plans remain
theoretical and useless.
• In implementing the plan, the manager
carries out several sub-functions of
management including organizing, staffing,
directing, motivating, supervising,
delegating, coordinating, reporting,
budgeting and communicating.
 i) Organizing

• Assessing resources (human, material,

financial, time)
ii) Staffing

• Selecting and recruiting staff.

• Training and developing staff.
iii) Directing

• Supervising
• Motivating
• Delegating
• Co-ordinating team effort
Evaluation
• Evaluation is mainly concerned with
assessing the achievement of results and the
economic use of resources.
• Evaluation is the managerial function that
keeps a health programme functioning as
planned. Some deviations are bound to
occur from the plan, including schedule,
targets and budget. The purpose of
evaluation is to check that these deviations
do not fall outside allowable limits and, if
they do, to take corrective action.
FUNCTIONS OF MANAGEMENT

1) Planning
2) Organizing
3) Supervising/Directing
4) Controlling
5) Delegating
6) Co-ordinating
7) Staffing
8) Motivating
FUNCTIONS OF
MANAGEMENT CONT’D
9) Communicating
10) Leading
11) Decision making
12) Budgeting
13) Evaluating (staff appraisal)
1) PLANNING

Definition: Determining in advance what is

to be accomplished (goals/objectives and
preparing how to meet them).
OR
Making a purposeful decision in advance of
what to do, who is to do it; how, when and
where it is to be done. Therefore, all
planning involves a choice, a necessity to
choose from among alternatives. This
definition implies that planning is a
proactive and deliberate process.
It is the stage of thinking, deciding and making plans
for what will be done in carrying out organization
goals and objectives.
It is future-oriented and goal-oriented. It helps in
evaluation whereby the planner will be able to
compare the outcome with the goals and objectives set
in the mind while planning.
It also involves taking into consideration the resources
available, the methods of accomplishing the task for
the purpose of the organization. Planning is based on
facts than on speculation and it
must be timely, prudent, flexible and comprehensive.
 Planning is critically important and
precedes all other management
functions. Without adequate planning,
the management process will fail.
(Without planning nothing can be
achieved).
Importance of Planning

1. To avoid frustration of having to do things

at the last minute.
2. It ensures efficiency
3. It provides for future needs
4. It enhances co-operation.
Some areas for planning by the
manager (Nursing Officer In-
charge of Wards)
• His/her individual time
• Department (ward) work schedule (duty
allocation).
• Continuous education programmes.
• Ward budget.
• Obtaining equipment and supplies.
• Patients/personnel – staffing and
development.
 PLANNING PROCESS

The planning process includes a series of

activities that the nurse manager sets out to
do. The process is subject to change as new
facts become available. If plans are fixed
and unchangeable, then they may fail.

The nurse plans and develops specific goals

and objectives for his/her area of
responsibility. The process of planning
includes:
• Assessments – Diagnosing the
problem/looking at the situation
• Setting goals – Selecting/finding the most
promising solutions from
alternatives. Analyzing and comparing
alternatives.
• Implementation – Selecting plans to be
followed.
• Evaluation
The figure below illustrates the
planning process.
Assessment

Evaluation Setting goals

Implementation
 1)assessment

This is the first stage in the process. It

involves identifying and clarifying or
diagnosing the problem.
A good diagnosis says what is wrong, for
example. It may identify a particular
situation that needs improvement like the
standards of nursing care. The main
questions to be asked are: Where is the
problem and what are the hindrances that
are affecting achievement.
2. Setting goals:
The next stage of the planning process is establishing
goals to be achieved. These goals determine the
direction of activities and serve as a guide for
action. This stage also involves developing a set
of actions for achieving the objectives and
selecting promising solutions from alternatives.

The alternatives can range from doing nothing or

finding means around the problem to dismissing a
member of staff or discharging a patient.
3. Implementation:

• This is the third stage, which is very

important because if plans are not
implemented, they remain theoretical.
Some of the principles of management like
division of labour, responsibility and
accountability are put into practice.
Implementation involves decision making,
which is the core of planning. These
decisions deal with the following issues:
• Activities, noting whether they are carried
out as planned and whether services are
delivered as intended.
• People (manpower), which should be
adequate, at the right place and right time to
perform the activities.
• Resources, referring to the physical,
financial and information resources needed
to perform the activities.
 4. Evaluation:
This is the last stage in the planning process.
It involves determining the extent to which
objectives have been achieved. The concern
for the nurse is to find out the effectiveness
of the results, as well as the efficiency in the
performance of activities and the economic
use of resources. The two questions one
should ask are:
Are the results as intended?
Are the results of any value?
If the answer is ‘yes’ to both questions, then
the decision would be likely to carry on as
planned. If the answer is in the negative, then
the decision will have to be made to re-open
the objectives or activities or both.

Planning is necessary for several reasons

including the following – Planning
• Contributes to a purposeful organization of
work.

• Reduces costs because efforts are directed

towards desired results.

• Provides for integration and co-ordination

of activities.

• Minimizes haphazard approaches and

avoids duplications.
SUMMARY

PROCESS OF PLANNING/PROCESS
A) A planning process ends in action plan
1) Identify problems (Diagnoses the
problems) or needs to meet, How?

• To get facts on the problem:

 Are they real or potential problems?
 If there are needs, are they felt needs or potential
needs?
 Are the needs or problems affecting a few people
or are general?
 If facts are missing then experience can be used to
make judgement.
 Arrange the problems/needs in a ranking order i.e
most felt to the least felt need.
2. Identify many possible solutions
required for solving each of the
problems or meeting each of the
needs.

3. Cost each of the

solution/option/activity in terms of the
manpower required, money required,
materials (supplies) and time required.
(analyzing and comparing
alternatives)
4.a) Choose the most cost-effective
(affordable, cheapest) solution.

b) Identify or select the best way to

implement the chosen solution and
make a simple work plan to include:.
 What should be done, activities or
objectives to be met.
 What to use (materials)
 Who to do what activity (assign
responsibility)
 When to do it (timetable, schedule)
 Who to supervise, follow up.
 Money required (budget
2) ORGANIZING

• Definition: The process of dividing up

the work to be done and then co-ordinating
results to achieve a desired purpose.
(Refers to the way work is divided and
allocated among members of the
organization with the aim of goal
attainment).
OR
• The process by which the structure and allocations
of jobs are determined. It is the second basic
managerial function.
• It is an important step at operational level. The
proper arrangement of tasks carried out, staff,
patients, clients and other resources so that
services can run smoothly. (Arranging the
resources, human and non-human in a
sequential order in such a way that
achievement of objectives will be easy and
timely).
How to organize resources

Tasks (work activities)

Must identify and organize.

Break the work, labour into parts or
components or departments or units.
Identify the activities to be carried out in
each unit or department or component.
Schedule activities.
Staff organization

• Have an organogram showing the chain of

command, job descriptions.
• Duty roster to show shifts, if in the ward; pt, client
organization, bed spacing.
• Stress on 1st come 1st served, unless to attend to
the elderly, the very sick, disabled.
• Have numbered cards.
• Clarify the flow of clients.
• Label the service areas, number to doors or
services areas.
• Clarify the clinic hours for each day.
• Keep benches in good order, test
equipment.
• Order adequate supplies, charts.
• Have a work plan for the outreach clinics.
• Frequent inventory, handing over at every
shift.
IMPORTANCE OF ORGANIZATION

1) Major reason is to avoid chaos i.e when an

organization becomes large with set
objectives with a lot of resources and with
more people, failure to organize results in
chaos.
2. Once organization occurs, members of the
organization are able to work among
themselves to attain the goal.
3. Some members in an organization may
not only be aggressive but could also be
irrational, so organizing needs to control
them so that they do not step on others
toes or trespass and practice their
irrational behavior
4) Members maybe reluctant to assume
responsibility unless assigned and required
to do so by the organization.
5) Human beings are irrational animals
and like conflicting each other, so they need
this control.
PURPOSES FOR ORGANIZING
(SUMMARY)

• Dividing work to specific jobs and

departments.
• Assigning tasks and responsibilities.
• Co-ordinating diverse organization tasks.
• Clustering jobs into units.
• Establishing relationships among
individuals, groups and departments.
• Establishing formal lines of authority.
• Allocating and deploying organization
resources.
 STEPS/PROCESS OF
ORGANIZING
a)Formulating departmental structure:
• Structure of the organization deals with
inter-relationships of functions and people
in doing a job.
• The purpose is to create a framework for
effective operation.
• It influences the design of operating
procedures.
b) Developing the Procedure
• Procedural aspect is concerned with
defining and bringing about the necessary
conditions that make achievement of
objectives feasible.
• Procedural component of the organization
builds a system that will specify how to
perform the various steps in a task.
• Change in the procedural pattern generally
affect the structure of an organization
c) Determine (ascertain) the
requirements of resources
d) Allocate and assemble the resources
These two steps go hand in hand. They
generally follow structural and procedural
development in organizing. It is assumed
that the nature of objectives, the plan, the
structure and the procedure determine the
number and kind of resources necessary to
their allocation and their collection.
 THE KEY ORGANIZING
COMPONENTS AND
CONCEPTS
• The basic concept relating to structural
theories of organizing recommends that an
organization must have:

1)Unity of Command: It means that every

member (a subordinate) of an organization
should receive orders from only one
(supervisor) superior i.e one boss.
• This means that no individual employee
should be subjected to the orders of more
than one immediate supervisor (superior).
• The concept of unity of command is
described as “one person-one boss” or one
man-one superior.
2) Span of Control: It means the
number of employees (subordinates) a
supervisor or a manager can supervise
effectively (directly).

 The shorter the span, the greater will be

the contact and consequently more
effective control.
3) Delegation: It is the process of
assigning responsibility and authority to
subordinates (co-workers) and ensuring
their accountability.
 Delegation is the means by which a
supervisor can share his duties with his
immediate subordinates.
4) Decentralization: It is where decision-
making and responsibility for key
functions are delegated to the lowest
possible managerial level in the
department, reserving comparatively a
few bigger and more important problems
only for those higher up.
 Thus, a decentralized nursing department
places most decision-making at the head
nurse level with each individual head
nurse running her/his unit independent of
the decisions of her/his fellow head
nurses.
5) Centralization: This is the systematic
retention of power and responsibility at
higher levels of the organization.

 Organizations vary greatly in their degree

of centralization. The degree may differ
for different tasks and responsibilities.
The chief nurse is responsible for
centralized departments where major
decision-making and responsibility for
key functions are centralized at the top
level. Thus, for example, the chief nurse
would be responsible for budgeting,
staffing and quality assurance.
6) Departmentation (Grouping Jobs):
This is the process of grouping jobs
according to one of these three bases;
function, product and location.

7) Exception Principle: This is where the

manager delegates routine operations and
concentrates on major policy operations or
work.
8. Specialization and division of labour:
Division of labour means that the work is
sub-divided into small tasks or areas. By
working at their narrow task, people gain
more skill and proficiency and become
specialists. The classical school was by
no means the first to recognize the gains
inefficiency that could be made from
specialization.
• Work specialization makes
efficient use of employees skills,
tasks allocated according to skills,
wages paid accordingly, skills
improve with repetition, work
specialization increases efficiency
and productivity by encouraging
creation of special inventions and
machines to perform work.
9) The principle of correspondence
• This states that authority should be
commensurate with responsibility.
Authority is the right to give an instruction
or carryout a task. Responsibility is the
obligation to carryout the task satisfactorily.
 3) LEADERSHIP

Definition:
It is the process of Influencing people to
willingly accomplish goals (it is the ability
to influence the behavior of others, towards
the achievement of a mutually established
goals).
OR
• Leadership is the use of one’s skills to
influence others to perform to the best
of their ability towards achievement of
goals, without the use of threat or
violence.

• Leadership is not a fixed position. It is

a process, which changes as situations
change. A manager leads by
personally and actively working with
subordinates for two main reasons:
• To guide and motivate their behaviour
to fit the plans that have been
established.

• To understand the feelings of

employees and the problems they face
as they translate plan into action.

There are two types of leadership defined

as formal and informal.
 Formal

 This is when an appointed leader is chosen

by the administration and given official or
legitimate authority.
 This has the greatest impact when followers
accept the leader.
 Informal

• An informal leader does not have official

authority to direct activities of others.
He/she is usually chosen from within a
specific group, for example, social group,
church organization or work group. An
individual may become an informal leader
as a result of a variety of factors including
age, seniority, special competences or
personality.
 THEORIES OF
LEADERSHIP
• Various writers have attempted to explain
the theoretical basis for leaders and
leadership.
 A) TRAIT THEORY/ GREAT
MAN THEORY
• This theory identifies personal
characteristics which a leader should have.
The theory states that leaders possess a set
of physical and emotional characteristics
that are important for inspiring others
towards a common goal.
:
• Some theorists who subscribe to this theory
believe that leaders are BORN with certain
qualities that determine leadership ability
and success. The leaders seen as gifted or
develops certain characteristics including:
.
• Body physique: weight (strong, muscular),
height,
• (mental abilities), knowledgeable, good
judgment, wisdom
• Verbal ability- fluent in verbal
communication
• Personality – confidence, aggressive,
outgoing, risk taker, authoritarian
• NOTE: According to this theory the
leader behaves according to the role
expectations of the group. Those who
believe in this theory always believe that a
leader is born (born leaders).
2) Situational Theory of
Leadership
This one is based on the belief that a given
situation produces or creates a leader, e.g in
political coups (Junior Officers takeover).
• Times of distress also create leadership,
problems uniting people (anybody who
comes out with some solution can take
advantage and become a leader).
 3) Contingency Theory of
Leadership
• This combines both trait and situational
theories. Maintains that people become
leaders because of their qualities with
personalities and various situational factors.
 DIFFERENCES BETWEEN A
MANAGER AND A LEADER
MANAGER LEADER

 Have an assigned position within  Often do not have delegated

the formal organization. authority but obtain their power through
other means, such as influence

 Have a legitimate source of  Have a wider variety of roles

power due to the delegated than do managers.
authority that accompanies their
position.
 Are expected to carry out  May not be part of the formal
specific functions, duties and organization
responsibilities.
MANAGER LEADER

 Emphasize control,  Focus on group

decision-making, decision process, information
analysis and results. gathering, feedback and
empowering others.
 Manipulate people, the Emphasize interpersonal
environment, money, time and relationships.
other resources to achieve
organizational goals.
 Have a greater formal Direct willing workers.
responsibility and accountability
for rationality and control than
leaders.
Direct willing and unwilling  Have goals that may or may
subordinates not reflect those of the organization.
• In order to understand the concept of
leadership, we need to define the following
terms:
 RESPONSIBILITY

• Definition:

• This is the work assigned that must be

performed in order to complete a task.
• (This is a duty or assignment related to a
job).
 AUTHORITY:

• Definition: It is a legal right of a position or

office that requires others to obey. (The
right to act/or the official power to act,
command the action of others.
 Types of Authorities:

a. Formal (Office Power) – This is where

an organization bestows the authority
upon the individual by means of his/her
job title and specification of reporting
relationship.
B. Technical authority: - This is where the
authority arises due to personal skill,
special knowledge and special training.
Note in this case the authority exists only
within the scope of this special knowledge
or skill.
• C. Informal/personal authority – This
authority arises from the managers special
talent that is recognized by
comrades/colleagues as being important
and influential
 POWER:

• Definition: It is the ability of an

individual to control or to influence others
to do something (it’s the ability/capacity to
exercise influence or control over others.

 In the functioning of a leader, the

ability to guide the action of others is
achieved through the authority. Carrying
out these decisions is accomplished because
of powers of the leader.
 SOURCES OF POWER

• 1. Legitimate power: This is power

given to an office/position by the
organization (it is the power inherent in
one’s position).
• 2) Reward Power: This power
originates from the managers ability to offer
benefits/rewards e.g promotion, further
studies, time off from work, attractive work
assignments (tangible rewards) or
psychological rewards like praise,
appreciation, approval and recognition.
• 3) Coercive Power (Punishment
Power)
Coercive power is the opposite of
reward power and is based on fear of
punishment. Managers are obeyed to avoid
punishment if one fails to conform. When
the followers knows that the manager can
enforce punishment such as demotion,
termination (dismissal), withhold pay
increases, undesired assignments,
criticism/embarrassment in front of
others, and disapproval, they will obey.
4)Referent Power: This power arise from
good character of a manager. If the
followers know that the manager has good
character that they may want to associate
with, they will obey the same (it is based on
identification with a leader and what that
leader symbolizes. The leader is admired
and exerts influence because the followers
desire to be like the leader.
• 5) Expert Power: This
originates from managers special
knowledge, skills and expertise in
a specific field that followers do
not have. They will obey (i.e
people gain expert power through
knowledge, skills and information.
Their expertise gains them respect
and compliance).
6) Charismatic Power
• This arises from a special talent of a
manager such as excessive wisdom,
vision.
7) Physique Power
Body structure Influence.