---Part II---

2. Supervision of Personnel (Principles and Techniques)

3. Motivation

3.1. Theories of Motivation (Content and Process Theories)

3.2. Use of Motivation Theories to Nursing Administration

4. Coordination of Services

5. Communication

5.1. Principles of Effective Communication5.2. Lines of Communications

●Supervision●

Definition

Supervision is the authoritative direction of thework of a subordinate. It is based on thehierarchal organization in which each level ofsubordinate to the one immediately above issubject to its orders. (Basavanthappa)

It is also known as a cooperative relationshipbetween a leader and one or more persons toaccomplish a particular purpose (Lambertson);and a kind of teaching which involves, advising,helping, inspiring leading and liberating. (JeanBarett)

Supervision is about nurturing employeesand not about intimidating, challenging, orover powering them. It is about sharingknowledge, skills, work expectations as wellas being committed to make superviseessuccessful in their roles rather than waitingfor them to make a mistake. Supervisorsneed to have clear thinking and a specificidea of how one can support the individualswho work for you and the organization. It isthe same as if you have a specific plan tomaintain a service or process. Goodsupervision requires a road map to getpeople to where they want to go with theirroles and careers (Wenger, 2009).

Principles of Supervision (Tan, 2009)

1. Good supervision is focused on theimprovement of work rather than upgrading theworker.

2. It is based on the lines of authority,organizational philosophy, vision/mission, jobdescription, policies and standards, and theneeds of the individual.

3. Focuses on the three areas of skill:conceptual, technical and interpersonal.

4. It is cooperatively planned, and accepts bothchallenge and change.

5. It uses a democratic process to facilitate:

-effective communication

-continuous improvement of staff

-respect for the individuality of each staffmember

-bring about a harmonious relationship and a conducive social, psychological and physical atmosphere

6. The ultimate goal of good supervision is to provide safe, effective, quality care.

Functions of Supervision (Dawson, 1926)

• Administrative (Normative)

• Educational (Formative)

• Supportive (Restorative)

Functions of Supervision in Directing (Borders, 2001)

1. Improve the quality of decision-making andinterventions.

2. Enable effective line management andorganizational accountability.

3. Identify and address issues related to caseloadsand workload management.

4. Help to identify and achieve personal learning,career and development opportunities.

5. Supervision is not always easy. A supervisor is often called upon to make decisions based upon the knowledge and skills which have been acquired through the years of professional involvement. A supervisor must serve many functions. Among these are:

• Articulating and achieving the unit's missions and needs

• Monitoring and managing the climate of the unit

• Fostering individual development

• Developing teamwork capabilities and group resources

• Coordinating work activities

• Promoting active problem solving

Qualities of good supervisor

Personality Character

Professional Competence

Techniques and tools for supervision

• Observation (nursing and supervisory rounds)• Individual and group conferences• Checklists• Rating scales• Written policies, printed manuals, bulletin records etc.• Reports written or verbal (anecdotal reports, incidence

reports)• Follow-up visits and evaluation• Staff meeting• In-service education• Performance evaluation (self-evaluation, peer

evaluation, supervisor’s evaluation, evaluation by the general public)

Approaches to Supervision

1. Authoritarian - based on the belief that staff members require constant attention

2. Laissez Faire - based on the desire to allow staff members freedom in accomplishing job responsibilities

3. Companionable - based on a friendship-like relationship

4. Synergistic - a cooperative effort between the supervisor and the staff member

Religion and Supervision

• Staff development is important in creating a positive work environment.

• There can be considerations for discussing religious practices, customs, in general to benefit all staff members.

• It may also be helpful for supervisors to have a listing of religious holidays. A better understanding of religion in the workplace can make for positive environments.

• It is also important to take religious holidays into account when planning staff or division wide events.

Gender Issues In Supervision

• Be attentive to the health and safety of women who may be pregnant. Do not ask them to lift or carry items that may cause them to strain and harm the baby (Certo, 1994).

• Be conscious of same gender communication and opposite gender communication patterns. These can be the source of difficulties.

• Mentor relationships need to be carefully examined. Understand the dynamics of same gender mentor relationships as well as opposite sex mentor relationships (Karsten, 1994).

• Do not stereotype new mothers as individuals notinterested in career advancement, or interested intheir current positions (Karsten, 1994).

• In the case of working mothers, devise a plan forhow the two of you will handle a child being sick. Itis advisable that this be done as soon after theiremployment as possible (Karsten, 1994).

DO DON'T

Openly discuss the goals and process of

supervision with each staff member

Treat supervision as a routine

administrative task

Include advancement of staff member's

personal and professional goals in the

supervisory process

Establish supervisory structure without

genuine input from supervisor

Show concern and interest in staff

member's personal concerns

Attempt to become a staff member's

therapist

Work at establishing friendly relationships

with staff

Allow romantic or "special" caring to

develop with persons supervised

Treat staff members equitably Show or appear to show favor to some staff

members

Confront problems and issues when first

realized

Confuse the value of the person with his or

her behaviors

Support the decisions of superiors

with subordinate staff and students

Hide disagreement from supervisor

during decision making process

Publicly admit when wrong or

mistaken

Criticize (correct) staff members

publicly

Deal with staff members face to

face

Discuss a staff member's problem

behavior with another subordinate

or coequal staff member

Keep confidences Hesitate to consult with supervisors

or other professionals

Be direct, open, and honest Try to send indirect message or

message thorough a third party to a

staff member about his or her

conduct

Keep records of supervisory

contacts

Rely on memory for details of

supervisory sessions

Establish specific performance

objectives or program outcomes

periodically (at least biannually)

Fail to follow up on accomplishment of

objectives periodically

Recognize and reward achievement Assume that a "good job" is the norm

and does not require acknowledgment

Make realistic assignments based on a

knowledge of the staff member's

experience and skill level, personal

maturity, and current life situation

Assume that everyone on a staff or in

an office should do the same thing at

the same time

Make explicit connection between

supervision and staff development

activities

Assume that staff members can always

identify the areas in which they need to

develop skills or acquire knowledge

Listen and learn from staff supervised Assume final knowledge about

supervision or about a supervisory

relationship

●Motivation●

Definition

Motivation is derived from the Latin word‘movere’ which means ‘to move’. It refers to theprocess that account for an individual’s intensity,direction, and persistence of effort towardsattaining a goal.

Common Aspects of Motivation

Effort

-concerns the magnitude or intensity of employee’s work-related behavior

Persistence

-concerns the sustained efforts employee manifested in their work-related activities

Direction

-quality of an employee’s work that is the investment of sustained effort in a direction that benefits the employer

Theories of Motivation (Content and Process Theories)

Content Theories (WHAT motivates us)

Process Theories (WHY and HOW motivation occurs)

Perspectives of Motivation

-approaches to motivation that try to answer the question: “What factors in the workplace

motivate people?”

Abraham Maslow’s Hierarchy of Needs

Maslow’s Hierarchy of Needs suggests that people are motivated to fulfill basic needs before moving on to other, more advanced needs. As a humanist,

Maslow believed that people have an inborn desire to be self-actualized. In his theory of motivation, he argued that there are five levels of need, and that these are hierarchical, such that lower level needs

must be satisfied before higher ones. Maslow's five levels of need (starting with the lowest) are:

physiological, safety, social, self-esteem and self-actualization.

Alderfer’s ERG Theory of Motivation

Growth refers to an intrinsic desire for personal development; the intrinsic component of Maslow’s social/love need, and the external component of his

esteem need.

Relatedness refers to the desire we have for maintaining interpersonal relationships; similar to

Maslow’s social/love need, and the external component of his esteem need.

Existence refers to our concern with basic material existence requirements; what Maslow called

psychological and safety needs.

• It suggests that people can be motivated byneeds from more than one level at the sametime. There is not necessarily a strict progressionfrom one level to the next.

• It acknowledges that the importance of the needsvaries for each person and as circumstanceschange. Some people might put a higher value ongrowth than relationships at certain stages oftheir lives.

• It has a "frustration-regression" element. Thismeans that that if needs remain unsatisfied atone of the higher levels, the person will becomefrustrated, and go back to pursuing lower levelneeds again.

Implication of the ERG Theory

• an employee has various needs that must be satisfied at the same time

• if the manager concentrates solely on one need at a time, this will not effectively motivate the employee

• if an employee is not provided with growth and advancement opportunities in an organization, he might revert to the relatedness need such as socializing needs and to meet those socializing needs

Mc Gregor’s Theory X and Y

Assumptions of Theory X• An average employee intrinsically does not like work

and tries to escape it whenever possible.• Since the employee does not want to work, he must be

persuaded, compelled, or warned with punishment so as to achieve organizational goals. A close supervision

is required on part of managers. The managers adopt a more dictatorial style.

• Many employees rank job security on top, and they have little or no aspiration/ ambition.

• Employees generally dislike responsibilities.• Employees resist change.

• An average employee needs formal direction.

Assumptions of Theory Y

• Employees can perceive their job as relaxing and normal. Theyexercise their physical and mental efforts in an inherent mannerin their jobs.

• Employees may not require only threat, external control andcoercion to work, but they can use self-direction and self-controlif they are dedicated and sincere to achieve the organizationalobjectives.

• If the job is rewarding and satisfying, then it will result inemployees’ loyalty and commitment to organization.

• An average employee can learn to admit and recognize theresponsibility. In fact, he can even learn to obtain responsibility.

• The employees have skills and capabilities. Their logicalcapabilities should be fully utilized. In other words, thecreativity, resourcefulness and innovative potentiality of theemployees can be utilized to solve organizational problems.

Implications of Theory X and Theory Y

• Theory X encourages use of tight control andsupervision. It implies that employees are reluctant toorganizational changes. Thus, it does not encourageinnovation.

• Theory Y implies that the managers should create andencourage a work environment which providesopportunities to employees to take initiative and self-direction. Employees should be given opportunities tocontribute to organizational well-being. It harmonizesand matches employees’ needs and aspirations withorganizational needs and aspirations.

Herzberg’s Two-factor Theory

According to Frederick Herzberg, there are some job factors that result in satisfaction while there

are other job factors that prevent dissatisfaction. According to Herzberg, the

opposite of “Satisfaction” is “No satisfaction” and the opposite of “Dissatisfaction” is “No

Dissatisfaction”.

Hygiene factors

-job factors which when adequate/reasonable in a job, pacify the employees and do not make

them dissatisfied

-are extrinsic to work

-also called as dissatisfiers or maintenance factors as they are required to avoid

dissatisfaction

Hygiene factors

• Pay

• Company Policies and administrative policies

• Fringe benefits

• Physical Working conditions

• Status

• Interpersonal relations

• Job Security

Motivational factors

• Recognition

• Sense of achievement

• Growth and promotional opportunities

• Responsibility

• Meaningfulness of the work

Implications of Two-Factor Theory

• Managers must stress upon guaranteeing theadequacy of the hygiene factors to avoidemployee dissatisfaction.

• Managers must make sure that the work isstimulating and rewarding so that theemployees are motivated to work andperform harder and better.

McClelland’s Achievement, Power, and Affiliation Needs

David McClelland identified three motivators that he believed we all have: a need for

achievement, a need for affiliation, and a need for power. People will have different

characteristics depending on their dominant motivator regardless of our gender, culture, or

age.

Achievement Has a strong need to set and accomplish challenging

goals.

Takes calculated risks to accomplish their goals.

Likes to receive regular feedback on their progress

and achievements.

Often likes to work alone.

Affiliation Wants to belong to the group.

Wants to be liked, and will often go along with

whatever the rest of the group wants to do.

Favors collaboration over competition.

Doesn't like high risk or uncertainty.

Power Wants to control and influence others.

Likes to win arguments.

Enjoys competition and winning.

Enjoys status and recognition.

Implications of Achievement, Power, and Affiliation Needs Motivation Theory

• Every person has one of three main drivingmotivators: the needs for achievement,affiliation, or power. These motivators are notinherent; we develop them through ourculture and life experiences.

●Coordination●

Definition

Coordination is the orderly synchronization of efforts to provide the proper amount, timing,

and directing execution resulting in harmonious and unified actions to a stated objective. It is also known as the integration of several parts

into an orderly whole to achieve the purpose of undertaking.

Importance of Coordination

1. Creative force. Group efforts when coordinated create a result greater than the

sum total of the individual and isolated.

2. Unity of direction. Coordination ensures unity if direction by way of securing spontaneous

collaboration on the part of different departments.

3. High employee morale. Coordination enhances the general level of employee morale

and provides satisfaction.

4. Diverse and specialized activities. Total activities of an organisation are divided into

several units and subunits on the basis of either product specialisation.

5. To avoid personal rivalries and prejudice. Human organization gives rise in course of time

to the development of personality politics among members.

6. To avoid conflict of interests. Subordination of individual interest to general interest often

happens in organizations. There is need for coordination to avoid conflicts or overlapping in

the work of employees or units or as organization.

Techniques of Coordination

• Communication

• Orderly plans

• Supervision

• Leadership

• Departmentalization

• Direct contact

Hindrances to Coordination

• Uncertainty of the future, as to the behaviour of the individual and the people.

• Lack of knowledge, experience, wisdom and character among leaders and their confused and conflicting ideas and objectives.

• Lack of administration skill and technique.

• Vast number of variables involved and theincompleteness of human knowledge,particularly with regard to men and life.

• Lack of orderly methods coordination.

• Size and complexity, personality and politicalfactors.

• Lack of leaders with wisdom and knowledgepertaining to public administration

• Accelerated expansion of publicadministration of international dimension.

Coordination Applied to Nursing Management

1. Health care system consists of different categories of health personnel which requires intense coordination to function it effectively.

2. Nursing service is often the largest group of health personnel with wide range of functions and skills.

3. Effective coordination of nursing services and patient care will lead to patient satisfaction, better quality of service and patient outcomes.

●Communication●

Definition

Communication supports each of a manager’s functions. The ability to effectively communicate is a necessary condition for successfully planning, organizing, leading, and controlling. Communication is vital to organizations—it’s how we coordinate actions and achieve goals. It is a process by which information is exchanged between individuals through a common system of symbols, signs, or behavior.” (Merriam-Webster)

Effective communication

Effective communication is a part and parcel of any successful organization. A communication

should be free from barriers so as to be effective. Communication is a two way process where the message sent by the sender should

be interpreted in the same terms by the recipient.

The Communication Process

Communication fulfills three main functions within an organization:

(1) transmitting information

(2) coordinating effort

(3) sharing emotions and feelings

Elements of Communication

(1) SenderThe person who intends to convey the message with theintention of passing information and ideas to others isknown as sender or communicator.(2) IdeasThis is the subject matter of the communication. This maybe an opinion, attitude, feelings, views, orders, orsuggestions.(3) EncodingSince the subject matter of communication is theoretical

and intangible, its further passing requires use of certainsymbols such as words, actions or pictures etc.Conversion of subject matter into these symbols is theprocess of encoding.

(4) Communication Channel

The person who is interested in communicating has tochoose the channel for sending the required information,ideas etc. This information is transmitted to the receiverthrough certain channels which may be either formal orinformal.

(5) Receiver

Receiver is the person who receives the message or forwhom the message is meant for. It is the receiver whotries to understand the message in the best possiblemanner in achieving the desired objectives.

(6) Decoding.

The person who receives the message or symbol from thecommunicator tries to convert the same in such a way sothat he may extract its meaning to his completeunderstanding.

(7) Feedback

Feedback is the process of ensuring that the receiver hasreceived the message and understood in the same senseas sender meant it.

Characteristics of Effective communication

1. The message to be delivered must be clear in the mind of sender.

2. The message delivered should not be incomplete.

3. The message should be concise.

4. The feedback should be timely and in personal. It should be specific rather than general.

5. Empathy with the listeners is essential foreffective verbal communication.

6. The information requirement by different peoplein the organization differs according to their needs.

7. For effective communication multiple channelsshould be used as it increases the chances of clarityof message.

8. The employees and managers should not alwaysdiscourage grapevine.

Principles of Effective Communication

1. Know your audience.

2. Know your purpose.

3. Know your topic.

4. Anticipate objections.

5. Present a rounded picture.

6. Follow through on what you say.

7. Communicate a little at a time, then check if the listener understands.

8. Present information in several ways.

9. Develop practical, useful ways to get feedback.

10. Use multiple communication techniques.

Ways of Communication (Corrado, 1994)

• Informal talks• Planned appointments• Telephone calls• Interoffice memos• Letters• Reports• Informal staff meeting• Planned conferences• Mass meetings/ General assemblies• Bulletin board notices• Posters• Exhibits• Displays• Visual aids

Dimensional Flow of Communication in Nursing

1. Vertical Communication

2. Horizontal Communication

3. Outward communication

4. Diagonal Communication

Lines of Communication

Line of Power

Line of Technology

In-Person Communication

Online Sources:

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References:Tan, C.B., & Beltran E.I. (2009). Leadership and Management in Nursing: A Transformative and Reflective Text and Workbook. Manila, Philippines: Educational Publishing House.

Berman, A. & Kozier, B. (2008) Kozier & Erb's Fundamentals of Nursing: Concepts, Process and Practice. Upper Saddle River, N.J.: Pearson Prentice Hall.