Page 27 - Essentials of Nursing Leadership and Management, 5th Edition

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14 unit 1 | Professional Considerations CikguOnline
Every nurse should be a good leader and a good name implies, the human-relations approach
follower. Not everyone should be a manager, how- emphasizes the interpersonal aspects of managing
ever. In fact, new graduates simply are not ready to people, whereas scientific management emphasizes
take on management responsibilities. Once you the task aspects.
have had time to develop your clinical and leader-
ship skills, you can begin to think about taking on Scientific Management
management responsibilities (Table 2-1). Almost 100 years ago, Frederick Taylor argued
that most jobs could be done more efficiently if
MANAGEMENT they were analyzed thoroughly (Lee, 1980; Locke,
1982). With a well-designed task and enough
incentive to get the work done, workers could be
Are You Ready to Be a Manager? more productive. For example, Taylor promoted
For most new nurses, the answer is no, you should the concept of paying people by the piece instead
not accept managerial responsibility. The breadth of by the hour. In health care, the equivalent
and depth of your experience are still undeveloped. would be by the number of patients bathed or vis-
You need to direct your energies to building your ited at home rather than by the number of hours
own skills before you begin supervising other people. worked. This would create an incentive to get the
most work done in the least amount of time.
What Is Management? Taylorism stresses that there is a best way to do a
The essence of management is getting work done job. Usually, this is also the fastest way to do the
through others. The classic definition of manage- job (Dantley, 2005).
ment is Henri Fayol’s 1916 list of managerial tasks: The work is analyzed to improve efficiency. In
planning, organizing, commanding, coordinating, health care, for example, there has been much dis-
and controlling the work of a group of employees cussion about the time it takes to bring patients to
(Wren, 1972). But Mintzberg (1989) argued that radiology or to physical therapy versus bringing the
managers really do whatever is needed to make sure technician or therapist to the patient. Eliminating
that employees do their work and do it well. excess staff or increasing the productivity of remain-
Lombardi (2001) points out that two-thirds of a ing employees is also based on this kind of thinking.
manager’s time is spent on people problems. The Nurse managers who use the principles of scien-
rest is taken up by budget work, going to meetings, tific management will pay particular attention to
preparing reports, and other administrative tasks. the type of assessments and treatments done on the
unit, the equipment needed to do this efficiently,
Management Theories and the strategies that would facilitate efficient
accomplishment of these tasks. Typically, these
There are two major but opposing schools of nurse managers keep careful records of the amount
thought in management: scientific management of work accomplished and reward those who
and the human relations–based approach. As its accomplish the most.

Human Relations–Based Management
table 2-1
McGregor’s theories X and Y provide a good
Differences Between Leadership example of the difference between scientific man-
and Management agement and human relations–based management.
Leadership Management Theory X, said McGregor (1960), reflects a com-
Based on influence Based on authority mon attitude among managers that most people do
and shared meaning not want to work very hard and that the manager’s
An informal role A formally designated role job is to make sure that they do work hard. To
An achieved position As assigned position accomplish this, according to Theory X, a manager
Part of every nurse’s Usually responsible for budgets, needs to employ strict rules, constant supervision,
responsibility hiring, and firing people
and the threat of punishment (reprimands,withheld
Requires initiative and Improved by the use of raises, and threats of job loss) to create industrious,
independent thinking effective leadership skills
conscientious workers.