ORGANIZATIONAL THEORY "the study of organizations for the benefit of identifying common themes for the purpose of solving

problems, maximizing efficiency and productivity, and meeting the needs of members The theory addresses how organizations reduce equivocality, or uncertainty through a process of information collection, management and use. (Karl E. Weick) I. CLASSICAL ORGANIZATION THEORY - Centers on theories of efficiency 1. Scientific Management approach (Frederick Winslow Taylor) -Efficiency & productivity; stresses the control of the labor force by management "Concerned with knowing exactly what you want men to do and see that they do it in the best & cheapest way." The Principles of Scientific Management 1) The creation of a scientific method of measurement that replaces the "rule-of-thumb" method 2) Emphasis placed on the training of workers by management 3) Co-operation between manager and workers to ensure the principles are being met 4) Equal Division of labor between managers and workers 2. Bureaucratic approach (Max Weber) Based on the principles of: Structure specialization predictability and stability rationality democracy 3. Administrative theory (Henry Fayol) - set of planning, organizing, and training, commanding and coordinating functions It is necessary to group people, distribute duties, and adapt the organic whole to requirements by putting essential employees where they will be most useful Nursing Organization:
Executive management and its staff

Intermediate executive- generator of ideas and power

Department managers (middle managers)

Operational managers (1stline managers)

Practicing professional & Technical nursing personnel

*nurse managers have as their object of development of a nursing organization that facilitates the work of clinical nurses

*Ignoring the importance of human needs II. NEOCLASSICAL THEORY o Emphasizes affective and socio-psychological aspects of human behaviors in organizations o Features on individual, work group and participatory management Hawthorne study suggested that employees have social and psychological needs along with economic needs in order to be motivated to complete their assigned tasks. *The theory gave a lot of importance to the social side of the study rather than addressing the needs of organization. III. MODERN THEORY o Organization is an adaptive system that adjust to changes in its environment 1. Systems approach

A system composed of a set of inter-related - and thus mutually dependent - sub-systems consisting of components, linking processes and goals 2. Socio-technical approach Composed of a social system, technical system and its environment interacting among themselves and it is necessary to balance them appropriately for effective functioning of the organization. 3. Contingency or situational approach Systems are inter-related with their environment and that different environments require different organizational relationships for effective working of the organization. *Implies that a leader switch is the only method to correct any problems facing leadership styles in certain organizational structures and that the model itself has been questioned in its credibility STEPS IN ORGANIZING Step 1: Compile a list of the key activities determined by the mission and objectives of patient care. The written philosophy and vision statements will help by indicating important values to be considered. When list are completed, it should be analyzed. Determine the central load-carrying elements. It must be related to primary care, and philosophy will usually dictate the excellence of patient care to accomplish its objectives. Whenever the strategy changes, the organizational structure should be reviewed and analyzed. o Changes in mission o Philosophy o Objectives o Vision o Operational plan The analysis of key activities can be done according to the kinds of contributions made. These will include the following: Results-producing activities related to direct patient care such as training, recruiting, and employment. Support activities, which may include those related to vision or future, values and standards, audit, advice, and teaching. Hygiene and housekeeping activities Top management activities such as vision, values, standards and audit as well as managing people, marketing and innovation. Step 2: Decision analysis Decide on the units of the organization Decide on which kind of decision will be required and who will make them Decisions involving functions of future commitments Decisions involving ethical values, principles of conduct and social and political beliefs should be analyzed All decisions should be placed at the lowest level and as close to the operational scene as possible. Step 3: decide which units or components will be joined and which separated join activities that make the same kind of contribution This will require relations analysis and will be related to the sequence of key activities or functions. Step 4: Decide on the size and shape of the units or components. Step 5: Decide on the appropriate placement and relationships of different units or components. Step 6: Draw or diagram the design and put it into operation. This will result in an organizational chart or schema.
MODALITIES OF CARE Manner in which nursing care is organized and provided; depends on the philosophy of the organization, nurse staffing and client population.

I.

Case Method/Total Patient Care The nurse cares for one patient exclusively (Private duty nursing) First type of nursing care delivery system In Total Patient Care, the nurse is responsible for the total care of the patient during the nurses working shift. The RN is responsible for several patients. Advantages: Disadvantage:

II.

Consistency in carrying out the nursing care plan Patient needs are quickly met as high number of RN hours are spent on the patient Relationship based on trust is developed between the RN and the patients family

It can be very costly

Functional Nursing A task-oriented method where a particular function is assigned to each staff which is beneficial when staffing was poor Key idea was for nurses to be assigned to tasks, not to patients. e.g. medication nurse, treatment nurse and bedside nurse Advantages: Disadvantages:

A very efficient way to delivery care. Care of patients become fragmented & depersonalized Could accomplish a lot of tasks in a small amt. of time Patients do not have one identifiable nurse Staff members do only what they are capable of doing Very narrow scope of practice for RNs Least costly as fewer RNs are required Leads to patient and nurse dissatisfaction III. Team Nursing (commonly used) Developed in the 1950s having the goal for a team to work democratically. In the ideal team, an RN is assigned as a Team Leader for a group of patients. The Team Leader has a core of staff reporting to her, and together they work to disseminate the care activities. The team member possessing the skill needed by the individual patient is assigned to that patient, but the Team Leader still has accountability for all of the care. Team conferences occur in which the expertise of every staff member is used to plan the care.
Advantages: Disadvantages:

Each members capabilities are maximized so job satisfaction should be high Patients have one nurse (the Team Leader) with immediate access to other health providers

Requires a team spirit and commitment to succeed RN may be the Team Leader one day and a team member the next, thus continuity of patient care may suffer Care is still fragmented with only 8 or 12 hour accountability

IV.

Primary Nursing One nurse cares for one group of patients within 24-hour accountable for planning their care. A Primary Nurse (PN) cares for her primary patients every time she works and for as long as the patient remains on her unit. An Associate Nurse cares for the patient in the PNs absence and follows the PNs individualized plan of care. -decentralized delivery model: more responsibility and authority is placed with each staff nurse. Advantages: Disadvantage:

Increased satisfaction for patients and nurses More professional system: RN plans and communicates with all healthcare members. RNs are seen as more knowledgeable and responsible.

Only confines a nurses talents to a limited number of patients, so other patients cannot benefit if the RN is competitive

Can be intimidating for RNs who are less skilled and knowledgeable

V.

RNs more satisfied because they continue to learn as part of the in-depth care they are required to deliver

Modular Nursing (District Nursing) A modification of team and primary nursing wherein geographical assignment of patient that encourages continuity of care by organizing a group of staff to work with a group of patients in the same locale Advantages: Disadvantage:

Useful when there are a few Rns RNs plan their care

Paraprofessionals do technical aspects of nursing care

TIME MANAGEMENT The appropriate use of tools, techniques, and principles to control time spent on low-priority needs and to ensure that the time is invested in activities leading toward achieving desired high-priority goals. The ability to spend your time on the things that matter to you and your organization. TIME STEALERS/ WASTERS Time Stealers
Doing Too Much If you think that you have too much to do, you probably do.

Management
Be realistic Limit major commitments Give full and undivided attention Complete one task at a time Prioritize your goals and activities Be honest Negotiate Identify the reason for procrastinating Reward yourself after finishing the task Select the least attractive element of the task to do first Break task into manageable pieces PERT and Gantt Chart Stop and ask yourself Talk with the person Rethink and generate possible solutions Be aware Do slightly less than a perfect job Resume doing it now Maintain the attitude that whatever the interruption, it is part of your responsibility

Inability To Say No

Procrastination

If you are suffering from overload, you probably have gotten there by not being able to sayno. -doing one thing when you should be doing something else.

Complaining

Perfectionism Interruptions

Disorganization

-act of expressing dissatisfaction or annoyance with persons, places, things, and situations. -tendency to never finish anything because it is not yet perfect. When you make a conscious decision not to worry about the things you cannot control, you have more energy to maintain a positive perspective and to move projects forward. Organization is a process rather than the product. Technology forces us to receive huge amounts of data and to transform these data into useful information. Information overload (data smog) occurs when you are overwhelmed by too much information, too fast and too often and do not have the skill to interpret the data into useful information. Symptoms: Sense of inability to keep up with everything Feeling that data keep you from accomplishing your real job Inability to proceed from the question or problem to fact finding Interference with sleep Decreased ability to concentrate Irritability Physical distress (indigestion, heart problems and hypertension)

Too Much Information

Eliminate clutter Keep everything in place Do similar tasks together Information literacy-developing data and information gathering, receiving and sending skills Appreciate new information

PERT (Program Evaluation and Review Technique) Chart Tool to assist in complex projects thus require a series of activities, some of which must be performed sequentially, and others that can be performed in parallel with other activities.

Indicates all predecessor activities that must be completed before a new activity is undertaken

Gantt Chart Consists of a table of project task information and a bar chart that graphically displays project schedule, depicting progress in relation to time and often used in planning and tracking a project. TIME MANAGEMENT TECHNIQUES Technique Purpose Organization Designated to promote efficiency and productivity

Keep focused on goals Tool usage Time management plan

Focuses on goal achievement Uses the right tool for planning and preparation Helps to refocus, to gain control and to use information

Actions Organize and systematize things, tasks, and people Use basic time management skills Assemble a prioritized to do list based on goals daily Use tools such as the Palm Pilot or bar code scanner Develop a personal time management plan appropriately

TIME MANAGEMENT STRATEGIES 1. Goal Setting Determine long-term and short term goals. Set reasonable and achievable goals. Give yourself time to meet the goals. Be flexible. 2. Setting Priorities Classify as important and urgent. 3. Organization There is a place for everything and everything in its place. Plan where things should go. Dont use your top desk for storage. Create a to do and to be filed folders Have a regularly scheduled time 4. Time Tools Organize or go with the flow Time log- to list work related activities 5. Managing Information Assess the source Develop information receiving skills Reduce or discard useless information Monitor information flow and decide what to do with the incoming data Find and focus on most important pieces Narrow down specific details you need Identify resources Build a picture of data received Recognize when you have enough information to act Develop information sending skills Keep the outflow short Select the most appropriate mode of communication for your message