2. ---Part I---
 Activities Related to the Directing Functions
 Elements of Directing
1. Delegation
1.1. Principles of Delegation
1.2. Reasons for Delegation
1.3. Management by Objectives
1.4. Effective Delegation
1.5. Nursing Care Assignment
1.6. Utilization of Policies and Procedures

3. ---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 Communication
5.2. Lines of Communications

4. ---Part III---
6. Staff Development
7. Decision-making
8. Benchmarking (Standards of Evaluating the
Directing Function)
9. Conflict Management
9.1. Characteristics of Conflict
9.2. Assessing Conflict
9.3. Sources/Causes and Types of Conflict
9.4. Conflict Management – What to Consider
9.5. Techniques/Skills for Managing Conflicts

5. ●Definitions of Directing●
Directing is known as the act of issuing of
orders, assignments, and instructions to
accomplish the organization’s goals and
objectives. It involves the process of
getting the organization’s work done. It
entails explaining what it is to be done,
to and by whom, at what time, how and
why the task should be done.

6. Directing is a function of management often
performed by top level management in order to
achieve organizational goals. It is a very important
and necessary function of management. Directing
consists of the processes and techniques utilized in
issuing instructions and making certain that
operations are carried as originally planned.
●Definitions of Directing●

7. Directing involves determining the course,
giving order and instruction and providing
dynamic leadership. (Marshall)
●Definitions of Directing●

8. ●Activities Related to the Directing
Functions●
-telling people what is to be done and explaining
how to do it
-issuing instructions and orders to subordinates
-inspiring them to contribute towards the
achievement of objectives
-supervising their activities
-providing leadership and motivation

11. ●Delegation●
-the act of assigning to someone
else a portion of the work to be
done with corresponding
authority, responsibility and
accountability
-a skill to be learned and
mastered beginning with
learning what cannot be
delegated and what will be
delegated to whom

12. History
The next day Moses took
his seat to serve as judge
for the people, and they
stood around him from
morning till evening. When
his father-in-law saw all
that Moses was doing for
the people, he said, “What
is this you are doing for the
people? Why do you alone
sit as judge, while all these
people stand around you
from morning till
evening?”

13. History
Moses answered him,
“Because the people
come to me to seek
God’s will. Whenever
they have a dispute, it is
brought to me, and I
decide between the
parties and inform them
of God’s decrees and
instructions.”

14. History
“The thing that you do is
not good. Both you and
these people who are
with you will surely wear
yourselves out. For this
thing is too much for
you; you are not able to
perform it by yourself”
(Exodus 18:17, 18)

15. History
“If you do this thing, and
God so commands you,
then you will be able to
endure, and all this
people will also go to
their place in peace.”

16. ●Reasons for Delegation●
For the nurse manager
1. To free up time for
planning and organizing.
2. To help the nurse
manager learn how to
properly and effectively
manage and develop
employees.

17. 3. To keep the nurse
manager from ‘spreading
him/herself too thin’.
4. Delegation encourages
open communication and
trust.
5. It can show the nurse
manager a better way of
handling people and
resources.

18. For the subordinates
6. Delegation motivates and
builds morale.
7. Delegation encourages
and stimulates creativity and
initiative.
8. Delegation helps develop
the skills of subordinates
9. Delegation allows the
subordinates to contribute
significantly to team
success.

19. For the organization
10. Delegation benefits
the team, the department,
and the organization.

20. ●Principles of Delegation●

21. Principle of Result Expected
Suggests that:
-every nurse manager before delegating the
powers to the subordinate should be able to
clearly define the goals as well as results
expected from them
-goals and targets should be completely and
clearly defined and the standards of
performance should also be notified clearly

22. Principle of Parity of Authority and
Responsibility
-the nurse manager should keep a
balance between authority and
responsibility - both of them should
go hand in hand
- if a subordinate is given a
responsibility to perform a task, at the
same time he should be given enough
independence and power to carry out
that task effectively

23. Principle of absolute responsibility
-responsibility is fixed; authority
can be delegated but responsibility
cannot
-the nurse manager is always
responsible to his superior for
carrying out his task by delegating
the powers
-every nurse manager is
responsible for the act of his/her
subordinate and is also
accountable to his/her superior

24. Principle
of
Authority level
-suggests that a nurse manager should exercise his
authority within the jurisdiction / framework given
-before a nurse manager takes any important
decision, he should make sure that he has the
authority to do so
-emphasizes the degree of authority and the level
up to which it has to be maintained

25. ●Delegation: Additional Information●

26. What cannot be delegated?
• Overall ARA
• Final evaluation of staff
performance
• Correcting and disciplining
staff
• Activities which the nurse
to whom the task is
delegated does not want to
do because it is unpleasant

27. Delegated tasks must
be based on
• Policies
• Job Description
• Capabilities of Workers

28. Why Managers do not want to delegate?
• Mistakes in delegation can be
costly.
• Failure to delegate wisely
increases management costs
and contributes to personnel
dissatisfaction.
• Fear on the part of the director,
of her own ability to delegate.
• Fear of losing control of the
staff.
• Fear of failing to get others do
the work.
• Fear of criticism.

29. Common Delegation Errors
Underdelegating
• manager’s false assumption:
delegation may be interpreted as the
lack of ability on his or her part to do
the job correctly or completely
• nurse manager manifests his desire to
do the job by himself due to fear that
subordinates will resent the work
delegated to them
• occurs when the nurse manager lacks
experience in the job

30. Overdelegating
• unnecessarily burdens the
subordinates with tasks that are
either inconsequential or irrelevant
to the delivery of the goal; culprit is
usually poor management of time
and insecurity on the part of the
nurse manager in her inability to
perform tasks
Common Delegation Errors

31. Improper delegating
• delegation of tasks and
responsibilities beyond
which the person
cannot perform
properly
Common Delegation Errors

34. ●Management by Objectives●
Management by
Objectives works if you
first think through your
objectives. Ninety
percent of the time you
haven’t. (Drucker)

35. A process whereby the superior and
subordinate managers of an
organization jointly identify its common
goals, define each individual’s major
areas of responsibility in terms of the
results expected of him and use these
measures as guides for operating the
unit and assessing the contribution of
each of its members. (George Odiorne)
●Management by Objectives●

36. MBO is a system for making
organizational structures work, of
bringing about vitality and personal
involvement in the hierarchy by means of
statements of what is expected from
everyone involved and measurement of
what is actually achieved. It stresses
ability and achievement rather than
personality. (Odiorne)
●Management by Objectives●

37. • allows the individual nurse to contribute
to the common goal of the enterprise
• nurse managers focus on the business
goals
• MBO promotes high standards, focusing
on the job and not on the manager
• Nurse managers know what to expect of
employees
• Just like their nurse managers, nursing
staff should know for what they will be
held accountable.
●Management by Objectives●

38. • spells out the results expected of
the clinical nursing unit itself and
in relation to other units
• emphasizes teamwork and team
results
• includes short and long-term
objectives as well as tangible and
intangible objectives
●Management by Objectives●

39. • allows people to control their own
performance and measure
themselves
• nurse managers will assume that
clinical nurses want to be
responsible, want to contribute,
want to achieve, and have the
strength and desire to do so.
●Management by Objectives●

40. Planning Phase Performance Review Phase Feedback Phase
Key Activities and Participants
Identify and define key organizational
goals (nurse manager)
Identify and define key departmental
goals that stem from overall goals
(nurse manager)
Identify and define performance
measures or operational goals for
employees (nurse manager)
Formulate and propose goals for a
specific job (subordinate)
Participate in management conferences
(nurse manager and subordinates)
Achieve joint agreement on individual
objectives and individual performance
(nurse manager and subordinates)
Set-up timetable for periodic meetings
for performance review. (nurse
manager and subordinates)
Continue to participate in periodic
management conferences. (nurse
manager and subordinates)
Adjust and refine objectives based on
feedback, new constraints, and new
inputs. (nurse manager and
subordinates)
Eliminate inappropriate goals. (nurse
manager and subordinates)
Readjust timetable as needed. (nurse
manager and subordinates)
Maintain ongoing comparison of
proposed time-table and actual
performance through use of control
monitoring devices, such as visible
control charts. (nurse manager and
subordinates)
Review overall organizational and
departmental goals for the next
planning period, such as the next fiscal
year. (nurse manager)

41. ●Effective Delegation●
Effective ways of delegation for nurse managers
• Train and develop subordinates.
• Plan ahead.
• Control and coordinate the work of subordinates
but do not peer over their shoulders.
• Follow-up by visiting subordinates frequently.
• Coordinate to prevent duplication of effort.
• Solve problems and think about new ideas.

42. • Accept delegation as desirable.
• Specify goals and objectives.
• Know subordinates capabilities and match the
task or duty to the employee.
• Agree on performance standards.
• Take an interest in employees.
• Assess results.
• Give appropriate rewards.
• Do not take back delegated tasks.
●Effective Delegation●

43. ●NURSING CARE ASSIGNMENT ●

44. ●Nursing Care Assignment●
Nursing Care Assignment is the allocation of
clients or client care responsibilities or
interventions that are within the nurse’s scope
of practice and/or scope of employment. It
describes the distribution of work that each staff
member is to accomplish (NCSBN, 2005).

45. It is a dynamic process in which decisions
are evaluated and adjusted as the
healthcare team works together to meet
the changing needs of clients. Nurses
determine assignments according to:

46. •the client’s condition (complexity, variability
and acuity)
•the scope of practice of the health provider’s
profession
•the individual scope/competence of the
individual performing the intervention
•the scope of employment/agency policy
•context of practice

47. • When client care or a client intervention is assigned to
an RN or LPN, they may perform the assignment
autonomously as they are accountable for their own
decisions and actions.
• When client care or a client intervention is assigned to
a UCP, the UCP is accountable to implement the
assigned care or task safely and competently within
their scope of practice/employment.

48. Types of Nursing Care Assignment
A nurse determines the most appropriate care
provider to be ‘assigned’ to a particular client
and is accountable for that decision. When
clients are ‘assigned’ to a particular nurse or
unregulated care provider, the accountability for
the client care resides with the individual
assigned to the client.

49. A nurse determines the most appropriate care
provider to ‘be assigned’ to perform a specific
intervention for one or more client(s).

50. Nursing care assignment to unregulated
care providers
Assignment is appropriate when the assigned task
falls within the UCP role description and training.
The nurse manager is responsible and accountable
for developing job/role descriptions that clearly
outline the tasks that can be assigned to a UCP in an
organization. UCPs may be assigned clients in
collaboration with an RN or LPN or assigned specific
interventions for one or more clients.

51. Prior to assigning a client or an intervention,
consideration should be given to the individual
competencies of the UCP.
If the task is within the role description but the
UCP has not yet performed the task, the nurse
manager would need to consider the
appropriateness of the assignment. The UCP may
have had past training in tasks but if the task is not
included in the UCP role description, the task could
not be assigned to the UCP. Regardless of the
assignment, the nurse assigning the task to the UCP
is always responsible and accountable for providing
appropriate supervision and feedback to the UCP.

52. ●Utilization of Policies and
Procedures●
Policies and Procedures
• Licensed nurses (Registered Nurse/Licensed Practical
Nurse) within the scope of their practice are
responsible for all nursing care that a patient receives
under their direction. Determining the nursing needs of
a patient, the plan of nursing actions, implementation
of the plan, and evaluation of the plan are essential
components of nursing practice. Unlicensed personnel
may be used to complement the licensed nurse in the
performance of nursing functions, but such personnel
cannot be used as a substitute for the licensed nurse.

53. • Delegation by Registered Nurses and Licensed
Practical Nurses must fall within their
respective scope of practice. Delegation must
occur within the framework of the job
description of the delegate, organizational
policies and organizational procedures.

54. As per R.A. 9173 (Nursing Act of 2002)
Liabilities of nurses for the work of nursing
aides
• Nurses should not delegate their functions to
nursing aides since the Philippine nursing act
specifies the scope of nursing practice of
professional nurses.

55. • Nurses are enjoined to supervise their
subordinates and see to it that they perform
only those which they been taught to do and
those which they are capable of doing.
• Nursing aides are responsible for their actions.
Nurses should not delegate their functions to
nursing aides. Nursing aides perform selected
nursing activities under the direct supervision
of nurses.

56. Liability for the work of nursing students
• Nursing students should not perform
professional nursing duties. In order for the
errors committed by nursing students to be
avoided or minimized, they should always be
under supervision of their clinical instructors.
• They should be given assignments that are
their level of training experience and
competency.

57. • They should be advised to seek guidance if
they are performing a procedure for the first
time.
• They should be oriented to the policies where
they are assigned.
• Their performance should be assessed
frequently to determine their strength and
weaknesses.

58. Five Rights of Delegation
• Right Task. One that is delegable for a specific patient.
• Right Circumstances. Appropriate patient setting,
available resources, and other relevant factors
considered.
• Right Person. Right person is delegating the right task
to the right person to be performed on the right
person.
• Right Direction/Communication. Clear, concise
description of the task, including its objective, limits
and expectations.
• Right Supervision. Appropriate monitoring, evaluation,
intervention, as needed, and feedback.

60. Online Sources:
http://www.slideshare.net/pragati_jain/directing-as-management-function
http://www.managementstudyguide.com/principles_of_delegation.htm
http://www.americannursetoday.com/from-our-readersdelegation-for-
nursing-managers-increasing-the-odds-of-success-2/
http://currentnursing.com/nursing_management/delegation.html
http://www.urbanministry.org/wiki/delegation-reasons-and-rules
http://www.ncsu.edu/project/parkprgrd/PSTrainingModules/delegating/del1
3frame.htm
http://www.bakercommunications.com/archive/apr13/management04013.ht
ml

61. References:
Kozier, Barbara. Fundamentals of Nursing: Concepts, Process and Practice,
2007.
Roussel, Linda, et. al. Management and Leadership for Nurse Administrators,
2006.
Rowland, Howard, et al. Nursing Administration Handbook. Retrieved from:
http://books.google.com.ph/books?id=zR6bRKsUp_0C&pg=PA32&lpg=PA32&
dq=nursing+management+by+roland+howard+directing&source=bl&ots=AVz
YOS2Y_5&sig=3YCE9g4lt2Fo2Gw4CzRTjUmZ2os&hl=en&sa=X&ei=qbVkVJPQJe
PQmAWsk4LoCA&ved=0CCoQ6AEwAw#v=onepage&q=nursing%20managem
ent%20by%20roland%20howard%20directing&f=false
College of Registered Nurses of Nova Scotia, Assignment and Delegation
Guidelines for Registered Nurses and Licensed Practical Nurses (2012).
Retrieved from:
http://www.clpnns.ca/sites/default/files/Assignment%20and%20Delegation%
20Guidelines.pdf