INTRODUCTION Administration is an essential factor in the development of any service. Administration provides the means whereby most effective use can be made of the knowledge and the skills of all those who are involved in it. The development of nursing service has been enhanced greatly by advances made in professional skills and technical proficiency. But it is apparent that the, same development has not been made in nursing administration. DEFINITION "Administration is the organization & direction of human and material resources to achieve desired ends". -Pfiffne r and Presthus. "Administration is the direction, coordination and control of many persons to achieve same purposes or objective - Nigro "Administration may be defined as the management of affairs with the use of well thought out principles and practices and rationalized techniques to achieve certain objectives." - Goel "Administration is the organization and use of men and materials to accomplish purposes. It is the specialized vocation of managers who have skill of organizing and directing men and material just as definitely as an engineer has skill of building structure" - James L NATURE OF ADMINISTRATION
Administrative process is intellectual, social, dynamic and creative as well as continuous. The feature or natures of administration are:1. It is universal- because irrespective of nature and objectives of the organization, all basic elements of administration such as planning, organizing, staffing, directing, coordinating, reporting, budgeting can apply for its effective achievement of goals. 2. It is holistic:- the whole process of administration embraces the organization and its function in entirely, i.e. involve total activities of the organizations. 3. It is intangible: - Since administration is visualized as abstract. It cannot be transferable to any where. So, every organization has to develop its own administrative style within the contact of functional elements of administration. 4. It is continuous and on going process . The cycle of administration goes on continuously. 5. It is goal oriented:- administration is always struggling to achieve the laid down goals and objectives of the organizations. 6. Its is social and human:- usually in administration group of people are there to achieve the objective. It needs good social and interpersonal contact or relationship to achieving the goal. 7. It is dynamic:- administration has the elements of flexibility and adaptability and adjustability rising to the needs and demands of different situation. 8. It is creative or innovative:- to have an effective administration existed administration provides innovation, offers and invites creative ideas to its organizational teams. PRINCIPLES OF ADMINISTRATION Fourteen principles of administration were identified by Henri Fayol as follows:1. Division of work:- In any organization administrator or manager cannot perform all the activities to achieve its
objective. So there should be division of work according to managerial and non-managerial. 2. Authority, responsibility and accountability : If the person has to perform job assignment effectively according to their own qualification and experience. 3. Discipline:- for smooth running of administration to achieve objectives, there should be proper observance of the rules, regulations, norms, decorum, manners, code of ethics and respect; this requires to be enforced within the organization by the managers. 4. Unity of Command: in any organization the subordinate should be supervised by a single supervisor to whom he/she should be accountable. 5. Unity of direction: In any organization, there should be one supervisor to give direction to his/her subordinate. 6. Subordination of individual interest to organizational interest. This implies that narrow selfish interest should be overcome or should turn to common and broad interest of the organization for its welfare. 7. Remuneration of personnel:- There should be fair policy for payment of the personnel justifying the workload job hazards, efficiency and quality of performance. 8. Centralization: - There should be some amount greater and larger authority resting with top level managers. 9. Scalar chain of command: This implies that there is chain or link of directional instructions from the top level to the lowest rank of organizational members in the hierarchy. 10. Order: In an administration there should be proper systematic arrangement of staff, materials, supplies and equipment according to requirement of specific job departments. 11. Equity: - In administration, there should be a fair and impartial treatment to all workers irrespective of their job.
12. Stability of tenure of personnel:- Organizations should make proper efforts to ensure stability and continuity in the tenure of personnel, which gives security and promotes productions. 13. Initiative: Administration should always be encouraging initiative from each employee by allowing him freedom to do his/her best. 14. Esprit de corps: It refers to sense of belonging. This fosters the team spirit, i.e. the spirit of working together to achieve objectives efficiently.
ELEMENTS OF ADMINISTRATION Professor Luther Gullick (1937- summed up certain principles or elements in the word POSDCORB). It is made up of initials and stands for the following. P stands for planning That is working out a broad outline. O stands for staffing That is the establishment of the formal structure of authority through which work of sub division are arranged defined and coordinated for the defined objectives. S Stands for staffing That is the whole personnel function of bringing in and training the staff and maintaining favorable conditions of work. D Stands for Directing That is the continuous task of making decision and embodying them, in specific and general orders and instructions and serving as leader of the enterprise. CO Stands for Coordinating That is all important duty of inter-relating the various parts of the work and eliminating of overlapping and conflict R Stands for Reporting That is keeping those to whom the executive is responsible informed as to what is going on, which thus include keeping himself and his subordinate informed through records, research and inspection.
B stands for Budgeting: With all that goes with budgeting in the form of fiscal planning, accounting and control.
P-Planning O-organizing
B- Budgeting
Elements Of Administration
R-Reporting
S-Staffing
Co-Coordinating
D-Directing
TRENDS IN NURSING ADMINISTRATION Trends denote general direction and tendencies especially of events, of opinion. So nursing trends refer to the general direction towards which the different nursing events, have moved and are moving, as well as the opinions in and around nursing and tendencies that we find in and about our profession.
training school at St. Thomas Hospital, London. This system of nursing offered economic independence and secular vocation for women.
This was published to give recognition to the minimum standards of average patient care. The manual was revised in 1942, and a third manual was published I 1950 under the title hospital Nursing Service Manual. Nursing service was beginning to function an own. The value of scientific method and fact were seen on the horizons of nursing service administration. As the hospital grew at the times of industrial revolution. It accepted norms of modern business organization. The hospital was under the control of board of directors who delegated authority to executive director or hospital administrator. The administration established personnel, dietary and purchasing departments. Administration was concerned with placing of nursing service as a whole in the hospital. The director of nurses won control over many administrative aspects of the nursing service. Nursing service continued to be responsible for supplies and equipment and for the employment and discharge of nursing service personnel. With the expansion of services to patients, the nursing director was forced to delegate more responsibility and authority to the nurses of the patients unit. The role of the graduate nurse in most hospitals became one of co-coordinating and controlling nursing services and hospital services. As the employee of the hospital, the nurse was and is still subjected to two distinct line of authority the hospital administrative line and the clinical or therapeutic line headed by the medical staff.
staff and the board of trustees. The nursing services were ignored.
Nurses have been accepted in health teams as functionary members; but they have had no part to play in planning and policy formation. But during 1070s, nurses were becoming more active advocates for their patients and were taking steps to personalize healthcare, rather than continuing to be handmaidens in the health care delivery system. NATIONAL LABOUR RELATIONS ACT-1974 (NLRA) The act in based on our societys respect for the dignity of both man and his work. The NLRA encourages the utilization of collective bargaining and are a means of establishing wages and conditions of worked of non-managerial and non-supervisory employees. In NLRA, a professional employee is defined as:1. Any employee engaged in work, predominantly intellectual and varied in character as opposed to routine mental, manual, mechanical or physical work. 2. Involving the consistent exercise of discretion and judgment in its performance 3. Required knowledge of an advanced type (Course of specialized instruction) in an institution of higher learning. This definition of a professional by NLRA encourages nurse upgrading effectively the practice of nursing in accordance with the nurse practice act of their state. Per reviews and profession standards review organization (PSPO) will strengthen professionalism in nursing as well as enhance the status and economic interests of nurses. Strike: - The right to strike is defined as the moral and political right of employees to withdraw or withheld labor in order to gain concessions from their employees. Nurses should strengthen their professional responsibilities in nursing practice. With support from their administrative leaders, nurses should create a professional model that includes standards of nursing practice. Patient care committee should be established in the hospitals with administrative medicine and nursing representatives. Arbitration: - From a practical view point, arbitration resolves problem. Arbitration involves a legal contract between two parties. Voluntary arbitration is decided by employees and employers, when they make the contract. An arbitrator may be
called when a dispute cannot be resolved through negotiations. Both parties agree on the selection of an arbitrator when one is needed. Arbitration of nurse-employer issues eliminates the need for strikes. If hospital and health agency administrations want to avoid strikes and their consequences, they may accept voluntary or compulsory arbitration as the best method for setting disputes. Fact Finding: - In fact finding, both parties agree to call in an impartial person or person to hear both sides. The fact finder will prepare a series of recommendation based on the facts presented. In 1966, California nurses voted to use the fact finding procedures rather than to go on strike, and the fact finders recommendation were affected. Mediation-arbitration: - In mediation- arbitration, a neutral and experienced arbitrator sits in during the contract negotiations or disputes. If difficulties arise, he endeavors to mediate between the parties and secure a voluntary agreement. Mediation and conciliation: Mediation and conciliation are used in traditional bargaining. The mediator is called in and he tries to achieve voluntary agreement. CREDENTIALING IN THE NURSING PROFESSION Licensure, certification and accreditation process comprise credentialing. All are closely inter-related. This system is being scrutinized critically by consumes professionals and others in our society. The consumer patients want quality care at a fair price. The department of health, education and welfare defines the various aspects of credentialing. Licensure:- A process by which a governmental agency grants permission to individuals who have met pre-determined qualifications to engage in a given profession or occupation, use a particular title or grant permission to institutions to perform specified functions.
Certification or Registration: - in the process by which nongovernment agency or association grant recognition to an individual who has met certain pre-determined qualification by that agency or association. Accreditation:- The process by which an agency or organization evaluate and recognizes an institution or programme of study, meeting certain predetermined qualification THE NEW STATE NURSING PRACTICE ACT (Amended in 1972) The practice of the profession of nursing encompasses diagnosing and treating human responses to actual or potential health problems through services such as case finding, health teaching, health counseling and provision of care supportive to or restorative of life and wellbeing.
and
Voluntary
In most states, licensed health practitioner has to renew their licenses. Some professional groups encourage the adoption of mandatory continuing education for professional reuse licensure. These should be continuing programs and educational opportunities for the development of nursing personnel. Some professionals are against mandatory continuing education. The believe that legal requirements downgrade professional autonomy and each practitioners right to determine what learning experience is best suited to her professional needs.
ISSUES IN NURSING ADMINSITRATION As far as nursing administration is concerned; it is in a pathetic condition. Health survey and Development Committee (1946) recommended giving gazette ranks for Nurse Manager and WHO guidelines are therefore giving decision making power to nurses. Both union and state government have decided give some gazetted ranks to nurses. Accordingly, now we have very few gazetted post, but there is no independent power or authority. Most of the equivalent posts of other cadres in government elevated to the gazette ranks group A and B but the key post like Nursing Superintended Grade I is only group B. In 1989, there is Government order considered Nursing Superintendent Grade II also gazette Class II (Group B), it was not implemented so far, without any genuine reason. Now the situation has gone from bad to worse, worst to the extent that for filling up of the vacancies of nursing cadre, the government Nurses Association has to go on agitation. After agitation/Strike, they will fill up few vacancies. Like this so many problems, prevailing in the nursing administration are as given below. 1. Non-involvement of nursing administrator in planning and decision-making in the governmental hospital administration. 2. No specific power assigned to nursing superintendents, but he/se has been made in-charge of all inventories and linen of hospital. 3. Nursing superintendent will have no authorities to sanction leave to their subordinates. 4. Lack of knowledge in management of Hospital among medical/nursing administration. 5. Administration is always dependant on the advice of clerical staff in all matters including technical aspects. 6. Prevalence of role ambiguity, among administration administrators. 7. Unnecessary interference of non-nursing personnel (Medical/ clerical) in nursing administration. 8. No written nursing policies and manuals. 9. No organized staff development programme which includes orientation, in service education, continuing education etc. 10. No special incentives like , Rajyosava Award, Republic Day Awards , Teachers Awards, as Government itself honor
with these awards other government servants like teachers, police persons etc. 11. Inefficiency of Nursing councils of state and union to maintain standards in nursing. 12. No efforts at higher level for implementation of separate Directorate of Nursing sanctioned by Karnataka Govt.
BIBLIOGRAPHY 1. Basavanthappa B.T., Nursing Administration, 2 nd Edition, Jaypee Publication, Chapter 5 & 31, Page No. 92-105, 843-844 2. Dr. Ashok Sahni, Clinical Updates and Management of Nursing Services, 2nd Edition, Chapter 2, page No. 11-13 3. Mary Lucita, Nursing: Practice and Public Health nd Administration, 2 Edition, Elsevier Publication, Chapter 1, Page No. 3-17 4. Mohanti B., School Administration and Supervision, 1 st Edition, Deep & Deep Publication, Chapter 1, Page No. 21-24 JOURNALS 1. The Nursing Journal of India, 1969 Sep. Vol. XIV, Modern Trends in
Nursing Administration, Page No. 69-70 INTERNET REFERENCE 1. www.publicadministation.org/trends in administration 2. www.americanjournalofadm.co.in/trends administration in nursing