THEORIES AND MODELS OF NURSING MANAGEMENT

I. INTRODUCTION: The knowledge on theories of management for nurse leaders can be useful in creating and developing their own management styles. One needs to understand that no single theory can be well fit and guide nursing leaders in every situation. The important theories developed at different periods of time are discussed in order to help nurse managers to adapt and function effectively. Objectives: General objectives: At the end of the class the students able to know about theories and models of nursing management. Specific objectives: At the end of the class the students able to: Define nursing management. Explain the five important theories. Describe the model. Describe the implication of management theories in nursing.

II. TERMINOLOGY: Accountability: an answerability of a subordinate to his /her superior for performance of the assigned tasks. Authority: right to decide command and perform the assigned responsibility. Charisma: the powerful personal quality that some people have to attract and impress other people. Control: the power to make decisions about a country, an area, an organization. Coordination: to organize the different parts of an activity and the people involved in it. So that it works well. Decentralization: to give some of the power of a central Government, organization, etc. To smaller parts or organization around the country. Discriminating: able to judge the good quality. Group dynamics: work done by a group of people working together.

Management: the act of running or controlling the business or organization. Manager: a person who is in charge of running business or organization. Motivation: a person does he what to do by self interest which involves hard work and interest. Organization: a group of people who form a business, club etc. Together in order to achieve a particular aim. Plan :something you intend to do or achieve. Principles: a moral rule or a strong belief that influences your action. Program: a plan of things that will be done or included. Management: the act of running or controlling the business or organization. Delegation: Decentralization of authority and decision making power to accomplish the task.

III. CONTENT:
Management: Definition : Management is the process and agency, which directs and guides the operations of an organization in realizing, established aims. o.tead. Management is defined as the process by which a co-operative group direct action towards common goals. Joseph messie (1973) Management is principally the task of planning, co-coordinating, motivating and controlling the efforts of others towards a specific objective. James lunde (1968) There are several theories of administration and management. Although strictly speaking the word theory may not be correct word to use at the present stage. Since the term theory is used because of its popularity. Actually the systematic study and analysis of organization started in later part of 19th century and early 20th centuries. Few prominent figures who attempted to study the organization as mentioned below. The four important theories focused for nurse managers are: Scientific management theory Classic organizational theory Human relations theory Behavioural science theory

 Modern management theory A. Scientific management theory: Principles: the scientific management focuses on Observation The measurement of outcome The pioneers of scientific management are: 1. Frederick W. Taylor (1856-1915) 2. Gantt Henry I. Gantt (1861-1910) 3. Emerson (1853-1936) 1) Frederick W. Taylor (1856-1915): Taylor is recognized as father of scientific management. He conducted TimeAnd- Motion studies to time the workers, Analyze their movements and set their standards. He used stop watches. He applied the principles of observation, measurement and scientific comparison to determine the most effective way to accomplish a task. Achievements of Taylor: 1. He trained his workers to follow the time to complete the task given. The most productive workers were hired even when they were paid an incentive or wage. 2. Labour costs per unit were reduced as a result. 3. Responsibilities of management were separated from the functions of the workers. 4. Developed systematic approach to determine the most efficient means of production. 5. He considered management function is to plan. 6. Working conditions and methods to be standardized to maximize the production. 7. It was the managements responsibility to select and train the workers rather than allow them to choose their own jobs and train by themselves. 8. He introduced an incentive plan to pay the workers according to the rate of production to minimize workers dissent and reduce resistance to improved methods. 9. Increased production and produce higher profits. The effect of time- motion study of Taylor: 1. Reduced wasted efforts 2. Set standards of performance 3. Encouraged specialization and stressed on the selection of qualified workers who could be developed for a particular job. 2) Gantt Henry I. Gantt (1861-1910):

Gantt was concerned with problems related to efficiency. He contributed to scientific management by refining the previous work of Taylor than introducing new concepts. 1. He studied the amount of work planned or completed on one axis to the time needed or taken to complete a task on the other axis. 2. Gantt also developed a task and bonus remuneration plan whereby workers received a guaranteed days wages plus a bonus for production above the standard to stimulate higher performance. 3. Gantt recommended to select workers scientifically and provided with detailed instructions for their tasks. 4. He argued for a more Humanitarian approach by management, placing emphasis on service rather than profit objectives. 5. He recognized useful non monetary incentives such as job security and encouraging staff development. 3) Emerson (1853-1936): His emphasis was on conservation and organizational goals and objectives. He defined principles of efficiency related to: 1. Interpersonal relations and to system in management. 2. Goals and ideas should be clear and well-defined as the primary objective is to produce the best product as quickly as possible at minimal expense. 3. Changes should be evaluated-management should not ignore commonsense by assuming that big is necessarily better. 4. Competent counsel is essential. His theory explains about 1. Management can strengthen discipline or adherence to the rules by justice, or equal enforcement on all records, including adequate, reliable and immediate information about the expenses of equipment and personnel should be available as a basis for decisions. 2. Dispatching or production scheduling is recommended. 3. Standardized schedules, conditions and written instructions should be there to facilitate performance. 4. Efficiency rewards should be given for successful completion of tasks. 5. Emerson moved further beyond scientific management to classic organizational theory. 4. Charles Babbage (1792-1871): Charles Babbage ,a scientist mainly interested in mathematics, contributed to the management theory by developing the principles of cost accounting and the nature of relationship between various disciplines. Charles Babbage laid the foundation for much of the work that later come to be known as scientific management. He concentrated on production problems and stressed the importance.

1) Division and assignment of work on the basis of skill and 2) The means of determining the feasibility of replacing manual operations with automatic machinery.

B. Classic organizational theory: Importance of classic organization theory: The classic administration-organization thinking began to receive attention in 1930. Organization is viewed as whole rather than focusing solely in production. The concepts of scalar levels, span of control, authority, responsibility, accountability, line staff relationships, decentralization, and departmentalization become prevalent. Three pioneers of Classic organizational theory: 1) Henry Fayol (1841-1925): Fayal was a French industrialist known as father of the management process school concerned with management of production shops. He studied the functions of managers and concluded that management is universal. All the managers regardless of the type of organization or their level in organization have essentially the same tasks such as planning, organizing, issuing orders, coordinating and controlling. These six aspects of administration, falling into two main groups related as to process and effect as follows: Process 1. Forecasting 2. Organization 3. Command effect plan coordination control

These six aspects of administration follow each other in logical sequences. The plan needs organization which in turn needs coordination of the effort of the person involved. In this sense, the schematic representation of the elements of administration can be shown below, PrinciplesInvestigationRealityOrderprocessforecasting organizationcommand objectiveplaneffect coordination of control

Functions of management: 1. Planning policies, programs and procedures. 2. Organization based on hierarchy of authority

3. Directing the business in order to gain optimum return from all workers. 4. Coordination, signifying harmony in activities of the organization and to facilitate its working 5. Control, the errors of the functionaries of organization and ensure that such errors do not occurs. Fayol divided all the work carried out in a business enterprise into the following categories. 1. 2. 3. 4. 5. Technical activities (production, manufacture, etc) Commercial activities (buying, selling, personnel, and industrial relations) Financial activities( to have optimum use of capitals) Security activities(production of property and persons) Managerial activities(planning organizing, commanding, directing, coordination control, communication, motivation .leadership)

He derived general principles of management: 1. Division of work 2. Authority and responsibility 3. Discipline 4. Unity of command 5. Unity of management 6. Subordination of industrial interests to the common good 7. Remunerative 8. Centralization 9. Hierarchy 10. Order of team members justice 11. justice 12. Stability of tenure 13. Initiative 14. Sense of union The requirements listed above, there, are still more principles by which good organization can be recognized. They are as follows: 1. The number of organization units should be the minimum needed to cover the major enterprise functions. 2. All related functions should be combined within one unit. 3. The number of levels of authority should be kept to a minimum. 4. There should be room for initiative with the limit of his assigned authority. 5. Functions should be assigned so as to minimize cross relations between organizational units. 6. No more employees should report to a superior than he can effectively direct and coordinate. Fayal also stressed that managers should possess physica,mental,moral,educational and technical qualities to conduct the multifaceted operations of business enterprise.

Fayol desired that management training should be provided to imbibe the principle and qualities essential for management. Technical ability is most important and managerial ability becomes more significant and quality to be cultivated for top-level executives. Fayol advocated some valuable concepts in management which can be incorporated usefully in present day analysis of management science. His emphasis on unity of command and direction, non-financial incentive, decentralization, coordination has greater relevance even today. 1. Division of work: there should be division of work and task specialization than different workers consistently carrying out different job responsibilities. 2. Authority: each worker should be given authority to commensurate with the amount of his responsibility. 3. Discipline: each worker and management should maintain proper discipline, voluntarily according to their placement. 4. Unity of command: each employee should receive orders from one supervisor only. 5. Unity of direction: one person should direct all activities that support a single objective. 6. Subordination of individual interest to general interest,i.e the interest of the individual work, should be subordinated to the interest of the total work group. 7. Remuneration: proper remuneration which includes salaries, allowance and other incentives to be given to all employees according to their level of performance and responsibility by the management or employee. 8. Centralization or decentralization: certain power and functions reserved with top level authorities and other power and functions are distributed to executives and co executives and workers also to some extent. 9. Scalar chain: there should be an unbroken scalar chain/hierarchy of authority extending from the top executive to the lowest level worker. 10. Order: there should be proper policies, rules and regulations to maintain an orderly situation in the organization. 11. Equity: All employees should be treated with equity and justice. 12. Stability and tenure: there should be prescribed tenure which is needed for all employees. 13. Initiative: all employees and management should take proper Initiative to achieve the objectives of the organization. 14. Esprit de corps: the group spirit and group morale can be cultivated among employees and employer to accomplish objectives. Fayol recognized the tentative and flexible nature of these principles, stressing that effective management result from basing each action on the appropriate principle. 2) Max Webber theory (1864-1920): He is German psychologist. He earned the title of father of organizational theory. His emphasis was on rules instead of individuals and on competencies over favouritism. His conceptualization was on bureaucracy, structure of authority that would facilitate the accomplishment of organizational objectives:

The three basis for authority: 1. Traditional authority, which is accepted because it seems things have always been that way such as the rule of a king in a monarchy. 2. Charisma, having a strong influential personality. 3. Rational legal authority which is considered rational in formal organizations because the person has demonstrated the knowledge, skills and ability to fulfil the position. 3) James Mooney Theory (1884-1957): Moony believed that management to be the technique of directing people and organization the technique of relating functions. Organization is managements responsibility. Four universal principles: 1. 2. 3. 4. Coordination and synchronization of activities for the accomplishment of goal. Functional affects the performance of ones job description. Scalar process organizes level of commands. Arrange authority in to a higher Archie.

Consequently people get their right to command from their position in the organization. C. HUMAN RELATION THEORY: The human relations movement began in 1940s. Focused on the effect that the individuals have on the success or failure of an organization. Classic organization and management theory concentrated on the physical environment fail to analyze the human element. Instead of concentrating on the organizations structure, managers encourage workers to develop their potentials and help them meet their needs for Recognition Accomplishment Sense of belonging 1). Follett theory(1868-1933): 1. Follett stressed the importance of coordinating the psychological and sociological aspects of management in 1920s. 2. She perceived the organization s a social system and management as a social process. 3. Indicated that legitimate power is produced by a circular behaviour where by superiors and subordinates mutually influence one another.

4. The law of the situation dictates that a person does not take orders from another person but from the situation. 2). Lewin theory (1890-1947): 1. Lewin focused on the Group dynamics. 2. He maintained that groups have personalities of their own: composites of the members personalities. 3. He showed that group forces can overcome individual interests. D. BEHAVIORAL SCIENCE THEORY: Emphasis is on: 1. Use of scientific procedures to study the psychological, 2. Sociological, 3. Anthropological aspects of human behaviour in organization. Behavioural Science Indicated: 1. 2. 3. 4. 5. 6. The importance of maintaining a positive attitude toward people, Training managers, Fitting supervisory actions to the situation, Meeting employees needs. Promoting employees sense of achievement, Obtaining commitment through participation in planning and decision making.

1) Douglas McGregors Theory (1932): McGregors is the father of the classical theory of management which termed theory. He developed the managerial implications of Maslows theory. He noted that ones style of management is dependent on ones philosophy of humans and categorized those assumptions as theory X and theory Y. Theory X 1. The managers emphasis is on the goal of organization. 2. The theory assumes that people dislike work and avoid it. Consequence of theory X Workers must be directed Controlled Coerced Threatened

So that organizational goals can be met. According to theory X

1. Most people want to be directed and to avoid responsibility because they have little ambition. 2. They desire security. Managers who accept the assumption of theory X 1. 2. 3. 4. Will do the thinking and planning with little input from staff associates. They will delegate little, supervise closely. Motivate workers through fear ad threats Failing to make use of the workers potentials.

Theory Y It is focuses on goal. 1. People do not inherently dislike the work and that work can be a source of satisfaction. 2. Workers have the self direction and self control necessary for meeting their objectives. 3. Will respond to the rewards for the accomplishment of those goals. Managers who believe in this Y theory: 1. 2. 3. 4. 5. Will allow participation They will delegate Give general supervision than close supervision Support job enlargement Use positive incentives such as praise and recognition.

They believe that under favourable conditions: people seek responsibility and display imagination, unity and creativity. According to theory Y human potentials are only partially used. 2).Rensis Likerts theory: Dr Rensis Likert has studied human behaviour within many organisations. After extensive research, Dr. Rensis Likert concluded that there are four systems of management. According to Likert, the efficiency of an organisation or its departments is influenced by their system of management. His theory of management is based on his work at the University of Michigans institute for social research.Likert categorised his four management systems as follows; He identified three variables in organizations. 1. The casual variable includes leadership behaviour. 2. The intervening variables are perceptions, attitudes and motivations. 3. The end results variables are measures of profits, costs and productivity. Likert believes that the managers may act in ways harmful to the organization because they evaluate end results to the exclusion of intervening variables.

So, he developed a Likert scale questionnaire that includes measures of casual and intervention variables. Factors measured by likert scale The scale measures several factors related to leadership behaviour process: Motivation Managerial Communication Decision making process Goal setting Staff development

Four types of management system according to likert.effcets on the management systems: a). Exploitive-authoritative: 1. He associates the first system with the least effective in performance. 2. Managers show less confidence in staff associates and ignore their ideas. 3. Consequently staff associates do not feel free to discuss their jobs with their managers b). Benevolent- authoritative: 1. Staff associates ideas are sometimes sought, but they do not feel free to discuss their jobs with the manager. 2. Top and middle management are responsible for setting goals. 3. There is minimal communication. Mostly downward and received with suspicion. 4. Decisions are made at the top with some delegation. c). consultative system: 1. The manager has substantial confidence in staff associates. 2. Their ideas are usually sought. 3. They fell free to discuss their job with the manager. 4. Goal setting is fairly general. 5. It has limited accuracy and accepted with some caution. 6. Broad policy is set at the top level. 7. There are decisions making throughout organization. 8. Control functions are delegated to lower level where. 9. Reward and self guidance are used. 10. There is some resistance from informal groups in the organization. d) Participative group: Group Participative is the most effective performance. Managers have complete confidence in their staff associates. Their ideas are always sought, and they feel

completely free to discuss their jobs with the manager. Goals are set at all levels. There is a great deal communication- upward, downward, and later that is accurate and received with open mind. He is strong believer of participative management and supportive relationships. His linking pin concept is based on studies about the differences between good and poor managers a measured by their level of productivity. Good mangers found to have more influence on their own managers than did poor managers. Their managerial abilities and procedures were better received by their staff associates. When middle managers have the opportunity for interaction with their manager, workers can have input and there is a chance for the individuals and the organizational goal to become similar. E. MODERN MANAGEMENT THEORIES: The modern era is characterized by trends in the management through viz:1. Microanalysis of human behaviour, motivation, group dynamics leadership leading to many theories of organization. 2. The macro search for fusion of the many systems in business organizationeconomic social technical political and quantitative methods in decisionmaking. Modern management theories era can be father classified as the three streams viz: 1. Quantitative approach 2. System approach 3. Contingency approach Indicating further refinement, extension and synthesis of all the classical and neoclassical approaches to management. 1. Quantitative approach: Management science refers to the application of Quantitative methods to management. Management science has an interdisciplinary basis in other words management science is a combination and interaction of different scientists. 2. System approach:-according to system approach the organization is the unified, purposeful systems composed of interrelated parts and also interrelated with its environment. Each unit must mesh/ interact with the organization as a whole, each manager most interact/ communicate and deal with executives of other unites and the organization itself must also interact with other organizations and society as whole.

External Environment

Transformation process

Input Nursing personal Supplies Equipments management of nursing care of clients by nursing personal critical thinking application

Output resolution of nursing problems of client improvement; client

Clients, knowledge, valus, nursing theory in management health care goals met Ethics skills and beliefs . and clinical care. Healing, peaceful death

Feed back

An open system model Ludwing Von Bertanffy: Bertanffy, a biology is credited with coining the general system theory. His contention were that it was possible to develop a theoretical framework for describing relationship in the real world and different disciplines with similarities could be developed into a general systems model. The similarities were:

1. Study of organization 2. State of equilibrium 3. Openness of all systems and their influence o the environment and environment influence on the system. 3. Contingency approach: The contingency approach can be described as the behavioural approach. Luther Gulick: He was influenced by Taylor and Fayol. He used Fayals five elements of administration viz.Planning,Organizing,Command,Coordination and Control as a frame work for his neutral principles. He condensed the duties of administration into a famous acronymPOSDCORB.Each letter in the acronym stands for one of the seven activities of the administrator as given below: Planning (P): working out the things that need to be done and the methods for doing them to accomplish the purpose set for the enterprise. Organising (O): establishment of the formal structure of authority through which work subdivisions are arranged, designed and coordinated for the defined objective. Staffing (S): the whole personnel function of bringing in and training the staff, and maintaining favourable conditions of work. Directing (D): continuous task of making decisions and embodying them in specific and general orders and instructions, and serving as the leader of the enterprise. Coordinating (CO): all important duties of interrelating the various parts of the work. Reporting (R): keeping the executive informed as to what is going on, which includes keeping himself and his subordinates informed through records, research and inspection. Budgeting (B): all that goes with budgeting in the form of fiscal planning, accounting and control. Luther Gulick was very much influenced by Fayals 14 basic elements of administration in expressing his principles of administration as follows: 1. 2. 3. 4. 5. 6. 7. 8. 9. Davison of work or specialization Bases of departmental organization Coordination though hierarchy Deliberate coordination Decentralization Unity of command Staff and line Delegation Span of control

LYNDAL URWICK:

lyndal urwick also one of the among classical theorist, attached more important to the structure of organization than the role of the people in the organization. lyndal urwick concentrated his efforts on the discovery of principles and identified eight principles of administration applicable to all organization as given below: 1. The principle of objective-that all organizations should be an expression of a purpose. 2. The principle of correspondence-that authority and responsibility must be co-equal. 3. The principle of responsibility-that the responsibility of higher authorities of the work of subordinates is absolute. 4. The scalar principle-that a paramedical type of structure is build up in an . 5. The principle of span control6. The principle of specialization-limiting ones work to single function. 7. The principle of coordination8. The principle of definition-clear prescribed of every duty. 4. Critical theory versus critical thinking: Steffy and Grimes note that a strict natural science approach to social science is native, since subjective or qualitative analysis is important to quantitative research. This holds true for management and, consequently for nursing management. The authors suggest a critical theory approach to organizational science rather than a phenomenological or hermeneutic approach. Phenomenological approach uses second order constructs interpretations of interpretation. The nurse manager would interpret the meaning of nursing of nursing management experience or observations and arrive at a nursing management theory from aggregate of meanings. Hermeneutic approach is the art of textual interpretation. She would consider the specific context and historic dimensions of data collected, and would reflect on the relationship between theory and history. Critical theory: Critical theory is an empirical philosophy of social institutions. It is translated into practice by decision makers, in these case nurse managers. It includes organizational development, management by objectives or results, performance appraisal, and other practice- oriented activities performed by managers. Aims: To critique the ideology of scientism, the institutionalized form of reasoning which accepts the idea that the meaning of knowledge is defined what the sciences do and thus can be adequately explicated through analysis of sciencetific producers. To develop an organizational science capable of changing organizational processes. it is used the practice of clinical nursing and nursing management.

Critical thinking: Concept analysis is advocated as a strategy for promoting critical thinking. The rudiments of critical thinking: recalling facts, principles, theories, and abstractions to make deductions, interpretations, and evaluations in solving problems, making decisions, and implementing changes. Concept analysis uses critical thinking to advance the knowledge base of nursing management as well as nursing practice. Definition: critical thinking is reflecting on a situation, a plan an event under the rule of standards and antecedent to making a decision. (Mackenzie) Critical thinking is both a philosophical orientation toward thinking and a cognitive process characterized by reasoned judgment and reflective thinking. (Jones and brown)

ABRAHAM MASLOW: Abraham Maslow an American psychologist has given best known classification of human needs as Need Hierarchy Abraham Maslow arranges individual needs in a Hierarchical manner. 1. Physiological needs:-the basic things necessary for human survival e.g. hunger thirst, shelter etc. 2. Security needs:- include job security or safety and the work place, thus giving psychological security to human being. 3. Social needs:-represent the relationship between and among groups of people working in the organization. 4. Self Esteem needs :-represent higher level needs of human being 5. Self actualization:-is a higher level need represents culmination of all other needs. Abraham Maslow's Hierarchy of Needs motivational model Abraham Maslow developed the Hierarchy of Needs model in 1940-50s USA, and the Hierarchy of Needs theory remains valid today for understanding human motivation, management training, and personal development. Indeed, Maslow's ideas surrounding the Hierarchy of Needs concerning the responsibility of employers to provide a workplace environment that encourages and enables employees to fulfil their own unique potential (self-actualization) are today more relevant than ever. Abraham Maslow's book Motivation and Personality, published in 1954 (second edition 1970) introduced the Hierarchy of Needs, and Maslow extended his ideas in other work, notably his later book Toward A Psychology Of Being, a significant and relevant commentary, which has been revised in recent times by Richard Lowry, who is in his own right a leading academic in the field of motivational psychology.

Abraham Maslow was born in New York in 1908 and died in 1970, although various publications appear in Maslow's name in later years. Maslow's PhD in psychology in 1934 at the University of Wisconsin formed the basis of his motivational research, initially studying rhesus monkeys. Maslow later moved to New York's Brooklyn College. The Maslow's Hierarchy of Needs five-stage model below (structure and terminology - not the precise pyramid diagram itself) is clearly and directly attributable to Maslow; later versions of the theory with added motivational stages are not so clearly attributable to Maslow. These extended models have instead been inferred by others from Maslow's work. Specifically Maslow refers to the needs Cognitive, Aesthetic and Transcendence (subsequently shown as distinct needs levels in some interpretations of his theory) as additional aspects of motivation, but not as distinct levels in the Hierarchy of Needs. Where Maslow's Hierarchy of Needs is shown with more than five levels these models have been extended through interpretation of Maslow's work by other people. These augmented models and diagrams are shown as the adapted seven and eight-stage Hierarchy of Needs pyramid diagrams and models below. There have been very many interpretations of Maslow's Hierarchy of Needs in the form of pyramid diagrams. The diagrams on this page are my own interpretations and are not offered as Maslow's original work. Interestingly in Maslow's book Motivation and Personality, which first introduced the Hierarchy of Needs, there is not a pyramid to be seen.

 HERZBERGS TWO FACTOR THEORY: This theory was developed in 1959.It is based on realisation that work motivation and job-satisfaction are two dimensions that influence the productivity of an employee. Herzbergs finding that good working conditions, adequate salary, good physical facilities, good human relation, quality of supervision might contribute to job satisfaction, of employees, which are hygiene factors. Whereas factors like recognition of work done, status, opportunities for growth, challenging task, play an important role in creating work motivation for employees, which are the motivation factors.ltter, many authors interpreted that all the motivation factors described by Herzberg do not give equal amount of satisfaction to all employees.

Implications of management theories in nursing: 1. Taylors theory can be implemented in nursing to study complexity of care and determine staffing needs and observe efficiency and nursing care.

2. Nurses can utilize Emersons theory of early notion of the importance of objectives setting in an organization. 3. Nurses should be aware of the managerial tasks as defined by Fayol: Planning, Organizing, Directing, Coordinating and Controlling. 4. The theory of human relations of Follett and Lewin emphasise the importance for nurse managers to develop staff to their full potential and meeting their needs for recognition, accomplishment and sense of belonging. 5. Mc Gregon and Likert support the benefits of positive attitudes towards people, development of workers, satisfaction of their needs and commitment through participation. Conclusion: The theories is very important in management of health care setting .proper planning of work will improve the quality of services provided in the organization. So the nurse managers should know about types of theories and model of nursing management. It is a process by which a co operative group direct action towards common goals.

BIBLIOGRAPHY: 1. Rebecca Samson. Leadership and Management in Nursing Practice and Education. First Edition .New Delhi: Jaypee Brothers Medical Publishers (p) ltd; 2009. Page no 11-20. 2. BT Basavanthappa. Nursing Administration. Second Edition. New Delhi: Jaypee Brothers Medical Publishers (p) ltd; 2009.page no 105 -118. 3. http://www.laynetworks.com/Theories-of-Motivation.html 4. Russel C.Swansburg.Introduction to Management and leadership for Nurse Managers. Third Edition.Boston: Jones and Bartlett Publishers; 2002.page no 22-38-25. 5. Prof.P.Nelson. Principles of Management. Revised New Edition. Anna Nagar. Good luck educational publishers; page .no.53. 6. Trained nurses Association of India l-17, Nursing Administration and Management .First Edition-2002 Green Park, New Delhi 110016.2002 Page no.16 -17.