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n small groups, discuss some work routines carried out in health-care organizations that seem to be inefficient. Could such routines or the time and motion involved to carry out a task be altered to improve efficiency without jeopardizing quality of care? Make a list of ways that nurses could work moreefficiently. Do not limit your examination to only nursing procedures and routines but examine the impact that other departments or the arrangement of the nurse’s work area may have on preventing nurses from working more efficiently. Share your ideas with your peers.
Management Functions Identified
Henri Fayol (1925) first identified the management functions of planning, organization, command, coordination, and control. Luther Gulick (1937) expanded on Fayol’s management functions in his
introduction of the “seven activities of management”—planning, organizing, staffing, directing, coordinating, reporting, and budgeting—as denoted by the mnemonic POSDCORB. Although often modified (either by including staffing as a management function or renaming elements), these functions or activities have changed little over time. Eventually, theorists began to refer to these functions as the management process.
The management process, shown in Figure 2.2, is this book’s organizing framework. Brief descriptions of the five functions for each phase of the management process follow:
1. Planning encompasses determining philosophy, goals, objectives, policies, procedures, and rules;
carrying out long- and short-range projections; determining a fiscal course of action; and managing planned change.
2. Organizing includes establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals. Other functions involve working within the structure of the organization and understanding and using power and authority appropriately.
3. Staffing functions consist of recruiting, interviewing, hiring, and orienting staff. Scheduling, staff development, employee socialization, and team building are also often included as staffing functions.
4. Directing sometimes includes several staffing functions. However, this phase’s functions usually entail human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration.
5. Controlling functions include performance appraisals, fiscal accountability, quality control, legal and ethical control, and professional and collegial control.
Human Relations Management (1930 to 1970)
During the 1920s, worker unrest developed. The Industrial Revolution had resulted in great numbers of relatively unskilled laborers working in large factories on specialized tasks. Thus, management scientists and organizational theorists began to look at the role of worker satisfaction in production. This human relations era developed the concepts of participatory and humanistic management, emphasizing people rather than machines.
Mary Parker Follett (1926) was one of the first theorists to suggest basic principles of what today would be called participative decision making or participative management. In her essay “The Giving of Orders,”
Follett espoused her belief that managers should have authority with, rather than over, employees. Thus, solutions could be found that satisfied both sides without having one side dominate the other.
The human relations era also attempted to correct what was perceived as the major shortcoming of the bureaucratic system—a failure to include the “human element.” Studies done at the Hawthorne Works of the Western Electric Company near Chicago between 1927 and 1932 played a major role in this shifting focus.
The studies, conducted by Elton Mayo and his Harvard associates, began as an attempt to look at the relationship between light illumination in the factory and productivity.
Mayo and his colleagues discovered that when management paid special attention to workers, productivity
was likely to increase, regardless of the environmental working conditions. This Hawthorne effect indicated that people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will continue to warrant the attention. Mayo (1953) also found that informal work groups and a socially informal work environment were factors in determining productivity, and Mayo recommended more employee participation in decision making.
Douglas McGregor (1960) reinforced these ideas by theorizing that managerial attitudes about employees (and, hence, how managers treat those employees) can be directly correlated with employee satisfaction. He labeled this Theory X and Theory Y. Theory X managers believe that their employees are basically lazy, need constant supervision and direction, and are indifferent to organizational needs. Theory Y managers believe that their workers enjoy their work, are self-motivated, and are willing to work hard to meet personal and organizational goals.
Chris Argyris (1964) supported McGregor (1960) and Mayo (1953) by saying that managerial domination causes workers to become discouraged and passive. He believed that if self-esteem and independence needs are not met, employees will become discouraged and troublesome or may leave the organization. Argyris stressed the need for flexibility within the organization and employee participation in decision making.
The human relations era of management science brought about a great interest in the study of workers.
Many sociologists and psychologists took up this challenge, and their work in management theory contributed to our understanding about worker motivation, which will be discussed in Chapter 18. Table 2.1 summarizes the development of management theory up to 1970. By the late 1960s, however, there was growing concern that the human relations approach to management was not without its problems. Most people continued to work in a bureaucratic environment, making it difficult to always apply a participatory approach to
management. The human relations approach was time consuming and often resulted in unmet organizational goals. In addition, not every employee liked working in a less structured environment. This resulted in a greater recognition of the need to intertwine management and leadership than ever before.
Historical Development of Leadership Theory (1900 to Present)
Because strong management skills were historically valued more than strong leadership skills, the scientific study of leadership did not begin until the 20th century. Early works focused on broad conceptualizations of leadership, such as the traits or behaviors of the leader. Contemporary research focuses more on leadership as a process of influencing others within an organizational culture and the interactive relationship of the leader and follower. To better understand newer views about leadership, it is necessary to look at how leadership theory has evolved over the last century.
Like management theory, leadership theory has been dynamic; that is, what is “known”
and believed about leadership continues to change over time.
The Great Man Theory/Trait Theories (1900 to 1940)
The Great Man theory and trait theories were the basis for most leadership research until the mid-1940s. The Great Man theory, from Aristotelian philosophy, asserts that some people are born to lead, whereas others are born to be led. It also suggests that great leaders will arise when the situation demands it.
Trait theories assume that some people have certain characteristics or personality traits that make them better leaders than others. To determine the traits that distinguish great leaders, researchers studied the lives of prominent people throughout history. The effect of followers and the impact of the situation were ignored.
Although trait theories have obvious shortcomings (e.g., they neglect the impact of others or the situation on the leadership role), they are worth examining. Many of the characteristics identified in trait theories (Display 2.5) are still used to describe successful leaders today. Contemporary opponents of these theories argue, however, that leadership skills can be developed, not just inherited.
DISPLAY 2.5 Characteristics Associated With Leadership
Intelligence Adaptability Ability
Knowledge Creativity Able to enlist cooperation
Judgment Cooperativeness Interpersonal skills
Decisiveness Alertness Tact
Oral fluency Self-confidence Diplomacy
Emotional intelligence Personal integrity Prestige
Independence Emotional balance and control Social participation
Personable Risk taking Charisma
Skilled communicator Critical thinking Collaborative priority setting
Perhaps leaders are both born and made that way.
Behavioral Theories (1940 to 1980)
During the human relations era, many behavioral and social scientists studying management also studied leadership. For example, McGregor’s (1960) theories had as much influence on leadership research as they did on management science. As leadership theory developed, researchers moved away from studying what traits the leader had and placed emphasis on what he or she did—the leader’s style of leadership.
A major breakthrough occurred when Lewin (1951) and White and Lippitt (1960) isolated common leadership styles. Later, these styles came to be called authoritarian, democratic, and laissez-faire.
LEARNING EXERCISE