What Is Management?
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Are You Ready to Be a Manager? For most new nurses, the answer is no, you should not accept managerial responsibility. Your clinical skills are still underdeveloped. You need to direct your energies to building your own skills, including your leadership skills, before you begin supervising other people.
What Is Management? The essence of management is getting work done through others. The classic definition of manage- ment was Henri Fayol’s 1916 list of managerial tasks: planning, organizing, commanding, coordi- nating, and controlling the work of a group of employees (Wren, 1972). But Mintzberg (1989) argued that managers really do whatever is needed
to make sure that employees do their work and do it well. Lombardi (2001) added that two-thirds of a manager’s time is spent on people problems. The rest is taken up by budget work, going to meetings, preparing reports, and other administrative tasks.
Management Theories
There are two major but opposing schools of thought in management: scientific management and the human relations–based approach. As its name implies, the human-relations approach emphasizes the interpersonal aspects of managing people, whereas scientific management emphasizes the task aspects.
Scientific Management Almost 100 years ago, Frederick Taylor argued that most jobs could be done more efficiently if they were analyzed thoroughly (Lee, 1980; Locke, 1982). Given a well-designed task and enough incentive to get the work done, workers will be more produc- tive. For example, Taylor promoted the concept of paying people by the piece instead of by the hour. In health care, the equivalent of what Taylor recom- mended would be paying by the number of patients bathed or visited at home rather than by the number of hours worked. This creates an incentive to get
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18 unit 1 ■ Professional Considerations
the most work done in the least amount of time. Taylorism stresses that there is a best way to do a job, which is usually the fastest way to do the job as well (Dantley, 2005).
Work is analyzed to improve efficiency. In health care, for example, there has been much discussion about the time and effort it takes to bring a disabled patient to physical therapy versus sending the ther- apist to the patient’s home or inpatient unit. Reduc- ing staff or increasing the productivity of existing employees to save money is also based on this kind of thinking.
Nurse managers who use the principles of sci- entific management will pay particular attention to the types of assessments and treatments done on the unit, the equipment needed to do them effi- ciently, and the strategies that would facilitate more efficient accomplishment of these tasks. Typically, these nurse managers keep careful records of the amount of work accomplished and reward those who accomplish the most.
Human Relations–Based Management McGregor’s theories X and Y provide a good con- trast between scientific management and human relations–based management. Like Taylorism, Theory X reflects a common attitude among man- agers that most people do not want to work very hard and that the manager’s job is to make sure that they do work hard (McGregor, 1960). To accom- plish this, according to Theory X, a manager needs to employ strict rules, constant supervision, and the threat of punishment (reprimands, withheld raises, and threats of job loss) to create industrious, con- scientious workers.
Theory Y, which McGregor preferred, is the opposite viewpoint. Theory Y managers believe that the work itself can be motivating and that people will work hard if their managers provide a supportive environment. A Theory Y manager
emphasizes guidance rather than control, develop- ment rather than close supervision, and reward rather than punishment (Fig. 2.1). A Theory Y nurse manager is concerned with keeping employee morale as high as possible, assuming that satisfied, motivated employees will do the best work. Employ- ees’ attitudes, opinions, hopes, and fears are impor- tant to this type of nurse manager. Considerable effort is expended to work out conflicts and promote mutual understanding to provide an environment in which people can do their best work.
Servant Leadership The emphasis on people and interpersonal rela- tionships is taken one step further by Greenleaf (2004), who wrote an essay in 1970 that began the servant leadership movement. Like transforma- tional and caring leadership, servant leadership has a special appeal to nurses and other health-care