Unit SixTime Management, StressManagement, and Delegation*

Learning objectivesAt the end of this unit, the learner will be able to;Define time, stress, and delegationList the benefit of time managementDiscuss the nature stressorsDescribe the advantages delegationIdentify the barriers of delegation*

Time management *

TimeIs not often thought as a resource.It is non-renewable resource.No event can take place unless there is time for it.*

Time Management Using time effectively is a management skill and can be seen from two angles:1. Finding out how staff uses time:Time spent on different activities by individual staff can be answered by keeping a daily- dairy for a few days.It useful to know what proportions of time is spent on certain activities. This will help to make the best use of time.Events are written in daily, weekly , monthly or yearly time periods, depending on their frequency or regularity.*

Time Management Time plans are written in various common forms;Timetable: For daily/weekly regular recurring events.Schedule: For intermittent, irregular or variable events, including details of where the events take place.Roaster: For duties planned for different staff members, for different times in turn.Program: For long term arrangements of several different events or activities.*

Time Management 2. Time plans in a health serviceA well-managed health unit may need the following time- plans:A weekly time table: showing the time of the week when certain regular events always occur, e.g. staff meetings.Several schedules: showing the detailed dates on which intermittent events occur and where they occur ,e.g. Visits to peripheral health centers.Several duty rosters: for different sections of the work, e.g. night call, out patient duties.*

Time Management Duty rosters are Common in all types of health work.They are needed for three purposes:1. To distribute work fairly and evenly out side normal working hours. E.g. night, weekends etc2. To distribute uninteresting or difficult work, and interesting or varied work, equally among the various members of the units, e.g. Maternity work.3. To divide extra duties among the whole staff*

Time Management Unless they are arranged very carefully they can cause a great deal of trouble and quarrelling. Therefore, rosters have to be changed frequently.Two rules for duty rosters:A. The length of time of each duty period must be the same as for all other types of duty period.B. The number of people /Groups working in turn must divide evenly in to the number of duty station/ duty periods.*

Time management A Program: is a plan that out lines a series of events or activities that will take place in the future. A Program usually includes:What will be done?Where it will take place?Who will do it? &When it will occur?There are several ways to make a program chart. A Convenient way is to list the activities, in the order in which they must occur.*

Benefits of time managementEfficient/EffectiveSuccessfulHealthy*

Obstacles to effective time managementUnclear objectivesDisorganization Inability to say no *

Obstacles to effective time managementInterruptionsMore interruptionsPeriods of inactivity*

Obstacles to effective time managementToo many things at onceStress and fatigueAll work and no play*

Techniques of effective time managementRecognize that obstacles existIdentify themEmploy strategies to overcome

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Techniques of effective time managementSet goals-SMARTSpecificMeasurableAchievable RealisticTime-based

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Techniques of effective time managementPrioritizeDoDelegateDelayDelete*

Techniques of effective time managementOrganize*

Techniques of effective time managementLearn when to say NOYou cant do everythingDont undertake things you cant completeRemain consistent to your goals*

Techniques of effective time managementUse your waiting timeOn public transportationAt the doctors officeWaiting for your plane On hold/waiting on telephone call/When you are early*

Techniques of effective time managementConcentrate on the task at handFocus on your goalTune out interruptions*

Techniques of effective time managementConsider your personal prime timeMorning?Evening?Late night?*

Techniques of effective time managementCelebrate your success*

The Ethiopian ContextThe daily attendance of staff is taken by using different formats and each staff has to sign over the formatUsually it is done twice per day during the morning and afternoon sessions.The Personnel office does the over all check up.Discuss other issues!!!*

Stress management *

Definition of stressJohn M. Ivancevich and Michael T. Matterson have defined stress asadoptive response, mediated by individual characteristics and/ or psychological processes, that is a consequence of any external action, situation or event that places special physical and/or psychological demands upon a person.*

Definition of stressIt is the wear and tear our minds and bodies experience as we attempt to cope with our continually changing environment.*

Stressor/Cause of Stress/ Are an internal or external event, condition or situation that has the potential to bring about significant physical or psychological reaction.

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Nature of stressorsThe nature of the stressor is variable. i.e An event or change that is stressful for one person may not be stressful for another.An event that produces stress at one time and place may not also at another time and place. Can be External or Internal *

1. External stressorsPhysical EnvironmentSocial InteractionOrganisationalMajor Life EventsDaily Hassles*

1. External stressorsPhysical environmentNoiseBright LightsHeatConfined Spaces*

1. External stressorsSocial InteractionAggressiveness by othersRudeness/Disrespect/Bossiness/Authocratic/Bullying/harassment/*

1. External stressorsOrganisational RulesRegulationsRed-TapeDeadlines*

1. External stressorsMajor life eventsBirthDeathLost jobPromotionMarital status change*

1. External stressorsDaily hasslesCommutingMisplaced keysMechanical breakdowns*

2. Internal stressorsLifestyle choicesNegative self - talkMind trapsPersonality traits

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2. Internal stressorsLifestyle choicesCaffeineLack of sleepOverloaded schedule*

2. Internal stressorsNegative self - talkPessimistic thinkingSelf criticismOver analyzing*

2. Internal stressorsMind trapsUnrealistic expectationsTaking things personallyAll or nothing thinkingExaggerationRigid thinking*

2. Internal stressorsPersonality traitsPerfectionistsWorkaholics*

Factors influencing work stressThe drive for successChanging work patternsWorking conditionsOverworkUnder-workUncertaintyConflictResponsibilityRelationships at workChange at work

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Sources of job stress*

Sources of job stressEnvironment Stressors:-societal, economic, financial, cultural, familial and technological factors which have tremendous influence on mental health of the employees.Organizational Stressors:-mission statement, strategies, policies, organizational structure and design, reporting channels, communication, various processes, systems and last but not the least the working conditions.*

Sources of job stress3. Group Stressors:- group cohesiveness, group norms and importance of group objective for attainment of organizational goals.4. Individual Stressors:-Personal life and events of official life cannot be separated. Events of marriage, divorce, death in the family has a remarkable impact on work situation. Personal life difficulties are highly stressful. It includes;*

Sources of job stress(a) Job Security :- A person must have a job commensurate with his qualification.(b) Relocation:- Relocation is related to transfer of a person to a different place.(c) Changes in life structure:- Span of life has many facets. Some of these are socio-economic environment, culture, systems, religion, race, education and persons interaction with society in different roles.*

Contd(d) Stress and Behavior*

Role stressors Stressful events in the nursing function /role stressors/ Work over load Conflict b/n staff membersIn appropriate salary income Limited resource In appropriate infrastructure Limited man power*

Role stressorsLack of promotion Job dissatisfaction Loss of job Inadequate knowledge New working environment New health policy Un-programmed work load Failure in achievement of work Upgrade to higher positionLack of educational opportunity

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Management of stressIndividual Level StrategiesDefine objective for SelfPlan your lifeSocial SupportPhysical FitnessBiofeedbackYogaMeditationTime ManagementLive a simple Life

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Management of stressB. Organizational Level StrategiesOrganizational goals must be in realms of achievement.Employees must be empowered.Corporate policies, physical work environment should be suitable for higher productivity.An updated systems and processes increases efficiency.Management must create an healthy working environment.*

Management of stressABC strategyA= AwarenessWhat causes you stress?How do you react?

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ContdB= BalanceThere is a fine line between positive / negative stressHow much can you cope with before it becomes negative ?C= ControlWhat can you do to help yourself combat the negative effects of stress?*

DelegationThe secret of success is not in doing your own work but in recognizing the right [person] to do it. ~Andrew Carnegie

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DelegationIt is the process of assigning part or all of one persons responsibility to another person or persons.Delegating is an effective management competency by which nurse managers get the work done through the employees.The purpose of delegation is efficiency; no one person can do all the work that must be done; therefore, some work must be passed on, or delegated to others. *

DelegationNurse managers need to be able to delegate some of their own duties, tasks, and responsibilities as a solution to overwork, which lead to stress, anger, and aggression. As nurse managers learn to accept the principle of delegation, they become more productive and come to enjoy relationships with the staff. *

Ways of successful delegationThe following list suggests ways for nurse managers to successfully delegate.Train and develop subordinates. It is an investment. Give them reasons for the task, authority, details, opportunity for growth, and written instructions if needed.*

Ways of successful delegationControl and coordinate the work of subordinates, but do not go over their shoulders. To prevent errors, develop ways of measuring the accomplishment of objectives with communication, standards, measurements, feedback and credit.

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Ways of successful delegationFollow up by visiting subordinates frequently. Expect employees to make suggestions to improve work and use the feasible ones.Encourage employees to solve their own problems, and then give them the autonomy and freedom to do.

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Ways of successful delegationAssess results. The nurse manager should accept the fact that employees will perform delegated tasks in their own style.Give appropriate rewardsDo not take back delegated tasks.

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Advantages of delegationDelegating some decision-making saves time for other duties.When work is spread over a large area, the health workers on the spot must be able to make decisions according to circumstances.*

Advantages of delegationDelegations of responsibility save long delays that occur then awaiting decisions from a central office or other distant authority.Health workers who are allowed to make decisions enjoy their work more and become more knowledgeable and skilful.*

Disadvantages of delegationIf wrong decisions are made, the work is not done or it may be done less well.A leader who does not delegate properly may pass all the work on to the team members, leaving very little more to do.A leader may delegate decisions to people with insufficient experience.*

Rules for delegating authority and responsibilityBe clear about exactly what is delegated.Select the person who you are sure can do the work.Explain to others that you have delegated work and to whom.Do not interfere unless asked to, and be prepared for some mistakes.Give support as needed and follow up the progress of work.*

Steps in DelegationIDEALS steps I Introduce the taskD-Demonstrate clearly what needs to be doneE-Ensure understandingA-Allocate authority, information and resourcesL-Let goS-Support and monitor*

Steps in DelegationI-Introduce the TaskDetermine task to be delegatedThose tasks you completed prior to assuming new roleThose tasks your delegates have more experience withRoutine activitiesThose things not in your core competency*

Steps in DelegationI-Introduce the TaskDetermine tasks to retainSupervision of subordinatesLong-term planningTasks only you can doAssurance of program complianceDismissal of volunteers/members/parents, etc.*

Steps in DelegationI-Introduce the TaskSelect delegateLook at individual strengths/weaknessesDetermine interest areasDetermine need for development of delegateUse What-Why Statements: I want you to do.. Because you

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Steps in DelegationD-Demonstrate ClearlyShow examples of previous workExplain objectivesDiscuss timetable, set deadlines*

Steps in DelegationE-Ensuring UnderstandingClear communicationAsk for clarificationSecure commitmentDont say no for themCollaboratively determine methods for follow-up*

Steps in DelegationA-Allocate authority, information, resourcesGrant authority to determine process, not desired outcomesProvide access to all information sourcesRefer delegate to contact persons or specific resources that have assisted previouslyProvide appropriate training to ensure success*

Steps in DelegationL-Let goCommunicate delegates authorityStep back, let them workUse constrained accessDont allow for reverse delegation*

Steps in DelegationS-Support and MonitorSchedule follow-up meetingsReview progressAssist, when requestedAvoid interferencePublicly praise progress and completionEncourage problem solving*

Delegation StressorsLoss of control?If you train your subordinates to apply the same criteria as you would yourself, then they will be exercising your control on your behalf.

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Delegation StressorsCompromising your own valueBy successfully utilizing appropriate delegation, your value to the group/organization will grow at a greater rate as you will have more time to do more things

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Delegation StressorsToo much time spent on explaining tasksThe amount of time spent up front is, in fact, great. But, continued use of delegation may free you up to complete more complex tasks and/or gain you some time for yourself.

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Consequences of poor delegatingInformation and decision-making not shared by the groupWhen leaders leave groups, no one has experience to carry onGroup morale becomes low and people become frustrated and feel powerless*

Consequences of poor delegatingThe skills and knowledge of the group/organization are concentrated in a few peopleNew members dont find any ways to contribute to the work of the group.Leaders become tired out*

Barriers to DelegatingBarriers in the DelegatorPreference for operating by oneselfDemand that everyone know all the detailsI can do it better myself fallacyLack of experience in the job or in delegating.*

Barriers to DelegatingBarriers in the DelegatorInsecurityFear of being dislikedRefusal to allow mistakesLack of confidence in subordinatesPerfectionism, leading to excessive controlLack of organizational skill in balancing workloads*

Barriers to DelegatingBarriers in the DelegatorFailure to delegate authority commensurate with responsibilityUncertainty over tasks and inability to explainDisinclination to develop subordinatesFailure to establish effective controls and to follow up*

Barriers to DelegatingBarriers in the DelegateeLack of experienceLack of competenceAvoidance of responsibilityOver dependence on the bossOverload of workImmersion in trivia*

Address the urgentAccomplish what you can earlyAttach deadlines to things you delay

*An internal or external event or situation that creates the potential for physiological, emotional, cognitive or behavioural changes in an individual.

*Needlessly time-consuming procedure/bureaucratic procedure/*Person with a compulsive need to work**A training program in which a person is given information about physiological processes (heart rate or blood pressure) that is not normally available with the goal of gaining conscious control of them***