Nursing Administration
Nursing administration covers management functions, staffing, patient assignment, quality assurance and the legal responsibilities of the nurse manager. Questions are situational: a conflict on the ward, a shortage of staff, an incident report.
Management basics
- Functions: planning, organising, staffing, directing, coordinating, reporting, budgeting, controlling. Planning comes first and controlling last.
- Leadership styles: autocratic (crisis, quick decisions), democratic (usual best for wards), laissez-faire (mature creative teams), transformational (vision and motivation).
- Delegation five rights: right task, right circumstance, right person, right direction and communication, right supervision. Assessment, teaching, evaluation and nursing judgement stay with the registered nurse.
Worked example
A 30-bed general ward needs staffing at a 1:3 nurse-to-patient ratio across three shifts, with 30% relief for leave and sickness. Per shift = 30 ÷ 3 = 10 nurses. Three shifts = 30. Relief = 30% of 30 = 9. Total sanctioned posts = 39. Reasoning: the ratio gives the number on duty, and the relief factor converts duty posts into sanctioned posts; without it the ward is short whenever anyone takes leave.
Quality and safety
- Incident reports are non-punitive, factual and completed for near misses as well as harm.
- Audit cycle: set the standard, measure practice, compare, implement change, re-audit.
- Patient assignment methods: functional (task-based, efficient but fragmented), team nursing, primary nursing (continuity and accountability), case method.
Key committees
Infection control committee, nursing audit committee, drugs and therapeutics committee, hospital safety and disaster committee.
Traps
Delegating patient assessment to a ward attendant, treating an incident report as a disciplinary tool, and using autocratic leadership as a default rather than as a crisis choice.