Nursing Management, Leadership and Health Policy
Nursing Management, Leadership and Health Policy tests first-line manager competencies: organising care, delegating legally, handling conflict, staffing a unit and applying quality tools, together with awareness of Iranian health policy such as hospital accreditation by the Ministry of Health and the family physician referral programme.
Management functions and styles
Planning, organising, directing and controlling form the cycle. Autocratic style suits emergencies and unstable novices; democratic style builds commitment for unit change; laissez-faire fails with new graduates. Transformational leadership uses shared vision and individual development, and is associated with better retention.
Delegation rules
Delegation requires the right task, circumstance, person, direction and supervision. The manager retains accountability for the nursing process; the delegate is accountable only for the task performed. Tasks with predictable outcomes may be delegated; assessment, care planning, teaching and evaluation may not.
Worked example
A medical unit is short of one nurse. The charge nurse asks a nursing assistant to obtain vital signs on stable patients, while the RN performs the admission assessment on a newly arrived breathless patient. Reasoning: vital signs on stable patients are a predictable, protocol-driven task with clear parameters for reporting; the assessment of an unstable patient requires nursing judgement and cannot be delegated.
Quality and policy tools
The Plan-Do-Check-Act cycle, benchmarking, audit and root cause analysis are the standard quality instruments. Incident reporting must be non-punitive to be useful. Accreditation surveys examine documented standards, patient safety goals and evidence of continuous improvement.
Traps that cost marks
- Delegating evaluation or patient teaching.
- Adopting a laissez-faire style for inexperienced staff.
- Punishing staff who report errors, which suppresses reporting and hides risk.