NURSING SERVICES
Nursing services refers to the department of the Christian Medical College managing the Nursing task
force of the hospital.
The Office of the Nursing Superintendent, known as Nursing Service Office (NSO) is the central hub
for all nursing care activities.
Nursing Administration
Is the strategic management of nursing personnel, patient care, and facility resources through the
support of regulating policies.
Levels of nursing management
Elements of administration – POSDCORB
• Planning
• Organizing
• Staffing
• Directing & leading
• Co-ordination
• Reporting & Budgeting – Controlling
1. Planning
A plan is a future course of actions. Planning involves selecting objectives, policies, strategies,
programs for the nursing services.
Planning process in health services
Steps:
• Analysis of the health situation
• Establishment of objective and goals
• Assessment of resources
• Fixing priorities
• Write up the formulated plan
• Programming and implementation
• Evaluation
Role of Nursing administrator in planning
• Laying down the vision and mission of Nursing Service and the Institution
• Representation on committees such as Administrative committee, executive committee,
quality steering committee, safety steering committee, budget management etc.
• Planning of human resources, equipment, infrastructure etc.
VISION
‘Christian Medical College seeks to be a witness to the healing ministry of Christ through excellence
in education, service and research.’
MISSION
‘The primary concern of the CMC, Vellore is to develop through education and training,
compassionate, professionally excellent, ethically sound individuals who will go out as servant-
leaders of health teams and healing communities’.
VISION
The Nursing Service of the Christian Medical College, Vellore seeks to provide Christ centred,
compassionate, holistic state of the art quality patient care through nurses excelling professionally in
practice, education, management and research.
MISSION
The Nursing Service
Committed to care for patients and their families in the physical,psychological, social and spiritual
dimensions maximising the potential for health and productivity or maintaining the patient's comfort
and dignity until death.
Strives to develop Nurses personally and professionally to be of sound faith, integrity, ethical conduct
and responsible to our society
Advocates the mandate of Christ to excel by developing nurse leaders who will impact nursing
practice through diligent management, education and research
OBJECTIVES
To practice the art and science of Nursing in the spirit of Christ
To provide promotive, preventive and curative care to patients irrespective of their caste, creed and
socioeconomic status with compassion
To equip the practising Nurses with the knowledge, guidance and resources required to provide
holistic, evidence based care
2. Organization
Process of developing physical, informational, and human resources as per plan.
Organizing involves the grouping of activities necessary to accomplish goals and plans, the
assignment of these activities to appropriate departments and provision of authority, delegation and
coordination.
Principles of Organizing
• Hierarchy
• Span of control
• Integration Versus disintegration
• Centralization Versus Decentralization
• Unity of Command
• Delegation
Hierarchy or chain of command – it means the rule or control of higher over the lower.
Span of control – refers to the number of subordinates a manager can effectively manage.
Integration (unification) vs disintegration (diversification)
Centralization and decentralisation
Centralisation refers to the concentration of authority and decision making in one single position in
the organization
Decentralisation – is one in which the lower levels are allowed the discretion to decide most of the
matter
Unity of command – An employee must get orders from one superior only
Delegation – assignment of the work to subordinates
4 STEPS TO NURSING DELEGATION
1. Know your resources
2. Build rapport
3. Communicate clearly and respectfully
4. Don't forget to follow up
Organizing as a process involves
• Identification of activities.
• Classification of grouping of activities.
• Assignment of duties.
• Delegation of authority and creation of responsibility
• Coordinating authority and responsibility relationships
Delegation of activities
Centralization: Activities such as recruitment, human resource planning, disciplinary action are
centralized and acted upon by the Nursing Superintendent
Decentralization: Day to day activity planning, staff development and training are handled by the
Department Heads and the Nurse Managers
Nursing Superintendent in the Organization
NSO ORGANOGRAM
The Nursing Superintendent is also assisted by the following administrative members:
Assoc. NS 1 - HR
Assoc. NS 2 - Peripheral area management
Assoc. NS 3-Chittoor
Dy. NS 1- Quality management
Dy. NS 2 - Material management
Dy. NS 3 - In-service education
CATEGORIES OF Nursing personnel
Heads of Dept. & Units (M.Sc / PhD ) 20
Nurse Managers (M.Sc / PhD ) 84
Charge Nurses (BSc) 141
Staff Nurse 3799
Multi Purpose Health Workers + Nursing Auxiliaries 229
TOTAL 4269
3. Staffing
It involves manning the organizational structure through proper and effective selection, appraisal and
development of nursing personnel.
The staffing process includes:
• Manpower planning
• Recruitment
• Placement
• Orientation and training
• Performance appraisal
Recruitment and placement
• Competency based training program
• Placement based on appropriate experience
• Induction training
Education and training
• Induction training
• In service training — Centralized & decentralized
• Workshop & conferences — Deputation leave
• Conduction of in house workshop — competency
Performance appraisal
• Every 3 months-2 yrs
• Every 6 mo- 1 yr
• Every year- confirmed staff
Staff welfare
• Organize welfare activities of staff – curricular and extracurricular activities
• Protecting the rights of staff
• Advocating for Nursing Staff
• Formulate policies related to staff welfare
4. Directing
Directing is influencing people's behaviour through motivation, communication, group dynamics,
leadership and discipline.
Elements of Direction
1. Communication
2. 2. Supervision
3. Motivation
4. Leadership
Communication – It is the process of sharing and transferring the information between nurse
managers and their subordinates
Supervision – involves guiding the efforts of others to achieve stated work output
Motivation –is the desire to act and move toward a goal
Leadership – it is a continuous process of influencing and supporting subordinates to work
enthusiastically towards achieving goals
5. Co-ordination
It is the act of synchronizing and unifying individual staff efforts for better action to achieve
organizational objectives.
Types of coordination
Internal coordination: Relationship between all the employees & departments
External coordination: Relationship between the employees and the outsiders.
Nursing
• Medical records
• Medical services
• Dietary services
• Laboratory services
• Radiology services
• Pharmacy services
• Community agencies
• Other institutions
6. Controlling
It is measuring and correcting the performance or the activities of staff as per expected performance.
Steps of control
• Standards are determined
• Actual performance is measured
• Actual performance is compared with standards
• Appropriate corrective actions are taken
Standards of care
• NABH standards
• Nursing Excellence standards
• Nursing Service Policy Manual
• Procedure manual
• Human resource manual
• Patient safety manual
• HICC manual
• Clinical manual
Capturing quality indicators
• Pressure sore
• Medication error
• Falls
• Extravasation
• Accidental de-lining
• Skin tear – Medical Adhesive Related Skin Injuries, Cautery burn
• Needle stick injury
7. Reporting and recording
Reports are oral or written exchanges of information shared between caregivers or workers in a
number of ways.
A report summarizes the services of the person, personnel and of the agency.
Reports are written usually daily, weekly, monthly or yearly.
Records of hospital
• Patient's clinical record
• Record of nurses' observations
• Record of orders carried out
• Record of treatment
• Record of admission and discharge
• Record of equipment loss and replacement
• Record of personnel performance.
8. Budgeting
Budgeting process is a systematic activity that develops a plan for the expenditure of a usually fixed
resource during a given period to achieve a desired result.
Budgeting is the allocation of resources (human, material and financial) to best assure the
accomplishment of nursing organizational goals.
Operating budget –daily activities and services including patient care revenues, labour costs, outside
purchase services, supplies etc.
Capital budget –money earmarked for the purchase of permanent equipment or major renovation,
construction projects
