SUPERVISION AND MANAGEMENT

INTRODUCTION
Supervision is defined as “An art or a process by which designated individual or
group of individuals oversee the work of others and establish controls to improve the
work as well as the worker”. Supervision is generally termed as an educational process in
which a person with better training or more experience takes the responsibility of training
a person with less training or less experience, and in this educational process the
leadership of the supervisor and the growth of the supervised combine to achieve and
maintain progressively the highest level of performance of which the worker is capable.
Supervision is observation and providing feedback to ensure the quality of the
program and to enable the staff to perform to their maximum potential. Traditional
approaches to supervision emphasized on ‘inspecting’ facilities and controlling individual
performance.

OBJECTIVES OF SUPERVISION
1. To help subordinate to do their job skillfully and efficiently.
2. To develop subordinates capacity to the fullest extent.
3. To promote team work
4. To promote moral and motivation among workers.
5. To bridge the gap between personal goal and organizational goal.

PURPOSE OF SUPERVISION:

To improve the
quality of work / Helping the person
performance doing the work and
develop the highest
possible standard

PRINCIPLES OF SUPERVISION
1. Supervision should aim at growth in knowledge and improvement of skill of the
person.
 2. Supervision should improve the ability in thinking and adjusting to the new
situation.
3. It should help to formulate objects.
4. Good supervision stimulates their interest and effectors.
5. No undue pressure for achievement
6. Autonomy to subordinate preferred
7. Supervision should have competence
8. Supervision should have receive training
9. Decision making is encouraged
10. Free communication to required
11. No over burdening to staff
12. Good leadership by supervisor
13. Suitable climate for work
14. Give guidance
15. Supervision should encourage innovation allowing free flow of ideas and share
positive experiences of personnel.

COMMON SUPERVISORY METHODS

1.Individual conference 4.Review of records

2.Group conference 5.Evaluation sessions

3.Training sessions 6.Direct observation

PRINCIPLES APPLIED TO NURSING:

 Supervision should be focused on the attainment of one goal, the giving of a high
quality of nursing care.
 Strives to make the ward a good learning situation.
  Supervision is well planned.
 It should posters the ability to think and act herself.
 Helps her to attain objectives stimulates interest and effort.
 Encourages and challenges her to greater endeavour through adequate approval
commendation and by recognition of work well done.
 To make pattern for analysis and to analyze continuously her success in reaching
the objectives.
 Respects the personality of the nurse.
 Stimulates the nurse’s ambition to grow in effective.

WHO IS SUPERVISOR?
• A supervisor is a person who is primarily incharge of a section & is responsible
for both quality & quantity of production, for the efficient performance of the
equipment, & for the employees in his charge & their efficiency, training &
morale
• A supervisor drives authority from the departmental head for getting work done
from the workers by using the resources of the enterprises.
• He issues instructions to the workers, directs their activities & reports to the
department head on the performance of his section.

QUALITIES OF A GOOD SUPERVISOR:

• Trained person
• Understand the training background and ability of the supervised.
• Good knowledge, the local practice
• Good in health, skills in T.G & PR/t have pleasing manner.
• Good listener.
• Supervisor should have leads examplenory life
• Creative enthusiasm
• Just impartial human, tolerant and tactful
• Helpful
• Good power of judgment.
SUPERVISION CONSIST OF

Leadership Communication

Motivation
Evaluation

FUNCTIONS OF SUPERVISION:

B. Educative
A. Administrativ

C. Communicative
D. Evaluative

A. Administrative:
• Assignment of the work loads of individual and groups according to the level of
physical and mental competence (or) preparing the duty roaster.
• Identify the needs for supplies and equipment and providing materials and
supplies to facilitate the staff performance.
• Identify the problem and helps to solve.
B. Educative:
• Orientation
• Teaching subordinates
• Plan and conduct in service education program
• Ensuring staff developments
C. Communicative
• The supervision act as a communicator between the staff and authorities and other
health team members.
 • She facilitates communication
• She should encourage free communication among persons between worker and
community representatives and members of health team.
D. Evaluative:
 Supervisor is supposed to carryout performance appraisal of all the staff this
include identify the cause of difficulty.
 Providing C E and guidance.

OTHER FUNCTIONS ARE:

• Co-ordinates there of subordinates and agents and promote team worker.
• Promote social contact with in the team to bring staff together and increases group
cohesiveness.
• Develops mutual confidence
• Raises level of motivation
• Develops good IPR
• Maintains R & R
• Establish control over the subordinates

AS A MANAGER SUPERVISOR HAS TO PERFORM THE FOLLOWING

FUNCTIONS
 Planning the work
 Issuing orders
 Providing guidance & leadership
 Motivation
 Preserving records
 Controlling output – performance of the worker
 Liaison between management & workers
 Grievance handling
 Industrial safety

STEPS IN SUPERVISION:
When supervision is needed the spur has to make plan for supervision by using certain
steps to follow.
1. Defining of the job to be done
2. Selection and organization of supervisor activities based on available resources.
3. Anticipation of difficulties
4. Establishment of criterion for evaluation determining what extent the programme
has met problem / objectives acc to plan.
Types of supervision:
(1) Direct supervision – Face to face talk with worker
 Points to be considered:
- Do not loose temper
- Use democratic approach and avoid autographic
- Give workers chance to reply
- Do not talk too much and too fast
- Be human in behavior
- Do not give instructions – haphazard way.
(2) Indirect supervision: With the help of record and reports of the worker and
through written instructions.
This includes:
- Ensuring – carrying out allotted work
- Analysis of monthly progress – input efforts and achievement
- Analyzing amount of work allotted
- Support and guidance.
Methods of supervision:
(1) Technical vs. creative supervision
(2) Co-operative vs. authoritarian
(3) Scientific vs. institutive
(4) Task oriented vs. employee oriented
I. Technical – These are basic supervisory skills and which need to be trained –
group discussion and conference
For example: techniques of service study, record construction, time study etc.
Creative – provides maximum adaptation to the situ
 Ex. Instead of orientation period of two week for each new staff member, a variable
plan in both contents and time according to the needs of each individual should
formulated.
II. Cooperative – full participation of each member of the group in planning, action
and decision.
Authorization: supervision responsibility centers entirely on the supervisor, with
the staff following his / her orders.
• Both are needed all to situation.
III. Scientific supervision – Relies on objective study and measurement than personal
judgment / opinion.
Intitutive supervision :It needs to maintain IPR
IV. Task oriented supervision emphasize the task more than performer.
Employee oriented: Supervisors are more concerned about worker staff their
needs and welfare than assigned tasks.

TOOLS FOR SUPERVISION

 Checklist
 Rating scales
 Nurses reports
 Nursing rounds
 Job descriptions
 Personnel policies
 Staff educations
 Problem solving approach

TECHNIQUES OF SUPERVISION
 A technique is a way of doing something. Techniques vary with the personality
and ability of the individuals who are being supervised, the activities that are being
performed under supervision and the immediate circumstances.
 Any technique used for supervision must be based on sound democratic
psychological principles which takes account the nurse’s individuality.
THE PROCESS OF SUPERVISION:
Stage 1: Preparation for supervision
1. A supervisor should focus on specific issue.
- Efficacy of service provided to the
- Relevant problems
- Efficacy problem utilization management of limited resources.
2. Study of document
3. Identification of priorities
4. Preparation of a supervision schedule
Stage 2: supervision
Use tools: - Job description
- Task description
- Weekly time table
- Check list / rating for each work
• As a supervisor the following duties has to be performed.
• Establish contact
• Review the objectives, targets and norms
• Review job descriptions
• Note actual / potential conflict
• Observe the actual performance.
• Observe the individual nursing staff carries out his/her tasks.
• Identify the gaps & needs for follow up action based on feed back data attained
through the observation.
Stage 3: Follow up of supervision
Unless actions to follow-up the gaps and needs identified during stage are taken,
supervision remains incomplete. Each supervisor must prepare a report on the
observations made during supervision. The follow-up action may include:
• Organizing in-service training programmes/continuing education programmes for
the nursing personnel.
 • Reorganization of time table / work plan/ duty roaster.
• Initiating changes in logistic support or supply system.
• Initiating actions for organizing staff welfare activities.
• Counseling and guidance regarding career development and professional growth.

THE EFFECTIVENESS OF SUPERVISION DEPENDS ON:

1. Human relations skill
2. Technical and Managerial knowledge
3. Leadership position
4. Improved upward relations
5. Relief from non-supervisory duties
6. General and lose supervision

1. Human relations skill:

Supervision is mainly concerned with instructing, guiding and inspiring human beings
towards greater performance. For purpose of direction, the supervisor has to rely on
leadership, counseling, communication and other determinants of human relations
2. Technical and Managerial knowledge:
Guidance implies a complete understanding of all work problems, for which
supervisor should have good knowledge about technical aspect of job and also the
managerial aspect
3. Leadership position
The authority of supervisor must be made commensurate with their duty so as to make
the job of supervision a satisfying, rewarding and challenging one
4. Improved upward relations
To ensure god quality of supervisors, the supervisor’s should be regularly allowed to
present their views and suggestions to top executive in regard to the personnel and
their works performance.
5. Relief from non-supervisory duties
To make the supervisory duties purposeful, the supervisors are to be relieved of many
routine activities that divert their attention from the real job.
6. General and lose supervision
According to some experience, the general and loose supervision is more productive
than close supervision. Here the leader must allow freedom and initiative to his
followers for pursuing a common course of action.
PROBLEMS OF SUPERVISION
Problems in Nursing Service:
There are no perfect nursing service programs/situations without any problems
1. Shortage of nursing personnel.
2. Individual differences among personnel in interests, capacities and abilities.
3. Lack of information, insight and understanding of changes and developments in
the interest of the continuance and improvement of nursing.
4. Lack of clearly defined assignments, multiple responsibility and lack of planning
on the part of those to whom personnel is responsible
5. Outdated policies, procedures and guides to workmanship which cause them to be
disregarded and unused.
6. Inadequate, unsafe, and defective equipment.
7. . Ill health in the part of personnel
8. Undesirable personnel characteristics with special attention to attitudes.

COMMON PROBLEMS IN COMMUNITY HEALTH NURSING SUPERVISION:

1. Problems inherent to budgeting, planning and timing.
2. Personnel problems including problems of poor performance.
3. Grievances
4. Lack of financial resources.
5. Lack administrative support
6. Staff members who are inflexible and resist any type of change
7. Assignment to projects other than those committed to perform
8. Lack of political support
9. . Staff members who do not accept or support the program goals.
10. Conflict within the nursing unit itself.
11. Inability to proceed (for many reasons) because the timing is wrong
12. Inability to hire qualified personnel.
13. .Changes in program priorities.
 14. Other issues can include anything from car rental, uniform allowance, security of
the staff within the community, need for supplies and equipment, duplication of
services provided by another organization.

SUPERVISION AND GUIDANCE

a) Supervise and guide the health worker female, dais and female health guides in the
delivery of health care services to community.
b) Strengthen the knowledge and skills of the health worker female.
c) Help the health worker female in improving her skills in working in the
community.
d) Help and guide the health worker female in planning and organizing her program
of activities.
e) Visit each sub centre at least one a week on a fixed day to observe and guide the
health worker female in her day – day action.
f) Assess fortnightly the progress of work of the health worker female and submit an
assessment report to the medical officer of the primary health programme.
g) Carryout supervisory Home visits in the area of the Health worker female with
report to their duties under various National Health Programmes.
h) Supervise referral of all pregnant women for VDRL testing to community health
centre/sub divisional hospital.

CONCLUSION
Concept of supervision in nursing, it is very important aspect for providing health
care services. In the beginning, supervision consisted of little more than inspectors. Its
aim was to detect that which was right or wrong and emphasis was placed on finding
defects. Now it is a part of health monitoring activities. “Management is only one
element in the implementation of primary health care, and much of its content and
methods must reflect the programme as a whole. Training should not only cover technical
aspect of program but also focus on problem solving skills of workers.