INTRODUCTION :

Nursing has undergone dramatically change due to advancement of medical sciences and technology,
abundance of clinical research and higher demands of consumer in response to social needs and influences.
Nursing we practice today is different from nursing as it was practiced years ago and it is expanded to
continue changing during the 21st century.
With rapid changes occurring in health care management system and more changes coming to take place, so
the shift over in nursing is also taking place from the past.
Nursing administration faces a dynamic landscape characterized by both opportunities and challenges.
Administrators must navigate evolving healthcare demands while ensuring quality care, staff satisfaction,
and organizational efficiency.
ADMINISTRATION:-
Administration is the activities of group co-operating to accomplish common goal. In other words, it is the
organization of use man and materials to accomplish the purpose and administration is an essential factor is
an development of any service.
TRENDS:-
It denote general direction and tendencies specially of events of opinion.
Trends mean movement in a particular direction according to time, environment and situation as everything
in this world is changeable.
NURSING TRENDS:-
A trend in nursing is change that is taking place in present days in any field of nursing, which affects the
profession as a whole.
Refers to direction towards which the different nursing event have moved or are moving as well as the
opinion in and around nursing that are found in and about nursing profession. Nursing trend seen in these
current days in different field of nursing which affects the profession as a whole, the current changes in
nursing area and influencing the profession.
TRENDS IN NURSING
A trend in nursing is a change that is taking place in present days in any field of nursing, which
affects the profession as a whole. A trend means a change or movement in a particular direction. It also
denotes general directions and tendencies especially of events of opinions or movements in a particular
direction.
It is the general direction toward which the different nursing events have moved and are moving as well as
the opinions in and around nursing and tendencies that we find in and about our profession. It also means a
change currently taking place in any area of nursing and influencing the profession. Many changes took
place in nursing services, administration, and nursing education.
ISSUES:-
A point or matter of discussion, debate or dispute or a matter of public concern.
NURSING TRENDS:
Refers to direction towards which the different nursing event have moved or are moving as well as the
opinion in and around nursing that are found in and about nursing profession.
Nursing trend seen in these current days in different field of nursing which affects the profession as a whole,
the current changes in nursing area and influencing the profession.
TRENDS IN NURSING SERVICES:
Trends in nursing services are multidimensional directly or indirectly related to nurses, their roles, nursing
education, and nursing services .
1. Nature of care: In the past, the focus was on a traditional type of care. Now more emphasis is on
evidence-based practice. The trends in caring may continue by evidence in the future.
2. Type of nursing care: At present, the emphasis is on specialized nursing care, e.g. caring for patients
suffering from cardiovascular, respiratory as compared to past that was an emphasis on general nursing. In
future, the focus of nursing care as well the nurses would be trained for super specialty care.
3. Use of information technology: There is an advancement in technology in the present era, which was
lacking in the past, and due to this, there are many changes in the curriculum as well in the practic area.
These days, the hospital uses computer-based information technology such as Hospital Information System
and Computerized Record System.
4. The Technological Explosion :
There is reduction in distance through speedy communication. Advances in digital technology have
increased the applications of tele-health and telemedicine mobiles, e-line, video conferences, bringing
together patient and provider without physical proximity.
Nanotechnology is a new form of clinical diagnosis and treatment, which is capable of detecting a wide
range of diseases from very minute specimens. There is computerization for patient care management.
5.Quality assurance in Nursing care :
Public knows their rights, human rights, commissions, protection acts and process etc, are putting constant
pressures on the professionals to deliver their best. Professionals cannot ignore or be careless in discharging
duties especially when it concerns people lives and health. Nurse managers have to ensure delivery of
quality care by practicing as per standards laid down by their counsels and institutions.
6. Decentralised approach to care Management : This makes each and every nurse responsible and
accountable for the care of assigned patients. It focuses on problem solving on the spot with the joint
participation of the supervisee and supervisor. This is effective in terms of patient satisfaction, quality care
and smooth functioning of the units
7. Continuing Nursing education : It has become essential to keep up with the changing needs of patient
care.
Nurses have to continuously update themselves with new and innovative approaches in patient care
management.
For this they should enable themselves with workshops, seminars, short term training programmes, attend
conferences, make use of library, subscribe and read periodicals and books. Discussion on bedside and

supportive supervision helps to keep abreast with newer techniques and information. Nurses have to
continuous update themselves with new and innovative approaches in patient care management.
To update and enhance the knowledge they should enables themselves with workshops ,seminars, short term
in-service training programs, attend conferences, and bedside discussion will lead to update with newer
techniques and information.
8.Evidence based Practice : There has been a significant Advancement in Nursing Science and Research.
There is lack in focus on the scholarship and science of nursing as top priorities. Doctorally prepared nursing
professionals are not being produced in large enough numbers to meet the growing need. There is need for
enhanced mentorship for new researchers to strengthen skills and capacity to conduct meaningful
nursing research.
9. Case management, disease management, and tele health care expand: There is a demand to manage
the care from a distance, being more people at home and in remote areas with chronic diseases and
complicated treatment regimens, through the use of telephones, television monitors, and telecommunication.
10. Marital status of nurses: In the past, nurses used to be unmarried, gradually; the majority of nurses are
married; and in the future, the same trend will continue.
11. Uniform attire: Earlier the image of nurses was due to uniform attire that was of a western type, and in
a white shade with cap, now the trend has been changed, and the uniform is per the Indian culture and
different shades. There is no uniform shade of uniforms for nurses throughout India.
12. Shift duty pattern: In the past, nurses used to work in split shift duties or 8-hour duties; now mostly all
the hospitals follow straight shift duty pattern, which is convenient for nurses, and this trend may continue
shortly.
13. Assignment of nurses: In most of the hospitals, nurses carry out the functional assignment. In the
present scenario, nurses have both functional and patient's assignment. In the future, nurses may be assigned
patients to give holistic or individualized care.
14. Role of nurses: Nurses' role in the past was hospital oriented. However, now they have multiple,
expanded, and specialized roles in a different setting.
15. Nurse practitioners: In the past, nurses had dependent jobs, now trends to prepare nurses as
independent practitioners, and this trend will continue in future as well.
16. Participation in staff development: Presently nurses take the initiative and active part in national and
international conferences seminars and workshops as compare to the past.
17. Awareness among nurses: In the past, the majority of nurses were not even aware of their rights, but
now nurses are aware of their rights and negotiate through their associations and societies to redress their
grievances.
18. Leadership styles: Nurse leaders exercise autocratic type leadership style in the past. But at present,
they believe in democratic and participatory leadership. It may continue in future as well.
19. Turnover: The trend of turnover is also changing. In the past, there was not much turnover in nursing.
The evidence shows that at present, there is a turn over in nursing and the future, it is questionable or
debatable.
20. Nursing institutions: Both unrecognized and recognized institutions were prevailing in the past, but at
present, it is mandatory to take approval from nursing councils and university before starting new courses in
nursing, and this trend will continue.
21. Number of schools and colleges: There were very few schools/colleges of nursing imparting training
program in the past, but at present, there is mushrooming of schools/colleges of nursing, and in future, there
will be a nursing institution per demand.
22. Increased specialization : The demand for nurses who specialize in specific area like leadership in
nursing ,nursing manager, psychiatry, gerontology etc is on the rise. Specialization enables the nurse to be an
expert in the area in which he or she is providing care. It also opens the door to opportunities for career
advancement. Specialization and subsequent certification provides the patient and the health care institution
with assurance that the nurse is highly knowledgeable and competent in a specific area of care.
23. Creating Safer Work Environments : Today’s nurse works in very complex, stressful environments.
In addition to needle sticks, infections, musculoskeletal injuries, and other typical workplace dangers, viral
outbreaks like Ebola, H1N1 ,covid 19 and more have served to increase the attention being placed on
creating and maintaining safer working environments. Nurses must be prepared to handle whatever the next
“big thing” is that comes along.
24. Changing role of women in society: Women are now becoming educated and active.The status of
nurses as women is improving in the society. They are now independent ,good leadership skill, can take
decision independently for themselves and client in any critical condition.
Trends in Nursing Education
Since the philosophy of nation, education, organization, and nursing influences nursing education, the trends
also go on changing per the requirement. The changes take place regarding curriculum, teaching-learning
methods, education quality, and standardization, educational technology, student status, and nurse teachers.
Some of the salient trends in nursing education are as follows:
1. Changing focus from cure to care: Due to shifting on promotive and preventive aspect of care , there is
a need for more workforce. Therefore the nursing curriculum of various courses is revised per the need of
national health policy and national education policy.
2. Change in admission criteria: Per the need of society and nation, the recruitment criteria regarding
minimum qualification and conditions, a method of recruitment and selection in nursing courses, are
different compared with the previous one. Presently nurses get employment through merit and apply online.
3. Improved teaching-learning methods: The nursing teachers these days rely on group methods,
simulation, problem-based learning, reflective learning, demonstration, and other interacting methods to
teach theory and practical compared to traditional classroom methods.
4. Advanced educational technology: Now the education technology approaches used both types: hardware
approach and software approach as well as system approach to provide a scientific base to nursing education
and to make education more productive, instructions more powerful, and useful to make equal and
immediate access to education.
5. Comprehensive evaluation: Presently the focus of evaluation is a continuous and comprehensive
evaluation. Formative and summative evaluations are well appreciated. Efforts are made to make clinical
evaluation more objective by using objective structured clinical examination and on various aspects in the
clinical areas.
6. Emphasis on interpersonal and human relation: Nurses are paying attention to critical thinking,
interpersonal relationship, communication, understanding self, and clients while making correct nursing
diagnoses and making the decision for nursing intervention.
7. The emergence of specialization and research: Due to advancement in medical and allied professions,
specialties and subspecialties are emerging. The nursing institutions have already taken the lead to prepare
specialized nurses to render care in super specialty areas. Due to an emphasis on evidence-based nursing
practice and different research methodologies, action research is gaining importance. Many research projects
are being taken up by the nurse faculty by getting funds from different agencies.
8. Gaining national importance: The nursing education has gained importance nationally like other
educational and professional programs. Private nursing institutions are coming up in all the states of India.
9. Opportunities for higher studies: Comparatively, currently many nursing both government and
approved private nursing institutions are offering nursing programs.
10. Improved student status: In the past, the student was given the student status, being working like
employed nurses; now they are viewed as student nurses rather than nursing students.
11. Uniform attire: There is a change in color and type of uniform attire of students in different programs.
There is no uniformity.
12. Accreditation of nursing institutions: Differing from the past, the nursing institutions are regularly
accredited by the licensing authority, state nursing council, university, and state government and follow
procedures per guidelines to start a program.
13. Standardization and quality of education: Standardization and quality of education are debatable
issues in nursing. Eminent nurse administrations discuss in forums, conferences, and seminars to find the
way to tackle these issues.
Nursing Trend:

FACTORS AFFECTING TRENDS IN NURSING :

1. Changing the health scenario of government: The government made efforts to deliver the healthcare to
both the rural and urban community especially slums, vulnerable under National Health Mission and
National Health Programmes. National Health Policy, 2017, has focused toward the attainment of the
highest possible level of well-being and affordable quality secondary and tertiary health-care services to
everyone and to achieve universal health coverage by ensuring availability of free and comprehensive
primary health services to people of all ages. The creation of “National Institute for Transforming India
(NITI)" Aayog in place of Planning Commission aims at sustainable developmental goals with a bottom-up
approach.
2. Changing demographics: The alarming increase in elderly population will impact on the health-care
services and nursing. The increased lifespan of people with chronic illnesses will pose further challenges.
There is a need that increased nursing workforce with geriatric nursing preparation to deal with them.
3. Change in health-care delivery system: Transition is taking place in the health-care system and in the
hospitals that affect the role of nurses at the top, supervisory, and operational level in hospitals
4.Impact of globalization: With globalization, there is the narrowing of distance; the risk of disease
transmission has increased; and its care has become imminent, and hence there is a need for knowledge
transfer to deal with these problems. Nursing education must, therefore, become more internationally
focused on disseminating information and benefiting from this change. Hence the need for curriculum
revision focused on international health and clinical modalities.
5. Advancement in technology: With the advancement of technology, old techniques, methods of
treatments, procedures, and activities have completely become obsolete. New technology facilitates
diagnosis, decision-making, and research although these technologies pose constant learning challenges for
all. However, advancement in technology always saves time and improves quality care.
In the hospital, more documentation will be done directly on a computer, often at the patient's bedside.
Wireless handheld computers will enable doctors and nurses to be close at hand, even far away. Personal
digital assistants (PDAs) and other electronic organizers will help nurses' access information and manage
time. Computerized records, informally called CPRs (computerized patient records), and CMRs
(computerized medical records), or OLPRS (online patient records) will be common. Nurses must have
thorough knowledge to manage advanced information and technology. Therefore, there is a need for
curriculum revision keeping in mind various clinical modalities, information system, and patient monitoring
devices, which is must for the safety of patients.
6.Impact on medical tourism: The concept of medical tourism is coming up. More and more stakeholders
are working on it, if it is so the nursing education and nursing practice will require focusing on
specialization, quality education, and practical oriented.
7. Advances in medical, paramedical, and allied professions: Growing specialization and super
specialization in medical and allied professions have brought the development of new tests, diagnostic
procedures, medicines, and machines. There is also focus on quality-oriented services. So the nurses also
need to be trained accordingly to keep pace with the medical and allied professionals' current knowledge in
the nursing field that has to be improved.
8. Informatics and efforts to standardize and unify nursing language: Informatics, the study of how to
use computers to capture the data, is proved to be better for clinical and research purposes, and it is growing
and on demand. Various programs are required to take decisions for nursing care.
9. Case management, disease management, and telehealth-care expansion: More nurses will become
involved in disease management and case management through telenursing to keep costs down by helping
people with chronic illnesses and improve their health status through close monitoring, early intervention,
and use of resources.
10. Diverse responsibilities: Nurses at all the levels in hospitals, homes, and communities are accountable
for the diagnosis, prevention, and management of various health problems. Primary healthcare, patient
education, health promotion, rehabilitation, self-care, and alternative methods of healing are the added
responsibilities. To carry out such responsibilities, the nurses need to have diverse skills, and they need to
prepare to gain and enhance their competencies in related roles. It also affects nursing education preparation.
11. Educated consumers: Education and technology advancement brings about a growing awareness of
health needs among people. They are becoming aware of their rights, so nursing needs are to be directed
according to their health needs.
12. Changing women' role: The status of nurses as women is improving in society. They are now
independent and can take independent decisions for themselves and their clients.
13. International influence: The international organizations and their influence encouraged nurses to
participate in international conferences and workshops. Most of the nurses are on deputation for undergoing
training programs in abroad sponsored by WHO, INC, etc. International Council of nurses promotes sharing
ideas, whereas WHO, USAID, etc. assist in research, education, and publications.
14. Changing the focus of nursing:
■Regulatory requirements: It is mandatory for nurses to prove their values to both customers and their
employers, showing how they impact on patient outcomes.
■ Changing role: The nursing role is changing with the advancement of technology. Therefore nurses at
managerial and supervisory level need to have managerial skills, organizational skills, leadership, critical
thinking, delegation, and supervision, and communication skills are required for the nurses working at
different levels.
■ Shared governance: Nurses must take part in decision-making to make rules and develop procedures,
manuals, and standard operative procedures for nursing care.
■ Specialization: It is an era of specialization and nurse demand for clinical nurse experts, so nursing
educational preparation has to be a focus on this direction.
■ Nursing shortage threatens patient care: More demand with fewer nurses threatens patient care. Ways
need to find out to attract and retain nurses.
■Nursing education goes online: Various courses of nursing education will go online in the future.
■Standards and practice guidelines: This is a high time to have the standards in nursing and practice
models, protocols, and guidelines that should aim to reduce useless or harmful practices.
■ Evidence-based care: Evidence-based care on research and clinical studies can be analyzed to come to the
consensus about what are the best approaches to specific conditions from outcome and cost perspectives.
These best approaches often are referred to as benchmarks or best practices. The nurses need to acquaint
with various types of research methodology, evidence-based nursing practice, action research, etc. and thus
call for appropriate planning nursing education curriculum.
■ New ethical concerns: Now the focus is on end-of-life care, technological advancements in the treatment
of infertility, genetic testing that challenges the traditional ethical and societal values regarding conception,
birth, death, and dying. Law is now more consumer friendly, and nurses must know ethical and legal issues.
■ Complementary and alternative therapies: There is a great focus on promoting health through
complementary and alternative therapies such as yoga, ayurveda, meditation, and other.
■ Healthy working environment: New regulations, laws, and organizations are making an effort to make the
working environment healthy so that nurses can work better and stress free.
ISSUES IN NURSING
A point or matter of discussion, debate or dispute or a matter of public concern. Issues are those point or
subject matter of discussion, debate or dispute or a matter of public concerns.
Issues Related to Nursing Services
1. Administrative Issues
■ The insufficient contribution of nurses to health- care development due to few positions for nurses at the
state and national levels
■ Inadequate nursing leadership and strategic management.
■Inappropriate nurse to population/patient ratio.
■ Inadequate preparedness of the nursing workforce.
■ Inadequate recognition of nurse's status in the health-care system.
■Limited active involvement of professional organizations
■ Limited career progression at all levels
■ Limited role and authority of INC in nursing development due to limited roles prescribed in the Indian
Nursing Council Act, 1947: inconsistency in state nursing councils and Indian Nursing Council and
insufficient information system in nursing: a shortage of staff at the INC and state nursing councils.

2. Practice Issues
■ Poor quality of care due to a shortage of nursing workforce and other reasons
■ Limited competency of nurses due to too many categories of nurses with overlapping roles
■ Unclear roles and responsibilities of nurses. But many of the biggest imperatives related to job
satisfaction for nurses could be respecting work/life balance, providing the tools and resources to succeed,
acknowledging good work, and building more authentic, personal relationships. Providing this personal care
for every nurse can help keep them invested in their roles.
■ Inadequate continuing education system and staff development methods
■ Ineffective clinical preparation and supervision during training and limited utilization of evidence and
research
■ Insufficient clinical nurse specialist and independent nurse practitioners
■ Inadequate infrastructure and facilities
■ Inadequate standards and guidelines for nursing practice
■ Ineffective regulation of nursing workforce
■Migration of Nurses. Migration of health worker is one of the biggest issues that is faced by country
today. Since most of the nurses graduated from different institutions have started leaving the country in
search of better jobs abroad and further study as the demand of nurses in developed countries is increasing.
■Lack of resources during this pandemic. Country and county people are facing a huge communicable
disease covid -19 .almost every sector are effected and monthly heath personnel.
The great challenges if to service towards covid19 patients or normal patients with minimum supply of
personnel protective equipment
■ Lack of motivation to provide effective care; Morale issues and burnout can also have detrimental effects
on the physical and psychological health of those employees who have no intention of leaving the unit.
Nurse leaders are in a prime position to boost team morale and help staff avoid burnout. Forging strong
relationships with nursing team members, acknowledging and addressing their concerns, and rewarding
them when they succeed can help show them that they are cared for and respected and that can go a long
way toward making them feel appreciated and helping them avoid burning out.
Issues Related to Nursing Education
1. Uniformity and standardization of nursing education: The nursing workforce available is less per
demand to meet the future health-care needs and challenges. Numbers of nursing institutions are coming up
to prepare nurses of different levels. There is limited involvement of nurses at the policy level.
2. The gap between theory and practice: There is a gap between theory and practice. The students that
they learn in the class are not the same as available in practice settings. Thus they became theory oriented
rather than skill oriented.
3. Changing teaching modalities: Since the nurse teachers are expected to teach through interactive
methods and simulations. But how far the teachers are expert in using these teaching modalities? It is a big
question in front of nursing planners. Therefore, to put into practice these types of modalities, there is a need
to have expert teachers and well oriented with these modalities to bring out expected teaching outcome.
4. Educational preparation: There is a need to prepare competent students with adequate knowledge,
attitude, and skill. The infrastructure, e.g. adequate library facility, clinical facilities, articles, etc., is lacking
in most of the nursing institutions, which even if available, it is not utilized properly.
5. Lack of competent teachers: Having qualified and competent nurse teachers is a major issue at present.
They should have rich experience of clinical with update knowledge of system and technology used for
patient care.
6. Lack of promotional aveues and team spirit among teachers: In most of the nursing institutions, the
carrier ladder of nursing faculty is poor, and there is a lack of team spirit among them. They have less
opportunity to have higher positions that may create frustrations among them.
7. Inadequate infrastructure: Inadequate library facilities, transport facilities, poor nursing lab facilities,
and inadequate hostel facilities need attention.
8. Lack of work culture: There is a need to develop a work culture among teachers and students who are
lacking.
9. Quality of nursing education: The quality of nursing education is in jeopardy due to an inadequate
national nursing educational plan, development, and evaluation system. The criteria for evaluating quality
will be through student competencies shortly.
FUTURE ISSUES IN NURSING
Future Nursing Practice Issues
The identified future nursing practice issues are differentiated nursing practice, competencies, practice
models, and a nursing classification to keep pace with international nursing standards .
1. Differentiated nursing practice: Differentiated nursing practice is the nursing role by education,
experience, and competence (Boston, 1990). Efforts to place the right nurse with the right competencies with
the right patient at the right cost become the goal of health-care professionals.
2. Defining and implementing differentiated nursing practice: Defining and implementing differentiated
nursing practice is a very challenging task, as there is a shortage of staff and a growing demand
for accountability.
3. Defining competencies and models: Competency refers to what an individual is capable of performing.
It includes cognitive skills such as decision-making and interpersonal skills and psychomotor or technical
skills associated with nursing procedures. There is a need to explore which type of competency model and
what competencies for the nurses will work out in the Indian setting. There is a need to have an innovative
practice model focused on differentiated nursing practice.
4. A nursing nomenclature (classification): Naming or describing phenomena in nursing is nursing
nomenclature. It is the language of nursing that addresses nursing diagnosis, nursing interventions, nursing
outcomes, and classification is the systematic arrangement or a structured framework of these phenomena.
The most common classification system adopted by the American Nurses Association is:
■ North American Nursing Diagnosis Association (NANDA): It contains 71 concepts and 143 items.
■ Nursing Intervention Classification (NIC): It is having 486 interventions organized into 30 classes and 7
domains.
■ Nursing Outcome Classification (NOC): It includes 247 individual-level outcomes, 7 family outcomes,
and 6 community outcomes.
■Omaha System: It includes an assessment component-problem classification scheme, intervention
component-intervention scheme, and an outcome component-problem rating scale for outcome.

Future Issues in Nursing Administration

The important issues in nursing administration are related to cost of healthcare affecting nursing, the
challenge of managed care, the impact of health-care policy and regulation, nursing shortage, opportunities
for lifelong learning, and significant advances in nursing science and research.
The issues recognized by Indian Nursing Council are renewal of nursing registration, diploma versus degree
in nursing for registration to practice in nursing, specialization in clinical areas, nursing care standards,
staffing pattern/ nurse-patient ratio, conduct of nursing research, nursing audits, and higher education for
senior positions in nursing and independent nurse practitioners.
Future Issues in Nursing Education
Future issues may include a system of nursing education, students, teachers, and infrastructure .
1. Standardization of nursing education: There is an urgent need have the uniformity and standardization
of nursing education. There is also a need to develop a system of ranking of university-level preparation of
nurses regarding the competency of the graduates, world-class research facilities, well-stocked library, and
so on (Samuel, 2012).
2. Practice-oriented education system: The nursing education system should be practice oriented. As we
know, the nursing profession has a social obligation to the public to meet their general, and specialized care
needs as well as the public expects that a nurse has the expert knowledge and skills to ensure safe care.
3. Well planned, mix, and match teaching methods: Pedagogies have been changed and replaced by
newer methods such as problem-based learning, competency- oriented education, and use of skill
laboratories will improve the teaching-learning process but cannot replace teachers and clinical experiences.
There is a need to work on a well-planned, wise, mix, and match methods.
4. Competent students' preparation: There is a need to prepare competent students with adequate
knowledge, attitude, and skill. The infrastructure, e.g. adequate library facility, clinical facilities, articles,
etc., which is lacking in most of the nursing institutions, if available, not utilized properly.
5. Preparation of competent teachers: The nurse teachers should have rich experience of clinical with
update knowledge of system and technology used for patient care. The nurse teacher must undergo in-
service training on the use of modern education technology human relation, communication methods,
reflective teaching-learning methods, and team building.
6. Promotional avenues for teachers: There is a need for a better career ladder for nursing faculty with
appropriate positions and salary structures.
7. Adequate infrastructure: There should be proper library facilities, transport facilities, poor nursing lab
facilities, and hostel facilities both students and faculties.
8. Lack of work culture
9. Quality of nursing education: There is a need for reviewing educational system-imparting knowledge,
developing skill, and inculcating a positive attitude to care, which is must for quality nursing education. The
selection of students needs objective criteria and transparency.
Ways to Meet Challenges
INC has recommended various solutions to improve the overall scenario of nursing services including
practice, administration, and education in India:
• Strengthen the involvement of nurses in health and nursing policy formulation and planning
• Empower nursing leaders.
• Development and implementation of quality assurance models and system in nursing
• Ensure nursing workforce management as an integral part of human resource planning and health system
development
• Enhance nursing autonomy in practice
• Enforce implementation of recommended norms on nurse-patient ratio
•Produce advanced practice nurses
• Ensure appropriate facilities and adequate equipment and supplies
• Promote evidence-based practice and nursing research
• Establish a continuing nursing education system
• Improve pay scales, incentives systems, and working conditions
• Ensure the quality of nursing education by strengthening nursing programs, increasing qualified maxse
educators, and allocate appropriate resources to maximize efficiency and effectiveness.

MANAGEMENT THEORIES AND MODELS

INTRODUCTION :
Management practice has always existed in some form as early as human civilization ,but a systematic study
has been started from the 19th century onwards . Before the 19th century ,the concept of administration
existed in Egypt in 1300 BC, Kautilya in 320 BC, and in Roman Catholic, a group of German and Australian
public administrators ,intellectuals during 16th to 18th century and later the concept of scientific
management emerged. Taylor made the beginning in the early 20th century.
MODELS IN MANAGEMENT
Models are graphic or symbolic representations of phenomena that objectify and present certain perspectives
or points of view about nature or function or both. Models may be theoretical or empirical.
EVOLUTION OF MANAGEMENT THOUGHT:
I. Classical Theories of Management:
a)Bureaucratic model : Max Weber - 1900.
b)Scientific management : Taylor – 1910
c)Process management : Henry Fayol and others – 1910
II. Neo classical Theory of Management:
a)Human relations : Elton Mayo – 1930s
 b)Behavioral sciences: Maslow ,McGregor and others - 1940s.
III. Modern Management Theories:
a)Quantitative approach: Taylor - 1950 (operational Research Analysis).
b)Systems approach: Boulding ,Johnson and others - 1950
c)Contingency approach : Lorch ,Lawrence and others – 1970s.(situational approach)

CLASSICAL THEORIES OF MANAGEMENT

The classical school of thought began in the early 90s. Organization is viewed as a whole rather than
focussing solely in production.
The concept of scalar levels, span of control, authority, responsibility, accountability, line staff relationship,
decentralization and departmentalization become prevalent. It focuses on efficiency and includes
bureaucratic, scientific and process or administrative management theories.
WEBER’S BUREAUCRATIC MANAGEMENT THEORY:
The main thinker of bureaucracy is Max Weber (1864- 1920). A German sociologist ,is known as father of
modern sociology and father of bureaucratic management. It believes rational guidelines such as rules and
procedures, hierarchy and a clear division of labor. He developed a working system in the office. He
analysed bureaucracy as the most logical and rational structure for large organizations.
Characteristics Of Bureaucracy:
Weber described bureaucracy as an "administrative body of appointed officials". Weber focused on dividing
organizations into hierarchies and establishing strong lines of authority and control. He looked organization
from a closed system perspective. He suggested that organizations should develop comprehensive and
detailed standard operating procedures for all routine tasks. The organization must consider specialization
while dividing the work and official rules in the administrative process. The bureaucratic model has
characteristics of legal-rational bureaucracy which include:
 Distribution of officially designated tasks among staff with a division of labor and specialization of
function.
 Organization of roles into hierarchical structures with superiors and subordinates must be clearly
defined.
 Formalization of policies and procedures to govern staff behavior .
 Ensure uniformity within organization.
 Encouragement of impersonal attitudes between staff members to maintain a psychological distance
between superiors and subordinates.
Criticism :
Behavioral scientists considered it as inhuman and incompatible with the development of a mature
personality. This model lacks empirical validity.
SCIENTIFIC MANAGEMANT THEORIES:
Scientific management approach focuses on the “ one best way’’ to do a job. Frederick W Taylor (1856 –
1915), an American Engineer ,developed scientific management theory. He is a pioneer in management
science and known as the father of scientific management. He conducted a series of experiment and in
1911,published principles of scientific management. The principles are the guide to practice management.
Taylor’s approach was from bottom to top level and focussed on work simplification, standardization, and
thus increasing efficiency and productivity.
Principles Of Scientific Management :
 Every job should be broken into elements and scientific methods to perform each element rather than
the rule of thumb method.
 Scientific procedure for selection, training, and development of employees.
 Cooperation between management and employees by scientific principles.
 Scientifically division of responsibility between management and employees
 Management should design ,set up, and supervise the work of workers, and workers should be free
to do work.
 Both management and employees try to achieve maximum output in place of restricted output.
Elements Of Scientific Management :
 Work measurement studies
 Standardization of tools and equipment
 Scientific selection ,placement and training
 Division of labor
 Cost accounting
 Mental attitude
Time & Motion Studies by Frank and Gilbreth
Frank Gilbreth (1868 – 1924) and Lillian Gilbreth (1878 – 1972) are the pioneer of time and motion studies.
Frank conducted time and motion studies ,and Lillian tried to find the role of human factors at work by
understanding the personality needs of the workers.
They believed that prior estimation of time is must to design work methods rather relying upon observation
based time studies. It enabled the manager to break down the job into its parts and streamline the process.
Gilbreth developed the “ laws of motion economy” and related principles of management to deal with
employees and designing tools and equipments. They are known for contributions in production and
operation management. Gilbreth developed “laws of motion economy” and related principles of
management to deal with employees and designing tools and equipment.
The Gantt Chart by Henry Gantt
Henry L Gantt (1861-1919) believed in the scientific selection of workers and "harmonious cooperation"
between labor and management. He developed planning and control techniques by using simple graphics
like a bar chart labeled as the Gantt chart to depict relationships between planned and completed work on
one axis and elapsed time on the other. He believed in the use of motivational strategies rather than
punishment.
Gantt developed a pay incentive system with a guaranteed minimum wage and bonus systems for people on
fixed wages. Gantt also focused on the importance of the qualities of leadership and management skills in
building effective industrial organizations and emphasized the need for training.
PROCESS MANAGEMENT THEORIES
Process theories deal with the functions of administrative management. It focuses on managing the
organization as a whole instead of managing the individuals. It emphasized the flow of information in the
operation of the organization, the manager, and the functions of management and dealt with total
management organization. Main thinkers of this school are Henri Fayol and Mary Parker Follett.
Henri Fayol and Process Management
Henri Fayol (1841-1925), was a French Manager and Industrialist born in 1841, in France. He developed a
systematic theory of management and a framework for studying management. He is known as "Universalist"
and the "Father of Principles of General Management or Functional Management". He was one of the
earliest administrative theorists to profound universal principles of the administration who translated his
personal experiences into universal truths. He was the father of modern operational management theory. His
theory is also known as Classical Organizational Theory. The process management has a variety of activities
such as technical, commercial, financial, accounting, and managerial.
According to this theory, the functions of process management are to plan, organize, command, coordinate
and control various managerial activities. It specifies 14 principles of management.
Fayol used top downward approach He recommended regular meetings of departmental heads and liaison
officers to improve coordination of organizational operations. These principles are flexible and can apply for
taking decisions in any situation.
Luther Gulick and Administrative Management
Both Gulick and Urwick had rich experience in working of civil services, military organizations, and
industrial undertakings. They developed a classical theory of organization which is also known as
Administrative Management.
Luther Halsey Gulick (1892-1993), born in Osaka, Japan in 1892, (expanded the works of Henri Fayol to
build a foundation for management theory. He viewed management functions as universal. He coined a
seven- activity acronym, POSDCORB; each letter represents one important function of the manager. It
stands for planning, organization, staffing, directing, coordinating, reporting and budgeting. His major
contribution was the theory of departmentalization. He identified 4P's: purpose (function), process, persons
(clientele), and place as the bases for dividing the work to create departments.
Lyndall Urwick and Administrative Management
Lyndall Urwick (1891-1983) born in Britain in 1891. Urwick defined the organization as determining
activities that are necessary for a purpose. His main contribution is in the field of managerial functions and
developing general managerial guidelines and principles of management.

NEOCLASSICAL THEORIES OF MANAGEMENT

The neoclassical theory is the extended work to the short comings of the classical approaches to
management . The beginning of applied research in the area of organizational behaviour. It includes
management thoughts of human relations school and human resources school.
Human Relations Management Theories
Behavioral or human relations management emerged in the 1920s. Its main concern was on human behavior
in the work place.
George Elton Mayo (1880 – 1949)
Elton Mayo (1880 – 1949) was an Australian psychologist, sociologist and organizational theorist. He is the
founder of the human relations ,movement and is known as the father of the Hawthorne studies. He
identified the Hawthorne Effect or the bias that occurs when people know that they are being studied or
observed. He along with his employees Roethlisberger and Dickinson conducted this study to determine the
effect of better physical facilities on workers' output. Some studies were conducted to find out the impact of
different situations on the efficiency of workers. The Hawthorne Studies demonstrated the important
influence of human factors such as high morale among individuals and group, people-oriented approach to
consider people as human beings, and understanding of group attitude and psychology on worker
productivity.
Mary Parker Follett and Management Theory
Mary Parker Follett (1868-1933) was born in Quincy, Massachusetts. She was an American social worker
and pioneer in the fields of organizational theory and organizational behavior. She emphasized participative
decision-making rather than using coercive power. She established a clear-cut channel of communication
and was in favor of using depersonalized authority and order in an organization. Three major concepts of
Follett's theory were:
• Universal goal: The universal goal of organizations is an integration of individual effort into a synergistic
whole. Integration is a method of settling conflicts instead of compromise or domination.
• Universal principle: It is a circular or reciprocal response emphasizing feedback to the sender considering
two-way communications.
• Law of the situation: According to the law of the situation, there is no one best way to do anything, but it
all depends on the situation. Facts of situation determine the basis of authority and responsibility.
Behavioral Sciences Management Theories
The School of Human Resources represented a substantial progression from human relations in the early
1950s. The contributors of behavioral sciences are Abraham Maslow, Chester Bernard, Douglas McGregor,
and Rensis Likert.
BEHAVIORAL SCIENCES MANAGEMENT THEORIES
The School of Human Resources represented a substantial progression from human relations in the early
1950s. The contributors of behavioral sciences are Abraham Maslow, Chester Bernard, Douglas McGregor,
and Rensis Likert.
Maslow's Theory of Motivation
Abraham Maslow (1908–1970) born in New York, developed the Hierarchy of Needs model in 1940-50s.
Maslow was an American psychologist whose theories have been influential in 20th century thought.
Maslow's motivation theory known as Need Hierarchy Theory is one of the best known and most influential
theories on workplace motivation. This theory is useful for understanding human motivation, management
training, and personal development.
According to this theory, human beings have a variety of needs to motivate them to work. These needs are in
a hierarchy, and the man starts satisfying needs step by step. It postulates that satisfied need never motivates
human behavior. Maslow enumerated a wide range of human needs and classified these needs into five
categories. Maslow represented these five needs in a hierarchical triangle in a model. He viewed that when
the first need is satisfied, then a person moves to next and so on to strive for self-actualization.
1. Physiological needs: These are basic needs required for survival and maintenance of life such as food,
clothing, shelter, etc.
2. Safety needs: These needs include physical safety against murder, fire, accident, security against
unemployment, etc.
3. Social needs: These are related to love, affection, belonging to the workgroup, family, etc.
4. Esteem needs: These needs ego needs, derived from achievement, mastery, independence, status,
dominance, prestige, managerial responsibility, etc.
5. Self-actualization needs: These needs are to fulfill the real mission of one's life. These include realizing
personal potential, self-fulfillment, seeking personal growth and peak experiences.
The basic core of Maslow's theory is motivation and can apply to motivate employees. The employer in the
organization should keep in mind that all human beings have basic needs and a right to strive for self-
actualization. The concept of self-actualization provides real meaning, the purpose for employees and the
basis for staff development.
Chester Irving Barnard (1886-1961)
Chester Barnard was a telecommunications executive and author of Functions of the Executive, an
influential 20th century management book, in which he presented a theory of organization and the functions
of executives in organizations. Two of his theories: i) the theory of authority, and ii) the theory of incentives
has seven essential rules of communication system.

These rules are as follows:

Rules of the communication system
•Definite channels of communication
• Each employee should know and have access to these channels of communication
• Keep communication short and direct
• Adequate skill among person dealing with communication
• No interruption of communication during working hours
• Be honest in communication.
According to Barnard, the organization is a system of discerning coordinating individual activities. He
emphasized efficiency and effectiveness as criteria for organizational survival. He divided organization into
formal and informal. The informal organization is a part of a formal one. He emphasized on developing a
major plan which he labeled as strategic planning.
The key areas of managers to plan are an effective communication system, recruitment, selection, and
retaining policies, and employees' motivation. Another major contribution of Barnard is on acceptance of
authority. Acceptance theory of authority states that managers only have as much authority as employees
allow them to have. Authority flows downward but depends on acceptance by the subordinate. The
employees must understand the expectation of the manager and should comply with the directive.
Herzberg's Motivation-Hygiene Theory
Frederick Herzberg (1923-2000), a clinical psychologist and pioneer of "job enrichment". He developed
two-factor theory. It identifies five strong motivational factors of job satisfaction (satisfiers) and five job
dissatisfaction factors (hygiene factors/dissatisfiers).
Satisfiers have an association with the growth of employees and task content of the job such as achievement,
recognition, works itself, responsibility, advancement, and growth. Hygienic factors or dissatisfiers define
the job context such as status, interpersonal relations with supervisor, peers, and subordinates, supervision,
company policy and administration, job security, working conditions, salary and personal life, that have little
or no relationship to the motivation of job-related behavior.
McGregor Theory X and Theory Y
Douglas McGregor (1906-1964) was an American social psychologist best known for the theory of
motivation, i.e. theory X and theory Y. These are two opposing assumptions about human behavior behind
every management decision.
i. Theory X (authoritative management style): Theory X represents a traditional or narrow view
of human nature. The managers think that employees are lazy and dislike work. They avoid
taking responsibility and prefers that somebody lead them. That they have no concern with
organizational objectives, need constant direction to achieve goals. They need the threat of job
loss and financial incentives to work hard. Managers who believe on theory X, generally get poor
results. Their management style is authoritarian with repressive style; have tight control without
any development. They produce limited, depressed culture.
ii. Theory Y (participative management style): Theory Y believes in human relations approach
and is adopted most of the modern management thinkers. Y theory assumed that:
■ The persons put efforts as natural as work and play
■ They have self-control and self-direction to achieve organizational objectives
■ Bound to a commitment
■ People are responsible and work with honesty
■ They are innovative and have the problem-solving ability.
Managers who use theory Y, get better results and allow people to grow and develop. Their management
style is liberating and developmental, have control for better achievement and continuous improvement
through enabling, empowering and giving responsibility.
Alderfer's ERG Theory
ERG theory, proposed by Clayton Alderfer is the extension of Maslow's theory, describes needs as
a hierarchy. The letters ERG stand for three levels of needs: existence, relatedness, and growth. Figure 8.3
depicts the ERG theory. It specifies three types of needs as discussed below:
Existence needs: Existence needs is the combination of Maslow's physiological and safety needs.
Relatedness needs: It is the combination of social and esteems needs. These needs are related to a feeling of
a sense of identity and position within society.
Growth needs: Growth needs include self-actualization and transcendence needs. These needs are the
highest level of needs and concern with growth and attainment of one's potential.
Managers must identify frustration due to the particular need among employees and try to satisfy by using
certain motivational techniques to maximize the output.
McClelland's Three Needs Theory
David Clarence McClelland (1917-98), the American Psychologist, is chiefly known for his work on
achievement motivation. He was a pioneer for workplace motivational thinking. He developed achievement-
based motivational theories and models and advocated competency-based assessment tests to evaluate the
performance of employees. His ideas relate closely to Herzberg two-factor theory. Achievement-
motivational theory is "three needs theory" developed by McClelland and his associates. According to this
theory, people have three types of needs and behave accordingly to fulfill those needs. These needs are:
1. Need for achievement (nAch): People who want to achieve something try to attain challenging goals and
set new records. They do something different from others. They try to become the best leaders. They believe
in hard work and put the effort to succeed.
2. Need for power (nPow): Persons who have this type of need are "authority motivated" and they want to
have personal status and prestige. They have a strong desire to lead, direct people and want that their ideas
should prevail.
3. Need for affiliation (nAff): People who have “need for affiliation" are friendly and have good
interpersonal relationships with the group. They participate and enjoy social activities. They cooperate and
support each other. They feel motivated by being "liked" and "accepted" by others. They prefer to work with
people who maintained group harmony and cohesion. Persons having moderate "need for affiliations" are
effective managers.
Locke's Goal Setting Theory
Edwin A Locke was a pioneer on "goal setting and motivation theory" based on an idea born out of
Aristotle's theory of "final causality," in the late 1960s understands how goals can influence an individual's
performance.
In 1990, Locke along with Latham published a theory of "Goal Setting and Task Performance". This theory
has five basic principles:
1. Clear goals: According to this theory, employees motivated to work if they have clear goals and get
appropriate feedback. Goals provide a major source of motivation for the employees to work and to improve
performance to achieve the goals. The goals must be productive, clear, measurable, unambiguous, and
behavioral and time-bound.
2. Challenge: Goals should be explicit and should pose sufficient challenge to the employees.
3. Commitment: According to this theory, if the employees are involved in goal setting, they feel more
committed rather than if not involved. Employees get motivated and will work hard if they find the goals
and tasks are difficult rather than easy.
4. Performance monitoring and feedback: Performance monitoring and feedback process are very
important to goal setting. Teamwork must be assessed at intervals of time to check its progress and to make
modification if required.
5. Self-efficacy: Self-efficiency of employees is an important factor to achieve goals. To make employees
self-sufficient, arrange a training session.
Likert's System 4 Management
Rensis Likert (1903-1981) was an American educator and organizational psychologist. He did extensive
research on organizations and management styles. He also developed Likert scale and linking pin model.
According to Likert, job oriented supervision was the cause of low productivity and low morale and
suggested participative management for decision making. Based on the type of working relationship
between superior and subordinates and the degree of involvement of subordinates in the decision-making
process, he classified management styles into the four categories:
I. Exploitive autocratic: There is no participation of workers with management in decision making
due to low confidence in them. They ignore them and use threats and other fear-based methods to
achieve the goal.
2. Benevolent authoritative: There are master and servant type of relationship among superior and
subordinates. The subordinates are encouraged for appropriate performance by giving few rewards by
top management.
3. Consultative: The management has partial confidence in employees and makes maximum use of
participative methods, allow them in decision-making for specific decisions. Employees in the
organization are closer together and work well together at all levels. The communication is downwards;
the upwards communication is cautious.
 4. Participative: Management has full confidence in employees and encourages group participation and
involves them in setting high-performance goals with some economic reward. Employees throughout the
organization feel responsible for achieving the organization's objectives.
MODERN MANAGEMENT THEORIES
The modern era is characterized by trends in the management through microanalysis of human behavior,
motivation, group dynamics leadership leading to many theories of organization. . The macro search for
fusion of the many systems in business organization-economic social technical political and quantitative
methods in decision- making.
 Modern management theories era can be father classified as the three streams :
 Quantitative approach
 System approach
 Contingency approach
QUANTITATIVE APPROACH
 Management science refers to the application of Quantitative methods to management.
 Management science has an interdisciplinary basis in other words management science is a
combination and interaction of different scientists
 Problem solving and decision making is the prime concern of this approach.
 Mathematical models have quantifying variables.
 Use of various mathematical tools to solve problems.
SYSTEM APPROACH:-
 According to system approach the organization is the unified, purposeful systems composed of
interrelated parts and also interrelated with its environment.
 Each unit must mesh/ interact with the organization as a whole, each manager most interact/
communicate and deal with executives of other unites .
 The organization itself must also interact with other organizations and society as whole.
IMPLICATIONS OF MANAGEMENT THEORIES IN NURSING :
Taylor’s theory can be implemented in nursing to study complexity of care and determine staffing needs and
observe efficiency and nursing care. Nurses can utilize Emerson’s theory of early notion of the importance
of objectives setting in an organization.
Nurses should be aware of the managerial tasks as defined by Fayol:
• Planning,
• Organizing,
• Directing,

• Coordinating and
• Controlling.
The theory of human relations of Follett and Lewin emphasize the importance for nurse managers to develop
staff to their full potential and meeting their needs or recognition, accomplishment and sense of belonging.
Mc Gregon and Likert support the benefits of positive attitudes towards people ,development of
workers ,satisfaction of their needs and commitment through participation.

CONCLUSION:
Nursing administration requires a proactive and adaptable approach to manage current trends and address
critical issues. By fostering innovation, supporting the workforce, and prioritizing quality care, nursing
leaders can create resilient healthcare systems that meet the needs of patients and staff alike. Management
theories and models are essential tools for nursing practice. They provide a basis for understanding and
improving organizational behavior and performance, as well as guiding decision – making and quality
improvement initiatives.

BIBLIOGRAPHY :
1. Vati Jogindra, Principles and Practice of Nursing Management and Administration, 2 nd Edition,
Jaypee Brotheres, New Delhi; 2020, Page no- 73-82
2. Basanvanthapa BT, Management of nursing Services and education, 1St edition, Jaypee brothers’
medical publishers Ltd: New Delhi;2017, P 211-230.
3. Huston J Carol, Marquis L Bessie, Leadership Roles and Management Functions in Nursing, 8th
Edition, Wolters Kluwer(India) Pvt Ltd: New Delhi; 2015, P 277-282.
4. K Deepak, Chandran S, Kumar M, A comprehensive Textbook on Nursing Management, 1st edition,
EMMES Medical Publishers: Bangalore; P 113-125.

Net reference :
II. https://nursinganswers.net/essays/the-contemporary-issues-in-the-professional-practice-
nursing-essay.php.
III. https://www.ukessays.com/essays/nursing/current-issues-and-future-perspectives-of-nursing-
workloads.php.
IV. http://nhrc.gov.np/wp-content/uploads/2019/04/Annual-Report-of-NHRC-2074-75.pdf.