AAMJ, Vol. 4, N.

1, January, 2006

TIME MANAGEMENT PRINCIPLES, DELEGATION SKILLS AND

STRESS MANAGEMENT TECHNIQUES USED BY THE NURSE
MANAGERS OF SUEZ CANAL UNIVERSITY HOSPITAL
Karima Hosny Abdel-Hafz*, Wafaa Abd El-Azeem El-Hosany**
Department of Nursing Administration, Faculty of Nursing, Assiut University*,
Faculty of Nursing, Suez canal University**.
------------------------------------------------------------------------------------------SUMMARY
Introduction: Time management is using your time wisely in order to stay
more organized, efficient and reduce stress! Delegating skill is an important
part of your personal time management. You cannot do everything by yourself.
Moreover, you should not.
Aim of the Study: The present study has been conducted on nurse managers at
Seuz Canal University Hospitals to assess the time management principles,
delegation skills and stress management techniques used by them.
Subjects and method: The present study was a descriptive and analytical
study, conducted at Suez Canal University Hospital. The subjects of the study
sample consisted of all nurse managers working in the selected departments
during the period of data collection. Their total number was (40 ) nurse
managers. Data collection tools were; Socio-demographic questionnaire form,
Time management principles questionnaire, Delegation skills scale, Stress
management scale. Data collection was conducted by the investigators through
conducting a workshop (for one week). Thus, the participants nurse managers
in Suez Canal University Hospital was interviewed. The whole duration for
data collection took about one week.
Results: the findings of the present study revealed that more than half of the
nurse managers did not apply all the time management principles, except as
regard they becoming satisfied when doing work in best manner, and doing
productive work is their concern, the majority of the nurse managers did not
have any idea about delegation factors and did not know the steps of
delegation process, while most of them did not have any training programs
about delegation. Moreover, regarding the principles and skills used in the
delegation process, nearly more than half of the nurse managers know to some
extent how to set parameters for selection, instruct and direct their
subordinates, identify limits of subordinates' responsibility, and support them
with sufficient authorities, most the nurse managers in the study subjects did
not apply the techniques to manage stress especially as regard to exercise
walking at least three times weekly and doing heavy work. While, the majority
of them perceived that they proud of their selves and not influenced by
stressors. There was strong positive statistically significant correlation was
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Karima Hosny Abdel-Hafz, Wafaa Abd El-Azeem El-Hosany

found between time management principles, and stress management

techniques. Additionally, a highly statistically significant positive correlation
was revealed between delegation skills, and stress management techniques.
Conclusion: Focusing on these common areas of managing time should reduce
the amount of time spent on each task. Adjusting the way tasks are executed
will save time and reducing stress. Delegating tasks to the most appropriate
person will reduce wasted time for the manager and others. Many employees
desire training such as time management, delegation and negotiation skills
courses may help individual managers to alleviate the stressors they
experience from their jobs.
Recommendations: Using an activity log to evaluate your use of time, and
your energy levels at different times of the day, Setting the goals and plans that
will lead you to that success, Time management education is a well-defined
target for intervention, both in university-based programs for future healthcare
administrators and in workplace-based programs, such as in-service training
for healthcare administrators who are already working, Delegating Effectively,
The nurse manager should know how to manage stress
INTRODUCTION AND AIM OF THE STUDY
Time is one of the major stress factors that managers face today.
Managers have to deal with deadlines and other time constraints on a daily
basis. More often than not there is too much to do and not enough time to do it.
Because of the time constraints, managers need to learn how to maximize their
time at work by doing more important tasks in the time they have and learn to
put aside the less important tasks. The emphasis of the importance of time is
big (Messme, 2003 )..
Managers can learn to control both personal and external time wasters
to increase their productivity. However, even with minimal time wasted, there
is frequently too much work to be accomplished by any one person. In those
situations, the delegation, or sharing of the work and responsibility with other
persons is indicated (Marquis and Huston, 2000 )
Time management is using your time wisely in order to stay more
organized, efficient and reduce stress! There are many different ways to
practice good time management, so you just need to find what works best for
you!. "We have time, keep time , buy time, save time, waste time, kill time,
pass time, give time, take time, and make time" (Whetten, 1995). Every field
deals with different levels of time stress so; therefore, there are several
methods of time management that can prove to be useful for these fields. These
methods can be as simple as remembering to make "To-Do" lists or can be
more difficult to learn because of the complexity of the methods. Learning
better time management skills will help the manager efficiently work through
the stressful tasks that they encounter. By working smarter rather than working
harder, managers may realize how much time they have been wasting. Once
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AAMJ, Vol. 4, N. 1, January, 2006

somebody knows how to manage their time, they will be able to maximize
what they do to accomplish more at work and, thereby, reduce stress (Time
Management Training.com., 2002).
One of the fundamental challenges in effective time management is
remembering the difference between "urgent" and "important." Urgency alone
cannot make a task important. It is the connection to our personal principles
and business priorities that determines the importance of a task.
There will be times when we simply can not get everything done. Sometimes
we have to say "no" or "not now" to other's requests. But, by scheduling what's
important first and then trying to get to the less important tasks in our
remaining time, we increase the odds that we will accomplish what's really
important (Mind Tools.com., 2002).
Delegation is the process of granting the authority and responsibility for
performing a task to another individual. Delegated tasks can motivate
members, spread the work load and train future officers. Delegation is a must
for effective leadership and is one of the single most important skills a leader
can develop. Delegating tasks is indispensable skill for managers of all levels,
but not only for managers. This skill is an important part of your personal time
management. You cannot do everything by yourself. Moreover, you should
not. If you want to manage your time effectively, you have to assign tasks and
responsibilities to others (Wilson, 1998 ).
The most important tip in creating effective time management skills is
to balance your life. Daily responsibilities may include a variety of things, but
you need to make sure you devote enough time to each activity without
wearing yourself out. Take time to enjoy your day while making sure you get
your tasks finished on time. Good time management will keep you from getting
stressed each day. You will learn how to prioritize your life responsibly and get
the most out of each day! (Shirey, 2005 ).
Stress management: The techniques necessary to effectively manage the
difficult and emotional task of stress management in ourselves helps to
understand the stress in others. There is no absolute known 'number' as to the
costs involved with stress. What is known as fact is that those whom are
trained how to handle it are more likely able to cope more effectively than
those who have no training. Stress is part of our daily lives, whether we deny
or accept its existence. As part of your management techniques training, this is
one subject you cannot underestimate (Centers For Disease Control And
Prevention, 2003 )
The following points may help you in delegating jobs: Deciding what to
delegate, Select capable, willing people to carry out job, Delegate complete
jobs, Explain why the job is done, and what results are expected, Then let go!,
Give help and coach when requested ,Give credit when a job has been
successfully completed (Duehring, 2001 )
Today's health care climate demand that care gives makes the
maximum use of their resources to take advantages of resources, It is important
to use time wisely by establishing priorities for patient care responsibilities.
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Karima Hosny Abdel-Hafz, Wafaa Abd El-Azeem El-Hosany

Developing skills in time management and priority setting will help you to
function more effectively and help you to prevent burnout. Time is scare and
valuable resource, so it is important for nurse manger to learn how to use their
time savely and provide care for patient in an organized fashion because when
they saving time, saving money (Adams and Jex, 1999 ).
It is common for people who are newly promoted to managerial
positions to have difficulty delegating. Often they will have been promoted
because they were good at what they were doing. This brings the temptation to
continue trying to do their previous job, rather than developing their new
subordinates to do the job well (Mind Tools.com., 1998).
Significance of the Study:
Managers at the Suez Canal University Hospital have a thousand
different things competing for their attention. They complaining from inability
to manage their time effectively which leads to activity mania, Living in the
present, becoming less effective, work over load, Less leisure time, and stress.
Sadly, however, many managers have never learned to be effective delegators.
Oh they delegate, but too often not with the results they seek. Either the desired
results are not achieved, the manager eventually involves himself/herself more
directly in the task or project, and/or frustration results . . . for the delegator
and for the chosen delegate. They mentioned that they have too much to do in a
short period of time. Being overwhelmed with activities, assignments and work
can lead a person to become stressed out.
So, it felt necessary to conduct this study to help these managers better
manage their priorities and time, allowing them to delegate effectively and
accomplishing more in less time. Ultimately, better time, delegation and stress
management allows them to reach a more satisfying work/life balance and
handle the pressure of your job more effectively.
Aim of the Study:
The present study has been conducted on nurse managers at Seuz Canal
University Hospitals to assess the time management principles, delegation
skills and stress management techniques used by them.
Subjects and method
The methodology pursued in the conduction of the study is portrayed
according to the following designs:
Technical design
Operational design.
Administrative design.
Statistical design.
I.TECHNICAL DESIGN
1. Research design:
The present study was a descriptive and analytical study, follows a
cross sectional study design. The dependent variables included those describing
stress management techniques, whereas the independent variables included

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AAMJ, Vol. 4, N. 1, January, 2006

mainly. Time management principles and delegation skills. All the variables
were measured at the same point in time, with no temporal relationship.
2. Setting:
The study was conducted at Suez canal University Hospital at the
following departments: cardiac and chest intensive care unit, general intensive
care unit, emergency department, general surgical and medical departments,
burn unit, operating rooms, and middle intensive care unit.
3. Subjects:
The subjects of the study sample consisted of all nurse managers
working in the selected departments during the period of data collection. Their
total number was (40) nurses.
4. Data collection tools:
Data collection was done through a questionnaire form, and five
different tools for measuring various scales.
a. Socio-demographic questionnaire form (Annex I):
This was designed for collection of demographic study variables, age,
gender, marital status, and educational level. It also served to collect important
data about respondents job characteristics, such as experience in nursing in
general and in management in particular, specialty area, work status, and job
position, including title, level, and income.
b. Time management principles questionnaire (Annex II):
This questionnaire was a modification of the original tool which
developed by El- Morsy (2004 ). It was consisted of 16 statements that reflect
nurse managers perception of the principles they should follow for managing
time effectively. The response to each item was on a four-point Likert scale
ranging from one for always to four for almost never.
c. Delegation skills scale (Annex III):
This questionnaire was a modification of the original tool which
developed by El- Morsy (2004 ), to assess the nurse managers skills in
delegating tasks. It consists of (10) items reflecting the exact behavior
regarding each delegation skill. The responses were also checked by
respondents on a three-points: yes, To some extent, and No. The scoring
system as follows:
26-30 : Excellent
21-25 : very good
16-20 : good
10-15 : weak
d. Stress management scale (Annex IV):
Again, this tool was based on a modification of the original developed
by El- Morsy (2004 ). It was used to measure nurse managers ability to deal
with job stressors. The responses were also checked by respondents on a threepoints: always, Sometimes, and Never. The scoring system as follows:
96-100 : Excellent ability
81-95 : Good ability
66-80 : Middle ability
51-65 : Weak ability
36-50: unable to deal with job stressors

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Karima Hosny Abdel-Hafz, Wafaa Abd El-Azeem El-Hosany

In each of the aforementioned tools, some questions were paraphrased

negatively. This was done to increase the reliability of the tools, and to
decrease the bias of regression to an extreme of the scale among respondents.
II.ADMINISTRATIVE DESIGN
An official approval to carry out the study was obtained from different
authorities to the completion of the study.
III.OPERATIONAL DESIGN
a. Preparatory phase:
An Arabic translation of all study instruments was done. Their content
validity was checked using experts opinions. Meanwhile, official letters were
issued from pertinent authorities. Necessary modifications prior to the final
application of the study tools with nurse managers in Suez Canal University
Hospital.
c. Field work:
The actual data collection from nurse managers in Suez Canal
University Hospital was started, aiming at testing through a non-experimental
survey design. Data collection was conducted by the investigators. This was
done through conducting a workshop (for one week). This workshop combines
elements of time management, effective delegation, and stress management to
be more effective and efficient in getting work done.
Thus, the participants nurse managers in Suez Canal University
Hospital was interviewed. The whole duration for data collection took about
one week.
IV.STATISTICAL DESIGN
a. Scoring system:
Time management principles Scale: The responses always, often,
sometimes, and never were respectively scored 4, 3, 2, and 1. The
maximal attainable score was 64 (16 items). The scores of the items were
summed-up and the total divided by the number of the items. These scores
were converted into a percent score were computed.
Delegation skills scale: The responses Yes, To some extent, and No
were respectively scored 3, 2, and 1. The maximal attainable score was 30 (10
items). The scores of the items were summed-up and the total divided by the
number of the items. These scores were converted into a percent score were
computed. The higher the score the excellent skills used by the nurse mangers
in delegation.
Stress management scale: The responses Yes, Sometimes, and No
were respectively scored 3, 2, and 1. The maximal attainable score was 30 (10
items). The scores of the items were summed-up and the total divided by the
number of the items. These scores were converted into a percent score were
computed. The higher the score the excellent ability to deal with job stressors.

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b. Statistical analysis:
Data entry and analysis were done using Epi-info 6.2 and SPSS statistical
software packages. Data were presented using descriptive statistics in the form
of frequencies and percentages. Quality control was done at the stages of
coding and data entry. Quantitative continuous data were compared using
Student t-test in case of comparisons between two groups. For multiple group
comparisons of quantitative data, one-way analysis of variance test (ANOVA)
was used. Sheff multiple range test was used to identify statistically
significantly different groups.
RESULTS
Table (1): Frequency distribution of the head nurses according to sociodemographic characteristics.

Demographic characteristics

Nurse managers
(n = 40 )
No
%

Age
25 years
25 - 30 years
30 - 40 years
Qualification
Bachelor of nursing
Diploma
Experience Nursing field
>5 year
5-10 year
< 10 year
Marital status
Single
Marred
Income
>400 L.E.
400 - 500 L.E
< 500 L.E.

12
22
6

30 %
55 %
15 %

39
1

97.5 %
2.5 %

17
17
6

42.5 %
42.5 %
15 %

14
26

35 %
65 %

13
25
2

32.5 %
62.5 %
5%

Table (1): shows that (55%) of the nurse managers were aged between
25-30 years old, the majority of them (97.5%) of them having bachelor degree
in nursing science, (42.5%) of them having from >5 to 10 years of experience
in nursing. It also appeared from this table that more than half of the nurse
managers (65%) were married and (62.5%) of them perceived that they having
from 400 to 500 L.E

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Karima Hosny Abdel-Hafz, Wafaa Abd El-Azeem El-Hosany

Table (2): Perception of the nurse mangers about the time management
principles they apply.
Always
Time management principles
Spend my time as I wish.
Satisfy when doing work in best
manner.
Doing productive work is my
concern.
Keeping regular training.
Planning for my work take a time
from working time.
Adhere objectives with fixed time
table.
Put list of day works and arrange
that works according to importance
and gave opportunity to most
important one.
Having time table including spare
time for facing any crisis.
Delegating every thing can be
delegated.
Writing reports once a time in
correct manner.
Making effort to avoid irritable
visits or telephones.
Having ability to say No to the
others when they need me to do
works preventing me to do my own
works.
Shorten the time of telephone call
during work.
Having agenda for items which will
be discussed during meeting.

Often

Sometimes

Never

17.5

20.0

20

50.0

12.5

18

45.0

12.5

15

37.5

5.0

18

45.0

7.5

12

30.0

17.5

5.0

20.0

30

75.0

12.5

35

87.5

5.0

34

85.0

10.0

27

67.5

2.5

7.5

22.5

15.0

10.0

10.0

26

65.0

22.5

5.0

12

30.0

17

42.5

7.5

10.0

12

30.0

21

52.5

5.0

15.0

17

42.5

15

37.5

15

37.5

12.5

22.5

11

27.5

16

40.0

10.0

10

25.0

10

25.0

7.5

10.0

17.5

26

65.0

Table (2): shows the principles of time management principles as perceived by

the nurse managers in the study sample. It was declared that more than half of
the nurse managers did not apply all the time management principles, except as
regard they becoming satisfied when doing work in best manner, and doing
productive work is their concern.
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Table (3): Perception of the nurse mangers about the delegation skills and they
apply.
yes
DELEGATIONS
I. 1
2

5
6

9
10

11
12
13

Setting parameters for selection of

delegated subordinate.
Instructing subordinate with complete
directions, and expectation about his
performance, before delegation.
Identifying limits of responsibility of
subordinate exactly, and assuring his
understanding to these limits.
Supporting subordinate with sufficient
authorities for doing delegated jobs
effectively.
Assuring willing and ability of subordinate
toward his delegated jobs.
Following up delegated jobs for assuring
good performance and observing problems
prevent implementation
Assessing others which not delegated for
supporting and co-operating with delegated
subordinate.
Supplying subordinate with sufficient and
suitable informations which facilitate
delegation.
Improving initiative attitude for facing
unexpected situations during delegation.
Accepting mistakes of delegated subordinate
as additional experience and never hesitate to
reward him when improving performance
during delegations.
Have any idea about delegation factors
know steps of delegations
Have training program about delegation

For some
extent
%
N

No

20.0

21

52.5

11

27.5

20.0

27

67.5

12.5

11

27.5

24

60.0

12.5

20.0

24

60.0

20.0

10

25.0

17

42.5

13

32.5

12

30.0

15

37.5

13

32.5

14

35.0

15

37.5

11

27.5

13

32.5

14

35.0

13

32.5

13

32.5

17

42.5

10

25.0

12

30.0

16

40.0

12

30.0

4
3
11

10
7.5
28.5

36
37
29

90
92.5
72.5

It was observed from table (3), Perception of the nurse mangers about
the delegation skills and they apply. It was shown that majority of the nurse
managers did not have any idea about delegation factors and did not know the
steps of delegation process (90%, 92.5% respectively), while most of them
(72%) did not have any training programs about delegation. Moreover,
regarding the principles and skills used in the delegation process, nearly more
than half of the nurse managers know to some extent how to set parameters for
selection, instruct and direct their subordinates, identify limits of subordinates'
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Karima Hosny Abdel-Hafz, Wafaa Abd El-Azeem El-Hosany

responsibility, and support them with sufficient authorities (52.5%, 67.5%,

60.0%, and 50.0% respectively).
Table (4): Perception of the nurse mangers about the techniques they apply to
manage the stress they expose to in their work.
Yes

Work stressors

Sometimes
%

No
N

Accepting and doing difficult things in my job.

12.5

22

55.0

13

32.5

Taking long holidays when needed.

5.0

14

35.0

24

60.0

5.0

14

35.0

24

60.0

5.0

10

25.0

28

70.0

11

27.5

11

27.5

18

45.0

Having hopes and always doing it .

10.0

14

35.0

22

55.0

Never work in Fridays.

2.5

16

40.0

23

57.5

14

35.0

11

27.5

15

37.5

15.0

16

40.0

18

45.0

15.0

15

37.5

19

47.5

Taking rest during work time.

10.0

12

30.0

24

60.0

Never do heavy work.

7.5

10

25.0

27

67.5

Always solve my problems by myself.

20.0

11

27.5

21

52.5

17.5

12

30.0

21

52.5

5 12.5
13 32.5
5 12.5
37 92.5
4 10.0
4 10.0
8 20.0
17 42.5
30 75.0
7 17.5

13
14
12
2
13
10
10
2
6
16

32.5
35.0
30.0
5.0
32.5
25.0
25.0
5.0
15.0
40.0

22
13
23
1
23
26
22
21
4
17

55.0
32.5
57.5
2.5
57.5
65.0
55.0
52.5
10.0
42.5

Daily eating healthy food (quality and

quantity in regular times).
Exercising (as walking) at least three times weekly.
Having many friends and many relatives.

Regular prays at accurate time.

Drinking limited cups of tea or coffee daily
( not more ).
Moderating energy in my daily life.

Keep my self fit (the food should be

suitable for the effort of work and sport )
Not allow my troubles or sadness to accumulate.
Sleep about 7: 8 hours at least four days a week.
Never allow my job controls my life.
Proud of my self.
Avoid talking about my work in my social life.
Calming and not accelerating in work.
Never work at night.
Join club and social groups.
Not influenced by Stressors.
Work gives me pleasure.

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Table (4), illustrated the Perception of the nurse mangers about the techniques
they apply to manage the stress they expose to in their work. It was illustrated
that most the nurse managers in the study subjects did not apply the techniques
to manage stress especially as regard to exercise walking at least three times
weekly and doing heavy work (70.0 %, 67.5% respectively). While, the
majority of them perceived that they proud of their selves and not influenced
by stressors (92.5%, 75.0%).
Table (5): Correlation matrix of time management skills, delegation principles,
and stress management techniques applied by nurse managers in the
study sample (n=150).
Work stress
Items
r. value

P. value

Time management

0.832(**)

.000

Delegations

0.878(**)

.000

** Correlation is significant at the 0.01 level.

Table (5) displays the correlation matrix of the scales of time
management principles, delegation skills, and stress management techniques.
A strong positive statistically significant correlation was found between time
management principles, and stress management techniques (r=0.832 ).
Additionally, a highly statistically significant positive correlation was revealed
between delegation skills, and stress management techniques (r=0.878 ).

30.00

Time manage ment

20.00

10.00

0.00

10.00

20.00

30.00

Work stress

70

40.00

Karima Hosny Abdel-Hafz, Wafaa Abd El-Azeem El-Hosany

DISCUSSION
Time management is a challenge for many people, and there are a
number of tips that can help employees to make better use of their time. By
learning delegating skills, prioritizing tasks appropriately, setting goals,
meeting deadlines early, staying organized, finding the most productive time of
the day, minimizing stress, saying "no" to some requests, and reducing the
intrusion of technology, employees may be able to improve their time
management. Additionally, many organizations now offer programs to teach
employees time-management skills in order to reduce stress and improve
overall well-being, and to assist them in managing their non-work lives
(Peeters and, Rutte, 2005 )
As regards time management principles, the findings of the present
study [Table (2)] declared that more than half of the nurse managers did not
apply all the time management principles, except as regard they becoming
satisfied when doing work in best manner, and doing productive work is their
concern. These findings may be due to managers rushing from meeting to
meeting, fighting fires--an astonishing amount of fast-moving activity that
allows almost no time for reflection. Managers think they are attending to
important matters, but they're really just spinning their wheels. Many managers
squander their time in all sorts of ineffective activities, spend their time in a
committed, purposeful, and reflective manner. Managers who suffer from low
levels of both energy and focus are the procrastinators: They dutifully perform
routine tasks but fail to take initiatve. Disengaged managers have high focus
but low energy: They have reservations about the jobs they are asked to do, so
they approach them half-heartedly. Distracted managers have high energy but
low focus: They confuse frenetic activity with constructive action. Also, these
findings may attributed to the lack of their awareness about the importance of
time, they do not have any training programs about time management, they do
not trained to share their subordinates in the work, and they do not know how
prioritize the work. Also, these findings may be attributed the inability of the
nurse managers to plan their work time appropriately.
The previous findings were consistent with the findings of (Sullivan,
1995 ) who stated that time management involves planning and scheduling for
anticipated and unanticipated events in the workday. Effective time
management hinges on priority setting and delegation, priority setting involves
classifying activities and determining the optimal order in which they should
be performed, delegation involves assigning duties and responsibilities to
subordinates and making these subordinates accountable for their performance.
Barriers to effective time management include interruptions and distractions,
such as phone calls and visitors. In addition, Kisa and Ersoy (2005 ) suggested
that the need for time management education is a well-defined target for
intervention, both in university-based programs for future healthcare
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AAMJ, Vol. 4, N. 1, January, 2006

administrators and in workplace-based programs, such as in-service training for

healthcare administrators who are already working.
In addition these findings were consistent with the findings of a study
conducted by Sullivan and Decker (2000 ) which showed that hospital nurses
inappropriately used their time doing the work of other department, they also
were required to do the work of lesser trained personnel such as vocational
nurses, aides, orderlies, unit clerks, and secretaries. Professional nurses who
are self-aware and have clearly identified personal goals and priorities have
greater control over how they expend their energy and over what they
subsequently accomplish (Marquis and Huston, 1994 ). Managers should also
become self-aware about how they waste time. Each individual has set patterns
of what types of work they avoid they go about wasting time. (Marquis and
Huston, 1997 ).
Moreover, Bernhard and walsh (1990 ) stated that a mistake common to
novice managers is not allowing adequate time for planning. Without sufficient
planning, the manager experiences difficulty in getting started and begins to
manage by crisis. Setting aside time at the beginning to plan each day allows
the manager to spend time on high priority tasks. Sometimes, the new manager
does allow time for planning, but has problems accurately predicting the length
of time it will take to complete a given activity. This ability is a management
skill that is acquired with experience. Planning also involves the creation of
objectives and goals in accord with a time frame. If the plan includes realistic
deadlines, there wick be less stress associated with the implementation of the
work. In every plan of action the possibility of unanticipated consequences
should be considered. By constructing alternatives and adopting an attitude of
flexibility, the manager will be able to cope with forces beyond control
(Groher-Murray and DiGrose, 1997 ).
As regards to delegation skills, the findings of the present study
revealed that [table (3)], the majority of the nurse managers did not have any
idea about delegation factors and did not know the steps of delegation process,
while most of them did not have any training programs about delegation.
Moreover, regarding the skills used in the delegation process, nearly more than
half of the nurse managers know to some extent how to set parameters for
selection, instruct and direct their subordinates, identify limits of subordinates'
responsibility, and support them with sufficient authorities. These findings may
be due to: Preference for operating by oneself, Demand that everyone know
all the details , I can do it better' fallacy, Lack of experience in the job or in
delegating. Insecurity, Fear of being disliked, Refusal to allow mistakes, Lack
of confidence in subordinates, Perfectionism, leading to excessive control,
Lack of organizational skill in balancing work loads, Failure to delegate
authority commensurate with responsibility, Uncertainty over tasks and
inability to explain, Disinclination to develop subordinates, and Failure to
establish effective controls and to follow up.
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In the same line, these findings go with the findings of Groher-Murray

and DiGrose, 1997 , who stated that delegation is used by the manager as a way
to ensure that the work of the organization is completed on schedule. The most
efficient and effective use of time is when the manager manages, and the
professional staff does the operative work. Efficiency refers to doing the right
task with the least amount of resources, and effectively refers to doing the right
task correctly and securing good outcomes. The manager who is results
oriented executes the plan of the organization through the appropriate use of
delegation. Delegating the work of the department to others is not only a part
of management but also a strategy for time management.
Moreover, Marquis and Huston, 1994 , stated that delegation is a
learned skill and managers with little experience in its' use frequently make
mistakes. Some of these errors in delegating include under-delegating, overdelegating, and improper delegation. Delegation is a high level skill essential to
the manager. As managers gain the maturity and self-confidence needed to
delegate wisely, they can increase their impact and power both within and
outside the organization, subordinates gain self-esteem and increased job
satisfaction due to the responsibility and authority given to tem and the
organization itself moves a step closer achieving its' goals.
In addition, it is common for people who are newly promoted to
managerial positions to have difficulty delegating. Often they will have been
promoted because they were good at what they were doing. This brings the
temptation to continue trying to do their previous job, rather than developing
their new subordinates to do the job well (Ales , 1994 ).
As regards stress management techniques, table (3) illustrated that most
the nurse managers did not apply the techniques to manage stress especially as
regard to exercise walking at least three times weekly and doing heavy work.
While, the majority of them perceived that they proud of their selves and not
influenced by stressors. These findings may be due to Nursing is extremely
stressful and nurses are at risk for stress syndrome from long-term exposure to
overwhelming demands. This finding has highlighted the major problems and
stressors experienced by retail managers. Many factors contribute to them
experiencing stress, but it is possible to argue that those which are related to
factors intrinsic to the job (e.g. long working hours, staff shortages, time and
performance level pressures) can be attributed to the nature and pace of change
in the current retail environment. Relationships with other people, including
customers, external agents (such as suppliers) and other managers across other
functions of the organization were also a source of stress for the retail
managers.
In the same line, Silvia, (2005 ), suggested that the physical and
occupational features of the nursing staff should be improved along with the
social and public health support system. Stress management skills, in addition,
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should be offered to individuals in all nursing categories to improve their

ability to cope with stress and improve quality of patient care. Subsequent
studies in the appearance of stress syndrome among Mexican nurses must
delve deeply into other worker features and occupational variables such as job
stress, job satisfaction, job motivation, organization, and the work structure
(Roach, 1994 ) Cooperative work relationships, training courses, and team
supervision are also important in preventing stress syndrome. Supportive
relationships with peers may reduce the occurrence of high stress levels among
nurses, leading us to conclude that social support and the psychosocial work
climate should be improved (Piko, 1999 ).
As regards the correlation matrix of the scales of time management
principles, delegation skills, and stress management techniques, table (5)
displays a strong positive statistically significant correlation was found
between time management principles, and stress management techniques.
Additionally, a highly statistically significant positive correlation was revealed
between delegation skills, and stress management techniques.
In the same perspective, Mancini and Marc (2003 ), concluded stress is
a major barrier to effective time management. Stress created by the workplace
or by personal concerns can create anxiety and worry that are distracting from
work. Even ineffective time management can lead to stress, since anxiety over
completing tasks in a timely manner can hinder their accomplishment. To
manage stress, it is important to first recognize what is creating the stress. Is it
worry over a particular task, a work situation, or an issue at home? Once the
stressor is recognized, it can be better managed. If the source of stress is
unidentified, then it cannot be managed.
Moreover, delegate to someone you know can do the jog; then do not
worry about it. One of hte advantages of delegating is that it eliminates some
of the stress and pressure in your life. If you spend your time worrying about
how your delegated task is going, you've wasted this advantage (Blair, 2003 ).
In the same line, the findings of the study conducted by Mayer, 1990 ,
concluded that if managers are aware of what tasks are important for
themselves and their organization and do not waste time on unimportant
matters, they will have that extra time to focus on high priority matters. Getting
time on your side is a major stress reducing procedure. Once somebody learns
to manage their time in a way that fits their ways they will be able to overlook
the obstacle that time had previously placed on them. Many people often
simply overlook or fail to realize why they feel pressured by time. If they can
sit down and take the time to attempt to fix the problem, they can be on their
way to having more time to work their tasks the right way without the stress of
not having time on their side.
Moreover, as the environment surrounding the delivery of health care
remains unpredictable, nurse managers are challenged to create new and
innovative ways to meet the demands before them. The ever-increasing
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Karima Hosny Abdel-Hafz, Wafaa Abd El-Azeem El-Hosany

challenges and decreasing resources can have great impact on the stress level
of even the most seasoned nurse manager. The key for successful stress
management is taking time to care for oneself and thus remain an effective
leader in the organization (Silvia et al, 1999 )..
Whetten, 1995 , stated that another method of effective time
management handles daily tasks by prioritizing them. By doing this you would
want to separate your tasks in order of importance and deal with them one at a
time. When this is done, managers should complete these tasks in order not
skipping from one to another leaving some partially finished. Something else to
be considered is delegating the less important task to subordinates to insure that
will get done. It is acceptable to handle minor tasks occasionally while
completing the larger task; it is just not suggested to go from one big task to
another. These little tasks require little time and thought so they really should
not mess up this cycle. Participants will learn how to plan their time and
organize their time for their personal success. From now on, checklists and
deadlines do not have to be dirty words in your vocabulary! You're not alone in
your quest to get organized. You too will learn how to delegate, limit
interruptions, and eliminate those piles of clutter on your desktop (Blair, 2003 ).
Many organizations are instigating written policies on stress in their
organizations and employing occupational health advisors as a stand on their
commitment to the issue. What is certain, however, is that if retail managers
stress levels are ignored, this will ultimately result in a loss of productivity for
the organization. Keeping employees healthy will result in healthier
organization and profits. Those retail organizations that tackle the issue of
work related stress will be better equipped to cope with the pace of change
within the retail environment which, in turn, may enhance their chances of
gaining competitive advantage (Broadbridge, 1998 a).
CONCLUSION
Focusing on these common areas of managing time should reduce the
amount of time spent on each task. Prioritizing is simple once a to-do-list is
utilized that fits your style; this requires the ability to distinguish what is
important and/or urgent during the day. Adjusting the way tasks are executed
will save time and reducing stress. Delegating tasks to the most appropriate
person will reduce wasted time for you and others. Finally, dealing with the
sources of procrastination will go a long way to making you an effective
manager of time.
Many employees desire some form of training in stress management
and such courses in stress awareness and its management can only be of benefit
to organizations. Other general human resource management training such as
time management, delegation and negotiation skills courses may help
individual managers to alleviate the stressors they experience from their jobs.
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RECOMMENDATIONS
A.1 . Start looking at your use of time management by:
Using an activity log to evaluate your use of time, and your energy levels at
different times of the day.
Knowing how much your time is worth, and hence which tasks should be
avoided, dropped or delegated.
Determining and agreeing what is important for success in your job, and
what constitutes exceptional performance
Setting the goals and plans that will lead you to that success
Time management education is a well-defined target for intervention, both
in university-based programs for future healthcare administrators and in
workplace-based programs, such as in-service training for healthcare
administrators who are already working.
A.3. How we could create more time by:
Delegating Effectively,
and Getting up early!
B.1. Prepare to Delegate Effectively
1. The specifics of the task or job to be delegated.
2. The experience, knowledge and skills of the individual as they apply to the
delegated task.
3. How this person works best (including what he or she wants from his or her
job, how he or she views the work, and so on.)
4. The current workload of this person.
The projects timelines/deadlines, including:
a) How much time is there available to do the job?
b) Is there time to redo the job if its not done properly the first time?
c) What are the consequences of not completing the job on time?
6. Resources for this person as he/she works to complete the task.
7. Your expectations or goals for the project or task(s), including:
a) How important is it that the results are of the highest possible quality?
b) Is an adequate result good enough?
c) Would a failure be crucial?
d) How much would failure impact other things?
8. The role you play as the person who is delegating in ensuring the projects
success, through ongoing monitoring, support, coaching, the providing of
resources, and so on.
C.1. Coping with stress
5.

There are three basic approaches people use to cope with stress:
1.
2.
3.
4.

Managing stress is the best way to deal with it.

Stress Self Analysis
Effective planning will help eliminate the stress of last minute work.
Try to keep organized files for your organization.
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Karima Hosny Abdel-Hafz, Wafaa Abd El-Azeem El-Hosany

5. Relaxation and massage

a. meditation
b. praying
c. mental imagery
d. deep breathing
e. progressive relaxation
f. reading
g. Eat right and exercise
6. Sleep
7. Stroke and reward
8. Shun the "super person" urge
9. Learn to say "no."
10. Learn to delegate
11. Develop a support system
12. Learning how to deal with stress is a very important life skill.
REFERENCES
1) Adams,G., Jex, S., 1999 . Relationships between time management,
control, work-family conflict, and strain. J Occup Health Psychol,4(1):72-7
2) Ales, B., 1995 . Mastering the art of delegation. Nurs Manage, 26(8): 32A, 32E
3) Bernhard and walsh (1990 ). Cited by, Marquis, B. & Huston, C.(2000).
Leadership Roles in Nursing Theory & application, Lippincott Company,
New York.
4) Blair, G, 2003 . Personal Time Management for Busy Managers.
http://www. Institute of Electrical and Electronics Engineers.com/pages/
article/ new HTE_05.htm. welcomes feedback either by email (Gerard
@ee. ed. ac.uk)
5) Broadbridge, A. 1998 a. Stress in Retailing: Preliminary Analysis of the
Experiences of Retail Managers, Institute for Retail Studies Working
Paper 9803 University of Stirling, 1998 , 40pp.
6) Centers For Disease Control And Prevention, 2003 . Manage Stress by
Managing Your time
http://www.aarp.org/health/staying_healthy/health/staying_healthy/stress/A
rticles/a2003-03-11 -strategies.html.
7) Duehring, G., 2001 . Delegation: developing the habit. Radiol Manage,
23(4): 16-20 , 22, 24
8) El- Morsy, A., 2004 . Time and stress management training program.
Trainers manual. FLDP.
9) Groher-Murray, M., and DiGrose, H., 1997 . Leadership and
management in nursing. 1 st ed. Chapter 15. Appleton & Lange, A Simon &
Schuster Company. 305-307 .
10 ) Kisa A , and Ersoy K. 2005 . The need for time management training is
universal: evidence from Turkey. Hosp Top, 83(1): 13-9 2005
11 ) Mancini and Marc 2003 . Time Management. New York: McGraw-Hill
Professional.
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12 ) Marquis and Huston, 1994 . Cited by, Marquis, B. & Huston, C., 2000.
Leadership Roles in Nursing Theory & application, Lippincott Company,
New York.
13 ) Marquis and Huston, 1997 . Cited by, Marquis, B. & Huston, C.(2000).
Leadership Roles in Nursing Theory & application, Lippincott Company,
New York.
14 ) Marquis, B. & Huston, C., 2000 . Leadership Roles in Nursing Theory &
application, Lippincott Company, New York.
15 ) Mayer, J., 1990 . Cited by, Silvia, L., 2005 . Burnout syndrome among
Mexican hospital nursery staff. Rev Med. IMSS, 43(1). 11-15
16 ) Messme M, 2003 . Its About Time: Strategies for Managing
Your Work Priorities. https://www.imanet.org/pdf/2633 .pdf.
17 ) Mind Tools.com, 1998 . Successful Delegation: How, When and Why
www.mindtools.com/pages/article/newLDR_98.htm
18 ) Mind Tools.com, 2002 . Priorities to do lists - remembering to do all
essential tasks, in the right order. http://www.mindtools.com/pages/ article/
new HTE_05.htm . Visited on February 9,
19 ) Peeters M , Rutte C., 2005 . Time management behavior as a moderator
for the job demand-control interaction. J Occup Health Psychol, 10(1): 6475 2005
20 ) Piko, B., 1999 . Cited by, Silvia, L., 2005 . Burnout syndrome among
Mexican hospital nursery staff. Rev Med. IMSS, 43(1). 11-15
21 ) Roach, B., 1994 . Cited by, Silvia, L., 2005 . Burnout syndrome among
Mexican hospital nursery staff. Rev Med. IMSS, 43(1). 11-15
22 ) Shirey, M., 2005 . Stress and coping in nurse managers: two decades of
research. Nurs Econ, 24(4): 193-203 , 211 passim
23 ) Silvia, L., 2005 . Burnout syndrome among Mexican hospital nursery staff.
Rev Med. IMSS, 43(1). 11-15
24 ) Silvia, M., Cabrera, H., Gutirrez. E., 1999 . Stress in nursery
relationship between depression and stress? Int J Psychiatry Med;
29(4):421-433 .
25 ) Sullivan J and Decker, P 2005 : Effective leadership management in
nursing. 6th ed, chapter 4. 62-65 .
26 ) Sullivan, J., 1995 . Nursing leadership and management. 2nd ed.
Springhouse Corporation, Pennsylvania. Chapter 8. 73-79 .
27 ) Time Management Training.com. Learn how to avoid the stress of work!
http://www.time-management-training.com/ . Visited on February 9, 2002 .
28 ) Whetten, H., 1995 . Cited by, Time Management Training.com. Learn
how to avoid the stress of work! http://www.time-managementtraining.com/ . Visited on February 9, 2002 .
29 ) Wilson, C., 1998 . Delegation: relief is just a swallow away. Aspens Advis
Nurse Exec, 13(10): 2
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