A Management Model for Professional Wholeness

Research Article Abstract The purpose of this article is to describe a management model for professional wholeness. A theory generating research design was followed. Based on this model the consequences of m ana­ gement could be a state, which varies dynam ica lly between m in im al and maximal professional wholeness. A list of descriptive words was developed to generate qua lita tive ind ica to rs of professional wholeness.


Overview
The negative experiences reflected by nurses (Muller & Coetzee, 1990) echo a sta te m e n t a b o u t c o n v e n tio n a l and prevailing management models.The essence of the inadequacy of general management models in resolving nursing management dilemmas is not so much in their basic fram ew ork but in their central motive.For example, Weber's (1947) m odel o f b u re a u c ra c y was designed to give ''legitimate authority" to bureaus, which in turn had to benefit the economic interests of the community and reinforce capitalism.Likert's (1961:293) m odel e n d e a vo u rs to relieve the deterioration in manufacturing, produc tion and control, by designing a formula fo r a high p ro d u c in g o rg a n is a tio n .Vroom's (1974) normative model focuses on decision making for better production results.
A myriad of classical and contemporary management models have undeniably moulded general management thought as well as nurse management practice.The significance of these models is not denied, but their relevance to present day n u rsin g m an ag em en t s itu a tio n s is certainly questioned.>In the search for clarification of the problems and crises in the nursing environment, managers and researchers alike tend to disregard the obvious fact that these models were not designed for the nursing scenario.The insufficiency of these m odels to adequately address the nurse manage-

Opsomming
Die doel van hierdie artikel is om 'n bestuursmodel vir professionele heelheid te b eskryf.' n T eo rie -g e n e re re n d e navorsingsontwerp is gevolg.Gegrond op hierdie model kan die gevolge van bestuur wissel van 'n toestand tussen minimale en maksimale professionele h e e lh e id .'n Lys van b e s kryw e n d e woorde was ontwikkel om kwalitatiewe aanwysers van professionele heelheid te genereer.
ment situation is thus self-evident.The irony is that nurses are in a ''caring" profession, but when it comes to them as individuals, very little caring is effected.In actual fact with the application of the various managerial models, the innate caring ability, which is vital in nursing interaction, is brutalised, instead of being nurtured, cultivated and developed.
Nurse managers need to urgently change course away from general management models.If they relentlessly persist with their application to the nursing environ ment, whilst their main focus is on all things else but the crucial service and caring aspects unique to the nursing environment, the looming crisis in our midst will prevail.In this study an attempt has been made to c o n trib u te to w a rd s a ch a n g e in direction for nurse management and to construct a model which deliberately diverges form existing general manage ment frameworks by applying a nursing theory as the point of departure -which can then enable us to address the nursing organisation as a unique organisational entity, with equivalent unique interactional paradigms.
The nursin g th e o ry fra m e w o rk and approach employed in designing this m odel is the "N ursing for the Whole Person Theory" (NWPT), developed by the Oral Roberts University Anna Vaughn School of Nursing (1990).The intrinsic service and wholeness orientation of this th e o ry was u tilise d as m eta ph o r to construct a management model, which will enable nurse managers to strive towards professional wholeness (Randse Afrikaanse U niversiteit, Departem ent Verpleegkunde, 1991).
The functional approach employed in this study aims at providing quality patient care.The achievement of the research o b je c tiv e , n am ely to g en erate and describe a nurse management model for professional w holeness, w ill be a d dressed in this article.

Research Design and Method
A contextual research design was emplo yed fo r e x p lo rin g , d e s c rib in g and generating the model.The type of model, which was generated, is regarded as ''m iddle-range" and ''situation-relating" theory.According to the classification of Walker & Avant (1983) the m odel is ''m id d le -ra n g e th e o ry " due to the utilisation of the global framework of the NWPT as grand theory, to meet the needs which exist in the nurse management do m a in fo r a m odel based on the wholeness approach.The model was further constructed as ''situation-relating theory" according to Dickoff, James & Wiedenbach's (1968)

Phase 1: Factor Isolation
In factor isolation the concepts relating to management interaction must first be identified and then redefined within the context of the model.The two steps involved in factor isolation are therefore the id e n tific a tio n and d e fin in g of concepts.Concept identification was effected by a survey of the literature and by applying a survey guide to analyse various categories.The survey was done by means of a literature investigation of e x is tin g m an ag em en t m od els and specific models were then selected for closer scrutiny.These m odels were deliberately selected from three main schools of managerial and organisational approach and the systems approach.A total of fourteen models were selected.Job-satisfaction and plan to stay or leave for registered nurses (Walek, 1979) Four systems m odels were selected, three of which from general management and one from nurse m an ag em en t, namely: ♦ Social systems model for organi sation (Beer, 1980 (1968) was e m ployed to refle ct the approach and content of each model w ithout interpreting it.Consequently, w ha t has been re fle c te d in these categories are the direct opinion of the author of a specific model and thus not the sentiments of the researcher.
The six main categories of the survey guide were em ployed in the form of questions.These ''questions" were used to reflect the content and views of a selected model about the following:

□
The agency (the manager); □ The recipient (the nurse and patient or client); □ The framework (the framework within which activities are execu ted); □ The terminus (the end result of activities); □ The procedure (the procedure or process that will lead to the end result); □ The dynamics (the motivation behind activities).
The data collected was handled as raw data and processed for content analysis.
The content analysis protocol of Wilson (1989) was a p p lie d b eca use the technique is suitable fo r processing qualitative raw data collected from this model survey.The data was categorised a ccordin g to three main categories, namely structural models, behavioural models and systems models.The six categories of the survey guide were used as secondary categories and emanating from these categories tertiary categories were developed.A manifesting analysis of the survey data examined the semantic content.The latent analysis examined the meaning and implications through the interpretation of statem ents (Wilson, 1989).The literature and the study leaders verified the content validity of the analysis.
The analysis was also confirm ed by exam ining the sem antic m eaning of words.Words and terminology in the raw d ata w ere u n d e rlin e d and listed according to the categories.The under lined descriptive words were tabled for comparison.The acceptance or rejection of the identified statements was then debated, based on their congruency with the philosophy and basic assumptions of the NWPT.
The th re e -s te p m eth od of W a ndelt (Wandelt & Stewart, 1975) was applied to do a systematic investigation of the sem antic d escription of the ultim ate concepts and term inology.The defi nitions of these concepts, as obtained from dictionaries and subject literature, were listed without accepting any one in particular.In the first step the general or dictionary definitions were investigated.
Explanations of concepts were noted.
The meaning of a concept, as specified within the discipline of management and nursing were reproduced as ''subject related" definitions.In the second step, pertinent definitions were investigated for the meaning of concepts where they were employed within a specific situation or circumstance in nurse management.

Phase 2: Factor Relation
In this phase the relationship between the identified factors was delineated as statement and logical arguments.
The categories of the survey guide and the assessm ent fram ew ork of the NWPT were utilised to describe the relationships in the form of propo sitions and assumptions.

Phase 3: Situation Relation
Based on the information and data collected from the previous phases, a The internal environm ent of the organisation is a micro replica of the broader external environm ent.
management is devotion and accoun tability.

The Organisa tional Framework
The c o n c e p t "o rg a n is a tio n " w ill be discussed primarily due to the critical framework it provides for management interaction.Within a wholeness perspec tive the organisation is defined as a complex and dynamic corporate body w hich fu n c tio n s p u rp o s e ly in an integrated and co-ordinated manner on a structu ra l/p h ysica l, psycho lo gica l, spiritual and social basis in the search for organisational is unique but also an integral part of the community in which it functions and forms part of the work or professional environment of its members.
The in te rn a l e n v iro n m e n t o f the o rg a n is a tio n is s tru c tu ra l/p h y s ic a l, psychological and social by nature whilst the external environm ent is physical, psychological, spiritual and social by nature.The organisation as a whole is continuously moulded by its internal and external environment.An organisation, as a professional entity, operates within the external environment of individuals, but as a corporate body it also has its own internal and external environment.
The margin delineating the internal and external environment of the organisation is perm eable and dem arcated by its p h y s ica l fra m e w o rk.The inte rn a l e n v iro n m e n t of the o rg a n is a tio n is therefore an external, internal environ m ent b eca use it is e xterna l to the individual member but internal in terms of the demarcation by its own physical organisational framework.
B etw een the in te rn a l and e xternal environment of the organisation there are reciprocal, complementary, correspon d in g , co m p a ra tive and in te rre la te d interactions.The internal environment of the organisation is a micro replica of the b roader external environm ent.The organisation's professional wholeness status is determined by the interactions within its internal environment on the one hand and its interactions with the external environment on the other hand.The promotion, maintenance and restoration of organisational wholeness require the actualisation and mobilisation of all the resources in the internal and external o rg a n is a tio n a l e n v iro n m e n t.The organisation as a whole functions in an integrated structural/physical, psycholo gical, spiritual and social manner in its pursuit of wholeness.
In this article the focus is on the internal organisational environment.The health care organisation's mission necessitates th e re n d e rin g o f a p u rp o s e fu l and dynamic service to assist individuals, fa m ilie s and c o m m u n itie s in the promotion, maintenance and restoration of health.The very reason for the existen ce of an organisation lies with its mission.W ith in the o rg a n is a tio n th e re are continuous processes and interactions to achieve the organisational mission.The organisational entity consists of two basic in c o rp o ra tin g s e c to rs , its p h y s ic a l structure and the persons who interact with the organisation.A physical struc ture without members would be like an empty shell and individuals w ithout a physical structure, is organisationally incapacitated.The physical framework and the human beings within that frame work must be in harmony with each other, otherwise chaos and destruction will result.The interaction between the organisational sectors does not manifest itself in an isolated manner but rather in an integrated, co-ordinated and dynamic configuration.
The physical structure combined with the individuals relating with an organisation com m un ally reflect the professional wholeness status of the organisation.The physical framework of the organisa tio n is the a c c u m u la te d o f v a rio u s concrete and tangible structural aspects and features.These involve the physical, material and product or service structures of the organisation.As a professional w h o le n e s s d im e n s io n the p h y s ic a l fra m e w o rk is in te g ra te d w ith and influenced by all the other dimensions and portrays the physical image of the organisation.The wholeness status of th e p h y s ic a l fra m e w o rk of the organisation can be appraised qualita tively by considering the manifestation of particular characteristics.Each organisa tion has some kind of physical structure, however, basic or flexible it might be.The physical structure can vary from huge buildings or mobile clinics to even more basic structures such as clinics in the shade of an African tree.The physical structure provides an essential framework fo r the o rg a n is a tio n 's tra n sa ctio n s, interactions and operations and plays a critical role in interactions, perceptions about and the reflection portrayed by the organisation to the external environment.
The material structure of the organisation is reflected by its other capital assets, for example office equipment and transport.The financial aspects are also part of the material structure of the organisation and are reflected by its budget, cash flow, income and expenses.It also entails the consuming profile of the organisation, which is reflected by the use of different materials (such as fuel and other consu mables).The product and or service orientation of the organisation defines the foundation for its physical existences.The product structure of the organisation is re fle c te d by va rio u s m a te ria ls or products, for example m edicines and prosthesis.When the mission of the organisation is founded on a service orientation (for example nursing services and educational services), the service structure is portrayed by the type and quality of the service rendered.
The human dimension of the organisation is personified by the individuals who relate with the organisation and are referred to as "members" .The individu als, w h e th e r te rm e d e m p lo ye e s, managers, directors, shareholder, clients or p atients, fu n c tio n parallel to the physical framework of the organisation and to g e th e r th e y form the w ho le o rg a n is a tio n .Each m em ber of the organisation is viewed as "person" and therefore regarded accordin g to the fo llo w in g d e fin itio n : " A person is a s p iritu a l being w ho fu n c tio n s in an integrated biopsychosocial manner to achieve his quest for wholeness.Each person, though a unique individual, is an integrated member of a family, group and comm unity.The p erson's pattern of interaction with the internal and external environment determines his wholeness status" (Oral Roberts University Anna Vaughn School of Nursing, 1990, Randse Afrikaanse U niversiteit, Departem ent Verpleegkunde, 1991).There are various m em bers in an o rg a n is a tio n th a t occupies certain positions, who execute certain functions and who fulfil certain roles.Attached to a member's position within an organisation is a mandate for the execution of certain functions.
Central to a member's mandate are the interactions, processes and dimensions of professional wholeness.Regardless of the objective of the organisation the focus of interaction amongst its members must be towards the quest for profes sional w holeness.In this quest for p ro fe s s io n a l w h o le n e s s the nurse manager's mandate requires a specific relationship with the nurse.
The nurse manager within the context of this model has been identified as the Curationis March 1999 5 a ge nt, the p erson w ho e xecu tes managerial processes and the nurse has been identified as the recipient.The nurse and the manager made critical career and position decisions.Their professional paths converge and diverge within the organisation in a specific way.The nurse made a career decision to qualify for the nursing profession through a professional advancement programme, which enabled him/her to act as facilitator in the n u rsin g m issio n.The nurse manager, as a qualified nurse, made a c a re e r ch o ic e by p re p a rin g fo r a managerial position through the expan d in g of kn o w le d g e and a b ilitie s of management.The nurse manager chose to serve in a managerial position in an organisation, by which he/she has been given a directive to execute a meaningful managerial service in order to facilitate the accomplishment of the mission of the organisation.
The manager» and employee share an organisational (work) environment.The environment of the manager and nurse employee respectively includes his/her own in te rn a l as w ell as e xterna l environment.The professional environ ment (related term: work environment) co m p rise s the internal and external organisational environment and forms part of the manager's and the nurse's own external environment.
Interaction between the internal and external environment of the manager and employee respectively will determine the manager and nurse's personal whole ness state, of which professional whole ness is a specific dimension.The profes sional experiences (related terminology: work experiences) of the manager and nurse, encompass all the interactions in the organisational environment, which are m irro re d in th e p ro fe ssio n a l wholeness status of the manager and the nurse.
Both the nurse manager and the nurse are employees of the organisation.This signifies that both the individual member and the organisation made a deliberate choice.The nurse manager and the nurse alike made the choice to avail themselves by applying for a position in the organisation and the organisation has selected them to o ccu p y a sp ecific p osition, by em ploying them fo r the e n h a n ce m e n t of its m issio n and compensating them for the services they render.
From this perspective then, the role of the manager is defined as that of a nurse who serves in a managerial position where he/ she renders a managerial service with the mandate to strive in an integrated manner towards own personal, organisational and professional wholeness, and with the objective to purposefully and dynamically facilitate interactions for the promotion, maintenance and restoration of maximal p rofessional w holeness, in ord er to a c c o m p lis h the m issio n of the organisation.
Equally then, the role of the nurse can be defined as that of a person who serves in a nursing position where he/she renders a nursing service in the mandate to strive in an integrated manner towards own personal, organisational and professional wholeness, and with the objective to purposefully and dynamically facilitate in te ra c tio n s fo r th e p ro m o tio n , maintenance and restoration of health in order, to accomplish the mission of the organisation.
The m anagerial position is a service position where "authority" does not signify line and staff authority but a service authority and mandate, namely to strive purposefully and dynamically towards the facilitation of wholeness of em ployees, the co m m un ity and the organisation.Thus, the distinctiveness of the manager does not lie in a position of superiority but rather in the managerial service mission and in the leadership of a unique group of people with unique talents.In order to occupy the managerial position, the prerequisites are that the m anager must be a specialist on the subject of management and must have skills and abilities to interact purppsefully and dynamically.
Both the m anager and the nurse as individuals have own unique b od ily/ physical, psychological and spiritual needs, and are outside the organisational environm ent, integral m em bers of a family, a group and a community.As a manager or a nurse, he/she is thus also an integral part of an organisation and professional community, which again fo rm s p art of his or her e xternal e n viro n m e n t.In the q u e s t fo r own personal and professional wholeness the manager or the nurse contributes not only towards the wholeness of others but to w a rd s th e w h o le n e s s of o th e r employees, the professional community and the organisation.The personal devotion of the manager and the nurse entails the quest for own personal and professional wholeness, enabling them to facilitate the professional wholeness of colleagues, the organisation and the community.The manager and the nurse who experience maximal personal and professional wholeness, have a greater potential to facilitate w holeness and hence to enhance the realisation of the organisational mission.
The m a n a g e ria l s e rvice re q u ire s le a d e rs h ip , te a c h in g , m e n to rin g , counselling and guidance in the quest for the p ro m o tio n , m a in te n a n ce and restoration of professional wholeness.The service m andate necessitates a managerial orientation of identifying with and relating to the em ployees.The m a n a g e ria l se rvice c o n s e q u e n tly requires dynamic, goal-oriented mentorship and facilitator skills.
Mentorship as a fundamental leadership paradigm in wholeness management refers to the personal, professional interactio n of the m anager w ith the em ployee.M entorship focuses the manager on the wholeness of each and every person in the organisation but specifically on the nurse employees.In providing mentorship, the inherent talents of people within the organisation are amplified, enhanced and developed and not suppressed.It is mandatory in the mentorship role that the manager should enhance his/her own qualities relating to appreciation, recognition, acceptance, consideration, flexibility, receptiveness, aw areness, se nsitivity, observance, attentiveness, cognition, reflection and thoughtfulness.Mentorship as a manner of leadership is fo un de d on m utual re sp e ct and s ig n ifie s g o a l-d ire c te d interaction, guidance to and counselling with employees.On a practical level it m eans p ro v id in g o p p o rtu n itie s , e nco urag ing nurses to achieve and intensify their inherent potential, abilities and ca p a b ilitie s and to develop the n ece ssary s k ills e n a b lin g them to experience a meaningful organisational relationship.In the mentorship role the manager facilitates professional whole ness of the nurse and the organisation in a co -o rd in a te d m anner th ro u g h the practising of purposeful and dynamic interactional leadership.
Facilitation is considered an essential interactional skill for assisting and serving em ployees in the attainm ent of their professional or organisational mandate.Facilitation refers primarily to amplifying,

The m anager and em ployee share an organisational (w o rk ) environm ent. The environm ent of th e m anager and nurse em ployee respectively includes h is /h e r own
internal as w ell as external environm ent.
The concept "professional wholeness" is defined as a com plex, integrated and dynam ic professional state, which is stru ctu ral/p h ysical, spiritual, social, intellectual, em otional and volitional by nature and which can be described q ualitatively on a continuum varying betw een m inim al or m axim al professional wholeness.
enabling, assisting and setting in motion the managerial processes.The whole ness managerial strategies of promoting, maintaining and restoring professional wholeness are accom plished through facilitation.With mentorship the nurse m an ag er u tilis e s the w ho len ess management strategies and processes as interactional paradigm to facilitate professional wholeness.
The organisational community consists of all the formal and informal groups within the organisation.The groups are represented by the various careers within the organisation.The internal nurse community thus forms part of the broader organisational community.The nurse co m m un ity is com p ose d o f nurses, organised in internal groups owing to their identification with the mission of a specific nursing organisation, and in external groups owing to their communal choice of nursing as a career.The internal and external groups of nurses are in interaction with each other, value each o th e r and re fle c t each o th e r's professional wholeness status.All the factors influence the nurse groups which again are reflected in the professional wholeness status of the organisation.

Professional Wholeness
The p o s s ib le c o n s e q u e n ce s of m an ag em en t are re fle cte d on a co ntin uu m varying from m inim al to maximal professional wholeness.The te rm in u s th o u g h , of w h o le n e ss managem ent is maximal professional wholeness represented by six equal and interrelated dimensions.The concept "professional wholeness" is defined as a com plex, integrated and dynam ic professional state, which is structural/ physical, spiritual, social, intellectual, emotional and volitional by nature and which can be described qualitatively on a continuum varying between minimal or maximal professional wholeness.The term " professional" is used instead of related terminology such as "work" or "job " .The concept "job " is viewed as referring to a laborious economic activity." Professional" -in the context of this model -signifies a "special devotion, commitment and service" .The concept of professional wholeness is applied to the organisation as well as to all its employees, which include for example the nursing assistant, the professional nurse and the manager.M axim al p ro fe s s io n a l w h o le n e ss is indicated as the terminus of management interaction instead of related concepts such as "job satisfaction" or "quality of work life" .Professional wholeness entails m uch m ore than m ere s a tisfa ctio n , although satisfaction could be used as an indicator of professional wholeness.

Professional Wholeness Dimensions and Processes
Professional wholeness dimensions and processes are two distinctive concepts although closely related.The six integral o rg a n is a tio n a l d im e n s io n s and processes of wholeness are identified as structural/physical, intellectual, emotio nal, volitional, spiritual and social in nature.These dimensions and processes are analogous and parallel although not essentially concurrent with each other.The dim ensions constitute the whole w h ils t the p ro c e s s e s fa c ilita te professional wholeness.Within each dimension two kinds of processes are encountered.One, the spontaneous organisational processes which occur naturally without managerial interaction (for e xam ple s o cia l o rg a n is a tio n a l processes) and tw o, the w holeness m an ag em en t in te ra c tio n s .W ithin a p a rtic u la r d im e n s io n s p o n ta n e o u s organisational processes are dynamic, integrated and co-ordinated.Within the day-to-day functioning of the organisation they can hardly ever be examined or explored in isolation, because they are reflected as the whole.
The wholeness management process culminates by goal-directed, dynamic m anagem ent interactio ns w hich are stru c tu ra l/p h y s ic a l, sp iritu a l, social, intellectual, emotional and volitional by natu re and w hich fu n c tio n in an integ ra te d, co -o rd in a te d m anner as scientific processes in the quest for the promotion, maintenance and restoration of professional wholeness.
The in te n s ity o f the m an ag em en t processes is directed by promotional, maintaining and restoration strategies.Promotional strategies are relevant when a m o d e ra te sta te of p ro fe s s io n a l wholeness is reflected, and restoration strategies are relevant when a minimal state of p ro fe s s io n a l w h o le n e s s is reflected.
The kind of stategy is directly related to the state of w holeness reflected, for example the intensity of an intellectual m an ag em en t p ro ce ss need n ot be re s o ra tio n a l w hen the o rg a n is a tio n reflects maximal intellectual wholeness, but can rather be m aintaining.The professional w holeness status of an organisation is appraised qualitatively by c o n s id e rin g the m a n ife s ta tio n of particular characteristics.Qualitative indicators are applied to assist in the assessment of the wholeness dim en sion s.
The re la tio n s h ip betw een management interaction and a particular wholeness dimension of concern can be symmetrical or asymmetrical.Symme tric a l in te ra c tio n s o c c u r w hen the interactions are parallel to the dimension of concern.For example, if minimal social wholeness is reflected by "isolation" then re s to ra tio n w ith in te n s ifie d s o cia l interaction such as participation and teamwork should take place.However, sym m etrical m anagem ent interaction need not specifically be relevant to the restoration, maintenance or promotion of the wholeness dimension of concern.In this instance an asymmetrical relationship differ from the dimension of concern.For example, if moderate volitional wholeness is reflected by "disappointm ent, then p ro m o te w ith e m o tio n a l in te ra c tio n "support" .
The sy m m e tric a l and a sym m etrical m anagem ent interactions relevant to restore, maintain and promote profes sional wholeness in any specific dimen sion are not mutually exclusive, but rather dynamic, integrated, multifaceted and goal directed.Multilevel interaction might well be necessary to restore, maintain Curationis March 1999 7 and promote professional wholeness on a particular dimension.The reflection of these m ultifa cete d sym m e trica l and asym m etrical rela tio n sh ip s betw een dimensions and management interaction results in a matrix as indicated in table one.The managerial skills and abilities are again c ritic a lly im p o rta n t in the assessm ent of a situation and in the c h o ic e o f a p p ro p ria te in te ra c tio n a l paradigms.
The wholeness management process, s im ila r to the n ursing process, is a scientific process, applying the activities of assessment, planning, implementation and evaluation.These scientific activities are relevant regardless of which kind of in te ra ctio n s are n ece ssitate d .The relationship and interaction between the management process and the nursing process are concurrent dynamic and co ordinated.The wholeness management process indirectly enhances the potential of the nursing process.The individual nurse is the direct facilitator of the nursing process whilst the management process facilitates the p ro fe s s io n a l w h o le n e s s of the individual nurse.When nurses expe rience p ro fessio na l w ho len ess to a significant maximal degree, they have a greater potential to fa cilita te q uality nursing care, and therefore health.Within the physical framework of the organi sation there are structural and physical processes.The structural processes are related to the physical framework of the o rg a n is a tio n , w h ils t the p h y s ic a l processes are related to the physical sta tu s o f the in d iv id u a ls w ith in the organisation.Spontaneous structural processes involve the natural structural processes, for example building and material deterioration, resource deprecia tion and econom ic influences on the organisation that takes its course.
Structural management processes entail the promotion, maintenance and resto ration of the physical structure of the organisation.It will, for example entail management of the material assets and budgetary, administrative and conser vation management.
The physical management processes entail the facilitation of the bodily/physical professional wholeness of the individuals functioning within the organisation.This indicates interaction for the promotion, m aintenance and resto ratio n of the bodily/physical occupational health of employees.
The s p iritu a l d im en sion p ertain s to intuition, differentiation and judgement betw een rig h t and w ro n g .In the organisation this pertains to conscience, laws, regulations, principles, morals, ethics, standards, values and policies.The spiritual management interactions involve policy-m aking, form ulation of s ta n d a rd s , d is c ip lin in g , c la rify in g mandates and corrective interaction.The social dimension is the reflection of the status of the interpersonal relationships, com m unication, group affiliation and O rg a n is a tio n a l m issio n , objectives and orientation are defined in this dimension.The intellectual manage ment processes entail all intellectual activities where deliberation and rational knowledge are required, for example analysis to gain insight into the details as well as the overall vision of the organi sation and information processing.To harmonise wholeness in this dimension, intellectual interactions such as analysis, logistics, factuality, training, planning, assessment and evaluation need to be activated.The em otional or " em o " dimension is reflected by the feelings and attitudes in the organisation.These feelings vary in degree.To harmonise the emotional climate in the organisation various promotional, restrorational and maintaining strategies are necessary.The emotional management processes entail empathy, caring, com passion, understanding, patience, acceptance and tolerance.The "vol" dimension is the basic inherent dyna m ic energy, willpower and driving force that propels the organisation into a specific direction.Volitional management processes are embedded in motivation, inspiration and design-making processes.

Professional Wholeness Indicators and Profiles
The professional wholeness status of the organisation or individual employee is appraised qualitatively by considering the manifestation of particular characteristics.To express these characteristics value laden descriptive words are applied to assist the manager in appraising the status of the professional wholeness dimensions.The words were chosen based on th e ir gen eral d ic tio n a ry meaning.
The descriptive words can by no means be more than just an indication of the professional wholeness status.They are not exact measurements of professional wholeness but can rather be viewed as reflections or impressions projected by the dimensions and can therefore merely aid in th e c o n c e p tu a lis in g o f the professional wholeness status.
Utilising the indicators as a qualitative assessment, a profile can be constructed to indicate the area of concern and where specific interactions and strategies are required.On the six dim ensions of professional wholeness each individual e m p lo ye e and o rg a n is a tio n w ill dynamically reflect a different state of professional wholeness.

The individual professional wholeness (ipw )
p ro file and o rg a n is a tio n a l professional wholeness (opw) profile are q ualitative instrum ents to assist the manager in appraising and estimating the state of p ro fe s s io n a l w h o le n e ss.Although quantitative values are used they are used not to quantify, but to describe a position on the professional wholeness continuum.To visualise a p ro fe s s io n a l w h o le n e s s p ro file an elem entary line graph is used.The reflection of a particular dimension as well as the w h o le p ic tu re sh o u ld be considered.The individual professional wholeness profile utilises the indicators on the d iffe re n t d im e n s io n s fo r an individual employee (refer to table one).A continuum is used as the instrument for appraising the professional wholeness profile.An individual employee marks a p o in t on the co n tin u u m a g a in st an indicator to signify his/her perception and experiences in relation to the professional environment.
Due to the uniqueness of individuals, some persons are more focused on one or more particular dimensions than on another.This preference to be more focused on one dim ension does not necessarily mean a minimal reflection of individual professional wholeness on the o th e r d im e n s io n s .An in d iv id u a l's inherent focus can be high on all the dimensions.There is no judgement on the appropriateness or the wrong or right of one dimension in favour of another.Each one of these orientations is essential to form the whole and therefore the inherent talents of persons m ust be enhanced and must not be suppressed.It basically confirms the fact that each one of us is unique with unique talents.
The six orientations are described as proto-types according to the professional wholeness dimensions.The orientations are not mutually exclusive, although for theoretical purpose they are discussed as such.The various orientations are essential for respectively prom oting, restoring and maintaining each of the w h o le n e ss d im e n s io n s .E xcessive emphasis on one dimension only will lead to dissonance in another dimension.The manager's concern is the facilitation of individual and organisational profes sional wholeness.Understanding the v a rio u s o rie n ta tio n s is, how ever, important to the manager in his under standing of h im self and in o rd e r to harmonise the interactional process on all the dimensions.
The physical orientation reflects excep tional proficiency in structural/physical aspects.High energy levels and activity are reflected.In his/her interaction with others the person with this orientation concentrates on structural and physical a sp e cts.The fo c u s is on h ygiene, budgetary control, environmental safety and security.
When a person has an exceptionally high social focus his/her inherent talents are a high p ro fic ie n c y in in te rp e rs o n a l relationships and skills.This person functions particularly well within a team, co-operates and participates easily and is generally very popular with colleagues.The person who has an exceptionally high spiritual focus has an irreproachable sense of justice and fairness.His/her talents are in loyalty and faithfulness.This person is also extremely honest, reliable, accountable and generally acts as the guardian of the organisational conscien ce.The person with an intense focus on the intellectual dimension has exceptional logical and rational abilities.His/her special talents are in analysis and in being systematic.A great deal of attention is given to detail as well as to visualise the overall picture.
The person with an intense orientation on the em o tion al d im en sion feels very strongly and identifies with emotional issues and very expressive in making a point.His/her exceptional talents are empathy for and compassion with others.The major distinctive ability of the person with an intense focus on the volitional

Conclusion And Recommendations
The m odel can be a pplied to nurse managem ent in the public as well as private sectors.In the public sector where the emphasis is on the superiority of the position -although unacceptable -the application is possible by bringing about a ch a n g e in v ie w p o in t as th e m anagem ent m odel for professional wholeness does not advocate disorder and disobedience.Although the basic motive of the model is not to increase p ro fits it can be p re d ic te d th a t the improved quality of service, as generated by th is m o d e l, w ill e n h a n ce the competitive edge of the private sector.
C on sta nt refin em en t and fu n c tio n a l a p p lic a tio n s are p re s e n tly b e in g researched through peer group review.
A manual for professional wholeness management is in the process of being compiled.The reliability and validity of the professional wholeness continuums are currently under review.Interest in the model has also been expressed by consultants in general m anagem ent, e s p e c ia lly b eca u se o f the m o d e ls relevancy and potential to the service industry in general.
classification, due to th e d e s c rip tio n of d yn a m ic relationships between wholeness and management within the context of the nurse m an ag em en t s itu a tio n .The m anagem ent m odel fo r professional w h o le n e ss was a c c o m p lis h e d by e m p lo y in g the th e o ry -g e n e ra tin g a p p ro a ch o f D ickoff, Jam es & Wiedenbach (1968) whereby the model w as d e ve lo p e d p ro g re s s iv e ly by fo llo w in g the three phases of factor isolation, factor relation, up to the level of situation relation.
s tru c te d .The c o n c e p ts and statements were consolidated to form th e o ve ra ll p ic tu re .W ith the c o n s tru ctio n of the new m odel a particular bond is depicted between the assum ptions of the NWPT and manage-ment interactions.A diagram was constructed to portray a visual image of the conceptualised model.The tentative m odel was then put through a process of refinement.This process of refinement consisted of a critical evaluation and discussions with d o m a in e xp e rts (m u ltic u ltu ra l representative; three nursing theorists; six general personnel m anagers;

Figure 1
Figure 1 Management model for professional wholeness ta tio n is h is /h e r w illp o w e r to succeed.This person has a great deal of determination, drive and ambition and does not hesitate to make decisions.The organisational professional profile is com piled, based on the average of a collection of instruments, completed by a g ro u p o f e m p lo ye e s a b o u t th e ir p ercep tion s and e xperiences of the professional wholeness status of the organisation.The professional whole ness dimensions are applied, although the indicators (compare Three of the selected structural models are general management models and two are nurse management models.The follow ing five structural m odels were selected:

Model Description "A M ANAG EM ENT M ODEL FOR PROFESSIONAL WHOLENESS (MPW)"
a c o n tin u u m betw een m inim al and maximal professional wholeness.The dynamic energy motivating wholeness

Table 2 Organisational professional wholeness indicators
table two) are m a rg in a lly d iffe re n t to th a t o f the individual employee indicators in that they are applicable to a situation, group or organisation.