Leadership and Management

Nursing Roles

Can’t Catch The Cat Coz Catwoman Loves Me, Run Cat Cat!”

Care GiverCommunicator

Teacher Councilor Client’s Advocate Change Agent Leader Manager Researcher Case Manager Collaborator

facts…• a gap exist between the growing demand of a

rising population for the delivery of quality and cost effective patient healthcare and the lack of a strong nursing leadership

• Leadership and management get things done right

…. NURSING PROFESSION NEED LEADERS!!!

CONCEPTUAL PARADIGM

GOAL

Resource7 M’s

Management Process

Theories & Principles

Effective & Efficient

Leadership

GOAL– The desired aim toward which one is willing to work– the heart of leading and managing is the attainment

of a goal– Stated in general terms and covers broad areasType: (user of the goal) (time or duration)a. Individual a. short termb. Group b. long termc. Organizational

7 M’sMoneyMenMachinesMaterialsMethodsMomentMANAGERS

LMR

juris

A Leader is;

a. Take the initiative to lead & Organize and staff

b. Emphasize tactics, structure, systems as well as Align people with direction

c. Inspire people to change and Avoid risksd. Takes risks

MANAGER LEADERAre given the position Take the initiative to

leadOrganize and staff Align people with

directionEmphasize tactics,

structure and systemsEmphasize philosophy, core value and shared

goalsFocus on the present Focus on the future

Avoid risks Takes risksMotivate people to

comply with standardsInspire people to

change

Operate WITHIN organizational rules, regulations, policies

and procedures

Operate OUTSIDE of organizational rules, regulations, policies

and procedures

Remember the terms..

Management and Leadership refers to the functions & relationship

Managers and Leaders refers to the actor or agents of leadership and

management

“managers do things right… …leaders do the right thing”

Leadership

- is a learned behavior involving influence and role modeling

- an ability to move other people to act

- leaving a mark

Attributes of a good leader:

1. Self awareness 2. Self confidence 3. Advocacy 4. Accountability

L.E.A.D.E.R.

L - ead E – nthusiatic A – ssertive D – edicated E – fficient R – esponsive

DIMENSIONS OF LEADERSHIP

LEADER FOLLOWER SITUATION

FOLLOWER• Not a passive component• A good follower leads himself• Maintain independence while

respecting the leaders authorityType:

1. Alienated 2. Sheep 3. Yes People 4. Survivors

FOLLOWER

• Qualities :1. Self Management2. Commitment3. Competence & Focus4. Courage

Elements of Leadership

1. Vision2. Influence3. Power4. ARA

Influence• Ability to obtain followers• A skill that can be developedType:

a. Assertivenessb. Ingratiationc. Rationalityd. Blockinge. Coalitionf. Sanctiong. Exchangeh. Upward Appeal

POWER

Communication

InfluenceRecognition

POWER

Capacity of “A” to influenceThe behavior of “B” so that

“B” does things he/she wouldNot otherwise do

A BINFLUENCE BEHAVIOR

Different forms of Power

coercive reward

legitimate expert

referent

Types of power• Reward

- needs follower to believe leader will reward them.- incentive

• Coercive- needs follower to believe leader will punish them.- punishment

• Legitimate- needs follower to believe leader has right to instruct them.

• Referent - need follower to believe leader has desirable qualities. - charisma

• Expert - need follower to believe leader is an expert.- expertise

• Information

- Well informed and up to date

ARA

A – Authority , the right to decide

R – Responsibility, ability to respond

A – Accountability, ability to account

Forms of Authority

1. Line Authority – direct authority from supervisor to subordinate

a. Chain of Commandb. Unity of Commandc. Spann of Control

2. Staff Authority – authority based on expertise - no authority to make final decision

3. Team Authority – granted to committees or work team - empowered to plan and organize work

Different leadership styles:

1. Autocratic -leaders exert

total control over members

2.Democratic/ Participative -leader shares

control with group members

3. Laissez-faire/ Permissive/ ultraliberal

-leader relinquishes

control to group members.

4.Contingency Model (Fred

Fiedler, 1967)

-this model highlights the need for flexibility

Multi critic/ Situational/ Contingency

-leader utilizes varying styles depending on the situation.

Multi critic/ Situational/ Contingency

-leader utilizes varying styles depending on the situation

- should be complementary to manager’s style, expectations & characteristics of workers

-how to accomplish? “Aligning closely the forces in the manager, worker & situation”

Consultative Leadership

- focuses on using the skills, experiences, and ideas of others

- leader: retains the final decision-making power (veto power)

- involved others in decision making

Bureaucratic Leadership Style

manages “by the book”

All must be done according to procedures

“more of a police enforcer than a leader”

Influence• Ability to obtain followers• A skill that can be developedType:

a. Assertivenessb. Ingratiationc. Rationalityd. Blockinge. Coalitionf. Sanctiong. Exchangeh. Upward Appeal

POWER

Communication

InfluenceRecognition

Different Types of Leadership theories:

Trait Theories

GREAT MAN THEORY

leaders are born not made.

TRAIT THEORY

believes that a leader must possess certain traits to be effective.

Individual Character Theories

- taller - attractive - self reliant - creative

Napoleon Complex

CHARISMATIC THEORY

arousing strong feelings of loyalty and enthusiasm.

Behavioral Theories

9.BEHAVIORAL THEORY

follow what the leader does.

The Field Theory of Human Behavior Kurt Lewin (1890 –m 1947)

• Proposes that workers behavior is influenced by interactions between personality, the structure of primary work group and socio technical climate of the workplace

• First to categorize leaders according to;1. Authoritarian2. Democratic3. Laissez-faire

• Element:1. Self perception2. environment

CHANGING PEOPLE’S BEHAVIOR

UNFREEZING Knowledge: Individual is introduced to change and begin to comprehend

REFREEZING Confirmation : looks for confirmation that

the choice was right

Renis Likert• TheoryAns : Four System of Management

• What to Remember?Ans: Exploitive authoritative system

Benevolent authoritative system Consultative system Participative (group) system

Robert Blake & Jane Mouton (1987)

• TheoryAns : Managerial Grid• What to Remember?Ans: CIOTaQuoPa

COUNTRY CLUB (1,9)IMPOVERISH (1,1)OPPORTUNISTIC (exploit and manipulate)TEAM MANAGEMENT (9,9)AUTHORITARIAN (9,1)status QUO (5,5)PATERNALISTIC (prescribe and guide)

Managerial Grid

Case Analysis 11. Nurse Ginalyn who just finish her job orientation, is

working with a patient for whom a surgical consult has been written. The unit clerk and long time nurse on the unit remarked that Dr. Reyes, the Physician doing the surgical consultation, should be named Dr. Reyes of the jungle because he often humiliates new nurse to try to put them in their place. He yells at them even at the tiniest mistake. Based on previous reports by other nurses on the unit, Ginalyn knows Dr. Reyes has the reputation of being demeaning and inappropriately demanding when on the unit and ask to see the nurse who did the surgical admission sheet. What would you do if you were Ginalyn? How would you approach Dr. Reyes? Use youre new found knowledge and concepts.

Case Analysis 2

2. A nurse is making rounds on her new postoperative kidney transplant patient. As she enters the room, the patient begins to bleed from his side incision. The nurse applies direct pressure with one hand and calls for assistance. Help arrives and the patient is taken to surgery with the nurse still maintaining pressure on the bleeding site. The patient lives and goes home a few days later. What leadership characteristics does this nurse demonstrate? Why is leadership important at all levels throughout a health care organization? How can a nurse develop this type of leadership skill?

Home work

• Create your own leadership definition using LEADER as pneumonic

• Make your own leadership elements • Among the leadership style

presented chose your leadership style and discuss why.

L.E.A.D.E.R.

L - ead E – nthusiatic A – ssertive D – edicated E – fficient R – esponsive

Elements of Leadership

1. Vision2. Influence3. Power4. ARA

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