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Nursing Leadership, Followership and Management
Nursing 493: Unit II
Why study leadership & management?
Who are our leaders?
What are the most serious problems people face in the work environment?
Technical Safety People Financial Ethical
Why? To learn how to work with people, not
only as individuals, but as members of groups, teams, and organizations
Provides greater understanding and control of events in the work situation
Imparts a sense of personal power & self direction
Definitions Leadership- the process of influencing
others
Leaders inspire thru personal trustworthiness & self-confidence
Leaders communicate a vision that turns self-interest into commitment to the job
What are the 3 primary tasks of a leader? Set direction: mission, goals, vision
Build commitment: motivate & inspire
Confront challenges: innovation, deal with change, turbulence, take risks
What does the study of leadership involve? Leadership theories Motivation Group development & team work Power & conflict Confrontation & negotiation Effective communication Critical thinking & problem solving
Leadership All people have untapped leadership
potential …it is there in you.
The attempt defines leadership…it does not have to be successful
To be a leader you must make a decision to act
What is Followership Followership & leadership are
reciprocal roles
Being an effective follower is as important to the new nurse as being an effective leader
What are the characteristics of an effective follower? Self direction Actively participates in setting
group direction Invests time & energy in the work
of the group Thinks critically Advocates for new ideas
What is management? Management – too is a process of
influencing people but with the specific intention of contributing to meeting the organization’s goals
Management is the process of getting work done through other people
Management is planning, organizing, coordinating, and controlling work given to employees
Management Functions Officially responsible for the work of a group Hiring & firing Evaluating staff performance Recommending raises and promotions Prepare & implement a budget Approve expenses & purchases Handle conflicts Work schedules & assignments Plan current & future activities of unit Be open to demands of continuous change
New definition of management
To do whatever is necessary to see that employees do their
work and do it well.
Differences b/w leadership & management
Leadership based on influence an informal
designation an achieved
position part of every
nurse’s role independent of
management
Management based on authority a formally
designated position an assigned position improved by use of
effective leadership skills
What makes a person a leader?
We look to Leadership theories
Most Prominent Leadership Theories TRAIT THEORIES BEHAVIORAL THEORIES
(Leadership styles) SITUATIONAL THEORIES
(understanding all the factors) TRANSFORAMTIONAL THEORIES
(inspiration & meaning)
Comparison of Authoritarian, Democratic, & Laissez-Faire
Authoritar. Democrat. Laissez-FDegree offreedom Little Moderate MuchDegree of control High Moderate NoneDecsision making By leader Leader&
groupGroup orno one
Leader activity level High High MinimalAssumption ofResponsibility Leader Shared AbdicatedOutput of group High&
good qual.High &creative
Variable-Poor?
What are the key differences in the 3 leadership styles? Democratic leader moves the
group toward its goals
Autocratic leader moves the group toward the leader’s goals
Laissez-faire leader makes no attempt to move the group
Behaviors of an Effective Leader Think critically Solve problems Respect people Communicate skillfully Set goals, share a vision Develop self & others
Transformative Leadership Qualities Integrity (Action
matches words) Courage (take
risks) Initiative (Act on
ideas) Energy
Optimism Balance(work, reflection,play) Ability to
handle stress Self-Awareness)
What distinguishes ordinary leaders from STARS?
Emotional Intelligence – addressing the effects of
people’s feelings on the team
Management Theories: Two Opposing Schools of Theory
Scientific management
Human relations-oriented management
Scientific management
Frederick Taylor Father of S.M.
Focus on tasks & ways to increase efficiency & productivity by getting more work out of individual employees
What makes a person a manager? Two Perspectives
Scientific Management - Frederick Taylor says (emphasis is on the task aspect of providing care, paying people by the # of clients seen, incentive is to get the most work done in the least amount of time. The current emphasis on reducing staff & increasing productivity is based on this type of thinking.
Human Relations-Oriented Management Theory: X&Y Theory X (McGregor’s ) says most
people think work is something to be avoided, and the managers job is to make them work hard.
According to Theory X employees need strict rules, constant supervision, & the threat of punishment to make them conscientious.
Theory Y Theory Y manager believes the
work itself is motivating and people really want to do a good job.
The Theory Y manager emphasizes guidance rather than control, development vs close supervision, & reward vs punishment.
Communication Is at the heart of leadership Leadership can not occur except in
relationship to other people & communication is the means through which leadership is accomplished
Communication
We “cannot not communicate”!
Communication Giving & receiving feedback
Linking (connecting ideas in a group)
Networking (connecting people in a group or organization
Verbal & Nonverbal:KeyPoints Most nonverbal is done unconsciously It is more difficult to control Discrepancies often exist between
verbal & nonverbal What is stated is often not felt or
believed Listening is the most critical
communication skill
Emotional Intelligence Listen to others
Pick up unspoken concerns
Acknowledge others’ perspectives
Welcome constructive criticism Bring people together in a spirit of
trust
Communication with colleagues Telephone etiquette Information systems/computer/e-mail Change-of-shift report Be assertive without being aggressive Staying calm & demonstrating good
communication skills demonstrates professionalism& an ability to work well with others
Communicating with other disciplines Nurses are client care coordinators Nurses spend the most time with clients,
therefore they are in the best position to communicate among disciplines info re client
Physicians: nurses need to communicate changes in the client condition, discuss modification in treatment plan, clarify orders
This may be stressful-have the info you need on hand before phoning (meds, vitals, general health assessment status)
Maintain a record of calling logs
Communicating with clients & family
Recognize signs of anger or anxiety
Intervene to diffuse the situationPractice good listening & show
respect
GIVING FEEDBACK 1. Give both positive & negative feedback
2. Give immediate feedback
3. Give frequently-keeps motivation high & prevents problems from growing high
4. Be objective - use standards for making judgments, tell “Why” it is good/bad
5. Base feedback on observable behavior- be factual & accurate
Feedback (cont’d) 6. Communicate effectively - give
feedback & be prepared to receive feedback in return. Engage in active listening. When you give negative feedback allow time for the individual to express their feelings & for problem solving to find ways to improve the situation. This is impt. If the problem has been ignored a long time.
7. Include suggestions for change. Try to
suggest alternative behaviors
8. Communicate in a non-threatening manner. Highly threatening messages reduce motivation & inhibit learning. Too much fear immobilizes people. Remember your ultimate purpose is to bring about improved performance.
Performance AppraisalPeer ReviewEvaluation proceduresOne by manager or superior
(hierarchical)One by colleagues with similar status
& educationPeer review may be combined with
performance appraisal to form a comprehensive system of evaluation
Case Scenario: Small Change in Procedure??!! It was not “big deal” just a small change
in procedure. At least that is what the VP Nursing of the Tri-County Home Care Agency thought when she ordered the staff to bring their lap top computers back to the office every evening. “These machines are expensive”, the VP noted, “We can not continue to let staff take them home. They could be broken, stolen, or used to play games in the evening.”
Questions for critical reflection How do you think the staff reacted to
this change? Explain why they reacted as you describe?
Did the VP act primarily as a leader or as a manger? Explain your choice
What alternative procedure might be implemented to protect the laptops?
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