1. An occupation is a job a career.

2. A profession is a learned vocation or occupation that has status of superiority and precedence within a division of work. It needs widely varying levels of training or education, skills and variable knowledge base.

3. All professions are occupations but not all occupations are professions (Logan,Franzen, Butcher,2004;Schwiran , 1998)

1) Utilizes in its practice a well-defined and well organized body of specialized knowledge on the intellectual level of the higher learning.

2) Constantly enlarges the body of knowledge it uses and improves its techniques of education and service by the use of scientific method.

3) Entrusts the education of its practitioners to institutions of higher education.

4) Applies its body of knowledge in practical services that are vital to human and social welfare.

5) Functions autonomously in the formulation of professional policy and in the control of professional activity.

6) Attracts individuals of intellectual and personal qualities who exalt service above personal gain and who recognize their chosen occupation as a life work.

7) Strives to compensate its practitioners by providing freedom of action, opportunity for continuous professional growth and economic security.

So, is nursing a profession or an occupation?

Leadership may be viewed as the process of guiding.

Teaching, motivating, and directing the activities of

others toward attaining goals.

It Involves having the ability to influence others.

Leadership often involves moving into a position

because of special abilities, skills or attributes and

may be formal or informal within the organization.

Management :Involves the coordination and integration of resources through the activities of planning. organizing. directing. and controlling in order to accomplish specific goals and objectives within an organization.

Management positions tend to be ones to which an individual is appointed.

Typically a manager has responsibility and accountability for tasks that must be accomplished, and to fulfill those responsibilities plans, hires, coordinates, directs, organizes, evaluates, and budgets.

If an individual functions poorly in the management role, the tendency within organizations is to replace that person with someone who can carry out the responsibilities in a more effective manner.

Ideally, a good manager should also possess leadership

ability, but this does not always occur.

On the other hand, a good leader may not possess

management skills.

However, both can be learned and improved by experience

and the desire to increase your abilities and skil1s in both

areas.

Nurses must understand leadership and management as

an important part of their responsibilities and must

prepare themselves to participate at all levels.

Great Man and Trait Theories: “some people are born to lead and others are born

to be led”. ◦ Set forth the premise that certain people are born to be

leaders, having inherited a set of innate characteristics that endow them with the unique ability to lead others.

◦ This theory grew because the ability to lead others was often seen within royal and prominent families.

◦ Others were not allowed to become leaders, a fact that also helps explain its premise.

◦ Currently most people do not accept the idea that an individual is born to lead.

The Trait /or Attribute Theory:

◦ It evolved from the Great Man Theory of leadership when

social and economic barriers no longer prevented members

of the general public from occupying leadership roles.

◦ Behavioral scientists began to identify the common traits of

great leaders throughout the ages.

◦ These traits frequently included

assertiveness ,

ambition,

Charisma (charismatic theory),

creativity,

decisiveness, حاسم

enthusiasm,

intelligence,

initiative,

persistence,

integrity,

physical characteristics

(especially above-average height),

sense of self,

technical mastery,

verbal ability, and similar skills.

Leaders in one situation may function as followers

in another.

leaders who are effective in some circumstances

calling for sociability, popularity and dependability

are ineffective in others that require prompt and

decisive actions.

Behavioral Theories: ◦ At times also referred to as the humanist approach.

◦ They were so named because they looked at the behaviors in which leaders engaged.

◦ Barnard, who was very influential in introducing the need to look at behavioral, intuitive, and emotional aspects of leadership, looked at both the formal and informal structures that exist in any organization and identified additional components, such as the cooperative system that must be a part of any organizational assessment.

◦ He suggested that authority is delegated upward and is granted by one's subordinates.

◦ Leaders who were uninvolved, did little planning, and

showed little concern for team members earned the lowest

ratings.

◦ The most effective leadership approach was identified as

one involving both a high-task and a high-relationship

orientation in which the leader

◦ promotes open communication

◦ sets goals,

◦ intervenes in conflicts,

◦ and involves team members in decision making.

Focus is the context or the situation in which the leader functions

Based on the premise that the leadership style that is successful in one set of circumstances may not be effective in another

The situational determines the approach to be followed

-Hierarchical structure of the organization -Atmosphere of the organization -Characteristics of the leader role and

follower role

The leader must remain sensitive to the

followers’ readiness (Hersey and

Blanchard

Leadership has four basic style: Telling Selling Participation And delegation

Looked at leadership as it related to group interaction

Transformational leadership theory: - define a leader as one who motivates follower

to perform at their full potential - by influencing change in perception and

providing a sense of direction in a group - group members are empowered and

motivated and provide input to decision making - and leaders and followers raise one another

to higher levels of performance

Relational model of leadership leader is empowering, process

oriented, moving the group toward the goal Servant leadership theory Successful leaders are able to influence

others as a result of dedicating their lives to serving others Social change model of leadership Individuals and groups work toward a

common goal

women have been viewed as less effective In leadership positions than men.

Some suggest that the lower prestige and desirability of nursing as a profession is related to the fact that it is primarily female oriented.

Bass (1990. p. 737) concluded that the role of women in leadership is changing so rapidly that earlier research may need to be discounted, but encourages continued consideration be directed to the underlying dynamics and dimensions of

importance to success and effectiveness of women leaders.

Some studies have found that stereotypes have

identified women as less competent, less aggressive,

less task oriented more dependent, and more

emotional than males.

He also noted that women were found to be more

effective communicators and more attentive to

upward communications from their subordinates

and more relations oriented than their male

counterparts.

Authoritarian or Autocratic leadership

Democratic or Participative Leadership

Style

Laissez-faire Leadership

Multicratic Leadership

Authoritarian or Autocratic leadership: ◦ The authoritarian or autocratic leadership style is

characterized by strong control by the manager over the workgroup and also may be referred to as the directive approach.

◦ The activities of the group are primarily directive with activities determined by the leader and dictated to the followers with no input from the followers on decisions.

◦ Communication flows downward and emphasis is on accomplishing the task.

◦ Managers who exercise this style of leadership are

characteristically found in bureaucratic organizations that

reinforce the centrality of authority and reliance on formal

rules such as seen in the military.

◦ Their authority is generally derived from position power

that is tied to their official job title within the organization.

◦ An authoritarian leadership style is appropriate when

there is a need for immediate action and the manager is the

individual with the best understanding of the situation.

◦ An example of this type of leadership might occur in an

emergency department setting.

◦ An advantage of this style of leadership is that decisions can be

made expeditiously without the lengthy time required for

consultation to arrive at a collaboratively agreed-on course of

action.

◦ Disadvantages of this type of leadership style are clear. When

subordinates feel that they are not listened to or supported, they

are less likely to have a personal stake in the achievement of

management goals.

◦ In addition. this style of leadership can create hostility and

dependency among followers.

Democratic or Participative Leadership Style:

◦ This style of leadership focuses on involving subordinates

in decision making.

◦ Democratic leaders see themselves as coworkers rather

than as superiors and stress the importance of

communication, consensus and teamwork.

◦ Although this authority is not exercised in a coercive

manner and the leader leads by providing information

suggesting direction, and being supportive of coworkers.

◦Generally, the democratic leader functions best In an organization in which power is less centralized and there is less reliance on formal rules and policies.

◦Disadvantages of this style of leadership are that

decision making can become a lengthy process. In addition, if coworkers are not confident about their own abilities to participate in planning and decision making they may feel that the manager is not doing his or her job and is foisting difficult decisions off onto others who are not being paid to manage.

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Advantages of the democratic style are that workers who are consulted and who have input into decisions are more motivated to support such decision.

Involving subordinates in data gathering, analysis, planning, implementation, and evaluation of task ensures the widest possible scope and may provide information to which the manager alone would not have had access.

Laissez-faire Leadership:

◦ Also called permissive leadership.

◦ laissez-faire leadership provides the least structure and control

and is also referred to as the delegating approach.

◦ Little or no direction is provided: coworkers develop their own

goals, make their own decisions and take responsibility for

their own management.

◦ Managers concentrate on providing maximum support and

freedom for coworkers, and decision making is dispersed

throughout the group.

◦ Advantages of this style of leadership include providing maximum

freedom for individuals and, presumably increased motivation of

subordinates to perform at high levels because of this

independence.

◦ An example of laissez-faire leadership might occur in an inpatient

psychiatric unit.

◦ Disadvantages of this style , because of the multidisciplinary

nature of patient care, there usually must be more centralized

decision making and agreement in following generally accepted

policies and procedures.

Multicratic Leadership:

Multicratic style combines the best of all styles

mediated by the requirements of the situation at hand.

The Multicratic leader provides a maximum of structure when the situation requires it,

a maximum of group participation when needed, and support and encouragement for subordinates in all instances.

The term Power evokes many different feelings such as fear, mistrust, control over others, and domination.

It also has a wide variety of synonyms, such as force,

strength, potency, stamina, vigor, control, and command. power has many different meanings: is the ability to do, act or produce: “the ability to

control others; authority; sway; influence”.

Power is not a static phenomenon:

it can change and shift, increase or decrease.

Bass (1990) points out that differences in power in a group, organization, or society influence the kind of leadership that can be effective. When there are great differences in power among individuals or groups, a more directive leadership is likely:

when the differences in power are small, a more participative leadership is likely.

Within an individual. power may vary from one time to another or from one situation to another.

For example, the unit manager may have a great

deal of power when it comes to the operation of a particular unit but very little in meetings chaired by the hospital administrator.

Legitimate power

Referent power

Reward power

Coercive power (punishment power)

Expert power

Connection power

Legitimate power, often termed authority, is most frequently thought of as the power granted by an official position who ever holds the position has the same amount of authority which may include making decisions on behalf of the organization.

Acquiring or controlling information. having

access to people of higher status or power, and controlling the human and material resources of the organization.

Most often. the individual holding legitimate

power is given a title to indicate the authority that has been delegated

such as unit manager, vice president of patient care services, or administrator

Referent power :refers to the potential influence one has because of the strength of the relationship between the leader and followers. For example; when people admire

leaders and see them as someone to model, leaders are said to have referent power.

The term charisma has been used to describe

this type of referent power and is sometimes referred to separately as another basis of power

Charisma is the power that attracts one person to

another and relates to the way leaders act, talk; walk; the organizations to which they belong; and personal associations.

Reward power: is achieved by having the potential to influence others because of one's control over desired resources.

These may include the power to give raises, bonuses, and promotions; select individuals for special projects or assignments, or distribute valued resources.

Coercive power: also referred to as punishment power, is the opposite of reward power.

It ranges from negative sanctions to verbal threats of punishments and is based on the fear of punishment if the manager's expectations are not met.

It implies the ability to impose penalties for noncompliance.

The manager can control through the fear of loss of job or of punishment, such as undesirable assignments or shifts.

Although we tend to view coercive power negatively, some situations may require coercion.

Expert power: is gained through the possession of special knowledge, wisdom, sound judgment, good decisions, skill, or ability.

Experts wield power and are able to accomplish their purposes because others recognize their abilities and turn to them for guidance.

Typically. this type of power is limited to a specialized area.

As nursing becomes evermore specialized, we see an increase in expert power among professionals.

Connection power: may be described as power based on having connections (or associations) with others who are powerful.

One often sees politicians exercising connection power when being seen with a powerful political figure may infer a higher personal status.

Connection power may also involve working with others to accomplish a common goal.

Definition: the process by which a leader shares power with others or enables them to act.

It is the basis of transformational leadership,

Delegates a great deal of authority for decision making

Allows employee to share in the satisfaction derived from goal achievement

It results in employees having a strong sense of self

Direction: sufficient to give confidence

Challenge: bring out creativity and satisfaction on completion

Autonomy/support: confidence, help

The opposite of empower is powerless:

in which the individual feels:

1- demotivated,

2- unable or incapable of accomplishing

desired activities

3- Frustrated with the work environment

Powerlessness lead to dependent behavior

Empowerment can begin with modeling personal behaviors that will encourage others to be active participants---- be patient with others.

Encourage others to make choices for themselves

To have input in decisions

delegate the power to make decision to subordinates-------thus fostering greater initiative and responsibility for task

Ex. Rather than direct the nursing assistant to do bathe to the pt.

permit the nursing assistant to decide which is the best which is the best way to proceed

in this way you help the nursing assistant to build self confidence in her/his own ability, a hallmark empowerment

Empower others by developing the habits of asking questions rather than giving directions

Share your pleasure and pride with subordinates and share the successes of individuals with the group-----this help in build confidence and self-esteem

Offer helpful suggestions to improve the situation and give recognition to the improvement

Be supportive and encouraging…….specially when an individual is feeling stress and anxiety

All recognition and praise must be provided in a sincere

manner and not to excess

The Reciprocal (shared/ mutual) Role

The effectiveness of an organization can be determined

on the basis of how well followers follow

We often find ourselves occupying two roles----one of leader, another as follower.-----when we have subordinates, we also have bosses.

The importance of recognizing this interchanging of roles in today’s health care setting is great.

Some individuals choose to stay in follower roles and serve as team players who gain satisfaction from helping accomplishing the goals of the organization in that role.

Role of the Follower

The distinguish between an effective followers from an ineffective one:

Enthusiastic

Intelligent

And self-reliant participation

The quality of the followers

1- they manage themselves well

2- they are committed to the organization and to the purpose, principle, or person outside themselves

3- they build their competence and focus their efforts for maximum impact

4- they are courageous, honest, and credible

Being a good follower

1-Invest yourselves---- you must begin to see how your own goal fit into the

goal of the organization as a whole

maintaining your competence by expand your skills through n education and workshop and seminars related to you area of practice

2- clearly identify your responsibilities as follower. 1. what is expected of you?

2. what does your job description involve?

3. to whom do you repot?

4. how is your performance evaluated and by whom?

- Usual resources include your job description

- Make sure you identify resource person to whom you can go for continued clarification and assistance

3- clearly identify your expectation of the leader: - the leader’s role and relationship to you - you need to understand what realistically to expect from your leader in relation to you and other

4- support your leader and your group - understanding your role as follower and manager’s role as a leader - learning to work productively with others

5- provide stimulation for your leader and your group - provide stimulate discussion - provide a fresh look at problems - propose other potential solution - carried out in constructive manner

6- follow channels of communication and responsibility - include channels of authority and routs of communication

Increase your personal competence and knowledge.

Develop and maintain flexibility.

Develop self-confidence. decisiveness and integrity in

decision making.

Walk, talk and look poised and confident (well groomed

and appearance as well as being assertive and gentle.

Develop and maintain alliances( Focus beyond yourself

and listen, support, provide feedback and coach).

Develop your personal physical resources (relax. rest. and

have fun).

Other factors influencing your leadership style The size of the group The abilities, educational abilities of the group The structure of the organization The task to be accomplished The degree of stress in the situation or

environment

Assessing Your Effectiveness As A leader

Self assessment---assessment of your own leadership and followership characteristics

Environment assessment

Identifying Role Models

Trying out Leadership Styles---experimentation with different styles

Evaluating Effectiveness---are part of the ongoing process of developing a good management style

All registered nurses, regardless of position, must be prepared to function as leaders and managers.

Nurses must be prepared to function as a leaders, because:

They are responsible for coordinating and managing care of patients

Delegating task to subordinates

And supervising the subordinates