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?