Ch 12 Leadership Management

Leadership

• The ability to influence, guide, or direct others

• Focuses on relationships using interpersonal skills

• May not have a position of authority

-communicate well

-motivating, inspire, big pirture thinking, pursue others to work on common goal

Management

• The process of coordinating others and directing them toward a common goal

• Focuses on the task at hand

• Holds a formal position of authority

-organize and running effectivily

-Includes accountability and responsibility

Trait theories

• Leaders are born with certain personality traits

-Classified into three categories:

• Intelligence, personality, and abilities

  • interpersonal skills, self-confidence, and willingness to take risks

Behavioral theories

Leaders learn certain behaviors

-task-oriented behavior and consideration for others

Situational theories

Leaders change their approach for each situation

-Change their approach depending on people involved, type of business, and economic climate

Contemporary theories

• Transactional leaders - rewards and punishment

  • ex: boss employee relationship- get a bonus for perfect attendance

  • Short-term goals

• Transformational leaders - transform the organization

  • Work with the help of others/ inspire others

• Long-term change

-James

Autocratic/authoritarian leadership

• Leader exerts strong control over subordinates

• assume that employees are motivated by external forces:

  • the need for approval by the supervisor

  • the need to avoid punishment

• Demands respect and obedience

-Makes all the decisions without others’ opinions

-Useful in a crisis; gives clear orders

Democratic

Employees want to participate in decisions

• Believe in internal means and participate in decision-making

• Foster communication and develop relationships

• See themselves as equal

-Team captain, value everyone’s opinion

Laissez-faire

• Permissive; Employees are motivated by their own (internal) desire to do well

• Few policies and procedures

• Hands-off leaders, little supervision, do not micromange,

Ex: OR; everyone knows thier roles

Bureaucratic

Employees are motivated by external forces

Rule in personal, follows hospital policies, safety, organization and structure, focus on consistency

Qualities of effective leadership

• Integrity, dedication, magnaimity-geneious spirt, humility, openness, and creativity

-Give credit when it is due, learning and improving

Integrity

• is the quality of having clear ethical principles and aligning one’s actions with the stated values

Dedication

is the ability to spend the time necessary to accomplish a task

Magnanimity

giving credit where credit is due

Humility

is the ability to recognize that no one is superior to another

Openness

refers to the leader’s ability to listen to other points of view w/o prejudging or discouraging them

Creativity

is the ability to think differently

Formal leadership

Practiced in an organization as part of an official position

—without holding an official title

Ex: nurse practitioner, clinical nurse specialists

Informal leadership

Emerges outside the structure of a formal position

Ex: staff nurses on a unit demonstrate informal leadership when they take responsibility for coordinating the staff schedule or act as part of the unit governance committee

Management theory overview

Fayol’s Functions of Management

• Planning

1. Set goals

2. Assessing the current situation & future trends

3. Setting the plan

4. Converting the plan into an action statement

• Organizing

• Directing

• Controlling: Comparing actual results, evaluation

-Strong communication, critical thinking skills, management styles and behaviors

Mintzberg’s Behavioral Model

• Included two assumptions: Much of a manager’s time is spent in human relations, and managers are more reactive than proactive

Interpersonal roles

• figurehead, leader, and liaison

Informational roles

• monitor, disseminator, and spokesperson

decisional roles

• Entrepreneur, disturbance handler, resource allocator, and negotiator

Mintzberg’s Contemporary Model

• Informational level

  • Communicating and controlling

• People level

  • Leading and linking people

• Action level

  • Doing- problem-solving and keep action to run things smoothly

Qualities of effective managers

• Self-belief, self-awareness, self-management, personal integrity, and a drive for improvement

Skills of effective managers

• Communication and relationship building, knowledge of the health care environment, leadership, professionalism, and business skills

Management styles

• Theory X or Theory Y

Theory X: believes the average person dislikes work and will avoid it if given; closely supervised, directed, coerced into doing their work, motivated by threats

Theory Y: employees are satisfied with work, capable of self-direction, self-control, initiative, and seek out responsibility

Nursing Leadership Roles

 Patient care provider: plan, organize, deliver, and evaluate
 Patient advocate
 Case manager: Begin discharge plans upon admission
 Clinical nurse leader: Patient care and update care plans, use evidence-based cases
 Nurse educator: provides vision, stimulates student learning in the clinical setting, questions current methods, and pursues relational integrity
 Financial resource manager: wisely using supplies, cost of prescribed therapy
 Collaborative team member: delegates care to meet the needs of the patient

Delegation-

• ANA: Transfer of responsibility

• NCSBN: Transfer of authority

• Nurses gives a competent individual the authority to perform a selected nursing task in a selected situation while retaining accountability for the delegation

Principles of delegation

➢ First principle of delegation
• Nurses must have knowledge of the nurse practice act in the state where they are licensed.
➢ Second principle of delegation
• The RN cannot delegate assessment, planning, evaluation, or accountability for the assigned task.
➢ Third principle of delegation
• The person to whom the assignment was delegated cannot
that assignment to someone else

Five rights of safe delegation

➢ Right task: One that is delegable for a specific patient
➢ Right person: The right person delegating the right task to the right person to be performed on the right patient
➢ Right circumstance: Appropriate patient setting, available resources, and other relevant factors considered
➢ Right communication: Clear, concise description of the task, including its objective, limits, and expectations
➢ Right supervision: Appropriate monitoring, evaluation, intervention, and feedback