1. Nursing Leadership, Followership and Management Nursing 493: Unit II

2. Why study leadership & management?
Who are our leaders?

3. What are the most serious problems people face in the work environment?
Technical
Safety
People
Financial
Ethical

4. 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

5. 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

6. 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

7. What does the study of leadership involve?
Leadership theories
Motivation
Group development & team work
Power & conflict
Confrontation & negotiation
Effective communication
Critical thinking & problem solving

8. 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

9. What is Followership Followership & leadership are reciprocal roles
Being an effective follower is as important to the new nurse as being an effective leader

10. 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

11. 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

12. 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

13. New definition of management
To do whatever is necessary to see that employees do their work and do it well.

14. Differences b/w leadership & management
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

15. What makes a person a leader?
We look to Leadership theories

16. Most Prominent Leadership Theories
TRAIT THEORIES
BEHAVIORAL THEORIES (Leadership styles)
SITUATIONAL THEORIES (understanding all the factors)
TRANSFORAMTIONAL THEORIES (inspiration & meaning)

17. Comparison of Authoritarian, Democratic, & Laissez-Faire

18. 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

19. Behaviors of an Effective Leader
Think critically
Solve problems
Respect people
Communicate skillfully
Set goals, share a vision
Develop self & others

20. 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)

21. What distinguishes ordinary leaders from STARS?
Emotional Intelligence – addressing the effects of people’s feelings on the team

22. Management Theories: Two Opposing Schools of Theory
Scientific management
Human relations-oriented management

23. Scientific management
Frederick Taylor Father of S.M.
Focus on tasks & ways to increase efficiency & productivity by getting more work out of individual employees

24. 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.

25. 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.

26. 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.

27. 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

28. Communication
We “cannot not communicate”!

29. Communication Giving & receiving feedback
Linking (connecting ideas in a group)
Networking (connecting people in a group or organization

30. 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

31. Emotional Intelligence
Listen to others
Pick up unspoken concerns
Acknowledge others’ perspectives
Welcome constructive criticism
Bring people together in a spirit of trust

32. Communication with colleagues
Telephone etiquette
Information systems/computer/
Change-of-shift report
Be assertive without being aggressive
Staying calm & demonstrating good communication skills demonstrates professionalism& an ability to work well with others

33. 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

34. Communicating with clients & family
Recognize signs of anger or anxiety
Intervene to diffuse the situation
Practice good listening & show respect

35. 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

36. 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.

37. 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.

38. Performance Appraisal Peer Review
Evaluation procedures
One by manager or superior (hierarchical)
One by colleagues with similar status & education
Peer review may be combined with performance appraisal to form a comprehensive system of evaluation

39. 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.”

40. 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?