Leadership and Management Authoritative leaders tend to approach

Leadership is the ability to influence people. leadership like a mentor guiding a mentee.
Instead of telling their team to follow
Management is the process of getting work done instructions and do as they say, much like the
through others. authoritarian leader, authoritative leaders
Nurse Leader is able to inspire others on the invite employees to join them and accomplish
health care team to make patient education an the mission together.
important aspect of all care activities.
LEADER MANAGER  The Visionary Leadership Style –
“Embrace my vision”
 May not have  Have assigned A visionary leader is someone who
delegated position within uncovers the hidden trends in the market or
authority. organizations industry in which they operate. They have a
 Obtains power  Obtain power clear vision of what the future of the company
through influence through delegated looks like and the needs of its customers.
authority Visionary leaders work on the product
 Possess a wide today so it will meet the needs of its
variety of roles  Expected to carry customers tomorrow. They often bring about
 May not be a part out specific change in the world or an industry and value
of the formal functions innovation and creativity.
organization  Always a part of
 Focus on group the formal  The Pacesetting Leadership Style – “Rise
process, organization to my standards”
information  Emphasize control, Pacesetting is a leadership style where
gathering, decision making, the leader sets high standards for
feedback, & decision analysis & performance and expects their team to
empowering results. exceed them with minimal management.
others.  Manipulate people  The Democratic Leadership Style – “Your
 Emphasize and resources to opinions are listened to”
interpersonal achieve goals Democratic leaders include their team
relationships  Direct willing and members in their decision-making process.
 Direct willing unwilling While they are ultimately responsible for
followers subordinates making final decisions, they often ask team
members what they think and try to take their
 Have goals that  Have greater thoughts and opinions into account.
may or may not formal
reflect the formal responsibility &
 The Coaching Leadership Style – “I
organization accountability for
support your growth”
control
A coaching leader is someone who can
quickly recognize their team members’
Leadership Styles strengths, weaknesses, and motivations to
help each individual improve.
 The Bureaucratic Leadership Style – This type of leader often assists team
“Follow the procedure” members in setting smart goals and then
Leaders that adopt the bureaucratic provides regular feedback with challenging
leadership style are all about rules. They set projects to promote growth. They’re skilled in
strict procedures which they follow precisely, setting clear expectations and creating a
and expect their team to do the same. positive, motivating environment.
 The Transactional Leadership style – “You  The Affiliative Leadership Style – “People
are rewarded when you achieve the goals, I come first”
have set for you” The affiliative leader promotes harmony
Transactional leadership is a managerial among their followers and helps to solve any
style that promotes compliance and attaining conflict.
goals through supervision, organization, and This type of leader will also build teams
a system of rewards and punishments. that make sure that their followers feel
connected to each other. Typically, the
 The Authoritarian Leadership Style – “Do followers will receive much praise from this
what I tell you” style of leader, however poor performance
Authoritarian leadership is a leadership tends to go unchecked.
style characterized by individual control over
all decisions and little input from group  The Laissez-Faire Leadership Style –
members. “Trust is the stepping stone of success”
Leaders who practice this style are
 The Authoritative Leadership Style – known for giving their team members a lot of
“Come with me and let’s accomplish our freedom.
mission together”
 They provide support and resources for
team members when it’s necessary, but they
don’t constantly micromanage employees.
 The Transformational Leadership Style –
“Improvement cannot happen without
transformation”
Transformational leaders work with the
goal of transforming their teams and
organizations so that they’re constantly
improving.
They create a vision of the future that
they share with their teams so that everyone
can work together toward that shared goal
and vision.
 The Servant Leadership Style – “My job is
to meet your needs”
Servant leaders are seen as charismatic
and generous and they are working hard to
meet the needs of their teams.
This often leads to high worker
satisfaction rates since team members feel
heard and cared for in their work.
Role of a Leader and a Manager
Leader guides people and groups to accomplish
common goals, influences, beliefs, opinions, or
behavior of a person, group, or groups of people.
The act of influencing and motivating a
group of people to act in the same direction
towards achieving a common goal.
Manager coordinates people, time, and supplies
to achieve desired outcomes, involves problem-
solving, and decision-making process. Maintain
control of the day-to-day operations, achieve
established goals and objectives.
The process of leading and directing an
organization to meet its goals through the use of
appropriate resources.
Theories of Leadership
• Great man theory: its premise is leaders are
born and not made
• Charismatic theory: a person may be a
leader because of charisma, an inspirational
quality
• Trait theory: traits are inherited but may be
improved by learning and experience. Traits
are: energy, drive, enthusiasm, ambition,
decisiveness, self-assurance, self-
confidence, friendliness, honesty,
dependability, & mastery.
Later research on trait theory found
other traits: intelligence, initiative, creativity,
emotional maturity, communication skills,
persuasion, perceptive, & sociable
• Situational theories: traits required of a
leader differ according to varying situations.
• Contingency theory: Fred Fiedler identified
3 aspects of a situation that structure the
leader’s role. They are:
1. Leader-member relations
2. Task structure
3. Position power
• Path-goal theory: (Robert House) the
leader facilitates task accomplishment by
minimizing obstruction to the goals and by
rewarding followers for completing their
tasks.
• Life-cycle theory: predicts the most
appropriate leadership style from the level of
maturity of the followers
• Integrative leadership model: leadership
behavior needs to be adaptive.
• Transformational leadership: is a
leadership style where one or more persons
engage with others in such a way that
leaders and followers raise one another to
higher levels of motivation and morality. It
was described by James MacGregor Burns in
1978. “Selling style”
• Transactional leader: works through
creating clear structures whereby it is clear
what is required of their subordinates, and
the rewards that they get for following orders.
Allocates work to a subordinate, they are
considered to be fully responsible for it,
whether or not they have the resources or
capability to carry it out. When things go
wrong, then the subordinate is considered to
be personally at fault, and is punished for
their failure (just as they are rewarded for
succeeding). “Telling style”
• Servant leadership: Greenleaf (1977) says
that true leadership "emerges from those
whose primary motivation is a deep desire to
help others." Servant leadership is a very
moral position, putting the well-being of the
followers before other goals.
Theories of Management
 Frederick Taylor: Theory of Scientific
Management states that work should be
studied scientifically to determine the method
of task performance that would yield
maximum work output with minimum work
expenditure.
 Henri Fayol: 14 Principles of Management
 Max Weber: Theory of Social and Economic
Organization advocated bureaucracy
 Mary Follett: emphasized training and
suggested that manager and employees
should analyze the situation and take orders
from the situation.
 Elton Mayo & Fritz Roethlisberger: much
more than the physical environment affects
work productivity. Factors such as support
from fellow workers, norms established by
work group, opportunity to participate in
decision making & recognition are important.
 Kurt Lewin: Field Theory of Human Behavior
describes the process of attitude and
 behavior change which are unfreezing,
changing, and refreezing.
 Douglas McGregor: Theory X and Theory Y.
Theory X assumes that the average
individual dislikes work & will avoid it, prefers
to be directed, & more interested in financial
than personal gains therefore they must be
force & threatened. Theory Y assumes that
work is as natural as play, workers have self-
control and self-direction, and accepts
responsibility.
 Frederick Herzberg: Two-factor Theory
identified two factors which motivate
employees. Motivators or satisfiers include
achievements, recognition, possibility for
growth, and status. Hygiene or maintenance
factors or dissatisfiers are salary, supervision,
job security, working conditions, and
interpersonal relations.
 Chris Argyris: The rigid structure and
stringent rules of bureaucracy block normal
maturational changes and encourages
passivity & dependency therefore diminishing
job satisfaction.
 Rensis Likert: System 4 Approach to
Organizational Development – superiors and
subordinates demonstrate trust in each other,
information flows freely, group participation,
decisions made at all levels
 Herbert Simon: Two approaches to decision
making – Optimizing approach used by the
economic man where he seeks to achieve
the greatest possible gain from each
management decision. Satisficing approach
used by the administrative man where one
looks not at the best solution to a problem but
one that is good enough.
 Alvin Toffler: emphasized the increasing
speed of change and the too rapid arrival of
the future leading to “future shock”, a physical
and psychological distress process. People
must design personal and change regulators
to decelerate change by modifying reactions.
 Henry Mintzberg: identified the manager’s
roles as interpersonal, informational, and
decision roles.
 William Ouchi: Theory Z involves lifetime
employment, collective decision making,
decision from within, non-specialized career
paths.
Modalities of Care
Modalities of Nursing Care - This refers to the
manner in which nursing care is organized and
provided. It depends on the philosophy of the
organization, nurse staffing and client population.
 Functional Nursing. It is a system of care
that concentrates on duties. It can be seen as
an “assembly line” of care. The RN
coordinates care for an entire unit or team.
Other nurses are assigned to pass
medications and perform treatments.
Personnel with less training are assigned to
provide more basic care such as bed bath
and bed making. It began during the World
War II when the demand for client care
outstripped the supply of nurses.
 Primary Nursing. It is a model of care
delivery that emerged during the 1980’s to
meet the increasing complex needs of clients.
The goal is for each client’s care to be
comprehensive and coordinated, from the
admission to discharge. Each client is
assigned to a primary nurse, who is a RN,
and that the nurse provides care for that
client when he or she is working. Advantages
are: the client has the same nurse, the
client’s psychosocial needs can be met,
communication with the physician has
improved and the nurse feels autonomous.
 Team Nursing. In team nursing, the RN
works with one or more health care personnel
to provide care for four or more clients.
Advantages are that an RN is usually head of
the team and generally knows the clients. In
addition, the team leader can provide
guidance to new or inexperienced nurses and
other staff.
 Case management. It is a care delivery
model that incorporates concepts of
continuity and efficiency in addressing both
long and short-term physical needs,
psychological and social needs of clients.
The primary goals are promoting self-care,
upgrading the quality of life and using
resources efficiently. Case managers are
nurses who coordinate care of a group of
clients, monitor the implementation of
interdisciplinary care plans, and maintain
communication with third party payers and
referral sources. The nurse follows the client
through the entire stay in the health care
system and back into the community.
 Case method. It is the oldest patient care
delivery method. In this method one
professional nurse assumes total
responsibility of providing complete care for
one or more patients (1-6) while she is on
duty. This method is used frequently in
intensive care units and in teaching nursing
students.
 Total Patient care. Is the oldest of the care
delivery system. One nurse is assigned to
one client and provides all care. The one-to-
one pattern is common in critical care, with
student nurses, and with private duty nurses.
The advantage is that the client needs to
work with only one nurse and that one nurse
can focus on meeting all the biopsychosocial
needs of the client and the family.
 Modular Nursing. The modular nursing uses
a mini-team (two or three members with at
least one member being an RN), with
members of the modular nursing team
 sometimes being called care pairs. In
modular nursing, patient care units are
typically divided into modules or districts, and
assignments are based on the geographical
location of patients.
 Innovative/Contemporary Method.
Contemporary nursing deals with the
formulation of important questions for nursing
and content-related responses, including
those related to the tasks that nursing has to
perform for the transformation of society.
Nursing includes such as: direct care of the
physically.
Planning
Planning: thinking ahead and making future
projections to achieve desired results. It involves:
1. Forecasting
2. Setting objectives
3. Developing schedules and programs
4. Preparing budgets and allocating resources
5. Establishing policies and procedures
Planning is deciding in advance what to do; who
is to do it; and how, when, and where it is to be
done.
Kinds of planning
1. Strategic planning or long-range
planning extends from 3 – 5 years.
2. Operational planning or short-range
planning extends from a few months to a
year.
 Nurse case manager: works to ensure that
quality health care is being delivered in an
efficient, cost-effective manner to individual
patients as they move from setting to setting
within the health care system. A Nurse Case
Manager usually specializes in the delivery of
care to a specific population, such as adults,
families, children, the elderly, AIDS patients,
patients with cardiovascular disease, etc.
The primary role of a case manager is to
coordinate the continuity of care and to
ensure that patients get the proper treatment
at the proper time to maximize health and
minimize hospitalization.
Different Forms of Power
1. Legitimate power: given by virtue of
position. Authority is the legitimate right to
give commands.
2. Reward power: based on the ability to give
rewards
3. Coercive power: based on the ability to give
punishment
4. Expert power: based on a special ability,
knowledge, or skill demonstrated by an
individual. Ex. “Knowledge is power.”
5. Referent power: based on the attractiveness
or appeal of one person to another or based
on a person’s connections or relationship with
another powerful individual

Purposes – It clarifies the following:

1. Beliefs and values
2. Strengths and weaknesses
3. Opportunities and threats
4. Direction of the organization

Nursing Care Delivery

 Case method: each patient is assigned to a
nurse for total patient care while that nurse is
on duty.
 Functional nursing: involves regimentation
of tasks or functions.
 Team nursing: utilizes the knowledge and
skills of professional nurses to supervise
auxiliary nursing staff at different levels.
 Primary nursing: features a nurse who gives
total patient care to 4 – 6 patients while she is
on duty and remains responsible for the care
of those patients 24/7 throughout the
patient’s hospitalization.
 Private duty nursing: nurses provide total
patient care while on duty to patients who
directly pay them for professional services.