LESSON 6

CONCEPT OF LEADERSHIP AND

MANAGEMENT
ROLE OF THE NURSE AS organizing, coordinating, and
LEADER/MANAGER directing the work of others, and for
establishing and evaluating
• Linked to each other (managers must
standards.
have leadership abilities, and leaders
• The nurse manager is involved in
often manage).
myriad daily tasks and details related
• These two roles are different from
to patient care planning, quality
each other.
improvement, goal setting, and
LEADER budgeting.

• Influences others to work together to • Nurse managers also oversee staff

accomplish a specific goal. schedules and assignments,

• Leaders are often visionary; they are performance, professional growth

informed, articulate, confident, and and the ongoing provision of

self-aware. educational and career opportunities.

• Leaders also usually have • Managers understand organizational

outstanding interpersonal skills and structure and culture.

are excellent listeners and • They control human, financial, and

communicators. material resources.

• Nurses are responsible for managing
MANAGER
client care.
• Is an employee of an organization • Some nurses assume a position
who is given authority, power, and within the organization as unit
responsibility for planning, manager, supervisor, or executive.

NCM 103: FUNDAMENTALS OF NURSING PRACTICE 1

As a manager, the nurse is responsible
for;
a. Efficiently accomplishing the
goals of the organization.
b. Efficiently using
organization’s resources.
c. Ensuring effective client care.
d. Ensuring compliance with
institutional, professional,
regulatory, and governmental
standards.
COMPARISON OF LEADER AND
MANAGER ROLES
LEADERS are;
- May or may not be officially
appointed to the position.
- Have power and authority to
enforce decisions only as long as
followers are willing to be led.
- Influence others toward goal.
- Informally
- Are interested in risk taking.
- Maintain an orderly, and exploring
new ideas.
- Relate to people personally in an
intuitive and empathic manner.
- Feel rewarded by personal
achievements
- May or may not be successful as
managers.
- Manage relationships.
- Focus on people.
the MANAGERS are;
- Are appointed officially to the
position.
- Have power and authority to
enforce decisions.
- Carry out predetermined setting
either formally or policies, rules,
and regulations.
- Controlled, rational and equitable
structure.
- Relate to people according to
their roles.
- Feel rewarded when fulfilling
organizational mission or goals.
- Are managers as long as the
appointment holds.
- Manage resources.
- Focus on systems.
LEADERSHIP STYLES ACCORDING TO
THE BEHAVIORS
1. Autocratic
- (AUTHORITARIAN) LEADER
- Makes decisions for the group.
NCM 103: FUNDAMENTALS OF NURSING PRACTICE 2
 - Determines policies, giving - This style allows more self-
orders and directions to the motivation and more creativity
group. among group members.
- Members are often dissatisfied - It also calls for a great deal of
with this leadership style; cooperation and coordination
however, at times an autocratic among group members.
style is the most effective. - This leadership style can be
- Examples; when urgent decisions extremely effective in the health
are necessary (e.g. a cardiac care setting.
arrest, a unit fire, or a terrorist 3. Laissez-Faire
attack), one person must assume - (NONDIRECTIVE, PERMISSIVE)
the responsibility for making LEADER
decisions without being - Recognizes the group’s need for
challenged by other team autonomy and self-regulation.
members. - Assumes a “hands-off” approach.
2. Democratic - A laissez-faire style is most
- (PARTICIPATIVE, CONSULTATIVE) effective for groups whose
LEADER members have both personal and
- Encourages group discussion and professional maturity, so that
decision making. once the group has made a
- Acts as a catalyst or facilitator, decision, the members become
actively guiding the group toward committed to it and have the
achieving the group goals. required expertise to implement
- Providing constructive feedback, it. The leader acts as a resource
offering information, making person.
suggestions, and asking 4. Bureaucratic Leader
questions become the focus of the - Does not trust self or others to
participative leader. make decisions and instead relies
on the organization’s rules,

NCM 103: FUNDAMENTALS OF NURSING PRACTICE 3

 policies, and procedures to direct ELEMENTS OF POSITIVE PRACTICE
the group’s work efforts. ENVIRONMENT
- Group members are usually
1. Positive Practice Environments are
dissatisfied with the leader’s
characterized by:
inflexibility and impersonal
- Occupational health, safety and
relations with them.
wellness policies that address
POSITIVE PRACTICE ENVIRONMENT workplace hazards,
discrimination, physical and
ELEMENTS AND CHARACTERISTICS psychological violence and issues

1. Positive Practice Environment (PPE) pertaining to personal security.

- Are health care settings that - Fair and manageable workloads

support excellence and decent and job demands/stress.

work conditions. - Organizational climate reflective

- Power to attract and retain staff, - of effective management and

improve patients’ satisfaction. leadership practices, good peer

- Safety and health outcomes. support, worker participation in

- Deliver cost-effective, people- decisionmaking, shared values.

centered health care services. - Healthy work-life balance.

- Estimates a shortage of 18 million - Equal opportunity and treatment.

health workers by 2030 (World - Opportunities for professional

Health Organization, 2016) development and career

- Poor quality of most healthcare advancement.

work environments. - Professional identity, autonomy

- Undermining health service and control over practice.

delivery and driving health - Job security

professionals away from their - Decent pay and benefit.

care giving role and/or country. - Safe staffing levels

- Support and supervision.

NCM 103: FUNDAMENTALS OF NURSING PRACTICE 4

- Open communication and 1. Professional Recognition and
transparency. Empowerment
- Recognition programs. - to improve performance and build
- Access to adequate equipment, professional self-worth.
supplies and support staff. 2. Management Practices and
Incentives
POSITIVE PRACTICE ENVIRONMENT
- enable and encourage health
- It is a health care setting that workers to stay in their jobs, in
supports excellence, and decent their profession and in their
work conditions, and has the countries.
power to attract and retain staff, 3. Occupational Health and Safety
provide quality care and deliver - to keep employees safe so they
cost-effective, people-centered remain healthy, motivated and
health care services. productive.

PPE CHECKLIST 4. Education and Information

- provide opportunities to learn,
- For use by employers,
develop, progress and save lives.
professional organizations,
regulatory bodies, government MAGNET HOSPITAL

agencies as well as health sector - It refers to a facility that is able to

professionals. attract and retain a staff of well
- Reference tool to enable these qualified nurses and consistently
groups to assess the quality of provide quality care.
their practice environments,
POSITIVE PRACTICE ENVIRONMENTS
identify any deficiencies and
develop strategies to address Quality Workplaces = Quality Patient Care

priority gaps.

NCM 103: FUNDAMENTALS OF NURSING PRACTICE 5