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  Management
 based on influence  based on authority
 an informal  a formally designated
designation position
 an achieved position  an assigned position
 part of every nurse’s  improved by use of
role effective leadership
 independent of skills
management
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-F
Degree of
freedom
Little Moderate Much
Degree of control
High Moderate None
Decsision making
By leader Leader& Group or
group no one
Leader activity level
High High Minimal
Assumption of
Responsibility Leader Shared Abdicated
Output of group
High& High & Variable-
good qual. creative 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  Optimism
matches words)  Balance(work,
 Courage (take  reflection,play)
risks)  Ability to handle
 Initiative (Act on stress
ideas)  Self-Awareness)
 Energy
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 situation
Practice 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 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
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?