Nursing Leadership, Followership and Management Nursing 493: Unit II

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Nursing Leadership, Followership and
ManagementNursing 493 Unit II
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Why study leadership management?

• Who are our leaders?

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What are the most serious problems people face in
the work environment?

• Technical
• Safety
• People
• Financial
• Ethical

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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

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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

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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

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What does the study of leadership involve?

• Leadership theories
• Motivation
• Group development team work
• Power conflict
• Confrontation negotiation
• Effective communication
• Critical thinking problem solving

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Leadership

• All people have untapped leadership potential it
  is there in you.
• The attempt defines leadershipit does not have
  to be successful
• To be a leader you must make a decision to act

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What is Followership

• Followership leadership are reciprocal roles
• Being an effective follower is as important to
  the new nurse as being an effective leader

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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

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What is management?

• Management too is a process of influencing
  people but with the specific intention of
  contributing to meeting the organizations goals
• Management is the process of getting work done
  through other people
• Management is planning, organizing, coordinating,
  and controlling work given to employees

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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

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New definition of management

• To do whatever is necessary to see that employees
  do their work and do it well.

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Differences b/w leadership management

• Leadership
• based on influence
• an informal designation
• an achieved position
• part of every nurses role
• independent of management

• Management
• based on authority
• a formally designated position
• an assigned position
• improved by use of effective leadership skills

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What makes a person a leader?

• We look to Leadership theories

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Most Prominent Leadership Theories

• TRAIT THEORIES
• BEHAVIORAL THEORIES (Leadership styles)
• SITUATIONAL THEORIES (understanding all the
  factors)
• TRANSFORAMTIONAL THEORIES (inspiration meaning)

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Comparison of Authoritarian, Democratic,
Laissez-Faire
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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
  leaders goals
• Laissez-faire leader makes no attempt to move the
  group

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Behaviors of an Effective Leader

• Think critically
• Solve problems
• Respect people
• Communicate skillfully
• Set goals, share a vision
• Develop self others

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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)

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What distinguishes ordinary leaders from STARS?

• Emotional Intelligence addressing the effects
  of peoples feelings on the team

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Management Theories Two Opposing Schools of
Theory

• Scientific management
• Human relations-oriented management

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Scientific management

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

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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.

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Human Relations-Oriented Management Theory XY

• Theory X (McGregors ) 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.

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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.

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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

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Communication

• We cannot not communicate!

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Communication

• Giving receiving feedback
• Linking (connecting ideas in a group)
• Networking (connecting people in a group or
  organization

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Verbal NonverbalKeyPoints

• 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

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Emotional Intelligence

• Listen to others
• Pick up unspoken concerns
• Acknowledge others perspectives
• Welcome constructive criticism
• Bring people together in a spirit of trust

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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

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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

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Communicating with clients family

• Recognize signs of anger or anxiety
• Intervene to diffuse the situation
• Practice good listening show respect

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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

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Feedback (contd)

• 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.

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• 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.

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Performance AppraisalPeer 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

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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.

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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?