NUR 410 Midterm Review - Week 1 PDF

NUR 410 Midterm Review -- Week 1 ================================ **[Week 1 Learning Objectives ]** - *Define leadership and associated competencies* - *Discuss the importance of nursing leadership* - *Identify task focused and relational styles of leadership* - *Describe the characteri...

NUR 410 Midterm Review -- Week 1 ================================ **[Week 1 Learning Objectives ]** - *Define leadership and associated competencies* - *Discuss the importance of nursing leadership* - *Identify task focused and relational styles of leadership* - *Describe the characteristics of clinical leadership* - *Define followership and follower responsibilities* **What is Leadership?** - A process whereby an individual influences a group of individuals to achieve a common goal - Process, considered by some to be a skill, behaviour or a role - Doesn't require formal authority of a management position - Can be demonstrated by all nurses **Nursing Leadership** - Nurse leaders influence and inspire others with the goal of achieving optimal outcomes at all levels of the health system - Establish vision and direction - Lead the "design and delivery of excellent care" - Influence care delivery, clinical operations, change, quality, research, policy, ethical practice, system transformation etc. - Responsible for setting clear vision and direction for their team (involves strategic planning, goal setting, resource availability) - Advocate for patient safety - Requires strong professional identity grounded in nursing knowledge, embedded in relational & ethical practice - Ensure practices are evidence-based, patient-centered, & continuously improved **Benefits of Nursing Leadership** - Leadership behaviours are associated with: - Improved patient outcomes - Low-mortality, fewer med errors, hospital acquired infection - Quality nursing care - Healthy work environments - Nurse job satisfaction, organizational commitment and intent to remain employed - Enhanced team collaboration - Increased innovation **Approaches to Leadership** - - Task focused -- focus on task at hand - Transactional - Autocratic - Laissez-faire - Relational -- focus on building relationships - Democratic - Authentic - Resonant - Servant - Transformational **Transactional Leadership** - Focused on exchange between leader and follower - Provides rewards for meeting or exceeding expectations - May offer negative feedback, corrective action or punishment if standards are not met - Uses bureaucratic leadership: - Maintains formal roles - Follow organizational structures - Clarifies work tasks and focuses on policy **Autocratic Leadership** - Highly directive - Decisions are made for the followers/staff -- unilateral decision - Followers are not able to participate in decision making - May decrease staff motivation - As a follower, you don't need to do a lot of thinking (benefit for those who do not want to lead) - Beneficial in emergencies b/c no time to get everyone's input + leader needs to take charge and rectify situation **Laissez-Faire Leadership** - The leader takes a back step (opposite of autocratic) - Non-hierarchical - Encourages autonomy - Relies heavily on trust in team - Does not always work well in teams consisting of younger/newer staff (they require more guidance, have less skill/judgement/experience) - Important decisions are left to the staff with little or no direction - Works well in teams that are more experienced - Ex. long term care nurses who have been around for a long time, can trust they know what they\'re doing **Democratic Leadership** - Participative leadership: Encourages active participation in decision-making - Emphasis on collaboration, shared responsibility, and open communication - May result in better decision making (i.e. 2 minds are better than 1) - Ex: Nurses may suggest diff strategies for reducing med errors, collaboratively, they\'ll come up with a plan. Leading to less med errors. - May result in more collaborative and inclusive work environments - Improve team morale -- people feel valued because their input matters - Leader will make the decision if group cannot come to a conclusion -- fosters sense of ownership & engagement amongst the staff **Authentic Leadership** - Leaders remain true to their values and beliefs - Leader's credibility relies on their integrity and ability to be a role model - Respect and listen to others, build on strengths - Value contribution of the team and open to feedback - Ex: nurse manager who had to make a difficult decision that won\'t make everyone happy. If they can explain their reasoning and it sticks with their values, then staff may be inspired to trust the leader a bit more - Self-aware of own values, ethics & emotions - Transparency in interactions with others **Resonant Leadership** - High levels of emotional intelligence - Builds strong, trusting relationships - Creates climate of optimism - Focus on empathy, coaching, developing, and mentoring other staff - Enhances job satisfaction - Ex: clinical leader notices new nurse is struggling w time management and feel overwhelmed. Leader will take the time to understand their struggles and provide them with personalized coaching, share their own stories to encourage that nurse to believe in their own abilities. **Servant Leadership** - Places the follower at the forefront -- emphasis on growth through collaboration, trust, empathy & ethical use of power - Prioritize follower's need above their own - Leader is a steward -- tries to share their power with the followers - Ex: Manager notices team is having hard time with new EMR system. They arrange more additional training to support staff. Show up on the unit to make sure staff have req. skills. May implement system to share concerns about the system so that concersn can be escalated appropriately inc job satisfaction, improved pt care - Less reliance on hierarchy - **CONS:** name reflects colonialism and patriarchal norms, can be time consuming leader burnout **Transformational Leadership** - Challenges the status quo - makes significant change in followers and organization - Leader creates mission to guide organization/challenge norms - Creates and communicates vision - Empowers staff - Inspires and motivates followers to go above and beyond, exceeding their own self-interest for the greater good - Attends to the needs of followers - Emphasizes relationships and a positive working environment - **Critique of transformational leadership** - Focused upon heroic and distant leaders -- assumption that a strong leader will automatically lead to organizational success - Idealizing a leader -- organizations follow the leader too easily and do not challenge leadership decisions - Less attention to leader personal integrity -- less attention to the ethical work of leaders (e.g. to promote social justice) - Fails to address "dark" or immoral leader behaviours -- even if goals are being met, a leader can be manipulative, narcissistic, or promote self-interests - Privileges certain stereotyped gendered assumptions -- a feminist perspective of leadership is often missing **Leads in a Caring Environment -- Canadian College of Health Leaders** - **Lead self:** leaders are self-aware, manage and develop themselves and demonstrate character - **Engage others:** leaders foster the development of others, contribute to the creation of healthy organizations, they communicate effectively and build teams - **Achieve results:** leaders set direction, strategically align decisions with the organization's vision, values, and evidence, take action to implement decisions and assess and evaluate - **Develop coalitions:** leaders build partnerships and networks to create results, demonstrate a commitment to patients/clients, mobilize knowledge and navigate socio-political environments - **Systems transformation:** leaders demonstrate critical thinking, encourage and support innovation, orient themselves to the future and champion and orchestrate change **Emotional Intelligence (EI)** - Abilities, skills, and personality traits and/or competencies that enable you to **recognize your own feelings and emotions and those of others** AND to manage those emotions in your decisions, relationships and adaptation to daily work and life - Twice as important as technical skills and cognitive abilities in developing leadership competence - People with high EI Are more likely to: - Stay calm under pressure - Resolve conflict effectively - Respond with empathy **Four Competencies of EI** 1. **Self-awareness:** knowing oneself including strengths & weaknesses. Recognizing the impact of your emotions on others 2. **Self-management:** managing your emotions 3. **Social awareness:** recognizing other's emotions 4. **Relationship management:** Managing relationships including influencing others and resolving conflict **Strengthening EI** - Reflective practice -- journaling - Paying attention to your emotions -- asking why - Active listening -- practice mindfulness - Getting feedback from others **Clinical Leadership** - Clinical leaders are clinical experts in their field and followed because they match their actions with their values and beliefs about quality patient care **Characteristics of Clinical Leadership** - **Clinical expertise:** clinically credible and directly involved in the delivery of nursing care. Recognized as having clinical competence and expertise in a clinical area. - **Effective communication:** Central attribute. Able to communicate at the right level, highly developed listening skills - **Collaboration:** has strong interpersonal skill, teamwork abilities, and group process. Cultivates a collegial orientation with front-line staff and are willing to work with them to provide optimal patient care. - **Role modeling:** other nurses view clinical leaders as aspirational and seek to emulate their professionalism, practice expertise, and work behaviours - **Coordination of care:** plans and organizes care holistically while prioritizing needs and sharing information to promote the delivery of effective care - **Advocacy & empowerment:** acts on behalf of patients and in some cases, staff. Escalates issues as required. - **Education:** serves as a source of knowledge for staff and patients. Provides information that is accessible. - **Accountability:** sets expectations for patients and holds them accountable in achieving goals. Accountable for their own actions. - **Authenticity:** acts with integrity and honesty - **Empathy:** understands the perspective of others, caring, compassionate, helpful and respectful - **Vision & driving change:** develops a strategic sense of how frontline practice might be improved and articulates this vision to others to promote change **Facilitators & barriers to clinical leadership** +-----------------------------------+-----------------------------------+ | **Facilitators** | **Barriers** | +===================================+===================================+ | - Positive relationships with | - Lack of support from | | management | management | | | | | - Positive relationships with | - Ineffective teamwork, poor | | team | inter/intradisciplinary | | | relationships poor team | | - Positive work culture | morale | | | | | - Enabling structures: | - Inc workload | | opportunities to contribute | | | your leadership knowledge to | - Burnout | | the organization itself - | | | Quality councils are great | - Poor communication | | for this | | | | - Lack of confidence | | | | | | - Lack of training and | | | development opportunities | +-----------------------------------+-----------------------------------+ **Followership** - Followership is a relational role in which followers have the ability to influence leaders and contribute to the improvement and attainment of group and organizational objectives. It is primarily a hierarchically upward influence - There are no leaders without followers (complementary role) -- to be an effective leader, you have to start as an effective follower - Followers may promote team-effectiveness through relationships, providing feedback and sharing responsibilities **Follower Responsibilities** - - Develop high degree of literacy about organization - Take ownership of work - Be active rather than passive - Become self-aware of personal and professional values - Engage in self-management - Contribute to team while being aware and raising relevant concerns - Express opinions - Contribute to and be open to change