Nursing Leadership and Management PDF

BASIC CONCEPTS OF LEADERSHIP AND MANAGEMENT **LEADERSHIP** - Has many meanings and there is no single definition broad enough to encompass the total leadership process. - Leaders are those individuals who are out front, taking risks, attempting to achieve shared goals, and inspiring o...

BASIC CONCEPTS OF LEADERSHIP AND MANAGEMENT **LEADERSHIP** - Has many meanings and there is no single definition broad enough to encompass the total leadership process. - Leaders are those individuals who are out front, taking risks, attempting to achieve shared goals, and inspiring others to action. Those individuals who choose to follow a leader do so by choice, not because they have to. - The essence of leadership is a social influence process where leaders use interpersonal behaviors to motivate followers to commit and give their best effort to contribute to group goals. - Leaders are in the front, moving forward, taking risks, and challenging the status quo. It is important to remember though that a job title alone does not make a person a leader. Only a person\'s behavior determines if he or she holds a leadership role. **Leadership Roles** Decision maker, Coach, Forecaster, Communicator, Counselor, Influencer, Evaluator, Teacher, Creative problem solver, Facilitator, Critical thinker, Change agent, Risk taker, Buffer Diplomat, Mentor, Advocate, Role model, Energizer Visionary Innovator Other characteristics of leaders include the following: - Leaders often do not have delegated authority but obtain their power through other means, such as influence. - Leaders have a wider variety of roles than do managers. - Leaders may or may not be part of the formal organization. - Leaders focus on group process, information gathering, feedback, and empowering others. - Leaders emphasize interpersonal relationships. - Leaders direct willing followers. - Leaders have goals that may or may not reflect those of the organization. **10 Fatal Leadership Flaws** 1\. A lack of energy and enthusiasm 2\. Acceptance of their own mediocre performance 3\. Lack of a clear vision and direction 4\. Having poor judgment 5\. Not collaborating 6\. Not walking the talk 7\. Resisting new ideas 8\. Not learning from mistakes 9\. A lack of interpersonal skills 10\. Failing to develop others. - It is important to remember that all it takes to stop being a leader is to have others stop following you. - Leadership then is more dynamic than management and leaders do make mistakes that can result in the loss of their followers. **MANAGEMENT** - Dictionary.com (2013, para 1) defines management as \"the act or manner of guiding or taking charge\" or \"handling, direction, or control. Both definitions imply that management is the process of leading and directing all or part of an organization, often a business, through the deployment and manipulation of resources. **Managers then typically:** - Have an assigned position within the formal organization. - Have a legitimate source of power due to the delegated authority that accompanies their position. A - Are expected to carry out specific functions, duties, and responsibilities. - Emphasize control, decision making, decision analysis, and results. - Manipulate people, the environment, money, time, and other resources to achieve organizational goals. - Have a greater formal responsibility and accountability for rationality and control than leaders. - Direct willing and unwilling subordinates. - If a manager guides, directs and motivates and a leader empowers others, then it could be said that every manager should be a leader. Similarly, leadership without and a leader empowers others, then it management results in chaos and failure for both the organization and the individual executive. \> **Thompson (2012)** agrees, suggesting that good management, as defined by strong planning, organizational skills, and control, allows managers to intervene when goals are threatened. But it is leadership skill that is needed to implement the planned change that is a part of system improvement. Thus, the integration of both leadership and management skills is critical to goal attainment. **HISTORICAL DEVELOPMENT OF MANAGEMENT THEORY** Theorists\' views of what successful management is and what it should have changed repeatedly in the last 100 years. **[Scientific Management (1900 to 1930)]** **Frederick W. Taylor**, the \"father of scientific management. The four overriding principles of scientific management as identified by Taylor (1911) are: 1\. Traditional \"rule of thumb\" means of organizing work must be replaced with scientific methods. In other words, by using time and motion studies and the expertise of experienced workers, work could be scientifically designed to promote the greatest efficiency of time and energy. 2\. A scientific personnel system must be established so that workers can be hired, trained, and promoted based on their technical competence and abilities. Taylor thought that each employee\'s abilities and limitations could be identified so that the worker could be best matched to the most appropriate job. 3\. Workers should be able to view how they \"fit\" into the organization and how they contribute to overall organizational productivity. This provides common goals and a sharing of the organizational mission - use of financial incentives at a reward for work accomplished Because Taylor viewed humans as \"economic animals motivated solely by money, workers were reimbursed according to their level of production rather than by an hourly wage. 4\. The relationship between managers and workers should be cooperative and interdependent, and the work should be shared equally. Their roles, however, were not the same. The role of managers, or functional foremen as they were called, was to plan, prepare, and supervise. The worker has to do the work. ***The result of scientific management**:* Productivity and profits rose dramatically. Taylor maintained that he truly believed managers and workers would be satisfied if financial rewards were adequate as a result of increased productivity. **Max Weber,** a well-known German sociologist, began to study large-scale organizations to determine what made some workers more efficient than others ➤Weber saw the need for legalized, formal authority and consistent rules and regulations for personnel in different positions - bureaucracy as an organizational design. His essay \"Bureaucracy\" was written in 1922 provide more rules, regulations, and structure within organizations to increase efficiency. **[Management Functions Identified (1925)]** **Henri Fayol (1925)** first identified the management functions of planning, organization, command, coordination, and control. **Luther Gulick (1937)** expanded on Fayol\'s management functions in his introduction of the \"seven activities of management\"- planning, organizing, staffing, directing, coordinating, reporting, and budgeting-as denoted by the mnemonic POSDCORB. *The management process and a brief description of the five functions for each phase management process follow:* 1\. Planning encompasses determining philosophy, goals, objectives, policies, procedures, and rules, carrying out long- and short-range projections, determining a fiscal course of action, and managing planed change. 2.Organizing includes establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals. Other functions involve working within the structure of the organization and understanding and using power and authority appropriately. 3\. Staffing functions consist of recruiting, interviewing, hiring, and orienting staff. Scheduling, staff development, employee socialization, and team building are also often included as staffing functions. 4\. Directing sometimes includes several staffing functions. However, this phase\'s functions usually entail human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration. 5\. Controlling functions include performance appraisals, fiscal accountability, quality control, legal and ethical control, and professional and collegial control. **[Human Relations Management (1930 to 1970)]** - During the 1920s, worker unrest developed. - The Industrial Revolution had resulted in great numbers of relatively unskilled laborers working in large factories on specialized tasks - Thus, management scientists and organizational theorists began to look at the role of worker satisfaction in production - This ***human relations era*** developed the concepts of participatory and humanistic management, emphasizing people rather than machines. **Mark Parker Follet (1926)** was one of the first theorists to suggest participate decision making or participative management. - In her essay**, "THE GIVING OF ORDERS**", Follet espoused her belief that managers should have authority with, rather than over, employees. Thus, solutions could be found that satisfied both sides without having one side dominate the other. - The human relations ear attempted to correct what was perceived as the major shortcoming of the bureaucratic system- a failure to include the " human element". **Douglas McGregor (1960**) reinforced the ideas that managerial attitudes about employees (and, hence, how managers treat those employees) can be directly correlated with employee satisfaction. He labeled this Theory X and Theory Y. ➤ Theory X managers believe that their employees are basically lazy, need constant supervision and direction, and are indifferent to organizational needs. ➤ Theory Y managers believe that their workers enjoy their work, are self- motivated, and are willing to work hard to meet personal and organizational goals. **Chris Argyris (1964)** supported McGregor by saying that managerial domination causes workers to become discouraged and passive. He believed that if self-esteem and independence needs are not met, employees will become discouraged and troublesome or may leave the organization. Argyris stressed the need for flexibility within the organization and employee participation in decision making \*\*The human relations era of management science brought about a great interest in the study of workers, contributed to our understanding about worker motivation. ***[Historical Development of Leadership Theory]*** **The Great Man Theory/Trait Theories (1900 to 1940)** - The basis for most leadership research until the mid- 1940s. The Great Man theory, from Aristotelian philosophy, asserts that some people are born to lead, whereas others are born to be led. It also suggests that great leaders will arise when the situation demands it. - Trait theories assume that some people have certain characteristics or personality traits that make them better leaders than others. - Contemporary opponents of these theories argue that leadership skills can be developed, not just inherited. Avolio, Walumbwa, and Weber (2009) suggest, however, that very little work has been done in the last 100 years to determine whether leadership can actually be developed. - A major breakthrough occurred when Lewin (1951) and White and Lippitt (1960) isolated common leadership styles. Later, these styles came to be called authoritarian, democratic, and laissez-faire. **The authoritarian leader is characterized by the following behaviors**: - Strong control is maintained over the work group. - Others are motivated by coercion. - Others are directed with commands. - Communication flows downward. - Decision making does not involve others. - Emphasis is on difference in status (\"I\" and \"you\"). - Criticism is punitive. **Behavioral Theories (1940 to 1980)** - During the human relations era, many behavioral and social scientists studying management also studied leadership. As leadership theory developed, researchers moved away from studying what traits the leader had and placed emphasis leader's style of leadership. - Authoritarian leadership results in well-defined group actions that are usually predictable, reducing frustration in the work group and giving members a feeling of security. Productivity is usually high, but creativity, self-motivation, and autonomy are reduced. Authoritarian leadership is frequently found in very large bureaucracies such as the armed forces. **The democratic leader exhibits the following behaviors:** - Less control is maintained - Economic and ego awards are used to motivate. - Others are directed through suggestions and guidance. - Communications flows up and down - Decision making involves others - Emphasis in one rather than \"I\" and \"you\" - Criticism is constructive ➤Democratic leadership, appropriate for groups who work together for extended periods, promotes autonomy and growth in individual workers. Democratic leadership is particularly effective when cooperation and coordination between groups are necessary. Studies have shown, however, that democratic leadership may be less efficient quantitavely than authoritative leadership. **The laissez faire leader is characterized by the following behaviors** - Is permissive, with little or no control. - Motivates by support when requested by the group or individuals - Provides little or no direction - Uses upward and downward communications between members of the group - Disperses decision making throughout the group - Places emphasis on the group. - Does not criticize. - Because it is nondirected leadership, the laissez faire style can be frustrating, group apathy and disinterest can occur However, when all group members are highly motivated and self-directed, this leadership style can-result in much creativity and productivity - Laissez-faire leadership appropriate when problems ate poorly defined, and brainstorming needed to generate alternance solutions. **[Situational and Contingency Leadership Theories (1950 to 1980) ]** **Mary Parker Follett**, one of the earliest management consultants and among the first to view an organization as a social system of contingencies. Her law of the situation, which said that the situation should determine the directives given after allowing everyone to know the problem, was contingency leadership in its humble origins. **Fiedler\'s (1967) contingency approach** reinforced these findings, suggesting that no one leadership style is ideal for every situation. Fiedler felt that the interrelationships between the group\'s leader and its members were most influenced by the manager\'s ability to be a good leader. The task to be accomplished and the power associated with the leader\'s position also were cited as key variables. **Hersey and Blanchard (1977**) also developed a situational approach to leadership. Their tridimensional leadership effectiveness model predicts which leadership style is most appropriate in each situation based on the level of the followers\' maturity. As people mature, leadership style becomes less task focused and more relationship oriented. **Tannenbaum and Schmidt (1958)** built on the work of Lewin and White, suggesting that managers need varying mixtures of autocratic and democratic leadership behavior. They believed that the primary determinants of leadership style should include the nature of the situation, the skills of the manager, and the abilities of the group members. [**INTERACTIONAL LEADERSHIP THEORIES (1970 TO PRESENT)** ] The basic premise of Interactional theory is that leadership behavior is generally determined by the relationship between the leader\'s personality and the specific situation. **Schein (1970), an interactional theorist**, was the first to propose a model of humans as complex beings whose working environment was an open system to which they responded. A system may be defined as a set of objects, with relationships between the objects and between their attributes. A system is considered open if it exchanges matter, energy, or information with its environment. **Schein\'s model**, based on systems theory, had the following assumptions: 1\. People are very complex and highly variable. They have multiple motives for doing things 2\. People\'s motives do not stay constant but change over time. 3\. Goals can differ in various situations. A person\'s performance and productivity are affected by the nature of the task and by his or her ability, experience, and motivation. 4\. No single leadership strategy is effective in every situation. To be successful, the leader must diagnose the situation and select appropriate strategies from a large repertoire of skills. Hollander (1978) was among the first to recognize that both leaders and followers have roles outside of the leadership situation and that both may be Influenced by events occurring in their other roles. With leader and follower contributing to the working relationship and both receiving something from it. Hollander (1978) saw leadership as a dynamic two-way process. According to Hollander, a leadership exchange involves three basic elements The leader, including his or her personality, perceptions, and abilities. The followers, with their personalities, perceptions, and abilities. The situation within which the leader and the followers function, Including formal and informal group norms, size, and density. Leadership effectiveness, according to Hollander, requires the ability to use the problem-solving process, maintain group effectiveness: communicate well; demonstrate leader fairness, competence. dependability, and creativity, and develop group identification. **Ouchi (1981) interactional leadership theory** in his application of Japanese style management to corporate America. Theory Z, is an expansion of McGregor\'s Theory Y and supports democratic leadership. Characteristics of Theory Z include consensus decision making, fitting employees to their jobs, job security, slower promotions, examining the long-term consequences of management decision making, quality circles. guarantee of lifetime employment, establishment of strong bonds of responsibility between superiors and subordinates, and a holistic concern for the workers **Nelson and Burns (1984)** suggested that organizations and their leaders have four developmental levels and that these levels influence productivity and worker satisfaction. 1\. The reactive leader focuses on the past, is crisis driven, and is frequently abusive to subordinates 2\. responsive, the leader is able to mold subordinates to work together as a team, although the leader maintains most decision-making responsibility. 3\. At the proactive level, the leader and followers become more future oriented and hold common driving values. Management and decision making are more participative. At the last level, high- performance teams, maximum productivity and worker satisfaction are apparent. **Brandt\'s (1994) interactive leadership model** suggests that leaders develop a work environment that fosters autonomy and creativity through valuing and empowering followers. This leadership \"affirms the uniqueness of each individual,\" motivating them to \"contribute their unique talents to a common goal\" **Kanter (1989)** perhaps best summarized the work of the interactive theorists by her assertion that title and position authority were no longer sufficient to mold a workforce where subordinates are encouraged to think for themselves, and instead managers must learn to work synergistically with others **Wolf, Boland, and Aukerman (1994)** also emphasized an interactive leadership model in their creation of a collaborative practice matrix. This matrix highlights the framework for the development and ongoing support of relationships between and among professionals working together. The \"social architecture\" of the work group is emphasized, as is how expectations, personal values, and interpersonal relationships affect the ability of leaders and followers to achieve the vision of the organization. **Transactional and Transformational Leadership Burns (2003),** both leaders and followers have the ability to raise each other to higher levels of motivation and morality. **2 Primary types of leaders in management.** ➤ Traditional manager, concerned with the day-to-day operations, was termed a transactional leader. ➤ The manager who is committed, has a vision, and is able to empower others with this vision was termed a transformational leader. Transactional leaders focus on tasks and getting the work done. Transformational leaders focus on vision and empowerment. **Bass and Avolio (1994)** suggested that transformational leadership leads followers to levels of higher morals because such leaders do the right thing for the right reason, treat people with care and compassion, encourage followers to be more creative and innovative, and inspire others with their vision. This new shared vision provides the energy required to move toward the future **Doody and Doody (2012) c**ontemporary health-care organizations need increasingly adaptive and flexible leadership. suggest that transformational leadership \"motivates followers by appealing to higher ideas and moral values. where the leader has a deep set of internal values and ideas. This leads followers acting to sustain the greater good, rather than their own interests, and supportive environments where responsibility is Shared **Kouzes and Posner** suggest that exemplary leaders foster a culture in which relationships between aspiring leaders and willing followers can thrive Kouzes and Posner\'s Five Practices for Exemplary Leadership 1\. Modeling the way. Requires value clarification and self-awareness so that behavior is congruent with values. 2\. Inspiring a shared vision: Entails visioning which inspires followers to want to participate in goal attainment. 3\. Challenging the process: Identifying opportunities and taking action. 4\. Enabling others to act: Fostering collaboration, trust, and the sharing of power 5\. Encouraging the heart: Recognize, appreciate, and celebrate followers **Full-Range Leadership Theory This theory,** **originally developed by Antonakis, Avolio, and Sivasubramaniam (2003)**, suggests that there are nine factors impacting leadership style and its impact on followers; five are transformational, three are transactional, and one is a nonleadership or laissez-faire leadership factor: Rowold and Schlotz (2009) suggested: **Transformational Factor:** 1.Iinspirational motivation is characterized by the leader\'s articulation and representation of vision. 2\. Idealized influence (attributed), relies on the charisma of the leaders to create emotional ties with followers that build trust and confidence 3\. Idealized influence (behavior), results in the leader creating a collective sense of mission and values and prompting followers to act upon these values. 4.Intellectual stimulation, leaders challenge the assumptions of followers\' beliefs as well as analyze subordinates\' problems and possible solutions. 5.Individualized consideration, occurs when the leader is able to individualize his or her followers, recognizing and appreciating their unique needs, strengths, and challenges. **Transactional factor:** 1\. Contingent reward the leader is task oriented in providing followers with meaningful rewards based on successful task completion. 2\. Active management-by-exception, suggests that the leader watches and searches actively for deviations from rules and standards and takes corrective actions when necessary. 3\. management-by-exception passive, describes a leader who intervenes only after errors have been detected or standards have been violated. - The ninth factor of full-range leadership theory is the absence of leadership. Thus, laissez-faire is a contrast to the active leadership styles of transformational and transactional leadership exemplified in the first eight factors. **[Leadership Competencies ]** The American College of Healthcare Executives, the American College of Physician Executives, the American Organization of Nurse Executives, the Healthcare Information and Management Systems Society, the Healthcare Financial Management Association, and the Medical Group Management Association have collaborated to identify leadership competencies, which included leadership skills and behavior; organizational climate and culture; communicating vision; and managing change (Espero and Rub 2014) **INTEGRATING LEADERSHIP AND MANAGEMENT** For managers and leaders to function at their greatest potential, the two must be integrated. Gardner (1990) asserted that integrated leader-managers possess six distinguishing traits: 1\. They think longer term: They are visionary and futuristic. They consider the effect that their decisions will have years from now as well as their immediate consequences. 2\. They look outward, toward the larger organization: They do not become narrowly focused. They are able to understand how their unit or department fits into the bigger picture. 3\. They influence others beyond their own group: Effective leader managers rise above an organization\'s bureaucratic boundaries. 4\. They emphasize vision, values, and motivation: They understand intuitively the unconscious and often non rational aspects that are present in interactions with others. They are very sensitive to others and to differences in each situation. 5. They are politically astute: They are capable of coping with conflicting requirements and expectations from their many constituencies. 6\. They think in terms of change and renewal: The traditional manager accepts the structure and processes of the organization, but the leader-manager examines the ever-changing reality of the world and seeks to revise the organization to keep-pace - Leadership and management skills can and should be integrated as they are learned. - The two concepts have a symbiotic or synergistic relationship. Every nurse is a leader and manager at some level, and the nursing role requires leadership and management skills - Because rapid, dramatic change will continue in nursing and the health-care industry, it continues to be critically important for nurses to develop skill in both leadership roles and management functions and to strive for the integration of leadership characteristics throughout every phase of the management process. **21ST CENTURY THINKING ABOUT LEADERSHIP AND MANAGEMENT** New thinking about Leadership and management **Japsen (2012)** suggests that new leadership will be required to build bridges and find solutions to the complex health-care problems that will be faced in the next 20 years. This leadership must embrace community needs and new roles to care and guide individuals across a more data-driven, accountable US health