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I. Concepts of Nursing Management and Leadership ANNE ROSE L. CALIMLIM, PHD, RN Concepts of Leadership and Management in Nursing Leadership in nursing refers to the ability to guide, motivate, and influence others towards achieving common goals in healthcare settings. It involves setting a pos...

I. Concepts of Nursing Management and Leadership ANNE ROSE L. CALIMLIM, PHD, RN Concepts of Leadership and Management in Nursing Leadership in nursing refers to the ability to guide, motivate, and influence others towards achieving common goals in healthcare settings. It involves setting a positive example, fostering teamwork, and making critical decisions. A nurse leader is responsible for inspiring and empowering their team members, ensuring quality patient care, and promoting a culture of continuous improvement. On the other hand, management in nursing involves the coordination and organization of resources, such as personnel, supplies, and budgets, to achieve optimal healthcare outcomes. A nurse manager oversees the day-to-day operations, assigns tasks, and ensures efficient workflow. They are responsible for maintaining a safe and productive work environment while adhering to policies and regulations. Leadership vs. Management Leaders Managers 1. Often do not have delegated authority but obtain 1. Are assigned by the organization. power through other means, such as influence. 2. Have a legitimate source of power due to delegated 2. Have a wider variety of roles than managers. authority that accompanies their position. 3. Focus on group process, information gathering, 3. Have specific duties and responsibilities they are feedback and empowering others. expected to carry out. 4. May or may not be part of the formal hierarchy of the 4. Emphasize control, decision-making, decision- organization. analysis and results. 5. Emphasize interpersonal relationships. 5. Manipulate people, the environment, money time, and other resources to achieve the goals of the 6. Directs willing followers. organization. 7. Have goals that may or may not reflect those of the 6. Have a greater formal responsibility and organization. accountability for rationality and control than leaders. 7. Direct willing and unwilling subordinates. Management Theories A. Scientific Management (1900-1930) Frederick Taylor also known as the “father of scientific management”. He was a mechanical engineer in the Midvale and Bethlehem Steel plants in Pennsylvania in the late 1800’s. He observed that the owners and managers of the factories knew little about what actually took place in the workshops. He believed that the system could be improved, and he looked around for an incentive. He settled on money. He believed a worker should get “a fair day’s pay for a fair day’s work”—no more, no less. He was the first to suggest that the primary functions of managers should be planning and training. Scientific management has at its heart four core principles that also apply to organizations today. They include the following: 1. Look at each job or task scientifically to determine the “one best way” to perform the job. This is a change from the previous “rule of thumb” method where workers devised their own ways to do the job. 2. Hire the right workers for each job, and train them to work at maximum efficiency. 3. Monitor worker performance, and provide instruction and training when needed. 4. Divide the work between management and labor so that management can plan and train, and workers can execute the task efficiently. B. 14 Principles of Management (1925) This theory was developed by Henri Fayol also known as the “Father of Modern Management Theory”. Fayol's 14 Principles of Management identified the skills that were needed to manage well. Created a list of the five primary functions of management, which go hand in hand with the principles. Fayol’s 14 Principles of Management 1. Division of Work. Assign each employee a task that they can become proficient at. Productivity increases as employees become more skilled, assured and efficient. 2. Authority. Managers must possess the authority to give orders and recognize that with authority comes responsibility. As well as rank, Fayol argues that a manager's intelligence, experience, and values should command respect. 3. Discipline. Everyone should follow the rules. 4. Unity of Command. Fayol wrote that an employee should receive orders from one supervisor only. Otherwise, authority, discipline, order, and stability are threatened. 5. Unity of Direction. Teams with the same objective should be working under the direction of one manager, using one plan. That, Fayol wrote, "is the condition essential to unity of action, coordination of strength and focusing of effort." Fayol’s 14 Principles of Management 6. Collective Interest Over Individual Interest. Individuals should pursue team interests over personal ones – including managers. 7. Remuneration. Employee satisfaction depends on fair remuneration for everyone, financial and non-financial. Payments and rewards should be fair. 8. Centralization. Balancing centralized decision making (from the top) with letting employees make decisions. Or as Fayol wrote, "A place for everyone and everyone in his place." 9. Scalar Chain. Employees should know where they stand in the organization's hierarchy and who to speak to within a chain of command. Fayol suggested the now-familiar organization chart as a way for employees to see this structure clearly. 10.Order. Fayol wrote that, "The right man in the right place" forms an effective social order. He applied the same maxim to materials: right one, right place. Fayol’s 14 Principles of Management 11. Equity. Managers should be fair to all employees through a "combination of kindliness and justice." Only then will the team "carry out its duties with... devotion and loyalty." 12. Stability of Tenure of Personnel. Organizations should minimize staff turnover and role changes to maximize efficiency. If people are secure and good at their jobs, they are happier and more productive. 13. Initiative. Employees should be encouraged to develop and carry out plans for improvement. As Fayol wrote, "At all levels of the organizational ladder, zeal and energy on the part of employees are augmented by initiative." 14. Esprit de Corps. Organizations should strive to promote team spirit, unity, and morale. Fayol's Five Functions of Management 1. Planning: the need "to assess the future and make provision for it." That includes a flexible action plan that considers a firm's resources, work in progress, and future market trends. 2. Organizing: laying out lines of authority and responsibility for employees. This covers recruitment and training, coordinating activities, and making employees' duties clear. 3. Commanding: getting the most from people. So, managers must know their employees' skills, delegate to tap into these skill sets, and set a good example. 4. Coordinating: in a well-coordinated organization, departments know their responsibilities, the needs of other teams, and their obligations to them. 5. Controlling: continually checking that rules, plans and processes are working as well as they should be. C. Human Relations Theory (1953) Elton Mayo and his colleagues discovered that when management paid special attention to workers, productivity was likely to increase, regardless of the working conditions. This “Hawthorne Effect” indicated that people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will continue to warrant the attention. Mayo also found that informal work groups and a socially informal work environment were factors in determining productivity, and he also recommended more employee participation in decision-making. 5 Human Relation Skills 1. Communication: Effective communication helps ensure that all employees not only are on the same page, but also feel motivated and valued in their work. This refers to in-person conversations as well as written communication such as emails and social media. 2. Conflict Resolution: When dissent arises, you must be able to take individual perspectives into account and make each person feel heard and understood. Once you’ve synthesized the presented information, you must work with all parties to come up with a solution where everyone feels comfortable moving forward. 3. Multi-tasking: A good leader must be able to manage multiple, often competing priorities at once, without missing deadlines. Another important aspect of multitasking is flexibility; as a manager, you must adapt to policy or workplace changes that affect your employees’ daily workflow. 5 Human Relation Skills 4. Negotiation: Whether there’s an employment offer to navigate, an agreement to establish between stakeholders and the company, or just opposing viewpoints to manage, negotiation happens regularly in the workplace. 5. Organization: Organization is one of the most important human relations skills, as it impacts all other areas of work. You must keep your physical workspace, as well as your workflow process, highly organized. This is especially important when you’re filing paperwork or employee records because everything must be completed correctly and on time. Staying organized is also a key part of time management and an efficient workflow. D. Systems Theory Leadership Theories Early Leadership Theories (1900-1940) A. Great Man Theory: The Great Man Theory by Thomas Carlyle, suggested that leadership traits are intrinsic, and will emerge when confronted with the appropriate situation. These individuals possess certain qualities and talents, such as deep honesty, moral vision, compassion, and care, that make them well-suited for leadership. B. Trait Theory: Similar in some ways to Great Man theories, trait theories assume that people inherit certain qualities and traits that make them better suited to leadership. Trait theories often identify a particular personality or behavioral characteristics shared by leaders. For example, traits like extroversion, self-confidence, and courage are all traits that could potentially be linked to great leaders. C. Behavioral Theory by Kurt Lewin (1940-1980) Authoritarian Leadership: Also known as autocratic leaders, provide clear expectations for what needs to be done, when it should be done, and how it should be done. Characterized by following behaviors: Strong control is maintained over the workgroup Others are motivated by coercion Others are directed with commands Communication flows downward Decision-making does not involve others Emphasis is on difference of status (I and you) Criticism is punitive C. Behavioral Theory by Kurt Lewin (1940-1980) 2. Democratic Leadership: Also known as participative leadership, where leaders offer guidance, but also allow input from other group members. Characterized by following behaviors: Less control is maintained Economic and ego awards are used to motivate Others are directed through suggestions and guidance Communication flows up and down Decision-making involves others Emphasis on “we” rather than I and you Criticism is constructive C. Behavioral Theory by Kurt Lewin (1940-1980) 3. Laisses-Faire Leadership: Also known as delegative leadership, where leaders offer little or no guidance to group members and leave the decision-making up to group members. Characterized by following behaviors: Is permissive, with little or no control Motivates by support when requested by the group or individuals Provides little or no direction Communication flows up and down between members of the group Disperses decision-making throughout the group Places emphasis on the group Does not criticize Contemporary Theories A. Emotional Intelligence All people have emotions. No matter who we are; behaviors, thoughts and actions are wound up with what we feel. Emotion is one key value people bring to organizations. This perspective is fundamental in health care organizations and plays an important role in helping professions like nursing. Nursing requires intensive emotional, physical and spiritual work, but it is also very rewarding and satisfying. Nurses have constant emotional involvement with patients and their relatives. They have to listen to their complaints and deal with helplessness, suffering and death associated issues. Tension and turmoil come within the territory of being a nurse (Calimlim, 2017). This can be done in 3 steps: 1. Emotionally intelligent leader recognizes and understands their own emotions. When a crisis occurs, the emotionally intelligent leader is able to manage their own emotions, channel them, stay calm and clear-headed, and suspend judgement until all the facts are in. 2. The emotionally intelligent leader welcomes constructive criticism, asks for help when needed, can juggle multiple demands without losing focus, and can turn problems into opportunities. 3. The emotionally intelligent leader listens attentively to others, recognizes unspoken concerns, acknowledges others’ perspectives, and brings people together in an atmosphere of respect, cooperation, and helpfulness so that they may direct their energies toward achieving the team’s goals. B. Situational Leadership The most well-known Situation Leadership Model is by Dr. Paul Heresy. This theory suggests that effective leadership depends on adapting one's leadership style to match the needs of followers and the demands of specific situations. It recognizes the importance of flexibility and adjusting leadership approaches accordingly. Instead of assuming that one particular approach works in all situations, situational theories recognize the complexity of work situations and encourage the leader to consider many factors when deciding what actions to take. Adaptability is the key to the situational approach (McNichol, 2000). B. Situational Leadership The appeal of this model is that it focuses on the task and follower. The key is to marry the readiness of the follower with the tasks at hand. Follower’s readiness levels can range from unable, willing, and insecure to able, willing, and confident. The leader’s behavior will focus on appropriately fulfilling the followers’ needs, which are identified by their readiness level and the task. Leaders’ behavior will range from telling, guiding, and directing to delegating, observing and monitoring. C. Transformational Leadership The transformational theory of leadership emphasizes that people need a sense of mission that goes beyond good interpersonal relationships or an appropriate reward for a job well done. This is especially true in nursing. Caring for people, sick or well, is the goal of the profession. Most people choose nursing in order to do something for the good of humankind; this is their vision. Transformational leaders can communicate their vision in a manner that is so meaningful and exciting that it can reduce negativity, increase staff nurse engagement, and inspire commitment in the people whom they work. D. Moral Leadership A series of highly publicized corporate scandals redirected attention to the values and ethics that underlie the practice of leadership as well as that of patient care. Moral leadership involves deciding how one ought to remain honest, fair, and socially responsible under any circumstances. Caring about one’s patients and the people who work for you as people as well as employees is part of moral leadership. This can be a great challenge in times of limited financial resources. E. Caring Leadership Caring leadership in nursing comes from two primary sources: servant leadership and emotional intelligence in the management literature and caring as a foundational value in nursing. Although it is uniquely suited to nursing leadership, it is hard to imagine any situation in which an uncaring leader would be preferred instead of a caring leader. Servant leaders choose to serve first and lead second, making sure that people’s needs within the work setting are met. Emotionally intelligent leaders are especially aware of not only their own feelings but others’ feelings as well. The following are behaviors of caring leaders: 1. They respect their co-workers as individuals. 2. They listen to other people’s opinions and preferences, giving them full consideration. 3. They maintain awareness of their own and other’s feelings. 4. They empathize with others, understanding their needs and concerns. 5. They develop their own and their team’s capacities. 6. They are competent, both in leadership and caring practice. Assignment: Contemporary Management and Leadership Theories Direction: In your own words, write an essay titled “Nursing Leadership” in which you will answer the following questions: 1. Why is important for nurses to be good leaders? 2. Review the various leadership theories discussed in this chapter. Which ones specifically apply to leading in today’s health-care environment? Support your answer with specific examples. 3. Select an individual whose leadership skills you particularly admire. What are some qualities and behaviors that this individual display? How do these relate to the leadership theories discussed in this chapter? In what ways can you emulate this person? Project for Midterms Direction: 10 minute Video, with English subtitles in the bottom of screen. Title of the video, BSN Level 4, section and group number, with all the names of the group. All background music and/ or other clips must be referenced.