Leadership and Management in Nursing PDF

SCHOOL OF ALLIED MEDICINE- NURSING DEPARTMENT UZ MAIN CAMPUS, Don Toribio Street, Tetuan, Zamboanga City 7000...

SCHOOL OF ALLIED MEDICINE- NURSING DEPARTMENT UZ MAIN CAMPUS, Don Toribio Street, Tetuan, Zamboanga City 7000 (63)(62) 991-1135 I. LEADERSHIP AND MANAGEMENT IN NURSING CONCEPTS OF LEADERSHIP & MANAGEMENT A. LEADERSHIP Definition/ Description  Although the term leader has been in use since the 1300s, the word leadership was not known in the English language until the first half of the 19th century.  Leadership occurs whenever one person attempts to influence the behavior of an individual or group—up, down, or sideways in the organization—regardless of the reason. It may be for personal goals or for the goals of others, and these goals may or may not be congruent with organizational goals. Leadership is influence (Hersey & Campbell, 2004)  Leadership is the art of motivating people to work towards a common goal. But motivating others isn’t enough. Leaders also need to connect with people. They work towards a vision through effective collaboration and communication. Leadership is defined and influenced by business goals and workplace culture. Therefore, leadership can be interpreted in different ways.  A management skill that focuses on the development and deployment of vision, mission, and strategy as well as the creation of a motivated workforce (Bitpipe 2006).  In order to lead, one must develop three important competencies: 1. Ability to diagnose or understand the situation you want to influence, 2. Adaptation in order to allow your behaviors and other resources to close the gap between the current situation and what you are hoping to achieve, and 3. Communication.  The manager is the person who brings things about—the one who accomplishes, has the responsibility, and conducts. A leader is the person who influences and guides direction, opinion, and course of action. Leadership Roles Decision maker Coach Forecaster Communicator Evaluator Counselor Teacher Critical thinker Facilitator Buffer Mentor Energizer Risk taker Advocate Visionary Influencer Role model Change agent Creative problem solver Diplomat Characteristics of a Leader a. Leaders often do not have delegated authority but obtain their power through other means such as influence. b. Leaders have a wider variety of roles than do managers.  SCHOOL OF ALLIED MEDICINE- NURSING DEPARTMENT UZ MAIN CAMPUS, Don Toribio Street, Tetuan, Zamboanga City 7000 (63)(62) 991-1135 c. Leaders may or may not be part of the formal organization. d. Leaders focus on group process, information gathering, feedback and empowering others. e. Leaders emphasizes interpersonal relationship f. Leaders direct willing followers. g. Leaders have goals that may or may not reflect those of the organization. B. MANAGEMENT Definition/ Description  The verb manage comes from the Italian maneggiare (to handle — especially tools), which in turn derives from the Latin manus (hand). The French word mesnagement (later ménagement) which means “the directing”, influenced the development in meaning of the English word management in the 17th and 18th centuries.  Organization and coordination of the activities of an enterprise in accordance with certain policies and in achievement of clearly defined objectives. Management is often included as a factor of production along with machines, materials, and money.  As a discipline, management comprises the interlocking functions of formulating corporate policy and organizing, planning, controlling, and directing the firm's resources to achieve the policy's objectives.  The task of getting results through others by coordinating their efforts is known as management. Just as the mind coordinates and regulates all the activities of a person, management coordinates and regulates the activities of various members of an organization.  Management is principally the task of planning, coordinating, motivating and controlling the efforts of others towards specific objectives.  The act of planning, organizing, staffing, direction, and controlling. Characteristics of a Manager Managers typically: a. Have assigned positions within the formal organization. b. Have a legitimate source of power due to the delegated authority that accompanies their positions. c. Are expected to carry out specific functions, duties, and responsibilities. d. Emphasizes control, decision making, decision analysis, and results. e. Manipulate people, the environment, money, time, and other resources to achieve organizational goals. f. Have greater formal responsibility and accountability for rationality and control than leaders. g. Direct willing and unwilling subordinates. UNIVERSAL PRINCIPLES OF MANAGEMENT Henri Fayol was an industrialist of the early twentieth century. He developed fourteen principles of management that are still taught today. The definition of management is taken as "The process of  SCHOOL OF ALLIED MEDICINE- NURSING DEPARTMENT UZ MAIN CAMPUS, Don Toribio Street, Tetuan, Zamboanga City 7000 (63)(62) 991-1135 coordinating and integrating work activities so that they are completed efficiently and effectively with and through other people." The principles are the universal truths of management that can be taught. The 14 Management Principles from Henri Fayol (1841-1925) are: 1. Division of Work.  Specialization allows the individual to build up experience, and to continuously improve his skills. Thereby he can be more productive.  This principle is the same as Adam Smith's 'division of labor'. Specialization increases output by making employees more efficient. A principle of work allocation and specialization in order to concentrate activities to enable specialization of skills and understandings, more work focus and efficiency. 2. Authority.  The right to issue commands, along with which must go the balanced responsibility for its function.  Managers must be able to give orders. Authority gives them this right. Note that responsibility arises wherever authority is exercised.  If responsibilities are allocated, then the post holder needs the requisite authority to carry these out including the right to require others in the area of responsibility to undertake duties.  A manager should never be given authority without responsibility--and also should never be given responsibility without the associated authority to get the work done. 3. Discipline.  Employees must obey, but this is two-sided: employees will only obey orders if management plays their part by providing good leadership.  The generalization about discipline is that discipline is essential for the smooth running of a business and without it - standards, consistency of action, adherence to rules and values - no enterprise could prosper. Employees must obey and respect the rules that govern the organization.  Good discipline is the result of effective leadership, a clear understanding between management and workers regarding the organization's rules, and the judicious use of penalties for infractions of the rules. 4. Unity of Command.  Each worker should have only one boss with no other conflicting lines of command.  The idea is that an employee should receive instructions from one superior only. This generalization still holds - even where we are involved with team and matrix structures which involve reporting to more than one boss - or being accountable to several clients.  SCHOOL OF ALLIED MEDICINE- NURSING DEPARTMENT UZ MAIN CAMPUS, Don Toribio Street, Tetuan, Zamboanga City 7000 (63)(62) 991-1135 5. Unity of Direction.  People engaged in the same kind of activities must have the same objectives in a single plan. This is essential to ensure unity and coordination in the enterprise. Unity of command does not exist without unity of direction but does not necessarily flow from it.  Each group of organizational activities that have the same objective should be directed by one manager using one plan. The unity of command idea of having one head (chief executive) with agreed purposes and objectives and one plan for a group of activities is clear. 6. Subordination of individual interest (to the general interest).  Management must see that the goals of the firms are always paramount.  Fayol's line was that one employee's interests or those of one group should not prevail over the organization as a whole. This would spark a lively debate about who decides that the interests of the organization as a whole are.  The interests of any one employee or group of employees should not take precedence over the interests of the organization. 7. Remuneration.  Payment is an important motivator although by analyzing a number of possibilities, Fayol points out that there is no such thing as a perfect system.  "The Price of Services Rendered". The general principle is that levels of compensation should be "fair" and as far as possible afford satisfaction both to the staff and the firm (in terms of its cost structures and desire for profitability/surplus). 8. Centralization (or Decentralization).  This is a matter of degree depending on the condition of the business and the quality of its personnel.  Centralization refers to the degree to which subordinates are involved in decision making. Whether decision making is centralized (to management) or decentralized (to subordinates) is a question of proper proportion. The task is to find the optimum degree of centralization for each situation. 9. Scalar chain (Line of Authority).  A hierarchy is necessary for unity of direction. But lateral communication is also fundamental, as long as superiors know that such communication is taking place.  Scalar chain refers to the number of levels in the hierarchy from the ultimate authority to the lowest level in the organization. It should not be over-stretched and consist of too- many levels.  The scalar chain of command of reporting relationships from top executive to the ordinary shop operative or driver needs to be sensible, clear and understood.  SCHOOL OF ALLIED MEDICINE- NURSING DEPARTMENT UZ MAIN CAMPUS, Don Toribio Street, Tetuan, Zamboanga City 7000 (63)(62) 991-1135  The line of authority from top management to the lowest ranks represents the scalar chain. Communications should follow this chain. However, if following the chain creates delays, cross-communications can be allowed if agreed to by all parties and superiors are kept informed. 10. Order.  Both material order and social order are necessary. The former minimizes lost time and useless handling of materials. The latter is achieved through organization and selection.  People and materials should be in the right place at the right time. The level of generalization becomes difficult with this principle. Basically, an organization "should" provide an orderly place for each individual member - who needs to see how their role fits into the organization and be confident, able to predict the organizations behavior towards them. Thus policies, rules, instructions and actions should be understandable and understood.  Orderliness implies steady evolutionary movement rather than wild, anxiety provoking, unpredictable movement. 11. Equity.  In running a business, a “combination of kindliness and justice” is needed. Treating employees well is important to achieve equity.  Equity, fairness and a sense of justice "should" pervade the organization - in principle and practice. Managers should be kind and fair to their subordinates. 12. Stability of Tenure of Personnel.  Employees work better if job security and career progress are assured to them. An insecure tenure and a high rate of employee turnover will affect the organization adversely.  High employee turnover is inefficient. Management should provide orderly personnel planning and ensure that replacements are available to fill vacancies. Time is needed for the employee to adapt to his/her work and perform it effectively. Stability of tenure promotes loyalty to the organization, its purposes and values. 13. Initiative.  Allowing all personnel to show their initiative in some way is a source of strength for the organization. Even though it may well involve a sacrifice of 'personal vanity' on the part of many managers.  Employees who are allowed to originate and carry out plans will exert high levels of effort. At all levels of the organizational structure, zeal, enthusiasm and energy are enabled by people having the scope for personal initiative.  SCHOOL OF ALLIED MEDICINE- NURSING DEPARTMENT UZ MAIN CAMPUS, Don Toribio Street, Tetuan, Zamboanga City 7000 (63)(62) 991-1135 14. Esprit de Corps.  Management must foster the morale of its employees. He further suggests that: "real talent is needed to coordinate effort, encourage keenness, use each person's abilities, and reward each one's merit without arousing possible jealousies and disturbing harmonious relations."  Here Fayol emphasizes the need for building and maintaining harmony among the work force, teamwork and sound interpersonal relationships. Promoting team spirit will build harmony and unity within the organization. NURSING MANAGEMENT  Is performing leadership functions of governance and decision-making within organizations employing nurses. It includes processes common to all management like planning, organizing, staffing, directing and controlling.  It is common for RNs to seek additional education to earn a Master of Science in Nursing or Doctorate in Nursing to prepare for leadership roles within nursing. Management positions increasingly require candidates to hold an advanced degree in nursing. “NURSING IS A CALL TO LEADERSHIP” By its very nature, the professional nurse role is one of leadership. Across the healthcare continuum, regardless of our role or practice setting, we are looked to as leaders. As nursing students, we are taught we will lead colleagues from other ancillary groups, oversee care teams and be accountable for patient care outcomes. Some nurses spend years leading in an informal leadership capacity, while others take on formal management and leadership roles. However, all management and leadership roles are not the same, and although the titles often are used interchangeably, they are not synonymous. THE NURSE LEADER ROLE UP CLOSE Upper-level nurse leaders, in most instances, are less task-oriented than nurse managers. They are less hands-on and more focused on setting standards, spearheading transformation and inspiring and influencing their teams. They are charged with fulfilling the organization’s mission, vision and strategic long-range plans. Their role involves: policy setting and overseeing quality measures; dealing with regulatory compliance,  SCHOOL OF ALLIED MEDICINE- NURSING DEPARTMENT UZ MAIN CAMPUS, Don Toribio Street, Tetuan, Zamboanga City 7000 (63)(62) 991-1135 taking on fiscal (economic) responsibilities responsibility and accountability for the overall quality of patient care delivery, patient and staff satisfaction, and organizational outcomes. Both staff and management look to them for their knowledge, experience and vision. Their role is an expansive one that touches the entire organization. THE NURSE MANAGER ROLE UP CLOSE Whether managing a unit, division or service line, at its core the nurse manager role is to ensure everything functions like a well-oiled machine. The nurse manager is involved in myriad daily tasks and details related to patient care planning, quality improvement, goal setting and budgeting. Nurse Managers also oversee staff schedules and assignments, performance, professional growth and the ongoing provision of educational and career enhancement opportunities. The manager is responsible for ensuring the staff carries out all assignments and is held accountable if they’re not. And staff members — nurses, CNAs, techs, etc. — have certain expectations for their nurse managers: They look to their managers for clear communication, direction and support in fulfilling their roles and responsibilities. They also want their managers to be available, open and honest. Nurse Managers are their source for information, advice and guidance, but they also want — and deserve — encouragement, clear expectations and directions, and some teaching and coaching. Most of all, they want to be included in decision-making, recognized for their contributions and considered important to the team. “Nurse Managers are their source for information, advice and guidance, but they also want — and deserve — encouragement, clear expectations and directions, and some teaching and coaching.” MANAGERS AND LEADERS COMPLEMENT EACH OTHER Managers function best in the company of good leaders, but both roles should be filled by individuals, who earn the respect and admiration of their staff, are passionate about their work and instill that passion in their staff. Both managers and leaders: ❖ Must be motivators who positively influence their staff and set positive examples. ❖ Must have excellent decision-making skills and should be able to coordinate teams and delegate duties. ❖ Must be committed to the organization and those they lead.  SCHOOL OF ALLIED MEDICINE- NURSING DEPARTMENT UZ MAIN CAMPUS, Don Toribio Street, Tetuan, Zamboanga City 7000 (63)(62) 991-1135 Title aside, ALL NURSES ARE CALLED TO LEADERSHIP The call to leadership moves all of us to a higher plane of responsibility and accountability, with or without a management title; it is inherent in all nursing positions from staff nurse to Chief Nurse. We all have similar goals and responsibilities for patient care. With all the changes currently underway in our healthcare delivery system and the nursing profession, all nurses must strive to emulate the hallmarks of good management and leadership and never stop working on our professional growth. We all need to stay informed and be politically savvy; we need to know what our professional journals and nursing organizations are saying and advance our education. In the end, all nurses must be visionaries, critical thinkers, skilled communicators and teachers. And the good news is you do not need a formal manager or leader title required to do any of these things. LEADERS VS MANAGERS “Leadership and managership are two synonymous terms” are an incorrect statement. Leadership doesn’t require any managerial position to act as a leader. On the other hand, a manager can be a true manager only if he has got the traits of leader in him. By virtue of his position, the manager has to provide leadership to his group. A manager has to perform all five functions to achieve goals, i.e., Planning, Organizing, Staffing, Directing, and Controlling. Leadership is a part of these functions. Leadership as a general term is not related to managership. A person can be a leader by virtue of qualities in him. For example: leader of a club, class, welfare association, social organization, etc. Therefore, it is true to say that “All managers are leaders, but all leaders are not managers.” A leader is one who influences the behavior and work of others in group efforts towards achievement of specified goals in each situation. On the other hand, manager can be a true manager only if he has got traits of leader in him. Managers at all levels are expected to be the leaders of work groups so that subordinates willingly carry instructions and accept their guidance. A person can be a leader by virtue of all qualities in him. Leaders and Managers can be compared on the following basis: Basis Manager Leader A person becomes a manager by A person becomes a leader on basis of Origin virtue of his position. his personal qualities. Manager has got formal rights in an Formal Rights Rights are not available to a leader. organization because of his status. The subordinates are the followers of The group of employees whom the Followers managers. leader’s leads are his followers.  SCHOOL OF ALLIED MEDICINE- NURSING DEPARTMENT UZ MAIN CAMPUS, Don Toribio Street, Tetuan, Zamboanga City 7000 (63)(62) 991-1135 A manager performs all five functions Leader influences people to work Functions of management. willingly for group objectives. A leader is required to create cordial A manager is very essential to a Necessity relation between person working in and concern. for organization. Stability It is more stable. Leadership is temporary. Mutual All managers are leaders. All leaders are not managers. Relationship Manager is accountable for self and Leaders have no well-defined Accountability subordinates’ behavior and accountability. performance. A manager’s concern is A leader’s concern is group goals and Concern organizational goals. member’s satisfaction. People follow manager by virtue of Followers People follow them on voluntary basis. job description. A manager can continue in office till Role A leader can maintain his position only he performs his duties satisfactorily in continuation through day to day wishes of followers. congruence with organizational goals. A leader has command over different Manager has command over sanctions and related task records. Sanctions allocation and distribution of These sanctions are essentially of sanctions. informal nature. Prepared by: Annabelle B. Ruiz Instructor