2023 Nursing Leadership Lecture PDF

2023 NURSING LEADERSHIP Nursing Leadership, Management and Professional Adjustment- NCM 119 Lecture Transcripted by Cruz, Larraine Jhasmine D. [email protected]  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E...

2023 NURSING LEADERSHIP Nursing Leadership, Management and Professional Adjustment- NCM 119 Lecture Transcripted by Cruz, Larraine Jhasmine D. [email protected]  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 Module 1 goals), delegating, and following up on Leadership and responsibilities They can work inside the Management office and delegate tasks and still achieve the organizational goals What is the first thing that comes to mind when you hear There’s a cut-off time, the word leader? Most of the time we dread to hear this word. We anticipate with great apprehension and fear paper, and any related when we are assigned as leaders. Why? Level 4 students, materials involved in the are you ready to be one? In this course, you will be transaction prepared to become a nurse leader/manager. Before you It is true that not all managers can lead but leave the 4 walls of Centro Escolar University we want to in nursing, all nurses must possess both make sure you have acquired the good qualities of being a leadership and management skills to Leader. achieve the common goals ANA said that Nursing leadership is one of the single ○ Nurses cannot stay in the four most important factors in motivating and inspiring nurses. corners of the office because what The ANA Leadership Institute describes a nurse leader as they care for is the lives of the “a nurse who is interested in excelling in a career path, a leader within a healthcare organization who represents the patients interests of the nursing profession, a seasoned nurse or ○ Leading your people; all patients healthcare administrator interested in refining skills to must be taken care of and all differentiate them from the competition or to advance to medical processes must be done the next level of leadership.” effectively and holistically According to Marquiz, the relationship between leadership and management continues to prompt some Management debate, although there clearly is a need for both. Leadership is viewed by some as one of management’s According to the book Effective Leadership and many functions; others maintain that leadership requires Management in Nursing, today, all nurses are managers. more complex skills than management and that Whether you work in a freestanding clinic, an management is only one role of leadership. Still, others ambulance-Top 8 Career Options In Nursing Field - suggest that management emphasizes control—control of CareerGuidetory surgical center, a critical unit in an acute hours, costs, salaries, overtime, use of sick leave, care hospital, or in hospice care for a home care agency, inventory, and supplies—whereas leadership increases you must deal with staff, including other nurses and productivity by maximizing workforce effectiveness. unlicensed assistive personnel, who work with you and for you. At the same time, you must be vigilant about Leadership vs costs. To manage well, you must understand the healthcare system and the organizations where you work. Management You need to recognize what external forces affect your work and how to influence those forces. You need to Can all leaders manage? know what motivates people and how you can help create ○ No. Leaders are made while an environment that inspires and sustains the individuals managers are elected who work in it. You must be able to collaborate with others, as a leader, a follower, and a team member, in Can all managers lead? order to become confident in your ability to be a leader ○ Why can managers still strive even and a manager. without leadership skills? Because they are good at Wikipedia states that the term management comes from the old French term menagement which means "the planning, choosing people directing" and from the Latin term manu agere, which whom they hire and work means "to lead by the hand." Both word origins imply with (the right people who that management is the process of leading and directing can do objectives and 1  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 all or part of an organization, often a business, through Maintains personal credibility with subordinates the deployment and manipulation of resources. Serves as a role model of the empowered nurse Management is indeed: Managers in the hospital have 2 functions: a process ○ Administrative universal All paperwork and office occurs in organizations work requires getting things done through people Monthly reports involves acting in a goal directed manner Budget reports involves the attempt to accomplish tasks Medical errors managerial excellence requires commitment Division of nursing Managers are: meetings Have an assigned position within the formal ○ Clinical organization Taking care of the patients Have a legitimate source of power due to the (all patients) delegated authority that accompanies their The priority responsibility position Ensure all staff nurses are Are expected to carry out specific functions, duties, and responsibilities complete and efficient with Emphasize control, decision making, decision 1:1 ratio of nurse and analysis, and results patient Manipulates people, the environment, money, Staff nurses still also lead in terms of all the time, and other resources to achieve junior nurses, staff under them, the patients, organizational goals and their s/o. Have a greater formal responsibility and accountability for rationality and control than Commonly there is no charge nurse, leaders commonly it is the most senior nurse on the Direct willing and unwilling subordinates shift especially if the unit nurse manager is not around Mangagement is: The manipulation of people, the environment, money, time, and other resources to reach Leaders Managers organizational goals To forecast and plan, to organize and to Often do not Are always command, to coordinate, and to control (Fayol) have delegated assigned a The creation of an internal environment in an authority, but position within enterprise in which individuals work together as obtain their an organization. power through Have a a group other means. legitimate source Now more than ever, there is a greater emphasis on the Have a wider of power due to business of health care, with managers being involved in variety of roles the delegated the financial and marketing aspects of their respective than managers. authority that Are frequently accompanies departments. not part of the their position. Management functions: formal Are expected to organization. carry out specific Uses authority to ensure that organizational Focus on group functions. goals are met process, Emphasize Uses political strategies that are complementary information control, decision to the unit and organization's functioning gathering, making, decision Builds a power base adequate for the assigned feedback, and analysis, and management role empowering results others. Maintains a small authority-power gap Is knowledgeable about the essence and Whereas management emphasizes control—control of appropriate use of power hours, costs, salaries, overtime, use of sick leave, 2  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 inventory, and supplies— Leadership increases coordination, and control. Luther Gulick (1937) expanded productivity by maximizing workforce effectiveness on Fayol’s management functions in his introduction of the “seven activities of management”—planning, Theories of Management organizing, staffing, directing, coordinating, reporting, I. Scientific Management (1900 to 1930) and budgeting—as denoted by the mnemonic POSDCORB. Although often modified (either by A. Frederick W. Taylor, the “father of scientific including staffing as a management function or renaming management,” was a mechanical engineer in the Midvale elements), these functions or activities have changed little and Bethlehem Steel plants in Pennsylvania in the late over time. Eventually, theorists began to refer to these 1800s. Frustrated with what he called “systematic functions as the management process. soldiering,” where workers achieved minimum standards doing the least amount of work possible, Taylor 1. Planning encompasses determining philosophy, goals, postulated that if workers could be taught the “one best objectives, policies, procedures, and rules; carrying out way to accomplish a task,” productivity would increase. long- and short-range projections; determining a fiscal Borrowing a term coined by Louis Brandeis, a colleague course of action; and managing planned change. of Taylor’s, Taylor called these principles scientific 2. Organizing includes establishing the structure to carry management. The four overriding principles of out plans, determining the most appropriate type of scientific management as identified by Taylor (1911) are patient care delivery, and grouping activities to meet unit the following: goals. Other functions involve working within the 1. Traditional “rule of thumb” means of structure of the organization and understanding and using organizing work must be replaced with scientific power and authority appropriately. methods. In other words, by using time and 3. Staffing functions consist of recruiting, interviewing, motion studies and the expertise of experienced hiring, and orienting staff. Scheduling, staff development, workers, work could be scientifically designed to employee socialization, and team building are also often promote greatest efficiency of time and energy. included as staffing functions. 2. A scientific personnel system must be 4. Directing sometimes includes several staffing established so that workers can be hired, trained, functions. However, this phase’s functions usually entail and promoted based on their technical human resource management responsibilities, such as competence and abilities. Taylor thought that motivating, managing conflict, delegating, each employee’s abilities and limitations could communicating, and facilitating collaboration. be identified so that the worker could be best matched to the most appropriate job. 5. Controlling functions include performance appraisals, fiscal accountability, quality control, legal and ethical 3. Workers should be able to view how they control, and professional and collegial control. “fit” into the organization and how they contribute to overall organizational productivity. Human Relations Management (1930 to 1970) This provides common goals and a sharing of the organizational mission. One way Taylor thought A. Mary Parker Follett (1926) was one of the first that this could be accomplished was by the use theorists to suggest basic principles of what today would of financial incentives as a reward for work be called participative decision-making or participative accomplished. Because Taylor viewed humans management. In her essay “The Giving of Orders,” Follett as “economic animals” motivated solely by espoused her belief that managers should have authority money, workers were reimbursed according to with, rather than over, employees. Thus, solutions could their level of production rather than by an hourly be found that satisfied both sides without having one side wage. dominate the other. The human relations era also attempted to correct what was perceived as the major 4. The relationship between managers and shortcoming of the bureaucratic system—a failure to workers should be cooperative and include the “human element.” interdependent, and the work should be shared equally. Their roles, however, were not the same. B. Elton Mayo Studies done at the Hawthorne Works of The role of managers, or functional foremen as the Western Electric Company near Chicago between they were called, was to plan, prepare, and 1927 and 1932 played a major role in this shifting focus. supervise. The worker was to do the work. The studies, conducted by Elton Mayo and his Harvard associates, began as an attempt to look at B. Henri Fayol (1925) first identified the management functions of planning, organization, command, 3  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 the relationship between light illumination in the factory relations approach to management was not without its and productivity. Mayo and his colleagues discovered that problems. Most people continued to work in a when management paid special attention to workers, bureaucratic environment, making it difficult to always productivity was likely to increase, regardless of the apply a participatory approach to management. The environmental working conditions. This Hawthorne effect human relations approach was time-consuming and often indicated that people respond to the fact that they are resulted in unmet organizational goals. In addition, not being studied, attempting to increase whatever behavior every employee liked working in a less structured they feel will continue to warrant the attention. Mayo environment. This resulted in a greater recognition of the (1953) also found that informal work groups and a need to intertwine management and leadership than ever socially informal work environment were factors in before. determining productivity, and Mayo recommended more employee participation in decision making. II. Motivational Theories C. Douglas McGregor (1960) reinforced these ideas by A motive is a need or desire that incites and directs a theorizing that managerial attitudes about employees person's actions. Motivation according to Mills, is a force (and, hence, how managers treat those employees) can be within the individual that influences strength or direction directly correlated with employee satisfaction. He labeled of behavior. this Theory X and Theory Y. Kinds of Motivation Theory X managers believe that their 1. Intrinsic motivation comes from within the employees are basically lazy, need constant person driving him to be more productive. A supervision and direction, and are indifferent to worker must value his/her performance to be organizational needs. intrinsically motivated. Intrinsic motivation to Theory Y managers believe that their workers achieve is directly related to a person's enjoy their work, are self-motivated, and are aspirations and goals in life shaped earlier on by willing to work hard to meet personal and parents and peers. organizational goals. 2. Extrinsic motivation is enhanced by the environment or external rewards. This may come in the form of promotions, increases in salary, added benefits, or external rewards. D. Chris Argyris (1964) supported McGregor (1960) and Mayo (1953) 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 A. Abraham’s Theory of Needs human relations era of management science brought about a great interest in the study of workers. Many sociologists and psychologists took up this challenge, and their work in management theory contributed to our understanding of worker motivation. By the late 1960s, however, there was growing concern that the human 4  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 1. The need for achievement is a strong desire to overcome challenge, to excel, to grow, to advance, or to succeed. 2. The need for power is the desire to be in control and to get others to behave contrary to what they would naturally do.. 3. The need for affiliation is the desire to work in a pleasant environment and the desire for friendly, close relationships. It is a desire to relate to people David McClelland (1961; 1976) identifies three basic needs theory 1. The need for achievement is a strong desire to overcome The first level of these needs includes challenge, to excel, to grow, to advance, or to physiological succeed. 2. The need for power is the desire to The second level is safety, security, and be in control and to get others to behave contrary protection needs. to what they would naturally do.. 3. The need for The third level is the need to belong which affiliation is the desire to work in a pleasant relates to affiliation or sense of belonging, environment and the desire for friendly, close affection, closeness, and intimacy. These are relationships. It is a desire to relate to people social needs D. Victor Vroom's expectancy theory of human The fourth level is esteem and ego needs. These motivation are needs to achieve independence, respect, and recognition from others. Indicates that felt needs of individuals in work At the apex of the pyramid is the need for settings are increased if a person perceives selfactualization-the need to maximize one's positive relationship between effort and potential and achieve a sense of personal performance. fulfillment, competence, and accomplishment Motivated behavior is further increased if there is positive relationship between good B. Frederick Herzberg (1991)’s two-factor theory of performance and outcomes or rewards motivation. particularly when these are valued. Hygiene factors relate to the working conditions E. B.F. Skinner's Operant Theory such as salary, quality of supervision, job security, interpersonal relations policies, and 1. Respondent behavior results from direct supervision. These hygiene factors are called stimulation. "dissatisfiers." 2. Operant behavior occurs in the absence of any Motivating factors relate to the job itself and apparent external stimulation. When followed by include opportunities for growth and consequences that increase or decrease the development and advancement; added likelihood of these behaviors' recurrence, the responsibilities, challenging aspects of work, consequence is termed a "reinforcer." A recognition, and achievement. These factors are reinforcer may be positive or negative. A called "satisfiers." positive reinforcer increases the probability that the behavior will be repeated. A negative reinforcer is a consequence that if removed, increases the probability that the behavior will be repeated. C. David McClelland (1961; 1976) identifies three basic needs theory 5  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 Harbizon and Myers offer a classic three-fold concept of management Economic resource - management is one of the factors of production together with land, labor and capital.. System of authority - management first develops with top individuals determining the course of action for the rank and file. An elite class – from a sociologists' point of view, management is a class and status system. Managers have become an elite group of brains and education. Entrance to this class is based on education and knowledge. F. Jo Stacy Adams (1960) perceptions of equity and Role of Managers inequity theory. The interpersonal role They found that employees assess fairness by ○ A symbol because of the position considering their input and the psychological, he/she occupies and consists of such social and financial rewards in comparison with duties as signing of papers/documents those of others. required by the organization; Perceived inequity causes tension which is found ○ A leader who hires, trains, encourages, to be proportioned to the magnitude of the fires, remunerates, and judges; and perceived tension. These feelings motivate an ○ A liaison between outside contacts such employee to resolve the inequity by reducing as the community, suppliers, and the input, changing 'the basis of comparison or by organization. resigning. If the comparison is equal, the person The informational role feels he/she is treated fairly. ○ one who monitors information, A manager should be attentive to he perceived ○ one who disseminates information from equity of the reward system. both external and internal sources, and ○ a spokesperson or representative of the organization. The decisional rol ○ an entrepreneur or innovator, problem discoverer, a designer to improve projects that direct and control change in the organization; ○ a trouble-shooter who handles unexpected situations such as resignation of subordinates, firing of subordinates, and losses of clients; and ○ as negotiator when conflicts arise Developing Future Managers Management Levels in Nursing Managerial development programs ○ Technical skills relate to the proficiency in performing an activity in the correct manner with the right technique. ○ Human relationship skills pertain to dealing with people and how to "get along" with them ○ Conceptual skills deal with the ability to see individual matters as they relate to the total picture and to develop creative ways of identifying pertinent 6  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 factors, responding to the big problems, Controlling and discarding irrelevant facts. Includes performance appraisals, fiscal accountability, Knowledge, attitude, and ability factors. quality control, legal and ethical control, and ○ Knowledge factors refer to ideas, professional and collegial control concepts, or principles that can be expressed and are accepted because they have logical proofs. ○ Attitude factors relate to those beliefs, feelings, and values that may be based on emotions and may not be subjected to conscious verbalization. ○ Ability factors include skill, art, judgment, and wisdom. These are abstract factors but they direct one's thinking to factors that can be developed by the individual manager who takes time to consider them. Management Process The management process is universal. It is used in business, in the practice of one's profession Leadership and even in running one's dayto-day personal affairs. A vital component of change (Bednash, ○ Planning 2003) ○ Organizing The process of persuasion and example by ○ Staffing which an individual (or leadership team) ○ Directing induces a group to pursue objectives held by ○ Controlling the leader or shared by the leader and his or her followers (Gardner, 1990) The art of getting work done through others Planning willingly Encompasses determining philosophy, goals, objectives, policies, procedures, and rules; carrying out “A job title alone does not make a person a leader.” long- and shortrange projections; determining a fiscal Leadership Roles course of action; and managing planned change Decision maker Communicator Organizing Includes establishing the structure to carry out plans, Evaluator determining the most appropriate type of patient care Facilitator delivery, and grouping activities to meet unit goals. Risk-taker Other functions involve working within the structure of the organization, and understanding and using power Energizer and authority appropriately Mentor Critical Thinker Staffing Buffer Consists of recruiting, interviewing, hiring, and orienting staff. Scheduling, staff development, Advocate employee socialization, and team building are also Coach often included as staffing functions. Counselor Teacher Directing Usually entails human resource management Forecaster responsibilities, such as motivating, managing conflict, Visionary delegating, communicating, and facilitating Influencer collaboration Creative Problem Solver Change Agent 7  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 Diplomat If your people love Role Model you, support you, Leadership Skills and respect you. Skills in personal behavior - This requires Theories of Leadership sensitivity to the feelings of others, Trait theories identification with the needs of the group, ○ Great Man Theory acceptance of other people's suggestion The Great Man theory, from Aristotelian philosophy, rather than criticizing or ridiculing them and asserts that some people are born to lead whereas helping others feel important and needed. others are born to be led. It also suggests that great Communication skills - This means the leaders will arise when the situation demands it. ability to listen attentively to the opinions of ○ Assume that some people have others, establish positive communication certain characteristics or personality within group and make sure everyone traits that make them better leaders understands what are expected of them. It than others. also includes getting feedback from ○ Trait theory is based on the belief followers and recognizing that everyone that leaders are born with certain may have important contributions to make. qualities that properly develop to Organization skills - This includes enable them to be successful leaders willingness to assist the group in making ○ Classification of Trait Theory short and long-range plans and objectives; Physical characteristics – sharing responsibilities and opportunities; age, built, height, weight, implementing plans, follow-up and bearing evaluating results, and participating in Background information – problem-solving. education, social status, Skills in self-analysis - This means experience. awareness of personal motivations of own Intelligence – knowledge, strengths and weaknesses and willingness to judgment, ability improve them. It also includes assisting the Personality – decisiveness, group in recognizing and utilizing the authority, extroversion, Filipino values essential to caring for their alertness, aggressiveness, patients. enthusiasm, independence, Essential Leadership Skills self-confidence. The nurse leader should have Task-oriented ○ Intellectual, technical, and characteristics – administrative skills; persistence, responsibility, ○ Integrity, honesty, ability to work achievement, initiative with others; Social characteristics – ○ Tact and emotional stability; supervisory, activity, Learn to calm thyself even popularity, prestige, tact, in undesirable situations diplomacy. Stay composed at all times Behavioral Theories ○ Ability to win the support and Kurt Lewin, Ralph K. White and Ronald Lippit ( loyalty of fellow-workers; and 1960) isolated the common leadership styles such as ○ Good human relationships with authoritarian, democratic, and laissez-fair co-workers. leadership. For some time, theorist believed that How will you know that leaders had a predominant leadership style and used you will be an effective it consistently. leader and/or manager? ○ The Autocratic Leader 8 Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 Strong control is maintained actions and decisions. The over the work group. manager may also become Others are motivated by dependent on his/her coercion. coordinates Others are directed with ○ The Laissez-Faire Leader commands. Is permissive, with little or Communication flows no control. downward. Motivates by support when Decision-making does not requested by the group or involve others. individuals. Emphasis is on differences Provides little or no in status ("I" and "you"). direction. Criticism is punitive. Left alone to self All directions are from the direct leader; no opinions, no Not appropriate for suggestions the nursing unit Everything is ordered; because there are listen and do the work numerous new Disadvantage: the team is guidelines and paralyzed without you techniques because of lack of decision Uses upward and downward making responsibility and communication between skills members of the group Appropriate for emergency Disperses decision making clinical cases or situations throughout the group. ○ The Democratic Leader Places emphasis on the The leader manager asks for group. suggestions and comments; Does not criticize collaborative decisions Only good if the Less control is maintained. subordinates are: Economic and ego awards Goal driven are used to motivate. Independent Others are directed through Experts suggestions and guidance. Dependables Communication flows up and down (upward and Situational Leadership Theories downward) There are five kinds of leaders under this theory Decision-making involves ○ The natural leader who becomes a others. leader inspite of himself or herself. Emphasis is on "we" rather He or she does not seek the role but than "I" and "you." tie group thrusts the leadership upon Good for building him/her by the tide of events. relationships with ○ The charismatic leader who is an staffers authentic hero in the eyes of his Criticism is constructive. followers. To them he/she can do no Disadvantage: The wrong. He/ She inspire people to decision is always delayed; make sacrifices for the cause they not good for immediate represent. 9  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 ○ The rational leader who is environment was an open system to consistent and persistent in what which they responded. A system he/she thinks is right. may be defined as a set of objects, ○ The consensus leader who is with relationships between the perceived to be acceptable to all. objects and between their attributes. He/ She rises in the absence of the ○ Hollander (1978) was among the above three. first to recognize that both leaders ○ The coercive leader who dominates and followers have roles outside of by force and fear. the leadership situation and that Hersey and Blanchard (1977) also developed a both may be influenced by events situational approach to leadership. Their occurring in their other roles. tridimensional leadership effectiveness model Hollander (1978) saw leadership as predicts which leadership style is most appropriate a dynamic two-way process. in each situation based on the level of the followers' According to Hollander, a maturity. As people mature, leadership style leadership exchange involves three becomes less task focused and more relationship basic elements: oriented. The leader, including his or Tannenbaum and Schmidt (1958) built on the her personality, perceptions, work of Lewin and White, suggesting that managers and abilities need varying mixtures of autocratic and democratic The followers, with their leadership behavior. They believed that the primary personalities, perceptions, determinants of leadership style should include the and abilities nature of the situation, the skills of the manager, and The situation within which the abilities of the group members. the leader and the followers Contingency Leadership Theories function, including formal ○ Knight Fiedler's (1967) contingency and informal group norms, approach reinforced these findings, size, and density suggesting that no one leadership ○ Goleman, Boyatzis, and McKee style is ideal for every situation. (2002) suggest that followership is ○ Fiedler felt that the actually the mirror image of interrelationships between the leadership. With leader and follower group's leader and its members were contributing to the working most influenced by the manager's relationship and both receiving ability to be a good leader. something from it. ○ The task to be accomplished and the ○ Kanter (1977), who developed the power associated with the leader's theory that the structural aspects of position also were cited as key the job shape a leader's variables. effectiveness. She postulated that Interactional Leadership Theories the leader becomes empowered ○ The basic premise of interactional through both formal and informal theory is that leadership behavior is systems of the organization. generally determined by the The three major work empowerment relationship between the leader's structures within the organization personality and the specific are opportunity, power, and situation. proportion. Kanter asserts that these ○ Schein (1970) was the first to work structures have the potential to propose a model of humans as explain differences in leader complex beings whose working 10 Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 responses, behaviors, and attitudes ○ William Ouchi Theory Z: in the work environment. Characteristics ○ Nelson and Burns (1984) consensus decision making suggested that organizations and fitting employees to their their leaders have four jobs developmental levels and that these job security levels influence productivity and slower promotions worker satisfaction. examination of the Reactive Level. The long-term consequences of reactive leader focuses on management decision the past, is crisis driven, and making is frequently abusive to quality circles subordinates guarantee of lifetime Responsive Level. The employment leader is able to mold establishment of strong subordinates to work bonds of responsibility together as a team, although between superiors and the leader maintains most subordinates decision-making a holistic concern for the responsibility. workers Proactive Level. The leader Transactional Leadership and followers become more ○ Focuses on management tasks future oriented and hold ○ Is a caretaker common driving values ○ Uses trade-offs to meet goals ○ Brandt's (1994) interactive ○ Does not identify shared values leadership model suggests that ○ Examines causes leaders develop a work environment ○ Uses contingency reward that fosters autonomy and creativity Transformational Leadership through valuing and empowering ○ Identifies common values followers. This leadership "affirms ○ Is committed the uniqueness of each individual," ○ Inspires others with vision motivating them to "contribute their ○ Has long-term vision unique talents to a common goal." ○ Looks at effects ○ Wolf, Boland, and Aukerman ○ Empowers others (1994) also emphasized an ○ Bass (1985) has described interactive leadership model in their transformational leaders in terms of creation of a collaborative practice charisma, inspirational leadership , matrix. This matrix highlights the individualized consideration , and framework for the development and intellectual stimulation Warren ongoing support of relationships ○ Bennis and Burt Nanus (1985) between and among professionals indicate that leaders do the right working together. things, whereas managers do things ○ Manojlovich's (2005) research right. Leaders focus on suggested that nurses may be able to effectiveness, managers deal with practice more professionally when efficiency Bennis and Nanus they perceive that their unit leaders identify four strategies for taking have strong leadership skills. charge: attention through vision 11 Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 meaning through He also identifies six core communication functions of leaders trust through positioning valuing deployment of self Visioning ○ James Kouzes and Barry Posner coaching (1987, 1990) identify five basic empowering practices and 10 specific behavior Team-building that leadership involves promoting quality challenging the process by Barriers to Communication searching for opportunities Physical Barriers and experimenting and ○ Use clear short sentences and faicng taking risks individual will improve the potential inspiring a shared vision by for the message to be received envisioning the future and ○ Use hearing aids if their is a hearing enlisting others impairment enabling others to act by ○ If visually impaired, announce your fostering collaboration and presence, touch as appropriate and strengthening others expain sounds or noises to the modeling the way by setting person example and planning small ○ Encourage patience, allowing them wins to take their time, or use of gestures encouraging the heart by to facilitate communication recognizing individual Psychological Barriers contributions and ○ Attitudes, prejudices and personality celebrating can get in the way of effective accomplishments communication. ○ Bernard Bass and Bruce Avolio ○ Judging others based on appearance, (1993) indicate that lifestyle or socioeconomic status transformational leaders change the ○ Stereotyping others such as “dumb organization’s culture with new blonde”, “computer nerd” or vision and revision of assumptions, “geezer” can negatively affect the values and norms They identify four communication process. components that characterize Cultural Barriers transformational leaders: ○ Culture is a values, belief, customs, idealized influence and attitudes shared by a group of inspirational motivation people. It lets us interpret the intellectual stimulation environment and behave individualized consideration appropriately. ○ William Hitt (1993) defines Attitudes and behaviors leadership as affecting people so ○ Giving opinions may tell the other that they will strive willingly toward person that you are judging his or group goals He identifies five types her values. of knowledge needed by a leader: ○ Silence have meanings. It may mean knowing self acceptance, fear or the time to think. knowing the job Talking when others are silent is knowing the organization usually due to nervousness. knowing the business and functions of leaders 12  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 ○ Changing the subject is sometimes Understanding your strengths and the done when the topic becomes strengths of others is a key to effective uncomfortable. leadership. Principles for Effective Leadership Strive for excellence Have a dream that will leave this world a ○ The people you want to influence better place will not rise to a higher standard of ○ "is there anything worse then being excellence than what they observe blind? Yes The most pathetic person in you in the whole world is someone who ○ The authors of megatrends for has sight but has no vision." so said women write., "male or female. the Helm Keller effective leader wins commitment ○ Leadership is simply the ability to by setting an example of excellence turn a dream or a vision of a desired ○ We wanted to influence leaders and future state into a reality with and we had to do things right, not only through the cooperation other do the right things. Leaders must people. To throw your life into strive for excellence something worthwhile, your dream ○ Strive for excellence and you will must be worth dying for. motivate others to do the same Have a big vision; something beyond your Be persistent capabilities to keep you challenged If we ○ Mother Teresa was a determined have aimed our efforts for this moment woman Margaret thatcher was a onlyfor ourselves, for the accumulation of determined woman The key to material things, for pleasure-we will soon being a good leader is become dissatisfied and disillusioned with endurance-being a non-quitter and life. be encouraged to quit by those who Former british prime minister margaret are friends and enemies. Be willing thatcher said, "there is little hope for to throw in the towel. Be democracy if the hearts of men and women determined. cannot be touched by a call to something ○ In order to leave this world a greater than themselves.“ different place, you have to be Have a dream and vision that is greater than persistent. Leaders don't grow in a yourself--one that will leave this world a comfort zone. Leaders are not better place. people with exceptional talent; they ▪ Know what your strengths are are people who have learned from ○ We need to surround ourselves with their mistakes and get up and try people to fill in our gaps. again. ▪ Persistence is a key to Seventynine year-old muriel tower, effective leadership an experienced entrepreneur, said. Be willing to stand alone "you get things done through other ○ If you have a passion, a dream or a people. Number one in business is mission, set measurable goals and get the best person for the job. work toward accomplishing them Number two, delegate. Number You will find that many times you three, supervisego back and see that may have to work Alone You will they did it.“ probably be lonely. ○ In order to be effective, you need a ○ People are looking for leaders who team to work with. We lead on the are willing to give it all they have, basis of our strengths; we gather our and they will follow-for a while team on the basis of their strengths. However, when the going gets 13  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 tough. when pleasure and comfort ○ "Work hard and become a leader: be compete with responsibility and lazy and never succeed." ▪ I am long hours, followers will drop amazed at how often people want a away. That is when you have to be position. Nit not the responsibility. sure that what you are doing is right, It is natural to want to escape so that you will keep going responsibility; we all do it. ○ James Cook said, "A person who However. being a leader means wants to lead the orchestra must working long hours It means being turn his back on the crowd." available to solve problems or give BE READY FOR RESISTANCE direction whenever necessary Being ○ One of the facts of life is that when a leader means being a servant, you are in leadership, you have to whether you are in your home or at solve problems. work You are always on call ▪ A ○ Pastor Lloyd Ogilvie, for many Leader Works Hard years the senior pastor at First Let God be your guide Presbyterian Church of Hollywood, ○ Elizabeth Dole, President of the California and now Chaplain of the American Red Cross, stated in an U.S. Senate, once observed that interview "To me it's very important "Everyone has problems; if you to know I have a source of strength don't have any now, you will have beyond my own When I'm problems: wherever you work or undertaking a difficult assignment live, you'll have problems, or you or making a tough decision I'm glad just might be someone else's I don't have to rely on my own problem." energy, wisdom, and judgement " Sometimes we have the faulty notion that ○ Twenty-four years ago. I realized I we should be able to go through life needed a source of strength beyond problem free--that if we have problems. myself. The goals I had set for something is wrong with our life. As myself were not satisfying and even leaders, we have to be responsible, no relationships did not fill my deepest matter how painful it is. Running away is need. At the age of thirty two, I riot an option gave the control of my life to God. Sometimes we have the faulty notion that He is that source of strength I we should be able to go through life needed. I simply prayed, “I want problem free--that if we have problems. you to be my guide from now until I something is wrong with our life. As die.” He heard me. leaders, we have to be responsible, no matter how painful it is. Running away is not an option You don't need to wait for someone else's help You will have problems Be ready Expect it. If you know you are doing what is right, you won't cave in when the going gets tough. Facing problems and dealing with them by making good decisions is the difference between a leader and a follower Set an example for your staff 14  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 Module 2 -Cost can be controlled through planning for efficient operation. Example: Projecting the number of operations Planning in a given day, including daily dressings, helps in determining accurately the needed weekly supplies in the surgical units so as to prevent undersupply, oversupply or PLANNING is one of the functions of the management pilferages. process. It is a principal duty of every manager. 6. Based on past and future activities; Planning may be defined as deciding in advance what to -Evaluation of programs, schedules, and activities do; who is to do it; and how, when, and where it is to be whether successful or not, prevents and/or reduces the done. Therefore, all planning involves choosing among recurrence of problems and provides better ideas in alternatives (Marquis). modifying or avoiding them. As defined by Fayol, it is making a plan of action to 7. Leads to the realization of the need for change; provide for the foreseeable future. Planning must have unity, continuity, flexibility and precision. -Many hospitals have found out that in-patient hospital days can greatly be reduced by having the laboratory and Further, Venzon defined planning as pre-determining a diagnostic work-up in the Out-patient Department rather course of action in order to arrive at a desired result. It is than have these examinations on admission. Minor a continuous process of assessing, establishing goals and surgeries are also done at the Out-patient Department so objectives, implementing and evaluating them, and that more hospital beds can be allotted to critically ill subjecting this change as new facts are known. patients or for those needing specialized services. According to Koontz and O’Donnell, planning is “an 8. Provides the basis for control; intellectual process, the conscious determination of courses of action, the basing of decisions on purpose, -It becomes the basis for evaluating the accomplishment facts and considered estimates.” of the set programs/activities. According to Theo Haiimann “Planning is deciding in 9. Necessary for effective control; advance what is to be done.When a manager plans, he projects a course of action for the future, attempting to -Nurse-managers evaluate the environment or setting in achieving a consistent, coordinated structure of operation which they work or where the patients are confined and aimed at desired result ” make necessary recommendations to make hospital conditions more therapeutic not only for the patients but Importance of Planning: for the workers as well. Performance of workers and evaluation of services to patients based on criteria set 1. Planning leads to the achievement of goals and during the planning stage will indicate whether standards objectives; are met and whether changes are indicated. -Workers relate what they do to meaningful results since Major Aspects of Planning plans are focused on objectives. 1. Planning should contribute to objectives 2. Gives meaning to work; 2. Planning precedes all other processes of -Workers experience greater satisfaction if what they do management becomes meaningful to them. 3. Planning pervades all levels;s 4. Planning should be efficient 3. Provides for effective use of available resources and facilities; Characteristics of a Good Plan -The best use of personnel and material resources 1. Have clearly worded objectives, including prevents wastage. desired results and methods for evaluation 2. Be guided by policies and/or procedures 4. Helps in coping with crises; affecting the planned action -Hospital should provide for disaster plans. This allows 3. Indicate priorities the workers to function more clearly and efficiently when 4. Develop actions that are flexible and realistic in actual emergencies occur such as fire, typhoons, terms of available personnel, equipment, earthquakes, etc. where more people are likely to get hurt. facilities and time 5. Develop logical sequence of activities 5. Cost effective; 15  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 6. Include the most practical methods for achieving is at least 6 months in the future may be considered each Objective. long-range planning. Principles of Planning Strategic planning focuses on purpose, mission, philosophy, and goals related to the external 1. Planning is always based and focused on the organizational environment. vision, mission, philosophy, and clearly defined objectives of the organization. ○ Tools: 2. Planning is a continuous process SWOT Analysis 3. Planning should be pervasive within the entire An effective tools that organization covering the various department, assist in strategic services, and the various levels of management planning. to provide maximal cooperation and harmony. SWOT analysis 4. Planning utilizes all available resources (identification of 5. Planning must be precise in its scope and nature. strengths, It should be realistic and focused on its expected weaknesses, outcomes. opportunities, and 6. Planning should be time- bound, i.e., with short threats) and long range plans. SWOT analysis, also 7. Projected plans must be documented for proper known as TOWS dissemination to all concerned for analysis, was implementation and evaluation as to the extent developed by Albert of its achievement Humphrey at Stanford University Scope of Planning in the 1960s and Top Management 1970s. ○ Chief nurse The first step in ○ Executive nurse SWOT analysis is to ○ Nurse director define the desired end They set the overall goals and state or objective. policies of the organization After the desired Middle Management objective is defined, ○ Nursing supervisor the SWOTs are They direct activities to discovered and listed. actually implement the Decision makers must operating policies of the then decide if the organization such as staffing objective can be Lower Management achieved in view of ○ Charge nurse the SWOTs. If the ○ Senior nurse decision is no, a ○ Staff nurse different objective is They do the daily and weekly selected and the plans for administration to process repeats. direct patient care in their Strengths are those respective unit internal attributes that help an organization Types of organizational planning to achieve its objectives Strategic or long-range planning Weaknesses are those It refers to determining the long term objectives of the internal attributes that institution and the policies that will be used to achieve challenge an these objectives. Generally, complex organizational plans organization in that involve a long period (usually 3 to 10 years) are achieving its referred to as long-range or strategic plans. objectives Opportunities are It may be done once or twice a year in an organization external conditions that changes rapidly. At the unit level, any planning that 16 Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 that promote ○ Internal achievement of Business organizational Process objective. ○ (Objectives, Threats are external measures conditions that ,targets and challenge or threaten initiatives) the achievement of the organizational, Operational or short-range planning objectives Be realistic about the It deals with day-to-day maintenance activities. It is done strengths and in conjunction with the preparation of the budget. weaknesses of your Planning may also be related to the improvement and organization. Be maintenance of facilities. clear about how the ○ Reactive planning present organization Reactive planning occurs after differs from what a problem exists might be possible in ○ Inactivism the future Be specific Consider the status quo as the about what you want stable environment and they to accomplish spend a great deal of energy Always apply SWOT preventing change and in relation to your maintaining conformity. competitors Keep ○ Preactivism SWOT short and Utilize technology to simple Remember accelerate change and are that SWOT is future-oriented. subjective. ○ Proactive planning They consider the past, present, and future and attempt to plan the future of their organization. Nurse managers are most likely to be involved in this type of planning. It gives individual managers freedom to accomplish their own objectives as well as those of the institution Why do plans FAIL? False assumptions Not knowing overall goal Not enough alternatives Inadequate time or other resources Balanced Scorecard Low motivation levels Translating Vision Sound strategies not used and Strategies Inadequate delegation of authority Communicating and Not recognizing organizational goals and needs Linking Planning too narrow in scope— does not Business Planning recognize community, legal, and licensing Feedback and requirements Learning ○ Financial Strategies for Successful Planning ○ Customer Start planning at the top. ○ Learning and Keep planning organized, clear, and definite. Growth Don’t bypass levels of people. 17  Nursing Leadership, Management and Professional Adjustment- NCM 119 Cruz, Larraine Jhasmine D. BSN-4E2 Have short-and long-range plans and goals will be provided (in-patient, out-patient, Know when to plan and when not to. emergency). Keep target dates realistic. A Philosophy describes the vision. It is a Gather data appropriately. statement of beliefs and values that direct one's Be sure objectives are clear. life or one's practice. In an organization, the Remember, interpersonal relationships are philosophy is the sense of purpose of the important. organization and the reason behind its structure and goals. A written statement of the philosophy Elements of Planning explains the beliefs that shape how the mission Planning as a managerial process are consists of the or purpose will be achieved. It gives direction following elements : toward the attainment of the set goals and objectives. Goals and Objectives they are action commitments through which its mission and purpose will be achieved and the philosophy or belief sustained. ○ Goal— the desired result toward which effort is directed. Goals are more general and they cover a broad area ○ Objective — how the goal will specifically be achieved (includes time frame and is measurable). Include a specific time completion.