NURSING LEADERSHIP AND MANAGEMENT LEADERSHIP STOGDILL The process of influencing the activities of an organized group in its effort

towards goal setting and goal achievement TALBOTT Is the vital ingredient that transforms a crowd into a functioning, useful organization the process of sustaining an initiated action GARDNER The process of persuasion and example by which an individual induces a group to take action that is in accord with the leaders purposes or the shared purposes of all The process in which a person inspires a group of constituents to work together using appropriate means to achieve a common mission and goals LEADERSHIP - Is the ability to achieve a workable unity in the group and build community - more of an art than science MANAGEMENT Science in which a series of steps must be followed to implement the goal Is the process of working through staff members to be able to provide comprehensive care to the patient 4 PRIMARY CONDITIONS FOR EFFECTIVE LEADERSHIP 1. the person receiving the communication understands 2. This person has the resources to do what is being asked of him 3. The person believes the behavior being asked of him is consistent with personal interests and values 4. The person believes the request is consistent with the purposes and values of the organization 4 Major variables involved in Leadership 1. Characteristics of the leader 2. Attitudes, needs and other characteristics of the followers 3. Characteristics of the organization 4. Social, economic and political milieu

1. 2. 3. 4. 5. 6. 7. 8. 9.

Envisioning goals Affirming values Motivating Managing Achieving a workable unity Explaining Serving as a symbol Representing the group Renewing

LEADERSHIP THEORIES A. EARLY LEADERSHIP THEORIES 1.TRAIT THEORIES 2. BEHAVIORAL THEORY 3. SITUATIONAL OR CONTINGENCY THEORIES B. CONTEMPORARY LEADERSHIP THEORIES 1. TRANSACTIONAL LEADERSHIP THEORY 2.TRANSFORMATIONAL LEADERSHIP 3. SERVANT LEADERSHIP THEORY 4. EMOTIONAL INTELLIGENCE IN NURSING LEADERSHIP THEORY 5. MULTIPLE INTELLIGENCES IN NURSING LEADERSHIP THEORY 1. TRAIT THEORY Assumes that people inherit extraordinary qualities and traits that make them better suited to leadership They have special traits that make them leaders like, tireless ambition, zest for life, great speaking skills, irresistible good looks and extremely persuasive Traits common to all GOOD Leaders: a. Honesty b. Trustworthiness c. Integrity d. Fair e. Skilled communicator f. Goal oriented g. Dedicated h. Hardworking i. Committed Pope John Paul II Mother Teresa Margaret Thatcher Nelson Mandela Gandhi

9 TASKS OF LEADERSHIP (Gardner)

2. GREAT MAN THEORY This theory was formulated after studying men who were already leaders This theory assumes that the capacity for leadership is inherent that great leaders are born and not made This theory often portrays leaders as HEROIC, MYTHIC & DESTINED TO RISE TO LEADERSHIP WHEN NEEDED Most of them were rich and born into leadership ARISTOTLE GENGHIS KHAN SUN TZU ABRAHAM LINCOLN TRAIT THEORY Reeves in 2001 found some traits of a leader EMOTIONAL STABILITY ADMITTING ERROR GOOD INTERPERSONAL SKILLS INTELLECTUAL BREADTH 3. INDIVIDUAL CHARACTER THEORY Traits determine whether or not an individual will become an effective leader, these people have innate character that makes them great leader Distinctive physical and psychological individual characteristics account for leadership effectiveness Napoleon Bonaparte 4. BEHAVIORAL THEORY - proponents assume that leaders are made not born - theorists believed anyone can learn to be a leader - behavioral theories were more concerned with what leaders do and act, the actions of the leaders and not their mental qualities and traits make them leaders. - several theorists studied the behavior of leaders as it affects management and how humans relate to each other in organizations these includes : KURT LEWIN, RENSIS LIKERT, BLAKE MOUTON, CHRIS ARGYRIS, ALVIN TOFFLER

KURT LEWIN psychologist who proposed that the workers behavior is influenced by interactions between the personality, the structure of the primary work and the socio technical climate of the work place. he categorized leadership into 3 he also developed FIELD THEORY BEHAVIOR FIELD THEORY OF HUMAN BEHAVIOR People act the way they do depending on self perceptions and their environment To understand a leaders behavior or that of the follower one must look into the totality of the individuals experience Change undergoes 3 stages UNFREEZING CHANGE OCCURS RE FREEZING UNFREEZING Overcoming inertia and dismantling the existing mind set Replace the previous culture learned with new one CHANGE OCCURS A period of confusion and transition Old ways are being challenged but there is no clear picture to replace them with yet may be ready to accept new role RE FREEZING The new mindset is crystallizing and ones comfort level is returning to previous level Have internalized new roles and can adapt to new environment and culture LEWINS LEADERSHIP STYLES: AUTOCRATIC DEMOCRATIC LAISSEZ FAIRE AUTOCRATIC Make decisions without consulting anyone Caused a great level of discontent and can lead to revolution Ex. Administration decides on a change without consulting nursing=low morale, bad feeling and undercover retaliation. DEMOCRATIC

BEHAVIORAL THEORY

Involve people in decision making, although they may make the final decision Democratic leader may appreciate being consulted , but they may be confused when confronted with wide range of options with no clear way to reach a decision. LAISSEZ FAIRE Are minimally involved in decision making this style works best when people are capable and motivated to decide and are not hindered by a central coordinator CHRIS ARGYRIS - Sought to study the way people in the organization act and react with each other - He also studied the patterns of reasoning that explains ones behavior - He developed the concepts: Ladder of Inference Double Loop Learning Ladder of Inference A reminder that when communicating, one needs to communicate not just subjective conclusions but also the objective reasoning process and assumptions that underlie the conclusions. DOUBLE LOOP LEARNING Sees learning as a process of detecting and correcting errors The focus of the theory is on solving problems that are complex and ill structured ALVIN TOFFLER He examined technology and its impact to the world and the reaction of and changes in the society
society needs people who takes care of the elderly and who knows how to be compassionate and honest. Society needs people who work in hospitals. Society needs all kinds of skill that are not just cognitive; they are emotional, they are affectionate. You cant run the society on data and computers alone

Strongly disagree Disagree Neither agree/disagree Agree Strongly agree LINKING PIN MODEL A concept of the ideal work relationship of workers in an organization Used the concept of family to characterize the desirable social interaction that should occur between different work units He also encouraged strong personal relations between work units above and below management to achieve an effective organization LIKERTS ORGANIZATIONAL DESIGN UNDER THIS APPROACH: - SUPERIORS AND SUBORDINATES TRUST EACH OTHER -INFORMATION FLOWS FREELY DOWNWARD AND LATERALLY -GROUP PARTICIPATION HIGH AND SETS REALISTIC GOALS -DECISIONS ARE DONE THROUGH DEMOCRATIC PROCESS -TRAINING HUMAN RESOURCES AND CONTROL IS DONE OFTEN LIKERTS LEADERSHIP STYLE EXPLOITIVE AUTHORITATIVE STYLE BENEVOLENT AUTHORITATIVE STYLE CONSULTATIVE LEADER PARTICIPATIVE LEADER EXPLOITIVE AUTHORITATIVE STYLE The leader uses threats and other fear based methods to achieve conformance Peoples concern are ignored, and communication comes from the top down BENEVOLENT AUTHORITATIVE Leader is concerned for people and forms a benevolent dictatorship rewards are dispensed and appropriate performance is praised The leader listens to peoples concerns although what others hear is often rose colored Some decisions maybe delegated but most are still made by the leader CONSULTATIVE LEADER Makes major decisions and offers somewhat rose colored information information flows upward from the staff and the leader listens to people

RENSIS LIKERT Likert Scale and Linking Pin model LIKERT SCALE 5 scale measurement tool that determines the level of agreement and disagreement of a respondent to a set of questions that could be objective or subjective in nature. Format:

PARTICIPATIVE LEADER makes maximum use of participative methods engages people in making decisions helps make sure everyone works well together at all levels the downside of participative leadership is that it can lead to feelings of betrayal and cynicism when managers ask for input and then ignore it 5. ROLE THEORY was based on the assumptions that individuals: a. define roles for themselves and others based on social learning and reading b. form expectations about the roles that they and others will play c. Subtly encourage others to act within role expectations d. Will act within the role they adopt Within organizations, informal and formal information about leadership values, culture, training and modeling shapes expectations and behavior. When expectations do not match behavior, role conflict can occur. THE LEADERSHIP GRID DR ROBERT BLAKE & DR JANE S MOUTON developed a grid to chart leaders concern about the work to be done compared to their concern for their people THE LEADERSHIP GRID 2 BEHAVIORAL DIMENSIONS: 1. CONCERN FOR TASK OR PRODUCTION - leaders care little for people and operates in fear of something going wrong - focus is on achieving results and productivity 2. CONCERN FOR PEOPLE - leaders care little about productivity and operates wholly from a desire to be loved and approved of 3 THINGS TO REMEMBER: 1. LEADERS LAY SOMEWHERE ALONG THE CONTINUUM OF CONCERN FOR PRODUCTIVITY TO CONCERN FOR PEOPLE 2. THERE IS NO ONE BEST WAY OF LEADERSHIP 3. DIFFERENT STYLES ARE NEEDED FOR DIFFERENT SITUATIONS 6. SITUATIONAL OR CONTINGENCY LEADERSHIP THEORY

(PAUL HERSEY AND KENNETH BLANCHARD) A situational leader takes into account followers motivation and capability and other factors within a particular situation leaders should adapt their style to their followers development levels of maturity based on the followers competence and motivation FRED FIEDLER CONTINGENCY MODEL fiedler believed there is no single approach that can provide an adequate solution for the various management problems his model focused on personality and relationship between leader and group members, programming of groups assignment and positional power of the leader It is a task oriented leadership style wherein the leader exerts a great influence or power over the group member 3 aspects of situation that needs to be considered: a. leader-member relation b. task structure c. position or power VICTOR HAROLD VROOM AND YETTON Suggested that selection of a leadership style will determine decision making The effectiveness of a decision procedure will depend on the aspects of situation: -Importance of the decision quality and acceptance - Amount of relevant info - Likelihood that the subordinates will accept the decision - Amount of disagreement between the subordinates with respect to their preferred alternatives Provided a set of rules that determine how a participatory leader should be when making decisions ROBERT HOUSE Proposed the PATH GOAL THEORY He said that leaders can affect the performance, satisfaction and motivation of a group through rewards , clarification of paths to goals and removal of obstacles in work performance

4 LEADERSHIP STYLES 1. HIGH TASK, LOW RELATIONSHIP

FOCUS When the follower cannot do the job and is unwilling or afraid to try, the leader steps in and tells the person what to do, providing a working structure for the follower, and determines the source of the lack of motivation 2. HIGH TASK, HIGH RELATIONSHIP FOCUS When the follower cannot do the job to some extent but is over confident, the leader listens, advises and coaches. 3. LOW TASK HIGH RELATIONSHIP FOCUS When the follower can do the job but refuses to do it, the leader listens, praises, and makes the follower feel good when he or she shows the necessary commitment 4. LOW TASK LOW RELATIONSHIP FOCUS when the follower can do the job and is motivated. The leader gets out of the way and doesnt interfere except to provide occasional recognition and praise NORMATIVE LEADERSHIP Is a variant situational leadership. Vroom and Yetton noted that situational factors could yield unpredictable leader behavior According to this theory, participation increases acceptance of a decision. This model is most apt when opinions about the decision are clear and accessible PATH GOAL THEORY (Robert House) leaders: a. Clarify the path toward the goal b. Remove the roadblocks c. Increase rewards along the way PATH GOAL THEORY ADOPTS THE FOLLOWING LEADERSHIP STYLE 1. SUPPORTIVE LEADERSHIP is the best choice when work is stressful, boring, and or hazardous - the leader strives to increase followers self esteem and make the job more interesting 2. DIRECTIVE LEADERSHIP Is the best choice when task is unstructured and/or complex and followers are inexperienced. 3. ACHIEVEMENT ORIENTED LEADERSHIP Is the best choice if the task is complex with this style, the leader knows the right and the best way of achieving a goal the follower is dependent but is believed to be able to succeed 4. PARTICIPATIVE LEADERSHIP Decision making is based on consultation with the

group and information is shared in the group B. CONTEMPORARY Attempts to define leadership in a nursing context , focus on the traits of the nurse involved Positive traits may not be enough. 2 TYPES LEADERSHIP RELEVANT TO NURSING 1. TRANSFORMATIONAL LEADERSHIP 2. AUTHENTIC LEADERSHIP 1. TRANSFORMATIONAL LEADERSHIP 3 ASSUMPTIONS: 1. People will follow a leader who inspires them 2. A leader with vision and passion can achieve great things but must maintain personal integrity, be willing to stand up and be counted and use ceremonies, rituals and other types of cultural symbolism 3. The best way to get things done is to inject enthusiasm and energy into the effort. Burns view it appeals to social values and encourages people to collaborate rather than work as individuals who compete with one another. transformational leaders give people an uplifting sense of being connected to a higher purpose enhancing their sense of meaning and identity. SERVANT LEADERSHIP Robert Greenleaf Emphasizes the leaders role as steward of resources It encourages leaders to serve others while staying focused on achieving the results A true SERVANT LEADER is a servant first rather than dominate then the individual must be prepared for the following: ENDURE MISUNDERSTANDING AND SUFFERING INSTEAD OF SEEKING HONOR AND GLORY SHOW INITIATIVE WHEN PEOPLE ARE APATHETIC FORGE AHEAD SO IT WILL BE EASY TO DRIFT WITH TIDE

Robert Greenleaf 10 characteristics

Listening Empathy Healing Awareness Persuasion Conceptualization

commitment to growth of people building community foresight steward

3. TRANSACTIONAL LEADERSHIP THE LEADER MOTIVATES THE FOLLOWER BY APPEALING TO THEIR OWN SELF INTEREST ITS PRINCIPLES ARE TO MOTIVATE BY MEANS OF EXCHANGE PROCESS 4. EMOTIONAL INTELLIGENCE IN NURSING LEADERSHIP DANIEL GOLEMAN EMOTIONAL INTELLIGENCE- an individuals SELF AWARNESS, SELF CONFIDENCE, SELF CONTROL, COMMITMENT & INTEGRITY AND THE PERSONS ABILITY TO COMMUNICATE, INFLUENCE, INITIATE AND ACCEPT CHANGE MODEL OF FIVE DIMENSION SELF AWARENESS SELF MANAGEMENT/SELF REGULATION MOTIVATION EMPATHY SOCIAL SKILLS Golemans definition of emotional intelligence proposes 4 broad domains of EQ which consist of 19 competencies GOLEMANS 4 QUADRANT MODEL SELF AWARENESS SELF MANAGEMENT SOCIAL AWARENESS RELATIONSHIP MANAGEMENT 5. MULTIPLE INTELLIGENCES IN NURSING LEADERSHIP HOWARD GARDNER Focuses on how different intellectual abilities affect leadership According to Gardner the traditional notion of IQ is far too limited Dr Gardner proposed 8 different intelligences to account for a human potential Dr Gardner proposed 8 different intelligences to account for a human potential LINGUISTIC INTELLIGENCE LOGICAL-MATHEMATICAL INTELLIGENCE SPATIAL INTELLIGENCE

BODILY-KINESTHETIC INTELLIGENCE MUSICAL INTELLIGENCE INTERPERSONAL INTELLIGENCE INTRAPERSONAL INTELLIGENCE NATURALIST INTELLIGENCE 6. QUANTUM LEADERSHIP PORTER O GRADY AND MALLOCH In quantum leadership, CONTROL is not an issue rather change dominates the climate. The quantum leader recognizes continual movement and change occur in reality and creativity and innovation are at the core of good work performance When quantum principles are applied healthcare administrators and faculty can. 1. Recognize how healthcare changes has affected all of them 2. Properly explain each change, actively engage in conflict resolution and exchange ideas 3. Work together to resolve the difficulties that emerge as their system interact. QUALITIES OF A QUANTUM NURSE 1. Offer creative and innovative solution 2. Seek to develop educational opportunities instead of relying on past methods 3. Provide mentoring opportunities and expert preceptorship, quantum leaders can help all involved to provide better care for pts. CHARISMATIC THEORY CHARISMA Quality that sets one apart from the others can be good or evil emerge in troubled time

MC GREGORS THEORY X AND Y each person is a whole individual living and interacting within a world of other individuals what happens to this person happens as a result of other peoples behavior an effective leader creates an atmosphere of approval for constituents

HOW DO TRANSFORMATION HAPPENS? According to the Institute of Medicine nurse leaders transform the work environment for nurses by: 1. Balancing the work b/w production and efficiency 2. Creating and sustaining trust through the organization 3. Managing the process of change 4. Involving workers in decision making 5. Establishing the organization as a learning organization. NEGATIVE ASPECT OF TRANSFORMATION LEADERS: 1. They may believe that passion and enthusiasm are more important than truth and reality 2. Their energy can wear out their followers 3. They may see only the big pictures not the details 4. They may become frustrated when an organization doesnt want to be transformed AUTHENTIC LEADERSHIP A positive leadership that is genuine, trustworthy, credible, reliable and believable authentic leaders have: PURPOSE: dev a better understanding of ones personal passion and finding a way to express it in work settings VALUES: are exemplified by authentic leaders actions, including speaking the truth HEART exemplified by authentic leaders who show they care for themselves and for others it is about encouraging others so that they will actually achieve higher levels of performance. RELATIONSHIP are close b/w authentic leaders and followers this psychological engagement is the key to a healthy work environment SELF DISCIPLINE Authentic leaders find a balance b/w their personal and professional lives. CREDIBILITY means authentic leaders do what they expect others to do DIFFERENCES BETWEEN MANAGERS AND LEADERS GOALS LEADERS very proactive because they typically arise out of -some personal passion for a better world goals are dev through dialogue with others,

engagement with the literature and self reflection shape ideas instead of merely responding to the ideas of others they act to change the way people think about what is desirable, possible and necessary MANAGERS adopt impersonal attitudes towards goals arise out of necessity rather than passion and desire CONCEPTIONS OF WORK LEADERS act to develop fresh approaches to long standing problems and to open issues for new options they tend to create excitement in their work MANAGERS Work is seen as a task to be accomplished with the least amount of turmoil and the greatest amount of coordination and balance they act to limit choices and to rock the boat as little as possible RELATIONSHIP WITH OTHERS LEADERS are concerned with what events and decision means to those affected by them they care about the people with whom they work they want to promote & develop individual creativity of their followers MANAGER Are thought of as human engineers They like people Tend to maintain a lower level of emotional involvement with employees Are concerned with how events occurred, how things get done and whether tasks get accomplished SENSE OF SELF LEADER Are not threatened by ideas of others because their sense of self comes from within, not from their roles or the expectations of others MANAGER Define themselves in terms of organization and prefer not to have their ideas as challenged Good leaders like good managers provide visionary inspiration, motivation and direction Good managers like good leaders attract and inspire People want to be led rather than managed, they want to pursue goals and values they consider worthwhile. therefore they want leaders who respect the dignity, autonomy

and self esteem of constituents