Leadership Skills of Staff

Nurses in Private Health Care Facilities, Calbayog City.

A Research Proposal Presented

to the Dean and the Faculty of the

College of NursingChrist the King College

Calbayog City

In Partial Fulfilment Of the Requirements

for the DegreeBachelor of Science

in Nursing

Chapter 1

Problem and

Background

Introduction

Leadership is a position of one who guides his

subordinates. It covers a great

responsibility, which includes setting up the

vision, tone, direction and

doing the right thing.

Perhaps you have heard

many people say that

nursing is a vocation,

while some say that it is

a profession.

Webster defines profession as “an

occupation or calling requiring advanced training and experience in some

specific or specialized body of

knowledge which provides service to society in that

special field”.

It is an occupation requiring a

unique body of knowledge and skills, which serves

society.

It is said that private

hospitals offer better

possibilities in terms of

health care services.

But in spite of the respectable image

maintains by private hospitals today, it is

undeniably true that the occurrence of some problems

greatly affect the effectiveness of the delivery of basic health services.

There is a continuous process and effort done by

private administration in

adopting measures and strategies to

put their respective institution always at

a competitive edge in

providing efficient and equitable

hospital care.

Performance appraisal is a

major responsibility

in the controlling

functions of the

management.

The ability to conduct

meaningful, effective

performance appraisals requires an investment

of time, effort and

practice on the part of the manager.

Although performance

appraisal is never easy, if used appropriately

it produces growth

in the employee and increases

productivity in the organization.

To increase the like hood of successful performance appraisal, managers should

use system of appraisal and gather data about

employee performance in a

systemic manner, using many

sources.

The managers also should

attempt to be as objective as

possible, using established standards for the

appraisal.

The result of the appraisal process

should provide the manager with

information for meeting training

and educational needs of

the employees.

By following up conscientiously on

identified performance

deficiencies, employees’ work problems can be corrected before they

become habits.

Integrating leadership into this

part of the controlling phase of

the management process provides an

opportunity for sharing,

communicating and growing. The

integrated leader is self-aware

regarding his or her own biases and

prejudices.

This self-awareness leads

to fairness and honesty in evaluating

performance. This, in turn,

increases trust in the manager and promotes a team

spirit among employees.

When anxiety is reduced during the

appraisal interview, the leader is able to

establish a relationship of mutual goal setting, which has

a greater potential to result in

increased motivation and corrected

deficiencies.

The result of the integration of leadership and

management is a performance

appraisal that facilitates

employee growth and increases

organizational productivity.

The aforementioned

scenario inspired the researcher to

conduct this particular study

with the hope that the findings may pave the way to

improve the leadership

skills of staff nurses in private

health care facilities.

Theoretical Framework

The study includes different theories

pertaining to leadership, the

theory of behavioural approach by Kurt

Lewin at Iowa State University (1930) and

Contingency theory by Fielder (1967).

The theory of Lewin focuses on the

leadership styles, which are Autocratic

Leadership, Democratic

Leadership and Laissez-faire leadership.

Autocratic leadership involves centralize decision making, with the leader making decisions and using power to command and control others.

Democratic leadership is

participatory, with authority

delegated to others.

Laissez-faire leadership is passive and permissive and the leader defers decision-making.

Fielder’s contingency theory views the pattern of leader behaviour as dependent upon the interaction of the personality of the leader and the needs of the situation.

Leader-member relations are the feelings and the attitude of followers regarding acceptance, trust, and credibility of the leader.

Good leader-member

relations exist when followers respect, trust, and have confidence in the leader.

Poor leader-member relations reflect distrust, a lack of

confidence and respect, and dissatisfaction with the leader by the followers.

Task structures refer to the degree to which work is defined, with specific procedures, explicit directions, and goals.

High task structures involve routine, predictable, clearly defined work tasks.

Low task structures

involve work that is not routine,

predictable, or clearly defined, such as creative, artistic,

or qualitative research activities.

Position power is the degree of formal authority and influence associated with the leader.

High position power is favourable for the leader and low position power is unfavourable.

Fielder showed that a task-directed leader, concerned with task accomplishment, was effective.

When the range of favourableness is

intermediate or moderate, a human relations leader, concerned about people, was

most effective.

Fielder’s contingency theory is an approach that matches the organizational situation to the most favourable leadership style for that situation.

Much of the early work on

leadership focused on the leader.

This research was directed toward identifying intellectual, emotional, and physical and other personal traits of effective leaders.

The underlying assumption was that are born, not made.

After many years of research, no particular set of traits has been found that predicts leadership potential. There are several possible reasons for this failure.

According to McGregor, Research findings to date suggest that it is more fruitful to consider leadership as a relationship is a human relations function and that different situations may require quite different characteristics

from a leader.

Is not to a large degree universally

accepted in nursing

that authoritarian power is effective in times of crisis but that it otherwise promotes instability.

In spite of the shortcomings of the trait theory, some traits have been identified that are common to all good leaders.

Dunphy and Stace describe about resistance to change. Resistance to change or attempting to maintain the status quo when efforts are being made to alter it, it is a common response. Change evokes stress that in turn evokes resistance.

Factors that stimulate resistance at change include habits, complacency, fear of disorganization, set patterns of response to change, conservatism, perceived loss of power, ego involvement, insecurity, perceived loss of current or meaningful personal relationship, and perceived lack of rewards.

People are afraid of change because of lack of knowledge, prejudices, resulting from a lifetime of personal experience and expose to others, and fear of the need for greater effort or a higher degree of difficulty.

People have developed fears, biases and social inhibitions from the cultural environment in which they live. Since they cannot be separated from these cultural factors, it is necessary to find ways of managing them within a system.

Schein (1970) was the first to propose a model of humans as complex beings whose working environment was an open system to which they responded.

Leadership effectiveness, According to Hollander, requires the ability to use the problem - solving process; maintain group effectiveness; communicate well; demonstrate leader fairness, competence, dependability, and creativity; and develop group identification.

Nelson and Burns (1984) suggested that organizations and their leaders have four developmental levels and that these levels influence productivity and worker satisfaction. The first of these levels is reactive.

The reactive leader focuses on the past, crisis driven, and is frequently abusive to subordinates. In the next level, responsive, the leader is able to mould subordinates to work

together as a team, although the leader maintains most

decision – making responsibility.

At the proactive leader, the leader and followers become more future – oriented and hold common driving values. Management and decision – making are more participative. At the last level, high performance teams, maximum productivity and worker satisfaction are apparent.

Conceptual Framework of the Study

The diagram indicated below

illustrates the flow of the variables

that are used in the study as conceived by the researcher.

Leadership Skills

Administrative Institutional skills

Human Relations

Factors affecting Leadership

Skills

Skills Enhancement Programs

Staff Nurses in Private Health Care Facilities, Calbayog City. As seen in the diagram, the study determines the leadership traits of the staff nurses particularly in terms of their intelligence, personality and abilities.

It also tries to find out the

factors affecting the leadership skills of staff

nurses.

Statement of the Problem

Leadership Skills of Staff Nurses in Private Health Care Facilities, Calbayog City.

The study seeks to determine the Leadership Skills of Staff Nurses in Private Health Care Facilities, Calbayog City.

Specifically it

seeks to answer

the following questions

:

1.What is the profile of respondents in terms of:

1.1 Age,1.2 Gender,

1.3 Civil Status, 1.4 Employment Status

1.6 MonthlyIncome;1.7 Length of

Service;1.8 Distance from

work and1.9 Work Assignment.

2. What are the leadership skills of staff nurses in Private Health Care Facilities as perceived by themselves and the student nurses in terms of:2.1 Human Relations, 2.2 Administrative and 2.3 Institutional Skills?

3. Is there a significant relationship between the demographic profile and the factors affecting the leadership skills

of respondents?

4. What are the factors affecting

the Leadership Skills of Staff

Nurses in Private Health Care

Facilities?

5. What recommendation can be proposed to improve the Leadership Skills of Staff Nurses in Private Health Care Facilities based on the findings of the study?

Null hypothe

sis

There is no significant relationship between the leadership skills of the staff nurses in health care facilities in Calbayog City towards the following respondent’s socio-demographic profile.

Scope and Delimitation

This study will focus on leadership skills of staff nurses in Private Health Care Facilities, Calbayog City.

The respondents of the study is composed of staff nurses in Private Health Care Facilities, Calbayog City. Likewise, it is limited to the use of survey questionnaires as research instrument in collecting data.

Significance ofThe

Study

Private Health Care Facilities in Calbayog

City and leadership skills of staff nurses is

very important because all action

undertaken by these people will affect the

entire organization.

The results of the study

are, therefore,

intended to benefit the following:

Hospital Administrations

. This would motivate them to

maintain a satisfactory

performance in their respective

departments, which serves as

inspiration to their

subordinates.

Staff Nurses. The result of this study would encourage them to perform their leadership skills and do their job well.

Nursing Students.

The findings of this study would encourage them

to be more diligently in

their studies and develop

their leadership skills.

Future Researchers.

This study will help serve as a

reference for future researches

to conduct studies that focuses on

intervention that enhance the

leadership skills of staff nurses.

Definition of terms

For better understanding and clarity of the terms used, the following

key terms were defined

conceptually and operationally.

Factors – there are conditions or situation that influence the occurrence of something. In this study, it includes those that affect the leadership skills of staff nurses.

Leadership – It is a position of a leader and an act of leading. In this study, it refers to the skills of staff nurses in managing situations and people in private health care facilities.

Profession – it is an occupation

that requires extensive education or specialized training. In this study, it refers to the registered nurses.

Profile – it is a demographic representation of important characteristics of an individual. In this study, it refers to the age, sex, civil status, employment status and position of respondents.

Skills – it is the ability to do

something well, usually gained through experience and training. In this study, it refers to the ability of the staff nurses to lead.

Staff Nurses – They are professionals trained to care for

the sick and disabled under the Supervisions of a physician. As used in this study, they are the nurses who are utilized as respondents of the study.

Review of Related Literature and Studies

This Chapter contains literature and studies which the Researchers believed related to the present study.

Related Literature

What leadership styles should senior nurses develop? This is

an extended version of the article published in Nursing Times; 104: 35, 23-24.

Senior nurses are likely to engage in a range of leadership activities in their daily routine. Some will naturally adopt an effective leadership style, while others may find the concept of leadership or seeing themselves as leaders difficult to understand.

Effective leadership is critical in delivering high-quality care, ensuring patient safety and facilitating positive staff development.

This article outlines the characteristics of an effective leader, the political context and various leadership activities for senior nurses.

It also discusses mentorship, different leadership models and the process of professional socialization (Frankel, 2003).

Leadership can be defined as a multifaceted process of identifying a goal or target, motivating other people to act, and providing support and motivation to achieve mutually negotiated goals.

In the daily life of a senior nurse, this could refer to coordinating the day/night shift and the team of nurses and support staff on duty under the direction of that nurse.

The successful operation of the shift, staff morale and managing difficult or challenging situations depends largely on the senior nurse's leadership skills

(Porter-O'Grady, 2003).

Leaders are often described as being visionary, equipped with strategies, a plan and desire to direct their teams and

services to a future goal .

Effective leaders are required to use problem-solving processes, maintain group effectiveness and develop group identification.

They should also be dynamic, passionate, have a motivational influence on other people, be solution-focused

and seek to inspire others (Mahoney,

2001).

Nurses should adopt a supportive leadership style with mentorship, coaching and supervision as core values showed that high levels of support from supervisors reduced emotional exhaustion and buffered negativeffects of the job environment.

Consequently, it would be particularly beneficial for supervisors to provide emotional support to nurses and give them adequate feedback about performance to increase self- esteem(Constable

and Russell, 1986).

Senior nurses should also apply leadership skills in encouraging staff to use critical reflection to facilitate new understanding (Bakker,2000).

Nurse leaders are often vulnerable to stress as experienced in the work environment, including long hours, patient overloads, and challenging work settings.

If ignored, these stressors may lead to physical, emotional and behavioral symptoms with possible reporting medical errors, absenteeism, health challenges, and job burnout (Cynthia J. Brown,

DNS, RN, 2009).

Ultimately, a goal of any healthcare organisation should be to influence the quality of patient care through good nursing leadership.

Good leaders should encourage junior staff to gain a

better understanding

of patients and their needs and values.

Overall, these strategies will lead to increased patient satisfaction, more effective nurse- patient relationships and quicker recovery times.

Empowered nurses are eager to implement evidence-based practice. They are highly motivated, well informed and committed to organisational goals, and thus deliver patient care with greater effectiveness (Kuokkanen and Leino-Kilpi, 2000).

Good leadership could produce better patient outcomes by promoting greater nursing expertise through

increased staff ability and a new level of competence.

The hospital practice environment has a significant effect on patient outcomes. Junior nurses should be encouraged to seek maximum rather than minimum standards, and be expected to achieve and maintain high-

quality benchmarks (Aiken et al, 2001).

The role of senior nurses is dynamic

and multifaceted. Nurse leaders in practice settings have unique opportunities to influence and even create the environment in which professional nursing practice can flourish.

In this highly influential role, nurse leaders have a major responsibility to change behaviour to provide an environment that supports the preparation of competent and expert practitioners.

It is part of nurse leaders' role to serve as a model in providing effective socialisation experiences that impart the appropriate values, beliefs, behaviours and skills to staff (Marriner-Tomey, 1993).

This is a democratic model of leadership, in which there is consideration

for the opinions of those who

have to carry out the task.

Individuals and groups are involved in decision-making processes concerning their work. The valuing of people, their knowledge, experience and skills is central

to this model.

Leadership models are a useful tool for senior nurses and help

to put the function of leadership activity into perspective. These nurses should not be concerned about using concepts from

various models and developing an eclectic strategy.

The models should be used as a framework on which to build an effective leadership style which suits the individual leader and those whom they are leading (Adair, 2003).

The way to empower people is to leave them alone and let them manage themselves. He also emphasized that empowerment goes beyond expecting professionals to be self-starting high performers who pretty much manage themselves.

Many proponents of what he calls “false empowerment” will say that managers shouldn’t keep close track of staff, and they definitely shouldn’t zero in on employees failures.

Staff should be made to feel they “own”

their work and should be set free to make

their own decisions. Managers are merely facilitators, there to align the natural talents and desires of staff with fitting role in the workplace. Managers shouldn’t tell people how to do their jobs, but rather let staff come up with their own methods.

The idea is make staffs feel good inside and results will take care of themselves. According to him, the best managers are people who learn proven techniques diligently until they become skills and continue practicing them until they become habits.

He presented eight steps for nurse managers to be guided in setting up staff nurses for success every step of the way by practicing highly engaged hands-on management, these are:

(a) get in the habit of managing everyday by setting aside one hour every day as you dedicated time for managing

up-front on your initiative, (b) lean to talk like a

performance coach by talking about the work,

(c) take it one person at a time, (d) make accountability a real

process,

(e) clarify what to do and how to do,

(f) follow performance every step of the way,(g) solve small problems before they turn into big problems,(k) do more for some people and less for others by giving every person the chance to meet the basic expectations of his or her job and then the chance to go above and beyond – and to be rewarded accordingly (Bruce Tulgan, 2007).

Related Studies

Student-researchers had conducted some studies concerning leadership skills Mendoza (2000) studied the factors affecting the

managerial performance of the

bank executives in Calbayog city.

Results of the study revealed that among the factors that promote very satisfactory performance of respondents are managerial abilities possess which is acquired through seminars and training, company policies that enhance employees’ productivity and consumer’s satisfaction, favorable business environment and self confidence.

The investigation of Mendoza has similarities with the present study because it also focuses on leadership skills. The difference of this study lies in the group being studied. Mendoza placed emphasis on skills of Bank executives in Calbayog City, whereas the present study considers the leadership skills of staff nurses.

Another similar study was undertaken by Delos Reyes (2000) who made an evaluation of the work performance of the officials in Barangay Tarabucan, Oquendo District, Calbayog City during the calendar year 1999.

The findings showed that as per evaluation of the resident-respondents, the elected officials of the said barangay, as a whole, performs their functions satisfactory and had accomplished several projects that benefited the people and the community.

The study of Delos Reyes had similarity with the present study because it focuses on leadership skills. The difference lies in the respondent being studied and the time being studied.

Olares (2002) made an investigation on the motivation and job satisfaction levels of government employee in Las Navas, Northern Samar.

Her study showed the government employees are highly motivated in their respective tasks and high job satisfaction levels. The study further revealed that there is a significant relationship between the respondent’s motivation and job significant levels.

The investigation of Olares is related to the present study because they also gave emphasis on motivation and satisfaction of staff. The difference lies in the group being studied. Olares placed emphasis on government employees on their respective task whereas the present study considers the leadership skills of staff nurses.

Leadership Skills of Staff Nurses in Private Health Care Facilities, Calbayog

City.

QUESTIONNAIRE

Direction: Check the boxes that corresponds your answer to the questions.

I. Profile of

Respondents

Name (optional): _________________________________Age: ____ Sex: Female Male

Civil Status: Single Married Separated Widowed

Employment Status: Permanent Temporary Contractual

Monthly income(Php): Php 21,000.00 and above Php 15,000.00 – Php 20,000.00 Php 10,000.00 – Php 14,999.00 Php 5,000.00 – Php 9,000.00 Php 5,000.00 and below

Length of service: 20 yrs. and above 15 – 29 yrs. 10 – 14 yrs. 5 – 9 yrs. 5 yrs. and below

Distance from work:

1 – 2 km 3 – 4 km 4 – 5 km 5 – 6 km

Work assignment: Emergency Room Ward Operating Room Delivery Room Out-Patient Department School Clinic Specify:__________

II. Leadership Skills

of Staff

Nurses

Direction: Check the column that corresponds to the leadership skills of staff nurses in terms of human relations, administrative and institutional skills using the numerical rating scale, as follows: Numerical Rating:

4 – Much Adequate 3 – Moderately Adequate

2 - Adequate1 – Not Adequate

A. Human Relations Numerical Rating

1. Ability to handle problems in times of emergency.2. Time to establish rapport.3. Ability to interact with each member of the health care team.

4 3 2 1

A. Human Relations Numerical Rating

4. Ability to show idea, opinion in terms of difficult problem of other staff. 5. Has the spirit of cooperation with in and out of the group. 6. Ability to work with other member of the health team effectively and efficiently the salary is low beyond family.

4 3 2 1

B. Administrative Numerical Rating

1. Ability to make memorandum.2. Has time to talk about problems encountered by different departments in their institutions.3. Ability to handle problem and make corresponding solutions on time.

4 3 2 1

B. Administrative Numerical Rating

1. Able to develop programs to enhance skills of staff nurses.2. Ability to supervise and evaluate the performance of staff within the institution.3. Able to enhance skills within the level of education attained.

4 3 2 1

C. Institutional Skills Numeric

al Rating

1. Involvement in the making of hospital policies for implementation.2. Supervisions of hospital facilities and equipments ready for use.3. Ability to recommend and implement rules regarding work assignments and correct work overloading.

4 3 2 1

C. Institutional Skills Numeric

al Rating

4. Ability to recommend and give recognition and merits for remarkable performance.5. Involvement of interagency program implementations6. Ability to conduct orientation to help the staff and student nurses to be familiar with the setting.

4 3 2 1

III. Factors

affecting the

leadership

Direction: Check the boxes that corresponds your answer to the questions.

Are there factors that influence your leadership skills?

Yes No

Factors:

A. Financial Incentives: Salary not given on time Frozen bonuses and other benefits Merits system and salary standardization not implemented Night shift differential not applied Irregular payment for

overtime pay

B. Superior Relationship: Heads involves policies affecting staff nurses Poor coordination between subordinates and other staff Superior favouritism; jealousy

and competition affect the relationship of nurses

Inadequate plans for professional advancement

Unfair selection of personnel sent for training and seminars

Head can’t stand to nurses’ problems and difficulties related to job.

C. Work Environment: Lack of Facilities, supplies and equipments Insufficient spaces to operate comfortably, safely and

efficiently. Inadequate temperature and

humidity control, creating excessive discomforts and overcrowding

No place to interact with colleagues

Superior behaviour does not give a feeling of accomplishments and satisfaction

IV. Recommendations to Improve Leadership Skills

Continuous Education Attending Seminar and

conventions to upgrade knowledge on nursing leadership.

Take post-graduate studies to improve educational potentials.

Hospitals work situations must be made conducive to nursing duties.

Benefits from work must commensurate with time and

effort. Derive satisfaction from work.

Others, specify __________________________

Thank you and God Bless.

Chapter III

Methodology

This chapter presents the research design, research locale, research respondents, research

instrumentation, and research procedure

and data gathering, and treatment analysis.

Research Design

The descriptive method will be used to determine the leadership skills of staff nurses in Private Health Care Facilities in Calbayog City.

As a survey research, questionnaire will be used to gather data and information from a sample population of respondents.

Research Responden

ts

The respondents of this study consist of all staff nurses in all Private Health Care Facilities in Calbayog City.

Research Locale

This study will be conducted at all Private Health Care Facilities in Calbayog City.

These will include three (3) Private Hospitals, Our Lady of Porziuncula Hospital, Inc., located at Rueda Street Calbayog City, Calbayog Sanitarium Hospital located at Barangay San Policarpo Purok 4 Calbayog City, and St. Camillus Hospital located at Barangay Trinidad, Calbayog City.

And three (3) Private School Clinics, Christ the King College located at Magsaysay Boulevard Calbayog City, St. Augustine International School located at Barangay Matobato Purok 2 Calbayog City, and New Life Christian Faith Academy located at Magsaysay Extension Calbayog City.

Research Instrumentati

on

The instrument of this study is a questionnaire

designed to answer the problem of this

study. It has four (4) parts.

The first part is the profile of the

respondents which includes age, sex, civil

status, employment status, monthly

income, length of service, distance from

work, and work assignment.

The second part is the leadership

skills of staff nurses in terms of

human relations, administrative, and institutional skills.

The third part is the factors affecting the

leadership skills of staff nurses, in terms

of financial incentives, superior relationships,

and work environment.

And the last part is the

recommendations to improve the

leadership skills of staff nurses in private health

care facilities.

Research Procedure

A letter of request to the Chief Nurse of the private health care facilities was made to ask permission to conduct this study in their respective institution.

With the chief nurses’ consent and approval, the questionnaires will be distributed to the staff nurses in the said institution.

The researcher will personally conduct the survey to ensure that the data in the questionnaires will be answered properly and to assist the respondents whenever they have some matters to be clarified.

After gathering the data, the responses will be tallied and analyzed.

Treatment

Analysis

Some of the data that will be

gathered, and will analyze using

the following statistical

measures:

1. Use of frequency

distribution (f), and ranking

2. Computation for

percentage (p).

Prepared by:

Mae O. Allequir

Maria Neze E. Dalimocon

Maribelle Encomio

Jovina R. Tan

Thank You!