LEADERSHIP Dr. James Malce Alo, RN,

MAN, MAPsych, PHD

Learning Outcomes

1. Explain why every nurse is a manager &can be a

leader.

2. Differentiate between leaders and managers.

3. Discuss how different theories explain leadership

and management.

4. Describe what management roles nurses fill in

practice.

5. Discuss how followership is essential to leadership.

6. Describe what makes a leader successful.

Manager, leader, supervisor, and

administrator

- are often used interchangeably, yet

they are not the same.

A Leader

Is anyone who uses interpersonal skills to

influence others to accomplish a specific

goals.

Exerts influence by using a flexible

repertoire of personal behaviors and

strategies

The Leader is Important in:

Forging links

Creating connections – among an

organization’s members

-to promote high levels of performance and

quality outcomes

Leaders Functions

To achieve a consensus within the group

about it’s goals

Maintain a structure that facilitates

accomplishing the goals

Supply necessary information that helps

provide direction and clarification

Maintain group satisfaction, cohesion and

performance.

A Manager

Individual employed by an organization

who is responsible and accountable for

efficiently accomplishing the goals of the

organization

Managers Focus on:

Coordinating and integrating resources

Using the function of planning, organizing,

supervising, staffing, evaluating,

negotiating, and representing.

Also, has the authority, responsibility,

accountability, and power defined by the

organization

Manager’s Job

Clarify the organizational structure

Choose the means by which to achieve

goals

Assign and coordinate tasks, developing

and motivating as needed

Evaluate outcomes and provide

feedback

All good managers are also good leaders

– the two go hand in hand

However, one may be a good manager

of resources and not be much of a leader

of people.

Likewise, a person who is a good leader

may not manage well

Both, roles can be learned; skills gained

can enhance either role.

LEADERSHIP May be:

1. Formal – when practice by a nurse with legitimate authority conferred by the

organization and described in a job description

Ex: nurse manger, supervisor, coordinator

- depends on personal skills

2. Informal – exercised by a staff member who

does not have a specified management role

- depends primarily on ones knowledge, status

Ex: APN, quality mgt coordinator, education

specialist, medical director

-personal skills in ; persuading and guiding others.

Traditional Leadership Theories

1. Trait Theories

- earliest studies researchers sought to identify inborn traits of successful leaders

2. Behavioral Theories

- 1930s focused on what leaders do

- In behavioral view of leadership, personal traits provide only a foundation for leadership

- Real leaders are made through education, training, and life experiences,

3. Contingency Theories

- Managers adapt their leadership styles in

relation to changing situation

- Leadership behavior range from authoritarian to

permissive and vary in relation to current needs

and future probabilities.

Ex: A nurse manager may use authoritarian style

when responding to emergency situation

(cardiac arrest) such as cardiac arrest but use a

participative style to encourage development of

a team strategy to care for patient multiple

system failure

The most effective leadership

style for a Nurse Manager

Is the one that best complements the:

1. Organizational development

2. Task to be accomplished

3. Personal characteristic of the people

involved in each situation.

CONTEMPORARY THEORIES

Leaders in today’s health care

environment place increasing value on

collaboration and teamwork in all aspects

of the organization.

Leaders in today’s health care

They recognize that;

1. health systems become more complex and

require integration

2. personnel who perform the managerial and

clinical work must cooperate

3. coordinate their efforts

4. produce joint results.

5. Must use additional skills; esp. group & political

leadership skills, to create collegial work envi.

1. Quantum Leadership Based on the concept of chaos theory

Reality is constantly shifting

Levels of complexity are constantly changing

Movement in one part of the system reverberates throughout the system

Roles are fluid and outcome oriented

It matters little what you did; it only matters what outcome you produced

Within this framework, employees become directly involved indecision making as equitable and accountable partners

Manager assume more of an influential facilitative role, rather than one of control( Malloch, 2010).

2. Transactional Leadership

Based on the principles of social exchange theory

The premise;

1. individuals engage in social interactions expecting to give and receive social, political, and psychological benefits or rewards

Exchange process bet. Leaders & followers is viewed as essentially economic

The nature of these transactions is determined

by the participating parties assessments of

what is in their best interest;

Ex: staff respond affirmatively to a nurse manger

request to work overtime in exchange for

granting special request for time off.

Leaders are successful to the extent that they

understand & meet the needs of followers &

use incentives to enhance employee loyalty

& performance.

Transactional Leadership is

aimed at:

1. Maintaining equilibrium or status quo,

by performing work according to policy &

procedures

2. Maximizing self-interest and personal

rewards

3. emphasizing interpersonal

dependence

4. Routinizing performance (Weston, 2008)

3. Transformational Leadership

Goes beyond transactional leadership to inspire & motivate followers (Marshall, 2010)

Emphasizes the importance of interpersonal relationship

NOT concerned with the status quo, but with effecting revolutionary change in organizations & human service.

FOCUSES on: merging the motives, desires, values, & goals of leaders & followers into a common cause.

GOAL to: generate employees commitment to the vision or ideal rather than to themselves.

They foster followers inborn desires to pursue higher values, humanitarian ideals, moral missions and causes.

Encourage others to exercise leadership

Inspires followers and uses power to instill a belief that followers also have the ability to do exceptional things.

T.L. may be a natural model for nursing managers, because nursing has traditionally been driven by its social mandate & it’s ethic of human service.

4. Shared Leadership

Reorganization, decentralization, and the

increasing complexity of problem solving

in health care have forced administrators

to recognize the value of S.L.

Based on the empowerment principles of

participative & transformational

leadership. (Everett, 2011).

Essential elements of S.L.

1. Relationships

2. Dialogues

3. Partnerships

4. Understanding boundaries

Application of S.L. Assumes

that:

1. A well educated, highly professional,

dedicated workforce is comprised of

many leaders.

2. The notion of a single nurse as the wise

and heroic leader is unrealistic & that

many individuals@ various levels in the

org. must be responsible for the

organization’s fate & performance.

Examples of S.L. in nursing

include:

1. Self-directed work teams – work groups

manage their own

planning,

organizing,

scheduling, &

day to day work activities.

2. Shared governance –

the nursing staff are formally organized at the

service area & organizational levels to make key

decisions about clinical practice standards,

quality assurance & improvement,

staff development,

professional development,

aspects of unit operation & research.

3. Co- Leadership

- Two people work together to execute a l. role

- Common in service-line management, where

the skills of both a clinical and administrative

leader are needed to successfully direct the

operations of a multidisciplinary service.

Ex: Nurse manager provides administrative

leadership in collaboration w/ a clinical nurse

specialist, who provides clinical leadership.

5. Servant Leadership

Based on the premise that leadership

originates from a desire to serve, and that

in the course of serving, one may be

called to lead (Keith, 2008).

3 Characteristics of a S.L.;

1. Empathy

2. Awareness

3. Persuasion (Saunders, 2008)

S.L. appeals to nurses for 2

reasons:

1. Our profession is founded on principles of

caring, service, & the growth & health of

others

2. Nurses serve many constituencies, often

quite selflessly, & consequently bring about

change in individuals, systems, &

organizations.

6. Emotional Leadership Emotional intelligence involves; 1. Personal competence w/c includes;

Self-awareness & self management

2. Social competence includes; Social awareness

Relationship mgt that begins w/ authenticity

Nurses w. their well-honed skills as compassionate caregivers are aptly suited to this direction in leadership that emphasizes emotions and relationship with others as primary attribute for success.

Ref: Eleanor J. Sullivan. (2013). Effective

Leadership & Mgt in Nsg. 8th

Ed.(International Edition)

- http://nursing,pearsonhighered.com

- THANK YOU! – Dr. James Malce Alo