Nursing Leadership,

Followership and
Management
Nursing 493: Unit II

Why study leadership &

management?

Who are our

leaders?

What are the most serious

problems people face in the
work environment?

Technical
Safety
People
Financial
Ethical

Why?

To learn how to work with people, not

only as individuals, but as members of
groups, teams, and organizations

Provides greater understanding and

control of events in the work situation

Imparts a sense of personal power &

self direction

Definitions

Leadership- the process of influencing

others

Leaders inspire thru personal

trustworthiness & self-confidence

Leaders communicate a vision that

turns self-interest into commitment to
the job

What are the 3 primary

tasks of a leader?

Set direction: mission, goals, vision

Build commitment: motivate &

inspire

Confront challenges: innovation, deal

with change, turbulence, take risks

What does the study of

leadership involve?

Leadership theories
Motivation
Group development & team work
Power & conflict
Confrontation & negotiation
Effective communication
Critical thinking & problem solving

Leadership

All people have untapped leadership

potential it is there in you.

The attempt defines leadershipit

does not have to be successful

To be a leader you must make a

decision to act

What is Followership

Followership & leadership are

reciprocal roles

Being an effective follower is as

important to the new nurse as
being an effective leader

What are the

characteristics of an
effective
follower?

Self direction
Actively participates in setting
group direction
Invests time & energy in the work
of the group
Thinks critically
Advocates for new ideas

What is management?

Management too is a process of

influencing people but with the specific
intention of contributing to meeting the
organizations goals
Management is the process of getting
work done through other people
Management is planning, organizing,
coordinating, and controlling work given
to employees

Management Functions

Officially responsible for the work of a group

Hiring & firing
Evaluating staff performance
Recommending raises and promotions
Prepare & implement a budget
Approve expenses & purchases
Handle conflicts
Work schedules & assignments
Plan current & future activities of unit
Be open to demands of continuous change

New definition of
management
To do whatever is necessary to
see that employees do their
work and do it well.

Differences b/w leadership

& management

Leadership
based on influence
an informal
designation
an achieved
position
part of every
nurses role
independent of
management

Management
based on authority
a formally
designated position
an assigned position
improved by use of
effective leadership
skills

What makes a person a

leader?
We look to Leadership
theories

Most Prominent
Leadership Theories

TRAIT THEORIES
BEHAVIORAL THEORIES
(Leadership styles)
SITUATIONAL THEORIES
(understanding all the factors)
TRANSFORAMTIONAL THEORIES
(inspiration & meaning)

Comparison of
Authoritarian, Democratic,
& Laissez-Faire
Authoritar. Democrat. Laissez-F
Degree of
freedom
Degree of control
Decsision making

Leader activity level

Assumption of
Responsibility
Output of group

Little
Moderate Much
High
Moderate None
By leader Leader& Group or
group
no one
High
High
Minimal
Leader
Shared
Abdicated
High&
High &
Variablegood qual. creative
Poor?

What are the key

differences in the 3
leadership
styles?

Democratic leader moves the

group toward its goals

Autocratic leader moves the group

toward the leaders goals

Laissez-faire leader makes no

attempt to move the group

Behaviors of an Effective
Leader

Think critically
Solve problems
Respect people
Communicate skillfully
Set goals, share a vision
Develop self & others

Transformative Leadership
Qualities

Integrity (Action
matches words)
Courage (take
risks)
Initiative (Act on
ideas)
Energy

Optimism
Balance(work,
reflection,play)
Ability to
handle stress
Self-Awareness)

What distinguishes
ordinary leaders from
STARS?
Emotional Intelligence
addressing the effects of
peoples feelings on the team

Management Theories:
Two Opposing Schools of
Theory

Scientific
management

Human relationsoriented
management

Scientific management

Frederick Taylor Father of S.M.

Focus on tasks & ways to increase

efficiency & productivity by getting
more work out of individual
employees

What makes a person a

manager?
Two
Perspectives
Scientific Management - Frederick

Taylor says (emphasis is on the task

aspect of providing care, paying
people by the # of clients seen,
incentive is to get the most work done
in the least amount of time. The
current emphasis on reducing staff &
increasing productivity is based on this
type of thinking.

Human Relations-Oriented
Management Theory: X&Y

Theory X (McGregors ) says most

people think work is something to be
avoided, and the managers job is to
make them work hard.
According to Theory X employees
need strict rules, constant supervision,
& the threat of punishment to make
them conscientious.

Theory Y

Theory Y manager believes the

work itself is motivating and people
really want to do a good job.
The Theory Y manager emphasizes
guidance rather than control,
development vs close supervision,
& reward vs punishment.

Communication

Is at the heart of leadership

Leadership can not occur except in
relationship to other people &
communication is the means
through which leadership is
accomplished

Communication

We cannot not
communicate!

Communication

Giving & receiving feedback

Linking (connecting ideas in a

group)

Networking (connecting people in a

group or organization

Verbal &
Nonverbal:KeyPoints

Most nonverbal is done unconsciously

It is more difficult to control
Discrepancies often exist between
verbal & nonverbal
What is stated is often not felt or
believed
Listening is the most critical
communication skill

Emotional Intelligence

Listen to others

Pick up unspoken concerns

Acknowledge others perspectives

Welcome constructive criticism

Bring people together in a spirit of
trust

Communication with
colleagues

Telephone etiquette
Information systems/computer/e-mail
Change-of-shift report
Be assertive without being aggressive
Staying calm & demonstrating good
communication skills demonstrates
professionalism& an ability to work
well with others

Communicating with other

disciplines

Nurses are client care coordinators

Nurses spend the most time with clients,
therefore they are in the best position to
communicate among disciplines info re
client
Physicians: nurses need to communicate
changes in the client condition, discuss
modification in treatment plan, clarify orders
This may be stressful-have the info you need
on hand before phoning (meds, vitals,
general health assessment status)
Maintain a record of calling logs

Communicating with
clients & family
Recognize signs of anger or
anxiety
Intervene to diffuse the situation
Practice good listening & show
respect

GIVING FEEDBACK

1. Give both positive & negative feedback

2. Give immediate feedback

3. Give frequently-keeps motivation high &

prevents problems from growing high

4. Be objective - use standards for making

judgments, tell Why it is good/bad

5. Base feedback on observable behavior- be

factual & accurate

Feedback (contd)

6. Communicate effectively - give

feedback & be prepared to receive
feedback in return. Engage in active
listening. When you give negative
feedback allow time for the individual
to express their feelings & for problem
solving to find ways to improve the
situation. This is impt. If the problem
has been ignored a long time.

7. Include suggestions for change. Try to

suggest alternative behaviors

8. Communicate in a non-threatening
manner. Highly threatening messages
reduce motivation & inhibit learning.
Too much fear immobilizes people.
Remember your ultimate purpose is to
bring about improved performance.

Performance Appraisal
Peer Review
Evaluation procedures
One by manager or superior
(hierarchical)
One by colleagues with similar status
& education
Peer review may be combined with
performance appraisal to form a
comprehensive system of evaluation

Case Scenario: Small

Change in Procedure??!!

It was not big deal just a small change

in procedure. At least that is what the VP
Nursing of the Tri-County Home Care
Agency thought when she ordered the
staff to bring their lap top computers back
to the office every evening. These
machines are expensive, the VP noted,
We can not continue to let staff take
them home. They could be broken, stolen,
or used to play games in the evening.

Questions for critical

reflection

How do you think the staff reacted to

this change? Explain why they
reacted as you describe?
Did the VP act primarily as a leader or
as a manger? Explain your choice
What alternative procedure might be
implemented to protect the laptops?