Submitted to:

Mrs. P.Girijamba Asst Professor Dept of Midwifery and Gynecology Nursing AECS Maaruti College of Nursing. Bangalore-76

Submitted by:
Rajeshwari.S 1ST M.Sc (N) AECS Maaruti College of Nursing. Bangalore-76

Lesson Plan Subject: Nursing Administration Topic: Leadership Styles Unit: IX Date & Time: 21 Jan 2008, 4.00pm to 5pm. Group: 4th Year BSc(N) students. Venue: 4th Year class room. Previous knowledge: Students will have some knowledge regarding leadership styles as they studied in first year A.V.Aids: PPT, Black board. General objective: At the end of the session students will be able to Knowledge: Project the concept different leadership styles. Attitude: Appreciate different leadership roles. Practice: practice different leadership skills according to situation .

Specific objectives:
1. Define community health nursing process. 2. Enumerate steps in community health nursing process. 3. Define community identification. 4. Explains information required for community identification and sources of information 5. Enumerate the methods/approach of collecting information 6. Enumerate the data collections steps 7. Explain data analysis 8. Explain the meaning of community health diagnosis 9. Explain diagnostic process 10. Define planning 11. Enumerate the purposes of planning. 12. Enumerate the steps in planning 13. Explain priority setting. 14. Explains the meaning 15. Explain the purposes of goals/expected out comes 16. Enumerate and explain types of goal 17. Explain the meaning of implementation 18. Explain nursing implementation 19. Explain evaluation in community health nursing process.

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Specific objective

Content

Teachers activity Introduction : Good leaders are made not born. If you have the desire and willpower, you can become an effective leader. Good leaders develop through a never ending process of self-study, education, training, and experience. This guide will help you through that process. To inspire your workers into higher levels of teamwork, there are certain things you must be, know, and, do. These do not come naturally, but are acquired through continual work and study. Good leaders are continually working and studying to improve their leadership skills; they are NOT resting on their laurels

Learners activity

AV Aids

Evaluation

Announcement of the topic: Announces the topic leadership styles verbally as introduction to role play.

Time Specific

Content

Teachers Activity Teacher discusses the meaning of leadership and difines. Teacher describes the principles to be followed for a effective leqadership

Learners activity Active listening and discussion.

AV aids PPT

Evaluation What do you mean by leadership?

Objective Define leadership. Definitions: Leadership is a process by which a person influences others to accomplish an objective and directs the organization in a way that makes it more cohesive and coherent Or It is the art of motivating a group of people to act towards Explain the principles of leadership achieving a common goal. Principles of leadership 1. Be technically proficient - As a leader, you must know your job and have a solid familiarity with your employees' tasks. 2. Seek responsibility and take responsibility for your actions - Search for ways to guide your organization to new heights. And when things go wrong, they always do sooner or later -- do not blame others. Analyze the situation, take corrective action, and move on to the next challenge. 3. Make sound and timely decisions - Use good problem solving, decision making, and planning tools. 4. Set the example - Be a good role model for your employees. They must not only hear what they are

Active listening and takes down the points.

PPT

What are the general principles to be considered in leadership?

expected to do, but also see. W e m u s t b e c o m e t h e c h a n g e w e w a n t t o s e e - Mahatma Gandhi 5. Know your people and look out for their wellbeing - Know human nature and the importance of sincerely caring for your workers. 6. Keep your workers informed - Know how to communicate with not only them, but also seniors and other key people. 7. Develop a sense of responsibility in your workers Help to develop good character traits that will help them carry out their professional responsibilities. 8. Ensure that tasks are understood, supervised, and accomplished - Communication is the key to this responsibility. 9. Train as a team - Although many so called leaders call their organization, department, section, etc. a team; they are not really teams...they are just a group of people doing their jobs. 10. Use the full capabilities of your organization - By developing a team spirit, you will be able to employ your organization, department, section, etc. to its Define assess fullest capabilities. Factors of leadership: Discusses Listens and PPT What is

the definition, meaning and importance of assessment

take down notes.

assessment?

Follower Different people require different styles of leadership. For example, a new hire requires more supervision than an experienced employee. A person who lacks motivation requires a different approach than one with a high degree of motivation. Leader leader must have a honest understanding of who he/she is, what he/she knows, and what he/she can do. Also, note that it is the followers, not the leader who determines if a leader is successful. Communication: Leader lead through two-way communication. Much of it is

nonverbal. For instance, when leader "set the example," that communicates to people that he/she would not ask them to perform anything that he/she would not be willing to do. What and how leader communicate either builds or harms the relationship between leader and follower. Situation All are different. What one do in one situation will not always work in another. Leader must use his/her judgment to decide the best course of action and the leadership style needed for each Enumerate different types of leadership. situation. Leadership style starts from very classical autocratic approach to a very creative participatory approach. Not everything old was bad and not every thing new is not good. Different leadership styles are needed different situations and each leader needs to know when to exhibit a particular approach. Different leadership styles: 1. Autocratic( authoritarian) 2. Democratic(participative) 3. Bureaucratic. 4. Laissez-faire (delegative) 5. Charismatic leadership. 6. Transactional leadership. Teacher lists Listens and PPT down different leadership roles. takes down the points. what are the different leadership styles?

7. Transformational leadership. 8. Quiet Leader 9. Creative leadership 10. Corrective leadership 11. Servant leadership Explain autocratic Autocratic : approach The classical approach. The manager retains as much power and decision making as possible. Does not consult staff nor take any input. Staff expected to obey orders with out receiving nay explanations. Structured set of rewards and punishments. When to use: New, untrained staffs do not know which task to perform or which procedure to follow. Effective supervision provided only through detailed orders and instructions. Staff do not respond to any other leadership style Limited time in which to make a decision Managers power challenged by staff Teacher enacts autocratic role in leadership. Students watch the role play Acting and What do you mean autocratic leadership style?

dialogues by

 Work needs to be coordinated with another department or organization. When not to be used: Staff becomes tensed fearful and resentful. Staffs expect their opinions heard. Staff depend on their manager to make all their decisions Low staff morale. High turn over and absenteeism and work Explain democratic or participatory approach in leadership stoppage. Democratic( Participative) Style: Encourages staff to be a part of decision making. Keeps staff informed about everything that affects their work and shares decision making and problem solving responsibilities. Produce high quality and high quantity work for long periods of time. Staffs like the trust they receive and respond with co operation, team spirit and high moral. Allows staff to establish goals Encourages staff to grow on the job and be promoted Recognizes and encourages achievements. When to use: Teacher enacts democratic or participatory role in leadership Students watch the role play Acting and What do you mean democratic or participatory leadership style?

dialogues by

 Wants to keep staff informed about matters affects them. Wants staff to share in decision making and problem- solving duties. Wants to provide opportunities for staff to develop a high sense of personal growth and job satisfaction. A large or complex problem that requires lots of input to solve. Changes must be made or problems solved that affects staff. Want to encourage team building and participation. When not to be used; Not enough time to get every ones input. Easier and most cost effective manager to make the decision. Can not afford mistakes\ Manager feels threatened by this type of leadership. Explain bureaucratic leadership approach Staff safety is a critical concern. Bureaucratic leadership: Manages by book. Everything done according to procedure or policy. If not covered by the book, refer to the next level above Enforces the rule: When to be used: Teacher enacts role of bureaucratic leader in leadership Students and watch the role play Acting What do you mean bureaucratic leadership style?

participates and

dialogues by

 Staff performing routine tasks over and over. Staff needs to understand certain standards or procedures. Safety or security training conducted. Staff performing tasks that require handling cash. When not to be used: Work habits from that are hard to break, especially if they are no longer useful. Staff loose their interest in their jibs and in their co-workers Staff do only what is expected of them and no more.

Explain Laissezfaire (delegative) leadership role

Laissez-faire (delegative): Also known as hands-off style. The manager provides little or no direction and gives staff as much freedom as possible. All authority or power given to the staff and they determine goals, make decisions and resolve problems on their own. When to use: Staff highly skilled, experienced, and educated. Staff have pride in their work and the drive to do it

Teacher enacts role of Explain Laissezfaire (delegative) leader in leadership

Students and watch the role play

Acting

What do you mean faire (delegative) leadership style?

participates and

dialogues by Laissez-

successfully in their own Outside experts, such as staff specialists or consultants. Staff trustworthy and experienced. When not to be used: Staffs feel insecure at the unavailability of a manager. The manager can not provide regular feed back to staff on how well they are doing. The managers unable to thank staff for the good work. The manager does not understand his or her responsibility and hoping the staffs cover for him or her.

Explain charismatic leadership

Charismatic leadership: The Charismatic Leader gathers followers through dint of personality and charm, rather than any form of external power or authority. They pay much attention to the person they are talking to at any one moment, making that person feel like they are, for that time, the most important person in the world. Charismatic Leaders pay a great deal of attention in scanning and reading their environment, and are good at picking up the moods and concerns of both individuals and larger audiences.

Teacher enacts role of Explain leader in charismatic leadership leadership

Students and watch the role play

Acting

What do you mean charismatic leadership style?

participates and

dialogues by

 They then will hone their actions and words to suit the situation They are very persuasive and make very effective use of body Explain transactional leadership approach. language as well as verbal language. Transactional leadership: Emphasizes getting things done within the umbrella of the status quo. By the book approach- the person works with in the rules. Commonly seen in large bureaucratic organizations. Time Specific Objective Enumerate the of collecting information Content Community identification is done by descriptive survey the dimensions of community, community health problems and associated factors. But it is neither feasible nor advisable to gather all possible data because it is labouriois, time consuming expensive and is not required. There are various easy method to gather data those are: Community forum method Observational method Questioning method Teacher enacts role of Explain leader in leadership Teachers activity Learners Activity AV Aids Students and watch the role Acting What do you mean transactional leadership style? Evaluation

participates and

dialogues by

transactional play

methods/approach approach. This approach provides wide range of data about all

 Questioning method Record review method Conversation/discussion method Other methods: physical examination, clinical examination, investigations etc So it is good to collect information from combination of Enumerate the data collections steps different methods. The community identification survey need to be planned carefully to ensure systematic and appropriate collection of valid information. The following steps to be considered: Define the community to be studied. Determine the objectives for community identification. Determine specific information Identify the population Develop the instrument decided Explain data analysis. Organize and conduct survey. Analysis of data consists of putting all the information collected in to an order, compile and summarize according to variables studied. This step is very important and essential to make the collected data meaningful and understandable. Explains data analysis with master sheet/ tally sheet Active listening, Master sheet chart What do you understand by data analysis? Explains data collection steps. Lists down different steps PPT Lists dowm data collection steps.

Explain the meaning of community health diagnosis.

Nursing diagnosis: The determination of nature and extent of nursing problems presented by the individual patients or families receiving nursing care. ABDELLA A nursing diagnosis is a clinical judgment about an individual, family or community that is derived through a deliberate, systematic process of data collection and analysis. It provides the basis of prescription for definitive therapy for which the nurse is accountable. It is expressed concisely and including the etiology of the condition when unknown. SHOEMAKER Community Diagnosis: Determining the pattern of health problems in a community, including factors which influence this pattern. This community diagnosis has the aspects of social medicine which includes social anatomy, social physiology, social pathology, social diagnosis and social therapy Steps in diagnostic process: 1. ANALYSING THE DATA 2. IDENTIFY HEALTH PROBLEMS, RISKS AND

Explains the meaning with definition

Listens and PPT takes down notes.

What is nursing diagnosis?

Explain diagnostic process

Explains diagnostic process with

Active listening and note

PPT

How do you Diagnose the

STRENGTHS 3. ESTABLISHING PRIORITIES 4. FORMULATING DIAGNOSTIC STATEMENTS IDENTIFICATION OF HEALTH PROBLEMS The nurse considers all the relevant assessment data and focuses on pertinent and abnormal data. The nurse moves from general to specific ACTUAL PROBLEM-one that is perceived or experienced by the client AT RISK HEALTH PROBLEM-alerts the nurse for preventive interventions POSSIBLE PROBLEM DETERMINING ETIOLOGIES-physiologic, psychological, sociological, spiritual or environmental factors believed to cause or contribute to the problem. STRENGTHS-the strengths, resources and abilities to cope can help to mobilize the health and regenerative process. FORMULATION OF NURSING DIAGNOSTIC STATEMENT ONE PART STATEMENT-NANDA LABEL ONLY e.g.., rape trauma syndrome, post-trauma syndrome,

examples

down the points

community health problems? List common problems of community.

anticipatory grieving TWO PART STATEMENT (P) Problem (E) etiology joined by related to or associated with THREE PART STATEMENT- P (P) Problem (E) etiology (S) Signs and symptoms- as evidenced by It is necessary to analyze the problem by defining the problem, finding measures to reduce or solve the problem. Many problems may exist in the community which are listed below: A] Health problems: Malaria, leprosy, TB, Hepatitis and other diseases. Malnutrition Respiratory infections Diarrhea Complications of pregnancy Low birth weight of infant Infections of eye, ear, nose throat etc. Worm infestations Insect and snake bites Dog bites others Prevalence of risk factors of CHD hypertension etc

 Lack of health knowledge and attitude. B.Health service problems: Lack of qualified health personnels. Insufficiency and inaccessibility of material for treatment. Inadequate working conditions. Lack of transport. Insufficient visit to community by health staff. Other inadequate, ineffective insufficient resources. C.Communication problems No roads to community Bad roads Seasonal variations, weather and others. Inadequate transport Floods and other disasters. D.Community problems in general: Inadequate water supply Contaminated water supply No primary education-illiteracy Poor environmental sanitation Bad and overcrowded housing

 Draught Unemployment etc Time Specific Objective Define planning Content Definition: Planning is a category of nursing behavior in which client centered goals and expected outcomes are established and nursing interventions are selected to achieve goals and outcomes of care. POTTER AND PERRY Planning is a logical, decision making process of designing an orderly, detailed program of action to accomplish specific goals and objectives. Enumerate the purposes of planning. BARBARA WALTON Purposes of planning To determine how to satisfy clients/family/community needs To prescribe specific actions To guide the activities of the health workers who are involved in patient/community health care. Enumerate the Steps in planning: Enumerat Takes PPT Enumerate steps Enumerat es purposes Takes down notes PPT What are the purposes of planning? Teachers Activity Defines planning Learners Activity Active listening and takes down notes AV Aids PPT Evaluation What is planning?

steps in planning

PRIORITY SETTING ESTABLISH DESIRED PATIENT OUTCOMES SELECT NURSING INTERVENTIONS WRITING NURSING ORDERS COMMUNICATE THE NURSING CARE

es steps in planning

down notes

in planning.

Explain priority setting.

PLANS Establishing prioroties Intermediate priority nursing diagnosis involve the non emergent, non life threatening needs of the client. Low priority are client needs that may not be directly related to a specific illness or prognosis. Involve the client in priority setting. Consider the needs of the client, resources of the health care system and limitations of time. Priorities must not remain fixed rather they change as the clients responses, problems and therapies change. Meaning:

Explains to how to priorities with examples

Active listening and takes down notes

PPT And Chalk board

How to prioritize the diagnosis?

Explains the

Explains

Active

PPT

Explain the

meaning of goals/expected out comes Explain the purposes of goals/expected outcomes

Goals and expected outcomes are specific statements used to indicate anticipated client behavior or responses from nursing care Purposes: To provide directions for individualized nursing interventions To set standards for determining the effectiveness of interventions. Each statement must have a time frame for evaluation which depends upon the nature of the problem, etiology, overall condition of the client/community and treatment/community setting.

meaning

listening

purposes of goals/expected out comes

Explain purposes and how to state goals.

Active listening

PPT

Explain the purposes of goals/expected out comes

Enumerate types of goal

Long term goals Short term goals

List out different types of goals

Active listening

PPT

Enumerate types of goals.

Explain different types of goal

LONG TERM GOALS- An objective that is expected to be achieved over a long period of time usually weeks or months.

Explains the different types of

Active listening

PPT

What are the different types of goals?

 SHORT TERM GOALS- an objective that is expected to be achieved in a short time usually less than a week. Eg: To assess growth of all underfive children from villages of PHC Konanakunte Short term goal: To assess growth of all underfive children from villages of subcentre Doddakammanahalli. Interventions: Informing community for assessment drive Nutritional status indicator Recording of measurement Recording venue Meaning of implementation. Days and timings of recording Mariner states that the implementation of nursing contributes to comprehensive care because the plan considers the biopsycho-social aspects of the patient and community

goal with examples

Explains the meaning

Active listening

PPT Black board

Explains the meaning of implementation

Explain nursing implementation

Implementation in nursing process is to translate the planning into practice according to the

Explains the

Active listening

PPT Black

Explain implementation.

principles of nursing. Implementation is the initiation and completion of the actions necessary to achieve the objectives defined in planning stage. Implementations can be carried out by health team, the patient or the patients family, community members. Involves documentations. Objectives of CHN in implementation stage: Supplemental Facilitative Developmental Co ordination with members of health team, activities and community. Communicate the decisions to all concerned with the work CHN must utilize her relationship skills, cognitive knowledge about the particular health problems which are the focus of attention. Categories of nursing care includes:

implemen tations with examples

board

 Providing functions for the patient and administration of drugs. Performing activities for the patient e.g arranging immunization clinic. Assisting the patients to carry out activities e.g; helping the patients to walk Directing the patient in performing activities. Teaching Explain evaluation in community health nursing process. Counselling Meaning: It is an ongoing process that determines the extend to which the goals of care have been achieved. The nurse assesses the progress of patient, institutes corrective measures if required and revises the nursing care plan as needed. Evaluation involves 3 activities: 1. The statement of criteria by which goal achieved, is determined, is frequently called out come criteria. 2. The gathering of data base about which a statement of goal achievement can be made.

3. The actual statement of judgment about degree of goal achievement. Evaluation is of both concurrent and terminal Concurrent evaluation is of the whole process and determines the strengths and weakness of each stage of the process and accordingly remedial measures are taken. Terminal evaluation determines the achievements of outcomes intended.

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Teachers activity Summary: Till now we discussed what is community health nursing process? What are the different steps involved in this? How to do the community identifications? What are the steps involved in community identification? How to diagnose the community health? What are the components of planning phase? How to implement the nursing intervention? And how to evaluate it?

Learners activity

AV Aids

Evaluation

Conclusion: Prevention of illness and maintenance of health are common goals in all areas of community

health. Nursing process is known as problem solving approach where we can identify the problems and can solve those systematically and organized manner. Just as the nursing process helps in providing skilled nursing care to individuals, when the same is applied in community health care setting it helps the nurse to make professional judgment and render good nursing care to the family and the community.

BIBLIOGRPHY: 1. Gulani KK. Community health nursing principles and practice. 1st edition. New Delhi: Kumar publishing house; 2005.P.92-109. 2. Rao KS. Introduction to community health nursing. 3rd edition. Chennai: B.I.Publications pvt ltd; 2000 3. Basavantappa BT. Community health nursing/ 1st edition. New Delhi: Jaypee brothers; 201. p42-65. 4. TNAI. A community health nursing manual. 3rd edition. New delhi: TNAI; 1999. P 31-8 5. Potter A, Patricia. Fundamentals of Nursing . 6th edition. New Delhi. Harcoart ; 2005