Nursing Leadership and Management (Chapter 1)
-Have high standards
-Value professional development
-Demonstrate power in the organization
-Active in a professional organization
-Model learned beliefs and practices as they mentor other nurses
-Associated with high-performing groups, but close supervision is necessary, and feelings of hostility are often present.
To be influential, the democratic leader *uses expert power and the power base afforded by having close, personal relationships*.
-Engenders positive feelings in their groups, and performance is strong whether or not the leader is present.
-Associated with low-productivity and feelings of frustration are found within their groups.
-The premise is that *different leader behavior patterns will be effective in different situations*.
*2)* Hersey and Blanchard’s Situational Theory
Fielder’s theory of leadership effectiveness views the pattern of leader behavior as *dependent upon* the* interaction of the personality of the leader* and the *needs of the situation*.
1) *leader-member relationships*,
2) the degree of *task structure*,
3) and the leader’s *position of power*.
–When all of these dimensions (leader-member relationships, task structure, and position power) are high, the situation is favorable for the leader.
–This approach can help match the needs of the organizational situation with the most favorable leadership style for the situation.
–*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.
–*High* task structure involves routine, predictable, clearly defined work tasks.
–*Low* task structure involves work that is not routine, predictable, or clearly defined, such as creative, artistic, or qualitative research activities.
–*High* position power is favorable for the leader
–*Low* position power is unfavorable
*Follower readiness*, called maturity, is assessed in order to select one of four leadership styles:
*1) Telling leadership* (high task, low relationship)
*2) Selling leadership* (high task, high relationship)
*3) Participating leadership* (low task, high relationship)
*4) Delegating leadership* (low task, low relationship)
–Use of these four leadership styles helps a nurse manager assign work to others.
*2)* Servant leadership
–This kind of leadership can influence both the leader and the follower to a higher level of conduct and achievement that transforms them both.
*2) Transformational leaders* are committed to a vision that *empowers others*.
–Characteristics include: listening, empathy, awareness, persuasion, foresight, stewardship, growth, and building community.
–This is most often *seen in the nurse-patient relationship*, and through a commitment to growth, nurses help patients grow as individuals.
They are valued for what they know.
–…a different type of intelligence. *It’s about being “heart smart,”* not just “book smart.”
*1) Lessen your stress*
*2) Understand your emotions* through self-awareness and self-regulation
*3) Connect with others through nonverbal communication*, express empathy, and improve on social skills
*4) Use humor*
*5) Resolve conflicts*
–Effective management can be viewed as the art of accomplishing things through people.
-*Legitimate source of power*
-*Carries out specific functions*, duties, and responsibilities
-*Emphasizes control*, decision making, decision analysis, and results
-*Manipulate people*, the environment, money, time, *and other resources* to achieve organizational goals
-Have *greater formal responsibility and accountability* for rationality and control *than leaders*
-*Direct willing and unwilling subordinates*
–Monitoring, Disseminator, Spokesperson
*2) Interpersonal role* is used to manage relationships with people
–Figurehead, Leader, Liaison
*3) Decision-making role* is used to take action when making decisions
–Entrepreneur, Disturbance handler, Resource allocator, Negotiator
-Creative problem solving
*2)* Middle-level managers
*3)* First-level managers
Direct supervision is *not* a major job requirement.
Nurses in these roles usually carry the title of *Chief Nurse Executive* or, in acute care hospitals, the title may be *Vice President of Patient Care Services*.
–Concerned mainly with conceptual aspects and their vision is 5-years.
–Concerned with many aspects of management and their vision is 1-year.
First-level managers spend the *majority of their time directly managing patient care* and *supervising others as they deliver care*.
–Concerned mainly with technical skills and their vision is focused on today.
*2)* Bureaucratic Management
*3)* Administrative Management
*4)* Human Relations
–Underlying theme is that the *organization is a machine to be run efficiently* to increase production and culminates in “one best way” of carrying out work.
–Competence is the basis for hiring and promoting an employee, and *decisions are made in an orderly and rational way* based on *rules and regulations*.
–There are *clear superior-subordinate communications and relations*, based on positional authority, in which *orders from the top are transmitted down through the organization via a clear chain of command*.
Emphasizes that *group decision making increases worker autonomy and provides training* to improve work.
*Emphasizes employee morale*
–Motivation occurs when needs are not met. Needs of one level (physiological, safety, social, self-esteem, self-actualization) must be satisfied before one is motivated by needs at the next level higher level of needs.
*2) Two-factor theory* (Herzberg)
–Hygiene-maintenance & Motivator Factors contribute to job motivation/satisfaction of work
*3)* *Theory X* and *Theory Y*
–*Theory X* states that leaders must direct and control because motivation results from reward and punishment.
–*Theory Y* says that leaders must remove obstacles because, under the right work conditions, workers have self-control and self-discipline.
*4) Theory Z*
–Humanistic style of motivation valuing collective decision making, mentoring, and holistic concerns
-Listen, consider, and respond respectfully. If possible, find a compromise solution. People want acknowledgement that they are being heard and their opinions are being considered.
-Don’t hesitate to seek the input and comments of others about your ideas or to review your work product. “Two heads are better than one.”
-A “good nurse” does not necessarily make the best supervisor. Supervisors and managers need to have and/or be willing to develop additional skill sets.
-Develop a “customer-service” focus and know who your customers are.
*Leadership* increases productivity by maximizing workforce *effectiveness*
–Have a *wider variety of roles* than managers
–Are *frequently not part of the formal organization*
–*Focus*: Group process, information gathering, feedback, and empowering others
–Have a *legitimate source of power* due to the *delegated authority* that accompanies their position
–Are expected to *carry out specific functions*
–*Emphasize*: Control, decision making, decision analysis, and results
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