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Nursing Leadership and Management (Chapter 1)

What is *leadership*?
A process of influence by which the leader influences others *toward goal achievement*
*Formal* leader
A person is *in a position of authority* or in a sanctioned, assigned role within an organization *that connotes influence*, such as a clinical nurse specialist.
*Informal* leader
An individual who *demonstrates leadership outside the scope of a formal leadership* role or *as a member of a group* rather than as the head or leader of the group.
Leadership *traits*
-Guiding vision
-Passion
-Integrity
-Self-confidence
-Determination
-Intelligence
-Sociability
-Visionary
-Resource
-Experience
-Humility
-Have high standards
-Value education
-Value professional development
-Demonstrate power in the organization
-Active in a professional organization
-Model learned beliefs and practices as they mentor other nurses
List the *3 behavioral theories* of leadership
*1)* Autocratic

*2)* Democratic

*3)* Laissez-faire

What is the *autocratic* behavioral theory of leadership?
*Autocratic* leadership involves *centralized decision making*, with the leader making decisions and *using power to command and control others*.

-Associated with high-performing groups, but close supervision is necessary, and feelings of hostility are often present.

What is the *democratic* behavioral theory of leadership?
*Democratic* leadership is participatory, with *authority delegated to others*.

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.

What is the *laissez-faire* behavioral theory of leadership?
Laissez-faire leadership is *passive and permissive*, and the *leader defers decision making*.

-Associated with low-productivity and feelings of frustration are found within their groups.

What are *contingency theories* of leadership?
Contingency theory acknowledges that *other factors in the environment influence outcomes as a much leadership style*.

-The premise is that *different leader behavior patterns will be effective in different situations*.

List the *2 contingency theories* of leadership
*1)* Fielder’s Contingency Theory

*2)* Hersey and Blanchard’s Situational Theory

What is *Fielder’s Contingency Theory*?
Fielder’s Contingency Theory is credited with the development of the contingency model of *leadership effectiveness*.

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*.

What is Fielder’s Contingency Theory contingent upon?
The needs of the situation or how favorable the situation is toward the leader *involves*:

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.

1) *Leader-member relations* (Fielder’s Contingency Theory)
*1) Leader-member relations* are the feelings and attitudes 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.

2) *Task structure* (Fielder’s Contingency Theory)
*2) Task structure* refers to the degree to which work is defined, with specific procedures, explicit directions, and goals.

–*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.

3) *Position power* (Fielder’s Contingency Theory)
*3) Position power* is the degree of formal authority and influence associated with the leader.

–*High* position power is favorable for the leader

–*Low* position power is unfavorable

What is *Hersey and Blanchard’s Situational Theory*?
Hersey and Blanchard’s Situational Theory *addresses follower characteristics/readiness in relation to effective leader behavior*.

*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.

List the *contemporary approaches* to leadership
*1)* Transformational theory

*2)* Servant leadership

What are *contemporary approaches* to leadership?
Contemporary approaches to leadership *address the leadership functions necessary to develop learning organizations*.
What is *Transformational theory*? (Contemporary approach to leadership)
Transformational theory is based on the idea of *empowering others* to engage in *pursuing a collective purpose* by working together to *achieve a vision of a preferred future*.

–This kind of leadership can influence both the leader and the follower to a higher level of conduct and achievement that transforms them both.

What is the difference between a *transactional leader* and a *transformational leader*?
*1) Transactional leaders* are the traditional managers concerned with the *day-to-day operations*.

*2) Transformational leaders* are committed to a vision that *empowers others*.

What is *Servant leadership*?
Servant leadership focuses on *putting the needs of others above all else* as the number one priority.

–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.

What are *knowledge workers*?
Knowledge workers, as defined by Peter Druker, are *those who bring specialized, expert knowledge to an organization* and are considered leaders in the organization.

They are valued for what they know.

What is *emotional intelligence*?
Emotional intelligence (EI) is a component of leadership and *refers to the capacity for recognizing your own feelings and those of others*, for motivating yourself, and for *managing emotions well in yourself and in your relationships*.

–…a different type of intelligence. *It’s about being “heart smart,”* not just “book smart.”

How can I develop *emotional intelligence*?
Emotional intelligence (EI) is developed through *five key skills*:

*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*

What is *management*?
Management is defined as *a process of coordinating actions and allocating resources* to achieve organizational goals.

–Effective management can be viewed as the art of accomplishing things through people.

Characteristics of *management* include:
-*Assigned position*

-*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*

What are the *3 Managerial Roles*
*1) Information-processing role* is used to manage the information needs people have.
–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

What *functions of management* define the *management process*?
-Controlling

-Planning

-Organizing

-Staffing

-Directing

-Creative problem solving

What are the *3 levels of management*?
*1)* Top-level (Executive-Level) managers

*2)* Middle-level managers

*3)* First-level managers

What are *Top*-level (*Executive*-Level) managers?
Top-level (Executive-Level) managers are concerned with *planning and generalizing at the highest levels* of an organization.

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.

What are *Middle*-level managers?
Middle-level managers, *often called nursing unit managers* or *nursing directors*, spend *less time in direct supervision* and *more time in other managerial roles* or functions, particularly, planning and coordinating.

–Concerned with many aspects of management and their vision is 1-year.

What are *First*-level managers?
A First-level managerial role or function in health care organizations is the *nurse manager at the clinical bedside*.

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.

List the *4 types of management theories*
*1)* Scientific Management

*2)* Bureaucratic Management

*3)* Administrative Management

*4)* Human Relations

What is *Scientific Management*?
Scientific management emphasizes the area of *focus on productivity*.

–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.

What is *Bureaucratic Management*?
Bureaucratic management *emphasizes impersonal relations within a formal structure*.

–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*.

What is *Human Relations Management*?
Human relations management *focuses on empowerment of the individual worker* as the source of control, motivation, and productivity in meeting the organization’s goals.

Emphasizes that *group decision making increases worker autonomy and provides training* to improve work.

*Emphasizes employee morale*

Name and describe the *4 selected Motivation Theories*
*1) Maslow: Hierarchy of Needs*
–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

Leadership tips (part 1 of 3)
-Always be willing to listen to another point of view

-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.”

Leadership tips (part 2 of 3)
-Always admit if there is a problem and make a commitment to “fix” it. Be willing to acknowledge that if there is a problem in the organization you want to know about it to be able to correct the issue.

-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.

Leadership tips (part 3 of 3)
-Follow-up on what you say you will do. People will remember.

-Develop a “customer-service” focus and know who your customers are.

*Management* vs *Leadership*
*Management* emphasizes *control* of hours, costs, salaries, overtime, use of sick leave, inventory, and supplies.

*Leadership* increases productivity by maximizing workforce *effectiveness*

*Leaders*
–Often *do not have delegated authority*, but obtain their power through other means

–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

*Managers*
–Are always *assigned a position* within an organization

–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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