Pamantasan ng Lungsod ng Maynila (University of the City of Manila) Intramuros, Manila College of Nursing

A Written Report

Leadership and Nursing Management: Directing

Submitted By: BSN IV-a/Group 4 Lora, Lester Losloso, Francis Anthony Mabulac,Kevin Pascua, Vlendy Pritos, Annalie Quetulio, Ma. Krizhelle

Prof. Marietess Nicolas Professor February 8, 2014

Communication According to Shannon and Weaver (1949), communication is all that occurs between two or more minds. Newstrom and Davis (2002) defined communication as the transfer of information and understanding from one person to another person and they added that it is the bridge between and among people. While Johnson (2003) saw the concept as a means for one person to relay a message to another, expecting a response. Communication is the transfer of information and understanding from one person (Cherie & Gebrekidan 2005).]

Process of Communication
SENDER

Ideation Reason for communicating

Encoding (Ideas put to words or symbols)

BRIDGE Message is transmitted over a verbal or a non-verbal channel

Decoding (Words or symbols put into ideas)

RECEIVER

Acts in response to sender (Feedback)

Figure 1. Communication Process (Rigolosi, 2005)

Communication Channel

Formal Communication Channels A formal communication channel transmits information such as the goals, policies and procedures of an organization. Messages in this type of communication channel follow a chain of command. This means information flows from a manager to his subordinates and they in turn pass on the information to the next level of staff. Informal Communication Channels Within a formal working environment, there always exists an informal communication network. The strict hierarchical web of communication cannot function efficiently on its own and hence there exists a communication channel outside of this web. While this type of communication channel may disrupt the chain of command, a good manager needs to find the fine balance between the formal and informal communication channel. Unofficial Communication Channels Good managers will recognize the fact that sometimes communication that takes place within an organization is interpersonal. In any organization, three types of communication channels exist: formal, informal and unofficial. While the ideal communication web is a formal structure in which informal communication can take place, unofficial communication channels also exist in an organization. Through these various channels, it is important for a manager to get his/her ideas across and then listen, absorb, glean and further communicate to employees. Modes of Communication Mainly there are three modes of communication: spoken word, written words, and physical expression or significant gesture. Verbal communication Involves spoken words Speaker must be able to speak slowly, enunciating the words clearly Words that can be clearly understood should be used instead of too technical terms Only relevant information should conveyed to prevent confusion

Immediate response is ascertained when time is short

Written communication Must be clear, correct, complete and concise Written in words that clearly understood by the reader Comes in the form of memoranda, hospital orders, documentation, records and reports, policies, procedures and the like Ambiguous terms should be avoided to prevent misunderstanding Non- verbal communication Transmission of message without the use of words People oftentimes unconsciously use facial expressions, gestures, touch, body language, or vocal tones Personal Appearance- gives general impression of his/ her personality and self concept. Intonation of voice- should be soft and gentle, and not irritating to the ear. Facial expression- a friendly smile establishes immediate rapport with the client and invites trust and confidence in the nurse. Posture and gait- indicate physical wellness, emotions, and attitude toward clients. Touch- touch is a way of caring. A gentle touch conveys a caring person. A rough touch indicates insensitivity to the patients and unresponsiveness to their needs. Principles of Effective Communication Clarity of Purpose - The message to be delivered must be clear in the mind of sender. The person to whom it is targeted and the aim of the message should be clear in the mind of the sender. Completeness - The message delivered should not be incomplete. It should be supported by facts and observations. It should be well planned and organized. No assumptions should be made by the receiver. Conciseness - The message should be concise. It should not include any unnecessary details. It should be short and complete. Feedback - Whether the message sent by the sender is understood in same terms by the receiver or not can be judged by the feedback received. The feedback should be timely and in personal. It should be specific rather than general. Empathy - Empathy with the listeners is essential for effective verbal communication. The speaker should step into the shoes of the listener and be

sensitive to their needs and emotions. This way he can understand things from their perspective and make communication more effective. Modify the message according to the audience - The information requirement by different people in the organization differs according to their needs. What is relevant to the middle level management might not be relevant to the top level of management. Use of jargons should be minimized because it might lead to misunderstanding and misinterpretations. The message should be modified according to the needs and requirements of the targeted audience. Multiple Channels of communication - For effective communication multiple channels should be used as it increases the chances of clarity of message. The message is reinforced by using different channels and there are less chances of deformation of message. Make effective use of Grapevine - The team and managers should not always discourage grapevine. They should make effective use of grapevine. The managers can use grapevine to deliver formal messages and for identification of issues which are significant for the employees. The managers can get to know the problems faced by the employees and can work upon it.

Lines of Communication Communication is described as a two- way process, yet in an organization, it is four dimensional. Downward Communication Traditional line of communication is from superior to subordinate which may pass through various levels of management. Primarily directive and activities are coordinated at various levels of the organization. Aims to impart what the personnel need to know, what they are to do and hy they are to do these. Includes policies, rules and regulations, memoranda, handbooks, interviews, job descriptions, and performance appraisal. Upward Communication Emanates from subordinates and goes upward. Usually in the form of feedback to show the extent to which downward communication has been received, accepted, and implemented. Subordinates may not have the ability to express their thoughts or may be too shy to express them. Supervisor and Head Nurses have a big role to play in ensuring the effectiveness of communication.

Through tactful questioning or observation any misinterpretation can be detected to avoid difficulty in implementation, Examples are discussions between subordinates and superiors, grievance procedures written reports, incidents reports, and statistical reports.

Horizontal Communication Also known as Lateral Communication Between peer, personnel or departments on the same level Used most frequently in the form of endorsements, between shifts, nursing rounds, journal meetings and conferences, or referrals between departments or services. Coordination of duties and cooperation among the various departments will be maximized if communication is open to ensure smooth work flow. Outward Communication Deals with information that flows from the caregivers to the patients, their families, relatives, visitors and the community. Patients should understand the nature of their illness, the medical, and the prescribed nursing plans of care so that they could participate in the decision regarding these. Image of organization to the public depends on the employees understanding of its philosophy, vision, mission, and objectives, and how these are communicated to the public. Clear explanation of policies, rules, and regulations promote good public relations. Also involves how employees value their work. Directly or indirectly communicated to their families. Job satisfaction is related to open communication lines, positive communication between employees and their immediate supervisors, and personal feedback on job performance. All personnel should have access to information when they need it most such as availability of supervisors, of procedure manual, job descriptions, and work schedules. Such as open access will enable them to do their jobs in the most effective and efficient manner. Communication should be clear and understandable. Personnel should be able to receive adequate and timely information regarding work- related issues or changes that may affect their jobs. Communication overload or under load should be avoided as these may cause confusion, distrust, and misunderstanding.

Communication can be enhanced by carefully choosing the words or information anyone wishes to convey, by creating an environment that promotes its acceptance, by avoiding preconceived opinions and biases about a person, by listening to and understanding the other persons point of view, and by being open and supportive. Most people learn to communicate through example. Nurse Managers should promote a responsive communication climate in their units

Purpose of Communication A critical component of nursing practice Good communication o Generate trust between nurse and clients. o Provides professional satisfaction o Is a mean for bringing about change, i.e. nurse listens, speaks and acts to negotiate changes that promotes clients well-being. o Is the foundation of the relationship between the nurse and the other members of the health team. o Helps to promote managerial efficiency. o Provides basis for leadership action. o Provides means of coordination. Communication Role of Supervisor Teams Feedback - Supervisors are responsible for providing team with constructive feedback about performance and workplace behavior. Communication skills are important because the way supervisors interact with employees affects how well employees receive supervisor feedback. A supervisor with the capability to communicate work directives and employee feedback clearly, succinctly and in a manner that motivates employees instead of alienating them is a more effective leader. Interdepartmental Relationships - Communication with colleagues is part of the supervisors daily routine. Building interdepartmental relationships occurs through verbal and written communication skills. Supervisors exchange information, ideas and recommendations with colleagues in creating interdepartmental alliances. This, n turn, advances the goals and objectives of each department and of the overall business. Resolving Conflict - Resolving workplace conflict requires communication skills, and in particular, the ability to listen. Employees who complain to their supervisors about workplace issues have the reasonable expectation that the supervisor will provide support and guidance. Listening well enables supervisors

to communicate with employees who are experiencing workplace problems. Supervisors who listen give employees a sense of appreciation for leadership. Employees who believe they are valued contributors are likely to have greater confidence and trust in company leadership, which underlies positive supervisoremployee relationships. Consequently, employees who believe they are valued team members are better able to discuss problems that impact their performance and to participate in dispute resolution. Supervisors as Role Models - Supervisors model behavior for their employees to emulate. The quality of supervisor communication skills is usually a direct reflection of the supervisors overall job performance. Its difficult to excel in certain areas of leadership and have poor communication skills. Employees observe their supervisors' communications with others and, ultimately, learn to use the same techniques in their professional and personal relationships. Performance Management - Communication is one of the essential components of an organizations performance management system. Companies that provide leadership training encourage supervisors to maintain open and candid communication lines with employees who report to them. This fosters the necessary two-way dialogue that must occur during performance appraisals and improves the ability of employees to meet the companys expectations. Self-Promotion - Supervisors communication skills are important for their own careers. Supervisors are accountable for certain performance standards. Including the ability to communicate well with employees, colleagues and managers. Promotions are often more available to supervisors who have good verbal and written communication skills and the ability to develop positive relationships with others in the workplace.

Prepared by: Lester Lora MOTIVATION All human beings are motivated by different goals, ambitions, and aspirations. MOTIVE a need or desire that incites and directs a persons actions. According to Mills, Motivation is a force within the individual that influences strength or direction of behavior. The amount and quality of work accomplished by the manager directly reflect their motivation and that of their subordinates. They teach and empower their

workers and apply knowledge, skills, and techniques of motivational theories to achieve their individual goals. However, these goals should be congruent with organizations goals of acceptable levels of quantity and quality. This is best achieved in a motivating climate. Intrinsic versus Extrinsic Motivation Intrinsic motivation Comes from within the person driving him/her to be more productive. A worker must value his/her performance to be intrinsically motivated. Intrinsic motivation to achieve is directly related to a persons aspiration and goals in life shaped earlier on by parents and peers. High but attainable expectations from parents help establish a strong achievement standards for their children. Focused on intrinsic needs for recognition, self-esteem, and selfactualization. Extrinsic motivation Enhanced by the environment or external rewards. This may come in the form of promotions, increases in salary, added benefits, or external rewards. Mostly focused on fiscal rewards Motivational Theories NEED THEORY 1. Abraham Maslows Hierarchy of Needs Shows that people are motivated to satisfy certain needs beginning from basic physiological needs to complex psychological needs. He/ She contends that people seek higher needs only when the lower needs have been met. First level: physiological needs for survival such as food, sleep, clothing, shelter. When these needs are met, other levels of needs emerge and dominate.

 Second level: includes need for safety, security, and protection. The employee needs to be free from physical harm and deprivation of basic physiological needs. He/ She needs a secured shelter where he/she can establish a family. Employee benefits are aimed at security needs. Third level: need to belong which relates to affiliation or sense of belonging, affection, closeness, and intimacy. These are social needs. In nursing work groups, social support and cohesion are examples of belonging needs. Fourth level: includes esteem and ego needs. These are needs to achieve independence, respect, and recognition from others. Satisfaction of esteem needs results in prestige, self-confidence, power, and feeling of usefulness. Recognition is an important motivation in nursing. At the apex of the Pyramid: is the need for self-actualizationthe need to maximize ones potential and achieve a sense of personal fulfillment, competence, and accomplishment.

 Maslows theory applies to people in general and explain personal motivation. His early work however was not specific to work or organizational behavior. When this theory is applied to the staff, leaders must be aware that the need for safety and security will override the opportunity to be creative and inventive in promoting job change for instance. 2. The Two-Factor Theory Frederick Herzberg (1991) is credited with developing a two-factor theory of motivation which was first published in 1968. Hygiene Factors relate to the working conditions such as salary, quality of supervision, job security, interpersonal relations policies, and supervision. These factors are growth-producing motivations for employees and prevent lost productivity due to dissatisfaction. These hygiene factors are called dissatisfiers Motivating factors relate to the job itself and include opportunities for growth and development and advancement; added

responsibilities, challenging aspects of work, recognition, and achievement. These factors are called satisfiers. 3. McClellands Three Basic Needs Theory David McClelland (1961; 1976) identifies three basic needs that people possess in varying degrees: Achievementa strong desire to overcome challenge, excel to grow, to advance, or to succeed. Powerdesire to be in control and to get others to behave contrary to what they would naturally do. Affiliationdesire to work in a pleasant environment and the desire for friendly, close relationship.

EXPECTANCY THEORY Victor Vrooms expectancy theory of human motivation (1964)

 Indicates that felt needs of individuals in work settings are increased if a person perceives positive relationship between effort and

performance. Motivated behavior is further increased if there is positive relationship between good performance and outcomes or rewards particularly when these are valued. OPERANT THEORY B.F. Skinners Operant Theory (1969) Suggests that an employees work motivation is controlled by conditions in the external environment instead of internal needs and desires. Human exhibits two types of behaviorrespondent and operant. Respondent behaviorresults from direct stimulation. Operant behavioroccurs in the absence of any apparent external stimulation. Reinforcerwhen followed by consequences that increase or decrease the likelihood of these behaviors recurrence. Positive reinforcer increases the probability that the behavior will be repeated. *A praise from Head Nurse for a work well done increases the likelihood that satisfactory performance will likely be repeated. Negative reinforcer consequence that if removed, increases the probability that the behavior will be repeated. *if a Head Nurse reprimands a staff nurse for failure to put side rail on the bed of an elderly confined patient, the nurse will likely put side rails to all elderly confined patients. The reprimand is a negative reinforcer and will likely remind the nurse to comply with unit policies/ job requirements. Prepared by:

Kevin Mabulac

Principles of Organization These principles with help maximize the efficiency of the bureaucratic structure. 1. Unity of Command Organization should have clear lines of authority running from the highest executive to the employee who has the least responsibility and no authority from others. Each person have only one boss. Although employees may interact with many different employees in the performance of their duties, they should be responsible to only one superior to avoid confusion, overlapping of duties and misunderstanding. All employees should know to whom they report and who reports to them. Authority and responsibility should be clearly defined, reducing role ambiguity which leads to anxiety, frustration, dissatisfaction, negative attitudes, and decreased productivity. Employees should know what is expected of them and their limitations, this is called Role Clarity. Thus, these will prevent gaps among responsibilities, avoid overlapping of authority and help determine proper point for decisions. Job descriptions increases productivity and satisfaction. 2. Delegation of Responsibility Patient care coordinators should delegate responsibility to the lowest level within organization. Increased delegation also increases effective performance, production, and employee satisfaction. Employees should be given formal authority commensurate

with the responsibility delegated. Delegation of responsibility should be accompanied by accountability. Scalar Principle, the authority and responsibility should flow in clear unbroken lines from the highest executive to the lowest. Proper definition of and delegation of authority and responsibility facilitate the accomplishment of work. The following must be observed: a. When responsibility for a particular job is delegated to a subordinate, the latter should have authority over resources needed to accomplish the task; b. When a particular function is delegated to a subordinate, the superiors own responsibility is no way diminished and; c. When a person is bestowed the authority for action, he is accountable for his actions to the person that bestowed him such 3. Span of Control The number of workers that a supervisor can effectively manage should be limited, depending upon the pace and pattern of the working area. This also refers to span of managerial responsibility and the number which one superior can assist, teach and help to reach the objectives of their own jobs. If the workers are highly skilled and are working near each other, their number may be increased. A decreased span of control is required as the complexity of the staff associates tasks increases. The span of control is not likely to be uniform throughout an organization. Three types of division: 1. Function or Process

Function is associated with specialization. It is preferable that if a person is accountable for more than one type of responsibility, they may be similar. 2. Product or Service Individuals performing the same tasks and having divisions with specific functions can help expand the range of control. Similarly, having departments that provide specific services or produce same products can influence the structure. 3. Region Organization by geographical location becomes increasingly viable when operations are scattered. Initial work with span of control was quantitative and attempted to devise formulas for determining the most desirable number of people reporting to a manager. General Hamilton, a British officer in World War I, concluded that managers at the lower levels could direct more people than those at higher levels. Then, Hamiltons principle has been elaborated by Andrius Vytautas Graicunas, a Lithuanian french management consultant, management theorist and engineer. The Graicunas Theory In 1933, Graicunas published a paper called "Relationship in Organisation." In this paper, he mentioned three types of Superior-Subordinate relationships: 1. Direct Single Relationships, 2. Direct Group Relationships, and 3. Cross Relationships.

For

example,

consider Gaurav (G)

is

superior

(boss)

and Manoj (M)

andSameer (S) are his subordinates (juniors or lower-grade employees).

According to V.A. Graicunas, Gaurav (G) has to control following three types of relationships, with or among Manoj (M) and Sameer (S):(a) Direct Single Relationships: G with M, and G with S, i.e. a total of 2 direct single relationships. (b) Direct Group Relationship: G with M in presence of S, and G with S in presence of M, i.e. a total of 2 direct group relationships. (c) Cross Relationships: M with S, and S with M, i.e. again a total of 2 cross relationships.

Therefore, total number of relationships which Gaurav (G) has to control are:- 2 + 2 + 2 = 6 relationships.Thus, when the number of subordinates is 2, the number of relationships, which the superior (boss) has to control is 6. Similarly, when the number of subordinates is 3, the number of relationships to control will be 18.

The Graicunas Formula 2n R = n ( ------- + n 1) 2

4. Departmentalization This is also known as Homogenous Assignment. In departmentalization, workers performing similar assignments are grouped together for a common purpose. Departmentalization promotes the specialization of activities, simplifies the

administrators work, and helps maintain effective control. Prepared by: Questulio, Krizhelle DECISION MAKING Innate abilities, past experience and intuition form the basis for making successful decisions.

Systematic, sequential process of choosing among alternatives and putting the choice into action (Lancaster and Lancaster). This acknowledges natural and learned abilities while providing order and continuity to the process of decision making.

Models

The Normative Model It is assumed to maximize satisf action and fulfills the perfect knowledge assumption that in any given situation calling for a decision, all possible choices and the consequences and potential outcome of each are known. Steps: 1. 2. 3. 4. 5. 6. 7. Define and analyze the problem Identify all available alternatives Evaluate the pros and cons of each alternative Rank the alternatives Select the alternative that maximizes satisfaction Implement Follow-up

It is unrealistic because it assumes that there are clear-cut choices between identified alternatives. The Decision-tree Model Focus on protecting the quality and acceptance of the decision and deal with adequacy of information, goal congruence, structure of the problem, acceptance by subordinates, conflict, fairness, and priority for implementation. Magee and Brown depict decision trees as starting with a basic problem and using branches to represent event fork and action forks. The number of branches corresponds to the number of identified alternatives. Every path through the tree corresponds to a possible sequence of action and events, each with its own distinct consequences. The Descriptive Model Decision maker is a rational person looking for acceptable solutions based on known information (Simon).

Allows for the fact that many decisions are made with incomplete information because of time, money or personnel limitations; it also allows for the fact that people do not always make the best choices. Steps: 1. 2. 3. 4. 5. 6. 7. Establish an acceptable goal Define subjective perceptions of the problem Identify acceptable alternatives Evaluate each alternative Select an alternative Implement a decision Follow-up

The Strategic Model It usually relates to long-term planning. Managers make final decision choices by using intuition, formal analysis and knowledge of organizational politics. They make good choices by doing extensive planning, communication and politicking. Strategies: 1. Building extensive networks of individuals and groups who would provide resources at local, state, and national levels. 2. Searching the nursing, hospital, and business literature. 3. Being knowledgeable and involved in the politics of ones organization and professional organizations.

The knowledge and skills of the decision maker transform the alternative into action by completing any necessary plans involving sequencing steps and preparing individuals to implement the solution while effectively community the process with all involved. Seven questions to increase ones decision: 1. Does the quality of the decision really make a difference? 2. Do I have all the information I need to make the decision alone? 3. Do I know what Im missing? Do I know where to find the information? Will I know what to do with the information Im given? 4. Do I need anybodys commitment to make sure this succeeds?

5. Can I gain commitments without offering participation in the decision? 6. Do those involved in the decision share the organizations goals? 7. Is there likely to be conflict about the available alternatives?

The final step in the process of decision making is to monitor the implementation and evaluate the outcomes. The nurse compares actual results with anticipated outcomes and makes modifications as needed to accomplish the desired outcome. Prescriptive Decision Theory Decision-making rules that are more clearly related to the rational modes of thinking (left-brain- analytical and logical thinking, mathematics and sequential information). Defining attributes of a decision: 1. 2. 3. 4. 5. Making a deliberate mental choice. Taking action based on indication or evidence. Choosing between two or more options. Bringing doubt or debate to an end by committing to certain actions or inactions. Expecting to accomplish certain goals. Antecedents of a decision: 1. 2. 3. 4. 5. Considering of a matter that causes doubt, wavering, debate or controversy. Awareness of choices or options. Gathering information about alternatives. Examination and evaluation of the feasibility of the various alternatives. Weighing the risks and possible consequences of each option.

Intuitive reasoning abilities have a place in the decision making process. The left brain activities are analytical and logical thinking, mathematics and sequential information are essential in decision making and problem solving, while the right brain allow people to simultaneously process information, conceive and use contradictory ideas, fantasize and perceive intuitively. Improving Decision Making by Improving Communication Educate people so they know how to make decisions. Securing top management support for decision making at the lowest possible level. Establishing decision-making checkpoints with appropriate time limits. Keep informed of progress by ensuring access to first-hand information. Using statistical analysis when possible to pinpoint problems for solution.

Open to use of new ideas and technologies.

A successful nurse is one who stays informed about decisions being made at different levels of the organization after appropriately delegating these responsibilities, who deals only with those decisions requiring his or her level of expertise, who supports implementation and who credits the decision maker. Managers who make all decisions themselves convey a lack of trust in the ability or loyalty to their subordinates (McKenzie). Selective delegation of decision making gains the support of staff members and raises their self-esteem.They gain the sense of belonging and develop loyalty. Delegation leads to leadership. Leaders share authority and power rather than impose it. This is not to say that leaders never make decisions without input from associates. This may be necessary on occasions and is acceptable to associates who know they participate in decisions that rely on their level of knowledge and experience. Good managers dont make policy decisions (Wrapp). They concentrate on a limited number of significant issues, identify areas in which they can make a difference, judge how hard to force an issue, give a sense of direction to the organization through open ended objectives and spot opportunities that permit others to own their own ideas and plans for implementation. Decision making involves critical thinking. As one becomes expert, the process becomes more intuitive and the expert automatically processes the decision-making action as a consequence of a high level of knowledge and experience. It is fostered by training, feedback and expansion of knowledge like case studies. The Problem-Solving Process It involves making several decisions. Steps: 1. Assessment includes systematic collection, organization and analysis of data related to a specific problem or need.

It involves logical fact finding, questioning all sources and differentiating between objective facts and subjective feelings, opinions and assumptions. Identification of problem is done.

2. Planning

It involves breaking the problem down into components and establishing priorities, develop alternative courses of action; determine probable outcomes for each alternative; decide which course is best in relation to resources, goals, risks and the like; and decide on and make a plan of action with a time table for implementation. (Prioritization, setting of goals, objectives and planning intervention).

3. Implementation of the plan

One must be informed in the status of the process because it is unlikely that he or she will be directly involved. This is the one step most likely to be delegated to associates. It requires knowledge and skills appropriate to the specific alternatives selected.

4. Evaluation

It includes determining how closely goals and objectives were met, the success or failure of actions taken in resolving the problem, and whether the plan should be terminated because the problem has been resolved or whether it should be continued with or without modification.

Effective problem solving requires that the practitioner frequently work at a high cognitive level, the level of abstract thinking. The essential difference between problem solving and decision making is that in the former, the thinking process works to solve a problem, whereas in the latter, it serves to reach a goal or condition. Prepared by: Losloso, Francis Anthony

LEADERSHIP Is a process that is used to move a group toward goal setting and goal achievement. The leadership process may be used by any person; therefore, any person can theoretically be a leader at any given time. Leadership can also be learned. The process of persuasion and example by which an individual (or leadership team) induces a group to take action that is in accord with the leaders purposes or the shared purposes of all. Gardner Leadership is the vital ingredient that transforms a crowd into a funct ioning, useful organization. Talbott Leadership is a social transaction in which one person influences others. Unknown Leadership Theories Great Man Theory Assumes the leader is different from the average person in terms of personality traits such as intelligence, perseverance, and ambition. Assumptions People are born with inherited traits. Some traits are particularly suited to leadership. People who make good leaders have the right (or sufficient) combination traits.

Trait Theory Early research on leadership was based on the psychological focus of the day, which was of people having Attention was given to discovering these traits, often by studying successful leaders.

Underlying assumption that if other people could also be found with these traits, then they, too, could also become a great leaders.

Behavioral Theories Description Behavioral theories do not seek inborn traits- they look at what leaders actually do. Success can be defined in terms of describable actions. Assumptions Leaders can be made, rather than are born Successful leadership is based in definable, learnable behaviour. Implications Leadership capability can be learned Attributes of Effective Leader 1. Awareness Leaders must be very aware of themselves and of all their personal characteristics, so that they able to assess their effects on the group. The leader should analyse several specific areas of self-awareness. A leaders ability depends on knowledge of the area responsibility The leader should be able to set appropriate short-term goals that will ultimately lead to achievement of the overall goal. Leadership involves power, the ability to obtain, retain, and move resources The leader must also be aware of how power is used Careful assessment of a leaders personality and how he or she is viewed by others is important Good interpersonal relationships are critical for leadership Self-awareness for the leader to analyse is his or her endurance The leader must also be aware of the group both individual members and the group as a whole

Knowing each individual well Communication among group members Assertiveness includes expressing ones feelings, needs, and ideas, and standing up for one rights, while considering the rights of others (Bloom, Coburn, &Pearlman 1975) an important aspect of assertiveness is maintenance of both ones own integrity and the integrity of the other person.

2. Assertiveness

There are 5 ways for the leader to act assertively Basic assertion- which is a simple statement of ones feelings, needs, or ideas. Empathic assertion- the leader first gives recognition to the other persons feeling or situation and then makes a statement about his or her own position. Escalating assertion- escalation is used when the other persons fails to respond. Confrontive assertion- when a persons words contradict his or her actions, assertion may use I-language assertion- leader makes a four- part that includes: when you do. . . the effects on me are.. I feel ..and I would prefer.. the purpose of this type of assertion is for the person to state his or her own feelings and expectations. It is often used when the leader feels hurt or irritated.

3. Accountability Leaders are accountable to themselves, their group, their profession, and their superiors. Accountability is answering to someone for the positive or negative outcomes of ones action.

To be accountable to oneself, one must be able to objectively view what one is doing with ones work and ones life. To be accountable to the group, the leader must be able to tell members what has been done on their behalf.

4. Advocacy Advocacy is an essential part of nursing leadership. In nursing the leaders group is often one or more patients. An advocate supports, defends and maintains the cause of someone or something. Advocacy has been called that part of a persons nature known as selfish benevolence the leader-advocate works to change the power structure, so that the situation of his or her group or client, which may be socially, politically, economically, or otherwise deprived, is improved. Leadership Styles The extent to which the leader influences his/hersubordinates in achieving their objectives of patient care, depends on the leadership style he/she exhibits A style in a way which something is said or done. It is a particular form of behavior associated with the individual. Leadership styles are basic approaches to management. The most common leadership styles are autocratic, democratic, permissive, and situational.

Autocratic Leadership

This style of leadership in sometimes called directive or bureautic. In its most extreme form it implies a leader who uses coercion in the exercise of his/her powers. The autocratic leader functions with high concern for task

accomplishment but low concern for the people who perform these tasks. He/She has no confidence and trust in his/her subordinates. In turn his/her subordinates

do not feel free to discuss their job with their superior. Autocratic managers seldom get ideas and opinions from their subordinates in solving work problems.

In nursing, the autocratic leader gives orders and expects adherence to policies and procedures. Subordinates are expected to follow without question. This style provides strong motivation and psychological regard for the leader. It is most effective in crisis situations when highly specialized skills are required and options for activities are limited. It is used to bring order out of chaos. This style is sometimes called centric because the leader makes the decision for the group. He/She is the center of attention. If the follower makes a decision, the leader questions him/her, implying that there is a better way of doing things known to only him/her.

The autocratic style of leadership is also called Theory X by McGregor. This is boss-centered. The leader thinks all workers are lazy, need to be coerced and threatened with punishment, indifferent to organizational goals, resistant to change, not very bright and cannot be trusted, want to avoid responsibility and are more interested in financial incentives than personal achievement. Wokers fear the leader. They become blind followers and most often they avoid their leader. Leadership The laissez-faire or let alone style of leadership is one in which the leader who is appointed manager abdicates leadership responsibility and leaves workers without direction, supervision, or coordination. The workers lack central direction and control. This free-rein leader avoids responsibility by relinquishing power to subordinates. He/She permits his/her followers to engage in managerial activities such as decision making, planning, structuring the organization, setting goals, and controlling the organization. The leader is ultraliberal. Permissive, Ultraliberal, or Laissez-faire Style of

This style of leadership is effective in highly motivated professionals, like those in research, where independent thinking is rewarded. It is not useful in organizations that are highly structured such as the healthcare delivery system where organization and control form the baseline of most operations.

This kind of leader is permissive with little or no control, motivates by support when requested by the group or individual, puts emphasis on the group, does not criticize, disperses decision making within the group, and provides little or no direction at all. Leadership

Democratic,

Participative

or

Consultative

Democratic leadership is people-oriented. It focuses on human aspects and builds effective teamwork. Interaction between the leader and subordinates is open, friendly, and trusting.

Collaborative spirit and joint efforts exist. It allows governance through group participation in decision making. Open communication prevails. The leader consults his/her subordinates in solving problems and work-related decisions are made by the group. Hence, it is also called consultative style of leadership. Performance standards exist to to provide guidelines and permit performance appraisal.

According to McGregor this style of leadership is called Theory Y. The leader considers workers as ambitious. He/She does not resist change, is creative, exercises self direction and self control. There is cohesiveness among members, greater job satisfaction, and few feelings of hostility and frustration. This style will satisfy higher human needs resulting in greater employee responsibility which in turn leads to high productivity. It is the most desirable form of management.

The democratic leader is also called radic leader because he/she radiates out to encompass the needs of others.

Situational or Contingency Style of Leadership This kind of leadership is one in which the leaders style matches the situation and its needs. Fiedler and Chenners state that in the work situation, the managers leadership style and expectations, and the followers characteristics and expectations blend together and form a productive combination. The nurse manager assesses each nurses needs and determines which leadership behaviors will help the nurse to do the work with the fewest problems. The nurse manager first considers the staff nurses ability (knowledge, experience, and skill) then determines the nurses willingness (confidence, commitment, motivation, and energy) to complete a given task. Then the nurse manager, in a particular situation, either tells or teaches the staff what to do and explains the benefits in learning from a new situation. He/She participates with the subordinate in doing a special procedure that the subordinate is not familiar with. He/she delegates a more experienced staff to work with the employee until the latter gains the skill and competence in performing a new task.

To accomplish the management process, the leader must know himself/herself, his/her followers, and the character of the work situation. The situational leader must be flexible enough to make adaptations and changes. Prepared by: Vlendy C. Pascua

Authority and Power AUTHORITY is the right given to a manager to achieve the objectives of the organization. is a right to get the things done through others. is a right to give orders to the subordinates and to get obedience from them. is the legitimate power of a manager to direct subordinates to take action within the scope of his/her position.

Forms of Authority Line authority -- is direct supervisory authority from superior to subordinate. Authority flows in a direct chain of command from the top of the company to the bottom. Staff authority -- is more limited authority to advice. It is authority that is based on expertise and which usually involves advising line managers. Team authority -- is granted to committees or work teams involved in an organization's daily operations.

POWER is the possession of authority, control, or influence by which a person influences the actions of others, either by direct authority or by some other, more intangible means.

is the ability to exert influence in the organization beyond authority, which is derived from position.

Sources of Power Legitimate -- generally known as authority, and implies the power to act, as well as the power over resources and is invariably limited in some way. Reward -- the use of rewards to influence peoples compliance. To be effective the rewards must be desired by the target group. --results in people doing what is asked because they desire positive benefits or rewards Coercive -- the crudest form, which uses threats and punishment to achieve its ends. Expert -- which comes from possessing specialize knowledge and skills, and is dependent on the expertise being recognized by those concern, thus credibility is vital. Referent -- generally known as personal power, or charisma and comes from the high regard he or she is held by others. -- refers to a person who has desirable resources or personal traits Prepared by: Annalie G. Pritos