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Seminar on Leadership & Management

Submitted to ; Mrs. Sudha, M.sc(N), Lecturer, Department of medical surgical nursing, J.M.J college of nursing, Sanath Nagar Hyderabad submitted By; Anie Maria Thomas 1st year M.sc Nursing J.M.J College Of Nursing Sanath Nagar, Hyderabad.

Submitted on;10/11/2010

Name of the student : Miss. Anie Maria Thomas Name of the guide Subject Name of the topic Unit Group Place Date Time A.V. aids : Mrs.Sudha M.sc(N), Lecturer : Advanced Nursing Practice : Leadership and Management :1 : 1st year M.sc Nursing students : M.sc Seminar hall : 27/1/2011 : 2pm- 4pm : Power point, Charts , Transparency , Flannel board, Handouts. Flashcards, Black board.

General Objective
By the end of the class, learners will acquire in depth knowledge on Leadership and Management and will be able to appreciate different styles and roles of a leader and manager and provide effective management, possess efficient leadership role in the health care settings.

Specific Objectives
At the end of the class the learners will be able to; define terms Leadership, Leader, Management and Manager mention the concepts related to leadership and management list out the power and influence in a leader or manager discuss the pre requisite for leadership classify characteristics of a leader list out qualities of a leader describe the roles of leader mention the four factors of leader explain five interwoven aspects in leadership describe styles and types of leaders enlist leadership skills explain leadership in nursing mention the components of management

discuss the principles of management list out steps in management process mention the characteristics of effective manager list out the skill of effective manager enumerate the roles and functions of manager describe management and medical profession mention the similarities and difference between the leader & manager

Introduction
Consider a company; there will be number of employees working in with different attitude and perceptions. Every time it is not possible for the management to pay attention to the individuals needs, abilities and opinions of the employees. It becomes possible only through a person who act as a link between the staffs and management, and also he will be able to direct each employee to the path of goal achievement. Can anyone guess who they are? Yes, they are called leaders. There is no matter in infrastructure resources like man power, money and materials, unless it is controlled and co-coordinated. The goal achievement comes to reality only with the careful management done by a good and efficient leader.

Definition
Leadership
1) Leadership is defined as a process of influencing the behavior of either an individual or a group, regardless of the reason, in an effort to achieve goals in a given situation. [Hersey and Colleagues 2001]

2) Leadership occurs when human beings with motives and purposes mobilize in competition or conflict with others so as to arouse, engage and satisfy motives. [Burns, 1978] 3) 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. 4) Leadership is a process whereby an individual influences a group of individuals to achieve a common goal.

Leader
1) A leader is an influential person has the ability to lead a group or department without having a formal appointment. 2) Leader is a person who influences others to accomplish specific goals using effective interpersonal skills. 3) Leader is one who guides and directs other people. [Louis A]

4) Great necessities call forth Great Leaders.

[Abigail Adams]

Management
1) Management is defined as the process of working with and through individuals and groups and other resources (such as equipment, capital and technology) to accomplish organizational goals. [Hersey and Colleagues 2001]

2) Resource coordination and integration to accomplish specific goals. [Grant 1994] 3) Management is process of influencing others with specific intention of getting them to perform effectively and contributing to meet the organizational goals. [Omker,1967] 4) To manage is to forecast and plan, to organize, to command, to coordinate and to control. [Henri Fayol, Father of Modern Management]

5) Management is a process of getting work done through other people.

Manager
1) A manager is formally and officially responsible for the work of a given group. 2) Manager is a person responsible for efficiently planning, organizing and evaluating effective attainment of goals and the thoughtful use of resources. 3) Manager is the one who get things done through other people.

Concepts Related to leadership and Management


General Concepts
1) Management is a formal, specially designated position within the organization. 2) To be a good manager... it is absolutely necessary to be an effective leader. 3) In fact all nurses should at times assume some leadership roles, but not everyone needs to be a manager. 4) The difference between leadership and management is equated to effectiveness and efficiency.

Specific Concepts
1) Authority and power 2) Effectiveness and efficiency

S. No. 1)

Specific Concepts Authority

Emphasis It is the legitimate right given to a manager or a leader by an organization to achieve its goals.

2)

Power

Power is to influence others to act, and it is the most important ingredient of a leader or

manager in an organization. It is the ability to impose the will on others to bring about certain behaviors. 3) 4) Effectiveness Efficiency It is related to leadership, vision and judgment. It is related to management and mastering routines.

Power and Influence in a Leader/ Manager

There are different types of power which need to be exercised by a leader or manager. The leader / manager need to use the power given to him by an organization in an appropriate manner depending on the situation.

Legitimate power Reward power Coercive power Expert power Referent power

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S. No. Types of Power a) Legitimative Power

Basis Given by an organization according to the position. Example. Principal / Nursing Director

How to use the power Make polite requests Use clear and simple language Explain the reason Follow-up to check compliance

b) Reward Power

Incentives the leader can provide for the subordinates and value by the group

Dont over emphasis incentives Reinforce good behavior, dont bribe. Size of the reward should reflect total performance. Money is not only the reward other means of appreciation may be used. Example: Awards, Certificates etc.

c)

Coercive Power

Found in fear. Example: Oral/Written Warnings, Suspension and termination.

Avoid it except when absolutely needed. Determine genuine fault. Discipline promptly without favoritism. State warnings without hostility. Fit the punishment to the seriousness of the fault. Warn before punishing.

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d) Expert Power

Special ability, skills and knowledge by virtue of education and experience. Example: Mastery over the subject and emotional stability.

Avoid careless decisions, and rash statements. Keep abreast with current development. Remain calm in crisis and act confidently. Respect staff ideas and include them. Do not threaten staff self esteem, respect staff concern and explain why the change is needed.

e)

Referent power

Admiration and respect the staff feels towards a leader. Personal qualities influence charisma.

Treat them fairly. Avoid hostility, rejection, distrust and in difference. Explain reliance on staff support and cooperation. Make requests reasonable. Be a good role model.

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LEADERSHIP
Definition
Leadership is a process of influencing a group in a particular situation at a given point of time and in a specific set of circumstances that stimulate people to strive willingly to attain a common objectives and satisfaction with the types of leadership provided. [James J. Cribbon]

Leadership is a complex relationship existing between the leader, the organization, social values, economic and political condition. Leadership is the quality of an individuals behavior whereby he is able to guide the people or their activities towards certain goals.

Pre-requisite for leadership


The structural support indicating prerequisites for effective leadership are Sound objectives Policies (systematic + workable) Programs Control system Effective communication network

Characteristics of a Leader
The characteristics of a leader can be classified under three areas:

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I) Intelligence

Knowledge Judgment Decisiveness Oral fluency Able to enlist cooperation

II) Abilities

Interpersonal skills Fact, diplomacy Prestige Social participation adaptability

III) Personality

creativity cooperativeness Alertness Self-confidence Personal integrity Emotional balance aand conformity Non control Independence

Qualities of a Leader
I) The leader must be able to; Plan [Setting objectives and anticipating future events] Analyze and solve problem Decide Co-ordinate Communicate Control Select Train 14

Develop Motivate Review Support, guide and counsel II)He should have; Good knowledge Well balanced personality Understanding skill Human relation attitude Good intelligence Vision and foresight Social maturity Adaptability III)Initiation IV)Adaptability and accommodation V)Good listener VI)Co-coordinator VII)Organizer VIII)Impartial IX)Discipline X)Motivator

Roles of Leader
The important roles of leader are listed below. They are:

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1. 4. 7. 10 13. 16. 19.

Decision maker Advocate Teacher Facilitator Influencer Change agent Counselor

2. 5. 8. 11. 14. 17. 20.

Critical thinker Visionary Communicator Risk taker Coach Diplomat Role model

3. 6 9. 12. 15. 18.

Buffer Forecaster Evaluator Mentor Creative problem solver Energizer

Four Factors of Leadership


Situation

communication

Follower

Leader

Five Interwoven Aspects In Leadership


Heresy and colleagues (2001) noted that the leadership process is a function of the leader, the follower and other situational variables. The leadership process involves 5 interwoven aspects The leader Situation Follower Communication process Goals

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Leader:
Has the values and skills, styles. Has honest understanding of oneself and roles. Confidence in employee. Sense of security in uncertainty. Interpersonal and emotional intelligence. To be successful, one must convince followers.

Followers:
Different people require different styles of leadership. Example: - people with less motivation. Accept or reject leader and determine the leaders personal power.

Situation:
All situations are different. You must use judgment to decide the best course of action and the leadership style needed for situation. Example:- Need to control for inappropriate behavior situation include Work demands Control system Amount of task structure Degree of interaction Amount of time available for decision External environment

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Communication:
Vary among groups. Verbal and nonverbal communication. There will be 2 way communication. Downward, upward, horizontal, grapevines of communication network. It can be formal / informal. Leader must set an example.

Goals:
To attain goals give; Teaching to clients Counseling

Leadership styles and types of leader


Definition
Leadership styles are defined as different combinations of table and relationship behaviors used to influence others to accomplish goals. Leadership style is how a leader uses interpersonal influence to accomplish goals of an organization.

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Types of leadership styles


There are four types Autocratic style of Leadership Democratic style of leadership Laissez Faire style of Leadership Bureaucratic style of Leadership

1) Autocratic style of Leadership Autocratic leadership is described as: Authoritarian leadership Directive leadership and the leader is referred to as Extreme form of Dictator. The leader assumes complete control over the decisions and activities of the group. The authority for decision making is not delegated to persons in lower level positions (centralized organization). Personality of the leader Firm personality, insistent, self assured, highly directive, dominating, with or without intention. Has high demand of concern for work than the people who perform the task. Uses the efforts of the workers to the best possible shows no regard to the interests of the employees. Sets rigid standards and methods of performance and expects the subordinates to obey the rules and follow the same.

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Makes all decision by himself or herself related to the work and pass orders to the workers and expect them carryout the orders. There is minimal group participation or none from the workers. Thinks that what he/she plans and does is the best. Has no trust or confidence in the subordinates in turn they fear and feel they have nothing much in common. Exercise power, manipulates the subordinates to act according to his goals, plans and keeps at the center of attention. Advantages 1) Efficient in times of crisis, easy to make decision by one person than by group and less time consuming. 2) It is useful when there is only leader who is experienced having new and essential information while subordinates are in- experienced and new. 3) It is useful when the workers are unsure of taking decision and expect the leader to tell them what to do. Disadvantages 1) Does not encourage the individuals growth and does not recognize the potentials, initiativeness and creates less cooperation among members. 2) The leader lacks supportive power that results in decisions made with consultation although he may be correct. 3) Inhibits groups participation which results in lack of growth, less job satisfaction can lead to less communication, commitment to the goals of organization.

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2) Democratic Leadership A democratic leadership described as: Participative or Consultative style of leadership

It is also referred to participative, consultative style of leadership. 1. This style is characterized by a sense of equality among leaders and followers. The leader is people oriented Focuses on the human aspects Builds effective work group Togetherness is emphasized

2. Open system of communication prevails. The group participates in work related decisions (sharing the thoughts in problem solving) 3. The interaction between the leader and the group id friendly and trusting The leader brings the subject to be discussed to the group Consults Decision of the majority is made and implemented by the entire group Make final decisions after seeking input from the total group Therefore, the group feels they have important contribution to make, freedom ideas drawn, develop sense of responsibilities for the good of the whole.

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4. Leader works through people not by domination but by suggestions and persuasions. The leader motivates the workers to set their own goals, makes their own work plans and evaluates their own performance. Informs the overall purpose and the progress of the organization.

5. Performance standards exist to provide guidelines and permit appraisal of workers, thus resulting in high productivity. Advantages 1) Permits and encourages all employees to practice decision making skills. 2) Promotes personal involvement, suggestions are welcomed. This results in greater commitment to work and enhanced job satisfaction. 3) Decisions made by the group are more effective than by the leader alone. Member may have more information than the leaders. Disadvantage It takes more time for making the decisions by the group than by leader alone. ,the advantages overweigh the negative outcomes. 3) Laissez Faire Leadership It is also referred to as Free Rein Anarchic Ultraliberal Style of leadership The leader gives up all power to the group.

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Characteristic Features 1) This leadership encourages independent activity by the group members An outsider would not be able to identify the leader in such a group. The leader exerts little or no influence on the group members. There is lack of central direction, supervision, coordination and control.

2) Group members are free to set their own goals, determine their own activities and allowed to do almost what they desire to do. A variety of goals may be set by every individual and it will be difficult to carryout to accomplish the task by the group easily. 3) This style may be chosen by the leader or it may evolve because. The leader is too weak to exert any influence on the group. Attempting to please everyone to feel good. Fails to function as an effective leader.

4) This style is effective in highly motivated professional groups. 5) Not useful in a highly structured health care delivery system or any institution 6) The group where there is no appointed leader will fall into this category. Advantages 1) In limited situations creativity may be encouraged for specific purpose. Example. Highly qualified people, plan a new approach to a problem that needs freedom of action. 2) To try new methods of actions.

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Disadvantages 1. May lead to instability, disorganization, inefficiency, no unity of actions. 2. Neither the group nor anyone in the group will feel to be responsible to solve the problems that arise. They lose interest, initiative and desire for achievement. 4) Bureaucratic style of Leadership In this kind of leadership the leader functions on lines with rules and regulations. The leader cannot be flexible and doesnt like to take any risk out of the rules. Example: Defense leaders: They are strictly adhering to the rules and maintain the discipline of group.

Comparison of leadership styles


Parameters Control over the group Motivation By coercion Economic / Ego awards Direction By command Suggestion / guidance Decision making Status difference Criticism Self I and U Punitive Participative We Constructive Little / upward and downward Dispersed The group None By support Authoritarian Strong Democratic Less Laissez-Faire Little or none

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Leadership Skills
The leadership skills can be classified as follows Skills of personal behavior Skills of communication Skills of organization Skills of self examination Other skills 1. Skills of personal behavior Is sensitive to feelings of the group. Identifies self with the needs of the group. Does not ridicule or criticize another suggestion. Help others feel important and needed. Does not argue. 2. Skills of communication Listen attentively Make sure everyone understand what is needed and the reason why? Establishes positive communication with the group as a routine part of that job. Recognizes that everyones contributions are important. 3. Skills of organization The effective leader helps the group. Developing long and short range objectives. Break big problems into small ones. 25

Share responsibilities and opportunities. Plan, act, follow-up and evaluate. Be attentive to details. 4. Skills of self examination Is aware of personal motivation. Is aware of the group members level of hospitals for taking opposite counter measures. Helps the group to be aware of their attitudes and values. 5. Other Skills. a). Listening and Feedback Skills, Listen to term members, regarding any suggestion that would lead to the betterment of the project being worked upon. b). Motivational Skills Leader should provide employee motivation and prepare the minds of the team members to use their capabilities to the fullest. c). Interpersonal Skills Related to the work place. Maintain good relations with employees. d). Decision-making Skills Decision should be taken by strategic thinking and suggestions from other experienced professionals

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e). Problem solving skills Problem solving skills plays an important role in leading a team to the set goals. Analyze the problems listening to probable solutions and finally take decisions. f). Strategic Planning and Execution skills. Understand the project prerequisites. Prepare a master plan. Allocate the resources. Make sure that the plans are executed properly.

Leadership in Nursing
Nursing is a profession that primarily depends on your ability to be objective gets compassionate and empathetic along with these; there are a lot of other personal qualities that makes for good nurse, and that function as effective nursing leadership qualities.

Qualities of a good Nurse leader

Motivation Problem - solving Development of new strategies Planning delegating integratdeligatingor Conflict resolution Empathy with the group

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Functions and Responsibilities of a nurse leader


1. Serving as a mentor A mentor is someone a person looks up to, to imitate her/his skills and make it a part of her/his personality Solve problems in the group Serve as a role model for your staff members. 2. Supporting your staff members One of the most important responsibilities is supporting your team under the different circumstances they may be faced with. Solving the issues related to the profession. Provide an environment to develop, nation and modify their knowledge and skills. Provide supportive environment to the group. 3. Feed back and Performance Evaluation. Evaluate the progress. Make criticism in a manner that is not perceived as harsh, but as a genuine effect on your part to encourage their growth in the right direction. Positive feedback to encourage the team to perform better and keep introducing innovative yet efficient ways of becoming independent. 4. Motivation and Encouragement Keep the staff motivated to perform well.

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This include reducing stress among them Dealing with burnout, absenteeism Giving incentives Word of encouragement

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MANAGEMENT
Definition
1) Management is principally the task of planning, coordinating, motivating and controlling the efforts of others towards as specific objective. 1963] 2) Management is a basic integrating process of individual activity. L.Alexander] 3) Management is the process and agency which directs and guides the operations of an organization on the realizing established aims. [Ordway Tead]. [Edith[James, Lundy,

Components of Management
Determining the goal and objectives of the enterprise. Acquisition and utilization of resources. Instituting communication systems. Determining control procedures. Evaluating the performance of the enterprise.

Principles of Management
The role, function and tasks of general management have been codified as principles of Management. It comprises of guidelines as well as commandments to the managers function.

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Useful for an understanding of management and helpful to all administrators including hospital administrators. I) Division of Work The work assigned to each worker should be clearly defined and activities of the organization precisely clarified. All work thus gets performed efficiently with gradual development of competence and skills. Necessary in the use of human resource. II) Authority and Responsibility Inseparable Without authority one cannot discharge responsibility. Authority should be commensurate with responsibility. III) Discipline

Considering discipline as respect for agreement which are directed for achieving obedience. Manager and administrators should set the good example through their actions and behavior. IV) Unity of Command

Means that employees should receive orders from one superior only. Each employee must know who is his immediate boss and be responsible to him for his work.

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V)

Unity of Direction Each group of activities with the same objective must have one head and one plan. Should be team work and unity in the organization.

VI)

Centralization of Authority

Refers to the extent to which authority is concentrated or dispersed. Clear organization. Conflicting orders will create confusion in the organization. VII) Scalar Chain The chain of supervisors from the highest to the lowest ranks in the organization. VIII) Order Place for everything in its place. Will result in optimization of the resources. IX) Remuneration

Equal pay for equal work. Each person should be paid according to his contribution, the remuneration and methods of payment should be fair and afford maximum possible satisfaction to employees and employer. X) Stability of Tenure Unnecessary turnover of employees is both the cause and the effect of bad management. The employee requires assurance about the permanent nature of job, resulting in a feeling of security and involvement in work. 32

XI)

Delegation of Authority

Through delegation, subordinates get prepared for higher responsibility. The needs training and motivation of the delegator and delegate must match. XII) Initiative Is the thinking out and execution of a plan. Employee should be given opportunities for use of creative ideas in their work. Mean job involvement and commitment to organizational goals. XIII) Subordination of Individual Interest to Organizational Interest When the two differ, management must reconcile them. As organization is setup to meet the needs of society, the individual must sacrifice some selfish interests in the overall interest of the organization and society. XIV) Equity Loyalty and devotion should be elicited from personal by combination of Impartiality Kindness Justice on the part of managers, when dealing with subordinates.

They must be treated without any bias for race, religion, sex and class.

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Steps in management process

Planning

Controlling

Manageme nt process

Organizing

Directing

Staffing

(1)

Planning: Planning is preparing a blue print. It is a continuous, intellectual process of determining philosophy, Objectives, Policies, Procedures and rules and standards, long and short term projected outcomes and fiscal course of actions and managing planned change.

(2)

Organizing Carryout Plans. Working within the structure of an organization. Understanding. Using power and authority appropriately.

(3)

Staffing Recruitment and selection of staff. Hiring and orienting staff 34

Staff scheduling. Staff development activities. Staffing often becomes part of organizing. (4) Directing Human resource management Motivating Managing a conflict Communicating Facilitating, collaboratin and Coordinating the team. (5) Controlling Quality assurance. Performance appraisal. Fiscal accountability. Legal, ethical and professional control.

Characteristics of Effective Manager;

It is given by Dr.Ashok Sahni

The effective managers will have good abilities in managing. 1)Clear and Realistic Goals. What they want Why they want What are the strategies Who will benefit Themselves Society Family World 35

2)Professional Par-Excellence Always try to do their best and perform at their best. They believe in providing the best services keeping the patient's, customers, employees or public interest in mind. 3)Perceptual and Cognitive Flexibility Are able to perceive the situations accurately and are able to forecast, look into the future, understand the environment, assimilate the environment and dare to be open in their knowledge and ideas. Ability to learn new ideas and make use of new knowledge in planning and programming. 4)Professional Growth Individuals continuously learn about their field new ideas new strategies, about innovations and applications in the field and learn from discussion with professional colleagues, reading books, attending conferences, workshops and other means. 5)commitment to the chosen field Show high degree of commitment to his field. They are not ready to change this field even if any others field has grater attraction in terms of Salary Prestige or other Worldly compensation

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6)Attitude and confidence Positive attitude toward themselves, others and the system in which they work. Positive attitudes helps in overcoming obstacles and in perceptual ability as well as cognitive flexibility. Professional competence, positive experience and inner security give confidence for professional identity. 7)Communication Professional exchange of ideas on problems and issues help in effective decision making. Have oral and written communication abilities to communicate effectively. 8)Diversity Effective individual undertake several specialties. Able to apply their knowledge in various areas. Helps in cognitive flexibility and developing perceptual ability. 9) Creative Orientation Highly creative and analytical in their approach Think of new ideas, new practices and new methods which they can use in solving problems. Positive attitude, perceptual ability, cognitive flexibility and motivation are necessary for creative orientation. 10)Motivation Highly motivated 37

High motivation and commitment helps to overcome frustrations, dejections and failures. 11)Satisfaction High degree of positive acceptance, trust in self and accept themselves as whatever they are aware of their strength and limitation and also aware of the environment in which they have to function.

Skills of Effective Manager


The successful management rests on three basic skills Technical Human Conceptual

Level of management Higher level of management Conceptual Human

Middle level of management

Lower level of management

Technical

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1) Technical Skill Is the understanding of and proficiency in specific type of activities involving methods, processes or techniques. Implies specialized knowledge in that trade and proficiency in the use of techniques and tools of the trade, and which can be easily observed and assessed (at the lower level) 2) Human Skill (Middle) Is the skill in dealing with people Involves ability and judgment in working with and through people, including and understanding of motivation. Ability to effectively communicate. Awareness of attitudes, beliefs and feelings. 3) Conceptual Skills (Higher Level) Ability to understand complexities of the whole organization and how changes in any one part of organization affect others. This knowledge permits the manager to act according to the objectives of the total organization rather than only on the basis of needs of the problem at hand.

Importance of the three skills


At the lower levels of every organization technical skills are the most important. As the manager advances from lower to higher levels in the organization, less technical skills tend to be needed.

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Although it is important at the lower level as well as the highest level, human skill assumes paramount important at the middle level. At higher level, conceptual skill more important in

Policy decisions

Strategy formulation and planning action

Roles and Functions


1) Working with people No direct clinical responsibility. Balance goals of the hospital by working with patient care teams where physician is the king pin who in turn work with others in rendering patient care. Understands workers, their motivations and aspirations and knit them together as team. 2) The enabling Role Ensure the provision of necessary physical facilities and ensure that the supportive services are available in right amount, of the right quality at the right time and place. 3) Hospital administration and Staff Understand the staff and understand variations in styles of administration.

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4) staff Motivation Develop measures to keep up motivation of all categories of staff, and be constantly on the look-out for cases of dissatisfaction and conflict. 5) Facilitating Decision Making Provide appropriate inputs to decision making at the clinical department level, and coordinate discussion making at the interdepartmental level. 6) Management of Resources Properly uses the resources Man Money 7) Negotiating Material to reach goal

Negotiating both with agencies outside the hospital and with staff members within, especially regarding their working arrangement and conflict resolution. Negotiating with Third party payers Regulatory agencies Planning group Equipment vendors and etc. Creative problem solving situation rather than turning to a choice situation. 8) Containing Cost Exercise control over financial matters through costing, cost control, budgeting and judicious investment of hospital funds. 9) Dealing with new technology

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A judicious balance between new technology and the hospital needs, cater for training and retraining to catch up with new technologies, innovations and improvements. 10) Establishing management climate Must be compatible with each other and with the organization where a change in managerial climate is called for, be prepared to recognize the need and be capable of meeting it. 11) Management Development The quality of patient care depends upon the quality of the hospitals human resources, which in turn is determined by the quality of the leadership at various levels. 12) Evaluation Ability to evaluate People Programmes Over all effectiveness of hospital Continuous ongoing self evaluation is a means of quality assurance. 13) Fact finding and Investigation Call for caution so that the workers sensibilities are not offended 14) Social commitment Balance the conflicting requirement of looking after the business interests of the hospital with the social obligations towards the society.

Medical Profession and Management


Managerial activities of a hospital
1) Determination of goals objectives.

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Consists of primarily with policy making. 2) Facility and programme planning Remodeling existing services Organizing new facilities, services and programmes

3) Financial Management Financial affairs of hospital Budgeting and costing 4) Personal Management Selection Motivation Guidance Includes wage and salary administration. 5) Coordinating departmental operations Includes interdependent activities dealing with the internal functioning of all hospital department. Example: frequent meeting with departmental heads. 6) Programme review and evaluation Relates to the functioning of the clinical services and programmes and is a continuous process. 7) Public and community activities Developing and maintaining interaction with other health service institutions including shared service arrangement with other hospital. 8) Health industry activities Activities those are external to the hospital.

Of employees

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Example: Participation in hospital association. 9) Government- related activities Concerned with legal problems of hospital and dealing with local, state and central government agencies. 10) Educational Development All teaching and lecturing responsibility. Continuous education of hospital personnel. Participation in professional activities.

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Similarities and differences between the leader and manager.


Leader
1) May or may not have an official appointment. 2) Have the power and authority to enforce decisions as long as followers are willing to be lead. 3) Influence others either formally or informally. 4) Interested in risk taking and exploring new ideas. 5) Relate to people personally in an empathetic manner. 6) Feel rewarded from personal achievements. 7) May or may not be successful as manager. 2) Have the power and authority to enforce decision.

Manager
1) Appointed officially to the position.

3) Carryout predetermined policies, rules and regulations. 4) Maintain an orderly, controlled, rational and equitable structure. 5) Relate to people according to their roles. 6) Feel rewarded when fulfilling organizational goals or mission. 7) They are managers as long as they hold the appointment.

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Conclusion

It is essential to understand the concepts, difference and similarities between a leader and a manager, and how to exercise the authority given to a person according to his or her position appropriately in order to analyze the kind of leadership and be successful. In general, efficient leadership and effective management skills are paramount to achieve the goal of an organization.

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Bibliography
Text books
1) Anitta W. Finkelman ; Leadership and Management in Nursing, 1st edition, India, published by Darling Kindersley, 2009, PgNo: 3-27 2) Bessie L. Marquis and Carol J. Histon Leadership Roles and Management functions in Nursing, 3rd edition, Philadelphia, Lippincott publishers, 2000, Pg No: 3-42. 3) Basavanthappa B.T; Nursing Administration, 1st edition, New Delhi, Jayapee Brothers Medical Publishers (P)Ltd, 2007, Pg No: 112-118, 244-251. 4) Diane L. Huber; Leadership and Nursing care management, 3rd edition, U.S.A, published by Saunders Elsevier, 2006, Pg No: 3-54. 5) Jeanette Lancaster Nursing issues in leading and managing change 1st edition, St. Louis, Missouri, Mosby publishers, 1996, Pg No: 219-238. 6) Rebecca Samson Leadership and Management in Nursing practice and education, 1st edition, New Delh, Jayapee Brothers Medical Publications, 2009, Pg No: 3-36. 7) Sakharakar B.M; Principles of Hospital Administration and planning, 1st edition, New Delhi, Jayapee Brothers Medical publishers (p)Ltd, 2003, Pg No: 94107.

Journals
1) Lewin, K; Lippil, R. and white, R.K.(1939), patterns of aggressive behavior in experimentally created social climates. Journal of social Psychology, 10,271-301. 2) Newstrom,, John W& Davis, Keith (1993), organizational. Behavior: Human Behavior at work. Newyork: Me Graw Hill

Website
1) http://en.wikipedia-org/wiki/leadership 2) http://www.buzzle.com/articles/nursing-leadership-qualities.html 3) http://en.wikipedia .org/wiki/nursing management 47

Thank you

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