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Nursing Leadership,

and Followership
What makes a person a
We look to Leadership theories
Most Prominent Leadership
all the factors)
(inspiration & meaning)
Trait Theories
• “Leaders are born, not made” = some are
natural leaders, but others are not
• Researchers attempt to identify the qualities,
or traits, that distinguish a leader from a
The traits are:
• Intelligence
• initiative
• excellent interpersonal skills, high self-esteem,
creativity, willingness to take risks, and ability
to tolerate the consequences of taking risks
(Northouse, 2013; White & Lippitt, 1960)
Behavioral Theories
• The trait theories were concerned with what a
leader is, whereas the behavior theories are
concerned with what the leader does
• BT concerned with leadership style
– A democratic leader tries to move the group toward
its goals.
– An autocratic leader tries to move the group toward
the leader’s goals.
– A laissez-faire leader makes little or no attempt to
move the group (Pavitt, 1999, p. 330; Zineldin &
Hytter, 2012).
Authoritarian Leadership
• called autocratic, directive, controlling.
• The authoritarian leader gives orders, makes decisions for
the group as a whole, and bears most of the responsibility
for the outcomes.
• For example, when a decision needs to be made, an
authoritarian leader would say, “I’ve given this a great deal
of thought and decided this is the way we’re going to solve
our problem.”
• Authoritarian leadership may be either punitive or kind and
• This type of leadership can be an efficient way to run things
when a group needs lots of direction in achieving high-
quality and high-quantity outputs (Marquis & Huston,
• However when used long term, it tends to inhibit creativity
and motivation.
Democratic Leadership
• called participative leadership.
• a democratic leader shares the planning,
decision making, and responsibility for
outcomes with members of the group.
• leader tends to provide guidance rather than
• Although this is often a less efficient way to
run things, it is more flexible and more likely
to foster motivation and creativity.
• Group output tends to be of high quality.
Laissez-Faire Leadership
• Also called permissive or nondirective,
• the laissez-faire (“let it alone”) leader:
– a relatively inactive style
– intervenes only when goals have not been met or a problem
arises (Zineldin & Hytter, 2012).
– gives followers the majority of control in the decision-making
• Some mature individuals thrive under laissez-faire
leadership because they need little guidance.
• However, in most instances, followers look to the leader for
direction and may become confused and frustrated with no
goal, guidance, or direction.
• The laissez-faire leader offers little feedback and support to
the followers, postpones decision making, or never makes
it at all, which leads to poor quality and inefficient work
Comparison of Authoritarian,
Democratic, & Laissez-Faire
Authoritar.Democrat. Laissez-F
Degree of
Little Moderate Much
Degree of control
High Moderate None
Decsision making
By leader Leader& Group or
group no one
Leader activity level
High High Minimal
Assumption of
Responsibility Leader Shared Abdicated
Output of group
High& High & Variable-
good qual. creative Poor?
What are the key differences in
the 3 leadership styles?
• Democratic leader moves the group
toward its goals

• Autocratic leader moves the group toward

the leader’s goals

• Laissez-faire leader makes no attempt to

move the group
Task Versus Relationship Theories
• Some leaders emphasize the tasks (e.g., keeping
the nursing station neat, getting charting done)
and fail to realize that interpersonal relationships
(e.g., attitude of physicians toward nursing staff,
treating housekeeping staff with respect) have
considerable impact on employee morale and
• Others focus on the interpersonal aspects and
ignore the quality of job performance.
• The most effective leader is able to balance the
two, attending to both the task and the
relationship aspects of working together.
Emotional Intelligence (EI) Theory

• EI theory focuses on the relationship aspects of

• This is done by leaders who:
– Learn how to recognize, understand, and manage their
own emotions; and how to stay clearheaded and suspend
judgment until all the facts are in (Feather, 2009).
– Listen attentively, perceive and accurately interpret
unspoken emotions, and acknowledge others’
– Bring people together in an environment of respect and
cooperation so they can direct their energies to- ward
achieving team goals.
• EI leader’s enthusiasm, caring, and support inspires the
same feelings throughout the team (Feather, 2009;
Sadri, 2012; Whitehead, Weiss, & Tappen, 2010).
What distinguishes ordinary
leaders from STARS?
Emotional Intelligence –
addressing the effects of people’s
feelings on the team
Situational Theories

• Situasi mungkin cepat sekali berubah-ubah,

dan diperlukan teori yang lebih kompleks
untuk menjelaskan bagaimana orang-orang
berespon terhadap situasi yang berubah-ubah
• Karena itu lahirlah teoris situasional ini,
• Kemampuan beradaptasi merupakan kunci dari
pendekatan situasional ini (Flackman, Hansebo, &
Kihlgren, 2009; Furtado, Batista, & Silva, 2011).
• Teori ini memahami kompleksitas dari situasi
kerja dan menekankan pemimpin untuk
mempertimbangakan sejumlah faktor ketika akan
membuat keputusan.
• Every situation is different.
• Situational theories emphasize that it is
important to
– understand all of the factors that affect a particular
group of people in a particular environment
– vary the type of leadership to meet the needs of the
Transformational Theories
• address to meaning, inspiration, and vision
• people need a sense of mission that goes
beyond good interpersonal relationships or
the reward for a job well done
• Transformational leadership involves the
ability to inspire and motivate followers.
• leader creates a supportive climate, listens to
followers, and acts as a coach and mentor.
• leaders communicate their vision in a way that
is so meaningful and exciting that it reduces
negativity and inspires commitment in the
people with whom they work (Leach, 2005;
Salanova, Lorente, Chambel, et al., 2011).
• Followers become motivated to go beyond
their own self-interests for the good of the
group or organization, often accomplishing
more than what would normally be expected
of them (Doody & Doody, 2012).
Transformative Leadership Qualities
• Integrity (Action • Optimism
matches words) • Balance(work,
• Courage (take • reflection,play)
risks) • Ability to handle
• Initiative (Act on stress
ideas) • Self-Awareness)
• Energy
Transactional Theories

• Whereas transformational leadership uses more of a

“selling” style, transactional leadership uses more of a
“telling” style.
• Transactional theory assumes that people are
motivated by reward and punishment and that they
work best within a clear chain of command.
• The leader creates structures to make clear what is
required of sub- ordinates and what the rewards are.
• The structure usually includes formal systems of
discipline. These leaders monitor behaviors closely to
point out errors and make corrective criticisms
• They enforce rules to avoid mistakes (Jones &
Rudd, 2007; Sabir, Sohail, & Khan, 2011).
• Transactional leadership is commonly used by
managers, and in an organization, the “rewards”
are salary and benefits (e.g., healthcare
• However, when the demand for a skill—or for
workers of a particular type—is greater than the
supply, the usual rewards may not be sufficient,
and other types of leadership are more effective.
Types of Leadership
• Intellectual leader
• Leader by the position achieved
• Leader by personality, charisma
• Leader by moral example
• Leader by power held
• Leader because of ability to
accomplish things

• Shape entities
• Focus on people
• Gives sense of
• Empowers people accomplishment
• Cheerleader • Do the right things
• Influence • Sets direction
• Motivate • Creates vision
• Build • Communication
• Inspire • Networks
• All people have untapped leadership
potential …it is there in you.

• The attempt defines leadership…it does

not have to be successful

• To be a leader you must make a decision

to act
Behaviors of an Effective Leader
• Think critically
• Solve problems
• Respect people
• Communicate skillfully
• Set goals, share a vision
• Develop self & others
What is Followership
• Followership & leadership are reciprocal

• Being an effective follower is as important

to the new nurse as being an effective
• Followers: individuals who take another
person as a role model and who act in
accordance with, imitate, support, and
advocate the ideas and opinions of another
(Grossman & Valiga, 2012)  followership:
the willingness to work with others toward
accomplishing the group mission
Great leaders can create
successful followers, and great
followers create successful
What are the characteristics of an
effective follower?
• Self direction
• Actively participates in setting group
• Invests time & energy in the work of the
• Thinks critically
• Advocates for new ideas
Followers’ important qualities and behaviors
(Grossman & Valiga, 2012; Kean, Haycock-Stuart,
Baggaley, et al., 2011; White- head, Weiss, & Tappen,
• Suggest ways to improve client care.
If you discover a problem, inform your team leader
right away. Include a suggestion for solving the
problem. If it is not accepted, your job is then to
support— not undermine —the leader.
• Listen carefully and reflect on what the leader or
manager says.
• Be truthful. Give honest feedback and
constructive criticism, even if it means politely
challenging the leader’s ideas. Suggest
alternative courses of action.
• If you feel you must have a “heated”
discussion with the leader, do so privately.
When you disagree, explain why.
• Freely invest your interest and energy in your
work and in finding best solutions for the
• Function independently; be a self-starter; take
on extra tasks without being asked.
• Be innovative, creative, and actively involved.
• Be responsible and hold up your end of the
bargain; accept responsibility when it is
• Be supportive of new ideas and directions
suggested by others, but think critically about
ideas that are proposed. Seek information so
you can see the larger picture.
• Don’t gossip.
• Think and act as a team; be cooperative and
• Draw on and complement one another’s and
the leader’s specialties, strengths, and areas
of expertise.
• Work on behalf of the organization and the
mutually agreed-on vision and goals.
• Continue to learn as much as you can about
your specialty area; share what you learn with
• Know your own strengths and what your
unique contributions to the effort can be.
• Know how to assume the role of the leader
when necessary.
• Have a positive sense of self-worth and a “can
do” attitude.
• Take care of yourself and your family. If you
and they are unhappy, your job performance
will suffer.
• Wilkinson, J.M., Treas, L.S., Barnett, K.L., Smith, M.H.
(2016). Fundamentals of nursing. Third edition.
Philadelphia: F.A Davis Company.
• Whitehead, D., Weiss, S., & Tappen, R. (2009).
Essentials of nursing leadership and management
(5th ed.). Philadelphia: F. A. Davis.
• Salanova, M., Lorente, L, Chambel, M., et al. (2011).
Linking transformational leadership to nurses’ extra-
role performance: The mediating role of self-efficacy
and work engagement. Journal of Advanced Nursing,
67(10), 2256–2266.