principles of leadership and management in nursing

It is possible that leaders can create a negative climate that becomes destructive to the group. Among these characteristics, honesty (defined as trustworthiness) and energy are at the top of the list. This can be seen in their distinct definitions. Leaders are active, not passive. There are two types of challenges: technical and adaptive. What are the goals? Every nurse needs two critical skills to enhance professional practice. For example, Bennis and Nanus (1985) studied 90 chief executives from 1978 to 1983 and found that there were two key leadership traits. In Situational Leadership® theory,* leadership in groups is never a static circumstance. Leadership is founded on trust: “Trust is the emotional glue that binds leaders and employees together and is a measure of the legitimacy of leadership” (Malloch, 2002, p. 14). This occurs because once the group has less conflict, individuals may begin to coast along and positive motivation may be lost as individuals become apathetic. Leadership can be understood as the ability to inspire confidence and support among followers, especially in organizations in which competence and commitment produce performance. Nursing has drawn from both classic and contemporary thinkers. Being the resident role model; who you are is whom you will attract. These readiness levels can be matched with the corresponding leadership styles of level 1 with telling, level 2 with selling, level 3 with participating, and level 4 with delegating. Leadership is not rank but responsibility. An example of an unfavorable situation in nursing is the following: A nurse’s job is to lead and manage a hospital’s critical care area, which has serious morale problems. Movement into a participative leadership style requires much less structure and task-directive behavior from the leader because the individual or group is performing but is not quite confident enough in its own ability for the leader to completely let go. Leaders engage their environment with behaviors of doing, influencing, and moving. Thus the overlap area appeared to be larger than previously thought. Effectiveness is a key outcome of leadership efforts in health care. Diagnosing: Diagnosing involves being able to understand the situation and the problem to be solved or resolved. They appear to learn leadership skills in stages (Bennis, 2004). It can be part of a formal organizational managerial position, or it can arise spontaneously in any group. Hersey and colleagues (2013) thought that leadership was a broader concept than management. • Knowledge of the health care environment The demands of management work are increasing in amount, scope, complexity, and intensity and thus increase role stress and leave less time to plan and focus on unit management (Porter-O’Grady, 2003). Cost containment, patient’s rights, safe staffing, stress and anger, and ethical dilemmas all challenge the leader to identify right from wrong and act from his or her sense of conviction. For example, a nurse is appointed as chair of a committee. Meeting the challenging times by establishing three priorities every 90 days and committing to seeing them through. Leadership is founded on trust and does not survive without it. Such an environment generates challenges to the nurse’s identity, coping skills, and ability to work with others in harmony. Leaders’ perceptions of themselves, their roles, and their expectations also have an impact on their followers. Budgeting, Productivity, and Costing Out Nursing. P.O. The two most common leadership styles are selling and participating. The idea of management can generate a negative reaction when it is equated with the “command and control” concept of authoritarian and bureaucratic organizations. theory or style is the best all depends on the situation at hand. Nurses can start by examining their own behaviors and then taking deliberative actions to strengthen trust in the environment. The ANCC’s magnet program acknowledges excellence in nursing services and leadership based on these five components: transformational leadership, structural empowerment, new knowledge, exemplary professional practice, and empirical outcomes (Wolf et al., 2008). One way to foster effective leadership is to evaluate leaders according to Fiedler’s contingency model (1967) and then use this information to increase leaders’ awareness of their natural style tendency: relationship-oriented or task-oriented. Arising from a drive to make things better, leaders use their power to bring teams together, spark innovation, create positive communication, and drive forward toward group goals. The LPC is an 18-item semantic differential scale that is the personality measure of Fiedler’s contingency model (Fiedler & Garcia, 1987). However, if interpersonal relationships are not an immediate problem or if the group is on the verge of collapse, then strong authoritative direction is needed to get the group moving and accomplishing. There are a variety of definitions of leadership. Some have seen management as a subset of leadership. The leadership process includes five interwoven aspects: (1) the leader, (2) the follower, (3) the situation, (4) the communication process, and (5) the goals (Kison, 1989). The practices and qualities of leadership help nurses enrich their own style and contribute to a more productive workplace. It is likely that without followers there is no leadership. This approach implies a relationship and person orientation. With a shift to primary care and care coordination, the nurse’s care management role has become more prominent, needed, and valued. Eventually, as the situation progresses, a relationship-oriented leader can become less effective. The nurse leader combines clinical, administrative, financial, and operational skills to solve problems in the care environment so that nurses can provide cost-effective care in a way that is satisfying and health promoting for patients and clients. When you enrol at ACN to study leadership and management skills, you can be confident that you have chosen a college that is recognised for providing courses … Thus readiness assessment can help predict appropriate leadership style selection. Leaders’ perceptions of themselves, their roles, and their expectations also have an impact on their followers. 3. A leader may see the need to chart a course that is new or unknown, unpopular, or risky because it challenges those with vested interests who have much to lose. This facilitates placement for success and a better match between leader and follower. Leadership is not rank but responsibility. The leader should use selling, convincing, encouraging, and motivating strategies. Exploring the feminist perspective on leadership is valuable in that it provides food for thought as health care organizations and the nurses working in them struggle with not wanting to let go of the familiar hierarchy management style yet needing to reconfigure to the circular or web structure to be effective. Followership is the flip side of leadership. The second is skill in applying the problem-solving process. These management models do not fit well with an environment that is constantly changing. Some democratic leaders cannot vary their style sufficiently to handle crises. Hersey and colleagues (2013) identified a second approach to leadership research that focused on the measurement of attitudes or predispositions toward leader behavior. This is fundamental to leadership and the work of nursing. What constitutes performance and results? The leadership, The values, skills, and style of leaders are important. The Trait Approach has led to long lists of skills and characteristics associated with successful leaders. Situational Theories However, good leaders are anchors to the vision and the larger mission, guides to coping and being productive, and champions of energy and enthusiasm for the work. Organizations include a variety of communication structures and flows. These may be downward, upward, horizontal, grapevines, or networks. What is needed by the leader is diagnostic ability. A task-oriented style is needed for situations on the extremes, whereas a relationship-oriented style is needed when the situation is moderately favorable. Choose from 500 different sets of nursing leadership and management flashcards on Quizlet. The long history of leadership theory has highlighted the importance of focusing on both of the two basic leadership elements of tasks and relationships. Empowerment means giving people the authority, responsibility, and freedom to act on their expert knowledge and skills. In times of chaos, complexity, and change, leadership is essential to provide the guidance, direction, and sense of stability needed to ensure followers’ effectiveness and satisfaction. Examples include when technology changes more quickly than clinicians are able to learn and adapt to it, when management duties extend to include temporary workers employed by others (e.g., outsourced functions and agency nurses), and when a radical organizational shift to an accountable care organization (ACO) is necessary. The individual nurse’s task is to determine in which environments he or she functions best and is most comfortable or where he or she most likely will succeed. LEADERSHIP AND CARE MANAGEMENT DIFFERENTIATED This is a behavioral competency. Since we started in 2010, Nurseslabs has become one of the most trusted nursing sites helping thousands of aspiring nurses achieve their goals. Leader-member relations refers to the type and quality of the leader’s personal relationships with followers. In contrast, management involves influencing employees to meet an organization’s goals and is focused primarily on organizational goals and objectives. Much attention has been focused on leadership as a group and organizational process because organizational change is heavily influenced by the context or environment. Nurses can start by examining their own behaviors and then taking deliberative actions to strengthen trust in the environment. 3. The leader’s behavior, patterns of actions, attitude, and performance have a special impact on the team’s attitude and behaviors and on the context and character of work life. In a very difficult situation, relationships may be the leader’s preferred emphasis. Leaders’ perceptions of themselves, their roles, and their expectations also have an impact on their followers. Both the leadership style (task versus relationship) and the attitude of the leader about leadership behaviors are important. For example, telling is an appropriate leadership style to use with followers who are at the novice level and with followers who are not able or willing. Level 3 is able but unwilling or insecure. Leadership is important to study, learn, and practice in today’s complex, rapidly changing, turbulent, and chaotic health care work environment. Clearly, “something changes as leadership blossoms” (, Leadership is a natural element of nursing practice because the majority of nurses practice in work groups or units. Possessing the license of an RN implies certain leadership skills and requires the ability to delegate and supervise the work of others. As applied to the continuum of authoritarian versus democratic styles, telling would be authoritarian and participating would be democratic. Leadership is founded on trust: “Trust is the emotional glue that binds leaders and employees together and is a measure of the legitimacy of leadership” (Malloch, 2002, p. 14). Because of the factor of constant change, maintaining good leadership is complicated for any group. Chapter 01: Leadership and Management Principles Huber: Leadership & Nursing Care Management, 6th Edition MULTIPLE CHOICE 1. Furthermore, the needs of disenfranchised minority groups must be balanced. For example, a staff nurse goes into a nursing unit meeting not wanting any extra assignments but hoping that some of the ongoing problems will be solved. These are core to all leadership in all situations. This occurs because once the group has less conflict, individuals may begin to coast along and positive motivation may be lost as individuals become apathetic. avoiding discussion of sensitive issues, and encouraging competition via winners and losers. Taken together, these source documents overlap and converge on the primary attributes, knowledge domains, and skills that nurse leaders need to lead people and manage organizations in health care. The situation is dynamic and subject to change. r any group. Encouraging the heart: Leaders appreciate and recognize individual contributions and formally celebrate accomplishments. The leader innovates and conquers the context. Leadership styles appear to have a gender component. The leadership courage continuum runs from “good coward” (cannot muster courage to make tough choices) to “reckless courage” (shoot from the hip). Much attention has been focused on leadership as a group and organizational process because organizational change is heavily influenced by the context or environment. the circumstances. Task structure means how structured the group’s assigned task is. Nursing is a service profession whose core mission is the care and nurturing of human beings in their experiences of health and illness. The leader’s behavior, patterns of actions, attitude, and performance have a special impact on the team’s attitude and behaviors and on the context and character of work life. Bennis (1994) listed a number of distinctions between leadership and management. For this situation, the task-oriented leader is a more effective match between leader and job. On the extremes of highly favorable or highly unfavorable situations, leaders need to use task-oriented behavior to get the work moving. Hersey and colleagues (2013) defined management as the “process of working with and through individuals and groups and other resources (such as equipment, capital, and technology) to accomplish organizational goals” (p. 3). Effectiveness is defined as how appropriately a given leader’s style interrelates with a given situation. Motivating participation is a constant challenge. Leadership theories have evolved away from an early focus on the traits or characteristics of the leader as a person because it was found that it is not possible to predict leadership from clusters of traits. Selling requires the most from a leader, who must provide high amounts of guidance and support. Thus no one leadership style is optimal in all situations. Research by Bennis and Thomas (2002) indicated that extraordinary leaders possess skills required to overcome adversity and emerge stronger and more committed. FIGURE 1-2 Continuum of leader behavior. Some individuals are able to integrate styles and flexibly match to the situation at hand, but this is rare. Based on the work of Goleman (2007), relational and emotional integrity are hallmarks of good leaders. Clearly, a balance of the two is necessary. Relationship management: Use of effective communication with others to disarm conflict, and the ability to develop the emotional maturity of team members This style promotes complete freedom for group or individual decisions. Nurses need to have a solid foundation of knowledge in leadership and care management. The two major leadership terms are task behavior and relationship behavior, and a leader’s leadership style is some combination of task and relationship behavior. These are trials, tests, and transformative experiences that force leaders to question themselves and what matters and to hone their judgment. Consequently, leaders come to a new or altered sense of identity. At its core, leadership is about influencing people. Fiedler’s measure for leadership style is the Least Preferred Coworker (LPC) scale (Fiedler & Chemers, 1984). This means that which theory or style is the best all depends on the situation at hand. If they do not know each other and the situation is politically charged, the nurse leader needs to help people become comfortable with each other. Groups have personalities that include a discernible level of trust. Develop your management and leadership skills. Some have seen management as a subset of leadership. Hersey and colleagues (2013) said that leadership styles are the consistent behavior patterns exhibited in influencing the activities of others by working with and through them, as perceived by those others. Hersey and colleagues (2013) identified the following three skills needed for leading or influencing: Environmental or cultural differences also cause the leadership situation to vary. Hersey and colleagues (2013) said that leadership styles are the consistent behavior patterns exhibited in influencing the activities of others by working with and through them, as perceived by those others. Photo used with permission from Photos.com. The two most common leadership styles are selling and participating. Communication – make your requests and/or thoughts known in a clear, concise way. Yet clearly there is overlap in that one can be both leading and managing in some cases. Their style can create hostility and dependency among followers; it may also stifle creativity and innovation. To choose an appropriate style, the leader needs to be knowledgeable about the readiness of the followers. Nursing Leadership & Management 1. The chaos and complexity of the seismic shifts in health care structure, delivery, form, technology, and content have made visible the urgent need for leaders to emerge, mobilize, and encourage followers. The leader observes and analyzes which abilities and motives are present in the followers. A combination of hardiness and ability to grasp context, called “adaptive capacity”. Tannenbaum and Schmidt (1973) suggested that a leader might select one of many behavior styles arrayed along a continuum. Exemplary Professional Practice. Enabling others to act: Leaders foster collaboration and develop and strengthen others so that the whole team performs well. In contrast, management involves influencing employees to meet an organization’s goals and is focused primarily on organizational goals and objectives. ; Case Studies at the end of each chapter present real-world leadership and management situations and illustrate how key concepts can be … The practices and qualities of leadership help nurses enrich their own style and contribute to a more productive workplace. When the problem no longer is just the need to get the group moving but also includes solving numerous interpersonal conflicts, a relationship-oriented leader is better matched to the situation. Different styles evoke variable responses in different situations. Initiating structure and consideration in the Ohio State Leadership Studies, 2. He noted three reasons why leaders are important: the character of change in society, the de-emphasis on integrity in institutions, and the responsibility for the effectiveness of organizations. A combination of hardiness and ability to grasp context, called “adaptive capacity” These quadrants represent four basic leadership styles: telling, selling, participating, and delegating. The situation is dynamic and subject to change. They described management as a special kind of leadership. One way to foster effective leadership is to evaluate leaders according to Fiedler’s contingency model (1967) and then use this information to increase leaders’ awareness of their natural style tendency: relationship-oriented or task-oriented. In a very difficult situation, relationships may be the leader’s preferred emphasis. One currently accepted view of organizational behavior describes leadership as situational or contingent and concerned with what produces effectiveness. The leader innovates and conquers the context. However, attitudinal theories still did not fully capture the leadership experience because the environment and its complexity were not factored in. Women tend to be more flexible and value cooperation, connectedness, and relationships. Once again, a task-oriented style is called for—challenging individuals by using the motivation they need to continue to produce. Different styles evoke variable responses in different situations. The nurse leader combines clinical, administrative, financial, and operational skills to solve problems in the care environment so that nurses can provide cost-effective care in a way that is satisfying and health promoting for patients and clients. The delivery of nursing services involves the organization and coordination of complex activities. Self-awareness is key to strategically using leadership styles. 1. Adapting: Adapting involves being able to adapt behaviors and other resources to match the situation. Nurses use managerial and leadership skills to facilitate delivery of quality nursing care. Keeping your staff motivated to perform at top quality takes clever nursing leadership. LEADERSHIP OVERVIEW 5. If the nurse leader is a task-oriented person, a high-relationship person may need to be called on to assist the group process so that it is facilitated and becomes effective. The only definition of a leader is someone who has followers. In her new position as ED nursing director at Hahnemann University Hospitalin Philadelphia, Sharon Sandt, BSN, RN, considers clear communication a key component of leadership. This model of leadership has been used in nursing research (Patrick et al., 2011). and moral courage form the backbone of making necessary and hard—but right and unpopular—decisions. Another distinction is that a leader innovates, whereas a manager administers. Organizations include a variety of communication structures and flows. Leadership can be best understood as a process. In nursing, leadership is studied as a way of increasing the skills and abilities needed to facilitate clinical outcomes while working with people across a variety of situations and to increase understanding and control of the professional work setting. Leaders need to be concerned about both tasks to be accomplished and human relationships in groups and organizations. The AONE 2005 nurse executive competencies are described in the following five domains of skill: In 140 articles reviewed, they found 894 competencies, of which 862 (96%) were common to both leadership and management. A distinction can be made between leadership and management roles. One is a guiding set of concepts, and the other is the ability to communicate a vision. The long history of leadership theory has highlighted the importance of focusing on both of the two basic leadership elements of tasks and relationships. The leader’s leadership style would have to take into account where the followers are in terms of their readiness as a critical factor for determining the style to choose. Followership is defined as an interpersonal process of participation. Leaders are those who talk about adventures into new territory and take the risks inherent in innovation (Kouzes & Posner, 1995). Leaders arise in a context, and they are said to be made, not born. Management and leadership are important for the delivery of good health services. Leadership is a natural element of nursing practice because the majority of nurses practice in work groups or units. Fiedler’s Contingency Theory These are trials, tests, and transformative experiences that force leaders to question themselves and what matters and to hone their judgment. Flexibility is important. Their internalized pattern of basic behaviors influences actions and the ability to lead. Enabling others to act: Leaders foster collaboration and develop and strengthen others so that the whole team performs well. Some individuals are able to integrate styles and flexibly match to the situation at hand, but this is rare. Styles should vary according to the appropriateness of the situation with reference to an evaluation of effectiveness. 4. He noted that the leader focuses on people, whereas the manager focuses on systems and structures. Democratic Hersey and colleagues (2013) defined leadership 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. It is important for nurses to recognize that they can learn, practice, and improve their personal leadership competencies. A task-oriented style is needed for situations on the extremes, whereas a relationship-oriented style is needed when the situation is moderately favorable. Kouzes and Posner (1995) defined the following five behaviors that correlated with leadership excellence: 1. Grant (1994) noted that leadership, management, and professionalism have different but related meanings, as follows: Overall, one style is not necessarily better than another. The other part of readiness is psychological willingness, which means being willing to take responsibility and have a positive attitude toward accepting the obligation to complete a task. Personal flexibility and leadership skills are needed to vary one’s style when the followers’ needs and motives change or vary. process includes five interwoven aspects: (1) the leader, (2) the follower, (3) the situation, (4) the communication process, and (5) the goals (Kison, 1989). On the other hand, in a staff meeting, an authoritarian leader may be ineffective with a group of professionals and would need to be flexible enough to switch to a democratic or laissez-faire style, depending on the circumstances. Leadership means giving guidance and using a focused vision. Thus leadership is a social exchange phenomenon. The risk-taking element of leadership involves taking action. Leaders are pivotal for connecting the efforts of followers to organizational goals. As situations become more complex, leadership becomes more difficult. Lack of leadership and poor management skills by nurse managers are the chief reasons employees give for leaving their jobs. Kouzes and Posner (1995) defined the following five behaviors that correlated with leadership excellence: Inspiring shared vision: Leaders envision the future and enlist others in sharing the dream. The area of overlap may not be clear or explained. Figure 1-1 shows how these components relate to one another. Authority-obedience: This style strives for efficiency in operations. nurses, such … Little reward came from the “thinking” and integrating skills nurses were capable of. First, a two-dimensional model was constructed, in which task behavior and relationship behavior were displayed on a grid from high to low and were divided into four quadrants: (1) high task, low relationship; (2) high task, high relationship; (3) high relationship, low task; and (4) low task, low relationship (Figure 1-3). For example, the nurse care provider concentrates on the coordination of nursing care to individuals or groups. On the other hand, in a staff meeting, an authoritarian leader may be ineffective with a group of professionals and would need to be flexible enough to switch to a democratic or laissez-faire style, depending on. The wise leader assesses the trust and readiness to change levels of the group. Hersey and colleagues (2013) identified a second approach to leadership research that focused on the measurement of attitudes or predispositions toward leader behavior. What can I do to make a difference? Contact Us  |  Site Map  |  Privacy Policy  |  Course Login. However, several authors have developed lists of traits common to good leaders (Bass, 1985; Bennis & Nanus, 1985), and interest remains in the characteristics to look for in good leaders. Styles can be chosen to match the situation (Hersey et al., 2013). Communication may be formal or informal (Hersey et al., 2013). One research-based nursing model (Mathena, 2002) identified the following six core behaviors critical for nursing leadership success: Although the lists of leadership characteristics and competencies vary somewhat, the functions of visioning, setting the direction, inspiration, motivation, and enabling systems and followers are at the core of leadership activity. Because the style is based on noninterference, a clear decision may never be formulated. It is not known whether gender differences are permanent characteristics or are culturally mediated artifacts that blur with time. Best practices for ethical nursing leadership Every day, nurses are confronted with situations that call for close examination of ethical principles and behaviors. Movement into a participative leadership style requires much less structure and task-directive behavior from the leader because the individual or group is performing but is not quite confident enough in its own ability for the leader to completely let go. The LPC is an 18-item semantic differential scale that is the personality measure of Fiedler’s contingency model (Fiedler & Garcia, 1987). Process Part 2: The Follower All rights reserved.). Leadership is a broad concept and a process that can be applied to any group. 3. Leadership is a unique role and function. Hersey and colleagues (2013) identified the following three skills needed for leading or influencing: 1. Leadership theory often is discussed separately from management theory. Bennis (1994) identified a recipe for leadership that contained six ingredients: a guiding vision, passion, integrity (including self-knowledge, candor, and maturity), trust, curiosity, and daring. For example, in one setting the culture may resemble one big happy family, with an emphasis on teamwork and morale boosting. Each has advantages and disadvantages. Organizational culture and ethos also are important factors in the situation. The individual or group wants to talk about things. Leaders need to be willing to make tough choices plus overcome the fear associated with them. Their Situational Leadership® is a synthesis of the interplay among task behavior, relationship behavior, and the readiness of the followers. If they do not know each other and the situation is politically charged, the nurse leader needs to help people become comfortable with each other. This is a cognitive competency. Nurses can be aware of the crucial nature of trust in the leadership and management relationship. The only definition of a leader is someone who has followers. Popularity is not leadership; results are. Great leaders possess the following four essential skills: 1. You may also needManaging Time and StressDelegationQuality and SafetyBudgeting, Productivity, and Costing Out NursingCommunication LeadershipChange and InnovationLegal and Ethical IssuesOrganizational Structure Hersey and Blanchard’s Tri-Dimensional Leader Effectiveness Model Leadership styles contribute to team cohesion, lower stress, and higher empowerment and self-efficacy. The authoritarian leadership style uses primarily directive behaviors. Leader-member relations refers to the type and quality of the leader’s personal relationships with followers. If you have an Associate Degree of Nursing, consider going for a BSN. A profile of leaderships dos includes honesty, energy, drive, tenacity, creativity, flexibility, visibility, emotional stability, knowledge, conceptual skills, and leadership motivation. Critical thinking can be applied to: 1. Work avoidance (resistance) means that people are outside the productive range of tension. Blake and Mouton (1964) used task and relationship concepts in their grid, which was later modified by Blake and McCanse (1991). Leadership theory often is discussed separately from management theory. Clearly, “something changes as leadership blossoms” (Huber & Watson, 2001, p. 29). They appear to learn leadership skills in stages (Bennis, 2004). Please contact us. Effective leadership is important in nursing for those same reasons, specifically because of its impact on the quality of nurses’ work lives, being a stabilizing influence during constant change, and for nurses’ productivity and quality of care. Exploring the feminist perspective on leadership is valuable in that it provides food for thought as health care organizations and the nurses working in them struggle with not wanting to let go of the familiar hierarchy management style yet needing to reconfigure to the circular or web structure to be effective. These dimensions are similar to the authoritarian (or task) and democratic (or relationship) ideas of the leader behavior continuum. If the delivery of nursing services involves the organization and coordination of complex activities in the human services realm, then both leadership and management are important elements. Empowerment means giving people the authority, responsibility, and freedom to act on their expert knowledge and skills. Situations in which members of a group are not accustomed to working together or do not hold shared expectations frequently lead to conflict. Policies are a matter of group discussion and decision. Certain acts performed by leaders have positive effects and make people feel more respected; listening and informal chatting are prime examples (Alvesson & Sveningsson, 2003). Decisions of policy are made solely by the leader who tends to dictate tasks and techniques to followers. Leaders need to be willing to make tough choices plus overcome the fear associated with them. The individual or group wants to talk about things. Hersey and colleagues (2013) noted that the leadership process is a function of the leader, the followers, and other situational variables. This, in turn, is driven by perseverance to be the best patient and employee advocate one can be. Clearly, leadership is a complex and multidimensional process. Do not feel obligated to have all the answers, but be adept at asking the right questions. The acute care medical model in hospitals over time came to be the primary focus of attention and jobs for nurses. 2. Favorable or unfavorable situations are determined in part by the receptivity of the followers, but they are also determined by whether the larger environment is positive or negative. The nature of the situation needs to be considered. For example, the goal of the organization may be to decrease costs or increase revenue. Trust-destroying behaviors include being insensitive to beliefs and values, The long history of leadership theory has highlighted the importance of focusing on both of the two basic leadership elements of tasks and relationships. Social awareness: An intuitive skill of empathy and expressiveness in being sensitive and aware of the emotions and moods of others This can be seen in their distinct definitions. Examples include when technology changes more quickly than clinicians are able to learn and adapt to it, when management duties extend to include temporary workers employed by others (e.g., outsourced functions and agency nurses), and when a radical organizational shift to an accountable care organization (ACO) is necessary. A good nurse leader is someone who can inspire others to work together in pursuit of a common goal, such as enhanced patient care. 3. Bennis (1994) made a strong argument for leadership, stating that quality of life depends on the quality of leaders. By submitting this form, I am providing my digital signature agreeing that University of Louisiana at Lafayette (UL Lafayette) may email me or contact me regarding educational services by telephone and/or text message utilizing automated technology or a pre-recorded message at the telephone number(s) provided above. and support among followers, especially in organizations in which competence and commitment produce performance. Have a question or concern about this article? Followers may need greater structure than the leader gives them. Arising from a drive to make things better, leaders use their power to bring teams together, spark innovation, create positive communication, and drive forward toward group goals. Trait Theories Nurses can start by examining their own behaviors and then taking deliberative actions to strengthen trust in the environment. Self-awareness: Ability to read one’s own emotional state and be aware of one’s own mood and how this affects staff relationships They may be sequential, and they are interrelated. Another distinction is that a leader innovates, whereas a manager administers. Trust goes both ways and needs to be nurtured. • Actively managing the change process through communication, feedback, training, sustained effort and attention, and worker involvement This is an unfavorable situation and a leadership challenge. With sensitivity, cues in the environment can be identified and used to make choices regarding leadership style. Organizational man: This approach works on balancing the necessity to accomplish the task with maintaining morale. There are five principles that form the framework for adaptive leadership: 1. Eventually, as the situation progresses, a relationship-oriented leader can become less effective. Organizations have goals, and individuals working in organizations also have goals. Nurseslabs.com is an education and nursing lifestyle website geared towards helping student nurses and registered nurses with knowledge for the progression and empowerment of their nursing careers. Exhibiting quiet but respected competence, a leader may be the wise or go-to person within the group, a superior problem solver, a strategic communicator, or someone who is emotionally intelligent and strong in interpersonal relationship skills. Hersey and colleagues (2013) noted that the common themes include the following: the leader needs to be flexible in behavior, able to diagnose the leadership style appropriate to the situation, and able to apply the appropriate style. Fiedler’s theory (1967) suggests that the best leadership style under unfavorable circumstances is task-oriented. Possessing the license of an RN implies certain leadership skills and requires the ability to delegate and supervise the work of others. Thus there is no one best way to influence others or one best style. People need a certain amount of tension to do their best work, but the amount of tension needs to be productive. The leader’s focus is on people; the manager focuses on systems and structure (Bennis, 1994). This means that which theory or style is the best all depends on the situation at hand. Nursing is a service profession whose core mission is the care and nurturing of human beings in their experiences of health and illness. Hersey and colleagues (2013) noted that Blake and Mouton’s (1964) conceptualization tended to be an attitudinal model that measured the values and feelings of managers, whereas the Ohio State model included both attitudes and behaviors and focused on leadership. Hersey and colleagues (2013) combined ability and willingness into four levels of readiness. Hersey and colleagues (2013) defined management as the “process of working with and through individuals and groups and other resources (such as equipment, capital, and technology) to accomplish organizational goals” (p. 3). The cultural aspects of that leadership situation are different from those of an organization in which there is a fast-paced tempo and people seem very busy. Examples: where to go for help, its climate and culture, who the unofficial leaders are. Leadership Skills The chaos and complexity of the seismic shifts in health care structure, delivery, form, technology, and content have made visible the urgent need for leaders to emerge, mobilize, and encourage followers. A leader using this style may seem to be apathetic. Leader behavior was described as having two separate dimensions, as follows: At its core, leadership is about influencing people. He classified group situational variables of leader-member relations, task structure, and position power into eight possible combinations, ranging from high to low on these three major variables. Sandt said meeting consistently with nurses going off shift and those coming on keeps her in close touch with clinical events and patients, ena… Strong evidence for the nurse leader’s critical role both in the business of a health care organization and in the quality and safety of service delivery has been laid out by the Institute of Medicine (IOM) (2004), the American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program® (, Balancing tensions between efficiency and reliability, Actively managing the change process through communication, feedback, training, sustained effort and attention, and worker involvement, Communication and relationship management, Both nurses and the health care delivery systems in which they practice need leaders. Workload complexity analysis Relational coordination is defined as “coordinating work through relationships of shared goals, shared knowledge, and mutual respect” (p. xiii). Readiness can be applied to a work group. 4. Remember the adage: if your unit or department can run without you, you've done your job. They suggest that “one of the most reliable indicators and predictors of true leadership is an individual’s ability to find meaning in negative events and to learn from even the most trying circumstances” (Bennis & Thomas, 2002, p. 39). Then a telling, selling, participating, or delegating style is selected. This overlap occurs where the two processes are integrated or synthesized to accomplish goals and where the same strategies are employed even though the goals may differ. The premise of this book is that leadership and management are not identical ideas. Among these characteristics, untrustworthiness is a fatal flaw, and insensitivity to others is a likely cause for ineffective leadership (Hersey et al., 2013). In nursing, leadership is studied as a way of increasing the skills and abilities needed to facilitate clinical outcomes while working with people across a variety of situations and to increase understanding and control of the professional work setting. This column is designed as a review of guiding principles and best practices of effective leaders along with a discussion of the distinction between management and leadership. • Leadership: Guiding, directing, teaching, and motivating to set and achieve goals One choice a leader has is to alter his or her own behavior and the leadership style used. Creating and developing leaders. Good RN to BSN programs explore leadership principles and how to implement them. They are sets or clusters of behaviors used in the process of effecting leadership. Women tend to focus on process; men tend to focus on achievement and closure. Whereas managers are adept at controlling processes, making decisions, and coordinating resources, leaders empower others, inspire innovation, and challenge traditional practices. The area of overlap may not be clear or explained. Diane L. Huber Communicating is basic to the process of influencing and thus to leadership. Certain acts performed by leaders have positive effects and make people feel more respected; listening and informal chatting are prime examples (Alvesson & Sveningsson, 2003). Kotter (2001) noted that managers cope with complexity whereas leaders cope with change. 3. All rights reserved.) For example, a nurse is appointed as chair of a committee. Characteristics of Leadership Presumably, leaders could be differentiated from non-leaders. The feminist perspective on leadership was presented by Helgeson (1995a, Initiating structure and consideration in the Ohio State Leadership Studies, Employee orientation and production orientation in the Michigan Leadership Studies, A third phase of leadership theories grew out of a group of contingency theories whose central idea was that organizational behavior is contingent on the situation or environment. It includes achievement motivation, wanting to do well, persistence, a work attitude, and a sense of independence. The leader is either permissive and fosters freedom or is inept at guiding a group. If the nurse has a reasonably good relationship with the leader, the leader should use a high-relationship style with the nurse. Leadership is founded on trust: “Trust is the emotional glue that binds leaders and employees together and is a measure of the legitimacy of leadership” (Malloch, 2002, p. 14). Through communication, the leader’s vision and message are received by the followers. This model of leadership has been used in nursing research (Patrick et al., 2011). Key concepts related to leadership are influence, communication, group process, goal attainment, and motivation. Strong evidence for the nurse leader’s critical role both in the business of a health care organization and in the quality and safety of service delivery has been laid out by the Institute of Medicine (IOM) (2004), the American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program® (ANCC, 2008a, b), and the American Organization of Nurse Executives (AONE) (2005). Terms related to leadership are leadership styles, followership, and empowerment.Leadership styles are defined as different combinations of task and relationship behaviors used to influence others to accomplish goals. This may include such activities as arranging access to services, providing direct care, doing referrals, and supporting a patient’s family. Thus although both are used to accomplish goals, each has a different focus. If the nurse leader is a task-oriented person, a high-relationship person may need to be called on to assist the group process so that it is facilitated and becomes effective. This is both tricky and risky and may be overwhelming (Porter-O’Grady, 2003). Leaders arise in a context, and they are said to be made, not born. Effectiveness is a key outcome of leadership efforts in health care. The inclination is for a democratic power style, and the emphasis is on the importance of establishing relationships, maintaining connections with others, and deriving strength from empowering others. Leaders need to ask the right questions, such as these: What needs to be done? Gittell (2009) emphasized the centrality of relationship management because patient care is a coordination challenge. This leads to the third dimension of effectiveness. The feminist perspective on leadership was presented by Helgeson (1995a, b). Box 41210, Lafayette, LA 70504 Strong evidence for the nurse leader’s critical role both in the business of a health care organization and in the quality and safety of service delivery has been laid out by the Institute of Medicine (IOM) (2004), the American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program® (ANCC, 2008a, b), and the American Organization of Nurse Executives (AONE) (2005). Service. These may be downward, upward, horizontal, grapevines, or networks. This applies at all levels: nurse care provider, nurse manager, and nurse executive. 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