LEADERSHIP IN NURSING Nurses are leaders who make a difference.

They belong to one profession where they are able to touch peoples lives in intimate and profound ways. Nurses expert knowledge and leadership enable them to provide caring that is go different. they possess the courage, compassion, & optimism to care in times of disability, uncertainty, or death. These are the trademarks of nurses as leaders. LEADERSHIP is the process of persuasion & example by which an individual ( or leadership team ) induces a group to take action that is in accordance with the leaders purposes or the shared purposes of all. ( Gardner, 1986) - is a process in which a person inspires a group of constituents to work together using appropriate means to achieve a common mission & common goals. They are influenced to do this willingly & cooperatively, with zeal and confidence and to their greatest potential (Holloman, 1986) - is the process of directing and influencing the task-related activities of group members (Stoner, 1978) - is a social transaction in which one person influences others. Persons in authority do not necessarily exert leadership. Rather, effective people in authoritative positions combine authority and leadership to assist an organization to achieve its goals (Merton, 1969) FLORES (1989) provided definitions of leadership such as: LEADERSHIP can be described as a process of influence on a group in a particular situation, at a given point in time, and in a specific set of circumstances that stimulate people to strive willingly to attain, organizational objectives, giving them the experience to attain the common objectives and satisfaction with the type of leadership provided. LEADERSHIP is the knacks of getting other people to follow you and do willingly the things you want them to do. It is the ability to motivate subordinates and other employees toward the achievement of company objectives. LEADERSHIP must be based on the insight into present realities. Leaders who succeed are those who can get inside their people and motivate them. A leader gets inside people so as to energize them.

HOW SHOULD A NURSE LEAD? Since leadership is viewed as the process of influencing the activities of an organized group in its efforts towards goal setting and goal achievement, it is

imperative to understand that there is a difference in responsibilities among group members, and everyone influences the group activities. Lundborg (1986) pointed out that a leader is the one who is followed by others willingly and voluntarily. A leader who aims to establish and continue to maintain a productive organization should not only be concerned with short-ranged task achievement but must develop an atmosphere that gives staff-members personal satisfaction and the incentive to continue to work towards the ultimate organizational goals. FUNDAMENTAL CONSIDERATIONS FOR EFFECTIVE LEADERSHIP: According to Merton (1969), effective leadership had to satisfy the following considerations : 1. A person receiving a communication understands it.

2. This person has the resources to do what is being asked in the communication. 3. This person believes the behavior being asked is consistent with personal interests and values. 4. This person believes it is consistent with the purposes and values of the organization.

MAJOR VARIABLES IN LEADERSHIP McGregor (1960) stipulated that four (4) major variables are significant in leadership. These are: 1. The characteristics of a leader 2. The attitudes, needs, and other personal characteristics of the followers; 3. The characteristics of the organization, such as its purpose, its structure, the nature of the task to be performed, and 4. The social, economic, and political milieu. The personal characteristics required for effective performance of a leader vary, depending on the other factors. The given four sets of leadership variables specifically refer to : (1) personality of the leader (2) personality of the group (3) situation in which leadership is exercised, and (4) organizational factors DIFFERENCE BETWEEN LEADERSHIP AND MANAGEMENT Leadership is different from management although these terms also overlap. For example, a nurse can hold a management position but fail to realize that this

position does not define her leadership abilities nor does it translate to having leadership qualities. One may be a good nurse leader but not a good manager. A leader is : 1. Able to inspire her followers or specifically her nursing staff to do things beyond their call of duty. 2. Able to lift the staffs morale, and 3. Able to motivate the nursing staff to think of a solution to an existing problem such as, for example the high percentage of bed falls in a geriatric ward. There are even instances when one may be a good manager but not a leader, such as a nurse who can deliver the work that is expected from the nursing unit she manages, but cannot inspire her staff to do more. A mark of a good nurse managerleader is the ability to initiate and innovate. Leadership is doing the right thing while management is doing things right. But whatever the differences, both are required for an efficient and effective organization. Management is a function that must be performed in nay organization, while leadership is a relationship between leader and followers that can give life to an organization. REMEMBER ! The terms management and leadership refer to the functions and relationships while the terms leaders and mangers refer to the actor or agent of leadership and management. Difference between Leaders and Managers Leader Manager May or may not have official Officially appointed appointment to the position Vested with power and authority by the Vested with power and authority by the group organization Influence others toward goal setting Implements predetermined goals, policies, rules and regulations Intersted in risk taking and exploring Measures the risk to be taken in line with new ideas the expected results, hence, an orderly , controlled performance must be carried out. Relates to people personally Relates to people according to their roles Feels rewarded by personal achievement Feels rewarded when accomplishing organizational missions or goals May or may not be as successful as Are managers as long as the managers appointment holds Managers do things right leaders do the right thing. (Bennes, 1994) POINTERS TO THE LEADERSHIP PATH

The question for every nurse, no matter what the workplace or career stage is , ask yourself this : Are you s leader? There are several pointers to lead you in your growth as a nursing leader. BEGIN WITH YOURSELF Know thy self, know thy enemy. - Sun Tzu Begin with yourself to lead and be led. Ask the tough questions that will allow you to know: 1. who you are and what you are, and 2. why you do what you do on a daily basis. Leadership is a habit and like all habits, it begins with the person knowing it. It is an awareness of ones peculiarities and idiosyncrasies in life. It is finding out ones strengths and weaknesses. Ask the support of your friends, family and community in your pathway to self-discovery. We can only discover the extent of our personalities when we learn not to rely on our own opinions of ourselves. KNOW HOW TO LEAD It is not enough that a nursing graduate knows the theories ... Bernardo -

Arm yourself with the theories and principles of leadership and management. Leading has become as essential requirement in a world that has become more technological and complex. As such, learn as much as you can about it. The exceptional manager leads and manages. APPLY IT YOURSELF Apply your knowledge to make learning meaningful. Nurse leaders have to put into practice the knowledge acquired from school and informal channels so that it can be put to good use. whether or not you hold a position, you are a leader. As nurses, you have to provide a service, a product. To be paid a salary, you must provide more value for your employer than it pays you. This value comes from self-leadership. EVALUATE YOUR GAINS AND REFLECT ON THE LOSSES As you travel the leadership path, youll meet both success and failure. Each of them will provide you with valuable insights about life in general and how best to approach it in particular. Assuming that you have taken notes of your journey in leadership, it is also advisable that you write down what your accomplishments are aside from what still needs to be done. It is not fulfilling to go through life without reflection. As such, learn from your experiences which you have gathered from both your successes and failures. CHANGE YOURSELF

After a thorough evaluation comes a change in the way of doing things. This is the ideal scenario but it does not often match the reality. It is expected that with evaluation and reflection, a person comes to realize that there are things that may require a different way of doing. People, in general are stubborn and would always want to cling to what they believe is right even when they are wrong. If everyone else is like this, imagine the challenge that a leader and manager have to be faced with. Thus, learn to make your own changes in yourself. Always change for the better! The concept of nursing leadership can be best characterized using the word LEADER as an acronym for the following traits and actions: L lead , love , learn E enthusiastic, energetic A assertive, achiever D dedicated, desirous E effective, efficient R responsible, respectful Lead, Love, Learn Because she is always with people, a nurse should be able to lead. She must act as the leader of a team when her skills and experience level call for it. She should also know how to love becuse of the number and diversity of patients she will serve, none of whom she can choose. Finally, she should be able to constantly learn since the practice of nursing is a continually evolving process. Enthusiastic and Energetic As a leader, a nurse must both be able and willing to work hard. She should bring both enthusiasm and proficiency to her assigned tasks, not only for the sake of the task itself but for the benefit of those around her. In connection, a truly professional nurse is one who is able to temporarily set aside her own concerns and problems and ill feelings while at work because she wants to devote full attention to the patients who look to her to provide care in their time of illness. As a leader, she always reserves a smile for all her patients no matter what her problems. Assertive and Achiever As a leader, a nurse should always know the reasons for doing things. She should know not only what things should be done but also why things must be done. Nursing has a very wide horizon; therefore, she should strive hard to achieve her goals. A nurse should remember that there is a difference between being assertive as opposed to being submissive. Being assertive means being able: 1. to express ones feelings,

2. 3. 4. 5. 6. their

to choose how one will act, to speak up for ones rights when it is appropriate, to enhance ones self-esteem, to help oneself develop self-confidence, to disagree when one thinks it is important, and to carry out plans for modifying ones behavior and asking others to change offensive behavior ( Bower, 1991)

Dedicated and Desirous As a leader, a nurse should develop her heart for the profession. She must be committed to what she is doing. She should also have the desire to pursue higher learning to continuously grow professionally. The nursing profession is challenging and quite rewarding. It provides room for improvement for those willing to take the challenge of going up the career ladder in the nursing profession. It is only those who prefer to take the path of obscurity that nursing becomes a failed endeavour. Efficient and Effective As a leader, a nurse should be able to do right things and to do the things right. She should be certain in all her actions. She should avoid ambiguity. This only comes about after careful reflection of the advantages and disadvantages of a plan or action. While it is difficult to avoid mistakes, she should minimize it and learn the lessons arising from those mistakes. Responsible and Respectful As a leader, her responsibility is directed to the patient. She is highly respected by the people she is leading. She assumes personal responsibility for the decisions she makes concerning the care of her patient. She holds herself accountable and answerable for the mistakes she might commit in the course of providing care for the patient. She remembers the maxim that before she can point a finger to other people, her four other fingers are pointing at her. She blames no one if things do not go her way. this encourages good social interactions and allows nurses to get along with other people. As a leader, she takes into consideration the views and desires of others and incorporates it into her decisions. Respecting another person means considering the other persons thoughts, opinions and desires in planning and decision-making. The leader does not necessarily agree or disagree with these thoughts and opinions on a matter but she considers them. DIMENSIONS OF LEADERSHIP Leadership is generally viewed as a dynamic interactive process that involves three dimensions: a leader, a follower and a situation. It is a result of the relationship between the environment, the organizational structure, the group members, and the leader.

FOLLOWERSHIP The follower is not a passive agent in leadership. A good follower leads herself by assuming responsibilities thus influencing her own performance. Effective followers are active, responsible, and autonomous in their behavior and critical in their thinking without being insubordinate or disrespectful (hock,1999). Both leaders and followers have a purpose to fulfill. TYPES OF FOLLOWERS: The types of followers are adapted from Kellerman (2007). The follower can be alienated, sheep, yes people, survivors, effective followers. ALIENATED - they are independent and critical yet passive in their behavior resulting in psychological and emotional distance with the leaders. They are potentially disruptive and a threat to health of the organization. SHEEP - they are dependent and uncritical. They simply do as they are told by their leaders. YES PEOPLE - they are dependent or uncritical, but very active in their behavior. They uncritically reinforce the thinking and ideas of their leaders with enthusiasm, never questioning or challenging the leaders ideas or proposals. But, they are the most dangerous to a leader because they are most likely to give a false positive reaction and give no warning of potentials pitfalls. SURVIVORS - they are the least disruptive and lowest risk followers. They perpetually sample the wind. Their motto is Better safe than sorry. EFFECTIVE FOLLOWERS - are self-leaders and do not require close supervision. They recognize that to be an effective leader, one need good followers. Leaders cannot exist without good followers. Four (4) essential qualities of effective followers: 1. Self-management. The key to being a good follower is to think for oneself and to work well without close supervision. Effective nurses see themselves as being capable as their leaders. 2. Commitment. Effective followers are committed to something beyond themselves. To a committed nurse, the leader facilitates making progress toward achieving a goal. 3. Competence and focus. Effective followers build their competence and focus their efforts for maximum impact. Competence centers on mastering skills that will be useful to the organization.

4. Courage. critical thinkers and

Effective followers establish themselves as independent, will fight for what they believe is right. ELEMENTS OF LEADERSHIP

The core elements of nursing leadership are vision, influence, power, authority, responsibility and accountability. VISION A vision provides direction to the influence process. A nurse can have one or more visions of the future to assist them to move a group successfully towards this goal. A vision, for effectiveness should: 1. Appear as simple, yet vibrant, image in the mind of the leader. 2. Describe a future state, credible and preferable to the present state, 3. Act as a bridge between the current state and a future optimum state, 4. Appear desirable enough to energize followers, and 5. Succeed in speaking to followers at an emotional or spiritual level (logical appeals by themselves seldom muster a following) For leadership to occur, leaders must communicate the vision to their followers in such a way that the followers adopt the vision as their own. Leaders must not just see the vision themselves; they must have the ability to get others to see it too. Vision is the essence of leadership. It is essential for organizational effectiveness and success. It is used as a major leadership tool in enlisting its members towards the defined objective, and focused on the constructive role of the organization within its environment. There are three (3) critical components involved in making that vision work: 1. The leader or the head of the organization 2. The members of the organization or staff, and 3. The environment in which they function or the community These 3 components work together to achieve the vision. As they interact, the leader, members and environment contribute to the implementation of the vision, the realization of objectives and the success of the organization. INFLUENCE

Leadership is also viewed largely as influence or the ability to obtain followers. One of the major components of the power triangle which includes recognition and communication. At the apex of the power triangle is communication. In the art of influencing people, communication holds utmost importance. Power is transmitted through the way the leader communicates to her followers. Communication may be good or bad depending on whether the message was received or not. Poor communication often leads to poor influence or none at all. The ability to articulate the needs of the group is one way for the leader to exercise power as her followers trust her to understand what their needs are. Another component of the power triangle is recognition. A leaders good deeds are recognized by the group. It is the group that vests power on the leader because of what they perceive to be her significant contribution. KINDS OF INFLUENCE: a. Assertiveness is a kind of influence where one sends direct messages to others and is able to stand up her own rights without violating those of others. b. Ingratiation is where individual makes another feel important or good before making a request. The person acts humbly or is friendly before making a request. (Buladas) c.Rationality - is a type of influence that involves convincing someone of the merits of a detailed plan, which is usually supported by information, reasoning or logic. Example: A nursing care plan is drawn up to address the chief complaint of the patient. This is then communicated to the patient showing the pros and cons of every option taken. d.Blocking is a hostile form of influence where an individual achieves the goaql of influencing another person either with the threat of or the actual act of cutting off from communication or interaction the other person intended to be influenced. Example : A new nurse is told to keep to herself her observations of abuses of some colleagues or else she will be ostracized from the group. e. Coalition - is a collective form of influence where a person gets several coworkers to back her up when making a request. Example: The entire pediatric nursing staff would go up to their area manager to request for a change in shift schedule. f. Sanction - is a form of influence hinged on the promise of punishment in the case of noncooperation and reward in case of acquiescence or cooperation. This is the kind of influence that is behavior based. Example: The nurse is given duties and responsibilities in the care of an autistic child with cancer. Should she fail to care for the patient properly, then she loses the opportunity to handle such a difficult case. g. Exchange involves offering a favor or a personal sacrifice as an incentive for the performance of the request. This occurs

when a nurse would ask favor from a colleague such as to cover her shift on Monday in exchange for a free weekend. h.Upward appeal involves obtaining support from a higher-up to push someone into action. A nurse talk to the manager to make sure that other non-performing nurses would do their jobs in the nursing care unit. LEVELS OF LEADERSHIP AS AN ACT OF INFLUENCE: According to John Maxwell (2001), there are basically five levels of leadership that anyone designated as a leader is likely to occupy depending on her personal and professional growth. Level 1: POSITION The only influence a nurse can have at this level is that which comes with the title. A real nurse leader knows the difference between being a leader and being the boss, because they are not always the same thing. Level 2: PERMISSION It is based on how well people know the leader. People want to know what motivates their leader and if this means she will care for them. LEADERSHIP begins with the heart not with the head. People at the position level often lead by intimidation. Examples are coaches, caotains, teachers or others. Leaders at the second level of leadership lead by interrelationships, or through caring concern for others. People who are unable to build solid, lasting relationships will soon discover they are unable to sustain long, effective leadership. Level 3 : PRODUCTION This is the level of products and results. The biggest difference between level 3 and level 2 is that on the relationship level, people get together for the sake of it, while on the results level, there is a purpose for coming together, or a desired result or outcome. People work together to achieve similar objectives and hope for the same things. Level 4: PEOPLE DEVELOPMENT How does one spot a leader? According to Robert Townsend, they come in all sizes, ages, shapes and conditions. Some may lack administration skills, while others may not be very bright. Still, the true leader is distinguishable through the consistently superior performance of her subordinates. A great leader is one who empowers others, because a leaders main responsibility is to develop others In nursing care setting, this means making new staff nurses stronger, or those already with the organization better. They are trained better and sent to developmental seminars and conferences. Level 5 : PERSONHOOD Only a proven leader may arrive at this level and reap the rewards that are eternally satisfying. The higher a leader climbs along the five levels the longer it takes to reach the next level.

With each increase in level comes a higher commitment to serve the people and the organization. When either the leader or the follower is unwilling to make the sacrifices a new level demands, influence will begin to decrease. the good news for the leader is that the higher she goes, the easier it becomes to lead and the greater the growth. For leadership to grow, it is essential that along with the leader the other influential people in the group ascend as well. Statesmanship is often the result of arriving at this level. A statesman is most anxious to produce a certain moral character in her fellow citizens, namely a disposition to virtue and the performance of virtuous actions. POWER Is defined as the ability to efficiently and effectively exercise authority and control through personal, organizational and social strength. It is the ability to impose the will of one person or group to bring about certain behaviors in other groups or persons. Powerless nurses are ineffective nurses, and the consequences of nurses lack of power can be disastrous. Powerless nurses are less satisfied with their jobs, and more susceptible to burn-out and depersonalization. Lack of nursing power may also contribute to poor patient outcomes or nursing care. SOURCES OF POWER: LRCEIR 1. LEGITIMATE POWER - is bestowed upon a leader by a given position in the hierarchy of an organization. Such power is sanctioned by titles such as director of nursing and provides a leader with a mantle of authority given by the administration. This is both the most obvious and most important kind of power. 2. REWARD POWER is derived from managers ability to give rewards to her subordinates for compliance with her orders or requests. It refers to the degree to which the individual somehow compensate her subordinates through means such as benefits, time off, desired gifts, promotions or increases in pay or responsibility. People who abuse reward power can become pushy or reprimanded for being too forthcoming or moving things too quickly. 3. COERCIVE POWER is based on the leaders ability to punish subordinates for non-compliance with his directives. It might refer to the ability to withhold rewards or even create an untenable working situation for such subordinates. It tends to be the most obvious but least effective form of power as it builds resentment and resistance within the targets of coercive power. 4. EXPERT POWER - Is derived from special abilities or skills unique to the leader. it is the ability to influence to others through the possession of knowledge or skills that are useful to them. The power associated with caring provided by nurses has been described as transformative and healing. 5. INFORMATION POWER is derived from being well-informed and up-todate. It is through Information power that nurses are able to persuade others. While people with Expert power are perceived by their image of expertise to show credibility (i.e. a qualified RN in a nurses uniform) 6. REFERENT POWER Is based on relationships and connections. It is also called networking. Referent power means the power or ability of individuals to attract others and build loyalty. It is based on the charisma and interpersonal skills of the power holder. those who follow these individuals who possess Referent

power desire to identify with the personal qualities of the leader and gains satisfaction from being an accepted follower. AUTHORITY, RESPONSIBILITY AND ACCOUNTABILITY (ARA) AAUTHORITY, the right to decide RRESPONSIBILITY, ability to respond AACCOUNTABILITY, ability to account AUTHORITY: A related concept to power is authority. Authority represents the right to expect or secure compliance; authority is backed by legitimacy. Power has the potential to control the behavior of others while authority has the potential to exert control through the legitimacy of a managerial position. Anonymous Forms of Authority: The 3 forms of authority are: Line Authority, staff authority , and team authority. 1. LINE AUTHORITY - is direct supervisory authority from superior to subordinate. Authority flows in a direct chain of command from the top of the company to the bottom. Under line authority, the chain of command is strictly followed. There is a unity of command within the chain that cannot be broken otherwise there will be chaos in the organization. The line authority also knows the extent or span of her control over her subordinates. a. chain of command is an unbroken line of reporting relationships that extends through the entire organization. The line defines the chain of command and the formal decision-making structure. It helps employees know to whom they are accountable, and whom to go with a problem. b. Unity of command the chain states that each person in an organization should take orders from and reports to only one person. This helps prevent conflicting demands being placed on employees by more than one superior. c. Span of control refers to the number of employees that should be placed under the direction of one leader-manager. Spans within effective organizations vary greatly. The actual number depends on the amount of complexity and the level of specialization. In general, a wide span of control is possible with bettertrained, more experienced, and committed employees. 2. STAFF AUTHORITY It is more limited authority to advice. It is authority that is based on expertise and which usually involves advising line managers. Broken line that links the staff (asst. to president) to the top of the chain of command (president) Staff members are advisers and counsellors who aid line departments in making decisions but do not have the authority to make final decisions. Staff supervisors help line departments decide what to do and how to do it. They coordinate and provide technical assistance or advice to all advisors, such as accounting, human resources, information technology, research, advertising, public relations and legal services.

3. TEAM AUTHORITY is granted to committees or work teams involved in an organizations daily operations. work teams are groups of operating employees who shared a common vision, goals and objectives. They are empowered to plan and organize their own work and to perform that work with a minimum of supervision. RESPONSIBILITY: While authority is the right to decide and command, responsibility is the corresponding obligation and accountability answers for all actions done. When a nurse is given responsibility for a job, she must also be given the degree of authority necessary to carry it out. The authority granted must equal the assigned responsibility. Upon accepting the delegated task, the nurse-employee has incurred an obligation to perform the assigned work and to properly utilize the granted authority. Responsibility is the obligation to do assigned tasks. The nurse-employee is responsible for being proficient at her job. 2 categories: individual and organizational.

1. Individual responsibilities - Nurses have individual responsibilities to be proficient in their job. They are responsible for their actions. Nobody gives or delegates individual responsibilities. They assume them when they accept a position in the organization. 2. Organizational Responsibilities refer to collective organizational accountability and include how well departments perform their work. ACCOUNTABILITY: When someone is responsible for something, she is liable or accountable to a superior, for the outcome. This means that a nurse will have to answer for the results or outcomes of her actions and decisions in her work. Accountability flows upward in the organization. Accountability is answering for the result of ones actions or omissions. It also establishes reasons, motives and importance for actions in the eyes of managers and employees alike. This the final act in the establishment of ones credibility. It is important to remember that accountability results in rewards for good performance, as well as discipline for poor performance. LEADERS TYPES OF LEADERS Leaders can be categorized as either formal or informal leaders. 1. FORMAL LEADER - is appointed, elected or designated, deliberately chosen by the administration and given the authority to act. He holds a formal position that has been determined as needed in the organization. Everyone in the nursing unit recognizes him as the leader, e.g., area manager or head nurse. 2. INFORMAL LEADER - Does not have the official sanction to direct the activities of others. He is chosen by his group itself as in social group because of age, seniority, special competence or personality.

BEHAVIOR OF LEADERS : Leaders can behave in various ways. They can be passive or non-assertive, aggressive and assertive. 1. PASSIVE OR NON-ASSERTIVE BEHAVIOR - Leader feels self-pity and is lacking self-worth, acts apologetically, is easily dominated by others and speaks hesitantly, softly refusing to look at others when talking. A passive leader has self-denial issues, inhibited, puts herself down as a norm. This behavior of the leader is borne from low self worth and confidence. oftentimes , the passive leader allows others to choose and does not achieve desired goals. 2. AGGRESSIVE BEHAVIOR - Aggressive leader talks loudly every subject. Often depreciates others remarks and has shown insensitivity to the feelings of other people. She disregards other peoples rights and the aggressive behavior is characterized by her propensity to point a finger and says you frequently. Oftentimes enhance their selves at the expense of others. They dictate the actions of others and achieve desired goals by hurting others. 3. ASSERTIVE BEHAVIOR - This is the midway between passive and aggressive. Assertive leaders express opinions and beliefs w/out infringing on or belittling the right or belief of others. They refuse to be dominated or manipulated. They survive to enhance self and others. They are also quite expressive. They naturally feel good about their self. They choose for their self and achieve desired goals. LEADERSHIP STYLES OF LEADERSHIP: 1. AUTOCRATIC LEADERSHIP STYLE This is often considered the classical approach. it is one in which the nurse leader-manager retains as much power and decision-making authority as possible. Under an aothocratic leadership , the nursing staff is m otivated by rewards and punishments. Authocratic leaders rely on threats, and punishment to influence others. They do not trust employees. Yet, autocratic leadership is not all bad. 2. BURUEAUCRATIC LEADERSHIP STYLE - This is where the nurse leader- manager manages by the book. Everything must be done according to procedure or policy. These leader is really more of a police officer than a leader. She enforces the rules. This style can be effective when : a) Routine tasks are performed, b) Certain standards or procedures are to be understood, c) employees are working with dangerous or delicate equipment that requires a definite set of procedures to operate,

d) Safety or security training is being conducted, and e) Employees are performing tasks that require handling cash. 3. DEMOCRATIC LEADERSHIP STYLE - Also called the participative style as it encourages employees to be part of the decision making. Under democratic leadership, the nurses are well-informed about everything that affects their work. They share in the decision making and problem solving responsibilities. Democratic leadership can produce high quality and high quantity work for long periods of time. Typically the democratic leader: a) Develops plans to help employees evaluate their own performance, b) Allows employees to establish goals c) Encourages employees to grow on the job and be promoted, d) Recognizes and encourages achievement, e) Shares the problem solving and decision- making to the staff, and f) Encourages team building and participation. 4. LAISSEZ-FAIRE LEADERSHIP STYLE: - Also known as the hands off style. There is little or no direction from the leader and the nursing staff has a s much freedom as possible. All authority or power is given to the employees and they must determine goals, make decisions, and resolve problems on their own. This is an effective style to use when: a) Employees are highly skilled, experienced, and educated, b) Employees have pride in their work and the drive to do it successfully on their own, c) Outside experts, such as staff specialists or consultants are being used, and d) Employees are trustworthy and experienced. FACE OF LEADERSHIP: RATIONAL AND EMOTIONAL Leadership involves both the rational and emotional sides of human experience. It includes `actions and influences based on reason and logic as well as those based on inspiration and passion. Because people are both rational and emotional, leaders can use rational techniques and/or emotional appeals in order to influence followers.

LEADERSHIP IN NURSING:

THEORIES AND MODELS

NURSING LEADERSHIP THEORIES Nursing practice, in the past years, focused on the management of patient care, not leadership. This has provided most nurses with a solid foundation in management. but little in terms of leadership. Leadership is an essential element of management and all managers must possess leadership qualities to be effective.

Theories on leadership may be classified as : EARLY AND CONTEMPORARY according to its emergence in history. EARLY LEADERSHIP THEORIES: Includes trait theories, behavioural theories, contingency and situational theories. TRAIT THEORIES - leadership theory focused on leader traits. It assumes that a person must have certain innate abilities or personality traits in order to be a leader. GREAT MAN Theory - this theory assumes that the capacity for leadership is inherent, that great leaders are born, not made. These theories often portray great leaders as heroic, mythic and destined to rise to leadership when needed. Sun Tzu would be considered a great man along with Genghis Khan, Aristotle, the Kings of Great Britain, and Abraham Lincoln. They are very influential men and women who have made an impact on history. TRAIT THEORY - assume that people inherit extraordinary qualities and traits that make them better suited to leadership. They believe that leaders were like tireless ambition, zest for life, great orator skills, irresistible good looks and extremely persuasive. For example, Pope John Paul II, Mother Teresa, Margaret Thatcher, Nelson Mandela and Gandhi are considered leaders because of the special traits that they possess. Common Traits of Leaders: POSITVE AND NEGATIVE

1. POSITIVE Leaders who have positive traits bring people to progress. They transcend their own traits to people who will become positive leaders themselves. They are cheerful, forgiving, intelligent, and good looking men and women among others. Effective leaders build leaders while leading . 2. NEGATIVE - Leaders who have negative traits bring people to destruction. They destroy rather than build. They are bitter, aggressive, loud-mouthed, sullen and ugly people. Ineffective leaders build incompetent followers . TRAITS AND SKILLS OF LEADERS by STOGDILL Traits Skills Adaptable to situations Clever Alert to social environment Conceptually skilled Ambitious and achievement oriented Creative Assertive Diplomatic and tactful Cooperative Fluent in speaking Decisive Knowledgeable about group task Dependable Organised

Dominant (desire to influence others) Energetic (high activity level) Persistent Self-confident Tolerant of stress Willing to assume responsibility

Persuasive Socially skilled

BEHAVIORAL THEORIES Behavioral theories were concerned with what leaders did and act than who the leader is . The actions of the leaders and not their mental qualities or traits make them leaders. These are beased upon the belief that great leaders are made, not born. people can be taught to become leaders through experience and observation. Several theorists studied the behavior of leaders as its affects management and how humans relate to each other in organizations. these include KURT LEWIN, RENSIS LIKERT, BLAKE MOUTON, CHRIS ARGYRIS, AND ALVIN TOFFLER. KURT LEWIN ( 1890-1947) - was an eminent psychologist who proposed that the workers behavior is influence by interactions between the personality, the structure of the primary work group and the socio-technical climate of the workplace (Miner, 2005) He categorized Leadership style as (1) authoritarian , (2) democratic ans (3) laissez-faire ( Lewin , 1939). -developed the FIELD THEORY OF HUMAN BEHAVIOR (LEWIN , 1951). Believed that people act the way they do depending on selfperceptions and their environments. Lewin (1951) proposed that change undergoes three stages : UNFREEZING, ACTUAL CHANGE AND RE-FREEZING. THE CHANGE PROCESS STAGE Characteristics Unfreezing People in the organization made aware of problems/performance gap and need for change Mind Set Changing People experiment with new workplace behavior to deal with needed change. Period of confusion and transition Re-freezing People employ new skills and attitudes and are rewarded by organization. CHRIS ARGYRIS ( 1923) Organizational Impact The diagnosis stage is often driven by a change agent This intervention stage features specific training plans for managers and employees. Changes are institutionalized in the corporate culture.

Is an organizational psychologist who sought to study the way people in organizations act and react with each other. He also studied the patterns of reasoning that explains ones behavior. He also developed the concepts: LADDER OF INFERENCE and DOUBLE LOOP LEARNING. LADDER OF INFERENCE - is based on the idea that individuals interpret data to make meaning and make sense of it. - This is a reminder that, when communicating, one needs to communicate not just subjective conclusions, but also the reasoning process and assumptions that underlie the conclusions. DOUBLE LOOP LEARNING - The focus of the theory is on solving problems that are complex and structured and which change as problem solving advances ( agrysis and shon, 1978; 1996). The commonly used example of single loop learning is the thermostat. ALVIN TOFFLER (1928-) Is a futurist known for his works discussing the digital revolution, communications, corporate revolution and technological singularity. He examine technology and its impact to the world and the reaction of and changes in society. RENSIS LIKERT (1903-1981) Likert is best known for his development of the Likert Scales and the Linking pin Model. 1. The LIKERT SCALE is a five (5) scale measurement tool to determine the level of agreement and disagreement of a respondent to a set of questions that could be objective or subjective in nature. The format of a typical five-level Likert item is: 1. Strongly disagree 2. Disagree 3. Neither agree nor disagree 4. Agree 5. Strongly agree 2. The LINKING PIN MODEL, on the other hand, is a concept of the ideal work relationship of workers in an organization. Likert used the concept of family to characterize the desirable social interaction that should occur between different work units. He also encouraged strong personal relations between work units above and below management to achieve an effective organization. Under this approach: 1. Superiors and subordinates trust each other, 2. Information flows freely downward and laterally, 3. Group participation high but there are realistic goals, 4. Decisions are through democratic process, and

5.

Training human resources and control is done often.

Likerts Four (4) Types of Management Systems 1. Exploitative Authoritative a) Least effective performance b) Managers show little confidence in staff associates and ignore their ideas c) Staff associate do not feel free to discuss their jobs with the manager d) Responsibility for organizations goal is at the top; goals are established through orders. Benevolent-Authoritative a) The manager is condescending to staff associates b) Staff associates ideas are sometimes sought but they do not feel very free to discuss their jobs with the manager c) top management & middle management are responsible for setting settings goals d) decisions are made at the top with some delegation e) staff associates are occasionally consulted for problem solving.

2.

3.

Consultative a) The manager has substantial confidence in staff associates b) their ideas are usually sought and they feel free to discuss their work with the manager c) Responsibility for setting goals is fairly general d) Managers are quite familiar with the problem faced by their staff associates 4. Participative a) Associated with the most effective performance b) Managers have complete confidence in their staff associates c) Ideas are always sought d) managers are very well informed about the problems faced by their staff associate and decision making is well integrated throughout the organization with full involvement of staff associates.

System 4 Leadership Management Styles developed by Likert. System Type Description System 1: Management uses fear and threats; Exploitative communication is top down with most decisions authoritative taken at the top; superiors and subordinates are distant. System 2: Management uses rewards; information flowing Benevolentupward is restricted to what management wants authoritative to hear and whilst policy decisions come from superiors expect subservience lower down

System 3: Consultative

System 4: Participative group management

Management offers rewards, occasional punishments; big decisions come from the top while there is some wider decision making involvement in details; and communication is downward while critical upward communication is cautious. Management encourage group participation and involvement is setting high performance goals with some economic rewards; communication flows in all directions and is open and frank; decision making through group processes with each group linked to others by persons who are members of more than one group called linking pins; and subordinates and superiors are close to each other . The result is high productivity and better industrial relations.

ROBERT R. BLAKE (1918-2004) AND JANE MOUTON ( -1987) Dr. Robert R. Blake with Dr. Jane S. Mouton developed the MANAGERIAL GRID MODEL, which attempts to conceptualize management in terms of relations and leadership style. The grid consists of 2 behavioural dimensions: 1. Concern for task or production. The leader cares little about people and operates in fear of something going wrong. This leaders focus is on achieving results and productivity. 2. Concern for people. This leader cares little about productivity and operates wholly from a desire to be loved and approved of. 3 Things to remember about the Blake & Mouton Managerial Grid: 1. Leaders lay somewhere along the continuum of concern for productivity to concern for people. 2. there is no one best way of leadership. 3. Different styles are needed for different situations. SITUATIONAL OR CONTINGENCY THEORIES Another approach to leadership is the situational approach. Under these theories, different situations demand different types of leadership. A situation, within this context, is a set of values and attitudes with which the individual or group has to deal in a process of activity and with regard to which this activity is the solution of a situation.

It is also called contingency theories because the leadership style would be dependent on the situation that a leader is faced at the moment. Among its proponents are Paul Hersey, Kenneth Blanchard, Fred Fiedler, Vroom and Yetton, and Robert House. PAUL HERSEY & KENNETH BLANCHARD Leaders should adapt their style to follower development style ( or maturity) , based on how ready and willing the follower is to perform required tasks. their readiness depends on their competence and motivation. There are 4 leadership styles (S1 to S4) that match the development levels (D1 to D4) of the followers. S1 : Directing / Telling Leaders

The leader defines the roles and tasks of the follower. and supervises them closely. Decisions are made by the leader and announced, so communication is largely one-way. S2: Coaching / Selling Leaders

The leader still defines roles and tasks, but seeks ideas and suggestions from the follower. Decisions remain the leaders prerogative, but communication is much more two-way. S3: Supporting/Participating Leaders

The leader passes day-to-day decisions, such as task allocation and processes, to the follower. The leader facilitates and takes part in decisions, but control is with the follower. S4: Delegating Leaders

Leaders are still involved in decisions problem-solving, but control is with the follower. The follower decides when and how the leader will be involved. Effective leaders need to be flexible, and must adapt themselves according to the situation. However, each leader tends to have a natural style, and in applying situational leadership she must know her intrinsic style. FRED FIEDLER (1922-) Fiedler (1967) developed his theory around the premise that leaders personal characteristics are stable and therefore so is the leadership style.

THE FIEDLER CONTINGENCY MODEL is a leadership theory that moved from the research of traits and personal characteristics of leaders to leadership styles and behaviors . His model focused on the personality and relationship between the leader and group members, programming of groups assignment and positional power of the leader. Three Aspects of the situation that needs to be considered are: 1. Leader member relation refers to how well the manager and the workers get along. 2. Task structure - refers to how the nature of the job to be done is highly structured or fairly unstructured or somewhere in between. 3. Position Power - refers to how much legitimate authority does the leader- manager possess. VICTOR HAROLD Vroom and YETTON They suggested that the selection of a leadership style will determine decision-making. the effectiveness of a decision procedure depends upon a number of aspects of the situation such as the : 1. Importance of the decision quality and acceptance; possessed by the leader and

2. Amount of relevant information subordinates;

3. Likelihood that subordinates will accept an autocratic decision or cooperate in trying to make a good decision if allowed to participate, and; 4. Amount of disagreement among subordinates with respect to their preferred alternatives. ROBERT HOUSE Proposed the PATH-GOAL THEORY OF LEADERSHIP. He said that the leader can affect the performances, satisfaction, and motivation of a group through rewards, clarification of paths to goals and removal of obstacles in work performance. Leadership style : Directive Leadership : specific advice is given to the group and ground rules and structure are established. Example : clarifying expectations, specifying or assigning certain work tasks to be followed.

Supportive Leadership : Good relations are promoted with the group and sensitivity to subordinates needs is shown. Participative Leadership : Decision making is based on consultation with the group and information is shared with the group. Achievement-oriented leadership : Challenging goals are set and high performance is encouraged while confidence is shown in the groups ability.

CONTEMPORARY LEADERSHIP THEORIES Contemporary leadership theories include transactional, transformational, servant leadership, emotional intelligence driven leadership and quantum leadership. TRANSACTIONAL LEADERSHIP STYLE - the leader motivates the followers by appealing to their own self-interest. Its principles are to motivate by means of the exchange process. It is a contract for mutual benefit that has contingent rewards. Transactional behavior focuses on the accomplishment of tasks and good worker relationships in exchange for desirable rewards. Transactional leadership may encourage the leader to adapt their style and behavior to meet the perceived expectations of the followers. It can be manipulative and counter-productive. 4 types of behavior according to transactional leadership: 1. Contingent Reward - To influence behavior, the leader clarifies the work needed to be accomplished. The leader uses rewards or incentives to achieve results when expectations are met. 2. Management by Exception (MBE) to influence behavior, the leader uses correction or punishment as of a response to unacceptable performance or deviation from the accepted standards. 3. Active Management by Exception - to influence behavior, the leader actively monitors the work performed and uses corrective methods to ensure the work is completed to meet accepted standards. 4. Laissez-Faire Leadership - the leader is indifferent and has a hands off approach toward the workers and their performance. This leader ignores the needs of others, does not respond to problems or does not monitor performance. TRANSFORMATIONAL LEADERSHIP:

The most effective and beneficial leadership behavior to achieve long-term success and improved performance is transformational leadership. The transformational leadership style: 1. Promotes employee development 2. Attends to needs and motives of followers 3. Inspires through optimism, influences changes in perception. 4. provides intellectual stimulation and encourages follower creativity 5. Uses role modelling 6. Provides sense of direction and encourages self- management. A person with this leadership style is a true leader who inspires her team constantly with a shared vision of the future. Transactional vs. Transformational leadership Transactional Transformational Hierarchy Networking Competitive Cooperative Task focus Process focus Exchange posture Promote employee development Identify needs of followers Attend to needs and motives of followers Provide rewards to meet Inspire through optimism Exchange for expected performance Influence change in perception Contract for manual benefits Provide for intellectual stimulation Contingent rewards Encouragement of follower creativity Caretaker Role model Set goals for employees Individualize consideration Focus on day-to-day operations Provide sense of direction Management by exception Encouragement of self-management Transformational leaders are highly visible, and spend a lot of time communicating. They do not necessarily lead from the front, as they tend to delegate responsibility among their team. While their enthusiasm is often infectious, they generally need to be supported by details people Transactinal leadership is steeped in hierarchy while transformational leadership spreads the domain of power to the followers or subordinates. SEREVANT LEADERSHIP If you are truly determined to help others rather than dominate them, then, you must be prepared to: 1. Endure misunderstanding and suffering instead of seeking honor and glory. 2. Show initiative when people are apathetic; and 3. Forge ahead so it will be easy to drift with the tide.

ROBERT GREENLEAF coined the termservant leadership. it emphasizes the leaders role as stewrd of the resources such as human, financial and otherwise provided by the organization . It encourages leaders to serve others while staying focused on achieving results in line with the organizations values and integrity. Greenleaf says that a true servant leader is a servant first. It is not dependent on a position that one holds. Others may aspire first to become a leader and then to serve., or to aspire to serve in a manner that is patriarchal and controlling. 10 critical characteristics that a servant leader should exhibit: 1. Listening 2. Empathy 3. healing 4. Awareness 5. Persuasion 6. Conceptualization 7. Foresight 8. Stewardship 9. Commitment to the growth of people 10. Building community EMOTIONAL Intelligence (EQ) in NURSING LEADERSHIP Leadership in nursing demands emotional stability. It requires the ability to relate to others if the leader truly wants to achieve the desired results. EMOTIONAL INTELLIGENCE (EQ) is defined as a persons self-awareness, self-confidence, self-control, commitment and integrity, and a persons ability to communicate, influence, initiate change and accept change(Goleman,1998) 3 aspects of emotional intelligence for a leaders ability to make effective decisions are: 1. Self-awareness 2. Communication and influence 3. Commitment and integrity Leaders who do not develop their emotional intelligence have difficulty in building good relationships with peers, subordinates, superiors and clients. Emotional intelligence is a combination of competencies. These skills contribute to a persons ability to manage and monitor her own emotions, to correctly gauge the emotional state of others and to influence opinions.

Goleman describes a model of 5 dimensions (1995). Each area has its own set of behavioural attributes as follows : 1. Self-awareness is the ability to recognize ones own feelings as it happens, to accurately perform self-assessments and have selfconfidence. it is the keystone of emotional intelligence. 2. Self- management or self regulation is the ability to keep disruptive emotions and impulses in check (self-control), maintain standards of honesty and integrity ( trustworthiness), take responsibility for ones performance ( conscientiousness) , handle change ( adaptability), and be comfortable with novel ideas and approaches ( innovation). 3. Motivation is the emotional tendency of guiding or facilitating the attainment of goals. 4. Empathy is the understanding of others by being aware of their needs, perspectives, feelings, concerns, and sensing the developmental needs of others. 5. Social skills are fundamental to emotional intelligence. They include : a. Influence or the ability to induce desirable responses in others by using effective diplomacy to persuade; b. Communication or the ability to both listen openly and send convincing messages c. Leadership or the ability to inspire and guide groups and individuals; d. Bulding bonds, or nurturing instrumental relationships; e. Collaboration and cooperation with others toward a shared goal ; and f. The ability to create group synergy in pursuing collective goals. Golemans Four (4) Qandrant Model with 19 competencies: 1. SELF- AWARENESS a. Emotional self-awareness : Reading ones own emotions and recognizing their impact b. Accurate self-assessment : Knowing ones strengths and limits c. Self-confidence : A sound sense of ones self-worth and capabilities 2. SELF-MANAGEMENT OR SELF-REGULATION a. Emotional self-control : Keeping disruptive emotions and impulses under control b. Transparency : Displaying honesty and integrity; trustworthiness c. Adaptability : Flexibility in adapting to changing situations or overcoming obstacles d. Achievement : The drive to improve performance to meet inner standards of excellence e. Initiative : Readiness to act and seize opportunities f. Optimism : Seeing the upside of events 3. SOCIAL AWARENESS

a. Empathy : Sensing others emotions, understanding their perspective, and taking active interest in their concerns b. organizational awareness : Reading the currents, decisions network and politics at the organizational level c. Service : Recognizing and meeting the needs of followers, clients, or customers. 4. RELATIONSHIP MANAGEMENT a. Inspirational Leadership : Guiding and motivating with compelling vision b. Influence : wielding a range of tactics for persuasion c. Change catalyst : Initiating, managing, and leading in a new direction d. Developing others : Bolstering others abilities through feedback and guidance e. Conflict management : resolving disagreements f. Building bonds : cultivating and maintaining a web of relationships g. Teamwork and collaboration : cooperation and team building An emotionally intelligent leader is able to use their strengths for the benefit of the team and the organization. MULTIPLE INTELLIGENCES IN NURSING LEADERSHIP - focuses on how different intellectual abilities affect leadership. Howard Gardner who developed this theory suggested that the traditional notion of intelligence, based on IQ testing is far too limited. Instead , Dr. Gardner proposed eight (8) different intelligences to account for a broader range of human potential. These intelligences are: 1. linguistic intelligence ( word smart) 2. Logical-mathematical intelligence ( number/reasoning smart) 3. spatial intelligence ( picture smart) 4. Bodily-kinesthetic intelligence ( body smart) 5. Musical intelligence ( music smart) 6. Interpersonal intelligence ( people smart) 7. Intrapersonal intelligence ( self-smart) 8. naturalist intelligence ( nature smart) MULTIPLE INTELLIGENCES Intelligence Area Is strong in : Verbal-linguistic Reading,writing, telling stories, memorizing dates, thinking in words

Likes to : Read, write, talk, memorize, work at puzzles

Learns best through: Reading, hearing and seeing words, speaking, writing, discussing and debating.

Logicalmathematical

Math, reasoning, logic, problemsolving, patterns

Solve problems, question, work with numbers, experiment.

Spatial

BodilyKinesthetic

Reading, maps, charts, drawing, mazes, puzzles,imaging things, visualization. Athletics, dancing, acting, crafts, using tools Singing, picking up sounds, remembering melodies, rhythms Understanding people, leading,organizin g, communicating, resolving conflicts, selling Understanding self, recognizing strengths and weaknesses, setting goals Understanding nature, making distinctions, identifying flora and fauna

Design,draw, build, create, daydream, look at pictures Move around, touch and talk, body language

Working with patterns and relationships, classifying, categorizing, working with the abstract. Working with pictures and colors, visualizing, drawing Touching, moving, processing knowledge through bodily sensations. Rhythm, melody, singing, listening to music and melodies Sharing, comparing, relating, interviewing, cooperating Working alone, doing self-paced projects, having space, reflecting. Working in nature, exploring things, learning about plants and natural events.

Musical

Sing,hum, play an instrument, listen to music Have friends, talk to people,join groups.

Interpersonal

Intrapersonal

Work alone, reflect, pursue interests Be involved with nature, make distinctions.

Naturalist

REMEMBER ! As in most things, Emotional Intelligence and Multiple Intelligences as a leadership requirement should be kept in perspective. the key to effectiveness is balance, such as: 1. A strong mix of cognitive capacity. this includes logical, conceptual and creative thinking. 2. People skills. Includes interpersonal and influence skills 3. Communication skills.

QUANTUM LEADERSHIP - in nursing was described by Porter-OGrady and Malloch (2003) as new leadership for new age. They think most leaders are neither fully prepared nor equipped to change outmoded models because the foundations of their leadership concepts are based in the past. In quantum leadership, control is not the issue; rather change dominates the climate. the quantum leader recognizes continual movement and change occur in reality and creativity and innovation are at the core of good work performance. When the principles of quantum leadership are applied, healthcare administrators and faculty can: 1. recognize how healthcare changes have affected all of them 2. Properly explain each change , actively engage in conflict resolution, and exchange ideas and 3. Work together to resolve the difficulties that emerge as their systems intersect. As quantum leaders, nurses: 1. Offer creative and innovative solutions 2. Seek to discover educational opportunities instead of relying on past methods of accommodating new nurses in the work force, and, 3. Provide mentoring opportunities and expert preceptorships, quantum leaders can effectively help all involved to provide better care for patients. EFFECTIVE NURSING LEADERSHIP Successful nursing leadership depends on a relationship that is mutually stimulating both for the leaders and the follower. Nurses clinical duties routinely thrust them into leadership roles. In addition to providing direct patient care, nurses educate patients and families and act as liaisons to physicians, dietitians, pharmacists, administrators, and many others in an increasingly complex health care system. As nurses, they are the first primary contact of the patient who seeks health care. Factors such as the quality of patient care, staff morale and effective nursing leadership exist to provide care to the patient and are directly related to each other. they do not exist in a vacuum. Each has to be fully satisfied to ensure continued service. EFFECIENCY VERSUS EFFECTIVENESS EFFECIENT LEADERSHIP is the ability to minimize time and use of resources in achieving organizational objectives which will yield maximum

output. It is DOING THINGS RIGHT THE FIRST TIME. It is more concerned with the 7 ms as gauge to accomplish task as expected. EFFECTIVENESS, on the other hand , is the ability to determine appropriate objectives for the group or organization to ensure appropriate and accurate results. It is concerned with output or results of performance. It is DOING THE RIGHT THING AT THE RIGHT TIME. EFFECTIVE LEADERSHIP Effective leadership understands individual strengths, weaknesses and potential. It is knowledge of the basic ingredients of leadership and management. it is also the systematic use of self to get the right things done at the right time and right results. Effective leaders generate higher productivity, lower costs, and more opportunities than ineffective leaders. Effective leaders create results, attain goals, realize vision and other objectives more quickly and at a higher level of quality than ineffective leaders. Effective leadership is honest and credible. they do not tolerate dishonesty nor they engage in it. They create an environment for everyone where honesty is a prized human quality. NURSING LEADERSHIP is a multidimensional process where the learned and inherited characteristics of the leader is combined with situational, interactional, goal directed dimensions of the first three levels of leadership theories. It is also the process that is used to move a group toward goal setting and goal achievement in the provision of nursing care for patients. EFFECTIVE NURSE LEADERS AND MANAGERS In todays health care environment, nurses are not only managers but also leaders and vice-versa. Effective nurse leaders-managers achieve understanding of individual strengths , weaknesses and potentials that allows them to produce tangible results and contributions. they have sufficient knowledge of the basic ingredients for leadership and management. they have an inner compass that allows time. This results not only in effective leadership but also in effective management . This is all what nurses should aspire in practice. Understanding of Individual strengths, Basic Ingredients for Knowledge of

Weaknesses and potentials Management

leadership

Systematic use of self to get the right things Leadership & Management done at the right time

Effective

MANAGEMENT IN NURSING THINGS ONE MUST KNOW ABOUT MANAGEMTN IN NURSING Organizations have changed a great deal over the years, and this is more apparent today than it has ever been. work pace in the hospitals has become more urgent and unceasing as with the growing population continuing to look to professional health care providers for their health needs. In order to meet the constantly evolving demands of patients and other stakeholders, it has become necessary to introduce new paradigms of management in health and nursing care. MANAGEMENT uses delegated authority within a formal organization to organize, direct and control subordinates so nursing services are coordinated. It refers to middle and lower levels of hierarchy and is often the implementing body. Management is a process of getting things done through people. it supervises people and uses resources in doing the tasks. Management is responsible for initiating steps by which organizational goals and objectives are accomplished.