Leadership in nursing , 2022-DTBY-S.pptx

Introduction to nursing Leadership and
management
After completing this chapter , you will be able to :
Define leadership
List principles of leadership
List types of leadership
Styles of leadership
Application to nursing profession
Application into health sector

Leadership
• Is the ability of a leader to influence the behavior of followers and
persuade them to follow a particular course of action.
• Is influencing people to achieve particular goal
• 'Leading an organization means marshalling/organizing/coordinating
the people, capital & intellectual resources of the organization to
move it in the right direction’

Leadership Cont.…
Competences that are must to lead your team or group:-
 Ability to diagnose or understand the situation
 Adaptation
 Communication
• Effective nurse leaders are those who engage others to work together
effectively in pursuit of a shared goal.

LEADERSHIP CHARACTERISTICS
• Leadership involves not just “doing,” but “being
• Leadership is exercised with others
• Leadership is responsibility.
• Leadership happens at all levels.
• Leadership is enabling people

QUALITIES OF AN EFFECTIVE LEADER
• Integrity
• Courage
• Initiative
• Energy
• Optimism
• Perseverance
• Balance
• Ability to handle stress
• Self-awareness

BEHAVIORS
Behaviors of effective leader
• Think critically
• Solve problems
• Communicate skillfully
• Set goals, share vision
• Develop self and others
BEHAVIORS

Roles of a Leader
Roles of a Leader
• Visionary & strategist
• Resource mobilization/effective utilization
• Team building/effective communication
• Effective partnership, collaboration, networking, dialoguing, negotiating
• Empowerment
• Challenger
• Change agent in a changing environment

THEORIES OF LEADERSHIP
1.Great Man Theory
2. Trait Theory
3. Behavioral Theories
4.Situational Leadership
5. Contingency Theory
6. Transactional Leadership
7. Transformational Leadership

THEORIES OF LEADERSHIP CONT.…
1. Great man theory: assumes that the capacity for leadership is inherent – that
great leaders are born, not made
2. Trait Theory: Leader traits - characteristics that might be used to differentiate
leaders from non leaders
Traits
1) Management of attention. able to communicate a sense of goal or direction to
attract followers.
2) Management of meaning. Created and communicated meaning with clarity and
purpose.
3) Management of trust. Demonstrated reliability and consistency.
4) Management of self. self and work within their strengths and weaknesses
(Bennis, 1984).

3. Behavioral Theories
• Focus on the behavior of leaders rather than on their
personal characteristics traits
• lent themselves more readily to scientific examination
• Behavioral Approach
• Two primary behaviors
– Task-oriented
– Relationship-oriented

University of Michigan Studies
• Identified two dimensions of leader behavior
– Employee oriented: emphasizing personal relationships
– Production oriented: emphasizing task accomplishment
Research findings:
– Leaders who are employee and product oriented are strongly
associated with high group productivity and high job satisfaction.

University of Iowa Studies (Kurt Lewin) identified three leadership styles:
I. Autocratic style: centralized authority, low participation
II.Democratic style: involvement, high participation, feedback
III.Laissez faire style: hands-off management-give complete freedom to
the followers. E.g. for experts and trusting staffs
Research findings: mixed results
– No specific style was consistently better for producing better performance
– Employees were more satisfied under a democratic leader than an
autocratic leader

Managerial Grid
– Appraises leadership styles using two dimensions:
– Concern for people
– Concern for production
– Places managerial styles in five categories:
– Impoverished management
– Task management
– Middle-of-the-road management
– Country club management
– Team management

MANAGERIAL GRID

4. Contingency Theories Of Leadership
Basic Assumptions
– leader effectiveness depends on the situation
–certain leadership style are effective in different types of situations.
–Matching the leader to the situation or changing the situation to make it
favorable to the leader is required.

Contingency Theories Of Leadership
Fiedler Model
Proposes that effective group performance depends upon the proper
match between
• the leader’s style of interacting with followers and
• the degree to which the situation allows the leader to control and
influence.
Assumptions:
– A certain leadership style should be most effective in different types of situations.
– Matching the leader to the situation or changing the situation to make it favorable to the
leader is required.

5. Hersey and Blanchard’s Situational
Leadership Theory
Argues that successful leadership is achieved by selecting the right leadership style which is
contingent/depend on the level of the followers’ acceptance and readiness.
• Creates four specific leadership styles incorporating Fiedler’s two leadership
dimensions:
• Telling: high task-low relationship leadership
• Selling: high task-high relationship leadership
• Participating: low task-high relationship leadership
• Delegating: low task-low relationship leadership

Transformational
A leadership style focused on effecting revolutionary change in
organizations through a commitment to the organization's vision
Why transformational leadership?
• Build & facilitate leadership
• Nurture employees
• Respond to current problems

DIMENSIONS OF TRANSFORMATIONAL LEADERSHIP (The four ‘I’s’)
Idealized influence (charisma):
- follower admiration & respect
- risk sharing
- consideration for follower needs
- ethical & moral conduct (trust)
• Inspirational motivation
- meaning & challenge to work
• Intellectual stimulation
– creative problem solving
• Individualized consideration
- listening, praising

Characteristics of Transformational Leaders
• Set Visions
• Communicate the Vision
• Model the Vision
• “walk the talk”-do what you say
• “watch what I do, not what I say.”
• Builds Commitment towards the vision
• Empower and involve

Transactional Leadership
• It is founded on the belief that leaders & followers can raise each other to higher levels
of motivation & morality by contributing to each other’s objectives.
• It uses rewards, punishments, reciprocity
( relationship involving mutual exchange),
• exchanges (economic, emotional, physical) & other; such "transactions" are the basis of
leadership.

Transformational versus transactional leadership

SUMMARY POINTS
‗ No single leader decision making authority style is correct all the time
‗ Managers / Leaders must adapt and change to fit to situation

MANAGEMENT
After completing this lesson you will be able to :
• Define management
• Explain the theories of management
• Explain the levels of management and their functions
• Explain skills of managers
• Explain roles of managers
Management

MANAGEMENT
• Management is the art of getting things done(reaching organizational goals )
through people.
• It is the process of PLANNING, ORGANIZING, LEADING AND CONTROLLING
the work of organization members and of using all available organizational
resources to reach stated organizational goals.
• It is the process of directing, coordinating and influencing the operation of an
organization to obtain desired result and enhance total performance
Management

Nursing Service Administration
• both an art and a science
• is the marshaling (arranging, organizing, coordinating, sort out, etc.)
of resources, activities, people, clients, etc. to accomplish a purpose or
goal (rendering of nursing service to clients.).

Reason For Learning Management and Leadership
– The universality of management
• Good management is needed in all organizations.
– The reality of work
• Employees either manage or are managed.
– Rewards and challenges of being a manager
• Management offers challenging, exciting and creative
opportunities for meaningful and fulfilling work.
• Successful managers receive significant monetary/finacial
rewards for their efforts.

Theories Of Management
Scientific management
• Frederick Taylor argued that most jobs could be done more efficiently
if they were analyzed thoroughly (Lee, 1980; Locke,1982).
Human relationship management
• Theory Y – Keep their moral high, Satisfied and motivated
Employees
• Theory X- Employee do not need to work hard
• a manager needs to employ strict rules, constant supervision, and the threat of
punishment

Levels of management
• Provide strategic direction for the
organization. Monitor the external
environment
• Supervise first-line managers. Link
between top management and first-
line managers. Translate strategy
into action / operations.
• Supervise individuals who are
directly responsible for producing the
organization’s service.
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Operational employees

Management Skills
Technical Skills
The ability to apply specialized knowledge or expertise
Human Skills
The ability to work with, understand, and motivate
other people, both individually and in groups
Conceptual Skills
The mental ability to analyze and diagnose complex
situations
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Managerial roles
Henry Mintzberg’s Managerial Roles
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Interpersonal
Roles
Figurehead
Leader
Liaison/
rshp
Informational
Roles
Monitor
Disseminator
Spokesperson
Decisional
Roles
Entrepreneur
Disturbance
handler
Resource allocator
Negotiator
Top managers spend their
time as follows:
59 % on scheduled meetings
22 % at their desks
10 % on unscheduled meetings
6 % on telephone calls
3 % on inspecting facilities

Mintzberg’s Managerial Roles
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Mintzberg’s Managerial Roles (cont’d)
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Mintzberg’s Managerial Roles (cont’d)
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Major management functions
• Major management functions includes:
Planning, Implementation, Evaluation
Planning, Organizing, Staffing, -Leading(directing
,motivating, communicating), Decision making,
Evaluation

After completing this lesson you will be able to:
• Define human resource management
• Explain components of human resource management
• Explain each tools of performance appraisal
• Explain common performance errors
Human resource Management

Resource Management
• Management is getting things done through people.
Key assumptions
• ‘Employees are the most important asset of the organization’
– Success for most organizations depends on :
• the quality of the people that are employed

Human resource management
• HSM : The strategies, tactics, plans, and programs that healthcare
organizations utilize to accomplish the work of the organization
through its employees.
• The process of:
– attracting,
– developing and
– maintaining a talented and energetic workforce to support organisational
mission, objectives and strategies.

2-COMPONENTS OF HRM
Human resource
management
Acquiring
Human resource
planning
Recruitment
Selection
Orientation
Retention
Performance appraisal
Training and development
Benefit and compensation
Safety and health
Promotion, transfer,
separation
2-Components
of hrm

RECRUITMENT
• Searching for and attracting prospective employees from
– within the organization or
– outside the organization.
• Selection is choosing the most suitable person among the applicants

SELECTION INSTRUMENT
• Degree to which selection techniques used accurately match people’s
qualifications to job requirements
• Validity
• Reliability
– Fewer than 25%
• Potential outcomes of a weak selection instrument:
– Poor matching of people to jobs
– Lack of knowledge of success in matching people to jobs
– Lack of information of how to improve matching process
– Lack of evidence to support legal challenges

ORIENTATION/INDUCTION
• Is the process of:
– receiving and welcoming an employee when he/she joins an organization
and
– giving in the basic information he/she needs to settle down quickly and
happily and start work

Orientation programmers
• General information about:
– the organization : history, purpose, operation, services
– expected contribution of the employee to the organization and providing
of job description
– Detailed information about the polices and rules of the organization
– Orientation to staff and mangers
– Safety measures

PERFORMANCE APPRAISAL
• Performance Appraisal is a systemic review of an individual employee's performance
on the job, which is used to evaluate the effectiveness of his/her work
Performance Appraisal
Purpose
• Provide information to decisions regarding
– salary raises, promotions, transfers, or discharges
• assist employees in their personal development
• assess the effectiveness of hiring practices
• identify training and development needs of the employees
• establishment of standards of job performance

TOOLS OF PERFORMANCE APPRAISAL
 Rating scales (each from poor to excellent)
 The checklist (traits of employees in the form of YES/NO)
 Multisource (360°) Appraisal (systematic collection of
performance data on an individual or group, derived from
number of stake holders like supervisors, team members,
customers, peers and self)
 Management by objective (Performance rated against the
achievement of the objectives stated)

Common problems in performance appraisal
• Leniency Errors (positive impression)
• Halo errors ( Bias in both direction)
• Central tendency errors (rate all or most employees as average)

TRAINING AND DEVELOPMENT
• Training and Development is the formal procedure which an
organization utilizes to facilitate learning so that the resultant behavior
contributes to the attainment of organization's goals and objectives

TYPES OF TRAINING
• On the job training
• Off-the-job training
12/9/2022 49

ASSESSING TRAINING NEEDS
1.Organizational analysis
2. Operational analysis
3. Personnel analysis
12/9/2022 50

COMPENSATION AND
BENEFIT
ADMINISTRATION
• Compensation: wage and fringe benefits
• Benefit
– Health insurance, housing , transportation, pension/retirement income,
vacation, sick leave, maternity leave…
• Equity
– Internal
– External
12/9/2022 51

PROMOTIONS, TRANSFERS, &
SEPARATION
• Promotion to shift to other positions with change in status or pay.
• Transfers refers to shift to other positions without change in status or pay.
• Separation : is departing a staff :
– with poor performance
– retirement, death, release…
• Discipline: is a form of training that enforces organizational rules
12/9/2022 52

After completing this lesson you will be able to :
• Define budgeting
• Explain each types of budgeting
• Explain each approaches of budgeting
Budgeting

BUDGETING
• Is a plan for the allocation of resources and a control for
ensuring that results comply with the plans
• Prerequisite for budgeting
– Sound organizational structure
– Goals and objectives
– Formal budgeting policies and procedures
12/9/2022 54

THE BUDGETING PROCESS
The budgeting process should provide for:
– Plans of anticipated activity
– A mechanism for measurement of work effort on timely basis
– Accountability by someone for variances from budget
– An awareness of costs by all participants in the budgeting program
12/9/2022 55

MAJOR TYPES OF BUDGETS
• Operating/recurrent-
– estimates of operating expenses, estimates of operating revenues and estimates of
activity
– Example: personnel salaries, supplies, light water, drugs, repairs and maintenance
• Plant/Capital-
– estimates of expenditure for adding, replacing or improving buildings or equipment for
the budget period
– Example: buildings, major equipment
12/9/2022 56

APPROACHES TO BUDGETING
• There are different ways in which budget-setting can be approached
The two main approaches to budgeting are incremental and zero-
based.
• Activity-based or flexible budgeting allows budget-holders to adjust
their budgets to reflect changes from the planned level of activity
12/9/2022 57

ZERO-BASED BUDGETING
• Many budgeting procedures allocate funds to departments based on
their previous year’s expenditures.
• managers decide how the funds will be used.
• Allows for :
– enrichment and
– enlargement of programs
– but seldom for decreases or deletion of programs..
12/9/2022 58

INCREMENTAL BUDGETING
– incremental budgeting is the most commonly used approach to budgeting in both
public and private sectors
– it involves taking the previous year’s budget as the starting point and
– concentrating on adjusting the figures to reflect the changes in planned activity
levels and in costs and prices between the two years
– this involves taking into account any change in planned activity as well as the level
of inflation and projected pay rises
12/9/2022 59

After this lesson you will be able to :
• Define time management
• Explain principles of time management
• Explain time wasting stations
• Explain how to handle time wasters
• Explain forms of time plan
Time management

W H AT I S T I M E M A N A G E M E N T ?
I S A T E C H N I Q U E F O R A L L O C AT I O N O F O N E ’ S T I M E
T H R O U G H :
S E T T I N G G O A L S
assigning priorities
identifying and eliminating time wasters, and
use of managerial techniques to reach goals efficiently
12/9/2022 62

Principles of time management
1. List goals and set priorities
2. Make a daily “to do” list
3. Start with the most important to do list
4. Handle each piece of paper only once
5. Do it now!
6. Setting priorities by placing elements of importance and urgency.
12/9/2022 63

TIME WASTERS
Something that prevents a person from
accomplishing the job or achieving goals .
Unclear objectives
Disorganization
inability to say no
Interruptions,
Periods of inactivity
Too many things at once etc .
12/9/2022 64

TIME WASTERS
• people waste about 2 hours per day.
Signs of time wasting:
– Messy desk and cluttered (or no) files(disorganized)
– Can’t find things
– Miss appointments, need to reschedule them late and/or unprepared for meetings
– Volunteer to do things other people should do
– Tired/unable to concentrate
12/9/2022 65

Planning time arrangements
 Events are arranged in daily, weekly, monthly or yearly time periods.
 The periodicity depends on the frequency or regularity of particular events.
Forms of Time plans:
 Timetable: daily or weekly regularly recurring events.
 Schedule: intermittent or irregular or variable events, and where they
take place.
 Roster: duties planned for different staff members, for different times in turn.
12/9/2022 66

After completing this lesson you will be able to ;
• Define group and team
• Explain types of group and team
• Explain reason for studying groups and teams
• Explain characteristics of effective team
• Explain stages of group developments and leadership style at
each stage
Group dynamics and team work

Overview of Groups and Group Dynamics
A group is two or more people who interact with one another such that each
person influences and is influenced by each other person.
• The Importance of Studying Groups
– studying the behavior of people in group settings helps to understand
organizational behavior.
– Managers can manage conflicts better when they understand why groups
form
Types of group
Formal and
Informal
12/9/2022 68
Group dynamics and team work
Time management

TUCK MAN’S FIVE-STAGE THEORY
OF GROUP DEVELOPMENT
12/9/2022 69
Individual
Issues
Forming Storming Norming Performing
“How do I fit
in?”
“What’s my
role here?”
“What do the
others expect
me to do?”
“How can I best
perform my
role?”
Group
Issues
“Why are we
here?”
“Why are we
fighting over
who’s in
charge and who
does what?”
“Can we agree
on roles and
work as a
team?”
“Can we do the
job properly?”

INDIVIDUAL VERSUS GROUP
DECISION MAKING
• Speed
• Clear Accountability
• Consistent Values
• Knowledge & Diversity
• High Quality Decisions
• Increased Acceptance
12/9/2022 70
Individuals Groups

TEAM WORK
A team is defined as :
• two or more people who interact and influence each other toward a
common purpose
• Multiple individuals with specific skills and roles, coordinating their
activities towards a mutually understood and agreed upon aim
Teamwork: is a set of interrelated behaviors, cognitions, and attitudes
that combine to facilitate coordinated, adaptive performance.”
• Knowledge: what we think
• Behaviors/Skills: what we do
• Attitudes: how we feel
12/9/2022 71

TEAM WORK
• “Individual commitment to a group effort --that is what
makes a team work, an organization work, a society work, a
civilization work.”
12/9/2022 72

TEAM WORK
Types of teams
1. Formal Team: is a team deliberately created by managers to carry out
specific activities, which help the organization to achieve its objectives.
2. Informal team: emerge whenever people come together and interact
regularly.
12/9/2022 73

WHY HAVE TEAMS?
• Society & technology are complex
• Require interdisciplinary knowledge
• Advantages in diversity
• One vision, many hands
• Shared responsibility
• Timing is essential
12/9/2022 74

CHARACTERISTICS OF EFFECTIVE
TEAM
• Communication
• Trust
• Shared decision-making
• Positive reinforcement
• Cooperation
• Flexibility
• Focus on common goals
• Synergy
12/9/2022 75

12/9/2022 76
TEAM DEVELOPMENT MODEL

LEADERSHIP MODEL
Stages of team
Development
Leadership
Forming Telling
Guidance and
direction
Storming Selling, coaching
Norming Participating:
facilitates, enables
12/9/2022 77

Task Variables and Group Composition
A homogenous group
is more useful for
A heterogeneous
group is more useful
for
Simple tasks Complex tasks
Sequential tasks Collective tasks
Tasks that require
cooperation
Tasks that require creativity
Tasks that must be done
quickly
Tasks that need not be
done quickly
12/9/2022 78

MANAGING GROUP
DYNAMICS
• Managing groups requires:
–Knowing what types of groups exist in the
organization.
–Possibly “formalizing” some informal groups.
–Breaking up groups to realign the organization
and goals.
12/9/2022 79

MANAGING GROUP
DYNAMICS
– Nurturing groups through the developmental stages.
– Encouraging the development of group norms and roles.
– Developing a reward structure that fosters individual
efforts to achieve group goals.
– Assuming a linking role to coordinate the activities of
groups.
12/9/2022 80

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