Leadership, Management and Followership
-Ability to influence other people
-“enables people to work more effectively together in a state of interdependence” (Covey, 1992)
-“the use of personal traits and personal power to constructively and ethically influence patients, families, and others toward an end point vision or goal” (Yoder-Wise, 2003)
Do whatever is necessary to make sure that employees do their work and do it well, includes interpersonal, informational, and decisional actions (Mintzberg 1989)
An informal role
An achieved position
Part of every nurse’s responsibility
A formally designated role
An assigned position
Usually responsible for budgets, hiring and firing people
Improved by the use of effective leadership skills
Distinguish between thoughts and feelings.
Take more responsibility for your feelings.
Use your feelings to help them make decisions.
Show respect for other people’s feelings
I feel impatient vs. This is ridiculous
Thoughts: I feel like… & I feel as if.. & I feel that Feelings: I feel: (feeling word)
I feel afraid vs. You are driving like an idiot
I feel jealous. vs. You are making me jealous.
Ask How will you feel if I do this? How will you feel if I don’t.
Feel energized, not angry.
Validate other people’s feelings.
Practice getting a positive value from emotions.
Don’t advise, command, control, criticize, judge or lecture to others.
Avoid people who invalidate you.
Use what others call anger to help feel energized to take productive action.
Show empathy, understanding, and acceptance of other people’s feelings.
Ask yourself: How do I feel? and What would help me feel better? Ask others How do you feel? and What would help you feel better?
Instead, try to just listen with empathy and non-judgment.
While this is not always possible, at least try to spend less time with them, or try not to let them have psychological power over you.
Sense of self
Great leaders can arise when there is a great need. is a 19th-century idea according to which history can be largely explained by the impact of “great men”, or heroes: highly influential individuals who, due to either their personal charisma, intelligence, wisdom, or political skill utilized their power in a way that had a decisive historical impact.
leader directs the group, makes all of the decisions, tell people what to do and how to do it
more people-oriented approach; decisions are made by the group, teamwork focus, leader shares responsibility for outcomes with the group and allows them to guide direction. Group concensus is fostered.
promotes complete individual and group freedom with little direction from leader; often seen in circumstances of leader apathy; not structured, leader gives no direction. The enefit to this style may be if working with a group of professionals who know their own jobs and do them independently; a different style might create group decension.
Came along in the early 20th century with industrialization/manufacturing industry
Formalized, ultra-structured, predictable, stable, and economically driven
People’s behavior improved when you give them some kind of extra attention
The “Hawthorne effect”
Post-WWI at a time where there was increasing activism and unionism; more democratic style where workers are empowered; focus on motivating workers.
Visionary: provides a sense of mission & instills pride, commitment, and trust
Intellectual stimulation: promotes intelligent, rational, problem solving
Individualized consideration: attentive, treats people individually, coaches/advises
Conflict negotiation and resolution
Rewards and punishment
Job analysis and redesign
Representing the organization
Share time and talents
Synergistically create and innovate solutions to problems
I’ll give it my best
We can do it!
Do I have to?
That’s nice, I guess
Impossible. It can’t be done
Pros – works directly to patients, MD, health care team members
Cons – continuity of care from shift to shift, day to day can be a problem
Total Patient Care
Pros – nurses become highly competent with tasks
Cons – lack of continuity, absence of holistic view of client, care becomes mechanical, communication not always clear
Pros – team leader acts as advisor and coordinates care, collaborative style
Cons – lack of time the team leader spends w pts
prep of assisted personnel
pts may see RN infrequently
Primary nurse over a couple of nurses who are responsible for pts
Pros – maintain continuity over shifts and days, reduces delays in therapies, increased collab with other members of hte health care team, enhanced nurs-pt relationship can be used in many settings
Cons – perceived as costly
Pros – continuity in lifespan, outcome oriented
Cons – cost outcomes may be overemphasized
used in the ICU
Pros – staff satisfaction
cons – staff dissatisfaction
Pros – quality
Cons – may have difficulty in focusing on client and family needs that are incongruent with business decisions
It is not the same as telling someone to do something
This means that the RN may authorize an LPN or an unlicensed assistant to do some phase of patient care but the original RN retains accountability for the accurate, safe, appropriate completion of that care.
The one that can be delegated
The Right Person
The one qualified to do the job
The Right Communication
Clear, concise description of the objective and your expectations
The Right Feedback
Evaluations in a timely manner, during and after the task is completed
National Council of State Boards of Nursing 1990
“While tasks and procedures may be delegated, the functions of assessment, evaluation, and nursing judgment should not be delegated.”
National Council of State Boards of Nursing 1990
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