Trends & Issues: Challenges of Nursing Management and Leadership

Challenges of Nursing Management
Differentiate between *management* and *leadership*
Describe various types of management
List characteristics of a good leader
Discuss the elements of transformational leadership
Identify distinguishing generational characteristics of today’s workforce
Challenges of Nursing Management (Cont.)
Differentiate between the concepts of power and authority
Apply problem-solving strategies to clinical management situations
Identify the characteristics of effective work groups
Discuss the change process
Discuss the value of using evidence-based management actions
Differences Between Management and Leadership
Differences Between Management and Leadership
A leader *selects and assumes a role*; a manager is *assigned or appointed to a role*
Management is a *problem-oriented* process with similarities to the nursing process
Leadership is a *way of behaving;* it is the ability to cause others to respond, not because they have to, but because they want to
Managers perform four functions:
Managers perform four functions:
Characteristics and Theories of Management
Traditional (scientific) theory
Also known as bureaucratic theory
High productivity level expected from worker
Behavioral (human interaction) theory
*Consider the workers’ needs*
Systems theory
*Decisions based on how others will be affected*
Considers the parts of a system as a whole
Contingency (motivational) theory
Examines *what* motivates workers to be productive and effective in completing the work
In what capacity do you see yourself functioning as a nurse manager?
A. Providing care for a group of patients
B. Serving as a team leader for other staff and an assigned group of patients
C. Organizing all the nursing staff for the shift on a nursing care unit
D. Organizing and being responsible for nursing care delivered over a 24-hour period
What Is Meant by Management Style?
Autocratic manager uses *authoritarian* approach to direct activities of others
Democratic manager is *people-oriented,* emphasizes effective group functioning
Laissez-faire manager maintains *permissive climate*, with little direction or control exerted
Which type of management style do you wish to possess as a nurse?
A. Autocratic
B. Laissez-faire
C. Democratic
D. A blending of autocratic, laissez-faire, and democratic
As a staff nurse, under which type of management style would you prefer to work in a nursing care unit?
A. Autocratic manager
B. Laissez-faire manager
C. Democratic manager
Characteristics and Theories of Leadership
Desired leadership traits can be learned through education and experience
Contingency leadership—leadership *flexible enough* to address varying situations
Situational leadership—*situation is analyzed*, leadership style is selected that will best address issue
Interactional leadership—*development of trust* in relationship; uses democratic concepts and views tasks from the standpoint of a team member
Transactional leadership—holds power and control over followers by *providing incentives* when followers respond in a positive way to leader’s vision and actions needed to reach that vision
Transformational leadership—process in which leader and followers work together in a way that *changes or transforms* the organization, employees/followers, and leader
Complexity theory leadership—need to look at *systems*, such as those in *health care organizations*, as patterns of relationships and interactions that occur among those in the system
Which leadership style do you see yourself using as a nurse leader?
A. Contingency leadership
B. Situational leadership
C. Interactional leadership
D. Transactional or transformational leadership
E. Complexity theory leadership
Management and Leadership in the 21st Century
Changes in health care are altering the foundations of nursing practice
Nurses are becoming increasingly frustrated with the reality of the nursing care they were taught to provide; they think that what they need to do is not possible because of *decreased time* spent with patients
Leadership of health care in the 21st century is affected by diverse generations in today’s workplace
Who Are the Veteran Nurses?
Who Are the Veteran Nurses?
This retiring group of nurses, as well as the oldest generation, were taught to rely on tried, true, and tested ways of doing things
Used to the autocratic style of leaders and managers
Who Are the Baby Boomers?* 1940-1960*
Baby Boomers make up *largest* group of nurse employees working *today*
They are caring for their own children and for their aging parents
This group has embraced technology as a method for being more productive and having more free time
Focused on building careers and are invested in *organizational loyalty*
Who Is Generation X?* 1961-1980*
Generation X employees have *little loyalty or confidence in leaders and institutions*
Grew up in the information age
Change jobs frequently and will stay in a position as long as it is good for them
Have no aspirations for retirement
Want different employment standards
Want to work under *motivational leadership with a democratic manager*
Value their free time, prefer flexible scheduling
Who Is Generation Y? * 1980-2000*, Also known as Nexters and Millennial
Generation “Net,” Nexter, or Millennium Generation born between 1980 and 2000
This generation represents large number of *children of Baby Boomers*
They are optimistic, interactive, learn and adapt quickly
Traits in this group include *individuality and uniqueness*; they can multitask and think fast, be extremely creative
They will be challenging to work with because they are typically *not team players*
Who Is Generation Now?
*Newest* generation also known as the “iGeneration” or “I Generation”
Never lived without the *Internet or other form of rapid communication*
Never known a world without immediacy
Will this group push forward a new leadership theory?
To which generation do you belong?
A. iGeneration or Generation Now
B. Generation Y
C. Generation X
D. Baby Boomers
Power and Authority in Nursing Management
Do you know the difference between power and authority?
Power is having the ability to *effect change and influence others*
Authority relates to a *specific position* and the *responsibility* associated with that position
What Are the Different Types of Power?
Legitimate power is power connected to a position of *authority*
Reward power comes about because the individual has the power to *provide or withhold rewards*
Coercive power is power derived from fear of *consequences*
Expert power is based on *specialized knowledge, skills, or abilities* that are recognized and respected by others
Referent power is power a person has because *others closely identify with* that person’s personal characteristics; they are liked and admired by others
Information power is *knowledge* a person possesses that is *needed by others to function* effectively
This type of power is perhaps the *most abused*
Leadership power is being able *create stability and calmness* out of the chaos created by conflict, problems, and disorder
Management Problem Solving
How are problem-solving strategies used in management?
Problem solving can be readily compared with the nursing process
Problem solving does not always flow in an orderly manner from one step to the next
It is important to differentiate among facts and opinions
Once the problem is clearly identified, the group should brainstorm all possible solutions
Evidence-Based Management Protocols and Interventions
*Manager* needs to be able to develop a commitment to searching for and using *factually based processes and solutions* (peer-reviewed literature and research)
It is believed that much *peer-reviewed information* about managing organizations is *not used* because of the desire to do things as they have always been done.
How Do We Relate Problem Solving and Decision Making?
Decision making requires the definition of a clear objective to guide the process
Both problem solving and decision making are *usually initiated in the presence of a problem*; the objective in *decision making* may not be to solve the problem, but only to deal with its *results*
Decision making is *values-based*, and *problem solving* is a more *scientific process*
What Effect Does the Leader Have on the Group?
Leader’s philosophy, personality, self-concept, and interpersonal skills all influence the functioning of the group
Most effective groups are those that have had consistent membership and are highly developed
Members with a good leader feel positive about their participation and the outcomes of the group process.
The Challenge of Change
Change is inevitable, particularly in today’s health care delivery system.
Economic factors have taken center stage, and cutbacks in all aspects of health care services are occurring.
Three options to deal with change:
Can move out of the situation and perhaps miss some opportunities
Stand there and withdraw, doing what you are told just to avoid conflict
Can start to run with the change and try to steer it in a positive direction
Nursing Process vs. Problem Solving vs. Change Process
Resisting change is a natural response for most people
Every change involves adaptation
Three phases in an effective change process:
Change Theory
Unfreeze phase
In the unfreezing phase, all the factors that may cause *resistance to change* are considered
Need to determine whether the environment of the organization is receptive to change
Moving phase
This phase occurs once a *group* of individuals has been recruited to take on responsibilities for *implementing the change*
Group identifies strategies and a plan to implement the change
Refreezing phase
This occurs when the *plan is in place* and everyone involved knows what is happening and what to expect
Need to publicize the ongoing assessment of pros and cons of the planned change
Someone needs to be responsible for continuing to work on the plan so that it does not lose momentum
Which element of change process do you find most interesting?
A. Unfreezing
B. Moving
C. Freezing
Who Initiates Change, and Why?
Most common reason for change is that *what you did before is no longer effective*
Change frequently occurs when new management enters the scene
This provides a new perspective and view regarding how the system operates
When customers are not happy, something within the system needs to change
WIIFM Principle: What’s in It for Me?
All change will elicit some type of resistance
You will either be actively involved in changes or choose to take a passive role
Motivational Strategies for Gen X and Y
Let them know that what they do matters
Tell them the truth
Explain why you are asking them to do something
Learn their language
Be on the lookout for rewarding opportunities
Praise them
Make the workplace *fun*
Model behavior
Give them the tools to do their jobs
Motivational Strategies for Generation Now
Look at where they are going for *information*
Make your message *relevant*
If you don’t like something, change it. If you can’t change it, change your attitude.
–Maya Angelou

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