1. Nursing Leadership and Management

2. LET HIM THAT WOULD MOVE
THE WORLD,
FIRST MOVE
HIMSESF Socrates

3. CONTENTS Leadership and Management Defined and Distinguished
Leadership and Management Theory
Management Functions
Roles of the Nurse Manager
Creating a Caring Environment
Leadership and Management Skills and Behaviors

4. Leadership Defined and Distinguished
Management Defined
Leadership and Management concepts
Power and Authority
Formal and Informal Leadership

5. Leadership Defined Leadership combines: intrinsic personality traits,
learned leadership skills,
characteristics of the situation.
Leader -
guides people and groups to accomplish common goals,
influences the beliefs, opinions, or behaviors of a person, group, or groups of people.

6. Leadership qualities:
Nurse leader
is able to inspire others on the health care team to make patient education an important aspect of all care activities.
Leadership qualities:
unique personality characteristics,
exceptional clinical expertise,
relationships with others in the organization.

7. Management Defined
Management -
coordinates people, time, and supplies to achieve desired outcomes,
involves problem-solving and decision-making processes.
Managers responsibility:
maintain control of the day-to-day operations,
achieve established goals and objectives.

8. Manager plans organizes how it is to be done what is to be done
who is to do it
how it is to be done

9. Nurse manager will have:
an appointed management position within the organization with responsibilities to perform administrative tasks:
planning staffing requirements,
performing employee performance appraisals,
controlling use of supplies and time,
meeting budget and productivity goals.

10. Leadership and Management
are intertwined concepts,
are different,
difficult to discuss one without the other .

11. A good manager also should be a good leader
Leadership, management skills:
- complementary;
- can be learned and developed:
through experience,
improving skills in one area will enhance abilities in the other.

12. Nurse manager has Power and Authority
authority - formal right to direct others granted by the organization,
power - ability to motivate people to get things done with or without the formal right granted by the organization,
ability to influence others to accomplish goals.

13. Formal and Informal Leadership
Formal leadership practices by:
nurse manager,
supervisor,
charge nurse,
coordinator and gives the authority to act by the organization.

14. is exercised by the person who
Informal Leadership
is exercised by the person who
has no official or appointed authority to act,
is able to persuade,
is able to influence others in the work group,
strategies the nurse manager can use to work with informal leaders.

15. Leadership and Management Theory
Leadership Trait Theory
Interactional Leadership Theories
Transformational Leadership
Management Theory
Organizational Theory

16. Leadership, management, and organizational theories
provide the building blocks on which to build effective nursing management practices and skills.

17. Contemporary theories of leadership
depends on several variables, including (Marquis and Huston, 2000):
1. Organizational culture.
2. Values of the leader.
3. Values of the followers.
4. Influence of the leader/manager.
5. Complexities of the situation.
6. Work to be accomplished.
7. Environment.

18. Transformational leaders
Identify and clearly communicate vision and direction.
Empower the work group to accomplish goals and achieve the vision.
Impart meaning and challenge to work.
Are admired and emulated.
Provide mentoring to individual staff members based on need.

19. Transactional leaders
Focus on day-to-day operations and are comfortable with the status quo (the existing state of affairs).
Reward staff for desired work ("I'll do x in exchange for you doing y").
Monitor work performance and correct as needed; or
Wait until problems occur and then deal with the problem.

20. Management Theory
Behavioral theories explain aspects of management and leadership based on behaviors of managers/leaders and followers. Organizational Theory
provides a framework for understanding complex organizations,
helps to understand the management process.

21. Management Functions
Planning
Organizing
Staffing
Directing
Controlling

22. Planning includes defining goals and objectives, developing policies and procedures; determining resource allocation; and developing evaluation methods.
Organizing includes identifying the management structure to accomplish work, determining communication processes, and coordinating people, time and work.
Staffing includes those activities required to have qualified people accomplish work such as recruiting, hiring, training, scheduling and ongoing staff development.

23. Management Functions
Directing encourages employees to accomplish goals and objectives and involves communicating, delegating, motivating, and managing conflict.
Controlling analyzes results to evaluate accomplishments and includes evaluating employee performance, analyzing financial activities, and monitoring quality of care.

24. Roles of the Nurse Manager
Customer Service Provider
Team Builder
Resource Manager
Decision Maker and
Problem Solver
Change Agent

25. Customer Service Provider
Providing service or care to customers (patient or clients).
Nurse must keep customer service first and foremost as the motivator of all plans and activities.
Without customers, the organization will go out of business.

26. Team Builder
A team is a group of people organized to accomplish the necessary work of an organization.

27. Teams have become important in the changing health care environment.
Teams bring together a range of people with different knowledge, skills, and experiences to meet customer.

28. Resource Manager
Resources include the personnel, time, and supplies needed to accomplish the goals of the organization.
Nurse manager has the responsibility - effectively manage resources in providing safe, effective patient care in an economic manner.

29. Three Types of Budgets
1. Personnel
Allocates funds for salaries, overtime, benefits, staff development and training, and employee turnover costs
2. Operating budget
Allocates funds for daily expenses such as utilities, repairs, maintenance, and patient care supplies
3. Capital budget
Allocates funds for construction projects and/or long-life equipment such as cardiac monitors, defibrillators, and
computer hardware; capital budget items are generally more expensive than operating supplies.

30. Decision Maker and Problem Solver
Components of effective leadership and management in clinical patient care.
Problem solving is focused on solving an immediate problem and
Decision maker includes a decision-making step.

31. Nursing process = problem-solving process includes :
assessment,
analysis and diagnosis,
planning,
implementation,
evaluation;
has proven to be effective to manage the complex decisions.

32. ASSESSMENT
Gather information about the situation
Identify the problem; separate the symptoms
Identify people and groups involved
Identify cultural and environmental factors
Encourage input from involved parties

33. ANALYSIS AND DIAGNOSIS
Analyze results of information gathered
Identify, clarify, and prioritize the actual problem (s)
Determine if intervention is appropriate

34. PLANNING Identify as many solutions as possible
Elicit participation from people or groups affected
Review options and consider safety, efficiency, costs, quality, and legal issues
Consider positive and negative outcomes
Remain open-minded and flexible when considering options

35. IMPLEMENTING Communicate plans to everyone affected
Be sure plans, goals, and objectives are clearly identified
Maintain open, two-way communication with staff
Support and encourage compliance among all staff

36. EVALUATION Identify evaluation criteria in the planning
Identify who is responsible for evaluation, what will be measured, and when it will take place
Maintain open communication with all involved
Was the decision successful?
What might have made it better?

37. The nurse - change agent
is responsible for guiding people
through the change process and needs
to develop an understanding about the nature of change and effective change strategies.

38. 1. Change should be implemented only for good reason.
2. Change should always be planned and implemented gradually.
3. Change should never be unexpected or abrupt.
4. All people who may be affected by the change should be involved in planning for the change.

39. The most important responsibility for the nurse in any leadership or management
role is to create an environment of caring - caring for staff members as well as for patients and families. Staff members who believe that their manager sincerely cares about them and the work they do are able to pass that feeling of caring on to their patients and other customers.

40. Caring for the staff members can be demonstrated through (McNeese-Smith, 1997):
Offering sincere positive recognition for both individuals and teams.
Praising and giving thanks for a job well done.
Spending time with staff members to reinforce positive work behaviors.

41. Meeting the staff member's personal needs whenever possible, such as accommodating scheduling needs for family events and being flexible in times of illness.
Providing guidance and support for professional and personal growth.
Maintaining a positive, confident attitude and a pleasant work environment.

42. Technical skills—such as clinical expertise and nursing knowledge.
LEADERSHIP AND MANAGEMENT SKILLS AND BEHAVIORS
Hersey and Blanchard (1988) have identified that effective leadership and management requires skills in three major areas:
Technical skills—such as clinical expertise and nursing knowledge.
Human skills—the ability and judgment to work with people in an effective leadership role.

43. Conceptual skills—the ability to understand the complexities of the overall organization and where one's own area of management fits into the overall organization.