1. Leadership, Management, and Followership
Dr. Belal Hijji, RN, PhD
September 28 October 5, 2011

2. Learning Outcomes
At the end of this lecture, students will be able to:
Define leadership, management, and followership.
Recognise the attributes of leaders and managers.
Identify the tasks of leading, managing, and following.

3. Definition of Terms
Leadership: Using personal traits and personal power to constructively and ethically influence patients, families, and others toward an end point goal.
Management: Is a set of behaviours and activities that provide structure and direction in conducting patient care and organisational functions where the outcomes to be achieved are known and where a desired sequence to accomplish these outcomes is prescribed in writing.
Followership: Behaviours demonstrated by individuals with whom the leader interacts. It is a set of behaviours that demonstrate collaboration, influence, and action with the leader.

4. Attributes of Leaders and Managers
Uses focused energy and stamina to accomplish a vision.
Uses critical thinking skills in decision making.
Trusts personal intuition and backs this with facts.
Accepts responsibility willingly and follows up on the consequences of actions taken.
Identifies the needs of others.
Deals with people skillfully: coaches [instructs or trains], communicates, and counsels.
Examines multiple options to accomplish an objective at hand.
Is trustworthy, handles information from various sources respectfully.
Motivates others toward achieving an objective at hand.

5. Tasks of Leading, Managing, and Following
Gardner’s Tasks of Leadership.
Envisioning Goals: Leading requires envisioning goals in partnership with those being led. In the case of patient care, leading is required to help patients envision their life when a specific disease trajectory [path, progress] is unknown. For example, helping a patient envision walking again or participating in family events.
Affirming Values: Values are the inner forces that give purpose, direction, and precedence to life priorities. The word value conjures [brings to mind] up an image of something that has worth; our values reflect through our actions those things of worth to us.
Motivating: When our values drive our actions, values become a source of motivation. Motivation is tapping into what we value, to achieve growth and movement toward our vision.

6. Gardner’s Tasks of Leadership (Continued…).
Managing: The ability to mange is an important subset of leading, especially when the leader holds a position of influence in an organisation (nurse manager). Good leaders need management skills and abilities, and good managers need leading skills and abilities.
Achieving workable unity: Another challenge of leading is to achieve workable unity among the parties being affected by change and to avoid, diminish, or resolve conflicts so that the desired vision can be achieved.
Developing trust: A hallmark task of leadership is to behave in a way that is trustworthy. When leaders are clear with others about where we are heading and that the way toward achieve high levels of performance is through building on strength, followers develop trust in the leader.

7. Gardner’s Tasks of Leadership (Continued…).
Explaining: Leading and managing require a willingness to, repeatedly, communicate and explain. The art of communication requires the leader to:
Know what information to share.
Know the parties who will receive the information.
Provide the opportunity for dialogue and feedback.
Know that it is possible to give too much information, which can temporarily paralyse the listener and divert energy away from key responsibilities.
Be willing to repeat information in many different ways, at different times.
Always explain why something is being asked or changing.
Acknowledge loss and tell about what will be missed, especially if change is involved.
Serving as symbol: Nurses may symbolically be present for patients and represent their department at an event.

8. Gardner’s Tasks of Leadership (Continued…).
Representing the group: There are many opportunities for leaders to represent the group through active participation. Employees may participate in human resource committees, safety and security task forces, quality improvement committees. Nurses can give their voice in each of these leadership opportunities.
Renewing: leaders can generate energy within and among others. Renewing is about providing self-care to enhance the ability to care for staff, patients, and the organisation served. For self-care, leaders must eat balanced diet, get adequate sleep and exercise, and participate in other wellness-oriented activities.

9. Tasks of Leading, Managing, and Following (Continued…)
Bleich’s Tasks of Management.
Identifies systems and processes for which the manager is responsible and accountable.
Verifies minimum and optimum standards for staff to achieve. For example, a nurse manager would require a staff nurse to obtain a minimum score of 90% in the annual medication administration test.
Validates the knowledge, skills, and abilities of staff; capitalises on strengths and improves what needs improvement.
Devises and communicates a comprehensive plan for the division of work. This may include required staffing level, in-service education, and material resources.
Eliminates workplace barriers that diminish effectiveness.
Offers rewards and recognition to individuals and teams.
Involves others in decision making when appropriate.

10. Tasks of Leading, Managing, and Following (Continued…)
Bleich’s Tasks of Followership. The follower:
Is accountable while working within the context of organisational systems and processes; does not change the way the work is done for personal gain.
Honors the standards and specifications required to deliver acceptable care/ service.
Offers knowledge, skills, and abilities to accomplish a task at hand.
Collaborates willingly with leaders and mangers; avoid passive-aggressive or nonassertive responses to work assignments.
Includes data collection as part of daily work activities as a self-guide to effectiveness.
Takes reasonable risks as an antidote for fearing change.

11. Bleich’s Tasks of Followership (Continued…). The follower:
Gives feedback on the efficiency and effectiveness of systems and processes that affect the outcome of care.
Gives and receives feedback to other team members, leaders, and managers to enhance a culture of support and nurturance [التعزيز].