23634638 nursing leadership management

8/9/2019 23634638 Nursing Leadership Management

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LEADER VERSUS

MANAGER JOE R. LACHER

MSN.RN.C.N.A.,B.C.ASSOCIATE PROFESSPR


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LEADERSHIP

IS THE PROCESS OF INFLUENCINGTHE ACTIVITIES OF AN

ORGANIZED GROUP TOWARDGOAL SETTING AND GOAL

ACHIEVEMENT


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NURSING LEADERSHIP

THE ABILITY TO INFLUENCEOTHERS TO RESPOND IN DESIRED

WAYS


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MANAGEMENT

ONE COMPONENT OF LEADERSHIP

IS WORKING THROUGH ANDWITH OTHERS TO ACCOMPLISHORGANIZATIONAL GOAL


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NURSING MANAGEMENT

THE JUDICIOUS USE OFRESOURCES TO ACHIEVE

IDENTIFIED CLIENT GOALS


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LEADER

THE PERSON WHO INFLUENCESINDIVIDUALS OR GROUPS

TOWARDS GOAL SETTING ANDGOAL ACHIEVEMENT


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MANAGER

THE PERSON WHO PLANS ANDIMPLEMENTS OR SEES THAT THEPLAN IS IMPLEMENTED TOACCOMPLISH A SPECIFIC GOAL


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THE LEADERSHIP

PROCESS

IS A PROCESS THAT CAN BELEARNED

CAN BE DELIBERATELY PREPARED INTERPERSONAL INFLUENCE IS

THE ESSENCE OF LEADERSHIP


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THE LEADERSHIP

PROCESS

THE LEADER TRIES TO AFFECT THE

BEHAVIOR OF THE FOLLOWERSTHROUGH COMMUNICATIONS

IS A CYCLICAL PROCESS IN THATEVENTS AT ANY STEP MAY BE FED BACK TO THE LEADER SO THATMODIFICATIONS MAY BE MADE


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TYPES OF LEADERSHIP

FORMAL/APPOINTED Is chosen by administration with official or

legitimate authority to act Formal power has its greatest impact when

the followers accept the leaders

and the members and the leaders work positively toward the same goal.


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TYPES OF LEADERSHIP

INFORMAL Occurs when the leader does not have

official sanction to direct the activitiesof others Is chosen by the group itself - as with

a social group


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TYPES OF LEADERSHIP

INFORMAL Usually arise subtly because of :

age, seniority,

special competencies, an inviting personality


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CHARACTERISTICS OF A

LEADER Self confidence with a sense of personal

identity

Strong drive for responsibility Completes tasks ( is persistent) Energetic


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LEADER Has planning and organizing skills Willing to accept consequences of

decisions and actions Accepts interpersonal stress Tolerant of frustration and delay


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LEADER Can influence behavior Has the ability to use group process Can structure social interactions to

accomplish purposes Excessive initiative in social situations


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MANAGEMENT STYLE


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MANAGEMENT STYLE

VARIETY OF STYLES CONTINUUM

AUTOCRATIC LAISSEZ-FAIRE (MIDDLE) = DEMOCRATIC


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AUTOCRATIC MANAGER

Authoritarian approach Makes most decisions alone

Emphasis is on tasks to be done Little concern with individual staff

members who perform the tasks

Most effective style in a crisis Situations where structure and

control are essential for success.


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DEMOCRATIC MANAGER

People oriented Emphasis on group functioning Goals of the group are identified

Manager = grouporganizer/member

Open environment

Two way communication Manager encourages member

participation


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LAISSEZ-FAIRE MANAGER

Permissive climate Little direction and control Allows staff to make and implement decisions

independently

Relinquishes all power and responsibility togroup.

Non-directive and participates only whenrequested

Group seeks out its own level of participation


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CONTINGENCY MANAGER Leader is flexible

Leader selects style according tothe situation. Not usually seen in clear cut in one

form but shifts according tocircumstances and need of thegroup


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LEADERSHIP STYLES

SITUATIONAL LEADERSHIPINCORPORATES:

the needs of the employee the needs of the work group and the type of work tasks

leadership stylesThe leader adopts style corresponding to the

workers response to the situation


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LEADERSHIP STYLES

SITUATIONAL LEADERSHIP Goal is:to help people understand and share

expectations in their environment so thatthey can gradually learn to supervisetheir own behavior and become moreresponsible, self motivated individuals

(Hersy and Blanchard 1982, 312 in Wywoalowski, 1993, 11)


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Leadership Abilities

Job - Centered behavior Employee-centered behavior


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High EmployeeHigh Job-centered

Democratic manager

Low EmployeeHigh Job-centered

Autocratic manager

High EmployeeLow Job-centered

Low Job-CenteredLow Employee

Laissez-faire manager


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ORGANIZATIONAL

STRUCTURESHealth Care Agency Types: Official Voluntary Proprietary Agencies

Health Maintenance Organizations


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THE ORGANIZATIONALSTRUCTURE WITHIN EACH

INSTITUTION:

Divides the work among all of the peopleemployed

Reflects how decisions are made


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TYPES OFORGANIZATIONAL

STRUCTURES

Bureaucratic (Centralized) Divides work along centralized departmental

or functional lines

Most decision making authority is in theupper levels


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STRUCTURES

Adhocracy (decentralized) Provides decentralized decision making andconsiderable employee participation

Places emphasis on customer-oriented services


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STRUCTURES

Matrix Used to organize functional work groups Allows a manager with special skills to guide

workers who report directly to another manager


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ORGANIZATION OF

DELIVERY OF NURSINGCARE


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FUNCTIONAL NURSING

Emphasis on tasks and proceduresgetting done

Assignments are divided among staff members according to job descriptionsand the amount of work that needs to be

completed. Quality of care is fragmented


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TOTAL CARE NURSING

All direct patient care is given by an RN May have others working with her Care is not fragmented during the time

the nurse is on the unit


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TEAM NURSING

A group of care givers working togetherto provide care for a group of clients

Registered nurse must provideleadership

Need to have effective communicationbetween members to assure continuity of care.


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PRIMARY NURSING

An RN is accountable for the care of thepatient for the entire 24 hour day.

RN gives direct patient care. Is patient centered care.


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CASE MANAGEMENT

NURSING Nurse is involved in care of patient from

time enters the health care system untilreturns home again.

Involves patient and family in all phasesof care.

Goal is to promote collaboration with allhealth care providers


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CASE MANAGEMENT

NURSING Promotes appropriate use of community

resources

Promotes continuity of care Is cost effective


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COMPARISON OF NURSINGAND MANAGEMENT

PROCESSES


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MANAGEMENT PROCESS

IS USED TO MEET THE CLIENTNEEDS IN AN EFFECTIVE AND

EFFICIENT MANNER WITH THEAVAILABLE RESOURCES


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MANAGEMENT PROCESS

IDENTIFICATION OF NEEDS IDENTIFICATION OF RESOURCES PLANNING ORGANIZING AND DIRECTING CONTROLLING


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THE NURSING PROCESS /

THE MANAGEMENT PROCESSNURSING PROCESS

Assessment

AnalysisPlanning

Implementation

Evaluation

MANAGEMENTPROCESS

ID of needs

ID of resources

Planning

Organizing & Directing

Controlling


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THE CLIENT CARE MANAGER :

DETERMINES SPECIFICALLYWHAT NURSING SERVICES EACH

CLIENT NEEDS DURING THE DAY IDENTIFIES GROUP PRIORITIES DETERMINES RESOURCES NEEDED IDENTIFIES AVAILABLE

RESOURCES


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Planning Phase

Should begin immediately after clientneeds and available resources are

identified. Dynamic planning - changes as clients

needs change

Realistic plans reflect that client managerrealizes that a staff member cannot be inmore than one place at a time


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ORGANIZING AND

DIRECTING The client manager attempts to provide

staff with an overview of client priorities

and plans to meet them Offers specific instructions to address

individual client approaches or adhere to

agency protocol Utilizes complex communication skills and

teaching skills


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CONTROLLING

(Evaluation)The Client Manager: Evaluates extent to which desired

outcomes are met during the shift Evaluates at intervals throughout the

shift - seeking feedback from co-workers

Careful attention to feedback to revise oradjust plans as needed


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Evaluates overall management plan forthe shift

Provides feedback to co-worker Communicates accurate status of clients

to next shift

23634638 nursing leadership management

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