Keys to Effective Leadership and Management

Keys to Effective Leadership and Management N. PETRENKO 1 Objectives Define leadership and management Distinguish between leadership and

management Discuss the qualities and behaviors that contribute to effective leadership Discuss the qualities and behaviors that contribute to effective management 2 Today, all nurses are managers

Must deal with other staff who work with them Must know what motivates people Must be able to collaborate with others, both as leaders and as members of the team Need to be confident in their ability to be leaders and managers 3 Leadership is the ability to influence other people 4

The Definition Leadership and Management 5 A Leadership Story: A group of workers and their leaders are set a task of clearing a road through a dense jungle on a remote island to get to the coast where an estuary

provides a perfect site for a port. The leaders organise the labour into efficient units and monitor the distribution and use of capital assets progress is excellent. The leaders continue to monitor and evaluate progress, making adjustments along the way to ensure the progress is maintained and efficiency increased wherever possible. Then, one day amidst all the hustle and bustle and activity, one person climbs up a nearby tree. The person surveys the scene from the top of the tree. 6 A Leadership Story:

And shouts down to the assembled group below Wrong Way! (Story adapted from Stephen Covey (2004) The Seven Habits of Highly Effective People Simon & Schuster). Management is doing things right, leadership is doing the right things (Warren Bennis and Peter Drucker) 7

LEADERSHIP Covey defined a leader as one who enables people to work more effectively together in a state of interdependence. Bryman influence, groups, and goal (involves influencing other people, usually in some type of group, to work toward the achievement of the groups goals ). Max DePree defined it as liberating people to do what is required of them in the most effective and humane way possible. 8 A nursing leader inspires others to work toward a goal.

9 According to Covey, managers Effective are able to elicit from each employee his or her deepest commitment, continued loyalty, finest creativity, consistent excellent productivity, and maximum potential contribution toward continuous improvement of process, product, and service.

10 In 1916, Henri Fayol defined management as: Planning Organizing Commanding Coordinating Controlling the work of a given set of employees

11 management Mitzberg (1989) said Fayols lists did not really describe what managers do.. They do whatever is necessary to make sure that employees do their work and do it well. This includes interpersonal, informational and decisional actions. 12 Are you ready to be a leader or manager? new graduates should not be given managerial responsibility under most circumstances, they

time to develop their own clinical skills, breadth and depth of their experience ON THE OTHER HAND new graduates can function as leaders within their new nursing roles. 13 The Differences Between Leadership and Management Managers have formal authority to direct the work of a given set of employees Managers are formally responsible for the quality and cost of that work Neither is necessary to be a leader On the other hand, to be an effective

manager, you need to be a good leader. 14 You do not have to be a manager to be a leader. Managers control aspect of the environment such as resources, time and money Management positions may be assigned

with a management position, comes power 15 Differences Between: Leadership Management Based on influence and Based on authority and shared meaning An informal role

An achieved position Part of every nurses responsibility Independent of management influence

A formally designated role An assigned position Usually responsible for budgets, hiring, and firing people Improved by the use of effective leadership skills 16 What Makes a Person a Leader? 17 Leadership

18 Types of Leadership Style 19 Types of Leadership Style Autocratic: (Authoritarian, Directive, Controlling) Leader makes decisions without reference to anyone else

High degree of dependency on the leader Can create de-motivation and alienation of staff May be valuable in some types of business where decisions need to be made quickly and decisively 20 Types of Leadership Style Autocratic: (Authoritarian, Directive, Controlling) Assumes individuals are motivated by external forces; therefore leader makes all the decisions Gives orders Makes decisions for the group as a whole Bears most of the responsibility for the

outcomes 21 Types of Leadership Style Autocratic: (Authoritarian, Directive, Controlling) this is an efficient way to run things, it usually stifles creativity may inhibit motivation, may be either punitive or benign

22 Types of Leadership Style Democratic (Participative) Encourages decision making from different perspectives leadership may be emphasised throughout the organisation Consultative: process of consultation before decisions are taken Persuasive: Leader takes decision and seeks to persuade others that the decision is correct

23 Types of Leadership Style Democratic (Participative) May help motivation and involvement Workers feel ownership of the firm and its ideas Improves the sharing of ideas and experiences within the business

Can delay decision making 24 Types of Leadership Style Democratic (Participative) Assumes individuals are motivated by internal forces, leader uses participation and majority rule to get work done Shares the planning, decision making and responsibility for the outcomes with other members of the group Often a less efficient way to run things, 25

Types of Leadership Style Democratic (Participative) More flexible and more likely to foster motivation and creativity Open, trusting environments encourages one to seek new skills Characterized by guidance rather than control Concerned with teamwork Fosters open communication Creates a spirit of collaboration 26 Types of Leadership Style Laissez-Faire (Permissive, nondirective)

(let it alone) Let it be the leadership responsibilities are shared by all Can be very useful in businesses where creative ideas are important Can be highly motivational, as people have control over their working life Can make coordination and decision making time-consuming and lacking in overall direction Relies on good team work Relies on good interpersonal relations 27 Types of Leadership Style Laissez-Faire (Permissive, nondirective)

(let it alone) Assumes individuals are motivated by internal forces and should be left alone to complete work; leader provides no direction or facilitation Leader does very little planning or decision making and fails to encourage others to participate in either Is a lack of leadership 28 Types of Leadership Style

Laissez-Faire (Permissive, nondirective) (let it alone) Leaves people feeling confused and frustrated because there is no goal, no guidance, and no direction Some mature individuals enjoy laissez-faire leadership because they need little guidance Has few established policies 29

Types of Leadership Style Paternalistic Leader acts as a father figure Paternalistic leader makes decision but may consult Believes in the need to support staff 30 Pavitt summed up the difference between these styles nicely

a democratic leader attempts to move the group toward its goals, an autocratic leader attempts to move the group toward the leaders goals, a laissezfaire leader makes no attempt to move the group 31 Authoritarian

Democratic Laissez-Faire Degree of freedom Little freedom Moderate freedom Much freedom Degree of control

High control Moderate control Little control Decision making By the leader Leader and group together By the group or by no one

Leader activity level High High Minimal Assumption of responsibility Leader Shared

Abdicated Output of the group High quantity, good quality Creative, high quality Variable, may be poor Efficiency Very efficient

Less efficient than quality 32 The most effective leader is able to balance tasks and relationships of working together Some emphasize tasks, other relationships

33 Change Leadership 34 Change Leadership The most challenging aspect of business is leading and managing change

The business environment is subject to fastpaced economic and social change Modern business must adapt and be flexible to survive Problems in leading change stem mainly from human resource management 35 Change Leadership Self-esteem 2. Minimisation: As the change becomes clearer, people try to fit in the change with their own personal position and may

try to believe that it will not affect them. 3. Depression: as reality begins to dawn staff may feel alienated and angry, feelings of a lack of control of events overtake people and they feel depressed as they try to reconcile what is happening with their own personal situation. 2 7

6 3 1 1. Immobilisation as rumours of the change circulate, the individual feels some sense of shock and possible disbelief so much so that they deem it worthy of doing nothing. 5 4

4. Acceptance/letting go: The lowest point in selfesteem finally sees people starting to accept the inevitable. Fear of the future Time is a feature of this stage. 36 Change Leadership Self-esteem 6. Search for meaning: Individuals begin to work with the change and see how they might be able to make the change work for

them self esteem begins to rise. 7 2 6 3 1 5 4 7. Internalisation: the change is understood and

adopted within the individuals own understanding they now know how to work with it and feel a renewed sense of confidence and self esteem. 5. Testing out: Individuals begin to interact with the change, they start to ask questions Time to see how they might work with the change. 37

Leadership Theories 38 Theories of Leadership 39 Leadership Theories

Many opinions how one becomes a leader No theory is clear provides the single best answer to the question: What makes a person a leader? We are not born to be leaders Trait, behavioral and contingency theories represent conventional approaches to leadership and have provided important foundations for leadership. We also have contemporary theories 40 Theories of Leadership May depend on:

Type of staff History of the business Culture of the business Quality of the relationships Nature of the changes needed Accepted norms within the institution 41 Theories of Leadership Trait Theories (concerned with what a leader is)

Leaders are born, not made. Intelligence Initiative Excellent interpersonal skills High self-esteem Creativity Willingness to take risks Ability to tolerate the consequences of taking risks 42 Theories of Leadership Trait Theories

Is there a set of characteristics that determine a good leader? Personality? Dominance and personal presence? Charisma? Self confidence? Achievement? Ability to formulate a clear vision? 43

Theories of Leadership Trait Theories Are such characteristics inherently gender biased? Do such characteristics produce good leaders? Is leadership more than just bringing about change? Does this imply that leaders are born not bred?

44 Theories of Leadership Behavioural Theories (concerned with hat the leader does) Imply that leaders can be trained focus on the way of doing things Structure based behavioural theories focus on the leader instituting structures task orientated Relationship based behavioural theories focus on the

development and maintenance of relationships process orientated 45 Theories of Leadership Behavioural Theories Type of Leadership Style used by the person Authoritarian Democratic Laissex-faire 46 Theories of Leadership Contingency (Situational) Theories

These theories recognize the complexity of work situations and encourage the leader to consider a number of factors when deciding what action to take 47 Theories of Leadership Contingency (Situational) Theories Leadership as being more flexible different

leadership styles used at different times depending on the circumstance. Suggests leadership is not a fixed series of characteristics that can be transposed into different contexts 48 Theories of Leadership Contingency (Situational) Theories suggest managers adapt their leadership styles in relation to changing situations May range from authoritarian to permissive and vary in relation to current needs and future probabilities

49 Contemporary Theories 50 Trait, behavioral, and contingency theories leadership and have provided important foundations for leadership Quantum leadership is based on the

concept that reality is a set of relationships expressed at varying and continuously changing levels of complexity Charismatic Leadership Transactional and transformational Leadership Connective Leadership 51 Theories of Leadership Charismatic Leadership Leadership

based on valued personal characteristics and beliefs 52 Theories of Leadership Transformational Recognized process as very complex Something was missing: Recognized inspiration and vision as outstanding features People need a sense of mission that goes beyond good interpersonal relationships or the appropriate reward for a job well done Goals should become fused, creating

unity, wholeness, and a collective purpose 53 Theories of Leadership Transformational Widespread changes to a business or organisation Requires: Long term strategic planning

Clear objectives Clear vision Leading by example walk the walk Efficiency of systems and processes 54 Theories of Leadership Transactional Theories A leadership style based on principles of social exchange theory in which social interaction between leaders and followers is essentially economic and success is achieved when needs are met, loyalty is enhanced, and work performance is enhanced

55 Theories of Leadership Transactional Theories Focus on the management of the organisation Focus on procedures and efficiency Focus on working to rules and contracts Managing current issues and problems 56

Theories of Leadership Connective Theories A leadership style that values collaboration and teamwork; interpersonal skills are used to promote collegiality in achieving organizational goals 57 Theories of Leadership Invitational Theories

Improving the atmosphere and message sent out by the organisation Focus on reducing negative messages sent out through the everyday actions of the business both externally and, crucially, internally Review internal processes to reduce these Build relationships and sense of belonging and identity with the organisation that gets communicated to customers, etc. 58

Qualities of Effective Leaders Effective leadership is defined as the accomplishment of the goals shared by leader and followers. Integrity Courage Initiative Energy Optimism Perseverance Balance

Ability to Handle Stress Self-Awareness 59 Qualities of Effective Leaders Integrity. Integrity is expected of healthcare professionals. Our clients, colleagues, and employers all expect nurses to be honest, law-abiding, and trustworthy.

Adherence to both a code of personal ethics and a code of professional ethics (see the American Nurses Association Code for Nurses in Appendix 1) is expected of every nurse. Would-be leaders who do not exhibit these characteristics cannot expect them of their followers either. 60 Qualities of Effective Leaders Courage. Sometimes, being a leader means

taking some risks. Initiative. Good ideas are not enough. To be a leader, you must act on those good ideas. This requires initiative on your part. Energy. Leadership also requires energy. Both leadership and management are hard but satisfying work that requires effort on your part. Of course, it is also important that you use your energy wisely. 61 Qualities of Effective Leaders Optimism. When the work is difficult and one crisis seems to follow another in rapid succession, it is easy to become discouraged. However, it is

important not to let discouragement keep you and your coworkers from seeking ways to resolve your difficulties. In fact, the ability to see a problem as an opportunity is part of the optimism that makes a person an effective leader. Like energy, optimism is catching. An optimistic leader can remotivate a discouraged group. Holman (1995) calls this being a winner instead of a whiner 62 Winner or WhinerWhich Are You? A winner says . . . A whiner says . . . We have a real challenge This is really a problem.

here. Ill give it my best. Do I have to? Thats great! Thats nice, I guess. We can do it. Impossible. It cant be Yes! done. 63

Qualities of Effective Leaders Perseverance. Perseverance is a closely related characteristic of effective leaders. Effective leaders do not give up easily. Instead, they persevere, continuing their efforts when others are tempted to give up the struggle. This perseverance often pays off. 64 Qualities of Effective Leaders

Balance. In our effort to become the best nurses we can be, we may forget that other aspects of life are equally important. As important as our clients and colleagues are to us, family and friends are important too. Although school and work are meaningful activities, cultural, social, recreational, and spiritual activities also have meaning. The most effective leaders have found a balance between work and play in their lives. Ability to Handle Stress. There is some stress in almost every job. Coping with stress in as positive and healthy a manner as possible helps you conserve your energy and be a model for others. 65

Behaviors of Effective Leaders As mentioned earlier, leadership requires action. The effective leader not only takes action but also chooses the action carefully. Important leadership behaviors include thinking critically, solving problems, respecting people, communicating skillfully, setting specific goals and communicating a vision for the future, and developing oneself and others 66 Behaviors of Effective Leaders

Think critically-choose actions clearly Solve problems Respect individuals Listen and communicate carefully and skillfully Set goals and a vision for the future Develop oneself and coach others 67 Behaviors of Effective Leaders Critical thinking

is reflective, reasoned analysis that focuses on thinking before deciding what to believe or do (Miller & Malcolm, 1990). The essence of critical thinking is questioning and analyzing ideas, suggestions, habits, routines, common practices, and policies before deciding to accept or reject them. To avoid falling prey to the assumptions and biases of oneself and others, ask yourself frequently, Why do I believe that . . .? (Ulrich & Glendon, 1999). 68 Behaviors of Effective Leaders Solving Problems.

Client problems, paperwork problems, staff problems: these and others occur frequently and need to be solved. The effective leader helps people to identify problems and to work through the problemsolving process to find a reasonable solution. 69 Behaviors of Effective Leaders Respecting the Individual. Although we all have much in common as thinking, feeling human beings, each of us has different wants and needs and has had different life experiences. For example, some people really value the psychological rewards of helping others, and other people are more concerned about earning a decent salary. There is nothing wrong with either of these points of view; they

are simply different. The effective leader recognizes these differences in people and helps them find the rewards in their work that mean the most to them. 70 Behaviors of Effective Leaders Listening to Others and Communicating Skillfully. The only way to find out peoples individual wants and needs is to watch what they do and to listen to what they tell you. It is amazing how often leaders fail simply because they did not listen to what other people were trying to tell them. We have separated listening from communicating with other people just to emphasize that communication involves both giving and receiving information, not just giving out information. Skillful communication

includes the following: 71 Behaviors of Effective Leaders Encouraging the Exchange of Information. Many misunderstandings and mistakes occur because people failed to share enough information with each other. The leaders role is to make sure that the channels of communication remain open and that people use them.

Providing Feedback. Everyone needs some information about the effectiveness of his or her performance. Frequent feedback, both positive and negative, is needed so that people can continually improve their performance. Some nurse leaders find it difficult to give negative feedback, fearing that they will upset the other person. How else can a person know where improvement is needed? Negative feedback can be given in a manner that is neither hurtful nor resented by the individual receiving it. In fact, it is often appreciated. Other nurse leaders forget to give positive feedback, assuming that coworkers will know when they are doing a good job. This is a mistake; everyone appreciates positive feedback. In fact, for some people, it is the most important reward they get from their jobs. 72

Behaviors of Effective Leaders Setting Specific Goals and Communicating a Vision for the Future. Just as each one of us is unique in terms of our experiences, needs, and wants, we are also likely to have unique goals for ourselves. An important leadership task is to find the common thread in all of those goals and to help the group reach a consensus about its goals. This may require considerable discussion before it is

achieved. The effective leader also has a vision for the future. Communicating this vision to the group and involving everyone in working toward that vision create the inspiration that keeps people going when things become difficult. Even better, involving people in creating the vision is not only more satisfying for employees but also has the potential for the most creative and innovative outcomes (Kerfott, 2000). It is this vision that helps make our work meaningful. 73 Behaviors of Effective Leaders Developing Oneself and Others. Learning does not end with leaving school. In fact, experienced nurses will tell you that school is just the beginning, that it only prepares you to continue learning throughout your career. As new

and better ways to care for clients are discovered, it is your responsibility as a professional to critically analyze these new approaches and decide whether they would be better for your clients than current approaches to care. 74 Behaviors of Effective Leaders Effective leaders not only continue to learn but also encourage others to do the same. Sometimes leaders function as teachers. At other times, their role is primarily to encourage and guide others to seek more knowledge. Observant, reflective, analytical practitioners know that learning takes place

every day if one is open to it (Kaagan, 1999). 75 Factors Affecting Style 76 Factors Affecting Style Leadership style may be dependent on various factors:

Risk - decision making and change initiatives based on degree of risk involved Type of business creative business or supply driven? How important change is change for changes sake? Organisational culture may be long embedded and difficult to change Nature of the task needing cooperation? Direction? Structure? 77

What Makes a Person a Manager? 78 What Makes a Person a Manager? One may emphasize the relationship of managing people where another may emphasize the task aspects of management 79

Although there are many management theories, it is most important to be familiar with the two major but opposing schools of thought in management: the human relations approach to management and scientific management. As you will see, one emphasizes the relationship aspects of managing people, and the other emphasizes the task aspects of management 80 Scientific Management Frederick Taylor believed that most jobs could be done more efficiently if they were

thoroughly analyzed and that most workers could work more efficiently given a properly designed tasks and sufficient incentive to get the work done The nurse manage would keep records on work done 81 Scientific Management The work itself was also analyzed to improve efficiency. In health care, for example, there has been a lot of discussion about the time it takes to

bring patients to x-ray or therapy versus bringing the x-ray or therapist to the patient. The current emphasis on eliminating excess staff and increasing the productivity of remaining employees is based on the same kind of thinking. 82 Scientific Management Nurse managers who use the principles of scientific management emphasize the task aspects of providing health care. They pay particular attention to the type of treatments and procedures done on the unit, the equipment needed to provide this care efficiently, and

strategies that would facilitate efficient accomplishment of these tasks. These nurse managers keep careful records of the amount of work accomplished and reward those who accomplish the most. 83 Human Relations-Oriented Management McGregors X, Y Theory keeping employee morale and

motivation as high as possible, assuming that satisfied, motivated employees will do the best work 84 Human Relations-Oriented Management McGregors (Theory X) Most people do not want to work very hard and the managers job is to see that they do work hard

Employees need strict rules, constant supervision, and the threat of punishment (in the form of reprimands, withheld raises, and threats fo job loss) to make them careful, conscientious workers 85 Human Relations-Oriented Management McGregors (Theory Y) Managers believe the work itself can be motivating and people will work hard if their managers provide an atmosphere in which

they are supported and encouraged to do so Emphasizes guidance rather than control, development rather than close supervision, and reward rather than punishment 86 X Y Work is something to be avoided The work itself can be motivating

People want to do as little as possible People really want to do their job well Use control-supervision punishment Use guidancedevelopment reward 87 A human relationsoriented nurse manager is concerned with keeping employee

morale as high as possible, assuming that satisfied, motivated employees will do the best work. Employees attitudes, opinions, hopes, and fears are important to this type of nurse manager. Considerable effort is expended to work out conflicts and promote mutual understanding among the staff to provide an atmosphere in which people can do their best work. 88 Qualities of An Effective Manager The effective nurse manager possesses a combination of qualities: Leadership

Clinical Expertise Business Sense None of these alone is enough; it is the combination that prepares an individual for the complex task of managing a group or team of healthcare providers. 89 Qualities of An Effective Manager Leadership. All of the people skills of the leader are essential to the effective manager. They are the core skills needed to function as a manager. Clinical

Expertise. It is very difficult to either help others develop their skills or evaluate how well they have done this without possessing clinical expertise oneself. It probably is not necessary (or even possible) to know everything every other professional on the team knows, but it is important to be able to assess the effectiveness of their work in terms of patient outcomes. 90 Qualities of An Effective Manager

Business Sense. Nurse managers also need to be concerned with the bottom line, that is, with the cost of providing the care that is given, especially in comparison with the benefit received from that care. In other words, nurse managers need to be able to analyze how much is spent to provide a given amount of client care and how effective that client care has been. This is a very complex task and requires knowledge of budgeting, staffing, and measurement of patient outcomes 91 Qualities of An Effective Manager

There is some controversy over the amount of clinical expertise versus business sense that is needed to be an effective nurse manager. Some argue that a person can be a generic manager, that the job of managing people is the same no matter what tasks they perform. Others argue that the manager must understand the tasks better than anyone else in the work group.

Our position is that both are needed, along with excellent leadership skills. 92 Behaviors of An Effective Manager Mintzberg (1989) divides the managers activities into three categories Interpersonal Informational Decisional 93 Behaviors of An Effective Manager Representing employees Representing the organization

Dissemination Networking Conflict negotiation and resolution Employee development Rewards and punishment Employee evaluation Resource allocation Planning Job analysis and redesign Informational Interpersonal Decisional 94

Behaviors of An Effective Manager The interpersonal area is one in which leaders and managers have similar responsibilities. However, the manager has some additional responsibilities that are seldom given to leaders. The following are additional interpersonal skills that nurse managers need: 95 Behaviors of An Effective Manager Interpersonal

Networking (The position of nurse managers in the hierarchy provides them with many opportunities to develop positive working relationships with other disciplines, departments, and units within the organization) Conflict Negotiation and resolution (Managers often find themselves occupied with resolving conflicts between employees, between clients and staff members, and between staff members and administration) 96 Behaviors of An Effective

Manager Interpersonal Employee Development (Providing for the continuing learning and upgrading of the skills of employees is a managerial responsibility that overlaps with managers informational responsibilities) Rewards and Punishments (Managers are in a position to provide both tangible (e.g., salary increases, time off) and intangible (e.g., praise, recognition) rewards as well as punishments ) 97

Behaviors of An Effective Manager Informational Spokesperson. Managers often speak for administration when relaying information to their staff members. Likewise, they often speak for staff members when relaying information to administration. In addition, they frequently represent their work group or department at various meetings and discussions. Monitoring. Nurse managers monitor the activities of their units or work groups. This may include the number of clients seen, average length of stay, infection rates, and so forth. They also monitor the staff (e.g., absentee rates, tardiness, unproductive time) and the budget (e.g., money spent, money left to spend in comparison with money needed to operate the unit). 98

Behaviors of An Effective Manager Informational Dissemination. Nurse managers share information with their clients, staff members, and employers. This information may be related to the results of their monitoring efforts, new developments in health care, policy changes, and so forth. As you can see, nurse managers have very complex, responsible positions within healthcare organizations. Ineffective managers may do harm to their employees and to the organization, but effective managers can help their staff members grow and develop as healthcare professionals while providing the highest quality care to their clients. 99 Behaviors of An Effective Manager

Decisional Employee Evaluation. Managers are responsible for conducting formal performance appraisals of their staff members. Resource Allocation. In decentralized organizations, nurse managers are often given a set amount of money for running their units or departments and must allocate these resources wisely, especially when they are very limited. Hiring and Firing Employees. Most nurse managers participate in or carry out themselves the hiring and firing for their units or departments. 100 Behaviors of An Effective Manager Decisional

Planning for the Future. Even though the day-to-day operation of most units is a sufficiently complex and time-consuming responsibility, nurse managers must also look forward and prepare themselves and their units for future changes in budgets, organizational priorities, and patient populations. Job Analysis and Redesign. In a time of extreme cost consciousness, nurse managers are frequently being called on to analyze and redesign the work of their units or departments to make them as efficient and cost effective as possible. 101 Thinking critically is something an effective leader uses The essence of critical thinking is

questioning and analyzing The effective leader influences others successfully A leader-manager is both a leader and a manager A leader may be an informal position A manager has a formal position 102 Effective leadership is defined as the accomplishment of the goals shared by leaders

and followers.inspiring commitment 103 Effective managers should be leaders Every registered nurse needs leadership skills to be effective as a practitioner and colleague !!!!!!!! 104

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