Leadership

Conflict resolution strategies --> win-lose outcomes

Accommodating one of the parties accommodates the other party and gives up personal goals.

Leadership Negative Consequences

Breakdown in team cohesiveness Being without direction Apathy/disengagement Mistrust/suspicion Breakdown in quality

Conflict resolution strategies --> win-win outcomes

Collaborating both parties work together to establish mutual goals

Leadership Positive Consequences

Collaboration Improved Patient Outcomes Improved organization and staff outcomes Shared decision making Transformational leader

Leadership Interrelated Concepts

Communication Care Coordination Teamwork Collaboration Professionalism Healthcare quality

a nurse discovers that the wrong medication was given to a confused client who answered to the name the nurse stated when entering the room. the provider is notified and states that the medication of the client received will not cause any harm. which of the following actions should the nurse take?

Complete an incident report documenting the occurrence. An incident report should be initiated whenever an error is made involving a client, even if no injury occurred. Incident reports are also used for statistical purposes in determining the types of incidents that occur. These reports might help administrators to recognize if a particular type of incident is occurring at an undesired frequency to determine if intervention is needed.

Highest task emphasis and highest people emphasis leadership style?

Democratic

Bill Gates was known for visiting all his sites and questioning his people over and over until he knew for sure that they were on track, on target and could accomplish the task. Bill would have intense 1:1 discussions, he is task-oriented, he provided correction when needed, and rewarded those who helped everyone to succeed. He drove everyone just as hard as he has driven himself. What leadership style is this?

Transactional

Lowest task emphasis and highest people emphasis leadership style?

Transformational

Nurses tend to favor ______________ leadership due to intrinsic motivation and job satisfaction.

Transformational

This leadership style was associated with reduced medication errors, lower patient mortality, increased patient satisfaction, lower staff turnover, and overall safer environment.

Transformational

this leadership style encourages open communication and places a focus on quality improvement of systems and processes, rather than on mistakes of individual team members

democratic

To be ________________ ___________, one needs to be able to understand and manage oneself and have social awareness and be able to manage relationships. Before hiring or promoting a nurse to the role of a nurse manager, nurse executives should consider the ___________ ____________of the individual.

emotionally intelligent, emotional intelligence

IHI goal of the triple aim is to

improve health of the communities in which each healthcare organization serves. Quadruple aim is to reduce burnout

Expectant Theory

individuals perceived needs influence their behavior. Positive relationship between effort and performance. Expectancy is the perceived probability of satisfying a particular need based on experience. Therefore nurses in leadership roles need to provide specific feedback about positive performance.

Included in a living will

"It allows the client to express personal wishes regarding health care decisions." The purpose of a living will is to allow the client an opportunity to specify what aspects of care and treatment are to be accepted or refused in the event that the client can no longer communicate those decisions.

Informal Leaders

-Informal leaders do not hold formal positions or have authority for a group -those individuals who influence others because they are engaged with those who listen to and follow the informal leaders -behind the scenes people who motivate others to act -informal leaders are either the formal leaders closest allies or their worst fears

How does leadership present itself?

-a journey which begins with being an effective follower -mindful of our actions and the motivation behind those actions -task as nurse is to continue to develop personally and professionally and to promote a focus on client centered care-goal is to provide accessible, least costly care, and highest quality outcomes

Democratic leadership style

-allows for constructive criticism -concentrates on day-to-day tasks -takes a broader view and provides direction towards achieving goals -a participative leader serves as a resource person and facilitator and is non-directive -help followers develop technical/emotional maturity Relationship/person orientation. Group discussions/decisions with leader encouragement. Shared responsibility, slower to get moving, challenge to get participation. Everyone feels valued. Needs experienced workers. Involve followers in the decision-making process. Participatory leadership style, followers are experienced, committed to goals. Motivates by supporting staff achievements. Communication occurs up-down the chain of command.

Transactional leadership style

-corrects performance on an as-needed basis -observes work performance to determine need for improvement. -identifies need for mentoring and provides what is necessary to improve performance -focused on daily operations -reward performance/correction when needed -getting job done, meeting everyone's self-interest Leader-caregiver role, focused on day to day operations, survey followers needs/set goals, focused on maintenance/management. Uses rewards/constructive feedback or correction. Exchange relationship, rewards, correction, satisfy needs of all. Focused on the NOW problems, maintains status quo, uses rewards to motivate followers

Laissez-faire leadership style

-depends on the group to make a decision -communication flows upward and downward -demonstrates a non-directive approach -exerts little or no leadership and control -Minimal information/ communication -Decisions within crisis -Great for very experienced workers -Has negative outcomes for employees Complete freedom for all. Minimal leader participation, noninterference, let events take their own course. Do not interfere with employees and their work, stand at a distance, give freedom to make decisions, minimal information/communication, manage by crisis, need very experienced followers. Does little planning, makes very few decisions, staff are the motivators. Communication up-down chain of command and between group. Work output is low without an informal leader.

Components of Leadership and Management

-essential skills -motivating clients/staff -plans, organizes, directs, coordinates, inspirational toward positive outcomes -leader is not always manager

Transformational leadership style

-identifies the need for mentoring and provides what is necessary to improve performance. -guides others to feel pride in their work -communicates the vision of the organization empowering staff to embrace the vision and to feel pride in their work -A transformational leader gives group members responsibilities that will enhance their professional development -recognize contributions of followers -long term focus develops people and organizaions motivates followers to full potential over time (change in perception). Charisma, consideration, intellectual stimulation, empowerment, vision, high expectations. changing or transforming the individual. Empowers followers (communal vision). Personal Development is secondary goal

Leader vs. Manager

-influencing people to accomplish goals -influence, vision, communication, group process, goal attainment, motivation -get others moving -informal power via peers -must have followers -coordination/integration of resources -planning, organizing, coordinating, directing, controlling -focused on goals/objectives -keep others focused on goals/objectives -formal power/authority assigned -plans what needs to be done, how it's done, who is going to do it -organizational structure (decision) -influences/motivates staff to perform roles (directing) -evaluates staff performance/unit goals--are outcomes being met? (controlling) -Characteristics: clinical expertise, networks, coaches, makes decisions (resources, budget, hiring, firing)

Transformational Theories

-leader attends to the needs and motives of followers so that the interaction raises each to high levels of motivation and morality. -the leader is a role model who inspires followers through displayed optimism, provides intellectual stimulation and encourages follower creativity.

Autocratic leadership style

-makes decisions independently and then notifies staff of the decisions made -maintains a high degree of control over the staff and allows little freedom of staff members -directive behaviors -HIGH concern for task, gives orders -Employees may become hostile/stifled/dependent -distanced from followers, punishment/rewards -motivates by coercion -communication occurs down the chain of command -Advantage: more efficient b/c time is not lost seeking input from others, crisies, new employees, quick decisions, large groups -Disadvantage: does not promote trust, communication, or teamwork for daily work

Care provider vs Care Coordinator

-providing care at bedside -central to coordinating service delivery/information flow -organization/coordination of complex activities

Gardner's leadership tasks are presented to demonstrate that leading, managing, and following are relevant to nurses in these 10 forms

1. Envisioning goals 2. Affirming values 3. Motivating 4. Managing 5. Achieving workable unity 6. Developing trust 7. Explaining 8. Serving as a symbol 9. Representing the group 10. Renewing

Situational Contingency Theories have 3 Factors that are critical

1. degree of trust and respect between and among leaders and followers 2. task structure denoting the clarity of goals and the complexity of problems faced 3. position power in terms of where the leader was able to reward followers and exert influence -personal characteristics of followers -environmental demands -adaptive leadership -leaders task at hand -interpersonal skills -favorableness of the work situation

Quadruple aim guidelines

1. enhance pt experience 2. improve population health 3. reduce cost 4. improve work life

5 Components of EI

1. self-awareness 2. self-regulation 3. motivation 4. empathy 5. social skills

Components of a Leadership Moment

1. the leader -values, skills, style -self-awareness of behaviors 2. follower -accepts/rejects leader-leader's personal power -vital to passive/unthinking-different types -trust/readiness 3. situation -system, environment, people, task structure, supply/demand, time/resource, personalities 4. communication -open/closed -high impact on success 5. goals -congruency

Leaders tend to be these 2 styles

1. transformational 2. transactional

Beneficence

Beneficence is based on the principle that actions should be taken with the intent to do good. It is associated with nonmaleficence, which is the requirement that health care providers do no harm to their clients.

a nurse is discussing with a newly licensed nurse about how to obtain informed consent from a client who is to undergo an epidural procedure. Which of the following ethical principles should the nurse include in the teaching?

Autonomy Informed consent is based on the ethical principle of autonomy, which is the right to self-determination, independence, and freedom of choice.

OB Modification Theory

Behavior is a function of its consequences -positive reinforcement

In this leadership style, knowledge is seen as power an can be withheld from the team. Mistakes are also not tolerated and blame is placed on individuals and not the faulty processes.

Authoritarian

a group or providers are participating in a cardiopulmonary resuscitation effort for a client who is in cardiac arrest which of the following types of leadership is required for this group to function efficiently?

Autocratic Autocratic leadership is most efficient in an emergency situation. An autocratic leader will direct and issues commands necessary for successful cardiopulmonary resuscitation.

a nurse manager calls a meeting of the unit's staff members to discuss cost-containment issues. the nurse manager has asked for staff input regarding strategies that might help reduce costs. which of the following types of leadership is the nurse manager using?

Democratic This is an example of democratic leadership. A democratic leader guides staff toward reaching an objective and shares responsibility with the staff. This is the ideal type of leadership in this situation because a great amount of creativity can occur and many strategies can be developed.

Leadership Characteristics

Different Styles Formal Informal Complex Adaptive Systems

Leadership Antecedents

Followers Vision Communication Decision Making Change Social Power Visibility/role modeling Competence

Conflict resolution strategies --> lose-lose outcomes

Smoothing one person tries to smooth over the conflict and focus on areas in which the parties agrees. there is no resolution. Also: avoidance, compromise

a nurse is completing an incident report after administering an incorrect dose of medication to a client, even though the client experienced no ill effects from error. which of the following should the nurse recognize as the purpose for completing the incident report?

Identifies situations that contribute to the occurrence of medication errors Identify factors that contribute to the occurrence of the problem. This is one aspect of quality improvement efforts in health care facilities.

Aspects of leader

Key: (1) articulate a vision for the future, (2) see possibilities when in challenging, complex uncharted circumstances, (3) communicate effectively with others, (4) adapt to new situations and environments, (5) use experiences and knowledge to judge risks Characteristics: Initiative Inspiration E Positive Attitude Communication Skills Respect Problem-solving/critical thinking skills: personality traits/leadership skills Goal oriented

Leadership Risk Factors

Lack of preparation for the job Bullying/incivility Ineffective leadership Lack of Organizational Support Lack of resources

In this leadership style, decisions are not made, changes rarely occur, and quality improvement is reactive and not proactive. Used by new inexperienced leaders or those at the end of their careers who do not care

Laissez-faire

Lowest task emphasis with lowest people emphasis leadership style?

Laissez-faire

_____________-___________ leadership was shown to negatively contribute to unit socialization and to create a culture of blame

Laissez-faire

Two Factor Theory

Organizations need hygiene and motivator factors to recruit and retain staff. Hygiene factors do not create job satisfaction, but must be in place for work to be accomplished. Hygiene factors i.e. working conditions, salary, status, security

Leadership Definition

an interactive process that provides needed guidance or direction that facilitates the establishment and acquisition/achievement of shared goals

Emotional Intelligence Definition

an understanding and managing of our own emotions with the added social awareness of discerning the emotions to others

Highest task emphasis with lowest people emphasis leadership style?

autocratic

Which of the following is NOT a characteristic of the democratic leadership style? a. Leaders asks before doing anything b. Leader enforces and relies on discipline c. Leader works together with the members as a group d. Leader considers followers' opinions and ideas

b. Leader enforces and relies on discipline

What is one characteristic about the autocratic leadership style? a. Leader relies less on authority and more on themselves b. Leader accepts power and knowledge of the members c. Leader tells others what to do d. Leader considers ideas and opinions of others

c. Leader tells others what to do

Servant

choosing first to serve others then be a leader. putting others first. Promote personal growth, autonomy, freedom

a nurse is caring for a client who is dying and unable to make decisions for himself. the client's adult children disagree on his code status. which of the following sources should the nurse depend on for decisions regard the client's end of life care?

client's health care proxy

Emotional Intelligence

the nurse be able to perceive and understand their own emotions and the emotions of the client and family in order to provide client centered care

this leadership style is effective in a crisis as well as when projects need to be carried out in a specific fashion

transactional

Research indicates that nurse managers with emotional intelligence have a predisposition of being a ________________ leader.

transformational

this leadership style is when individualized consideration occurs when the leader is concerned about the needs and skills of his or her followers

transformational