leadership and management nursing

controlling

evaluation of staff performance evaluation of unit goals to ensure identified outcomes are being met - evaluation, fiscal accountability, legal and ethical control

transactional leadership

focus on management task is a caretaker uses trade offs to meet goals dose not identify shared vales examines causes uses contingency reward

Things a manager should never delegate

their own personal accountability discipline praise and recognition

supervising

"the provision of guidance and direction, oversight, evaluation and follow up by the licensed nurse for accomplishment of a nursing task delegated to nursing assistive personnel." - is the process of directing, monitoring, and evaluating the performance of a task of another team member. - RN supervise the care of clients delegated to UAP, and LPN

10 fatal flaws of leaders

- a lack of energy and enthusiasm - acceptance of their own mediocre performance - lack of clear vision and direction - having poor judgement - not collaborating - not walking the talk - resisting new ideas - not learning from their mistakes - a lack of interpersonal skills - failing to develop others

task that may be delegated to UAPs

- answering the phone - cleaning after procedures - transportation of patients - clerical task - assisting with procedures - data collection without analysis

task that Should Not be delegated to UAPs

- any that involves nursing judgement or application of the nursing process - assessment of patients - assessment of pain - teaching - evaluation of treatment - interpreting test - identifying needs - triage - counseling

full range leadership

- articulate and are able to represent their vision well - the leader has charisma, is able to create emotional ties with the followers that builds trust and confidence - is able to create a collective sense of the mission and values and prompts others to acts on these values - challenges and analyzes subordinates problems and possible solutions - recognizes and appreciates the staffs unique needs, strengths, and challenges

to be a leader you must make a decision to act. this requires:

- decision maker - communicator - evaluator - facilitator - risk taker - mentor - energizer - coach - counselor - teacher - critical thinker - buffer - advocate - visionary - forecaster - influencer - creative problem solver - change agent - diplomat - role model - innovator

improper delegation

- delegating without providing adequate information - results from management making decisions based on incomplete information

resistance to delegation

- failure of the delegation to see the subordinates perspective - they believe they are incapable of completing the task - may lack confidence - may need coaching - may need to build self confidence - inherent resistance to authority - over delegation

management roles and responsibilities

- have an assigned position of authority - responsible for the overall function of the unit 24/7 - responsible for decision making, decision analysis and results - manipulate people, environment, money, time and other resources to achieve the organization goals - possess clinical expertise - coach subordinates - network with team members - handle exceptions - problem solve - resolve conflicts

Leadership Characteristics

- it is not one definitive thing - they are out front making decisions - they aren't given authority, but rather obtain it - they have goals - they lead willing followers

under delegating

- lack of ability of manager's part to do the job correctly or completely - manager's desire to complete the job himself - lack of trust in subordinate - lack of experience - need to control

laissez-faire leaders

- leaders are very permissive, nondirective, passive, and inactive - leaders do not plan or coordinate - leaders provide little direction - leaders do not criticize - motivates by support when requested by the group or individuals - provides upward and downward communication between members - disperses decision making, throughout the group

democratic leaders

- leaders maintain less control - leaders ask questions and make suggestions - leaders tend to get group involved in planning, problem solving and decision making process - leaders encourage creativity and motivation - leaders communicate up and down - leaders use constructive criticism - use economic and ego awards to motivate staff - decision making involves others - communication is on "WE" rather than "I or ME"

authoritative leaders

- leaders maintain strong control - leaders do the planning, make decisions and give orders - leaders tend to be directive, criticism is punitive in nature - leaders decisions are usually not in the interest of the entire group - leaders think of themselves as being a higher status than group members - leaders do not stimulate creativity and autonomy of self motivation - leaders do not develop personnel

leader traits according to literature

- leaders need to be more intelligent than the group - leaders posses initiative, the ability to perceive and start courses of action not considered by others - leaders possess creativity as an asset - leaders have a sense of purpose and direction, persistence, dependability and objectivity - leaders must be able to community effectively - leaders need to be perceptive enough to distinguish the allies from their opponents - leaders use persuasion of ten to gain the consent of followers

integration of management and leadership

- nurses must be able to integrate management and leadership skills in their practice - nurses must be able to see how a unit fits into the large picture of the organization - nurses must be able to influence others positively - nurses must be sensitive to others - nurses must be able to cope with conflicting requirements and expectations from many constituencies - nurses must be able to change in order to meet the needs of the organization

effective delegation steps

- plan ahead - identify the skill - identify the person - communicate - empower the delegate - set deadlines and monitor progress - model and provide guidance - evaluate the performance - reward performance

over delegation

- poor managers of time - trying to get organized - feel insecure in their ability to perform a certain task

reasons why managers delegate

- so that managers are free to handle problems - if someone is better prepared or has greater expertise - learning experience for others for professional growth

Situational and Contingency

- suggest that the traits required of a leader differ according to the varying situations. - leaders may be a leader in one situation and a follower in another or vise versa. - believed that a leader will be effective or ineffective depending on the situation. - leader member, relations involve the amount of confidence and loyalty the followers have with the leader. - task structure, refers to the ability of a task to be defined and measurable. - position power, refers to the authority inherent in a position, the power to use rewards and punishment and the organizations support of one's decision.

interactional leadership

- the leadership behavior is generally determined by the relationship between the leader's personality and the specific situation. - leader has to be able to problem solve, maintain group effectiveness, communicate well, be fair, competent dependable and creative. - foster autonomy by valuing and empowering followers - focus on leadership as a process of influencing others within the organizational culture

The most important responsibility of the nurse is to prioritize and ensure that routine nursing measures on non-critical clients are assigned. The nurse is performing which of the following functions? A. Delegation B. Networking C. Clinical coordination D. Advocacy

A. Delegation

Delegation is the process of transferring work to subordinates. A nurse-manager may appropriately delegate which task? A. Scheduling staff assignments for the next month. B. Terminating a nursing assistant for in subordination. C. Deciding on salary increases for nurses after they complete orientation. D. Telling a staff nurse to initiate disciplinary action against one of her peers.

A. Scheduling staff assignments for the next month.

A registered nurse should assign a nursing assistant to care for a client with inflammatory bowel disease who: A. requires assistance with ambulation. B. requires nasogastric suctioning. C. requires continuous pulse oximetry monitoring. D. is receiving patient-controlled analgesia.

A. requires assistance with ambulation

A Nurse in a long-term care facility consistently administers clients' medications 60 to 90 minutes after the scheduled administration time. The nurse also leaves scheduled treatment procedures for nurses to complete on the next shift. Which of the following would be an appropriate strategy for this nurse to pursue? A. Reschedule treatment procedures for the next shift. B. Ask the nurse manager for a lighter load. C. Pre-pour medications for the shift to expedite the process D. Seek input and direction on time management and priority setting.

D. Seek input and direction on time management and priority setting.

leadership theories

Great Man Theory Situational and Contingency Interactional leadership ( Ouchi, Kanter, Bradnt's) Transactional and Transformational Full Range Leadership Servant Leadership

Leadership vs. Management

Leadership: - leaders to the right things - leaders are challenged by change - leaders have future time frames - leaders are concerned with the why of events Management: - managers do things right - managers are challenged by continuity - managers focus on structure and procedures - managers are concerned with who, what, when, and where

the 5 rights of delegation

Right person Right task Right circumstances Right direction and communication Right supervision and evaluation

3 leadership styles

authoritative democratic laissex-faire

organizing

determines the lines of authority, channels of communication and where decisions are made

Unliscensed Assisstive Personnel (UAP)

an unlicensed people who are trained who are trained to function in an assistive role to the RN in the provision of patient/client activities as delegated by the RN

Great Man Theory

believes that a few people are born with the necessary characteristics to be great. able to organize, control the activities of subordinates to accomplish the organization's goals. allow participation and consultation from subordinates for decisions that affect them. leaders are born, not developed

transformational leadership

identifies common values is committed inspires others with a vision has long-term visions looks at effects empowers others

What is leadership?

is a process of persuading and influencing other towards a goal and is composed of a wide variety of roles

management

is the process of leading and directing all or part of an organization through the deployment and manipulation of resources - the activities needed to plan, organize, motivate, and control the human and material resources needed to achieve outcomes consistent with the organization's mission and purpose

assigning

is the process of transferring the authority, accountability, and responsibility of client care to another member of the health care team

directing

mangers play an important role in order to influence and motivate the staff to perform their assigned roles - human resource management, managing conflict, delegating, communication, getting staff to cooperate

RN's responsibility with UAP's

must know the UAP's job description must know their knowledge base must know their demonstrated skills

5 major management function

planning organizing staffing directing controlling

staffing

the acquisition and management of the staff and staff mix of employees to provide 24/7 care the clients - hiring/firing - discipline of staff - recruiting, interviewing, doing an orientation, staff development

delegating

the process of transferring the authority to perform a selected nursing task in a selected situation. the nurse retains the accountability for the delegation.

3 delegation errors

under delegating over delegating improper delegation

planning

what needs to be done how will it be done who is going to do it