Management and Leadership in Nursing

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Management and Leadership in Nursing

• NUR 211
• Spring 2003
• Ginny Rogers

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• To be good is noble. To teach others to be good
  is nobler, and no trouble.
• Mark Twain

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NUR 211

• Syllabus and PowerPoints available on the web
• Final exam Room May 7th 1100 AM 100PM
• Weekly exams
• Project- see grading criteria page in Student
  Assignments

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NUR 211

• Paper see grading criteria page
• Journal
• See journal assignment eval. page
• ATI comprehensive exam
• passing rate
• Failure requires taking review class and retake
  Seminars required, info will be included on
  exams

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• Clinical information
• Read role definitions
• Weekly evals must be filled in by preceptor and
  signed, student must return to instructor with
  journal.
• Students must inform instructor of ANY problems
  immediately.
• Final evaluation- critical behaviors must be
  achieved independently by the completion of
  clinical work
• Please spend time looking over the final
  evaluation tool, if you feel you are unable to
  achieve any objectives in your facility, let your
  instructor know. This is your responsibility.

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Unit 1
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• Health Care Delivery Systems
• Reforms began ½ century ago
• DRGS first federally organized incentive to
  keep health care costs down
• 1992 Clintons task force looked at including
  the 40 M Americans w/o insurance (part of
  P.Bushs agenda post war)
• Managed Care
• Refers to the assumption of responsibility and
  accountability for the health of a defined
  population and the simultaneous acceptance of
  financial risk.
• Care is population based ( imp. Change of
  approach)

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Changes in Health Care

• MANAGED CARE
• COST CONTAINMENT
• CONTROL OF RESOURCES
• RESTRUCTURING OF HEALTH CARE ENVIRONMENT
• NURSING CASE MANAGEMENT

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Managed Care

• Care is population based
• All participants are held accountable\
• Information to assess value will be necessary
• Primary care is of central importance
• Interdependence is very important
• Contracts are used to detail finances and
  delivery of care

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Nursing Shortage

• Aging work force
• Image
• Retention
• Emigration of internationally trained
  (controversial)
• Nurses need to be politically active

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Leadership Theories

• Great Man theory
• Charismatic theory
• Trait theory
• Behavioral school
• Autocratic
• Democratic
• Laissez-faire
• Eclectic
• Situational theory
• Contingency Model

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• Life-Cycle theory
• New theory of leadership
• Transformational leadership
• Connective leadership

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Leadership Style and Leader Behaviors Leader
centered Group-centered Use of Authority
by Leader abdicrat autocrat
Freedom of the
group Tells Sells Tests Consults Joins
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TRAITS OF A MANAGER

• HAVE AN ASSIGNED POSITION WITHIN THE FORMAL
  ORGANIZATION
• HAVE A LEGITIMATE SOURCE OF POWER DUE TO THE
  DELEGATED AUTHORITY THAT ACCOMPANIES THEIR
  POSITION
• ARE EXPECTED TO CARRY OUT SPECIFIC FUNCTIONS,
  DUTIES, AND RESPONSIBILITIES
• EMPHASIZE CONTROL, DECISION MAKING, DECISION
  ANALYSIS, AND RESULTS
• MANIPULATE INDIVIDUALS, THE ENVIRONMENT, MONEY,
  TIME, AND OTHER RESOURCES TO ACHIEVE ORGANIZED
  GOALS
• HAVE A GREATER FORMAL RESPONSIBILITY AND
  ACCOUNTABILITY FOR RATIONALITY AND CONTROL THAT
  LEADERS
• DIRECT WILLING AND UNWILLING SUBORDINATES

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TRAITS OF A LEADER

• OTHERS OFTEN DO NOT HAVE DELEGATED AUTHORITY BUT
  OBTAIN THEIR POWER THROUGH OTHER MEANS, SUCH AS
  INFLUENCE
• HAVE A WIDER VARIETY OF ROLES THAN DO MANAGERS
• ARE FREQUENTLY NOT PART OF THE FORMAL
  ORGANIZATION
• FOCUS ON GROUP PROCESS, INFORMATION GATHERING,
  FEEDBACK, AND EMPOWERING

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Traits of a Leader

• EMPHASIZE INTERPERSONAL RELATIONSHIPS
• DIRECT WILLING FOLLOWERS
• HAVE GOALS THAT MAY OR MAY NOT REFLECT THOSE OF
  THE ORGANIZATION

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ETHICS IN LEADERSHIP

• MANAGEMENT WITHOUT VALUES, COMMITMENT, AND
  CONVICTIONS CAN ONLY DO HARM
• WITHOUT INTEGRITY TRUST IS IMPOSSIBLE

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Tnansformational vs. Transactional Leader

• Transactional is traditional, one person steps
  up, leader and follower/s have separate but
  related purpose
• Transformational leader mobilizes others, has a
  vision, and is values oriented

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Contingency Theories

• Fiedlers theory
• Match the leadership style to the situation
• Situational leadership theory
• Expansion of above theory looked at four
  leadership behaviors matching four types of
  followers
• Roles and Functions of Nursing Manager
• Read through the roles not on test

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Characteristics of Organizations

• All organizations resemble one another
• Organizations are a cluster of suborganizations
• Organizations have similar problems
• Organizations have cylces
• Organizations have crises
• Some organizational goals are easier to meet than
  others

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Organizations - Theory

• Classical Theory
• Division and specialization of labor
• Chain of command
• Organizational structure
• Span of control
• Bureaucracy
• Neoclassical
• Humanistic
• Systems theory
• Closed or open

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Types of power

• Coercive
• Reward
• Legitimate
• Expert
• Referent
• Information
• connection

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Power and Leadership

• Image as power
• Power and professional influence
• Power plus vision
• How can nurses become more powerful?
• As individuals?
• As a group?

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Political Influence

• Allocation of scarce resources
• Interpersonal endeavors
• Collective activity
• Analysis and planning
• Image

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Political Action Framework

• Politics in the workplace
• Politics in government
• Financing
• Organizational politics

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• Contingency
• Matches structure to environment
• Chaos
• Based on continuous change
• Health care organizations
• Types of Ownership
• Types of organizations
• Organizational Structure
• Horizontal
• Vertical
• Hybrid
• Matrix
• Parallel
• Shared governance

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• Strategic Planning
• Values
• Vision
• Mission Statement
• Philosophy
• Goals
• Writing Mission Statements