Nursing

Leadership &
Management

Conceptual Paradigm of Leadership and

Management

What is Leadership?
Are you a leader?

Leadership
A process of influence
It is the interpersonal process that
involves motivating and guiding others
to achieve goals
the process where the nurse influences
one or more persons to achieve specific
goals in the provision of nursing care of
one or more patients. It is a
multidimensional process. (Gardner)
doing the right thing
relationship

Leadership
Traits and actions of a leader

L
E
A
D
E
R

lead, love, learn

enthusiastic, energetic
assertive, achiever
dedicated, desirous
efficient and effective
responsible, respectful

Leadership
Core Traits of Leaders
1.Guiding vision able to see a picture of
the desired future
2.Passion enthusiastic about future
possibilities.
-ability to inspire people
3. Integrity
4. Curiosity facilitate change
Other traits:
flexibility, intelligence, ability to support
others,
self-confidence, desire to
lead

Leadership
3 dimensions :
Leader follower situation
Types of followers (Kelley 1998)
1.Effective or exemplary followers

Self-leaders, dont require close supervision,

function independently, think critically, challenge
the ideas of a leader, suggest alternative courses
of action, invest time and energy to arrive at the
best possible solution for the group

2.Alienated followers

Independent, think critically but passive, rarely

invest time to suggest alternative
solutions/approaches

Leadership
3. Yes People
-dependent,

uncritical,
active
in
their
behavior(most dangerous to a leader because
they are most likely to give a false positive
reaction and give no warning of potential pitfalls)

4. Sheep
- dependent & uncritical, passive, they simply do
as they are told by their leaders

Leadership

Elements
Vision
Communication skills
Change
Stewardship
Developing and renewing followers

Leadership
Types of Leadership
1.Formal leadership by virtue of
appointment to the position
2.Informal Leadership

Leadership theories
Early Leadership theories
Trait theories
Behavioral Theories
Situational/contingency Theories

Leadership theories

Early Leadership theories

Great Man Theory

Asserts that some people are born to

lead whereas others are born to be led
Great Leaders are born and not made
All leaders were men and all were great
Leadership roles were determined by
their genetic & social inheritance
Portrays leaders as HEROIC, MYTHIC &
DESTINED to rise to leadership when
needed.
Aristotelian philosophy

Leadership theories

Trait Theory

Assumes that some people have certain

characteristics or personality traits that
make them better leaders than others
Common traits to all good leaders:
honesty, trustworthiness, integrity. fair,
skilled communicator, goal oriented,
dedicated, hard working, committed
Pope John Paul II, Mother Teresa,
Mahatma Gandhi

Leadership theories

Behavioral Theories

leaders are made not born

Anyone can learn to be a leader
Concerned with what leaders do and act,
the actions of the leaders and not the
mental qualities and traits make them
leaders
Kurt Lewin psychologist proposed that
the workers behavior is influenced by
interactions between personality, the
structure of the primary work and the
socio technical climate of the work place.

Leadership theories

Lewins leadership Style

1.Autocratic leadership
2.Democratic leadership
3.Laissez-faire leadership

Leadership theories

Lewins leadership Style

Autocratic/Authoritarian/bureaucratic/dire
ctive
Uses power to command and control others
Centralizes decision making(downward
communication)
More concerned with task accomplishment than
people
Uses coercion
Promotes hostility and apathy
Criticism is punitive
Emphasis is on difference in status (I and you)

Useful in crisis situation

Leadership theories
Democratic/consultative/Participative
Allows others to participate in decision
making
People oriented/focus on human relation
Economic and ego awards are used to
motivate
Open communication
Criticism is constructive
Emphasis is on we

Leadership theories
Laissez-faire/Permissive/Ultraliberal
let alone style-leader abdicates
leadership responsibility and leaves
workers without direction, supervision or
coordination
Appropriate when problems are poorly
defined and brainstorming is needed to
generate alternative solutions

Leadership theories

Situational / Contingency Theories

-state that a leadership style should vary
according to the situation or the individual
involved or to the environmental factors

Fred Fiedler (Fiedlers Contingency

Approach)
-leader behavior depends on the interaction of
the leaders personality and the particular
needs of the situation
- No one leadership style is ideal for every
situation

Leadership theories

Fielders Theory
-focused on the personality and relationship
between the leader and group members,
programming of groups assignment and
positional power of the leader
-task-oriented leadership style
-the leader has great influence or power

3 aspects of the situation that needs to be

considered:
1.leader-member relation
2.Task structure
3.Position power

Leadership theories

Paul Hersey and Kenneth Blanchards

Situational theory
-the effectiveness of a persons leadership
style depends not so much on the leader
but on the follower the followers maturity
should be assessed in order for the most
appropriate leadership style to be
implemented.

Leadership theories
4 leadership style(based on task relationship)
1.Directing/Telling leadership style ( high task/low relationship behavior)

Leader defines the roles & task of the followers and supervises them closely
Decisions made by the leader
Communication is one way

2.Coaching/Selling leadership ( high task/high r.b.)

- Leader defines the roles & task but seeks ideas &
- Decisions remain the leaders prerogative
- communication: two way

suggestions from the followers

Leadership theories

3. Supporting/Participating leadership ( low

task/ high r.b)
- leader passes day to day decisions , such as task
allocation & processes to the follower
- leader facilitates and takes part in decisions, but
control is with the follower

4. Delegating leadership ( low task/low r.b)

-leaders involve in decisions and problem solving but
control is within the follower
- the follower decides when and how the leader will be
involved

Leadership theories

Robert house (Houses Path- Goal Theory)

-leader can affect the performance, satisfaction and
motivation of a group through rewards, clarification of
paths to goals and removal of obstacles in work
performance

Leadership Styles
1. Directive leadershipspecific advice is given,
ground rules and structure are established
2. Supportive leadership-- good relations are
promoted
3. Participative leadership decision making is
based on consultation with the group & information
is shared
4. Achievement-oriented leadership-- challenging
goals are set and high performance is encouraged

Leadership theories

Contemporary Leadership Theories

Transactional
Transformational
Servant leadership
Principal agent theory
Human and social capital theory
Emotional intelligence driven leadership
Authentic leadership
Thought leadership
Quantum leadership
Cultural bridging

Leadership theories

Transactional Leadership

Involves an exchange in which both the leader

and the followers get something
Principle: to motivate by means of exchange
process
Uses rewards to reinforce behavior
Focus: accomplishment of task
The leader is a caretaker who set goals for
employees, focuses on day-to day operations
and uses management by exception
Do as I say and you will get a raise
Meet this quota or you will get fired

Leadership theories

Transformational Leadership

Focus: process
Promotes employee development
Attend s to needs and motives of followers
Inspires through optimism
Provides intellectual stimulation and
encourages followers creativity
Uses role modeling
Provides sense of direction and encourages
self-management
High level of commitment

Leadership theories

Servant Leadership

Robert Greenleaf
Serving others is the number-one priority
Leaders consider the needs of their followers and
empower them to achieve organizational goals

Qualities of servant leaders:

1. Listener/understanding
2. Open minded/ non judgemental
3. Ability to deal with difficult situations
4. The belief that honestly sharing critical
challenges with all parties and asking for their
input is more important than personally
providing solutions

Leadership theories
5. Being clear on goals and good at pointing the
direction toward goal achievement without
giving orders
6. The ability to be a servant , helper, and
teacher first and then a leader
7. Always thinking before reacting
8. Choosing words carefully so as not to damage
those being led
9. The ability to use foresight and intuition
10. Seeing things whole and sensing
relationships and connections

Leadership theories
Principal Agent theory

not all followers are inherently motivated to

act in the best interest of the principal
Followers may have informational
(expertise/knowledge) advantage over the
leader as well as their preference s, which
may deviate from the principals preferences
Risk: agents will pursue their own
objectives/interest
Principals must identify and provide agents
with appropriate incentives to act in the
organizations best interest

Leadership theories
Human and Social Capital Theory

Human capital refers to a groups collective

knowledge, skills and abilities
Social Capital refers to relationship

Determines what a group of employees can and

will accomplish together

Recognizes that individuals and organizations

invest in human capital in anticipation of
gains in the forms of increased productivity
and financial returns

Leadership theories
Emotional Intelligence Theory

Refers to the ability to use emotions effectively and

is required by leader-managers in order to enhance
their success

5 Components of Emotional Intelligence

1. Self-awareness ability to recognize and understand ones
2.
3.
4.
5.

moods, emotions, and drives as well as their effects on others

Self-regulation the ability to control or redirect
disruptive impulses or moods as well as the propensity to
suspend judgment
Motivation passion to work for reasons that go beyond
money or status
Empathy the ability to understand and accept the
emotional make up of other people
Social skills proficiency in handling relationships and
building networks

Leadership theories
Authentic Leadership Theory

Suggests that in order to lead, leaders must be

true to themselves and their values and act
accordingly
Positive leadership style
It is the leaders principles and their conviction
to act accordingly that inspire followers

5 distinguishing characteristics of authentic leader

1. Purpose
2. Values
3. Heart
4. Relationships
5. Self-discipline

Leadership theories
Thought Leadership Theory

Refers to any situation whereby one individual

convinces another to consider a new idea,
product, or way of looking at things
Thought leaders recognized for their
innovative ideas and shows confidence to
promote those ideas
Attract followers not by any promise of
representation or empowerment but by
their risk taking and vision in terms of
being innovative

Leadership theories
Quantum Leadership Theory

Used to better understand dynamics of

environments such as health care
Suggests that the environment and context
in which people work is complex and dynamic
and that this has a direct impact on
organizational productivity
Control is not the issue; rather, change
dominates the climate

Quantum leaders
Recognizes continual movement and change
occur in reality and creativity and innovation
are at the core of good work performance

Leadership theories
Quantum Leadership Theory
As quantum leaders, nurses:
1. Offer creative and innovative solutions
2. Seek to discover educational opportunities
instead of relying on past methods of
accommodating new nurses in the work force
3. Provide mentoring opportunities and expert
preceptorships, quantum leaders can effective
help all involved to provide better care for
patients

Leadership theories
Cultural Bridging
Cultural bridge new role of the leadermanager
Becomes a requirement as our society
becomes more diverse
It helps understand the differences among
individuals or groups

Leadership Skills

1. skills in personal behavior

Requires sensitivity to the feelings of
others
Identification with the needs of the
group
Acceptance of other peoples
suggestion
Helping others feel important

2. Communication Skills

Leadership Skills

3. Organization skills
Willingness:
to assist the group in making plans &
objectives
To share responsibilities &
opportunities
To implement plans, follow-up &
evaluate results
To participate in problem-solving

Leadership Skills

4. Skills in self analysis

Means awareness of personal
motivations of own strengths &
weaknesses & willingness to improve
them
Includes assisting the group in
recognizing & utilizing the Filipino values
essential to caring for their patients

primary Skills for nursing leaders

1.
2.
3.
4.
5.
6.

Communication Skills
Decision-Making Skills
Time Management Skills
Change Management Skills
Conflict resolution Skills
Team building skills

Leadership
Position
Selected or allowed by a group of followers / may or may
not have official appointment to the position
Power base
Comes from knowledge, credibility and ability to motivate
followers
Goals/visions
Arise from personal interests and passion that may not be
synonymous with the goals of the organizations
Innovative Ideas
Developed, tested, and encouraged among all members of
the group

Leadership
Risk level
High risk, creativity, innovation
Degree of order
Relative disorder seems to be generated
Nature of Activities
Related to vision and judgment
Focus
People
Perspective
Long-range, with an eye on the horizon

Leadership
Degree of freedom
Freestanding and not limited to an organizational position
of authority
Actions
Does the right thing