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NSG Leadership..priyanka Dii
NSG Leadership..priyanka Dii
INTRODUCTION
Health care system and hospital structure has undergone major change in recent years. Along with it, nursing
organizations too have undergone changes. Nursing as a profession , involves more than day-to-day care of
individuals i.e., administration, supervision, etc. Thus, there is a need for effective leadership in nursing at all
levels to ensure successful cooperation and direction of group to provide high quality of health care.
In nursing, the need for leadership is present even at the grassroots level. The student nurse, the ANM and
the staff nurse are in potential leadership position, a person in which they can make a difference. It is
surprising that many nurses still believe that only senior people in organizations can be nurse leaders. In the
following section of the unit we are going to discuss the definition and leadership skills required. We shall
then go to functions of leader..
DEFINITION:
According to Allen:
"Leadership is the activity to persuade people to coordinate and co-operate in the achievement of a
common objective."
Chester I Bernard:
"Leadership is the quality of the behaviour of individuals whereby they guide people or
George Terry:
Ralph, Stogdlll:
"The Process of influencing the activities and efforts of an organized group towards goal
NATURE OF LEADERSHIP
Traitist – superior individuals who would lead in whatever situation or time they might find them self.
ELEMENTS IN LEADERSHIP
PRINCIPLES OF LEADERSHIP
Learn to fight
Do it right
Expect the worst
Pull together
Show the way
Know the facts
Size the day
Do it better
Keep them guessing
MODELS OF LEADERSHIP
As a nurse administrator, yo11 have come across various models of leadership. We have described here four
models. These are:
Trait Model
Situational Model
Behavioral (Style) Model
Tridimensional Leader Effectiveness Model
Trait Model
a) A forceful personality
c) Efficiency'
Situational Model
According to this approach, a leader is the product of a given situation and his behaviour may, in fact, vary
from one situation to another. This theory includes the traits of the man (qualities and motivations), the role
expectation of the group, and the social forces at work (external factors)the at bring forth and shape the
leadership potential. Combining these three factors, we see the emergence of five kinds of leaders:
a) Natural Leader: He becomes a leader though lie does not seek the role; it is thrust upon him
by the group and by the tide of events.
b) Charismatic Leader: He is an authentic hero in the eyes of his followers for he can do no
wrong. He inspires people to make any sacrifice--even their lives for the cause.
absence of the above three and this leader is in a tenuous position of walking a tightrope for existence.
e) Leader by force: His power speaks through the muzzle of a gun. He dominate others through
fear. He is ruthless in suppressing opposition. He does not rule long, as this type of leadership contains
within itself the seeds of its own destruction.
The situational theory states that the leader must have insight and flexibility. he must be aware
of and assess the force in him self, the group members and the situation.
The classic research done by Lewin, Lippitt and White (1968) on interaction between leader and group.
According to this model a leader behaves according to certain role expectations of the group. According to
these role expectations, traditional leadership theorists say that every leader can be identified by one of the
four basic styles:
a) Democratic: The leader is a catalyst for group decision-making and shared responsibility.
b) Laissez Faire: The leader leaves all decision-making and responsibility to the group.
f ) Manipulative Leadership
g) Expert Leadership
h) Super Leadership
Hersey and Blanchard were greatly influenced by Reddin in their Tri-dimensional Leadership Effectiveness
Model. This seems to be a further synthesis of all previous work. In Hersey and Blanchard's Model,
effectiveness is a continuum. The degree of effectiveness or ineffectiveness is measurable. What is the
crucial situational factor? The maturity level of the followers is the crucial factor in the situation. Hersey and
Richard's Situational Leadership Theory (to be hereafter known as Situational Leadership Theory) is a
curvilinear relationship between task behavior and relationship behavior and maturity. That is, there is an
interplay among:
c) The maturity level that followers exhibit on a specific task, functions, of objectives that the leader is
attempting to accomplish through the individual's or the follower group's own initiative.
S 1 - Telling: One way communication; the leader defines the roles of the followers and tells them what,
how, when, and where to do various tasks.
S2 - Selling: Most of the direction is still provided by the leader. He attempts a two way communication and
gives socio-emotional support to get the followers psychologically to agree to decisions that have to be made.
S3 - Participating: The leader and followers share decision making process through two-way communication
and high degree of facilitating behaviour from the leader, since the followers have the ability and knowledge
to do the task,
S4 - Delegation: The leader lets the followers run their own show, they direct their own behaviour.
STYLES OF LEADERSHIP
As a nurse manager you will learn various styles of leadership so that you can judge which is best in Nursing
profession specially when you are in a clinical field.
a) Autocratic: Takes all decisions and assigns all responsibility to himself (Aurangzeb, Tipu, Ashoka, Shah
Jahan)
b) Democratic: The leader is a catalyst for group decisio3making and shared responsibility (La1 Bahadur
Shastri)
c) Laissez Faire: The leader leaves all decision making process and responsibility to the group. Uninvolved
(King Farod)
d) Charismatic Leadership
Authoritarian leaders use their power to influence their power and tend to be task oriented. Such leaders are
dictators and do not allow the subordinates to reason. They give orders and assign tasks without taking the
subordinates into confidence. Authoritarian leader is found in dictatorship state (one man show).
Authoritarian leader has more absolute power. He alone dictates the activities of the members, serve as
ultimate judge and purveyor of rewards and punishment. Fate of each individual is in his hands. Group
involvement is less and goals are not clear. Inter communication between members is little. Leader is the
keystone, group structure falls with the fall of leader. It causes more frustration, aggression, hostility and
conflict. The authoritarian leader maintains strong control over people in the group. This control hay be
benevolent and considerate (Paternalistic leadership).
Decision of autocratic leader is fast and time saving, One-man show frame work is rigid, more emphasis is
on obedience. Authoritarian leaders give orders often and expect group members to obey these orders.
Directions are given as commands, not suggestions. Criticism is more common from authoritarian leader.
Many authoritarian leaders are also quite punitive. Authoritarian leadership emphasizes difference in status.
He makes the status of leader higher than the status of group members. This reduces the degree of trust and
openness between leader and group members. Productivity is high. Dependency needs are usually met but
growth and autonomy needs are not. Authoritarian leadership is particularly suitable in crisis situations when
clear directions are the highest priority-. It is often referred today as a directive or controlling style of
leadership. It is useful when group is not educated or emergency situations are there. There is rigid control
over subordinates and one wav communication. "Carrot and stick" method is used to motivate.
b) Democratic Leadership
Democratic leader exercises his power in different way. He seeks maximum involvement and participation of
every one in-group activity and in determination of group objectives. He spreads responsibility. He seeks to
encourage interpersonal relationship in the group and reduce intra group tension and conflict. Leader has
focal importance in the group. All members are inter-related. He serves as the agent of the group, mandate of
the group. Group go along without him.
Democratic leader is work oriented and group oriented and gives considerable freedom to their followers in
their work. Decision is time consuming and may not come to conclusion. Role of leader is facilitative and
counselling. It is useful when workers are well trained, more responsible, acknowledgeable, and independent.
Democratic leader allows members to participate in decision making process. Maintaining good interpersonal
relationship with the subordinates, gives a sense of belongingness. There should be concern and
consideration for each member as a unique individual. Leadership style adopted by manager would depend
on his values system; degree of confidence in his subordinates and his tolerance for ambiguity. It also
depends on his perception of his role, his own standing in the group and degree of maturity.
Factors influencing the subordinates are:
Manager exercises minimum control over the group members. The group is left to itself to try for goal
achievement without any interference from the leader or if his assistance is sought. It allows the members to
develop themselves by giving them an opportunity to try and find ways and means of achieving group
objectives. Lack of.contro1 over the group members lead to non attainment of specific goals and objectives
for which the group is created. If there is clash of interest among members of group objectives, it may result
in serious group conflict and loss of group cohesiveness. It permits the members of the group to do whatever
they like and represents an absence of formal leadership.
d) Charismatic Leadership
The charismatic leader is a man of "specific gifts of the body and spirit", these gilts are supposed to be super
natural and are not possessed by anyone else. The charismatic leader is a man with "hypnotic" effect on
others. Well known examples of this form of leadership are found in Jesus Christ, Buddha, Gandhi. In this
kind of leadership the leader and the followers are not usually dependent. The leader has his own 'inner force'
and lie needs nobody's direction or advice.
J.M. Burns defines two types of leadership: transactional and transformational. Burns state transactional
leadership occurs "When one person takes the initiative in making contact with others for the exchange of
valued things" that may be economic, psychological or political. It is a bargain or contract that aids the
individual differences of both the leader and follower.
In Transformational leadership situations, the leader or follower have the same purpose. Transformational
leadership occurs ‘when one or more persons engage with others in such a way that leaders raise one another
to higher levels of motivation and mortality’.
EMERGE OF LEADER
A person who emerge as a leader among the group is a very unique task. The emerging leader depends upon
a number of factor.
Leadership training – Training programs are offered to manager to several to several or varied leadership
situation and teach them knew to tackle them. The situation are partly real. The trainer create a situation .The
leadership training gives deep insight and experience to the manager and an appropriate attitude and
behavior.
Internal organization exposure- another important reason which help the person to emerge as a leader is the
internal organizational exposure. The critical situation called for application of leadership abilities by the
administrators to overcome the situation to see that a leader emerges from the person they have to be put in
charge of committees , task of project, coordinator, control and employee grievances , which gives an
opportunity for the manager to develop into a very good leader on emerge as a leader in the group.
Autonomy and Accountability - administrator may be able to sharpen their leadership abilities. They should
allow the large number of freedom to evolve their own method or tackling situation calling for critical
leadership abilities
Opportunities to interaction – administrator should also have opportunity to interact with their subordinates
in amore intense and continues manner. So that they cant talk or listen to their sub ordinates
Setting challenging but realistic goals- he has to work very hard to achieve the objects the in born leadership
to emerge as a leader.
Job rotation –she may also a emerge as a leader if they help the followers , colleagues and junior to develop
leadership skills by the process of systemic rotation of their role.
To be effective leader, the nursing administration needs to know the principles of team
leadership, administration and supervision and motivational theory; to identify the personnel needs and their
differences as individuals. The following are the techniques which can be applied by the nurse administrators
to be effective leaders:
a) Planning and Organizing: These are the foremost principles of administration and very important for
effective leadership. For the nurses. at every level, it is important to plan and organize the work schedule
according to availability of personnel and materials.
b) Division of Labour: The work assigned to the subordinate must be defined and should be recorded
because clear-cut directions by the nurse leader enables the subordinates to function properly.
c) Guidance: Negative criticism should be avoided. Proper teaching and guidance with counselling will help
the group to accomplish their objectives.
d) Effective Communication: It is very important for a leader to have a clear idea about what she wants to
say and how to say it. Good communication is needed for understanding, cooperation and unified action.
e) Cooperation and Coordination: As a part of effective leadership, cooperation and coordination among
the leaders and the subordinate employees is essential. If the leader keeps the group informed about the
various ward and hospital activities the subordinate feel satisfied and also the group will cooperate with the
leader.
f) Encouraging Participation: 'The effective leader first identifies the individual capabilities of subordinates
and then provides opportunities to them to participate in decision making.
g) Supervision: Democratic supervision may be in the form of observation and is one of the most important
responsibilities of an effective leader. It helps to:
h) Evaluation: It is a continuous process of assessment of the personnel or their work. It also helps them to
improve in those areas in which they are weak. Self evaluation by the nurse leader is also a must be needed.
Good judgment
Insight and vision
intelligence
Ability to accept responsibility
Effective communication skills
Well balanced personality
Sense of humor
Sensitivity to signs of stress among nurses in intensive care situations
Dealing with burn-out
Professional development
Welfare of nurses
Recognition of nurse's work
Clinical specialization of staff
Leadership skills in nursing can be learnt, acquired and improved Development of leadership takes place in
various ways which help one to create his/ her leadership abilities. Ways which help in the development of
leadership qualities are;
2) Working as an assistant to an effective and reputed leader and observing her behaviours
6) Correspondence courses
FUNCTIONS OF LEADER
Primary Functions
a) Executive: He is the top coordinator of the activities of the group. He determines and execute the policies
and assigns work to other group members.
b) Planner: He decides the way and means by which the group shall achieve its ends and may involve
immediate and long-range future steps to achieve the goal. Leader alone knows entire plan and group
members are appraised only of segments.
c) Policy-maker: He establishes group goals and policies and these may arise from sources i.e 1. from above
(higher authority)2. From below( Group members) 3. Leader himself
d) Expert: Leader is a source of readily available information. With a high degree of specialization of
functions, leader of formal groups come to learn more about technical assistants and advising, In informal
and spontaneous technical groups, the man who demonstrates the greatest and latest technical knowledge
relevant to the group goals become the leader.
e) External Group Representative: All members of a large group deal directly with other groups and other
people out side the group, is impossible, the leader assumes the role of representative of the group in its
external relation. He is the official spokesman for the group and outgoing and incoming communications of
the group are channeled through him.
f ) Controller of Internal relations- He governs the group structure and functions as the controller of in-
group relation e.g., (1) Internal ;elations are primarily channelized through him, (2) Leader may remain
remote for all .
g) Purveyor of Rewards and Punishments: Particularly, from a members points of view, it is the leader
who has the power to apply reward, baring punishments, which enables him to exercise control over the
group members. Sometimes the rewards and punishments are concerned with action, e.g., promotion,
reduction in status or dismissal.
h) Arbitrator and Mediator: He has to act as both judge and conciliator, it is within the power of the leader
to reduce or to encourage factionalism within the group depending upon what personal aims he seeks to
achieve.
ACCESSORY FUNCTIONS
Exampler: In same groups he may serve as a model of behaviour for the group members thus providing
them with a concrete indication of what they should be doing, e.g., military leader.
Symbol of the Group: Group unity is likely to be enhanced by any factor that makes the group distinct
entity, like uniform or badges. Leader plays similar role by providing a kind of cognitive focus for group
unity and group continuity.
Substitute for Individual Responsibility: He plays an important role for the individual member in relieving
him of responsibility for personal decisions md acts that he wishes to avoid. The individual puts his trust in
the leader and lets him make the decisions.
Ideologist: He may furnish the ideology of the group. He serves as a source of beliefs, values and norms of
individual members. The official ideology of group reflects the thinking of the rank and file membership.
Father Figure: Leader serves as a perfect focus for the positive emotional feelings of the individuals. He is
the ideal object for identification, for transference. Feeling of submissiveness, when he does not fulfill this
need immediately, the followers may "remake" him to fit into their needs.
Scapegoat: He may constitute an ideal object for positive rational feelings, so he may serve as a target for
the aggressions of the frustrated, disappointed and disillusioned group and it is the opposite side of the coin,
he may be blamed in the event of failure too.
DEFINITION:
STUDY:
According to Webster, The study is defined as an act process of acquiring by one’s own effort
knowledge of some subject.
Study is defined as planned effort on the part of the learner in solving problem, in getting knowledge or
understanding or in acquiring certain abilities.
Directed Study:
Directed study is the term that applies to the actual direction by the teacher of those student activities
concern primarily with the solution of the problem, the attainment of knowledge and understanding or the
acquisition of abilities through planned effort on the part of the learner.
Directed study is providing opportunity for students in class and outside of class to develop increasing
the independent or self directed study.
1. Self/ directed study is important for the student to continue their learning.
2. It helps to continue study of nursing and related area knowledge as long as the practice of nursing for
nurse practioner.
3. It is possible for students never to discover the satisfaction of self- directed study in the solution of self-
selected problem nor to know the attributes the library, because they are able to complete their course
without much of their initiative and own development.
4. Directed study is necessary which provides guidelines or outlines to the students regarding their
development.
5. It aid the students in retaining and developing technics for lifelong learning.
6. It encourages the student to search, to create, to organize and to interpret acquires lifelong technics.
7. It directs the student in development of habits effective study habits.
The reading is one of the most important tools of learning for nursing student. The ability to
comprehend what is read in direct ratio to the ability to read effectively. The student who cannot read
comprehendingly and speedily will be handicapped seriously throughout her years.
There are two main types of reading: the rapid and thoughtful. In rapid reading, the reading is
done for large ideas; its skimming, and is used in all types of research. The other type, the thoughtful type is
not necessary slow type of reading, for thoughtful reading does not always mean comprehensive reading. In
thoughtful reading the students as she reads and tries to establish associations and mental summaries.
Analysis of specific reading difficulties and remedial practice to overcome those difficulties.
Persistent effort and practice to read more rapidly and more understandingly .
It may be necessary to refer the student to special reading clinics for diagnosis of difficulties .Three main
suggestions for improving reading may be helpful to the teacher
The student should have something definite in mind to look for such as a point of information, answer
to specific question solution to problem.
Outlining
Underling and making marginal notes
Reading summary first, and then looking for improvement points when reading the entire chapter.
Upon completion of paragraph, summarizing what has been read.
Gradually mastering the fundamental vocabulary by digesting all words, using dictionary etc.
2 .Most students can increasing their rate of reading with surprising facilities
Most difficulties, ranging from the least to the most series, are thought to be primarily to the failure of the
student to acquire good reading technics. If all serious reading disabilities in the student have been ruled out
by the proper diagnostic reading tests and eye examination, the student can improve her reading speed
considerably.
The following suggestions may help the student to increase the speed of reading,
In order to understand the meaning, the student should make as many association as possible. New
information or points of view should be related to want to what is already known.
A. Material should be recalled and reviewed immediately after reading. The student should continue to
recall until the topic is familiar.
B. The student can be facilitate over learning by well-spaced reviews. These take place immediately after
study and more briefly preparing the next lesson.
Note making:
Note making should represent what goes on in the mind of the leaner. Good notes express in the
students own word’s high points of the teacher’s lecture and are achieved through the use of the sense of
hearing, the sense of touch and sense of vision, all of which influences learning.
The following suggestions should be offered to the student as guide to the successful taking of notes.
Memorizing
The amount of memorization varies greatly from one course to another when verbatim is necessary , a
teacher should expect to help the students by showing them the most efficient ways of doing it. She should
aid them in deciding what to memorize student should learn material in the form and the manner which they
will be used.
Students are inclined to clutter up their minds with worthless materials. They should not be encouraged to be
an encyclopedia . but to be its master. This memorizing can be distinguished by the abilities but not by the
acquired information students should be taught to distinguish between what should and should not be
remembered . they should contribute to thinking should be permanently retained eg- difficult to remember
the principles and facts , so it should organized into meaningful units of thought instead of being
remembered as unrelated details.
The students should retain clear cut, accurate and vivid impression of those things that are to be
remembered.
Using Library
Most of the information gained from experience in the study hall library combination . few students
will have browsed enough in a library to discover the wealth of fugitive material that most libraries contain
yet still the library is the one of the effective means to learn.
Research and experience have shown that a definite need does exist for instruction in the use of the library.
The librarian may give the student formal instruction in the technique of library use , and she should guide
the student when she needs it. The teacher can also reinforce the students by giving assignment.
Planning prevents waste of both time and energy. The teacher should assist the student to make a
schedule so that time will be properly allocated for each subject. The plan should not be rigid or fired but
flexible. Planning and budgeting time includes a consideration of all the activities study , leisure , sleep ,
routine habits.
Assignment
One of the best opportunities that the teacher has to direct studies, of course, through assignment . if
properly given, the assignment creates the right mind set, states the objectives , suggest methods of attacking
the work and provides study materials
Knowledge of Progress
Learning without knowledge of progress is blind. The student must know whether or not she is progressing
satisfactory. If she is doing poorly, the teacher must direst. Individuals conferences, observation of students
work, examination of notebooks, reports and test at the end of units or subdivision of units improves her
progress
The teacher should be familiar with each individuals methods of learning, in order achieve effective study
habits. Proper diagnosis of difficulties and means of correction is a continuous process . the various methods
in diagnosing students are questionnaire , analyzing students schedules, personal interview , careful
observation of students at work and testing.
SUMMARY
In this seminar, we discussed and learned about the definition, nature, elements, theories, styles,
techniques, qualities and function of leadership and also about definition, needs, and aids of study habits.
CONCLUSION
Health care system and hospital structure has undergone major change in recent years. Along
with it, nursing organizations too have undergone changes. Nursing as a profession, involves more than day-
to-day care of individuals i.e., administration, supervision, etc. Thus, there is a need for effective leadership
in nursing at all levels to ensure successful cooperation and direction of group to provide high quality of
health care. True leadership qualities / skills and in convincing and influencing people. These can be
achieved by demonstrating high quality of work and good communication skills by the leader.
Study habits are very important for regular study, improving learning capacity, keeping interest
and memory.
BIBLIOGRAPHY:
K.P Neeraja.Text book of communication and education technology for nurses.1st ed. Jaypee publisher:New
delhi;2011.p.602-604
At the end of seminar the group will be able to acquire knowledge regarding training for nursing
leadership and development of effective study habits and able to apply the knowledge in clinical practice.
Specific objectives:
1. Define leadership
11. Explain the aids or measure to improve the effective study habits
VSPM’S COLLEGE OF NURSING & RESEARCH CENTER
LATA MANGESHKAR HOSPITAL, DIGDOH HILLS, HIGHNA ROAD,
NAGPUR
SEMINAR
ON
MRS. BARANYA. S