ROLE OF RESEARCH, LEADERSHIP AND MANAGEMENT

INTRODUCTION:

Nurse means to foster or cherish; to treat or handle with care. So, the term “nurse” suggests attendance and
service.

In 1966, Virginia Henderson gave her concept of the unique function of the nurse as follows:

 “The unique function of the nurse is to assist the individual, sick or well, in the performance of those
activities contributing to health or its recovery (or to peaceful death) that he would perform unaided
if he had the necessary strength, will or knowledge, and to do this, in such a way as to help him gain
independence as quickly as possible.”

 The root meaning of word research means ‘to search again’ or ‘carefully examine.’ Thus, research
means close and careful examination of facts and their relationship to discover new knowledge.

 “Research is systematic inquiry that uses disciplined methods to answer questions and solve
problems. The ultimate goal of research is to develop, refine, and expand a body of knowledge.”
(POLIT AND BECK,
2010)

NURSING RESEARCH:

“Nursing research is a scientific, systematic and orderly process to find out solution for problems concerned
to nursing or generating and refining the nursing knowledge to improve quality of nursing care, nursing
education, and nursing administration.” (S. K. SHARMA, 2005)

Importance of research in Nursing:

Through nursing research, scientific knowledge can be developed to improve nursing care, patient outcomes,
and health care delivery system. Nurses need scientific knowledge to improve their decision making
regarding what care to provide, patients and how to implement that care. The knowledge generated through
research is essential to provide a scientific basis for description, explanation, prediction and control of
nursing practice.
Description: It involves identifying the nature and attributes of nursing phenomena and sometimes
the relationships among these problems. Through selected research methods, nurses are able to
describe what exists in nursing practice, discover new information for use in the discipline.

Explanation: In explanation, the relationships among variables are clarified reasons for occurrence
of certain events are identified. For example, research has indicated that elderly patients are at high-
risk of developing pressure ulcers related to level of mobility and support services can be used to
explain the incidence of pressure ulcers in elderly patients and this knowledge can also be used in
selecting nursing interventions to prevent pressure ulcers.

Prediction:Through prediction, the probability of a specific outcome in a given situation can be

estimated. However, it does not necessarily enable to modify or control the outcome.

Control: Control is to manipulate the situation to produce the desired or predicted outcome. Control
can be described as the ability to write the prescription to produce desired result. Nurses could
prescribe certain interventions to patients and their families to achieve high quality outcomes.
Example: Based on research of Meek (1993), nurses could prescribe slowly stock back massage to
promote comfort and relaxation in hospice patients.
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 Therefore, research enables nurses to promote high quality patient outcomes essential to the
development of the nursing profession.
Nurses’ responsibility in relation to research:
Ideally every nurse should participate in the research, but practically all should use research results to
improve their practices. All registered nurses should do the following:
1. read and interpret report of research in their own nursing fields, so that they can keep up to date
with current knowledge, and where appropriate, base their own policy and practice on their
research findings, to do this the must be familiar with research concepts and knowledge.
2. Identify areas of nursing where research is needed, nurses should be aware of the boundaries of
their knowledge and situations in which lack of information is a serious detriment to effectual
decision making.
3. Collaborate intelligently with researchers whose work brings them into contact with nursing,
assist them as possible, and particularly where patients are involved, be aware of ethical issues
which may not always be apparent to research workers themselves.
4. Discuss with patient any research in which they are asked to participate in the same way as
nurses are called upon to discuss with the patients the diagnostic and therapeutic measures
prescribed by medical staff.
In addition, a nurse teacher must:
5. Research findings as a basis for deciding what to teach and incorporate research findings into
their teaching.
6. Use research findings as a basis for deciding how to teach, make use of psychological theories of
learning and techniques of educational assessment.
7. Plan and supervise students project work in a way which will help the students to develop the
ways of thinking, questioning, observing, analyzing and testing which are the elements of
research.
In addition, nurse administrators should:
8. How information about resources (financial, human, mechanical) available for carrying out
research and be able to decide nursing research priorities, to make the best possible use of this
resources.
9. Initiate and facilitate research in areas where research is needed, provide the appropriate
“climate”, have sufficient understanding of research methods to know what type of research is
appropriate to the investigation of particular problems and from where specialist advice may be
sought.
10. Monitor the progress of research project to ensure that the work being carried out is consistent
with the agreed objectives.
In addition, some nurses should:
11. Acquire skills in application of research techniques, so that they can make the use of existing
research tools, e.g., patient opinionate or questionnaire, personality inventors, to carry out similar
studies for themselves.
12. Become trained research workers capable of designing tools for nursing research, of leading unit
and multidisciplinary research teams and of taking part in planning and formulating research
policy for the nursing and midwifery profession in both intra and interprofessional capacity.
Thus, every nurse, regardless of educational preparation, can be involved in and benefit from
nursing research.

Levels of educational preparation and levels of participation in nursing research

Levels of research participation
Level of preparation Level of participation
Student nurse Consumer
BSc nurse Problem identifier, data collector
MSc nurse Replicator, concept tester
Doctoral nurse theory generator

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 Postdoctoral nurse Funded programme director

ROLE OF RESEARCH IN NURSING:

Nursing research is needed to discover, verify, structure and restructure the professional knowledge through
systematic inquiry. Research is the only way to:
 Build a body of nursing knowledge.
 Validate improvement in nursing.
 Make health care efficient as well as cost effective.

1. To mould the attitudes, intellectual competence and technical skills: Nursing is service to
individual, families and therefore, society. It is based on arts and science which mould the attitude,
intellectual competencies and technical skills of individual nurse into the desired to and to help
people, well or sick and cope with their health needs.

2. Filling the gaps in knowledge and practice: The gap exists in both nursing education and nursing
service. To meet the new challenges, investigate unsolved problems and to scrutinize the changes in
nursing, the individual nurse must actively seek to understand and apply the basic principles of
research.

3. Fostering a commitment, accountability to clientele: The ultimate goal of a profession is to

improve the practice of its member, so that services provided to clientele should have greatest
impact. This can be done by continual development of scientific body of knowledge fundamental to
its practice that can be instrumental in fostering commitment and accountability to profession and
clientele.

4. Providing basis for professionalism: The increasing awareness of nurses to include research as an
integral part of professional nursing behaviour is rapidly increasing. Research provides abstract
knowledge that is foundation for establishing nursing as a profession.

5. Providing basis for professional accountability: The quality of nursing care can be improved only
if scientific accountability becomes part of tradition. Accountability is essential for nurse teacher in
dealing with students, for nurse practitioner dealing with patients and for nurse administrator dealing
with the clients or professionals of health care delivery system.

6. Identifying the role of nurse in changing society: Nowadays consumers of health care are
recognizing health care as a right than privilege due to spiraling costs of health care, so there is a
need to evaluate the efficacy of presently existing nursing practices, in all areas to modify or
abandon the practices that have no effect on health status and provide nursing services according to
needs of clients.

7. Discovering new measures for nursing practice: Scientific studies are needed to understand,
explain the functions and forms of nursing care in meeting the needs of society and helping
individual regain or maintain health.

8. Helping to take prompt decisions by the administration to related problems: Nursing

administrators are more frequently looking to the findings from research in solving persistent
problems in organization, delivery and evaluation of client or patient care.

9. Helping to improve the standards in nursing education: Nursing educators utilize the findings
from research in structuring programs of study, in developing course contents and in designing
methods of teachings.

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 10. Defining the existing theories and discovering new theories: The primary test of nursing research
is to develop and refine nursing theories which serve as a guide to nursing practice and which can be
organized into a body of scientific nursing knowledge.

ROLE OF LEADERSHIP AND MANAGEMENT IN NURSING

Nursing is a major component of health care delivery system and nursing services are necessary for every
client seeking care. So, the nurses must be good leaders and managers to provide quality care to the patient.

Leadership:

 It is the art of getting others to do something that you are convinced to be done. The origin of the
word lead is “to go”. The verb “to lead” can be defined in several ways to guide, to run in specific
direction, to direct, to be first and to open play.
 Leadership can be defined as the process of moving individual or groups in some direction through
mostly noncoercive means.
 A leader is a person who influences and guides direction, opinion and course of action.

The leaders:

 Often do not have delegated authority but obtain their power through other means, such as influence.
 Have a wider role.
 Are frequently not parts of formal organization?
 Focus on groups process, information gathering, feedback and empowering others.
 Emphasizing interpersonal relationships.
 Direct willing followers.
 Have goals that may or may not reflect those of the organization.

Need of leadership in nursing:

There is a need to develop leadership skills in nursing because:

Raises the consciousness of the nurses: The nursing leadership is required to raise the consciousness of the
nurses through an ongoing critique of present system and philosophical and practical rationales for
fundamental change based on nursing values.

For team building: Leadership techniques are required for team building at the organizational level,
ensuring success in all aspects of nursing and maintaining high quality in areas of nursing services, nursing
education and nursing administration as a whole. It is needed to align employees in support of goals, for
group interactions and blend efforts of diverse specialties.

Foundation block for nursing practice: Leadership skills are foundation block for nursing professional
practice. Nurses can exercise leadership in various ways. It is not limited to formal role. Nurses may be able
to lead at bedside in client teams and management teams.

Increase the body of knowledge: It helped the nurses to increase knowledge of business, human resource,
organizational behavior and health care system issues in addition to clinical knowledge and skills. She can
practice leadership skills if she knows public speaking project planning, management of resources and
developing resolutions and position papers.

For advocacy in nurses: leadership is required to convey the standards and ethics of nursing profession
and advocates for and contributes to advances in nursing education.

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To provide directions: leadership is required directing for the staff and people towards common goals by
use of assignments, orders, policies, procedures, rules, regulations, standards, opinions, suggestions and
questions to direct their behavior.

Supervision: it helps in providing supervision and contribution towards continuous growth of supervision
by inspecting the work of other nurses and evaluating their performance and approving correct performance.
Inspiring the staff: nursing leadership is required to inspire the staff and fulfill their personal and
institutional goals, create an atmosphere where one would live and work in a dignified manner.

Role model: Nursing leadership is required to set an example by own actions and as an advocate for patients
and staff.

Nursing leadership can be improved in following ways:

Power at high level: increased recognition of role of nursing has usually come through appreciation of their
significant contribution to make towards health.

Prepare nurses for collective bargaining: by removing wide variations in many nursing organizations and
associations.

Make INC and state nursing councils strong and autonomous bodies.

A definite number of nurses to be prepared for top management level: courses for head nurses and
nursing Superintendent.

Leadership without authority does not get recognition: nursing administrators must have authority to
reward as well as to initiate punitive measures to subordinates according to need.

Nursing should have role in planning of nursing care of patients and insist change in doctor’s orders and
contribute towards effective patient care.

Team spirit must be encouraged between the staff by enforcing and highlighting of handing over.

Nurse managers should be provided with adequate resources such as phone, computers in well
maintained office, financial and clerical support that are important symbols of position and leadership.

Nursing education should match with nursing services provided in institute/state.

The professional associations must prepare nurses to be well informed in labour relations, collective
bargaining, public relations, legal aspects of the nursing, ethical issues and nursing standards, media
awareness and use, improvement in interactive skills with doctors, patient and administrators.

To help better coordination and obtain better professional output, nursing professional must be under
control of nursing administrator and become a self-governing autonomous body.

Role of nursing leaders:

The nurse leaders must
1) Widen nursing horizons: it is needed to establish lines of communication with other professionals,
sectors, and public and policy makers. Interact with like-minded groups and other professional
groups, participate and hold more inter professional meetings and conferences.

2) To enhance professional knowledge and skill: Take clinical specialization from colleges to
hospitals and community, engage in clinical and field-based research rather than education related
topics, write widely on nursing and about nursing, publish more journals, newsletters and books.
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 3) Strive towards professional autonomy: Nurses have to take and accept more responsibility in
practice; take up and encourage independent practice; learn and practice accountability and form
network of all nursing organizations.

4) Need to learn new skills: Public speaking and assertiveness; political influencing and advocacy for
health; negotiations, economical and financial management; networking and linking; writing and
publication.

MANAGEMENT
 The word “manages” came from the word “hand”.
 Managing means handlings things.
 According to James Lunde, “management is principally the task of planning, coordinating,
motivating, controlling the efforts of others towards a specific objective.”
 Managers are basically leaders possessing skills. Leadership is one function of management.
 Management lays more emphasis on control, i.e., control of hours, costs, salaries, overtime, use
of sick leaves, inventory and supplies.
 A manager guides, directs, motivates others and a leader empowers others so it can be said that
every manager is a leader.

Usually the managers:

 Have an assigned position within the formal organization.
 Have a legitimate source of power due to delegated authority that accompanies their position.
 Are expected to carry out specific functions.
 Emphasize control, decision making, decision analysis and results.
 Manipulate individuals, the environment, money, time, and other sources to achieve
organizational goals.
 Have a greater formal responsibility and accountability for rationality and control than leaders.
 Direct willing and unwilling subordinates.

 Henri Fayol (1925) first identified the management functions of planning, organization,
command, coordination and control.
 Luther Gulick (1937) explained on Fayol’s management function in his introduction of seven
activities of management – planning, Organization, Staffing, Directing, Coordinating, Reporting,
Budgeting, as denoted by mnemonic POSDCORB.
 In nursing it can be applied as a nurse manager can spend part of day working on budget
(planning), mats with staff about changing patient management delivery system from primary
care to team nursing (organizing), alters the staffing policy to include 12 hours shifts (staffing),
holds a meeting to resolve a conflict between nurses and physicians (directing) and gives an
employee a job performance evaluation (controlling).

Functions of management:
1. Planning 8. Problem-solving
2. Organizing 9. Manage day-to-day operations
3. Staffing 10. Empower staff
4. Directing 11. Maintain quality
5. Coordinating 12. Controlling
6. Reporting 13. Delegating
7. Budgeting 14. Evaluating

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 1. Planning: It is working out of broad outline, the things that need to be done and the methods of
doing them to accomplish the purpose set for the enterprise.
2. Organizing: it is the process of building up the structure of authority through which the entire work
to be done is arranged into well-defined subdivisions and coordination.
3. Staffing: it is the appointing suitable persons to various posts under the organization and whole of
personal management.
4. Directing: it is making decisions and issues orders and instructions embodying them for the
guidance of the staff.
5. Coordinating: it is the interrelation between various parts of the work and eliminating of
overlapping and conflict.
6. Reporting: includes keeping oneself and the subordinates informed through records, research and
inspection.
7. Budgeting: helps the nurse supervisor to set the budget for the nursing services.
8. Problem solving: helps the nurses to solve the conflicts within themselves by providing different
measures of decision making.
9. Manage day-to-day operations: helps the nursing supervisor to perform the daily activities like
nursing rounds, duty roster preparation, etc.
10. Empower staff: helping others to become all they are capable of being. It is enabling the individuals
to do what they do the best.
11. Maintain quality: effective in maintaining the quality of nursing services provided to the patients by
evaluating, monitoring or regulating the services rendered to the consumers.
12. Controlling: helps to set the standards, measuring performance against those standards, reporting the
results and taking action.
13. Delegating: it is the transfer of certain specified functions by the superior to the subordinates
authority. It is assigning responsibility and authority to coworkers and ensuring his accountability.
14. Evaluating: the evaluation is the final step of a program. It helps in evaluation to do best of his
ability.

Need of management in nursing:

Nurses irrespective of their primary job must assume responsibility functions that are inherent in every
nursing job.
1) The nurses in the past used to follow the directions and orders of administrators and physicians but
the changing trends in community need to produce nursing, administrators who think independently
and solve problems as well as direct others in goal setting and achievement.

2) The increasing complexity of delivery of patient care requires nurse to be a good manager and needs
to be an effective communicator. The managerial activities include delegation, management of
people, time and resources for the achievement of organizational goals.

3) Nurse needs to be manage change, resolve conflicts and making organizational goals, focus on care
of patient, support of organization, profession and oneself as a professional.

4) Management in nurses makes the nurses able to understand the conditions promoting and innovating
the expression of talent among team members.

5) Management helps the nurses to make decisions in organization and encourage nurses to determine
ways to make the delivery system to function at its best.

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6) Management skills help the nurses to provide visibility for organizational goals, to mediate conflict,
serve as coach, and monitor results. It provides opportunity for persons to manage their own work
and give clear directions to nursing personnel.

7) The role of management in nursing is to provide opportunities for managers to manage their own
work and give clear directions to nursing personnel to assume responsibility in every area of nursing.

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