Solution Manual for Leadership and Nursing

Care Management 5th Huber

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Lesson Plan for

1 Leadership and Management Principles
OBJECTIVES
1. Define and describe leadership.
2. Critique the qualities of leadership.
3. Analyze leadership styles.
4. Specify the connections between followership and leadership.
5. Apply leadership to nursing practice.
6. Exercise critical thinking to conceptualize and analyze possible solutions to a practice exercise.
7. Define and describe management and nursing management.
8. Formulate the management process.
9. Critique the nature of managerial work.
10. Analyze the roles a manager plays.
11. Distinguish classic management theory from contemporary theories.
12. Relate management concepts to nursing leadership and management.
13. Exercise critical thinking to conceptualize and analyze possible solutions to a practice exercise.

TEACHING FOCUS
 Focus on leadership in turbulent, complex, changing health care environments.
 Discuss the development of strong leadership skills for nurses who facilitate the development of
employees and initiate health care changes.
 Define leadership, management, followership, and empowerment.
 Present characteristics of leadership and theories of leadership, including attitudinal leadership,
Situational Leadership, Fiedler’s contingency, and Hersey and Blanchard’s tridimensional leader
effectiveness model.
 Describe transactional and transformational leadership along with the leadership-followership
concept.
 Present and apply the concept of management to nursing.
 Review the management process with an emphasis on planning, organizing, directing, and
controlling.
 Explore similarities and differences in management and leadership.
 Discuss the nature of managerial work using classic management theory and research.
 Describe effective methods to manage difficult individuals.
 Focus on the five areas of management practice for the IOM.
 Discuss the Magnet Recognition Program as an evidence-based nursing response.

Leadership and Nursing Care Management, 5th ed.

Copyright © 2014, 2010, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. Huber
2 Chapter 1 | Leadership and Management Principles

KEY TERMS
 authoritarian leadership style, p. 10  learning organizations, p. 16
 chaos theory, p. 32  management, p. 21
 commitment, p. 15  negligence, p. 26
 complexity theory, p. 16  nurse manager, p. 5
 contingency theory, p. 31  nursing management, p. 22
 controlling, p. 26  organizing, p. 24
 coordinating, p. 26  planning, p. 23
 democratic leadership style, p. 10  quantum leadership, p. 16
 directing, p. 25  servant leadership, p. 16
 empowerment, p. 5  Situational Leadership theories, p. 12
 Fiedler’s contingency theory, p. 12  strategic planning, p. 23
 followership, p. 5  systems theory, p. 30
 interactive planning, p. 24  tactical planning, p. 23
 laissez-faire leadership style, p. 10  transactional leader, p. 14
 leadership, p. 4  transformational leader, p. 14
 leadership styles, p. 5

NURSING CURRICULUM STANDARDS
QSEN
 Patient-Centered Care
o Clinical Leadership, pp. 16-17
 Teamwork and Collaboration
o Process Part 4: Communication, p. 6
o Leadership Styles: Democratic, p. 10
o Servant Leadership, p. 16
o Effective Leadership, pp. 17-18
o Followership, pp. 18-19
o Leadership and Management Implications, pp. 19-20
o Practices That Ensure That the Whole Organization Feels Responsible and Accountable,
pp. 22-23
 Evidence-Based Practice
o Leadership and Care Management Differentiated, pp. 1-3
o Research Note, p. 32
 Quality Improvement
o Leadership Skills, p. 4
o Transactional and Transformational Leadership, pp. 14-16
o Controlling, p. 26
o Research Note, p. 32
o Current Issues and Trends, p. 35
 Safety
o Clinical Leadership, pp. 16-17
o Leadership and Management Implications, pp. 19-20
o Research Note, p. 32
o Leadership and Management Implications, pp. 34-35

Leadership and Nursing Care Management, 5th ed.

Copyright © 2014, 2010, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. Huber
 Chapter 1Leadership and Management Principles 3

CONCEPTS
The following conceptual themes and specific concepts match those presented in Giddens, J. R. (2013).
Concepts for nursing practice. St. Louis: Elsevier.
THEME: Attributes/Roles of Nurse
 Concept: Professionalism
o Exemplar: Ethics
 Characteristics of Leadership, pp. 7-8
 Leadership and Management Implications, pp. 34-35
 Concept: Leadership
o Exemplar: Clinical Agency—Operational Level
 Leadership and Care Management Differentiated, pp. 1-3
 The Leadership Role, p. 3
 Leadership Overview, pp. 3-4
 Leadership and Management Roles, p. 5
 Background on Leadership, p. 5
 Leadership: Five Interwoven Aspects, p. 5
 Leadership Theories, pp. 7-11
 Attitudinal Leadership Theories, pp. 11-14
 Transactional and Transformational Leadership, pp. 14-16
 Contemporary Leadership, p. 16
 Clinical Leadership, pp. 16-17
 Effective Leadership, pp. 17-18
 Leadership and Management Implications, pp. 19-20
 Management Overview, p. 21
 Background: The Management Process, pp. 22-26
 Management in Nursing Practice, pp. 26-27
 Management in Organizations, pp. 27-34
 Leadership and Management Implications, pp. 34-35
THEME: Care Competencies
 Concept: Collaboration
o Exemplar: Nurse–Nurse Collaboration
 Leadership and Care Management Differentiated, pp. 1-3
 The Leadership Role, p. 3
 Leadership Overview, pp. 3-4
 Leadership and Management Roles, p. 5
 Background on Leadership, p. 5
 Leadership: Five Interwoven Aspects, p. 5
 Leadership Theories, pp. 7-11
 Attitudinal Leadership Theories, pp. 11-14
 Transactional and Transformational Leadership, pp. 14-16
 Contemporary Leadership, p. 16
 Clinical Leadership, pp. 16-17
 Effective Leadership, pp. 17-18
 Leadership and Management Implications, pp. 19-20
 Management Overview, p. 21
 Management in Nursing Practice, pp. 26-27
 Leadership and Management Implications, pp. 34-35

Leadership and Nursing Care Management, 5th ed.

Copyright © 2014, 2010, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. Huber
4 Chapter 1 | Leadership and Management Principles

 Concept: Safety
o Exemplar: Systems Level
 Clinical Leadership, pp. 16-17
 Leadership and Management Implications, pp. 19-20
 Research Note, p. 32
 Leadership and Management Implications, pp. 34-35
 Concept: Evidence
o Exemplar: Qualitative Research Studies
 Research Note, p. 32
 Concept: Health Care Quality
o Exemplar: Quality Plans and Philosophies
 Leadership Skills, p. 4
 Transactional and Transformational Leadership, p. 14
 Controlling, p. 26
 Research Note, p. 32
 Current Issues and Trends, p. 35
BSN Essentials
 Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety
o Leadership and Care Management Differentiated, pp. 1-3
o The Leadership Role, p. 3
o Leadership Overview, pp. 3-4
o Leadership and Management Roles, p. 5
o Background on Leadership, p. 5
o Leadership: Five Interwoven Aspects, pp. 5-7
o Leadership Theories, pp. 7-11
o Attitudinal Leadership Theories, pp. 11-14
o Transactional and Transformational Leadership, pp. 14-16
o Contemporary Leadership, p. 16
o Clinical Leadership, pp. 16-17
o Effective Leadership, pp. 17-18
o Leadership and Management Implications, pp. 19-20 and 34-35
o Current Issues and Trends, pp. 20-21
o Controlling, p. 26
o Research Note, p. 32
o Current Issues and Trends, p. 35
 Essential III: Scholarship for Evidence-Based Practice
o Leadership and Care Management Differentiated, pp. 1-3
o Research Note, p. 32
 Essential V: Health Care Policy, Finance, and Regulatory Environments
o Current Issues and Trends, pp. 20-21, 35
 Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health
Outcomes
o Process Part 4: Communication, p. 6
o Leadership Styles: Democratic, p. 10
o Servant Leadership, p. 16
o Effective Leadership, pp. 17-18
o Followership, pp. 18-19

Leadership and Nursing Care Management, 5th ed.

Copyright © 2014, 2010, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. Huber
 Chapter 1Leadership and Management Principles 5

o Leadership and Management Implications, pp. 19-20

o Practices That Ensure That the Whole Organization Feels Responsible and Accountable,
pp. 22-23
 Essential VIII: Professionalism and Professional Values
o Characteristics of Leadership, pp. 7-8
o Current Issues and Trends, pp. 20-21, 35
o Leadership and Management Implications, pp. 34-35
 Essential IX: Baccalaureate Generalist Nursing Practice
o Clinical Leadership, pp. 16-17

STUDENT CHAPTER RESOURCES

Chap. 1 READ – Textbook (pp. 1-36)
* Chapter 1 NCLEX Review Questions

INSTRUCTOR CHAPTER RESOURCES

TB Test Bank
 To access the ExamView format, go to the Downloads section.

PPT PowerPoint Presentation

IC Image Collection
 Figure 1-1. Components of a leadership moment.
 Figure 1-2. Continuum of leader behavior.
 Figure 1-3. Expanded Situational Leadership® model.
 Figure 1-4. Transactional and transformational leadership.
 Figure 1-5. Systems view of management.
 Figure 1-6. Four steps of the management process.
 Figure 1-7. Linkage of clinical and management domains.
 Figure 1-8. Mintzberg's 10 managerial roles.
 Figure 1-9. Mintzberg's Model of Managerial Work.

ETC. Chapter 1: In-Class/Online Case Study (below)

Leadership and Nursing Care Management, 5th ed.

Copyright © 2014, 2010, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. Huber
6 Chapter 1 | Leadership and Management Principles
TEACHING STRATEGIES
CONTENT FOCUS
LEADERSHIP AND CARE
MANAGEMENT
DIFFERENTIATED, p. 1
THE TWO ROLES OF A
NURSE, p. 3
THE LEADERSHIP ROLE,
p. 3
LEADERSHIP OVERVIEW,
p. 3
Leadership Skills, p. 4
DEFINITIONS, p. 4
LEADERSHIP AND
MANAGEMENT ROLES,
p. 5
BACKGROUND ON
LEADERSHIP, p. 5
LEADERSHIP: FIVE
INTERWOVEN ASPECTS,
p. 5
Process Part 1: The
Leader, p. 6
Process Part 2: The
Follower, p. 6
Process Part 3: The
Situation, p. 6
Process Part 4:
Communication, p. 6
Process Part 5: Goals, p. 7
LEADERSHIP THEORIES,
p. 7
Trait Theories, p. 7
Feminist Leadership
Perspective, p. 11
Copyright © 2014, 2010, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc.
CONTENT HIGHLIGHTS
Distinguish leadership from
management: Management
focuses on accomplishing tasks,
and leadership focuses on
human relationship aspects.
Discuss how providing and
coordinating care are separate
and overlap.
Discuss why nurses and health
care delivery systems both need
leaders. Compare formal and
informal leadership.
Explain that leadership can be
understood as the ability to
inspire confidence and support
among followers.
Define leadership, management,
and professionalism.
Discuss the differences in
leadership and management
roles.
Define leadership styles,
followership, and
empowerment. Discuss how
leadership is a process.
Review Figure 1-1 on the
components of a leadership
moment and discuss each.
Suggest how critical thinking can
be applied to:
1. Diagnosing and analyzing the
five elements, 2. Adapting to the
situation, and 3. Communicating
for effectiveness.
Review characteristics of
leadership, including the
importance of vision and trust.
Discuss dos and don’ts of
leadership. Examine leadership
styles: democratic,
authoritarian, and laissez faire.
LEARNING ACTIVITIES
 Discussion Topic: Ask students to provide a single
word to define leadership. Ask students to
summarize management in one sentence.
 Online Activity: Have students visit the ANCC web
site and report on an aspect of certification that
they investigated: www.nursecredentialing.org
 Discussion Topic: How does leadership fit into
providing and coordinating care?
 Discussion Topic: Ask students why inspiration,
trust, communication, and action are each a
component of leadership.
 Discussion Topic: Discuss the characteristics of
exceptional leaders. Be sure to cover diagnosing,
adapting, and communicating; as well as self-
awareness, self-management, social awareness,
and relationship management.
 Discussion Topic: What does the term
professionalism mean in relationship to leadership
and management?
 Activity: Have students identify nurse leaders in
their community and describe their professional
contributions.
 Discussion Topic: Ask students to give specific
examples of how they can be empowered as a
nurse.
 Discussion Topics: Ask students, “How do you see
leadership assessment now, versus how do you
anticipate seeing it once you are practicing?”
“Why is communication an important part of
leadership?”
 Discussion Topic: Ask students to discuss the
differences between male and female leadership
styles.
Leadership and Nursing Care Management, 5th ed.
Huber

ATTITUDINAL LEADERSHIP
THEORIES, p. 11
Situational Theories,
p. 11
TRANSACTIONAL AND
TRANSFORMATIONAL
LEADERSHIP, p. 14
CONTEMPORARY
LEADERSHIP:
Interactional and
Relationship-Based,
p. 16
Quantum Leadership,
p. 16
Servant Leadership, p. 16
CLINICAL LEADERSHIP,
p. 16
EFFECTIVE LEADERSHIP,
p. 17
FOLLOWERSHIP, p. 18
Types of Followers, p. 18
LEADERSHIP AND
MANAGEMENT
IMPLICATIONS, p. 19
CURRENT ISSUES AND
TRENDS, p. 20
MANAGEMENT
OVERVIEW, p. 21
DEFINITIONS, p. 21
Copyright © 2014, 2010, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc.
Chapter 1Leadership and Management Principles 7
Discuss how concern for task
and relationship influences
attitudinal leadership theories.
Review Fiedler’s as well as
Hersey and Blanchard’s models,
and explain how situational
models differ from attitudinal
models.
Define and distinguish
transactional versus
transformational leadership.
Explain that health care
demands that nurses maintain
the expertise and information
necessary to take action to solve
problems; they need leadership
that is interactional, relational,
and transformational at all
levels. Define and contrast
quantum versus servant
leadership.
Define clinical leadership and
discuss how the IOM’s goals
relate to it.
Describe characteristics of
effective leadership. Review
Table 1-1 on Tornabeni’s advice.
Emphasize that leadership
effectiveness is based on the
ability to adapt in a complex and
chaotic environment.
Specify the linkage between
followership and leadership.
Discuss types of followers.
Discuss how the size of the
profession and the complexity
of nursing tasks require
leadership.
Review demographic data and
trends that affect nursing.
The recruitment, deployment,
development, motivation, and
leveraging of nurses as scarce
resources and prime assets are
critical management issues for
nursing and health care.
Define and describe
management.
 Activity: After discussing the theories, have
students journal (during or outside of class) about
which theory fits their own perspective, why, and
how they see themselves using that theory in
practice.
 Discussion Topic: Is a transactional or
transformational leadership style most effective?
 Small Group Activity: Have groups of students act
out different leadership styles for a particular
scenario that you describe. Then have a group
discussion about what actions revealed each style.
 Discussion Topic: What are the major leadership
styles? Which style is optimal to use in which
situation?
 Discussion Topic: What practices are common to
most exceptional leadership achievements?
 Activity: Provide names of nurse leaders in your
community and describe their professional
contributions.
 Online Activity: Have students visit
http://www.nwlink.com/~donclark/leader/survlea
d.html to access a Leadership Self-Assessment
Activity. Ask students how leaders can use this
assessment to identify strengths and areas of
improvement.
 Discussion Topic: What are characteristics of an
effective leader? Give an example of an effective
leader you know, and explain why and how s(he)
is effective.
 Discussion Topic: Define the characteristics of
followership and leadership and then have
students describe how they are connected.
 Discussion Topic: How does nurses’ variety of
educational backgrounds affect nursing’s need for
leadership?
 Discussion Topic: Ask students, “What current
issues in leadership concern you?”
 Discussion Topic: Ask students if all managers are
leaders.
 Discussion Topic: Have students provide
examples of management practices that they
have seen in clinical situations.
 Discussion Topic: Ask students what tasks are
common to both leadership and management.
Leadership and Nursing Care Management, 5th ed.
Huber
8 Chapter 1 | Leadership and Management Principles
BACKGROUND: THE
MANAGEMENT
PROCESS, p. 22
Practices That Give
Executives the
Knowledge They Need,
p. 22
Practices That Help
Executives Convert
Knowledge to Action,
p. 22
Practices That Ensure That
the Whole Organization
Feels Responsible and
Accountable, p. 22
Planning, p. 23
Organizing, p. 24
Directing, p. 25
Controlling, p. 26
MANAGEMENT IN
NURSING PRACTICE,
p. 26
Two Roles of the Nurse,
p. 26
MANAGEMENT IN
ORGANIZATIONS, p. 27
The Nature of Managerial
Work, p. 27
Contemporary
Management Theories,
p. 29
LEADERSHIP AND
MANAGEMENT
IMPLICATIONS, p. 34
CURRENT ISSUES AND
TRENDS, p. 35
Copyright © 2014, 2010, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc.
Define nursing management and
describe the practices involved.
Define and review the four steps
of the management process
(Figure 1-6). Discuss the
balancing of competing needs:
the needs of the staff related to
growth, efficiency, motivation,
morale, and accomplishment
with the outcome of staff
satisfaction; and the needs of
the employer for productivity,
quality, and cost-effectiveness
with the outcome of
productivity.
Discuss the roles of nurse as
care provider and integrator.
Explain that managers in nursing
perform functions that provide
an environment and climate to
facilitate delivery of client
services.
The manager's role is distinct
and important for individual and
organizational outcomes
because of its direct impact on
how and what gets done.
Discuss Mintzberg’s managerial
skills (Fig. 1-8) and Mintzberg’s
model of managerial work (Fig.
1-9). Review the contingency,
systems, complexity, and chaos
theories of management.
Discuss the different duties of a
nurse manager versus nurse
executive. Review challenges of
balancing day-to-day operations
with transformative
management and leadership.
Review issues and trends in
access, cost, and quality.
 Large Group Activity: Quiz Show! Divide the class
into two groups. Have students decide within
each group who will write out each key term and
its definition on an index card. At the next class
period, have students sit together as groups.
Collect the cards, and read the definitions
alternately to the two groups. When a group
correctly provides the key term for the definition
you read, award a point to that group. Let the
group members talk amongst themselves before
giving the answer. Choose in advance what prize
the winning team will receive, such as no
homework for a night or the losing team will write
out the definitions for the next quiz show.
 Discussion Topic: How does management in
nursing practice differ from management in
general?
 Activity: Invite an exceptional nurse manager as a
speaker for the class. Have the manager discuss
his or her role.
 Activity: Divide the class into three groups. Assign
Group 1 to the three interpersonal roles
(figurehead, leader, and liaison), Group 2 to the
three informational roles (monitor, disseminator,
and spokesperson), and Group 3 to the four
decisional roles (entrepreneur, disturbance
handler, resource allocator, and negotiator). Have
each group discuss each of the assigned roles, the
purpose and function for each, and then role-play
each assigned role for the entire class.
 Activity: Have each student choose one of the
contemporary management theories, describe it,
and explain its advantages and disadvantages in a
short paper.
 Activity: Have students work in small groups to
present a video (posted on YouTube if desired)
explaining Mintzberg’s model or another
contemporary management theory.
 Discussion Topic: Which of Curtin’s 10 ethical
values in the text is most important for nurse
managers?
 Activity: Have students complete one of the case
studies below and then host a group discussion of
the answers and rationales to the questions.
Discussion Topic: Ask students, “What current
issues in management concern you?”
Leadership and Nursing Care Management, 5th ed.
Huber
 Chapter 1Leadership and Management Principles 9

IN-CLASS/ONLINE CASE STUDY

CASE STUDY

Lucille Brown is a nurse manager for a 26-bed critical care unit for a major teaching hospital in New
York. She is very relationship- and people-oriented. Nurse Brown encourages and facilitates group
discussion and group decision making. Teamwork is the focus for all projects on her unit, and she
provides needed resources to the team. Nurse Brown makes sure that everyone has a role on the unit
and input into decision making.

1. (a) What style of leadership does Nurse Brown seem to exhibit most of the time? (b) Where do you
predict this places her leadership style in terms of Tannenbaum and Schmidt’s behavioral style
continuum?
Answer: (a) Nurse Brown most often exhibits a “relationship behavior” leadership style. (b) This predicts
that her leadership will be more democratic than authoritarian.
Rationale: The way people influence others through actions taken and the perspectives of other people
is related to leadership efforts and constitutes leadership style. The two major leadership terms are task
behavior and relationship behavior, and a leader's leadership style is some combination of task and
relationship behavior. Tannenbaum and Schmidt (1973) suggested that a leader might select one of
many behavior styles arrayed along a continuum. The continuum ranges from democratic to
authoritarian (or subordinate-centered to leader-centered).

2. In what situations may this leadership style be inefficient?

Answer: This type of leadership may take longer to implement than authoritarian style, which can
sometimes slow things down. It can also be very challenging to get a diverse group of people to come to
a consensus and thus take action. Instead, differences can get in the way of focusing on the problem at
hand.
Rationale: The democratic style makes output appear to move more slowly and is thought to take
longer than using an authoritarian style. Group consensus needs time and facilitation to be fostered.
Furthermore, the needs of disenfranchised minority groups must be balanced. Intergroup cohesion is a
focus with this style. The challenge of the democratic style is to get people with different professional
backgrounds, personal biases, and psychological needs together to focus on the problem and next
action steps. Motivating participation is a constant challenge.

3. What type of leadership style do you prefer your boss to use?

Answer and Rationale: Because this is an issue of personal style, answers will vary somewhat. Use
differences in responses as a jumping-off point in a class discussion of leadership styles.

Leadership and Nursing Care Management, 5th ed.

Copyright © 2014, 2010, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. Huber