CENTRAL LUZON DOCTORS’ HOSPITAL

EDUCATIONAL INSTITUTION, INC.

Romulo Highway, San Pablo, Tarlac City
Department of Graduate Studies
Master of Science in Nursing

COURSE TITLE: NURSING ADMINISTRATION I

PREPARED BY: VICTOR M. CUENO JR.

TOPIC: CHAPTER I: LEADING, MANAGING, AND FOLLOWING

At the end of discussion, we will able to learn and understand the

following:

1. Theory Development in Leading, Managing, and Following

2. Complexity Science Takes Hold

3. Task of Leading, Managing, and Following

THEORY DEVELOPMENT IN LEADING, MANAGING, AND

FOLLOWING

IMPORTANT FUCTIONS OF THEORY FOR THE NURSING

PROFESSION

1. First, Theory can help address important questions that have yet to be

answered

2. Second, Theory (and the expanding array of research methods

available to research) adds to evidence-based care and management

practices.

3. Third, Theory directs and sharpens the ability to predict or guide clinical

and organizational problem solving and outcomes.

 These include theories related to change, conflict, economic, clinical,

individual and group interactions, communication and social

networking, and many more.

COMPLEXITY SCIENCE TAKES HOLD

Complexity Theory

 Is important because it is a nontraditional theory, emerging from the

work of physical sciences and more recently, social sciences.

 Promotes the idea that the world is full of patterns that interact and

adapt through relationships,

 As health care providers are very focused on problems and predictable

solutions, it is possible that reframing care unleashes solutions to

complex problems and shifts human energy toward positive outcome.

LEADERSHIP THEORIES

Trait Theory

 These theories are sometimes referred to as the Great Man Theory,

from Aristotle’s philosophy- the virtue of being born with leadership

traits.

 Have a certain set of physical and emotional characteristics that are

crucial for inspiring others toward a common goal.

 E.g., assertiveness, drive motivation , integrity, confidence, cognitive

ability and task knowledge.

 Style Theory

 Referred to as group and exchange theories of leadership.

 Focus on what leaders do in relational and contextual terms. The

achievement of satisfactory performance measures requires

supervisors to pursue effective relationships with their subordinates

while comprehending the factors in the work environment that influence

outcomes.

 To understand STYLE, leaders need to obtain feedback from followers,

superior and peers.

Situational-Contingency Theory

 Theorists believed that leadership effectiveness depends on the

relationship among the leader’s task at hand, his/her interpersonal

skills and the favorableness of the work situation.

 The most important implications for leaders are that these theories

consider the challenge of a situation and encourage an adaptive

leadership style to compliment the issue being faced.

Transformational Theory

 Transformational leadership refers to a process whereby the leader

attends to the needs and motives of the followers so that the interaction

raises each to high levels of motivation and morality.

 The leader is a role model who inspires followers through displayed

optimism, provides intellectual stimulation, and encourages follower

creativity.

Hierarchy Of Needs (MASLOW)

 People are motivated on human needs

 Physiological needs, safety, social, esteem and self-actualizing needs.

 When this theory is applied to staff, leaders must be aware that the

need for safety and security will override the opportunity to be creative

and inventive, such as in promoting job change.

Two-Factor Theory (Herzberg 1991)

 Hygiene factors, such as working conditions, salary, status, and

security, motivate workers by meeting safety and security needs and

avoiding job dissatisfaction.

 Organizations need both hygiene and motivator factors to recruit and

retain staff.

Expectancy Theory (Vroom 1994)

 Individuals’ perceived needs influence their behavior. In the work

setting, this motivated behavior is increased if a person perceives a

positive relationship between effort and performance.

 Expectancy is the perceived probability of satisfying a particular need

based on experience. Therefore, nurses in leadership roles need to

provide specific feedback about positive performance.

 Organizational Behavioral Modification (Luthans 2011)

 OB Mod performance analysis follows a 3-step ABC model

• Antecedent analysis of clear expectations and baseline data

collection.

• Behavioral analysis and determination

• Consequence analysis, including reinforcement strategies.

 The leader uses positive reinforcement to motivate followers to repeat

constructive behaviors in the work place. Negative events that demotivate

staff are negatively reinforced, and the staff is motivated to avoid certain

situations that cause discomfort.

Tasks of Leading, Managing and Following

 Gardner’s tasks of leadership

1. ENVISIONING GOALS

Establishing a shared vision is an important leadership concept.

“Visioning” requires the leader to engage with others to assess the

current reality, determine and specify a desired end-point state, and

then strategize to reduce the difference.

2. AFFIRMING VALUES

Values are the connecting thoughts and inner driving forces that

give purpose, direction and precedence to life priorities.

3. MOTIVATING

When values drive our actions, they become a source of motivation.

4. MANAGING

Management requires determining routines and practices that offer

structure and stability to others.

5. ACHIEVING WORKABLE UNITY

To achieve workable unity between and among the parties being

affected by change and to avoid, diminish, or resolve conflict so that

vision can be achieved.

6. DEVELOPING TRUST

A hallmark task of leadership is to behave with consistency so that

others believe in and can count on the leader’s intentions and

direction.

7. EXPLAINING

8. SERVING AS A SYMBOL

Serving as a symbol reflects unity and collective identity.

9. REPRESENTING THE GROUP

More than being present symbolically, many opportunities exist for

leaders to represent the group through active participation.

10. RENEWING

Leaders can generate energy within and among others.

 Bleich’s Task of Management

1. Identify systems and processes that require responsibility and

accountability, and specify who owns the process

2. Verify minimum and optimum standards/specifications, and

identify roles and individuals responsible to adhere to them

3. Validate the knowledge, skills, and abilities of available staff

engaged in the process; capitalize on strengths; and strengthen

areas in need of development.

4. Devise and communicate a comprehensive big-picture plan for

the division of work, honoring the complexity and variety of

assignments made at an individual level.

5. Eliminate barriers/ obstacles to work effectiveness.

6. Measure the equity of workload, and use data to support

judgments about efficiency and effectiveness.

7. Offer rewards and recognition to individuals and teams.

8. Recommend ways to improve systems and processes.

9. Use a social network to engage others in decision-making and

for feedback, when appropriate or relevant.

Bleich’s Tasks of Followership

1. Demonstrate individual accountability while working within the

context of organizational systems and processes; do not alter the

process for personal gain or shortcuts.

2. Honor and implement care to the standards and specifications

required for safe and acceptable care/service.

3. Offer knowledge, skills, and abilities to accomplish the task at hand.

4. Collaborate with leaders and managers; avoid passive-aggressive

or nonassertive responses to work assignments.

5. Include evidence-based feedback as part of daily work activities as

a self-guide to efficiency and effectiveness and to contribute to

outcome measurement.

6. Demonstrate accountability to the team effort.

7. Take reasonable risks as an antidote for fearing change or

unknown circumstances.

8. Evaluate the efficiency and effectiveness of systems and processes

that affect outcomes of care/service; advocate for well-designed

work.

9. Give and receive feedback to others to promote a nurturing and

generative culture.