NURSING LEADERSHIP

AND MANAGEMENT
Charmaine R. Quina , RN,MAN
Definition/description
Leadership
- the action of leading a group of people or
an organization.
- is the art of motivating a group of people to
act towards achieving a common goal.
-is the ability of a company's management to
set and achieve challenging goals, take swift and
decisive action, outperform the competition, and
inspire others to perform well.
Characteristics of Effective Leadership
1. strong character- involves clear communication
skills, speak with and listen to staff members,
respond to questions and concerns, and are
empathetic, use effective communication skills for
moving the company forward and achieving new
levels of success
2.exhibit honesty
3. Integrity
4.trustworthiness
5.ethics
2. Management
- the act or manner of guiding or taking
charge or handling,direction,
-the process of dealing with or controlling
things or people.
- is the administration of an organization,
whether it is a business, a not-for-profit
organization, or government body.
Managers typically;
1. Have an assigned position within the formal organization.
2. Have a legitimate source of power due to the delegated authority
that accompanies their position
3. Are expected to carry out specific functions, duties, and
responsibilities
4. Emphasize control, decision making, decision making analysis, and
results
5. Manipulate people, the environment, money, time, and other
resources to achieve organizational goals
6. Have a greater responsibility and accountability for rationality and
control the than leaders
7. Direct willing and unwilling subordinates.
Principles of Management (Henri Fayol)
1.Division of Work
- the whole work is divided into small tasks.
-The specialization of the workforce according to
the skills of a person, creating specific personal and
professional development within the labour force and
therefore increasing productivity; leads to specialization
which increases the efficiency of labour.
2. Authority and Responsibility
- This is the issue of commands followed by
responsibility for their consequences.
-Authority means the right of a superior to
give enhance order to his subordinates;
responsibility means obligation for performance.
3. Discipline
- It is obedience, proper conduct in relation
to others, respect of authority, etc. It is essential for
the smooth functioning of all organizations.
4. Unity of Command - This principle states that
each subordinate should receive orders and be
accountable to one and only one superior. If an
employee receives orders from more than one
superior, it is likely to create confusion and conflict.
5. Unity of Direction
- All related activities should be put under
one group, there should be one plan of action for
them, and they should be under the control of one
manager
6. Subordination of Individual Interest to Mutual
Interest
- The management must put aside personal
considerations and put company objectives firstly.
Therefore the interests of goals of the organization
must prevail over the personal interests of
individuals.
7. Renumeration
- Workers must be paid sufficiently as this is
a chief motivation of employees and therefore
greatly influences productivity. The quantum and
methods of remuneration payable should be fair,
reasonable and rewarding of effort.
8. The Degree of Centralization
- The amount of power wielded with the
central management depends on company size.
Centralization implies the concentration of decision
making authority at the top management.
9.Line of Authority/Scalar Chain
- This refers to the chain of superiors
ranging from top management to the lowest rank.
The principle suggests that there should be a clear
line of authority from top to bottom linking all
managers at all levels.
10. Order
- Social order ensures the fluid operation of a
company through authoritative procedure. Material
order ensures safety and efficiency in the
workplace. Order should be acceptable and under
the rules of the company
11. Equity
- Employees must be treated kindly, and
justice must be enacted to ensure a just
workplace. Managers should be fair and impartial
when dealing with employees, giving equal
attention towards all employees.
13. Initiative
- Using the initiative of employees can add
strength and new ideas to an organization.
Initiative on the part of employees is a source of
strength for organization because it provides new
and better ideas. Employees are likely to take
greater interest in the functioning of the
organization.
12. Stability of Tenure of Personnel
- Stability of tenure of personnel is a principle
stating that in order for an organization to run
smoothly, personnel (especially managerial
personnel) must not frequently enter and exit the
organization.
14.Esprit de Corps/Team Spirit
- This refers to the need of managers to
ensure and develop morale in the workplace;
individually and communally. Team spirit helps
develop an atmosphere of mutual trust and
understanding. Team spirit helps to finish the task
on time and easily.
 Comparison of Leadership and Management

Leadership Management
Motto Do the right things Do things right

Challenge Change Continuity

Focus Purposes Structures and procedures

Time frame Future present

Methods strategies Schedules

Questions Why Who,what,when,where,how

Outcomes Journeys Destinations

Human Potential Performance

Management Theories and Theorists
1.Scientific Management- Frederick W.Taylor
2. Bureaucratic Organizations- Max Weber
3. Management Functions – Henri Fayol
4.Activities of Management – Luther Gulick
5. Participative Management – Mary Parker Follette
6. Hawthorne Effect – George Elton Mayo
7. Theories X and Y – Douglas Mcgregor
8. Employee Participation – Chris Argyris
1.Scientific Management
Four overriding principles of scientific
management;
1.Traditional “ rule of thumb “ means of organizing must be
replaced with scientific methods by using time and motion
studies and the expertise of experienced workers, work
could be scientifically designed to promote greatest
efficiency of time and energy.
2.A scientific personnel system must be
established so that workers can be hired, trained,
and promoted based on their technical
competence and abilities
3.Workers should be able to view how they fit into
the organization and how they contribute to the
overall organizational productivity. This provides
common goals and a sharing of the organizational
mirrors.
4.The relationship between the managers and
workers should be cooperative and
interdependent, and the work should be shared
equally.
2. Bureaucratic Organizations
- Max Weber study large scale organizations to
determine what made some workers more efficient than
others
- Weber saw the need for legalized, formal,
authority, consistent rules and regulations for personnel in
different positions
- Weber proposed bureaucracy as an
organizational design, thus a need to provide more rules,
regulations, and structure within the organization to
increase efficiency
The following three elements support bureaucratic
management:
1All regular activities within a bureaucracy can be regarded
as official duties;
2.Management has the authority to impose rules;
3. Rules can easily be respected on the basis of established
methods.
Bureaucracy definition
“Bureaucracy is an organisational structure that is
characterised by many rules, standardised
processes, procedures and requirements, number
of desks, meticulous division of labour and
responsibility, clear hierarchies and professional,
almost impersonal interactions between
employees”.
Cont.bureaucracy
- every employee has a specific place within
the organisation and is expected to solely focus on
his/ her area of expertise
- going beyond your responsibilities and
taking on tasks of colleagues is not permitted
within a bureaucracy.
Max Weber’s bureaucratic management principles:
1. Task specialisation
-tasks are divided into simple, routine categories on
the basis of competencies and functional specialisations.
- every employee is responsible for what he/she
does best and knows exactly what is expected of him/her.
-each department has specific powers
- every employee knows exactly what is expected of
him/ her and what his/ her powers are within the
organization
Cont.Max Weber
2. Hierarchical authority
Managers are organised into hierarchical layers,
where each layer of management is responsible for its staff
and overall performance.
3. Formal selection
-all employees are selected on the basis of technical
skills and competences, which have been acquired through
training, education and experience.
- one of the basic principles is that employees are
paid for their services and that level of their salary is
dependent on their position.
4. Rules and requirements
-formal rules and requirements are required to
ensure uniformity, so that employees know exactly what is
expected of them. In this sense, the rules and requirements
can be considered predictable
-All administrative processes are defined in the
official rules.
5. Impersonal
-regulations and clear requirements create distant
and impersonal relationships between employees, with the
additional advantage of preventing nepotism or
involvement from outsiders or politics.
6. Career orientation
Employees are selected on the basis of their
expertise. This helps in the deployment of the right people
in the right positions and thereby optimally utilising human
capital.
Management Functions Theory
- Henri Fayol (1925) first identified the
management functions of planning ,organization,
command, coordination, and control.
cont.management functions
1. Planning
-planning is looking ahead
- the hardest of the five functions of management.
-requires an active participation of the entire
organization
- with respect to time and implementation, planning
must be linked to and coordinated on different levels
- must take the organization’s available resources
and flexibility of personnel into consideration as this will
guarantee continuity.
Cont. management functions
2. Organizing
-an organization can only function well if it is well-
organized
-there must be sufficient capital, staff and raw
materials so that the organization can run smoothly and
that it can build a good working structure
- organizational structure with a good division of
functions and tasks is important.
-when the number of functions increases, the
organization will expand both horizontally and vertically.
-important function of the five functions of
management.
Henri Fayol divided “organizing” into five ;
1.Specialization -every employee is allowed to use their
individual skills this will be advantageous to their area of
expertise.
2.Unity of command- in which an employee is answerable
to one manager only
3. Formal chain of communication-the employee will know
how and with whom they will have to communicate
4. Unity of direction- all employees must be aware of the
organization’s strategic objectives
5. Authority and responsibility- managers have the authority
to give orders.
3. Commanding
-when given orders and clear working instructions,
employees will know exactly what is required of them.
-return from all employees will be optimized if they
are given concrete instructions with respect to the activities
that must be carried out by them
-managers have integrity, communicate clearly and
base their decisions on regular audits
-managers are capable of motivating a team and
encouraging employees to take initiative
4. Coordinating
-coordination aims at stimulating motivation
and discipline within the group dynamics
- requires clear communication and good
leadership.
-only through positive employee behaviour
management can the intended objectives be
achieved.
5. Controlling
By verifying whether everything is going according to
plan, the organization knows exactly whether the activities
are carried out in conformity with the plan.
Control takes place in a four-step process:
1.Establish performance standards based on organizational
objectives
2.Measure and report on actual performance
3.Compare results with performance and standards
4.Take corrective or preventive measures as needed
4.Activities of Management Theory
- Luther Halsey Gulick (1937) expanded
on Fayol’s management functions in his
introduction of the “ seven activities of
management “- planning, organizing, staffing,
directing, coordinating, reporting, and budgeting
- denoted by the mnemonic POSDCORB
1.Planning: refers to establishing a broad sketch of the
work to be completed and the procedures incorporated to
implement them.
2. Organizing: Organizing involves formally classifying,
defining and synchronizing the various sub-processes or
subdivisions of the work to be done.
3. Staffing: This involves recruiting and selecting the right
candidates for the job and facilitating their orientation and
training while maintaining a favorable work environment.
4. Directing: This entails decision making and delegating
structured instructions and orders to execute them.

5. Coordinating: This basically refers to orchestrating and

interlinking the various components of the work.

6. Reporting: Reporting involves regularly updating the

superior about the progress or the work related activities.
The information dissemination can be through records or
inspection.

7. Budgeting: Budgeting involves all the activities that

under Auditing, Accounting, Fiscal Planning and Control.
Participative Management or Paticipative decision making
-Mary Parker Follett (September 3, 1868 – December
18, 1933) was an American social worker, management
consultant, philosopher, and pioneer in the fields of
organizational theory and organizational behavior
- known to be "Mother of Modern Management“
- known for her essay “The Giving Orders”
- espoused for her belief that managers should have
authority with, rather than over, employees
- she defined management as: "the art of getting
things done through people"
cont.participative mgmt.
Three principles of Participative Management:
1. Functions are specific task areas within organizations.
The appropriate degree of authority and responsibility
should be allocated to them so tasks can be
accomplished.
2. Responsibility is expressed in terms of an empirical duty:
People should manage their responsibility on the basis of
evidence and should integrate this effectively with the
functions of others.
3. Authority flows from an entitlement to exercise power,
which is based upon legitimate authority.
Hawthorne Effect
- Professor George Elton Mayo (1880-1949)
- conducted a study ,together with his Harvard
associates done at the Hawthorne Works of the Western
Electric Company near Chicago between 1927- 1932
- the study was an attempt to look at the relationship
between light illumination in the factory and productivity.
- it was discovered in the study that when management
paid special attention workers, productivity was likely to
increase, regardless of the environmental conditions.
Cont.hawthorne effect
- Hawthorne set the individual in a social context,
establishing that the performance of employees is
influenced by their surroundings and by the people that
they are working with as much as by their own innate
abilities.
cont.hawthorne effect
- it was also found out that Hawthorne effect indicated
that people respond to the fact they are being studied,
attempting to increase whatever behaviour they feel will
continue to warrant the attention.
- it was found out in the study that informal work groups
and socially informal work environment were factors in
determining productivity and Mayo recommended more
employee participation in decision- making.
Theory X and Theory Y
- by Douglas Mcgregor (1960), while he was
working at the MIT Sloan School of Management in the
1950s
- reinforced the ideas by theorizing that managerial
attitudes about employees (and,hence,how managers treat
those employees) can be directly correlated with
employees satisfaction
- he labeled Theory X managers basically believe
that their employees are lazy, need constant supervision
and direction and are indifferent to organizational needs.
Cont. theory x and y
- Theory Y managers believe that their employees
enjoy their work , are self- motivated and are willing to
work hard to meet personal and organizational goals.
- Theory X explains the importance of heightened
supervision, external rewards, and penalties
- Theory Y highlights the motivating role of job
satisfaction and encourages workers to approach tasks
without direct supervision.
Employee Participation
- by Chris Argyris (1964) supported Mcgregor and
Mayo by saying that managerial domination causes
workers to become discouraged and passive.
- believed that if self- esteem and independence
needs are not met, employees will become discouraged
and troublesome or may leave the organization
- stressed that the need for flexibility within the
organization and employee participation in decision
making.
Management Process
Roles that managers fulfill in an organization;
1.Figurehead
2.Leader
3.Liaison
4.Monitor
5.Disseminator
6.Spokesperson
7.Entrepreneur
8.Disturbance Handler
9.Resource Allocator
10.Negotiator
The 10 roles are then divided up into three categories, as
follows:

Category Roles
Figurehead
Interpersonal Leader
Liaison
Monitor
Informational Disseminator
Spokesperson
Entrepreneur
Disturbance Handler
Decisional
Resource Allocator
Negotiator
Interpersonal Category
The managerial roles in this category involve
providing information and ideas.
1.Figurehead
- As a manager, you have social, ceremonial
and legal responsibilities
-You're expected to be a source of
inspiration.
-People look up to you as a person with
authority, and as a figurehead.
2. Leader
– This is where you provide leadership for
your team, your department or perhaps your entire
organization; and it's where you manage the
performance and responsibilities of everyone in
the group
3. Liaison
– Managers must communicate with internal
and external contacts. You need to be able to
network effectively on behalf of your organization.
Informational Category
The managerial roles in this category involve
processing information.
4.Monitor – regularly seek out information related
to your organization and industry
-looking for relevant changes in the
environment
-monitor team, in terms of both their
productivity, and their well-being.
5.Disseminator
-communicate potentially useful information
to your colleagues and your team.

6.Spokesperson
– represent and speak for their organization
- In this role you're responsible for
transmitting information about your organization
and its goals to the people outside it
Decisional Category
The managerial roles in this category involve using
information.
7.Entrepreneur
–create and control change within the
organization
-This means solving problems, generating new
ideas, and implementing them.
8.Disturbance Handler
– When an organization or team hits an
unexpected roadblock, it's the manager who must take
charge. You also need to help mediate disputes within
it.
9.Resource Allocator
– You'll also need to determine where organizational
resources are best applied. This involves allocating
funding, as well as assigning staff and other organizational
resources.
10.Negotiator
– You may be needed to take part in, and direct,
important negotiations within your team, department, or
organization.
Strategic Planning Process
Definition
The strategic planning process are the steps that you go
through as an organization to determine the direction of
your organization (Its Vision), what you're going to do and
for whom (Your mission) and someway to measure it or to
guide you in a strategy to get there (Your goals).
The five stages of the Strategic Management Process:
1.goal-setting – clarify your vision
This stage consists of identifying three key facets:
a. define both short- and long-term objectives
b. identify the process of how to accomplish your
objective
c. customize the process for your staff, give each
person a task with which he can succeed
2.Analysis – gather and analyze information
3.Strategy formation
4.Strategy implementation
5. Strategy monitoring.
cont. five stages of the Strategic Management Process
2. Analysis
- is a key stage because the information gained in this
stage will shape the next two stages
- gather as much information and data relevant to
accomplishing your vision
-the focus of the analysis should be on understanding the
needs of the business as a sustainable entity, its strategic
direction and identifying initiatives that will help your business
grow.
- examine any external or internal issues that can affect
your goals and objectives
-identify both the strengths and weaknesses of your
organization as well as any threats and opportunities that may
arise along the path.
cont. five stages of the Strategic Management
Process
SWOT Analysis – one of the most commonly effective tool
that assist in strategic planning
- identification of Strengths,Weaknesses,Opportunities,and
Threats (SWOT)
- Developed by Albert HUMPHREY at Stanford University
in the 1960s and 1970s
- - also known as TOWS Analysis
cont. five stages of the Strategic Management
Process
Simple rules for SWOT Analysis:
1.Be realistic about the strengths and weaknesses of your
organization
2. Be clear on how the present organization differs from
what might be possible in the future
3. Be specific of what you want to accomplish
4. Always apply SWOT in relation to your competitors
5. Keep SWOT short and simple
6. Remember that SWOT is subjective
cont. five stages of the Strategic Management
Process
3.Strategy Formation
- the first step in forming a strategy is to review the
information gleaned from completing the analysis
- determine what resources the business currently
has that can help reach the defined goals and objectives
- identify any areas of which the business must seek
external resources
- the issues facing the company should be prioritized
by their importance to your success
cont. five stages of the Strategic Management
Process
4.Strategy Implementation
- This is the action stage of the strategic
management process
- everyone within the organization must be made
clear of their responsibilities and duties, and how that fits in
with the overall goal
-additionally, any resources or funding for the
venture must be secured at this point. Once the funding is
in place and the employees are ready, execute the plan.
cont. five stages of the Strategic Management
Process
5 .Evaluation and Monitoring
- actions include performance measurements,
consistent review of internal and external issues and
making corrective actions when necessary.
Strategic Planning (Vision/Mission/Philosophy/Objectives/Core Values

Mission

Philosophy

Goals

Objectives

Policies

Procedures

Rules
Strategic Planning
(Vision/Mission/Philosophy/Objectives/Core Values
Vision and Mission Statements
- Vision statements are used to describe future goals
or aims of an organization. It is the description in words that
conjures up a picture for all group members of what they
want to accomplish together.

Sample Vision Statement:

Samar Provincial Hospital will be the leading center for
trauma care in the region.
Strategic Planning
(Vision/Mission/Philosophy/Objectives/Core Values
Mission (or purpose)Statement
-is a brief statement ( typically no more than
three of four sentences) identifying the reason that an
organization exists
- identifies the organization’s constituency and
addresses its position regarding ethics, principles and
standards of practice
- a well –written mission statement will identify what
is unique about the organization
Strategic Planning
(Vision/Mission/Philosophy/Objectives/Core Values
Sample Mission Statement:
Samar Provincial Hospital is a tertiary care facility that
provides comprehensive, holistic care to all Samarnons
who seek treatment. The purpose Of SPH is to combine
high quality, holistic health care with the provision of
learning opportunities for students in medicine, nursing,
pharmacists and allied health sciences. Research is
encouraged to identify new treatment regimens and to
promote high quality health care for generations to come.
Strategic Planning
(Vision/Mission/Philosophy/Objectives/Core Values
The Philosophy Statement
- The statement of philosophy is defined as an
explanation of the systems of beliefs that determine how a
mission or a purpose is to be achieved
- an organization’s philosophy states the beliefs,
concepts and principles of an organization
Strategic Planning
(Vision/Mission/Philosophy/Objectives/Core Values
Sample Philosophy Statement:
The board of directors, medical nursing staff and
administrators of SPH believe that human beings are
unique, due to different genetic endowments, personal
experiences in social and physical environments , and the
ability to adapt to biophysical, psychosocial, and spiritual
stressors. Thus, each patient is considered a unique
individual with unique needs. Identifying outcomes and
goals, setting priorities, prescribing strategy options, and
selecting an optimal strategy will be negotiated by the
patient, physician, and health-care team.
Cont. sample philosophy

As unique individuals, patients provide medical,

nursing, and allied health students invaluable diverse
learning opportunities. Because the Board of Directors,
medical and nursing staff, and administrators believe that
the quality of health care provided directly reflects the
quality of the education of its future health-care providers,
students are welcomed and encouraged to seek out as
many learning opportunities as possible. Because high-
quality health care is defined by and depends on
technological advances and scientific discovery, Samar
Provincial Hospital encourages research as a means of
scientific inquiry.
Strategic Planning
(Vision/Mission/Philosophy/Objectives/Core Values
VALUE STATEMENTS
-Value statements define the organisation’s basic
philosophy, principles and ideals
- also set the ethical tone for the institution.An
organisation’s values are evident in the statements that
define the organization and the processes used to achieve
its mission and vision.
Strategic Planning
(Vision/Mission/Philosophy/Objectives/Core Values
Goal and Objectives
- are the ends toward which the organization is working
- all philosophies must be translated into specific goals
and objectives if they are to result in action
- goals and objectives operationalize the philosophy
- goals usually have multiple objectives

Goal may be defined as the desired result toward which

effort is directed; it is the aim of the philosophy.
Strategic Planning
(Vision/Mission/Philosophy/Objectives/Core Values
Objectives
- are similar to goal in that they motivate people to specific end and
are explicit, measurable, observable or retrievable and obtainable.
- are more measurable than goals because identify how
and when the goal is to be accomplished.
Strategic Planning
(Vision/Mission/Philosophy/Objectives/Core Values
POLICIES AND PROCEDURES
Policies are plans reduced to statements or instructions
that direct organizations in their decision making
- policies direct individual behavior toward the
organization’s mission and define broad limits and desired
outcomes of commonly recurring situations while leaving
some discretion and initiative to those who must carry out
that policy
Types of Policy:
1.Implied Policy–neither written nor expressed
2. Expressed Policy – are delineated verbally or in writing
Strategic Planning
(Vision/Mission/Philosophy/Objectives/Core Values
Procedures are plans that establish customary or
acceptable ways of accomplishing a specific task and
delineate a sequence of steps of required action
- established procedures save staff time, facilitate
delegation, reduce cost, increase productivity, and provide
a of means of control
- identify the process or steps needed to implement a
policy and are generally found in manuals at the unit level
of the organization
Strategic Planning
(Vision/Mission/Philosophy/Objectives/Core Values
RULES
Rules and regulations are plans that define specific action
or nonaction. Generally included as part of policy and
procedure statements, rules describe situations that allow
only one choice of action