CONCEPT OF

LEADERSHIP &
MANAGEMENT
OBJECTIVES
 Define what leadership and management is
 Explain the nurse’s role as a leader
 Define what is meant by positive practice
environment
 Discuss the elements and characteristics of
positive practice environment
 LEADERSHIP
 Skill or ability to encourage people to work together and
do their best to achieve common goals
 Leads or guides others, is in charge or in command of
others
 It is a myth that leaders are born. Actually leaders
develop by their own effort
 LEADERSHIP
Characteristics of Leaders:
1. Respects rights, dignity, opinions and abilities of others
2. Understands the principles of democracy
3. Works with a group to guide the group toward a goal
4. Understands their own strengths, weaknesses
5. Displays self confidence and willingness to take a stand
 LEADERSHIP
Characteristics of Leaders:
5. Communicates effectively & verbalizes ideas clearly
6. Shows self initiative, a willingness to work, and
completes tasks
7. Shows optimism, is open minded and can compromise
8. Praises others and gives credit to others
9. Dedicated to meeting high standards
– P ro f e s s i o n a l n u r s e a s s u m e s t h e rol e s o f l e a d e r & manager.
– Th e se 2 rol e s are l i n k e d b u t differ.
– M a n a g e r m u s t h a v e l e a d e r s h i p ab i l i t i e s
– Leaders manage

Manager – i s a n e m p l o y e e o f a n o r g a n i z a t i o n w h o i s g i v e n
au th ority, p o w e r & re s p o n s i b i l i t y for p l a n n i n g ,
o r g a n i z i n g , c o o r d i n a t i n g & d i re c t i n g , e v a l u a t i n g
works of others.
 Co n trols m an p o w e r, fin a n cia l, & ma teria l
re s o u rc e s
 S e t g o a l s , m a k e d e c i s i o n s & s o l v e p ro b l e m s
 Initiate & i m p l e m e n t c h a n g e
Nurse s – a s s u m e s the position within the
as: organization
 Unit m a n a g e r
 Supervisor
 E x e c ut iv e
 a s m a n a g e r, t h e n u r s e i s re s p o n s i b l e for :
1. Efficiently a c c o m p l i s h i n g t h e g o a l s o f t h e
organization
2. Efficiently u s i n g o r g a n i z a t i o n ’s re s o u rc e s
3. E n s u r i n g e f f e c t i v e c l i e n t ’s c a re
4. E n s u r i n g c o m p l i a n c e w i t h i n s ti tut i o na l , p r o f e s s i o n a l
re g u l a t o r y & g o v e r n m e n t a l s t a n d a r d
5. Development of licensed & unlicensed personnel
 MANAGEMENT FUNCTIONS

1. Planning – o n - g o i n g p ro c e s s th at i n v o l v e s :
1. a s s e s s i n g si tua tio n
2. establishing goals & objectives
3. d e v e l o p s , p l a n o f action
 I denti fi e s priorities - WHAT De l i n e a t e s
 w h o i s re s p o n s i b l e - WHO Determine
 d e a d l i n e - WHEN
 De s cri b e s h o w th e inte n d e d ou tcome s w ill b e
a c h i e v e d & e v a l u a t e d - HOW
 MANAGEMENT FUNCTIONS

2. Organizing – o n - g o i n g p ro c e s s o f coord in ating work

- in v olv e s d e te rmin in g res p o n s i b ilitie s
(job descrip tion)
- com m un ica ti ng e xp e cta tion s (n u rs in g p olicie s ,
ure)
- e s t a b l i s h i n g t h e c h a i n o f c o mma nd for authori ty
MANAGEMENT FUNCTIONS

3. Directing – is th e p roces s of g e ttin g

the o r g a n i z a t i o n ’s work a c c o m p l i s h e d .
 I n v o l v e s a s s i g n i n g t a s k s to b e c o m p l e t e d
 P ro v i d i n g instr uction & g u i d a n c e
 Nurses

4. Coordinating – p roces s o f e n s u r in g th a t
p la n s a re carried out & e v a l u a t i n g o u t c o m e s .
- m e a s u r e s resu lt/ac ti on s a g a i n s t s t a n d a r d
 POSITIVE PRACTICE ENVIRONMENT
 Are settings that support excellence and decent work.
 Strive to ensure:
health, safety and personal well-being of staff
support quality patient care and ;
improve the motivation, productivity and
performance of individuals and organizations
 POSITIVE PRACTICE ENVIRONMENT
 An environment that is safe, empowering, and
satisfying (ANA, 2016)
 Environment that optimally promotes the “physical,
mental and social well-being” of the nurses (WHO)
 Work environment focus: job satisfaction and intent to
stay (Al- Hamdan, 2017)
 ELEMENTS OF POSITIVE PRACTICE
ENVIRONMENT
 Occupational health, safety and wellness policies that address
workplace hazards, discrimination, physical and psychological violence
and issues pertaining to personal security
 Fair and manageable workloads and job demands/stress
 Organizational climate reflective of effective management and
leadership practices, good peer support, worker participation in
decision-making, shared values
 Healthy work-life balance
 Equal opportunity and treatment
 Opportunities for professional development and career advancement
 ELEMENTS OF POSITIVE PRACTICE
ENVIRONMENT (ICN, 2007)
 Professional identity, autonomy and control over practice
 Job security
 Decent pay and benefit
 Safe staffing levels
 Support and supervision
 Open communication and transparency
 Recognition programmes
 Access to adequate equipment, supplies and support staff
 CHARACTERISTICS OF POSITIVE PRACTICE
ENVIRONMENT (Kristensen,1999)
  Demands that fit the resources of the person  A high level of
predictability  Good social support from colleagues and managers and
access to education and professional development opportunities 
Meaningful work  A high level of influence  A balance between effort
and reward First level
 Second level
 Third level
 Fourth level
 Fifth level
 PRINCIPLES OF MANAGEMENT:
A ma n a g er has a u th o rity, a ccou n ta b ility
& resp onsibil ity.
1. Authority – i s t h e legi timate right to direct t h e work o f
o t h e rs
 It i s c o n v e y e d t h ro u g h l e a d e r s h i p a c t i o n s
 It is a lw ay s a s s o cia t e d w i th re s p o n s ibility
& a ccounta bility
2. Accountability – th e a b ility & w illing n e s s to a s s u me
ownership
for on e ’ s a ction & to a c ce p t th e
con s e q u e n c e of o n e ’s behavior.
 It i s v i e w e d a s hierarchy
a. Sta rtin g a t in d iv i d u a l le v e l – a ccou n ta b ility is
reflected in t h e n u r s e ’s ethical integrity
 b. Insti tuti onal or p ro fe s s i o n a l l e ve l
 Ins titu tion refle c t e d in th e s ta te me n t of
p h ilos op h y & ob je ctiv e s of the n u r s in g
department.
Professional level – reflected in t h e s t a n d a r d o f
practice d e v e l o p e d b y t h e n a t i o n a l n u r s i n g
association.
c. Societal l e v e l – reflected in l e g i s l a t e d n u r s e
practice a c t s .
3. Responsibility – a n o b l i g a t i o n to pe r f or m a t a s k
 M a n a g e r s a re r e s p on s ib le f or e f fe c tiv e
utilization o f re s o u rc e s , c o m m un i c a t i o n to
subordinates and implementation of
organizational goals a n d objectives.
 Skills & Competencies of Manager:
1. Think critically – creative c og n i t i ve p ro c e s s t h at
i n c l u d e s problem s o l v i n g & d e c i s i o n m a k i n g .
2. Communicating w ell – u s e s b o t h v e r b a l & written
communication.
 Assertive, e x p r e s s i n g i d e a s clearly, accurately, &
h on estly.
 U s e s n e t w o r k i n g – e s t a b l i s h p ro f e s s i o n a l l i n k s
3. M a n a g i n g re s o u rc e s – b u d g e t i n g & d et e rm i n in g
variances between the actual & budgeted expenses.
4. E n h a n c i n g Em p loye r ’s Performance
 Provid ing app rop riat e l e a r n i n g opportu nities (in-
s e r v i c e trai n in g, h i g h e r d e g re e )
  Coaching or s e r v e a s a preceptor or mentor
Me ntor – is a w is e r & m ore e x p e r i e n c e d
person who guides,
s u p p o r t s & n u r t ure s p e o p l e .
Pre ce ptor – e xp e rie n ce d nurse w ho
a s s is t t h e n e w n u r s e in
i mprovi ng n u r s i n g s k i l l s .
5.B ui ldi ng & m a n a g i n g t e a m – t h e t e a m c o n s i s t s
o f h e a l t h p ro v i d e r s , n u r s e u n l i c e n s e d p e r s o n n e l ,
th e r a pi s t, etc . e a c h member m u s t f e e l tha t
e v e r y b o d y i s re c o g ni z e & contributions i s
valued.
M a n a g e r s e v a l u a t e s t h e g ro u p w o r k s .
 3 Outcomes m e a s u r e s t h at a re u s e d i n h e a l t h c a re :
1. Efficiency – m e a s u r e o f t h e re s o u rc e s u s e d i n t h e
p ro v i s i o n o f n u r s i n g s e r v i c e s .
2. Effectiveness – t h e m e a s u r e s o f t h e q u a n t i t y &
q u a l i t y o f s e r v i c e s p ro v i d e d .
3. Productivity – t h e p e r f o r m a n c e m e a s u r e b o t h
e f f e c t i v e n e s s & e f f i c i e n c y o f n u r s i n g c a re ,
m e a s u r e d b y t h e a m o u n t o f re s o u rc e s u s e d p e r
client ( e . g . re q u i re d v s . h o u r s o f c a re p ro v i d e d )
6. M a n a g i n g Conflict
 Conflict a r i s e from d i f f e ri n g v a l u e s , p h i l o s o p h i e s ,
or p e r s o n a l i t i e s .
 It m a y a r i s e d u e to competition (position)
 M a n a g e r n e g o t i a t e , collaborate, & compromise
  B a s i c p r i n c i p l e s for all t y p e o f confl ict i n c l u d i n g :
 Demo nstrat i ng re s p e c t for all
 Avoiding b l a m e
 Allowing full d i s c u s s i o n
 U si n g g ro u n d rule d u r i n g m e e t i n g
 Exploring al t ernat i ve s o l u t i o n s
6 . M a n a g i n g time
 In order to u s e time w el l , s e t g o a l s & priorities
 U si n g regu l ar s c h e d u l e s that a v o i d interruption
 Se t time limits o n a ct i vi t ies
 Delegating
 DELEGATING
 The a c t o f t r a n s f e r r i n g to a c o m p e t e n t
i n d i v i d u a l , t h e aut hor i t y to perform a s e l e c t e d
nursing t as ks in a selected situation.
 D e l e g a t e a s s u m e s re s p o n s i b i l i t y for a c t u a l
performances.
 Del egat or re t a i n s a c c o u n t a b i l i t y for t h e
out co m e
 Define t h e t a s k
 S e e k a g re e m e n t
 Moni tori ng
 feedback
Prin cip le s Us e d b y th e Nu rs e to Det e rmin e De le g at ion
to U nlicen s ed A s s i sti ve Pe rs o n n e l
1. Th e n u rs e mu s t a s s e s s t h e in d iv id u a l c lie n t p rior
to d e l e g a t i n g t a s k s .
2. Th e c lie n t mu s t b e me d ic a lly s ta b le or in a c h ro n ic
c o n d ition a n d n o t f r a g i l e .
3. The t a s k m u s t b e c o n s i d e r e d routi ne for t h i s cl ient.
4. Th e ta s k mu s t n o t req u ire a s u b s ta n tia l a mo u n t o f
s c ie n t ific k n o w l e d g e or t e c h n i c a l s k i l l .
5. The t a s k m u s t b e c o n s i d e r e d s a f e for t h i s cl i ent.
6. The t a s k m u s t h a v e a p re d i c t a b l e o u t c o m e .
7. Learn t h e a g e n c y ’ s p ro c e d u r e s a n d p o l i c i e s a b o u t d e l e g a t i o n .
8. K n o w t h e s c o p e o f p r ac ti ce a n d t h e c u s t o m a r y k n o w l e d g e , s k i l l s ,
a n d j o b d e s c r i p t i o n for e a c h h e a l t h c a re d i s c i p l i n e re p re s e n t e d o n
your team.
9 . Be a w a re o f i n d i v i d u a l v a r i a t i o n s in work a b i l i t i es . Each
i n d i v i d u a l c a re g i v er h a s di fferent e x p e r i e n c e s a n d m a y not
b e c a p a b l e o f perf o rmi ng e v e r y t a s k cited in t h e job
des c ri p t i o n .
10W. h e n u n s u re a b o u t a n a s s i s t a n t ’s ab i l i ti es to perform a
task, observe while the p e r s o n p erf orms it, or
demonstrate it to t h e p e r s o n a n d g e t a return
dem o n s t ra t i o n b e f o re a l l o w i n g t h e p e r s o n to perform it
i n d e p e n d e n t l y.
11C. lari fy reporting e x p e c t a t i o n s to e n s u re t h e t a s k i s
accomplished.
12C. reat e a n a t m o s p h e re t h a t f o s t e r s communication,
t e a c h i n g , a n d l e a r n i n g . For e x a m p l e , e n c o u r a g e s t a f f to
a s k q u e s t i o n s , l i s t en c a ref u l l y to their c o n c e r n s , a n d m a k e
u s e o f e v e r y opport unity to t e a c h .
Ta s k s t h a t ma y b e d e le g a t e d to u n lice n s e d a s s is tiv e
personnel
1. Taking o f v i t a l s i g n s
2. M e a s u r i n g a n d re c o r d i n g i n t a k e a n d o u t p u t
3. Client t r a n s f e r s a n d a m b u l a t i o n
4. Postmortem c a re
5. B a t h i n g
6. F e e d i n g
7. G a s t ro s t o m y f e e d i n g s i n e s t a b l i s h e d s y s t e m s
8. A t t e n d i n g to s a f e t y
9. We ig h in g
10.P er f o rm in g s i m p l e d r e s s i n g c h a n g e s
11 . S u c t i o n i n g o f ch ron ic t r a c h e o s t o m i e s
1 2 . P er fo rm i n g b a s i c l i f e s u p p o r t (CPR)
Ta s k s th a t ma y n ot b e d e le g a te d to u n lice n s e d
a s s i s ti v e p e r s o n n e l
1. A s s e s s m e n t
2. Interpretation o f d a t a
3. M a k i n g a n u r s i n g d i a g n o s i s
4. Creation o f a n u r s i n g c a re p l a n
5. E v a l u a t i o n o f c a re e f f e c t i v e n e s s
6. Care o f i n v a s i v e l i n e s
7. Ad mi n i s t er i n g p a re n t a l m e d i c a t i o n s
8. I n s er t i o n o f n a s o g a s t r i c t u b e s
9. Client e d u c a t i o n
10. P erf o r mi n g t r i a g e
11. G i v i n g t e l e p h o n e a d v i c e