Nursing 401
“Courage is not the
absence of fear, it’s
inspiring others to move
beyond it”
- Nelson Mandela
• Critical thinking – thinking about lots of things
at any given time, multitasking. The ability to
be able to take all that information in,
reorganize it, and spit it back out in an
organized fashion
• Vision
• Influence
– Not all influence is good, you can influence people in a bad way. It’s
your choice to be good or bad
• Empower
– To give people the tools they need to do what they need to be able to
do
•
•
•
•
Communication
Collaborative
Genuine
Healthy work environment
– Huge push right now in nursing…
– Read the article he posted, what it means to be a leader and what a
healthy work environment entails
•
•
•
•
•
Trait Theories
Behavioral Theory
Situational
Interactional
Transactional/Transformational
•
•
•
•
Autocratic
Democratic
Laissez-faire
Bureaucratic
•
•
•
•
•
Charismatic
Transactional
Transformational
Connective
Shared
• Leader makes decisions for the group
• Assumes workers are incapable of
independent decisions
• Where is this style effective?
– Military does this perfectly
– When the leader is the expert, what they say goes
– Effective in code situations and what not
• Leader encourages participative decisionmaking
• Empowers workers through collaboration
• Communication flow up and down
•
•
•
•
•
•
Presumes workers are internally motivated
Hands off approach
Assumes autonomy
Not a good style for every situation
You have to know the style of person
Veterans – will do what the dr tells them to, but maybe not you.
Don’t change very well… Told stories of his dad
• Baby boomers – hard workers, come in early, stays late. Invented
casual Friday, i.e. work hard and play hard.
• Generation X – Pearl Jam and what not. They like to get a task,
leave them alone, don’t tell them how to do it. “Latchkey Kids.” Like
to have a task and be left alone, don’t tell them how to do it. Don’t
like to be micro managed.
• Millennial Generation – have reputation of being hard workers,
good task people. Get things done when given a task.
•
•
•
•
Assumes workers are externally motivated
Relies on organizational rules and policies.
Inflexible approach
Everything is done is a specific way… They
discount completely the humanistic factor, but
the policy is the policy is the policy. There is a
problem with this, you have to sometimes
amend that.
• Personality invokes commitment
• Emotional relationship is formed with group
members
• Establishes rapport through contact
• Network very well
• Focused on day-to-day tasks to achieve
organizational goals
• Incentives to promote loyalty
• Emphasizes the process
• Attempts to control situations and followers
• The control factor is an issue, this might be
the person that is a micromanager…
•
•
•
•
Fosters creativity, risk-taking, collaboration
Empowers workers
Promotes independence, growth, change
Converts followers to leader through shared
values, trust and honesty
• But still focuses on the operational aspects of
your day to day leadership
• Promotes collaboration and teamwork
• Assumes the organization contains many
leaders
• Members get equal share in decision-making
• Participated decision making (shared decision
making) is like how everyone gets a voice in
the situation. The problems with this is that if
you have large groups, you can’t always have
everyone’s voice counting all the time
•
•
•
•
•
Introduction of managed care
Greater emphasis on business
New challenges
Expanded roles
Changed the face of nursing, made it more like a
business model, not just a medical model or
whatever.
• The most expensive commodity in the hospital is
nurses. Any healthcare organization, we are their
biggest expense
•
•
•
•
•
Servant
Authentic
Thought
Quantum
Cultural Bridging
“ to be a great leader, one must be a servant
first.” -Florence Nightingale
•
•
•
•
Communicator
Open minded
Critical thinker
Self-directed
Being a leader isn’t about
telling people what to do
and expecting them to do
it. Need to be a servant
first. Think about humility
• Exhibits humility
– Being able to admit when
you were wrong
• Emotional intelligence
– Self awareness
• Connects relationships
• Emotional intelligence refers to the ability to
use emotions effectively and is required by
leader/managers in order to enhance their
success.
• Emotional intelligence is critical for building a
cooperative and effective team.
• You have to listen to what’s going on
•
•
•
•
•
Self-awareness
Self-regulation
Motivation
Empathy
Social skills
– Networking with others, resource utilization is
important
• Adopted by the Nursing Organization Alliance
• This is the #1 nursing style of leadership right now, it
would be beneficial to read about this and be familiar
with it…
• “the glue that holds together a healthy work
environment.”
(Shirey, p. 257, 2006)
• Authentic leadership suggests that in order to
lead, leaders must be true to themselves and
their values and act accordingly.
• Values and purpose are linked!
What is the definition of transparent integrity?
a. Holding one’s employees accountable
b. Standing by one’s values in the face of
pressure
c. Willingly following the rules of one’s
organization
d. All of the above
• Purpose
– Key component. Maybe hear congruent leader, meaning
that you are able to walk the walk. When you say
something you’re going to do it. When you talk about stuff
you’re genuine and follow thru. Lead by example. What
you say and what you do are the same
•
•
•
•
Exhibit self-discipline
Link purpose and values
Establish relationships
Lead with your heart and ears
– You listen and you use your values in decision making
• Create healthy work environment
• A work setting structured in such a way,
employees can achieve personal satisfaction.
(Shirey, 2006)
• If you’re in a leadership role, what’s important for your
employees. You need to listen, ask them, what is important to
you? Gen X people want to work, then get outta here! Go
home and do stuff that they want to do! Baby boomers want
to work long hours in the hope that they will be running the
show someday.
• Employees are treated respectfully
• Strong trust between management and staff
– Way to do this is keeping your word, congruent
leadership, walk the walk, listen!
• Pervasive communication and collaboration
• Employees feel safe
– Physical safety and emotional safety
– There have to be emotional outlets for people
– Physical safety could be making sure everyone on your
floor understand proper body mechanics so they don’t
get hurt lifting people…
•
•
•
•
•
•
•
Humility
Courage
Empathy
Fair-mindedness
Integrity
Perseverance
Faith in Reason
– You have to have faith in the process and your people, very very
important
• Confidence
• Contextual Perspective
– If they’re always late, don’t just
make a snap decision, ask why
they’re late, maybe having family
problems or something
• Creativity
• Flexibility
• Inquisitiveness
• Integrity
• Intuition
• Open-mindedness
•
•
•
•
Thought provoking style
Attract others through innovation
Choose ideas with significant impact
Provoking innovation in others, empowerment
•
•
•
•
•
Based on environmental conditions
Change is constant
Constant interaction with the environment
Connecting points in time
Environment is always changing! Veterans and
people who don’t like change will have
problems with this!
Thought leaders attract followers by the
promise of representation or empowerment.
A. True
B. False
Which of the Following Is a Component of Emotional
Intelligence?
• Self-reliance
•
Assertiveness
•
Self-regulation
•
Charisma
Industrial leadership style
Focused on tasks and getting the job done to
increase productivity. Missing humanistic factor,
things happen, etc.
VS.
Relationship Age Leadership
Decision Making, Problem Solving,
and Thinking Critically
•
•
•
•
Result or outcome-oriented
Good problem-solving skills
Effective team-builder
Encourage “followership”
– Followership means setting a good example so
people want to emulate you
• Facilitates task management
• Scientific management (1900-1930)
- Frederick Taylor
More the industrial age, if you teach people to do this like a
robot, productivity will go up
o Management Functions
- Henri Fayol (1925)
hawthorn something or other, in the book
o Human Relations Management
o Everything from this point forward has included the human
aspect
Upper
Organizational responsibilities
Middle
Liaison to upper management
First
day-to-day operations
•
•
•
•
•
•
Leadership
Planning
Organizing
Coordinating
Directing
Thinking critically
Planning
Organizing
Controlling
Staffing
Directing
• Competing values in management, you’re always
moving between all of these characteristics
• Conflict management
– HUGE! Always a lot of this!
• Assertiveness
• Advocacy
– The pt and your staff, and your collegues
• Supervision
• Decision Making
•
•
•
•
Cognitive process
Choosing a course of action
Entails comprehensive problem solving skills
Critical thinking
– More complex than decision making
• Experiential Learning
– Learning by doing, not just by being told
• Sometimes not making a decision is making a
decision…
• Hands on approach
• Mock experiences
• Focused interaction between learners and
management
• Assess
• Identify the decision
• Plan
• Identify criteria for decision
• Choose and alternative
• Evaluate steps in decision
• Implement
• Evaluation
•
•
•
•
•
Define Objectives
Gather data accurately
Generate alternatives
Think logically
Act decisively
You can make a decision and never solve the
underlying problem, but you should. Don’t just
make a decision based on what needs to happen
• Take time to reflect
• Establish goals and objectives
• Define the purpose of the decision
•
•
•
•
Accuracy is crucial
Identify the problem
Persistent
Perception may influence values
• Decisions made on the best evidence
• Understanding why certain practices are
appropriate
• Understanding how best practices evolved
• Generate many alternatives
• May choose to not do anything
• Brainstorming
• Deductive reasoning
• Think through the
information
• Questions related to
problem
• Think of your own values
• Over-generalizing
• Affirming the
Consequences
• Arguing from the analogy
•
•
•
•
Consequences to actions
Change must be evaluated
Participative decision making
Ongoing learning process
• Make a decision!! Right, wrong, or
indifferent… Just do the shit already
• Dynamic in nature
• Vary from person-to-person
• Gender
– Women use more neuro capacities, different
hemospheres, blah blah blah
• Values
• Life experience
– Really influence how you make decisions, comes into
play about being self aware…
• Individual preference
•
•
•
•
Self-awareness
Life experiences
Individual preference
Individual thought process
• Organizational dynamics
• The influence of power
• The use of decision-making tools
- decision grids
- payoff tables
- decision trees
- consequence tables
• Think long term
– Overall vision and direction of things
•
•
•
•
•
Broad-based worldview
Influence and motivate others
Emphasize vision and values
Embrace change
Capable of coping with conflict
•
•
•
•
Functions as a role model
Life-long learner
Utilizes evidence-based practice
Team building
Performance
Outer
Results
Skills
Abilities
Technical
Leader
Competence
Character
Adaptive
Influence
Inner
Authenticity
• You are working as a nurse in the adult ED.
The flight crew arrives in the adult ED
proclaiming an airway emergency following a
MVC. No trauma activation has occurred.
• How would you expect the nurse manager
handle the situation?
• You are the nurse manager on a cardiac
telemetry floor. An experienced nurse that is 6
months off orientation fails to level chest
tubes, document output, and complete I’s and
O’s. When confronted, the nurse states, “it is
not my fault. You did not give me what I
needed in orientation.”
• A long time nurse working on the unit is
outspoken and negative in the workplace
about everything. The employee is known to
be a hard worker and often works overtime,
helping out when needed. However, his/her
behavior is toxic to the overall work
environment.
• How would you handle this situation as a
nurse/nurse manager?
Marquis, B. L., & Huston C. J. (2006). Leadership roles and management functions in
nursing: Theory and application. Philadelphia: Wolters Kluwer.
Shirey, M. R. (2006). Authentic leaders creating healthy work environments for nursing
practice. American Journal of Critical Care, 15(3), 256-267.