Nursing Leadership &
Management
Patricia Kelly-Heidenthal
0-7668-2508-6
Delmar Learning
Copyright © 2003 Delmar Learning, a Thomson Learning company
Chapter 8
Leadership and Management
Delmar Learning
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Objectives

Upon completion of this chapter, the reader should be
able to:
•
•
•
•
•
•
Define management.
Describe the management process.
List 10 roles that managers fulfill in an organization.
Explain management theories.
Discuss motivation theories.
Define leadership and explain its importance for
organizations.
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Objectives
•
•
•
•
Differentiate between leadership and management.
Describe characteristics of effective leaders.
Identify leadership styles.
Explain Hersey and Blanchard’s situational theory of
leadership.
• Discuss transformational leadership theory.
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Definition of Management

Management can be defined as a process of
coordinating actions and allocating resources to
achieve organizational goals.
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Management Theories
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Ideas of management can be found in ancient Samaria
and Egypt as early as 3000 B.C.
Most current understanding of management comes
from the later 1800s.
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Management Theories
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Scientific Management: 1900–1930
Bureaucratic Management: 1900–1920
Administrative Management: 1900–1930
Human Relations: 1930–1970
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Motivation Theories

Motivation is a process that occurs internally to
influence and direct a person’s behavior in order to
satisfy his or her needs.
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Maslow’s Hierarchy of Needs
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Needs occur in a hierarchy.
Needs must be satisfied at one level before a person is
motivated to satisfy needs at the next level.
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Hygiene and Motivation Factors:
Herzberg
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Maintenance or hygiene factors are necessary for
neutral job satisfaction—salary, job security, working
conditions, status, quality of supervision, relationships
with others.
Motivation factors are intrinsic and provide
motivation and enhanced job satisfaction—
achievement, recognition, responsibility,
advancement, opportunity for development.
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Theory X and Y: McGregor
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This theory focuses on two contrasting attitudes.
Theory X suggests that employees prefer security,
direction, and minimal responsibility; employees are
uncreative and must be coerced or threatened to get
them to work.
Theory Y suggests that employees can exhibit selfcontrol and discipline; employees can be creative and
intrinsically motivated by work.
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Theory Z: Ouchi
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This theory is based on observations of Japanese
organizations.
It views organizations and workers more holistically.
The emphasis is on collective decision making, longterm employment with slower promotions, and less
direct supervision.
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The Changing Nature of Managerial
Work
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Fewer managers, more responsibility
Nurse-managers increasingly manage systems, not
just groups of nurses
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Definition of Leadership
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Leadership is commonly defined as a process of
influence whereby the leader influences others toward
goal achievement.
Formal and informal leadership
• Formal leadership is based on occupying a position in an
organization, called assigned leadership.
• Informal leadership occurs when an individual
demonstrates leadership outside the scope of a formal
leadership role or as a member of a group, rather than as the
head or leader of the group. The informal leader can be
considered to emerge as a leader when accepted by others
and perceived to have influence.
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Leadership and Management Are
Different
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Leadership is about creating change, and management
is about coping with complexity.
Leadership characteristics
• Leaders focus on a professional and purposeful vision that
provides direction toward the preferred future.
• Passion expressed by leaders involves the ability to inspire
and align people toward the promises of life.
• Leaders possess integrity based on knowledge of self,
honesty, and maturity developed through experience and
growth.
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Leadership Theories

The major leadership theories can be classified
according to the following approaches:
• Behavioral Approach
• Contingency Approach
• Contemporary Approach
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Behavioral Approach
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Autocratic leadership involves centralized decision
making, with the leader making decisions and using
power to command and control others.
Democratic leadership is participatory, and authority
is delegated to others. The democratic leader uses
expert power and the power base afforded by having
close, personal relationships to be influential.
Laissez-faire leadership is passive and permissive,
and the leader defers decision making.
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University of Michigan and Ohio State
University Studies
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Employee-centered leadership was considered more
effective and was described as having a focus on the
human needs of subordinates.
Job-centered leadership was seen as less effective for
its focus on schedules, cost, and efficiency and the
resulting lack of attention to developing work groups
and high performance goals.
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Leader Behavior
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Initiating structure involves an emphasis on the work
to be done, a focus on the task and production.
Leaders who focus on initiating structure are
concerned with how work is organized and on the
achievement of goals.
Consideration involves activities that focus on the
employee and emphasize relating and getting along
with people. The leader is involved in creating a
relationship that fosters communication and trust as a
basis for respecting other people and their potential
contribution.
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Contingency Approaches

Contingency theory acknowledges that other factors in
the environment influence outcomes as much as
leadership style and behavior.
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Fielder’s Contingency Theory
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Fiedler’s theory views leader behavior as dependent
upon the interaction of the leader’s personality and the
needs of the situation. The needs of the situation or
how favorable the situation is toward the leader
involves leader-member relationships, the degree of
task structure, and the leader’s position power.
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Fielder’s Contingency Theory
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Leader-member relations are the feelings and attitudes
of followers regarding acceptance, trust, and
credibility of the leader.
Task structure means the degree to which work is
defined with specific procedures, explicit directions,
and goals.
Position power is the degree of formal authority and
influence associated with the
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Hersey and Blanchard’s Situational
Theory

Situational leadership theory emphasizes follower
readiness as a factor in determining leadership style.
Follower readiness, called maturity, is assessed in
order to select one of four leadership styles for a
situation:
•
•
•
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Telling: high task, low relationship behavior
Selling: high task, high relationship behavior
Participating: low task, high relationship behavior
Delegating: low task, low relationship behavior
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Path-Goal Theory
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In this leadership approach, the leader works to
motivate followers and influence goal accomplishment.
• Directive Style provides structure through direction and
authority; leader is focused on the task and getting the job
done.
• Supportive Style is relationship-oriented; the leader provides
encouragement, interest, and attention.
• Participative Style focuses on involving followers in the
decision-making process.
• Achievement-oriented Style provides high structure and
direction as well as high support through consideration
behavior.
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Substitutes for Leadership
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Substitutes for leadership are variables that may
influence or have an effect on followers to the same
extent as the leader’s behavior:
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•
•
•
•
•
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Experience, ability, training
Professionalism
Structured, routine tasks
Feedback provided by the task
Intrinsic satisfaction
Cohesive group
Formalized organization
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Contemporary Approaches

Contemporary approaches to leadership address the
leadership functions necessary to develop learning
organizations and lead transforming change.
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Charismatic Leadership Theory

Charismatic leaders display self-confidence, have
strength in their convictions, and communicate high
expectations and their confidence in others. They have
been described as emerging during a crisis,
communicating vision and using personal power and
unconventional strategies.
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Transformational Leadership

Transformational leadership theory is based on the
idea of empowering others to engage in pursuing a
collective purpose by working together to achieve a
vision of a preferred future.
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Future Directions
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The organization of the future is the knowledge
organization composed of knowledge workers.
The New Leadership
• A new view of leadership encompasses connectedness and
self-organizing systems that follow a natural order of both
chaos and uncertainty, which is different from a linear order
in a hierarchy.
• The leader’s function is to guide an organization using
vision, to make choices based on mutual values, and to
engage in the culture to provide meaning and coherence.
• This type of leadership fosters growth within people both as
individuals and as members of groups.
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