Management and
Leadership in Nursing
NUR 211
Spring 2003
Ginny Rogers
Ginny Rogers NUR211 2003
“To be good is noble. To
teach others to be good is
nobler, and no trouble.”
Mark Twain
Ginny Rogers NUR211 2003
NUR 211
Syllabus and PowerPoints available on
the web
Final exam Room May 7th 11:00 AM –
1:00PM
Weekly exams
Project- see grading criteria page in
Student Assignments
Ginny Rogers NUR211 2003
NUR 211
Paper – see grading criteria page
Journal

See journal assignment eval. page
ATI comprehensive exam
passing rate
 Failure requires taking review class and
retake Seminars – required, info will be
included on exams

Ginny Rogers NUR211 2003
Clinical information
Read role definitions
 Weekly evals must be filled in by preceptor
and signed, student must return to
instructor with journal.
 Students must inform instructor of ANY
problems immediately.
 Final evaluation- critical behaviors must be
achieved independently by the completion
of clinical work
 Please spend time looking over the final
evaluation tool, if you feel you are unable
to achieve any objectives in your facility, let
your instructor know. This is your
responsibility.

Ginny Rogers NUR211 2003
Unit 1
Ginny Rogers NUR211 2003
Health Care Delivery Systems
Reforms began ½ century ago
 DRGS – first federally organized incentive
to keep health care costs down
 1992 – Clinton’s task force looked at
including the 40 M Americans w/o
insurance (part of P.Bush’s agenda post
war)

Managed Care
Refers to the assumption of responsibility
and accountability for the health of a
defined population and the simultaneous
acceptance of financial risk.
 Care is population
based ( imp. Change of
Ginny Rogers NUR211 2003
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Changes in Health
Care
MANAGED CARE
COST CONTAINMENT
CONTROL OF RESOURCES
RESTRUCTURING OF HEALTH CARE
ENVIRONMENT
NURSING CASE MANAGEMENT
Ginny Rogers NUR211 2003
Managed Care
Care is population based
All participants are held accountable\
Information to assess value will be
necessary
Primary care is of central importance
Interdependence is very important
Contracts are used to detail finances
and delivery of care
Ginny Rogers NUR211 2003
Nursing Shortage
Aging work force
Image
Retention
Emigration of internationally trained
(controversial)
Nurses need to be politically active
Ginny Rogers NUR211 2003
Leadership Theories
Great Man theory
Charismatic theory
Trait theory
Behavioral school
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Autocratic
Democratic
Laissez-faire
Eclectic
Situational theory
Contingency Model
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Life-Cycle theory
New theory of leadership
Transformational leadership
Connective leadership
Ginny Rogers NUR211 2003
Leadership Style and Leader Behaviors
Leader –centered
Group-centered
Use of Authority by Leader
abdicrat
autocrat
Tells
Freedom of the group
Sells
Tests
Ginny Rogers NUR211 2003
Consults
Joi
TRAITS OF A MANAGER
HAVE AN ASSIGNED POSITION WITHIN THE
FORMAL ORGANIZATION
HAVE A LEGITIMATE SOURCE OF POWER DUE
TO THE DELEGATED AUTHORITY THAT
ACCOMPANIES THEIR POSITION
ARE EXPECTED TO CARRY OUT SPECIFIC
FUNCTIONS, DUTIES, AND RESPONSIBILITIES
EMPHASIZE CONTROL, DECISION MAKING,
DECISION ANALYSIS, AND RESULTS
MANIPULATE INDIVIDUALS, THE ENVIRONMENT,
MONEY, TIME, AND OTHER RESOURCES TO
ACHIEVE ORGANIZED GOALS
HAVE A GREATER FORMAL RESPONSIBILITY AND
ACCOUNTABILITY FOR RATIONALITY AND CONTROL THAT
LEADERS
DIRECT WILLING AND
UNWILLING SUBORDINATES
Ginny Rogers NUR211 2003
TRAITS OF A LEADER
OTHERS OFTEN DO NOT HAVE
DELEGATED AUTHORITY BUT OBTAIN
THEIR POWER THROUGH OTHER MEANS,
SUCH AS INFLUENCE
HAVE A WIDER VARIETY OF ROLES THAN
DO MANAGERS
ARE FREQUENTLY NOT PART OF THE
FORMAL ORGANIZATION
FOCUS ON GROUP PROCESS,
INFORMATION GATHERING, FEEDBACK,
AND EMPOWERING
Ginny Rogers NUR211 2003
Traits of a Leader
EMPHASIZE INTERPERSONAL RELATIONSHIPS
DIRECT WILLING FOLLOWERS
HAVE GOALS THAT MAY OR MAY NOT REFLECT
THOSE OF THE ORGANIZATION
Ginny Rogers NUR211 2003
ETHICS IN LEADERSHIP
MANAGEMENT WITHOUT VALUES,
COMMITMENT, AND CONVICTIONS
CAN ONLY DO HARM”
“WITHOUT INTEGRITY TRUST IS
IMPOSSIBLE”
Ginny Rogers NUR211 2003
Tnansformational vs.
Transactional Leader
Transactional is traditional, one person
steps up, leader and follower/s have
separate but related purpose
Transformational leader mobilizes
others, has a vision, and is values
oriented
Ginny Rogers NUR211 2003
Contingency Theories
Fiedler’s theory
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Match the leadership style to the situation
Situational leadership theory

Expansion of above theory – looked at four
leadership behaviors matching four types of
followers
Roles and Functions of Nursing Manager

Read through the roles – not on test
Ginny Rogers NUR211 2003
Characteristics of
Organizations
All organizations resemble one another
Organizations are a cluster of
suborganizations
Organizations have similar problems
Organizations have cylces
Organizations have crises
Some organizational goals are easier to
meet than others
Ginny Rogers NUR211 2003
Organizations - Theory
Classical Theory
Division and specialization of labor
 Chain of command
 Organizational structure
 Span of control
 Bureaucracy
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Neoclassical
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Humanistic
Systems theory
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Closed or open
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Types of power
Coercive
Reward
Legitimate
Expert
Referent
Information
connection
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Power and Leadership
Image as power
Power and professional influence
Power plus vision
How can nurses become more
powerful?
As individuals?
 As a group?
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Political Influence
Allocation of scarce resources
Interpersonal endeavors
Collective activity
Analysis and planning
Image
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Political Action
Framework
Politics in the workplace
Politics in government
Financing
Organizational politics
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Contingency
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Matches structure to environment
Chaos
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Based on continuous change
Health care organizations
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Types of Ownership
Types of organizations
Organizational Structure
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Horizontal
Vertical
Hybrid
Matrix
Parallel
Shared governance
Ginny Rogers NUR211 2003
Strategic Planning
Values
 Vision
 Mission Statement
 Philosophy
 Goals
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Writing Mission Statements
Ginny Rogers NUR211 2003