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PAD.DR.D Y PATIL COLLEGE OF NURSING
ASSIGNMENT ON leadership
SUBMITTED TO:
Mrs. Nisha Naik Lecturer
SUBMITTED BY:
Mrs. Priyanka Pathak 2ND Year M. Sc. Nursing
LEADERSHIP
INTRODUCTION Leadership is that leadership is the art of motivating a group of people to act towards achieving a common goal. Put even more simply; the leader is the inspiration and director of the action. He or she is the person in the group that possesses the combination of personality and skills that makes others want to follow his or her direction. In business, leadership is welded to performance. Effective leaders are those who increase their companies' bottom lines. To further confuse the issue, we tend to use the terms "leadership" and "management" interchangeably, referring to a company's management structure as its leadership, or to individuals who are actually managers as the "leaders" of various management teams. leadership involves more. To be effective, a leader certainly has to manage the resources at her disposal. But leadership also involves communicating, inspiring and supervising - just to name three more of the main skills a leader has to have to be successful.
CONCEPT OF LEADERSHIP Leaders typically are the ones who “go first”. They have vision and influence other by their actions and their comments. This ability is the essence of leadership like the word “lead” another word manage comes from meaning. “Hand” managing them means “handling things “. In essence managers get other people to do, but leaders get other people to want to do. Leaders are most often associated with times of turbulence innovation social transformation and change, whereas manager are more often assist anted with improving productivity, establishing order and stability and making thing run to smoothly management is the proceed of v getting work done through others . Nurse
Managers at agree hierarchical level are expected to lead subordinates towards institutional. Objectives as efficiently as possible.
DEFINITION OF LEADERSHIP Although the term leader has been in use since the 1300s, the word leadership was not known in the English language until the first half of the 19th century. Leadership is the process of influencing people to accomplish goals, i.e. it is the ability to influence behaviors o f others, towards the achievements of a mutually establishes goal. The leader and follower roles are determined by peoples interaction within groups, in contrast, the role of managers or administrator are jobs within organization the role of manager is to coordinate the efforts of lower level employees i.e. subordinates to advance the goals of the organization. Leadership is a force that creates a capacity among a group of people to do something that is different or better Leadership – what leaders do; the process of influencing a group to achieve goals An effective leader is a catalyst who facilitates effective interaction among manpower, material and time. A skilful leader is synergist, who co-ordinates the efforts of multiple workers with diverse skill. Leadership is social relationship in which one party has a greater ability to influenced b him or her. Thus, leadership is based on a powerful differential between interacting persons. Leadership is needed in cooperative enterprise to align employees in support of goals, to spark group interaction, to blend efforts of specialties. Thus nurse managers at every organizational level select leadership style and methods that suit work force requirements.
HISTORY OF LEADERSHIP PRACTICE IN NURSING NIGHTINGALE‟S SCHOOL OF NURSING She considered first nurse executive. She integrated the functions of modern nursing as care provider, management interdisciplinary education and scientific research.
EARLY US HOSPITAL The better nursing school wanted superintendents, teachers and head nurse who were cultivated women and educators as well as practioners. 1930-1940 THE BUREACACY Nurse experienced difficulty in returning bureaucrat hospital setting after functioning independently head nurses made in charges over staff nurses.
1940-1950 TEAM NURSING As a mechanism for other nurses to share the supervision responsibility team leader was senior nurse.
1960 PRIMARY NURSING Primary nursing delegates‟ decision making to bed side nurses. 1970 DECENTRALIZATION To move a way from vertical organization with authority and decision making task a t the top level. 1980 SHARED GOVERNANCE It recognizes the interdependence of every department in achieving quality product. 1990 PATIENT CENTERED CARE. It recognizes the interdependence of every department in achieving quality product.
PRINCIPLES OF LEADERSHIP 1. Vision: (leadership begins with a vision.)A vision is a clear picture of what the leader sees his group being or doing. If followers grasp the vision, become cohesive and will be able to work towards common goal. A commitment to act on a vision a mission. 2. Goal setting: goals are a set of specific measurable steps designed to achieve the vision and the mission. Goals must be S-M-A-R-T; specific, measurable, attainable, realistic and tangible. Goal setting is an ongoing process. 3. Love: An act of the will on which the leader works towards the highest good of others. 4.Humility: A humble person is free from pride and arrogance, helpful and courteous. 5. Self control: essential attitude and characteristic of a leader.It brings freedom, confidence , joy , stability and strong sense of leadership. 6.Communication: the ability to communicate effectively through speech and writing. 7. Investment: to maximize its benefit to the group. 8. Opportunity: obstacles as the key to opportunities, attitude to handle mistakes. 9.Energy: attracts attention and followers .A leader with energy and enthusiasm gains acceptance and confidence of others. 10. Staying power: essential to overcome problems and discouragement. Indicates strong awareness to a commitment. 11. Authority: - Internal authority- the charisma, self esteem, the personality that causes a person to command respect of others. 12. Awareness: the leader must be aware of her leadership, constantly monitoring the performance against a standard that she has set for herself to achieve excellence.
TYPES OF LEADERSHIP
TRANSACTIONAL VERSUS TRANSFORMATIONAL LEADERSHIP
Outhwaite (2003) cites definitions of transactional and transformational leadership as posited by bass in 1990. Transactional leadership involves how an integrated team works together and the innovativeness of their approach to the work Outhwaite (2003). For example, a leader can empower team member by allowing individual to lead certain aspect of a project based on their areas of expertise. This will encourage to development of individual leadership skill. In addition, leaders should explore barriers and identify conflicts when they arise, and then work collaboratively with team, sharing in the work, thus remaining close to perspective (Outhwaite, 2003) Transactional leadership focuses on providing day to day care, while transformational leadership is more focused on processes that motivate followers to perform to their full potentential influencing change and providing a sense of
direction (Cook2001). The ability of a leader to articulate a shared vision is an important aspect of transformational leadership (Faugier & Woolnough, 2002). Transactional leadership is most concerned with managing predictability and order, while transformational leaders recognize the importance of challenging the status quo (Faugier & Woolnough, 2002) . One group of authors described the use of transformational leadership by Magnet hospital (De Geest, Clsaessens, Longerich, & Schubert, 2003). This leadership style allows for solving, transmission of values and ethical principles, and ethical principles, and provision of challenging goals while communicating a vision for the future (De Geest, Clsaessens, Longerich, & Schubert, 2003). Transformational leadership is extremely important.
TRANSACTIONAL AND TRANSFORMATIONAL LEADERS Transactional Leaders 1. focuses in management tasks 2. Is care taker 3. Uses trade- offs to meet goals 4. Shared values not indentified 5. Examines causes 6. Uses reward contingency Transformational Leaders 1. Identifies common values 2. Is committed 3. Inspires- others within vision 4. Has long-term vision 5. Looks at effects 6. Empowers others
LEADERSHIP STYLES: THEORIES The word”style” is the way in which the leader influences followers. Style is distinctive or characteristics manner of performance. Style is defined as “the exclusive privilege of the expert. With style, the end is attained without side issues”. Style implies an elegance and economy of effort to be sought by every professional manager. Style in general involves the way in which something is said or done, including particular behaviors associated with an individual. Leadership style specifically is the way that the leaders influence the group to accomplish goals. Let us have a look at the various studies that help us to understand the leadership styles..
LEADERSHIP THEORIES 1. Scientific leaders? Manager, style theory 2. Human relation theory 3. Henri fayol theory of managerial style 4. Mcgregor theory 5. Theory z 6. Trait theory of leadership 7. Behavioral theory of leadership style 8. Situational theory
1. SCIENTIFIC LEADERS? MANAGER, STYLE THEORY This theory was developed by Fredrick Winslow Taylor (1856-1915). In 1911, he emphasized technology as the basis of increasing productivity. He introduced time-and-motion studies to analyses tasks based on belief that improving the performance would improve the efficiency of the organization. He relied on scientific study of time and movement spent and used for a job to improve the performance of the worker and recommended careful selection and training of workers, who could meet the established work standard. The leaders utilize this Taylor‟s principle.
2. HUMAN RELATION THEORY This theory was developed by Elton Mayo and Fritz Roethlisberger after conducting series of studies from 1924 to 1932 at Howthorne Western Electric plan, Chicago, to test several assumption of scientific management. They believe that real power centers within the organization are the interpersonal relationship established within the work organization. These studies aimed at finding out if changes in illumination, rest period and lunch breaks can affect the productivity of worker‟s. It was found that less light, shorter and fewer rest periods and shorter lunch breaks resulted in increase in productivity. Increase in productivity was attributed to the attitude to the workers by researchers made them feel important which resulted in improvement in their work performance. It suggests that employees. The finding of this study concludes that a leader not only should plan, decide, organize, lead and control but also consider the human element.
3. HENRI FAYOL THEORY OF MANAGERIAL STYLE Henry Fayol (1841-1925 defined functions of manager in they that has come to be known as the management process, which includes planning, organizing, directing and controlling. These functions are similar in many ways to the “Nursing
process” Manger/ Leader; assess the type and amount of work needed and capabilities of the employees to perform it. Manager also plan to organizes work duties ,direct staff and customers and finally control the quality work by evaluating and revising plans. This management function constitutes a set of behaviors expected of managers/leader. When it can be applied to nursing unit, where about nurses assess their clients needs, plans and organize client care, direct staff and clients, and control the quality of client care by evaluating and revising care plans. Fayol defines the essential activities needed to maintain of functioning organization and his experience led him to develop following management principles. 1) There should be such a division of work and task specialization that different workers consistently carry out different job responsibilities. 2) Each worker should be given authority commensurate with the amount of his responsibility. 3) Each employee should receive orders from only one supervisor. 4) One person should direct all activities that support simple activities. 5) The interest of individual worker should be subordinated to interest of the total work group. 6) There should be an unbroken scalar chain of authority extending from the top executive to the lowest level worker. 7) All employees should be treated with equity and justice. 8) Manager should help workers to develop team work and esprit De corps.
4. McGREGOR THEORY Douglas McGregor (1960) categorized leadership style into two brand categories in his management theories, i.e. theory X and theory Y, having two different beliefs and assumption about subordinates. Manager, who believes in theory X and assumes that people inherently dislike work, will and avoid it when possible and the average individual prefers to be directed, wants to avoid responsibility and is more interested in financial incentives than personal achievement. Therefore, the style of leadership exercises strong controls and direction
s and wherever necessary punish people if they do not do the work of people do the work as desired, they may even get monetary or other rewards. In contrast to theory X, the theory Y provide a more accurate assessment of human nature, one that encourages workers to develop their full potential. This theory Y, assumes that employees can enjoy physical and mental work justly as they enjoy play and rest. Employees are capable of self motivation and job satisfaction if they are happy in the organization and committed to its goals. Under proper conditions, the average person learns both to seek and accept responsibility. The capacity to apply creativity to solving organizational problem is widely, not narrowly distributed among the workers. Theory Y leaders assume that people will work hard and assume responsibility if they can satisfy their personal needs, and the objectives or goals of their organization. It suggested that theory Y organization will satisfy higher human needs, resulting in greater employee responsibility and in turn, higher productivity
5. THEORY Z Japanese have adapted the principle of human relation theory, is commonly known as “theory Z” the trust of this theory is participation in management involvement of the employees in decisions that affect them. This theory emphasizes group decision making, lifetime job security, and strong commitment to the goals of the organization. The desire results are a greater sense of a job commitment, higher productivity and lower turnover. Here as stressed in human relations theory, the importance of employee morale on productivity is reflected in the value placed group decision making.
6. TRAIT THEORY OF LEADERSHIP The great man theory trait theories were basis for most leadership research until the mid 1940s. The great man theory, from Aristotelian Philosophy, asserts tat some people are born to lead, whereas other is born to be led. Trait theories assume that some people have certain characteristics or personality traits the distinguish great
leaders; researchers studied the lives of prominent people through out history. The effect of followers and the impact of the situation were ignored. Although trait theories has obvious short coming (i.e. they neglect they impact of others or the situations on the leadership roles) they are worth examine many of the characteristics identified in trait theory are still used to describe successful leaders today.
CHARACTERSTICS OF A LEADER Intelligence Knowledge Judgment Decisiveness Oral fluency Personality Adaptability Creativity Cooperativeness Alertness Self confidence Personal integrity Emotional control Nonconformity independence
7. BEHAVIORAL THEORY OF LEADERSHIP STYLE According to the theory, a leader behaves according to the role expectations of the group. This theorist believes that leadership style like other behaviors can be learned regulated and developed. There is no one best leadership style. The effectiveness of each leadership style depends upon the situation. As the situation changes, the effectiveness manager adapt by changing leader behaviour research has identified four styles of leadership in mangers from various fields; autocratic, democratic participative and laissez- faire.
Ability Able to enlist
cooperation Interpersonal skills Tact, diplomacy Prestige Social participation &
balance
Autocratic style:In this autocratic style of leadership task oriented. Leader uses positional and personal power in authority‟s manner, retaining responsibility for all goal setting and incision making. A leader of this type makes decision without the participation of people concerned. Autocratic style leader characterized by the following behaviors; 1. Strong control is maintained over the group 2. Others are motivated by the concerned 3. Communication flow downward 4. Decision making does not involve others 5. Emphasis on difference and status 6. Criticism is punitive.
Democratic Style:In the democratic style of leadership, the leader values the individual characteristics‟ and abilities and subordinates Democratic style leader characterized by the following behaviors; 1. Less control is maintained 2. Economic and ego awards are used to motivate 3. Others are directive through suggestion and guidance 4. Communication flows up to down 5. Decision making involve others 6. Emphasis in “We” rather than I and you 7. Criticism is constructive
The Participative Leadership Style:In this style, the manger presents her or his analysis of problems and proposal of action o employees, inviting their criticism and comments. Having weighed the subordinates “response” the manager makes final decisions about the group future
activities. Here the leader allows subordinates to participate in decision making; consequently the subordinates have the feeling of satisfaction and freedom.
Laissez faire style/ abdicratic:In this “let alone” style of leadership, the appointed manager abdicates
leadership responsibility, leaving workers without direction, supervision or coordination and allows them to plan, execute, and evaluate the work in any way they like. Abdicratic style leader characterized by the following behaviors; 1. He or she is permissive with little or no controle 2. Motivate by support when requested by the group or individual 3. Little or no direction provided 4. Decision making is dispersed throughout the group 5. Emphasis on the group 6. Criticism not given
8. SITUATIONAL THEORY In this approach, a leader is the product of given situation and the behiour may infact, vary from one situation to another. This theory includes the traits of mani.e. qualities and motivcations, that bring forth and shape the leadership potential. According to this theory, we can find five kinds of leader as follows 1. Natural leader:Here person becomes a leader in spite of himself. He does not seek the role, it is thurstwed upon him byb the group and by the tide of events, e,g, Abraham Lincoline, Mahatma Gandhi, JP Naryan. 2. Charismatic leader:Here person is in authentic hero in the eyes of his followers for he can do no wrong. He/she inspire people to make any sacrifice even their lives for the cause e.g. Ashok, Akbar, Netaji Subhashchandr bose etc. 3. Rational leader:-
Here the person is consistent and persistent, e.g. Karl Marx, Lenin, Mao, GK Gokhle. 4. Consensus leader:This leader is perceived as acceptable to all. He or she in the absence of the above three and this leader is in tenous position of walking atight rope for existence E.g. president of india, spekers of the assembly of parliament. 5. Leader by the force:Here the leader‟s power speaks through the nozzle of gun. She/he dominates others through fear. He is ruthless in suppressing opposition. He does not reign long as thus type of leadership contains within itself the seeds of its own destruction. E.g. Napoleon, Hitler, Staline Idi Amin etc.
LEADERSHIP SKILLS To be effective Leader the nurses need the primary leader shipskills that as foolws: 1. Skills of personal I. II. III. IV. V. Is sensitive to feelings of the groups. Identifies self with thee needs of the group. Does not ridicule or critcise another suggestion Helps others feel important and needed. Does not argue
2. Skills of communication. I. II. III. IV. Listen attentively Make sure everyone understand what is needed and the reason why? Establishes positive communication with group as routine part of the job Recognizes that everyone‟s contributions important
3. Skills of organization: the effective leader helps the group to; I. II. III. IV. V. Developing long and short range objectives Break big problem into small ones Share responsibilities and opportunities Plan act follow up and evaluative Be attentive details
4. Skills of self examination I. II. Is aware of personal motivations Is aware of the group members; level of hospitals for taking appropriate countermeasures III. Helps the group to be their attitudes and values.
S=self reliant E=enthusiastic
L=loyal F=factual
LEADERSHIP ACTIVTIES 1. DIRECTING: - it is the process by which actual performances of staff and people, is guided towards common goals. A leader uses assignments, order, policies, procedure, rules. Regulations, standard, opinions, suggestions and questions to direct subordinates behaviour. 2. SUPERVISING: - supervision is continuous administrative and educative process which enables the supervisor through the medium of his relationship with supervisors to contributes towards the continuous growth of the supervision which includes inspecting another‟s work, evaluating her or his performance, and approving or correcting performances. 3. CO- ORDINATING: - Co-coordinating includes all the activities that enable work group members to work together harmoniously.
QUALITIES OF A NURSE LEADER 1. KNOWLEDGE OF SELF 2. PERSONAL QUALITIES 3. INITIATIVE QUALITIES 4. TECHNICAL QUALITIES 5. TEACHING QUALITIES 6. ADMINISTRATIVE QUALITIES 7. INTELLECTUAL SKILLS 8. ENTHUSIASM 9. TACTFUL 10.EMOTIONAL CONTROL 11.AWARENESS OF RESPONSIBILITIES 12.QUALITY OF BUILDING HUMAN RELATIONS
CHARACTERISTICS OF EFFECTIVE LEADERSHIP: 1. Initiates action- Leader is a person who starts the work by communicating the policies and plans to the subordinates from where the work actually starts. 2. Motivation- A leader proves to be playing an incentive role in the concern‟s working. He motivates the employees with economic and non-economic rewards and thereby gets the work from the subordinates. 3. Providing guidance- A leader has to not only supervise but also play a guiding role for the subordinates. Guidance here means instructing the subordinates the way they have to perform their work effectively and efficiently. 4. Creating confidence- Confidence is an important factor which can be achieved through expressing the work efforts to the subordinates, explaining them clearly their role and giving them guidelines to achieve the goals effectively. It is also important to hear the employees with regards to their complaints and problems. 5. Building morale- Morale denotes willing co-operation of the employees towards their work and getting them into confidence and winning their trust. A leader can be a morale booster by achieving full co-operation so that they perform with best of their abilities as they work to achieve goals. 6. Builds work environment- Management is getting things done from people. An efficient work environment helps in sound and stable growth. Therefore, human relations should be kept into mind by a leader. He should have personal contacts with employees and should listen to their problems and solve them. He should treat employees on humanitarian terms. 7. Co-ordination- Co-ordination can be achieved through reconciling personal interests with organizational goals. This synchronization can be achieved through proper and effective co-ordination which should be primary motive of a leader.
Critical thinking & decision making in leadership
Application of critical thinking to nursing practice: Nurse leader function effectively some part of every day without thinking critically. Many small decisions are based primarily on habits with minimal thinking involved; example include selecting what cloths to wear, choosing which route to take
work, and deciding what to eat for lunch. The nurse clinician and nurse manager seeks to be aware of their thinking while they are thinking, as they apply standards for thinking, and as thinking progresses. A. Problem solving: Nurse leader use critical thinking to rationally resolve problems related to direct client care. Nurse Manager use critical thinking to resolve problems related to overall client care, unit administration, and staff interpersonal issues. Strader 1992 defines problem solving as “the process used when a gap is perceived between an existing state and a desired state.” - Trial and error: One way to solve problems is trial and error, in which a number of approaches are tried until a solution is found. - Intuition: Intuition as a problem solving method has not been considered either sound or legitimate. Rather, it has been viewed as a form of guessing and as such an inappropriate basis for nursing decisions. B. Decision making: Tschikota 1993 states that, “effective clinical decision making is critical to the future of professional nursing practice.” Nurses make decisions in the course of solving problems, for example, in each step of nursing process. Decision making, however, is also used in situations that do not involve problem solving. Nurses make value decisions; time management decision; scheduling decisions and priority decisions. Strader 1992 describes seven steps of decision making process: 1. Identify the purpose. 2. Set the criteria. 3. Weight the criteria. 4. Seek alternatives. 5. Test alternatives. 6. Troubleshoot. 7. Evaluate the action. The decision making process and the nursing process share similarities. The nurse use decision making in all steps of the nursing process. C. Clinical decision making: When a nurse approaches a clinical problem, such as a client who has developed a pressure ulcer or who is anxious about having surgery; the nurse collaborates with the client to make a decision that identifies the problem and then chooses those nursing interventions that will meet the mutually established goals of care. Nurses make clinical decision all the time in an attempt to improve a client‟s health or to maintain ongoing wellness. This may mean resolving the problem completely. The clinical decision making process requires careful reasoning so that the options for the best client outcomes are chosen on the basis of the clients condition and the priority of the problem.
D. Scientific method: The scientific method is one approach to reasoning that is used in nursing, and a variety of other disciplines. It is approach to seeking the truth or verifying that a set of facts agrees with reality. Nurse researcher uses the scientific method when testing research questions in nursing practice situations. For example, a nurse researcher might observe that clients in a hospice program often have difficulty communicating their feelings to family members. The nurse learns more about what cause this problem and consider this possibility that family members might have ineffective communication skills. The nurse might design a study that involves formal instruction in communication skills and use a support group to help family members practice and apply the skill. E. Diagnostic reasoning: As soon as a nurse receives information about a client in a particular clinical situation, diagnostic reasoning begins. It is a process of determining a client‟s health status after the nurse assigns meaning to the behaviors, physical signs, and symptoms presented by the client. Part of diagnostic reasoning is inference, that is, the process of drawing conclusions fro drawing conclusions from related pieces of evidence. For example, when a client presents symptoms of restlessness, guarded posturing and abnormal discomfort, the nurse must retrieve knowledge regarding pain in the abdomen and the reason in a direct and precise way to determine the specific nature of client‟s pain. F. Nursing process: Nurses apply the nursing process as a competency when delivering client care. The nursing process consists of five steps: assessment, diagnosis, planning, implementation and evaluation. The purpose of the nursing process is to diagnose and treat human responses to actual and potential health problems.
Nursing process: Assessment Diagnosis Plan
Critical thinking and decision making process: Identify the Purpose.
Set a criteria Weigh the criteria Seek alternatives Test alternatives Evaluate the action
Implement Evaluation
Leader As A Critical Thinking 1. 2. 3. 4. 5. 6. 7. Leadership provides progressive environment. Leader should encourage. Leader should believe in compassion Leader should be sensitive Leader should possess energy more than member Leader should consider suggestion and criticism. Leader should believe in justice .
Stress Management In Leadership 1. Take a Deep Breath When you feel „uptight‟ try taking a minute to slow down and breathe deeply. Breathe in through your nose and out through your mouth. Try to inhale enough so that your lower abdomen rises and falls. Count as you exhale – slowly. 2. Practice Specific Relaxation Techniques Relaxation techniques are extremely valuable tools in stress management. Most of the techniques like meditation, self hypnosis, and deep muscle relaxation work in a similar fashion. In this state both the body and the mind are at rest and the outside world is screened out for a time period. The practice of one of these techniques on a regular basis can provide a wonderfully calming and relaxing feeling that seems to have a lasting effect for many people. 3. Manage Time One of the greatest sources of stress is poor time management. Give priority to the most important ones and so those first. If a particularly unpleasant task faces you, tackle it early in the day and get over with it; the rest of your day will include much less anxiety. Most importantly, do not overwork yourself, schedule time for both work and recreation. 4. Connect with Others A good way to combat sadness, boredom and loneliness is to see out activities involving others.
5. Talk it Out When you feel something, try to express it. Share your feelings. “Bottled Up” emotions increase frustration and stress. Talking with someone else can help clear you mind of confusion so that you can focus on problem solving. Also consider writing down thoughts and feelings. Putting problems on paper can assist you in clarifying the situation and allow you a new perspective. 6. Take a “Minute” Vacation magining a quiet country scene can take you out of the turmoil of a stressful situation. When you have the opportunity, take a moment to close your eyes and imagine a place where you feel relaxed and comfortable. Notice all the details of your chosen place, including pleasant sounds, smells and temperature or change your mental “channel” by reading a god book or playing relaxing music to create a sense of peace and tranquility. 7. Monitor Your Physical Comfort Wear comfortable clothing. If it‟s too hot, go somewhere where it‟s not. If your chair is uncomfortable, change it. If your computer screen causes eye-strain or backaches, change that, too. Don‟t wait until your discomfort turns into a real problem. Taking five minutes to arrange back support can save you several days of back pain. 8. Get Physical When you feel nervous, angry or upset, release the pressure through exercise or physical activity. Running, walking or swimming are good options for some people, while others prefer dance or martial arts. Working in the garden, washing your car, or playing with children can relieve that “uptight” feeling, relax you and often will actually energize you. Remember, your body and mind work together. Most experts recommend doing 20 minutes of aerobic activity daily will reduce stress. 9. Take Care of Your Body Healthy eating and adequate sleep fuels you mind as well as your body. Avoid consuming too much caffeine and sugar. Take time to eat breakfast in the
morning, it really will help keep going through the day. Well nourished bodies are better prepared to cope with stress. If you are irritable and tense from lack of sleep or not eating right, you will be less able to “go the distance in dealing with stressful situations”. Increase the amount of fruits and vegetables in daily diet. Take time for personal interests and hobbies. Listen to one‟s body. 10.Laugh Maintain your sense of humor, including the ability to laugh at yourself. 11.Know Your Limits There are many circumstances in life beyond your control, consider the fact that we live in an imperfect world. Know your limits. If a problem is beyond your control and cannot be changed at the moment, don‟t fight the situation. Learn to accept what is, for now, until such time when you can change things. 12.Think Positively Refocus the negative to be positive. Make an effort to stop negative thoughts. 13.Have a Good Cry A good cry during periods of stress can be a healthy way to bring relief to your anxiety, and it might prevent a headache or other physical consequences of “bottling” things up. 14.Avoid Self Medication Alcohol and other drugs do not remove the conditions that cause stress. Although they may seem to offer temporary relief, these substances only mask or disguise problems. In the long run, alcohol use increases rather than decreases stress, by changing the way you think and solve problems and by impairing your judgment and other cognitive capacities. Medications should be taken only on the advice of a doctor.
Group dynamic in leadership Individual Role Of Group Members 1. Aggressor: expresses disapproval of others values 2. Blocker: expressing negative points of view 3. Recognition seeker: works to focus positive attention 4. Self confessor: uses the group setting as a forum for personal expression 5. Dominator: attempts to control and manipulate the group 6. Help seeker: uses expressions of personal insecurity, confusion 7. Special interest pleader: cloaks personal prejudices or biases
Conclusion:-
REFERENCES
Basawanthappa BT, Nursing administration, Jaypee brothers medical publishers (p) ltd 2004, edition 1st , Pp:43- 49, 258-259
Bernhard LA, Walsh M: Leadership the key to the professionalization of nursing. 3rd edition. Missouri: Mosby publishers 1995, Pp:36- 47
Marquis L.Bessiel, Leadership roles and management functions in Nursing theory and application, Lippincott Williams and Wilkins publications 2000, edition 3rd, Pp:67-73
Marriner Ann, Guide to nursing management, Mosby publishers 1988, edition 4th Pp: 29-31, 273- 274, 287.
Swansburg. C. Russell, Swansburg J. Richard, Introduction to management and leadership for nurse managers, Jones and Barlett publishers 2002, edition 3rd , Pp:68- 70
Journal of Clinical Nursing 2000, 9(4) Pp: 545-548
Journal of Holistic Nursing 1999, 30(6), Pp: 1375-82
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ASSIGNMENT ON leadership
SUBMITTED TO:
Mrs. Nisha Naik Lecturer
SUBMITTED BY:
Mrs. Priyanka Pathak 2ND Year M. Sc. Nursing
LEADERSHIP
INTRODUCTION Leadership is that leadership is the art of motivating a group of people to act towards achieving a common goal. Put even more simply; the leader is the inspiration and director of the action. He or she is the person in the group that possesses the combination of personality and skills that makes others want to follow his or her direction. In business, leadership is welded to performance. Effective leaders are those who increase their companies' bottom lines. To further confuse the issue, we tend to use the terms "leadership" and "management" interchangeably, referring to a company's management structure as its leadership, or to individuals who are actually managers as the "leaders" of various management teams. leadership involves more. To be effective, a leader certainly has to manage the resources at her disposal. But leadership also involves communicating, inspiring and supervising - just to name three more of the main skills a leader has to have to be successful.
CONCEPT OF LEADERSHIP Leaders typically are the ones who “go first”. They have vision and influence other by their actions and their comments. This ability is the essence of leadership like the word “lead” another word manage comes from meaning. “Hand” managing them means “handling things “. In essence managers get other people to do, but leaders get other people to want to do. Leaders are most often associated with times of turbulence innovation social transformation and change, whereas manager are more often assist anted with improving productivity, establishing order and stability and making thing run to smoothly management is the proceed of v getting work done through others . Nurse
Managers at agree hierarchical level are expected to lead subordinates towards institutional. Objectives as efficiently as possible.
DEFINITION OF LEADERSHIP Although the term leader has been in use since the 1300s, the word leadership was not known in the English language until the first half of the 19th century. Leadership is the process of influencing people to accomplish goals, i.e. it is the ability to influence behaviors o f others, towards the achievements of a mutually establishes goal. The leader and follower roles are determined by peoples interaction within groups, in contrast, the role of managers or administrator are jobs within organization the role of manager is to coordinate the efforts of lower level employees i.e. subordinates to advance the goals of the organization. Leadership is a force that creates a capacity among a group of people to do something that is different or better Leadership – what leaders do; the process of influencing a group to achieve goals An effective leader is a catalyst who facilitates effective interaction among manpower, material and time. A skilful leader is synergist, who co-ordinates the efforts of multiple workers with diverse skill. Leadership is social relationship in which one party has a greater ability to influenced b him or her. Thus, leadership is based on a powerful differential between interacting persons. Leadership is needed in cooperative enterprise to align employees in support of goals, to spark group interaction, to blend efforts of specialties. Thus nurse managers at every organizational level select leadership style and methods that suit work force requirements.
HISTORY OF LEADERSHIP PRACTICE IN NURSING NIGHTINGALE‟S SCHOOL OF NURSING She considered first nurse executive. She integrated the functions of modern nursing as care provider, management interdisciplinary education and scientific research.
EARLY US HOSPITAL The better nursing school wanted superintendents, teachers and head nurse who were cultivated women and educators as well as practioners. 1930-1940 THE BUREACACY Nurse experienced difficulty in returning bureaucrat hospital setting after functioning independently head nurses made in charges over staff nurses.
1940-1950 TEAM NURSING As a mechanism for other nurses to share the supervision responsibility team leader was senior nurse.
1960 PRIMARY NURSING Primary nursing delegates‟ decision making to bed side nurses. 1970 DECENTRALIZATION To move a way from vertical organization with authority and decision making task a t the top level. 1980 SHARED GOVERNANCE It recognizes the interdependence of every department in achieving quality product. 1990 PATIENT CENTERED CARE. It recognizes the interdependence of every department in achieving quality product.
PRINCIPLES OF LEADERSHIP 1. Vision: (leadership begins with a vision.)A vision is a clear picture of what the leader sees his group being or doing. If followers grasp the vision, become cohesive and will be able to work towards common goal. A commitment to act on a vision a mission. 2. Goal setting: goals are a set of specific measurable steps designed to achieve the vision and the mission. Goals must be S-M-A-R-T; specific, measurable, attainable, realistic and tangible. Goal setting is an ongoing process. 3. Love: An act of the will on which the leader works towards the highest good of others. 4.Humility: A humble person is free from pride and arrogance, helpful and courteous. 5. Self control: essential attitude and characteristic of a leader.It brings freedom, confidence , joy , stability and strong sense of leadership. 6.Communication: the ability to communicate effectively through speech and writing. 7. Investment: to maximize its benefit to the group. 8. Opportunity: obstacles as the key to opportunities, attitude to handle mistakes. 9.Energy: attracts attention and followers .A leader with energy and enthusiasm gains acceptance and confidence of others. 10. Staying power: essential to overcome problems and discouragement. Indicates strong awareness to a commitment. 11. Authority: - Internal authority- the charisma, self esteem, the personality that causes a person to command respect of others. 12. Awareness: the leader must be aware of her leadership, constantly monitoring the performance against a standard that she has set for herself to achieve excellence.
TYPES OF LEADERSHIP
TRANSACTIONAL VERSUS TRANSFORMATIONAL LEADERSHIP
Outhwaite (2003) cites definitions of transactional and transformational leadership as posited by bass in 1990. Transactional leadership involves how an integrated team works together and the innovativeness of their approach to the work Outhwaite (2003). For example, a leader can empower team member by allowing individual to lead certain aspect of a project based on their areas of expertise. This will encourage to development of individual leadership skill. In addition, leaders should explore barriers and identify conflicts when they arise, and then work collaboratively with team, sharing in the work, thus remaining close to perspective (Outhwaite, 2003) Transactional leadership focuses on providing day to day care, while transformational leadership is more focused on processes that motivate followers to perform to their full potentential influencing change and providing a sense of
direction (Cook2001). The ability of a leader to articulate a shared vision is an important aspect of transformational leadership (Faugier & Woolnough, 2002). Transactional leadership is most concerned with managing predictability and order, while transformational leaders recognize the importance of challenging the status quo (Faugier & Woolnough, 2002) . One group of authors described the use of transformational leadership by Magnet hospital (De Geest, Clsaessens, Longerich, & Schubert, 2003). This leadership style allows for solving, transmission of values and ethical principles, and ethical principles, and provision of challenging goals while communicating a vision for the future (De Geest, Clsaessens, Longerich, & Schubert, 2003). Transformational leadership is extremely important.
TRANSACTIONAL AND TRANSFORMATIONAL LEADERS Transactional Leaders 1. focuses in management tasks 2. Is care taker 3. Uses trade- offs to meet goals 4. Shared values not indentified 5. Examines causes 6. Uses reward contingency Transformational Leaders 1. Identifies common values 2. Is committed 3. Inspires- others within vision 4. Has long-term vision 5. Looks at effects 6. Empowers others
LEADERSHIP STYLES: THEORIES The word”style” is the way in which the leader influences followers. Style is distinctive or characteristics manner of performance. Style is defined as “the exclusive privilege of the expert. With style, the end is attained without side issues”. Style implies an elegance and economy of effort to be sought by every professional manager. Style in general involves the way in which something is said or done, including particular behaviors associated with an individual. Leadership style specifically is the way that the leaders influence the group to accomplish goals. Let us have a look at the various studies that help us to understand the leadership styles..
LEADERSHIP THEORIES 1. Scientific leaders? Manager, style theory 2. Human relation theory 3. Henri fayol theory of managerial style 4. Mcgregor theory 5. Theory z 6. Trait theory of leadership 7. Behavioral theory of leadership style 8. Situational theory
1. SCIENTIFIC LEADERS? MANAGER, STYLE THEORY This theory was developed by Fredrick Winslow Taylor (1856-1915). In 1911, he emphasized technology as the basis of increasing productivity. He introduced time-and-motion studies to analyses tasks based on belief that improving the performance would improve the efficiency of the organization. He relied on scientific study of time and movement spent and used for a job to improve the performance of the worker and recommended careful selection and training of workers, who could meet the established work standard. The leaders utilize this Taylor‟s principle.
2. HUMAN RELATION THEORY This theory was developed by Elton Mayo and Fritz Roethlisberger after conducting series of studies from 1924 to 1932 at Howthorne Western Electric plan, Chicago, to test several assumption of scientific management. They believe that real power centers within the organization are the interpersonal relationship established within the work organization. These studies aimed at finding out if changes in illumination, rest period and lunch breaks can affect the productivity of worker‟s. It was found that less light, shorter and fewer rest periods and shorter lunch breaks resulted in increase in productivity. Increase in productivity was attributed to the attitude to the workers by researchers made them feel important which resulted in improvement in their work performance. It suggests that employees. The finding of this study concludes that a leader not only should plan, decide, organize, lead and control but also consider the human element.
3. HENRI FAYOL THEORY OF MANAGERIAL STYLE Henry Fayol (1841-1925 defined functions of manager in they that has come to be known as the management process, which includes planning, organizing, directing and controlling. These functions are similar in many ways to the “Nursing
process” Manger/ Leader; assess the type and amount of work needed and capabilities of the employees to perform it. Manager also plan to organizes work duties ,direct staff and customers and finally control the quality work by evaluating and revising plans. This management function constitutes a set of behaviors expected of managers/leader. When it can be applied to nursing unit, where about nurses assess their clients needs, plans and organize client care, direct staff and clients, and control the quality of client care by evaluating and revising care plans. Fayol defines the essential activities needed to maintain of functioning organization and his experience led him to develop following management principles. 1) There should be such a division of work and task specialization that different workers consistently carry out different job responsibilities. 2) Each worker should be given authority commensurate with the amount of his responsibility. 3) Each employee should receive orders from only one supervisor. 4) One person should direct all activities that support simple activities. 5) The interest of individual worker should be subordinated to interest of the total work group. 6) There should be an unbroken scalar chain of authority extending from the top executive to the lowest level worker. 7) All employees should be treated with equity and justice. 8) Manager should help workers to develop team work and esprit De corps.
4. McGREGOR THEORY Douglas McGregor (1960) categorized leadership style into two brand categories in his management theories, i.e. theory X and theory Y, having two different beliefs and assumption about subordinates. Manager, who believes in theory X and assumes that people inherently dislike work, will and avoid it when possible and the average individual prefers to be directed, wants to avoid responsibility and is more interested in financial incentives than personal achievement. Therefore, the style of leadership exercises strong controls and direction
s and wherever necessary punish people if they do not do the work of people do the work as desired, they may even get monetary or other rewards. In contrast to theory X, the theory Y provide a more accurate assessment of human nature, one that encourages workers to develop their full potential. This theory Y, assumes that employees can enjoy physical and mental work justly as they enjoy play and rest. Employees are capable of self motivation and job satisfaction if they are happy in the organization and committed to its goals. Under proper conditions, the average person learns both to seek and accept responsibility. The capacity to apply creativity to solving organizational problem is widely, not narrowly distributed among the workers. Theory Y leaders assume that people will work hard and assume responsibility if they can satisfy their personal needs, and the objectives or goals of their organization. It suggested that theory Y organization will satisfy higher human needs, resulting in greater employee responsibility and in turn, higher productivity
5. THEORY Z Japanese have adapted the principle of human relation theory, is commonly known as “theory Z” the trust of this theory is participation in management involvement of the employees in decisions that affect them. This theory emphasizes group decision making, lifetime job security, and strong commitment to the goals of the organization. The desire results are a greater sense of a job commitment, higher productivity and lower turnover. Here as stressed in human relations theory, the importance of employee morale on productivity is reflected in the value placed group decision making.
6. TRAIT THEORY OF LEADERSHIP The great man theory trait theories were basis for most leadership research until the mid 1940s. The great man theory, from Aristotelian Philosophy, asserts tat some people are born to lead, whereas other is born to be led. Trait theories assume that some people have certain characteristics or personality traits the distinguish great
leaders; researchers studied the lives of prominent people through out history. The effect of followers and the impact of the situation were ignored. Although trait theories has obvious short coming (i.e. they neglect they impact of others or the situations on the leadership roles) they are worth examine many of the characteristics identified in trait theory are still used to describe successful leaders today.
CHARACTERSTICS OF A LEADER Intelligence Knowledge Judgment Decisiveness Oral fluency Personality Adaptability Creativity Cooperativeness Alertness Self confidence Personal integrity Emotional control Nonconformity independence
7. BEHAVIORAL THEORY OF LEADERSHIP STYLE According to the theory, a leader behaves according to the role expectations of the group. This theorist believes that leadership style like other behaviors can be learned regulated and developed. There is no one best leadership style. The effectiveness of each leadership style depends upon the situation. As the situation changes, the effectiveness manager adapt by changing leader behaviour research has identified four styles of leadership in mangers from various fields; autocratic, democratic participative and laissez- faire.
Ability Able to enlist
cooperation Interpersonal skills Tact, diplomacy Prestige Social participation &
balance
Autocratic style:In this autocratic style of leadership task oriented. Leader uses positional and personal power in authority‟s manner, retaining responsibility for all goal setting and incision making. A leader of this type makes decision without the participation of people concerned. Autocratic style leader characterized by the following behaviors; 1. Strong control is maintained over the group 2. Others are motivated by the concerned 3. Communication flow downward 4. Decision making does not involve others 5. Emphasis on difference and status 6. Criticism is punitive.
Democratic Style:In the democratic style of leadership, the leader values the individual characteristics‟ and abilities and subordinates Democratic style leader characterized by the following behaviors; 1. Less control is maintained 2. Economic and ego awards are used to motivate 3. Others are directive through suggestion and guidance 4. Communication flows up to down 5. Decision making involve others 6. Emphasis in “We” rather than I and you 7. Criticism is constructive
The Participative Leadership Style:In this style, the manger presents her or his analysis of problems and proposal of action o employees, inviting their criticism and comments. Having weighed the subordinates “response” the manager makes final decisions about the group future
activities. Here the leader allows subordinates to participate in decision making; consequently the subordinates have the feeling of satisfaction and freedom.
Laissez faire style/ abdicratic:In this “let alone” style of leadership, the appointed manager abdicates
leadership responsibility, leaving workers without direction, supervision or coordination and allows them to plan, execute, and evaluate the work in any way they like. Abdicratic style leader characterized by the following behaviors; 1. He or she is permissive with little or no controle 2. Motivate by support when requested by the group or individual 3. Little or no direction provided 4. Decision making is dispersed throughout the group 5. Emphasis on the group 6. Criticism not given
8. SITUATIONAL THEORY In this approach, a leader is the product of given situation and the behiour may infact, vary from one situation to another. This theory includes the traits of mani.e. qualities and motivcations, that bring forth and shape the leadership potential. According to this theory, we can find five kinds of leader as follows 1. Natural leader:Here person becomes a leader in spite of himself. He does not seek the role, it is thurstwed upon him byb the group and by the tide of events, e,g, Abraham Lincoline, Mahatma Gandhi, JP Naryan. 2. Charismatic leader:Here person is in authentic hero in the eyes of his followers for he can do no wrong. He/she inspire people to make any sacrifice even their lives for the cause e.g. Ashok, Akbar, Netaji Subhashchandr bose etc. 3. Rational leader:-
Here the person is consistent and persistent, e.g. Karl Marx, Lenin, Mao, GK Gokhle. 4. Consensus leader:This leader is perceived as acceptable to all. He or she in the absence of the above three and this leader is in tenous position of walking atight rope for existence E.g. president of india, spekers of the assembly of parliament. 5. Leader by the force:Here the leader‟s power speaks through the nozzle of gun. She/he dominates others through fear. He is ruthless in suppressing opposition. He does not reign long as thus type of leadership contains within itself the seeds of its own destruction. E.g. Napoleon, Hitler, Staline Idi Amin etc.
LEADERSHIP SKILLS To be effective Leader the nurses need the primary leader shipskills that as foolws: 1. Skills of personal I. II. III. IV. V. Is sensitive to feelings of the groups. Identifies self with thee needs of the group. Does not ridicule or critcise another suggestion Helps others feel important and needed. Does not argue
2. Skills of communication. I. II. III. IV. Listen attentively Make sure everyone understand what is needed and the reason why? Establishes positive communication with group as routine part of the job Recognizes that everyone‟s contributions important
3. Skills of organization: the effective leader helps the group to; I. II. III. IV. V. Developing long and short range objectives Break big problem into small ones Share responsibilities and opportunities Plan act follow up and evaluative Be attentive details
4. Skills of self examination I. II. Is aware of personal motivations Is aware of the group members; level of hospitals for taking appropriate countermeasures III. Helps the group to be their attitudes and values.
S=self reliant E=enthusiastic
L=loyal F=factual
LEADERSHIP ACTIVTIES 1. DIRECTING: - it is the process by which actual performances of staff and people, is guided towards common goals. A leader uses assignments, order, policies, procedure, rules. Regulations, standard, opinions, suggestions and questions to direct subordinates behaviour. 2. SUPERVISING: - supervision is continuous administrative and educative process which enables the supervisor through the medium of his relationship with supervisors to contributes towards the continuous growth of the supervision which includes inspecting another‟s work, evaluating her or his performance, and approving or correcting performances. 3. CO- ORDINATING: - Co-coordinating includes all the activities that enable work group members to work together harmoniously.
QUALITIES OF A NURSE LEADER 1. KNOWLEDGE OF SELF 2. PERSONAL QUALITIES 3. INITIATIVE QUALITIES 4. TECHNICAL QUALITIES 5. TEACHING QUALITIES 6. ADMINISTRATIVE QUALITIES 7. INTELLECTUAL SKILLS 8. ENTHUSIASM 9. TACTFUL 10.EMOTIONAL CONTROL 11.AWARENESS OF RESPONSIBILITIES 12.QUALITY OF BUILDING HUMAN RELATIONS
CHARACTERISTICS OF EFFECTIVE LEADERSHIP: 1. Initiates action- Leader is a person who starts the work by communicating the policies and plans to the subordinates from where the work actually starts. 2. Motivation- A leader proves to be playing an incentive role in the concern‟s working. He motivates the employees with economic and non-economic rewards and thereby gets the work from the subordinates. 3. Providing guidance- A leader has to not only supervise but also play a guiding role for the subordinates. Guidance here means instructing the subordinates the way they have to perform their work effectively and efficiently. 4. Creating confidence- Confidence is an important factor which can be achieved through expressing the work efforts to the subordinates, explaining them clearly their role and giving them guidelines to achieve the goals effectively. It is also important to hear the employees with regards to their complaints and problems. 5. Building morale- Morale denotes willing co-operation of the employees towards their work and getting them into confidence and winning their trust. A leader can be a morale booster by achieving full co-operation so that they perform with best of their abilities as they work to achieve goals. 6. Builds work environment- Management is getting things done from people. An efficient work environment helps in sound and stable growth. Therefore, human relations should be kept into mind by a leader. He should have personal contacts with employees and should listen to their problems and solve them. He should treat employees on humanitarian terms. 7. Co-ordination- Co-ordination can be achieved through reconciling personal interests with organizational goals. This synchronization can be achieved through proper and effective co-ordination which should be primary motive of a leader.
Critical thinking & decision making in leadership
Application of critical thinking to nursing practice: Nurse leader function effectively some part of every day without thinking critically. Many small decisions are based primarily on habits with minimal thinking involved; example include selecting what cloths to wear, choosing which route to take
work, and deciding what to eat for lunch. The nurse clinician and nurse manager seeks to be aware of their thinking while they are thinking, as they apply standards for thinking, and as thinking progresses. A. Problem solving: Nurse leader use critical thinking to rationally resolve problems related to direct client care. Nurse Manager use critical thinking to resolve problems related to overall client care, unit administration, and staff interpersonal issues. Strader 1992 defines problem solving as “the process used when a gap is perceived between an existing state and a desired state.” - Trial and error: One way to solve problems is trial and error, in which a number of approaches are tried until a solution is found. - Intuition: Intuition as a problem solving method has not been considered either sound or legitimate. Rather, it has been viewed as a form of guessing and as such an inappropriate basis for nursing decisions. B. Decision making: Tschikota 1993 states that, “effective clinical decision making is critical to the future of professional nursing practice.” Nurses make decisions in the course of solving problems, for example, in each step of nursing process. Decision making, however, is also used in situations that do not involve problem solving. Nurses make value decisions; time management decision; scheduling decisions and priority decisions. Strader 1992 describes seven steps of decision making process: 1. Identify the purpose. 2. Set the criteria. 3. Weight the criteria. 4. Seek alternatives. 5. Test alternatives. 6. Troubleshoot. 7. Evaluate the action. The decision making process and the nursing process share similarities. The nurse use decision making in all steps of the nursing process. C. Clinical decision making: When a nurse approaches a clinical problem, such as a client who has developed a pressure ulcer or who is anxious about having surgery; the nurse collaborates with the client to make a decision that identifies the problem and then chooses those nursing interventions that will meet the mutually established goals of care. Nurses make clinical decision all the time in an attempt to improve a client‟s health or to maintain ongoing wellness. This may mean resolving the problem completely. The clinical decision making process requires careful reasoning so that the options for the best client outcomes are chosen on the basis of the clients condition and the priority of the problem.
D. Scientific method: The scientific method is one approach to reasoning that is used in nursing, and a variety of other disciplines. It is approach to seeking the truth or verifying that a set of facts agrees with reality. Nurse researcher uses the scientific method when testing research questions in nursing practice situations. For example, a nurse researcher might observe that clients in a hospice program often have difficulty communicating their feelings to family members. The nurse learns more about what cause this problem and consider this possibility that family members might have ineffective communication skills. The nurse might design a study that involves formal instruction in communication skills and use a support group to help family members practice and apply the skill. E. Diagnostic reasoning: As soon as a nurse receives information about a client in a particular clinical situation, diagnostic reasoning begins. It is a process of determining a client‟s health status after the nurse assigns meaning to the behaviors, physical signs, and symptoms presented by the client. Part of diagnostic reasoning is inference, that is, the process of drawing conclusions fro drawing conclusions from related pieces of evidence. For example, when a client presents symptoms of restlessness, guarded posturing and abnormal discomfort, the nurse must retrieve knowledge regarding pain in the abdomen and the reason in a direct and precise way to determine the specific nature of client‟s pain. F. Nursing process: Nurses apply the nursing process as a competency when delivering client care. The nursing process consists of five steps: assessment, diagnosis, planning, implementation and evaluation. The purpose of the nursing process is to diagnose and treat human responses to actual and potential health problems.
Nursing process: Assessment Diagnosis Plan
Critical thinking and decision making process: Identify the Purpose.
Set a criteria Weigh the criteria Seek alternatives Test alternatives Evaluate the action
Implement Evaluation
Leader As A Critical Thinking 1. 2. 3. 4. 5. 6. 7. Leadership provides progressive environment. Leader should encourage. Leader should believe in compassion Leader should be sensitive Leader should possess energy more than member Leader should consider suggestion and criticism. Leader should believe in justice .
Stress Management In Leadership 1. Take a Deep Breath When you feel „uptight‟ try taking a minute to slow down and breathe deeply. Breathe in through your nose and out through your mouth. Try to inhale enough so that your lower abdomen rises and falls. Count as you exhale – slowly. 2. Practice Specific Relaxation Techniques Relaxation techniques are extremely valuable tools in stress management. Most of the techniques like meditation, self hypnosis, and deep muscle relaxation work in a similar fashion. In this state both the body and the mind are at rest and the outside world is screened out for a time period. The practice of one of these techniques on a regular basis can provide a wonderfully calming and relaxing feeling that seems to have a lasting effect for many people. 3. Manage Time One of the greatest sources of stress is poor time management. Give priority to the most important ones and so those first. If a particularly unpleasant task faces you, tackle it early in the day and get over with it; the rest of your day will include much less anxiety. Most importantly, do not overwork yourself, schedule time for both work and recreation. 4. Connect with Others A good way to combat sadness, boredom and loneliness is to see out activities involving others.
5. Talk it Out When you feel something, try to express it. Share your feelings. “Bottled Up” emotions increase frustration and stress. Talking with someone else can help clear you mind of confusion so that you can focus on problem solving. Also consider writing down thoughts and feelings. Putting problems on paper can assist you in clarifying the situation and allow you a new perspective. 6. Take a “Minute” Vacation magining a quiet country scene can take you out of the turmoil of a stressful situation. When you have the opportunity, take a moment to close your eyes and imagine a place where you feel relaxed and comfortable. Notice all the details of your chosen place, including pleasant sounds, smells and temperature or change your mental “channel” by reading a god book or playing relaxing music to create a sense of peace and tranquility. 7. Monitor Your Physical Comfort Wear comfortable clothing. If it‟s too hot, go somewhere where it‟s not. If your chair is uncomfortable, change it. If your computer screen causes eye-strain or backaches, change that, too. Don‟t wait until your discomfort turns into a real problem. Taking five minutes to arrange back support can save you several days of back pain. 8. Get Physical When you feel nervous, angry or upset, release the pressure through exercise or physical activity. Running, walking or swimming are good options for some people, while others prefer dance or martial arts. Working in the garden, washing your car, or playing with children can relieve that “uptight” feeling, relax you and often will actually energize you. Remember, your body and mind work together. Most experts recommend doing 20 minutes of aerobic activity daily will reduce stress. 9. Take Care of Your Body Healthy eating and adequate sleep fuels you mind as well as your body. Avoid consuming too much caffeine and sugar. Take time to eat breakfast in the
morning, it really will help keep going through the day. Well nourished bodies are better prepared to cope with stress. If you are irritable and tense from lack of sleep or not eating right, you will be less able to “go the distance in dealing with stressful situations”. Increase the amount of fruits and vegetables in daily diet. Take time for personal interests and hobbies. Listen to one‟s body. 10.Laugh Maintain your sense of humor, including the ability to laugh at yourself. 11.Know Your Limits There are many circumstances in life beyond your control, consider the fact that we live in an imperfect world. Know your limits. If a problem is beyond your control and cannot be changed at the moment, don‟t fight the situation. Learn to accept what is, for now, until such time when you can change things. 12.Think Positively Refocus the negative to be positive. Make an effort to stop negative thoughts. 13.Have a Good Cry A good cry during periods of stress can be a healthy way to bring relief to your anxiety, and it might prevent a headache or other physical consequences of “bottling” things up. 14.Avoid Self Medication Alcohol and other drugs do not remove the conditions that cause stress. Although they may seem to offer temporary relief, these substances only mask or disguise problems. In the long run, alcohol use increases rather than decreases stress, by changing the way you think and solve problems and by impairing your judgment and other cognitive capacities. Medications should be taken only on the advice of a doctor.
Group dynamic in leadership Individual Role Of Group Members 1. Aggressor: expresses disapproval of others values 2. Blocker: expressing negative points of view 3. Recognition seeker: works to focus positive attention 4. Self confessor: uses the group setting as a forum for personal expression 5. Dominator: attempts to control and manipulate the group 6. Help seeker: uses expressions of personal insecurity, confusion 7. Special interest pleader: cloaks personal prejudices or biases
Conclusion:-
REFERENCES
Basawanthappa BT, Nursing administration, Jaypee brothers medical publishers (p) ltd 2004, edition 1st , Pp:43- 49, 258-259
Bernhard LA, Walsh M: Leadership the key to the professionalization of nursing. 3rd edition. Missouri: Mosby publishers 1995, Pp:36- 47
Marquis L.Bessiel, Leadership roles and management functions in Nursing theory and application, Lippincott Williams and Wilkins publications 2000, edition 3rd, Pp:67-73
Marriner Ann, Guide to nursing management, Mosby publishers 1988, edition 4th Pp: 29-31, 273- 274, 287.
Swansburg. C. Russell, Swansburg J. Richard, Introduction to management and leadership for nurse managers, Jones and Barlett publishers 2002, edition 3rd , Pp:68- 70
Journal of Clinical Nursing 2000, 9(4) Pp: 545-548
Journal of Holistic Nursing 1999, 30(6), Pp: 1375-82
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