SEMINAR<br /> ON <br />LEADERSHIP<br /> BY<br />MR. MANOJ B. SABLE.<br /> SEMINAR ON LEADERSHIP<br />INTRODUCTION<br />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.<br />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.<br />I am not saying that this is a bad thing; just pointing out that 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.<br />CONCEPT OF LEADERSHIP<br />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.<br /> 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.<br />DEFINITION OF LEADERSHIP<br />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.<br />Leadership is the process of influencing people to accomplish goals, i.e. it is the ability to influence behaviors of 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.<br /> <br /> Leadership is a force that creates a capacity among a group of people to do something that is different or better<br />Leadership – what leaders do; the process of influencing a group to achieve goals<br />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.<br />TYPES OF LEADERSHIP <br />TRANSACTIONAL VERSUS TRANSFORMATIONAL LEADERSHIP <br />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). Fir 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)<br /> 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) .<br />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. <br /><ul><li>TRANSACTIONAL AND TRANSFORMATIONAL LEADERSTransactional Leadersfocuses in management tasksIs care takerUses trade- offs to meet goalsShared values not indentifiedExamines causesUses reward contingencyTransformational LeadersIdentifies common valuesIs committedInspires- others within visionHas long-term visionLooks at effectsEmpowers others</li></ul>LEADERSHIP STYLES: THEORIES<br /> 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.. <br />LEADERSHIP THEORIES<br /><ul><li>Scientific leaders? Manager, style theory
SCIENTIFIC LEADERS? MANAGER, STYLE THEORY </li></ul> 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.<br /><ul><li>HUMAN RELATION THEORY </li></ul> 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. <br /> 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.<br /><ul><li>HENRI FAYOL THEORY OF MANAGERIAL STYLE</li></ul> 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.<br />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.<br />Fayol defines the essential activities needed to maintain of functioning organization and his experience led him to develop following management principles.<br /><ul><li>There should be such a division of work and task specialization that different workers consistently carry out different job responsibilities.
Each worker should be given authority commensurate with the amount of his responsibility.
Each employee should receive orders from only one supervisor.
One person should direct all activities that support simple activities.
The interest of individual worker should be subordinated to interest of the total work group.
There should be an unbroken scalar chain of authority extending from the top executive to the lowest level worker.
All employees should be treated with equity and justice.
Manager should help workers to develop team work and esprit De corps.
McGREGOR THEORY</li></ul>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.<br />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.<br /> 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.<br />It suggested that theory Y organization will satisfy higher human needs, resulting in greater employee responsibility and in turn, higher productivity.<br /><ul><li>THEORY Z</li></ul>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.<br /><ul><li>TRAIT THEORY OF LEADERSHIP</li></ul>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. <br />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.<br />CHARACTERSTICS OF A LEADER<br />Intelligence PersonalityAbility Knowledge Judgment Decisiveness Oral fluencyAdaptabilityCreativityCooperativenessAlertnessSelf confidencePersonal integrityEmotional balance & controlNonconformityindependence Able to enlist cooperationInterpersonal skillsTact, diplomacyPrestigeSocial participation <br /><ul><li>BEHAVIORAL THEORY OF LEADERSHIP STYLE</li></ul>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.<br />Autocratic style:-<br />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.<br />Autocratic style leader characterized by the following behaviors;<br /><ul><li> Strong control is maintained over the group
Criticism is punitive.</li></ul>Democratic Style:-<br /> In the democratic style of leadership, the leader values the individual characteristics’ and abilities and subordinates<br />Democratic style leader characterized by the following behaviors;<br /><ul><li>Less control is maintained
Criticism is constructive</li></ul>The Participative Leadership Style:-<br /> 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.<br />Laissez faire style/ abdicratic:-<br />In this “let alone” style of leadership, the appointed manager abdicates leadership responsibility, leaving workers without direction, supervision or co-ordination and allows them to plan, execute, and evaluate the work in any way they like.<br />Abdicratic style leader characterized by the following behaviors;<br /><ul><li>He or she is permissive with little or no controle
Motivate by support when requested by the group or individual
SITUATIONAL THEORY</li></ul>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<br /><ul><li>Natural leader:-</li></ul> 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.<br /><ul><li>Charismatic leader:-</li></ul> 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. <br /><ul><li>Rational leader:-
Here the person is consistent and persistent, e.g. Karl Marx, Lenin, Mao, GK Gokhle.
Consensus leader:-</li></ul> 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.<br /><ul><li>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.</li></ul>LEADERSHIP SKILLS<br />To be effective Leader the nurses need the primary leader shipskills that as foolws:<br /><ul><li>Skills of personal
CHARACTERISTICS OF EFFECTIVE LEADERSHIP:</li></ul>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. <br />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. <br />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. <br />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. <br />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. <br />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. <br />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.<br />GROUP DYNAMICS<br />GENERAL OBJECTIVE:<br />At the end of the seminar the student will be able to gain in depth knowledge about group dynamic and apply it in nursing services or nursing administration & management.<br />SPECIFIC OBJECTIVE:<br />At the end of the seminar the students will be able to:<br /><ul><li>Define the term group
Politics & Lobbying</li></ul>GROUP DYNAMICS:-<br />INTRODUCTION:-<br />Human beings exhibit some characteristic behavior patterns in groups. People involved in managing groups and group members themselves can benefit from studying theories and doing practical exercises which help them to better understand people's behaviour in groups and group dynamics.<br />When group patterns are combined with study of individual development, then group dynamics can also are applied to education and therapy (as is often the case in experiential, outdoor and adventure education).<br />People may underestimate the importance of society and group memberships on their lives. Whilst people sometimes undertake solo journeys us by and large much of our experiences of life involves being engaged with others and groups. The nature of these groups can be quite varied, from a family going for a walk, to the crowd at a football game, to an internet discussion group, to a group of fellow workers.<br />DEFINATION OF GROUP DYNAMIC:-<br />A group is a number of people, who have a common objective, interacting with ether to achieve a common objective and are aware of the existence of each other and also preview themselves to be a part of the group.<br />GROUP DYNAMICS: The term group dynamics was coined to describe the way groups and individuals act and react to changing circumstances. <br />----------Kurt Lewin <br />According to Kimball Young. 'A group consists of two or more persons in a state of social interaction".<br />A group can be defined as a collection of people, working together with achieve common objectives.<br />Group Dynamics is defined as complex forces that are constantly acting upon every group member throughout its existence dictating duration. <br />Group Dynamics can be also defined as the interaction of the forces and their resultant effects on a group.<br />TYPES OF GROUPS:-<br />Primary groups are small groups with intimate, kin-based relationships: families, for example. They commonly last for years. They are small and display face to face interaction.<br />Secondary groups, in contrast to primary groups, are large groups whose relationships are formal and institutional. They may last for years or may disband after a short time. The formation of primary groups happens within secondary groups.<br />Individuals almost universally have a bond toward what are known as reference groups. These are groups to which the individual conceptually relates him/herself, and from which he/she adopts goals and values as a part of his/her self identity.<br />Other types of groups include the following:<br />Peer group - A peer group is a group of approximately the same age, social status, and interests. Generally, people are relatively equal in terms of power when they interact with peers. <br />Clique - An informal, tight-knit group, usually in a High School/College setting, that shares common interests. There is an established yet shifting power structure in most Cliques. <br />Club - A club is a group, which usually requires one to apply to become a member. Such clubs may be dedicated to particular activities, such as sporting clubs. <br />Household - all individuals who live in the same home, there are various models in anglophone culture including the family, blended families, share housing, and group homes. <br />Community - A community is a group of people with a commonality or sometimes a complex net of overlapping commonalities, often - but not always - in proximity with one another with some degree of continuity over time. They often have some organization and leaders. <br />Franchise- this is an organization which runs several instances of a business in many locations. <br />Gang - A gang is usually an urban group that gathers in a particular area. It is a group of people that often hang around each other. They can be like some clubs, but much less formal. <br />Mob - A mob is usually a group of people that has taken the law into their own hands. Mobs are usually a group which gather temporarily for a particular reason. <br />Posse - A posse was initially an American term for a group of citizens that had banded together to enforce the law. However, it can also refer to a street group. <br />Squad - This is usually a small group, of around 3-8 people, that would work as a team to accomplish their goals. <br />Team - similar to a squad, though a team may contain many more members. A team works in a similar way to a squad. <br />CRITERIA’S FOR A GROUP TO INCLUDE<br />Formal social structure<br />Face to face interaction<br />Two or more persons<br />Common fate<br />Common goals<br />Interdependence<br />Self-definition as group members<br />Recognition by others<br />FACTORS AFFECTING THE INDIVIDUAL BEHAVIOUR<br />Past Experience Forces<br />Psychological Forces <br />Associated Forces <br />Goals and Ideology Forces<br /> Effect of Forces on Individual Behavior of a Nurse<br />ESSENTIALS OF GROUP FORMATION<br />Interaction <br />Common needs <br />Common Goals <br />Group Ideology <br />Group structure <br />GROUP PROCESS<br />1. FORMING STAGE – a process of meeting each other. (Pretending to get on or get along with others);<br /><ul><li>2. STORMING STAGE- there is competition and attempts at the establishment of individual identities(letting down the politeness barrier and trying to get down to the issues even if tempers flare up );</li></ul>3. NORMING STAGE- the group begins to establish rules and design its work. (getting used to each other and developing trust and productivity); <br /><ul><li>4.PERFORMING STAGE- the work actually gets done. (getting used to each other and developing trust and productivity);</li></ul>TASK ROLES OF GROUPS<br />INITIATOR : suggests group goals, redefines the problem<br />INFORMATION SEEKER : searches for a factual basis<br />INFORMATION GIVER: offers an opinion<br />OPINION SEEKER: seeks opinions that clarify or reflect others suggestions<br />ELABORATOR : extends meaning of suggestions<br />COORDINATOR: coordinates ideas, suggestions, activities<br />ORIENTER: summarizes decisions and actions<br /> EVALUATOR: compares with standard<br /> ENERGIZER: stimulates to act<br />PROCEDURAL TECHNICIAN: arranging environment<br /> RECORDER : records activities<br />INDIVIDUAL ROLES OF GROUP MEMBERS<br />AGGRESSOR: expresses disapproval of others values<br />BLOCKER: expressing negative points of view<br />RECOGNITION SEEKER: works to focus positive attention<br />SELF CONFESSOR: uses the group setting as a forum for personal expression<br />PLAYBOY : demonstrates horseplay or cynicism<br />DOMINATOR: attempts to control and manipulate the group<br />HELP SEEKER: uses expressions of personal insecurity, confusion<br />SPECIAL INTEREST PLEADER: cloaks personal prejudices or biases<br />PRACTICAL BENEFITS FROM INFORMAL ORGANIZATION<br />More effective total system<br />Lightens workload on management<br />Fills in gaps in a managers abilities<br />Provides safety valve for employee emotions<br />Improves communication<br />GROUPS FAIL DUE TO THE FOLLOWING<br />Absence of trust<br />Fear of conflict<br />Lack of commitment<br />Avoidance of accountability<br />Inattention to results<br />GUIDELINES FOR BETTER USE OF GROUP DYNAMICS<br />People who are to be changed & who influence the group should have strong sense of belongingness<br />Group should be more attractive to its members<br />Attitudes/Values/Behavior that needs to be changes should be relevant to Group<br />Group Member having more prestige can exert more influence<br />GROUP PROBLEM SOLVING ACTIVITIES<br />There are a number of exercises that propose a problem that the group must solve. Some of these simply benefit from the diversity of perspectives and background knowledge inherent in groups to find the answer more quickly (Trivia, Wuzzles) while another approach is to give each individual some information and the collective information is needed to solve the problem or challenge.<br />These can be simple or truly elegant situations. Many, like ZinObelisk, can be found for free on various websites and in books designed for use by trainers. Some of these free programs come with adequate support instructions while others are less complete. Many are readily adaptable to different situations and desired outcomes.<br />Some companies market ready-to-play board games that are good for large groups. An example is Performance Management Company, which sells games like "The Search for The Lost Dutchman's Gold Mine." These types of programs often give teams resources, provides a structured environment for problem solving, and rewards collaboration (rather than competition). You can expect that these for-sale products will be bundled with instructor's guides, templates for play and other facilitation and instructional resources.<br />Many of these team building kinds of events are available. A good place to search is under the general keywords of "teambuilding exercises"<br />POWER<br />Power implies the ability to change the attitudes and behaviors of individual people and groups. <br />The gap that exists between a position of authority and subordinate response is called the authority-power gap. Power has both a positive and a negative face.<br />TYPES OF POWER<br />Reward power<br />Coercive power<br />Legitimate power<br />Expert power<br />Referent power<br />Charismatic power<br />Information power<br />Feminist power or self power<br />POLITICS<br />Politics exist in every organization, so nurses waste energy and remain powerless when they refuse to learn the art and skill of political maneuvers. <br />POLITICAL STRATEGIES<br />expert in communication and information<br />good decision maker<br />developing personal resources<br />developing political alliances<br />sensitive to timing<br />promoting subordinate identification<br />viewing personal and unit goals<br />LOBBYING<br />Meeting room, discussion room or waiting room, conference hall lobbying tips<br />1. Informed current issues<br />2. Know your friends in congress<br />3. Become familiar with committees<br />4. Know your own local representatives<br />5. Increase your influence by supporting candidates<br />6. Remind candidates about registered women voters<br />CRITICAL THINKING & DECISION MAKING<br />INTRODUCTION:-<br /> Nurses are a cadre (basic unit or nucleus) of knowledge workers within the health care system . As such they need information ,resources <br />& support from their environment. <br /> In acute care hospitals & other health care delivery system settings ,complexity, change & unpredictability in the environment have left nurses with increased uncertainty & a perception that critical information for decision making has been lacking . The nurse who is a critical thinker has to be open minded & have the ability to reflect on present & past actions & to analyze complex information.<br />What is Critical Thinking ?<br />A reasoned, purposive, and introspective approach to solving problems or<br />addressing questions with incomplete evidence and information and for<br />which an incontrovertible solution is unlikely.<br /> Rudd & Baker, 1999<br />Or<br />Definition:- <br /> Critical thinking in nursing practice is a discipline specific , reflective reasoning process that guides a nurse in generating , implementing & evaluating approaches for dealing with client care & professional concerns.<br /> -National league for nursing 2000.<br />DEFINITION OF DECISION MAKING:-<br /> Decision making is complex cognitive process often defined as choosing a particular course of action -- to “judge or settle”.<br /> -Webster’s ,1991. <br /> DECISION MAKING:-<br /> Decision making may be defined as a systematic , sequential <br /> process choosing among alternatives & putting the<br /> choice in action<br /> -Lancaster <br />Scheduling decisions eg to bath the client before visiting hrs<br />Priority decisions eg which interventions are most urgent & which can be delegated.<br />LEVELS OF CRITICAL THINKING:-<br /> 1.Basic critical thinking:-<br /> Thinking is concerns & based on a set of rules or principles eg nurse uses an procedures manual to confirm how to insert a Foleys catheter student nurse follow procedure step by step however inexperience weak competencies , inflexible attitude can restrict a persons ability to move to the next level of critical thinking.<br />2. Complex critical thinking :-<br /> A person begins to detach from authorities & analyze & examine alternatives more independently at complex level of critical thinking .<br /> Thinking can become more creative & innovative there is a willingness to consider deviations from standard protocols or policies when complex situations develop nurses learn a variety of different approach for the same therapy. <br />3. Commitment:-<br /> Individual anticipate need to make choices without assistance from others & then assumes accountability for them nurse assumes accountability for the decision, attention is given to the results of the decision & a determination of whether it was appropriate.<br />Skill used in critical thinking by leader:-<br /> To be effective leader , nurse need to think critically ,communicate well, manage teams , manage conflict , manage time & initiate & manage change.<br /> Complex mental process such as analysis , problem solving & decision making require the use of cognitive thinking skills.<br />Critical analysis skill:- <br />Eg what evidence do you have for that? <br />What are the alternatives ?<br />Inductive reasoning <br />Deductive reasoning<br />Attitude that foster the critical thinking :-<br /> Independence fair mindedness<br />Intellectual humility insight in to egocentricity<br />Attitude for critical thinking<br /> Integrity courage<br />Use of skill:-<br />Nurses use knowledge from other subjects & field .<br />Nurses deal with change in stressful environment <br />Nurses make important decision during the course of a work day & make vital decisions of many kinds <br />In nursing service nurse generate idea rapidly <br />Create original solutions to problem <br />Tend to be independent self confident ,even when under pressure<br />Demonstrate individuality.<br />COMPONENT OF CRITICAL THINKING MODEL:-<br /> Nurse as a changing agent will practice effective leadership components in her day to day life.<br />componentscommunicationSelf awarenessSkill&knowledgeeenergygoalaction<br /> <br /> <br />set goals which are clear , congruence & meaningful to the group <br />has adequate knowledge & skills in leadership & in professional field of endeavor<br />possesses self awareness & uses this understanding to recognize personal needs & those of others human beings .<br />communicates clearly & effectively <br />mobilizes adequate energy for leadership functions<br />takes action<br />Universal Intellectual Standards for critical thinking:-<br /> Clear: If a statement is unclear we cannot evaluate its fit with the other standards.<br /> Accurate: Accuracy - TRUTH. Is it true?<br /><ul><li> Precise: Is there enough detail to completely understand the statement.
Relevant: Is the information connected to the question at hand?
Depth: Does the statement, fact, etc. address the complexity of the issue?
Breadth: Are there other points of view or other ways to consider this question? </li></ul>Are you considering the key factors?<br /><ul><li>Logic: Does it make sense? Can you make that conclusion based on the information and evidence?</li></ul>Significance:-which of these fact most important ?<br />Completeness:- have I considering any important aspects?<br />Fairness :- what makes this a difficult problem? <br />By R. Paul & L. Elder foundation of critical thinking 2005.<br />CRITICAL THINKING MODEL:-KATAOKA-YAHIRO<br /> Model helps to explain concepts , because critical thinking in nursing is complex a model can helps to explain all of the factors involved in making decision & judgments about clients.<br />The model defines the outcome of critical thinking relevant to nursing problem components of this model,<br />Knowledge base<br />Experience<br />Competence<br />Attitude<br />Standard<br />Elements of this model explains how nurses make judgments which are necessary to safe ,effective, nursing care.<br /> <br />Skill for decision making <br />Judgment :- Decision making requires judgment <br />Diagnostic judgment:- collection , analysis , synthesis of problem <br />Eg Continuing education program & seminars<br />Clinical professional administration <br />Related to client care based on documented assessed<br />Their needs <br />Evaluative judgment:- eg making judgments about values of ideas ,solutions, <br />Methods or materials .<br />Evaluation can be quantitative qualitative.<br />10- SEQUENTIAL STEPS TO THE DECISION MAKING;-<br />Identify the purpose <br />Set the criteria <br /> eg. Client with pain criteria would be as follows <br />what is desired outcome for relief of pain? <br />What needs to be preserved? Physical, cognitive , psycho logic functioning<br />What needs to be avoided? CNS depression , respiratory depression<br />3.Weight the criteria :- decision maker set the priority or ranks activities<br /> Eg. Nurse avoids medication that can cause sedation of client <br /> With a head injury but for a client with terminal cancer <br /> Pain relief is more important<br /> 4.Seek alternatives :-pain may be treated with oral or injectible <br /> 5. Examine alternatives :- iv narcotic might be the better choice if pain not <br /> Reduced with oral medications<br /> 6.Project :-nurse applies creative thinking & skepticism to determine to prevent<br /> Minimize or overcome any problem<br /> 7. Implement :- pain treatment is begun <br /> 8. Evaluate the outcome:- with all nursing care <br /> 9. Comparison ;-between the nursing Process & decision making process 10.Reassessment<br />Nursing process Decision making process<br />Assess Identify the purpose<br />Diagnosis problem identification <br />Plan set the criteria , weight the criteria <br /> Seek alternatives ,examine alternatives<br /> Project<br />Implement implement<br />Evaluation evaluate the outcome<br />QUALITIES OF A SUCCESSFUL DECISION MAKER HUSTON (1990)<br />Courage :- willingness to take risk<br />Sensitivity :- sensitive to situation to others <br />Energy :- energy & desire to make things happen<br />Creativity:- they develop new ways to solve problems.<br />DECISION MAKING STYLE:-<br />The decision style range from autocratic to delegatory or participative with individual decisions the leader acts alone ,<br />Following are the decision making styles:-<br />Authoritative or autocratic:- the leader make the decision without seeking assistance <br />Consultative or collective-participative:-leader seeks input before making the decision.<br />Facilitative :-leader & followers work together to reach a shared decision <br />Delegative:- only the group is involved in the decision & leader gives control over the decision.<br /> The choice of style is dependent on the situation for effectiveness.<br />THE DECISION MAKING PROCESS:-<br />Decision can be thought of as resulting action with series of sequential steps those are as follows,<br />Collect information <br />Process information in to advice <br />Make the choice<br />Authorize the implementation <br />Execute what is to be done<br />This idea is helpful to the nurses for decision making with their clients eg in managing care & with situations in their work settings eg in coordinating nursing service delivery.<br />For nursing leadership process requires a sound basis for making judgments with knowledge , skills of decision maker when faced with more than one alternative in planning clients care .<br /> Relating to others require an ample degree of charity feeling & values for ones fellow man .<br />The facilitative phase is effective & constructively change affects it is in active process .<br />Relating trust & respect for one another essential in establishing a relationship that is productive of good effects.<br />Influencing all of the knowledge used to make decision & relate to others is required for influencing positive influence is paramount so that the nurse leader is moving productively this phase effective when all other phases are moving effectively<br />DECISION MAKING STRATEGIES: -<br />Strategies are used for problem solving & decision making which reflect time & mental structure variations eg fast, slow ,intuitive or logical etc<br />Following are some formal decision making strategies:-<br />TRIAL & ERROR:-A solution is chosen & simply tried out.<br />PIOLT PROJECT:- Experimentation with limited trials.<br />PROBLEM CRITIQUE:- Approach occurs in a one on one situation <br />CREATIVE TECHNIQUE:- It includes brainstorming sessions, Delphi process, group exercises etc<br />DECISION TREE :- Is a graphic model that visually displays options , outcomes & risk to be anticipated<br />Eg Are you committed to becoming nurse?<br /> Answer may be yes or no depending on answer corresponding path is to be followed as mopped out on the decision tree.<br /> Decision tree graphic model<br /> Questions or problem<br /> Possible options are to be given <br /> Choice of options positive <br /> Negative<br /> Outcome <br />6.CAUSE & EFFECT CHART :- Used to identify possible cause of production <br /> problem <br />7.GROUP PROBLEM SOLVING:- Leader calls a group to discuss & participate <br /> for solving the problem <br />8.COST BENEFIT ANALYSIS :- Is a formal balancing of driving forces list is up of positive supporting factors for decision cost benefit analysis is helps to clarify the elements inherently related to the problem & to facilitate subsequent decision making.<br />9.COMPUTERISED DECISION MAKING ;- Sophisticated computerized forecasting technique such as linear programming models & mathematical techniques that assign for each possible outcome.<br />It provides a “what-if” analysis of various tactis aimed at decision making. <br />Eg COPE (computerized physician order entry) is helpful to reduce medication error .<br />10.INFORMATION PROCESSING:- Useful for client care & management <br />11.PERCEPTION & INNOVATION :-Perception is defined as an individuals filtering & interpretation of events. <br /> Innovation can be used as modes of decision making to expand available <br /> course of action. eg wireless devices, bar coding , robotics & communications <br /> technology etc <br />Application to service that use of decision making strategies at improving the medication use reduce the medication error.<br />HAVARDS DAVID GARVIN’S 8 KEY DIMENSIONS FOR CRITICAL THINKING & DECISION MAKING FOR QUALITY CARE:-<br />Performance or the primary operating characterized of a service.<br />features or the secondary characteristics that supplement the service basic functioning.<br />Reliability or the probability of malfunction or failure within a specified period of time.<br />Conformance or the degree to which a service meets preestablished industry standards .<br />Durability or the amount of use one gets from a product before it physically deteriorates<br />Service ability or speed , courtesy, competence & ease of repair ,responsiveness<br />Aesthetics or how a product looks , feels, tastes, sounds, smells.<br />Perceived quality or what the customers thinks is quality etc<br />STRESS MANAGEMENT:-<br />Introduction :-<br /> Nurses are the healers they focus on activities related to related to caring in the diagnosis & treatment of human responses to health & illness .as occupation are numerous source of built in a stress that become occupational hazards for nurses .<br />Eg dealing with human illness & suffering , life & death situations, clients who are demanding or in a pain , making critical judgment about interventions & treatments & balancing work & family commitments become forces that generate stress in nurses here the leader plays the very important role to overcome out from such type of situations & promote healthy environment to the other staff.<br />Definition of stress:-<br /> A physical ,mental , psychological, & spiritual responses to any stressor.<br /> -By Narasi,1994.<br />TERMS:-<br />STRESSORS:-<br /> An experience in a person –environment relationship that is evaluated by a person as taxing or exceeding resources & threatening the sense of well-being.<br />OCCUPATIONAL OR JOB STRESS:-<br /> A tension arising in a person that is related to the demands of the role or job.<br />BURNOUT:-<br /> Responses to chronic emotional stress that have 3 components <br />emotional or physical exhaustion<br />lowered job productively & <br />over depersonalization<br /> -(Perlman & Hartman, 1982)<br />Historical foundation<br />Walter Cannon and Hans Selye used animal studies to establish the earliest scientific basis for the study of stress. They measured the physiological responses of animals to external pressures, such as heat and cold, prolonged restraint, and surgical procedures, then extrapolated from these studies to human beings. <br />Subsequent studies of stress in humans by Richard Rahe and others established the view that stress is caused by distinct, measureable life stressors, and further, that these life stressors can be ranked by the median degree of stress they produce (leading to the Holmes and Rahe Stress Scale). Thus, stress was traditionally conceptualized to be a result of external insults beyond the control of those experiencing the stress. More recently, however, it has been argued that external circumstances do not have any intrinsic capacity to produce stress, but instead their effect is mediated by the individual's perceptions, capacities, and understanding.<br />Models of stress management<br />Transactional model<br />Richard Lazarus and Susan Folkman suggested in 1984 that stress can be thought of as resulting from an “imbalance between demands and resources” or as occurring when “pressure exceeds one's perceived ability to cope”. Stress management was developed and premised on the idea that stress is not a direct response to a stressor but rather one's resources and ability to cope mediate the stress response and are amenable to change, thus allowing stress to be controllable.]<br />In order to develop an effective stress management programme it is first necessary to identify the factors that are central to a person controlling his/her stress, and to identify the intervention methods which effectively target these factors. Lazarus and Folkman's interpretation of stress focuses on the transaction between people and their external environment (known as the Transactional Model). The model conceptualizes stress as a result of how a stressor is appraised and how a person appraises his/her resources to cope with the stressor. The model breaks the stressor-stress link by proposing that if stressors are perceived as positive or challenging rather than a threat, and if the stressed person is confident that he/she possesses adequate rather than deficient coping strategies, stress may not necessarily follow the presence of<br />Stressors are disruptive forces operating within or on any system so we need to know about stress , we recognize stress in clients & families & intervene effectively also it affects on the health care professional stress stimulates thinking process & helps to stay alert to the environment also it provides stimulation & motivation , as well as causing discomfort & retreat.<br />TYPES OF STRESS:-<br /> Selye identified two types of stress 1. Distress or damaging stress<br /> 2. Eustress protects health<br /> 3.chronic stress with stressful roles <br /> or living with a long term illness<br /> 4.crisis persons emotional <br /> equilibrium is upset <br />Also it includes work stress, family stress , chronic stress, acute stress, daily stress , trauma, & crisis.<br />It differs with different individuals perception one may look at a stimulus &sees it as a challenge , leading to mastery & growth. another sees the same stimulus as a threat , leading to stagnation & loss.<br />So it is necessary for nurses & leader to understand stress both on a personal level & in relation to their work.<br /> <br />CAUSATIVE FACTORS OR SOURSES RESPONSIBLE FOR STRESS:-<br />1.INDIVIDUAL SOURSES OF STRESS IN NURSES:-<br />Internal personal emotional conflicts need to balance work & family role.<br />Intrapersonal conflict tensions in careers <br />External sources eg individual may not adjust with the given situation or work environment.<br />Hardiness personality composed of commitment , control, & challenge may create job stress , negative attitude ,apathy , alienation , job dissatisfaction & depersonalization etc<br />Feeling of helplessness , powerlessness , frustration & dissatisfaction.<br />Family problems like death of the spouse or close relatives ,divorce, marital separation , marriage or remarriage ,personal illness or injury <br />Changes in living condition , personal achievements , job performance <br />Role of ambiguity & conflict <br />2.SOURCES OF STRESS IN NURSING:-<br />Associated with daily working situation ,internal tension, conflict<br />Organizational & managerial concerns ,absentisum of nursing personnel , turnover <br />In depth background of stress ie nurses faces stress life & death situations, heavy workload involves physical & mental strain.<br />Knowledge of how to use numerous pieces of equipment & consequences of equipment failure <br />Communication problems among staff members , physicians, families & other departments <br />Hospital is one of the stressful work environment , awareness of the serious consequences of mistakes <br />High standards , competition organizational demands etc<br />3.ORGNIZATIONAL SOURCES OF STRESS:-<br />Organization that treat with the nurses ,the intrinsic nature of work is recognized as stressful eg bedside nursing care delivery to ill or hospitalized clients.<br />Organizations can do generate multiple & conflicting demands on nurses , that generates stressful working situations to the nurses<br />Expectation of certain types of behavior by the organization , location of the role in social structure , inadequate resources ,social context create role difficulties & stressors<br />Too much expectations in the limited time , leadership style, physical & technical environment , patterns of IPR, staffing & workload, negative client outcomes, <br />Lack of participation in policy decisions , inadequate knowledge & skills for role functions <br />Structural ,procedural contextual factors causes stress & conflicts <br />Organizational climate, group cohesion, job satisfaction , turnover, productivity , conflict, change, & organizational restructuring <br />Organization system in to complex networks of community health care systems , change in response to social, consumer related , governance, technology & economic pressure , chaos opportunities arise.<br />Lack of resources available , & lack of autonomy ,interpersonal stressors from the group dynamics create stress in both leader & staff. <br />Typology of 7 sources of stress is that :-<br />ROLE AMBIGUITY<br />ROLE OVERLOAD<br />ROLE STRESS<br />ROLE CONFLICT<br />ROLE UNDERLOAD<br />ROLE UNDERQUALIFICATIONROLE OVERQUALIFICATIONROLE INCONGRUITY <br />SIGN & SYMPTOMS OF STRESS:-<br /> Over 60 yrs ago Walter Cannon proposed fight or- flight –response to stress an arousal of sympathetic nervous system . this reaction prepares a person for action by increasing heart rate , <br /> Diverting blood from the intestines to the brain & striated muscle <br /> Increasing BP , heart rate, respiratory rate, blood glucose level <br />Cannon’s hypothesis to describe GAS :- 3 stage reaction to stress GAS reflects how the body responds to stressors through the alarm reaction, the resistance stage , & the exhaustion stage .<br /> The GAS triggered either directly by the a physical event or indirectly by a psychological event, it involves several body systems & the endocrine system <br />ALARM REACTION :- Rising hormone levels result in an increased blood volume , blood glucose levels, epinephrine & norepinephrine amounts & causes exchange of body systems prepares an individual for fight & lasts from 1 min to many hrs the person progresses to the second stage , resistance.<br />RESISTANCE STAGE:- The body stabilizes & responds in an opposite manner to the alarm reaction here body repairs any damage occurs if the stressors remains & adaptation does not happen , the person enters the third stage .<br />EXHAUSTION STAGE:- Occurs when the body is no longer able to resist the effects of the stressors & the struggle to maintain adaptation drain al available energy physiological regulation diminishes , & if the stress continues ,illness & death result. <br />LOCAL ADAPTATION SYNDROME (LAS):- EG for small injury dressing otherwise may cause more infection & gangrene & amputation etc <br /> <br />GENERAL OF MODEL STRESS:- (ELLIOTT & EISDORFER, 1982)<br />At one end potential stressor eg demanding client<br /> Then mediators eg social support , coping behaviors, defense mechanism <br />Individual psychological reactions eg emotional states of anxiety or fear <br />Biological reactions eg increase in catecholamines <br />Outcome eg may be physical illness , burnout, or coping <br />Transaction continuum coping strategies may be active or inactive ie active is work together resolving or reducing stress .<br />Inactive strategies are focused on avoiding the stress .<br /> In nursing hardiness & burnout have been investigated as stress outcomes.<br />MANAGEMENT OF STRESS & COPING TECHNIQUE:-<br />The nurse manager can prevent & control burnout by <br />setting personal & professional goals , <br />establishing priorities <br />practicing good health habits<br />relaxation technique <br />improving self esteem by obtaining the skills she needs <br />using support system<br />value clarification;- chosen by leader with thoughtful consideration to the each alternatives shared with others <br />GOAL SETTINGS :-consistent with ones values desired the achievement of desired outcomes through the different approaches increases flexibility & decreases stress caused by unmet goals.<br />STRESS AVOIDANCE & REGULATION :-<br /> One should avoid troublesome transactions , the frequency of <br /> stress inducing situations should be minimized <br /> unnecessary changes should be prevented during period of high <br /> stress increase positive sources of tension that foster growth such as <br /> learning sport can help offset the deleterious effect of negative tension.<br /> 3. TIME BLOCKING ;-Is the setting aside of specific time for adaptation <br /> to a stressor to reduce stress one could set the time for reading about <br /> management it helps for task accomplishment & it reduces anxiety , time <br /> urgency , & feelings of frustration .<br /> 4.TIME MANAGEMENT :-Helps to control stress by conserving more time <br /> sets goal & plans strategies for accomplishments of goals one can also use <br /> organizes such as to do lists & calendars to plan god use of ones time. <br /> <br /> 5.ASSERTIVENESS:- It increases self esteem & reduces anxiety &reduces <br /> stress assertiveness involves thinking through the goals acting with ones own <br /> values through the effective work habits & by setting limits on others attempts to block the ones goals.<br /> An assertive person makes eye contact with others , stands straight , sits in an <br /> open, & speaks in a clear voice . they achieve desired goals through self- <br /> enhancing behavior that reduces stress.<br /> 6. FEELING PAUSE:- Feeling pause are useful . that is take time to identify a <br /> feeling , label it , distinguish between thinking & feeling & accept the feeling for what it is rather than talking oneself into what it should be , negative feeling may be acted out should be aside by getting by getting involved in something pleasant such as exercise , hobbies , music, television , or talking to a friends <br /> <br /> 7. SORTING :- Is a choosing the interpretation of event & should focus on <br /> positive aspects of situations.<br /> 8. THOUGHT STOPPING :- Negative thought encourages maladaptive <br /> behavior So one should think of beautiful pleasant experiences .<br /> 9. COMPARTMENTALIZATION:- Of thought is the deliberate decision to <br /> think During the alloted time & work positively.<br /> 10. ENVIRONMENTAL CHANGES :-Designed to reduce stress ie as painting a room a favorite color or adding picture , candle , this type of remolding may be help to reduce stress .<br />11. HUMOR:- Related to an attitude towards life is most likely to reduce stress it <br /> includes flexibility, spontaneity, playfulness, humility, irony. These are qualities can be developed used to look situation from several different point of view to problem. <br /> 12. CENTERING:- Centering helps to reduce stress by bringing the mind & body back into balance<br /> 13. NUTRITION :-Good nutrition helps to body full functioning .<br /> <br />.EXERCISE:-Regular vigorous exercise can help one withstand chronic stress. jogging, swimming are good aerobic exercise<br />.SLEEP:-is important for dealing with stress.<br />.RELAXATION;-abdominal breathing is a quick method foster relaxation <br /> Massage can relieve tension , provide a passive form of exercise & foster tactile <br /> communication it stimulates relaxation & flexibility<br />17.progressive relaxation :-used to foster sleep it is conscious contraction & relaxation of muscle.<br />18. BIOFEEDBACK:-Biofeedback uses mechanical devices to gain self regulation to control autonomic response.<br />19. AUTOGENIC TRAINING SELF HYPONOSIS :-Produces deep relaxation with self hypnosis <br />20 MEDITATION:-Focuses attention on an experience, helps one become aware of ones response & facilitates the integration of the physical , mental, emotional, & spiritual aspects of life.<br />21.VISUALIZATION & MENTAL IMAGERY:-Visualizes pleasant thought can imagine being a favorite place such as sandy beach ,in the mountains ,listening music ,feeling of pleasant thought .<br />23 ENHANCING SELF ESTEEM :- Positive thoughts among herself.<br />24. SUPPORT GROUPS:-It provides a feeling of being accepted ,valued , loved ,esteemed & a sense of belongingness .<br />APPLICATION OF LEADERSHIP TO NURSING SERVICE:-<br />Definition:-<br />Leadership has different meanings in various authors. Harold Koontz (1990) defines leadership as influence, that is, the art or process of influencing people so that they will strive willingly and enthusiastically toward the achievement of group goals.<br />Leaders act to help a group attain objectives through the maximum application of its capabilities.<br /> Ideally, leaders do not stand behind a group to push and prod; they place themselves before the group as they facilitate progress and inspire the group to accomplish organizational goals.<br />In these lines, a good example is an orchestra leader, whose function is to produce coordinated sound and correct tempo through the integrated effort of the musicians. Depending upon the quality of the director's leadership, the group will respond.<br />Characteristics of the leader:-<br />The following are regarded as the minimum requisites for a person to act successfully as a leader: At least median IQ, professional competence, ability to formulate and transmit messages, instructions and orders, ability to conceive concepts integrated concepts, an inquiring mind, spiritual balance, aptitude for learning. Inclination to decentralize competencies and finally, an active interest in the group's affluence.<br />According to research though, there are a number of qualities, absolutely necessary for a successful<br />leader to be. <br />These are:<br />Appropriate knowledge: appropriate knowledge is needed so that her abilities cannot be questioned.<br />Experience: certain amount of cognitive and notional experience is required so that he will react instinctively, giving the right solution.<br />Virtuosity: he knows the best solving methods and he applies them in complex situations.<br />Trust: her abilities create a feeling of trust among her followers.<br />Mobility: he is able to move to different settings and groups, within the appropriate field of his experience.<br />Effectiveness: she wants to be effective and she is using her abilities to do so.<br />Recognition: he is satisfied with his work and most importantly his followers are as well.<br />Leading: she is happy to lead and she is devoting time and effort to do so. She is well known as a giver rather as a receiver. <br />However either these characteristics to exist partially or as a whole, they are not enough in the practice to they ensure the achievement of objectives and the prosperity of team.<br />An effective leadership is considered the one that maintains the entire rings of this chain intact,<br />facilitating and supporting continuously the individual operations of this labour model.<br />The characteristics of leader and followers:-<br />The relation of leader and followers can be determined on a continuous with the complete conflict and the complete harmony in the two endpoints as it appears in figure<br />Yet, there are certain characteristics in both the leader and the follower, which if they share thy will determine the point where the leader and the follower will meet towards harmony rather than conflict.<br />LEADER FOLLOWER<br /> <br />He sets up realistic objectives and He accepts the objectives of team <br />works hardly for their & participate in the common effort <br />achievement. For success.<br />He searches for new ideas and He is willing to work with new<br />methods, he is willing to dare. Ideas he does not obstruct them.<br /> <br />He is effective in communication. He is willing it listen<br />He has confidence in his followers. He has confidence in his leader<br />He has sense of humour, he does He has a sense of humor , he does not <br />not hesitate to even laughs at hesitate to laughs at himself , never <br />himself, never however at the however at the other.<br />other.<br />He is faithful in his follower. He is faithful in his leader.<br />He is not egoist, but willing to He is not egoist, but willing to share <br />share information with his information with his leader & his <br />followers-collaborators. Collaborator.<br />LEADER<br />The coupling of these characteristics between the leader and his followers in one or more points shows<br />also the degree of their harmonious collaboration or not.<br />According to Lester (1974), the 9 commonest complaints that employees hold towards their superiors during service<br />are the following: <br />1. being unpredictable,<br />2. being ironic,<br />3. failing in showing his/her appreciation,<br />4. failing in showing empathy,<br />5. failing in being “in control”,<br />6. not being honest,<br />7. failing in delivering tasks appropriately,<br />8. indecisiveness,<br />9. allow prejudices take over logical decisions.<br />A leader earns respect when he/she is expressing him/herself in an honest and direct way.<br /> When leaders communicate in a positive and direct way, their followers learn to trust them, especially when<br />they are told that something can or not be done.8<br />Yet, leadership in nursing is not merely managing people in order to achieve departmental or<br />organizational goals. The traditional leadership healthcare culture which is all about strict rules,<br />hierarchy and power relationships, needs to gradually shift towards a patient centered system where patients are treated with dignity, respect and by the best standards of care. By the same token, the<br />nurses’ hard work in achieving these goals is the responsibility of effective leadership. <br />In a more formal manner, the Royal College of Nursing (1993) in the UK, introduced three major leadership initiatives<br />the RCN clinical leadership programme<br /> the Leading an Empowered Organization (LEO) project and<br />regionally–led national programmes linked to national service framework (NSF) targets.<br /> All three initiatives are designed to give nurses valuable leadership skills and to enable plans for all ward sisters and charge nurses to control ward staffing budgets to be put in place. A drive has also been launched to increase the number of senior nurses appointed to chief executive roles.<br /> Another dimension that emerged was that before a nurse can effectively lead teams or organizations, he/she should first<br />invest in his/herself. The essence of this message is that one can not be an effective leader if he/she has not invested in his/her own personal development.<br />Furthermore, these initiatives assist nurses to take more responsibility for their own clinical environments, for safe keeping standards of care, acting as the patient’s advocate and being more<br />conscious about health care costs. <br />Finally leadership courses might also have a significant impact on<br />retention, because when nurses feel empowered and can influence patient care in the ways they wish,<br />they are less likely to leave the profession. In this sense, classes on leadership skills are a way to help nurses to understand the bigger picture.<br />The informal leader:-<br />In every organization there are formal and legitimate leaders who are deriving their power from their official position in the organizational hierarchy.<br />Quite often though, informal leaders appear on the scene. Their power is related to personal rather than position power. Depending on the situation or the group's needs these persons act as leaders with the instigation, acceptance or tolerance of the group members.<br />Others may act as informal leaders, deriving power from their unique characteristics.<br /> Education, experience, drive and decisiveness are viewed positively and help establish credibility. <br />The person with these qualities may be viewed as reliable and therefore others are willing to cooperate. Attractiveness gains an individual access to people who will help promote her cause, because people enjoy being around others, who have a happy temperament, generate a sense of well being and faster goodwill in others.<br />Leadership and Management: major functions and differences:-<br />Leadership involves working through individuals and groups to accomplish goals, but these goals may be different from organizational goals, or may involve one segment of organizational goals. In a sense, the key difference between the concepts of leadership and management is the phrase "organizational goals".<br />A manager works for an organization (for example a director of Nursing employed by a hospital) and carries the responsibility of accomplishing the organization's goals through specific professional services.<br />Leadership is a much broader concept because all nurses are leaders. Anytime a person is a recognized authority and has followers who count on this person's expertise to carry their objectives, the person is a leader. Furthermore, anyone who is responsible for giving assistance to others is also a leader. <br />The staff nurse is a leader to clients; the student nurse is also a leader to clients;<br /> the head nurse is a leader to all team followers; <br />and parents are leaders to children.<br />Nursing management uses administrative directives and should use leadership skills to ensure the efficient use of time, equipment, supplies, and staff to reach the goals and objectives of the nursing department.<br />A person may be a good manager and not exert effective leadership. On the other hand, an individual may be a leader but not an effective manager or may not have the opportunity to exercise managerial<br />authority. A person in a managerial position has a certain amount of power and authority. <br />The key to success in the role includes linking three variables to these skills. They are motivation, ability and role clarity.<br />SkillsTechnicalBehavioralConceptual VariablesMotivationAbilitiesRole claritySuccessfulManagerPerformance<br />NURSES LEADERSHIP DESCRIPTIVE COMPETENCIES.<br />SNCompetenciesDescription1Managing the dreamSensing the windows of opportunities; articulating the resources.2Mastery of changeProviding life to the vision, taking risks, accepting error, managing change.3Anticipating LearningPreparing futuristically including preparing others, energizing the vision through learning with co- workers.4Taking the initiativeMaking the things happen beginning the idea and seeing it to completion.<br />