Leadership and management
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Leadership and management






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Leadership and management Presentation Transcript

  • 1. Prepared by:Adrian R. Adriano, R.N., R.M., M.A.N.
  • 2.  An interpersonal process to effect change on the behavior of others Process by which a nurse influence one or more person to achieve specific goals in the provision of nursing care in one or more patients The process of envisioning a new and better world, communicating that vision to others, motivating others and enticing them to join in efforts to realize the vision, thinking in a different way, challenging the status quo, taking risks, and facilitating change.
  • 3.  Often do not have delegated authority but obtain their power through other means, such as influence Have a wider variety of roles than managers do May or may not be a part of the formal organization Focus on group process, information gathering, feedback, and empowering others Emphasize interpersonal relationships Direct willing followers Have goals that may or may not reflect those of the organization.
  • 4.  Great Man Theory ◦ Asserts that some people are born to lead, whereas others are born to be led ◦ This theory assumed that all leaders were men and all were great (i.e of the noble class).
  • 5.  Trait Theory ◦ Assume that some people have certain characteristics or personality traits that make them better leaders than others ◦ Studies revealed that these leaders possessed multiple characteristics of commonalities.
  • 6.  Charismatic Theory ◦ Possession of a quality that sets one person apart from others: supernatural, superhuman, endowed with exceptional qualities or powers ◦ Theses qualities are said to be magnetic, persuasive and fascinating.
  • 7.  Situational Theory ◦ Embodies the idea that the right thing to do depended on the situation the leader was facing ◦ Involves assessing the nature of the task and the follower‟s motivation or readiness to learn.
  • 8.  Transformational Theory ◦ The true nature of leadership is not the ability to transform followers to become more self-directed in all they do. ◦ “Look for potential motives in followers, seek to satisfy higher needs, and engage the full person of the follower”.
  • 9.  Behavioral Theory ◦ Also called functional theories theory ◦ Concerned with what a leader does rather than who the leader is.
  • 10.  Autocratic Leadership ◦ Also known as Authoritarian/Directive ◦ Strong control is maintained over the work group ◦ Others are motivated by coercion ◦ Others are directed with commands ◦ Communication flows downward ◦ Decision making does not involve others ◦ Emphasis is on difference in status (“I” and “YOU” ◦ Criticism is punitive .
  • 11.  Democratic Leadership ◦ Also called Participative ◦ Less control is maintained ◦ Economic and ego awards are used to motivated ◦ Others are directed through suggestions and guidance ◦ Communication flows up and down ◦ Decision making involves others ◦ Emphasis is on “WE” rather than “I” and “YOU” ◦ Criticism is constructive.
  • 12.  Laissez-Faire Leadership ◦ Also called Ultraliberal/Permissive ◦ Permissiveness, with little or no control ◦ Motivation by support when requested by the group or individuals ◦ Provision of little or no direction ◦ Communication upward and downward flow among members of the group ◦ Emphasis on the group ◦ Criticism is withheld.
  • 13. Formal or Informal Formal Leaders ◦ Appointed by organization and given office or legitimate authority to act Informal Leaders ◦ Don‟t have official power to direct activities of others ◦ Mostly based on seniority.
  • 14.  Reward Power ◦ Based upon the incentives the leader can provide for group members to influence behavior by granting rewards.
  • 15.  Coercive Power ◦ Based in influencing behavior through the negative things a leader might do to individual group members or the group as a whole by withholding rewards or applying sanctions ◦ The manager may obtain compliance through threats of transfer, layoff, demotion, or dismissal.
  • 16.  Legitimate Power ◦ Power of position ◦ Authority is called legitimate power ◦ Power gained by a title or official position within an organization ◦ Legitimate power has inherent in it the ability to create feelings of obligation or responsibility.
  • 17.  Referent Power ◦ The power a person has because others identify with the leader or with what the leader symbolizes ◦ Also occurs when one gives another person feelings of personal acceptance or approval ◦ Perception based on personal charisma, the way the leader talks or acts, the organization to which he or she belongs, or the people with whom he or she associates.
  • 18.  Expert Power ◦ Based upon particular knowledge and skill not possessed by staff members ◦ Gained through knowledge, expertise, or experience ◦ This type of power is limited to a specialized area.
  • 19.  Informational Power ◦ Based upon “who knows what” in an organization and the degree to which they can control access to that information by other individuals ◦ Obtained when people have information that others must have to accomplish their goals.
  • 20.  Self Power ◦ Also referred to as feminist power ◦ The power a person gains over his or her own life – and maintains that this power is a personal power that comes from maturity, ego, security in relationships, and confidence in one‟s impulse.
  • 21.  UNPLANNED CHANGE vs PLANNED CHANGE Unplanned Change ◦ Usually haphazard and the results can be unpredictable ◦ Example: Change as a result of natural disaster Planned Change ◦ Change that results from a well thought-out and deliberate effort make something happen ◦ Intended, purposive attempt by individual, group and organization.
  • 22.  COVERT vs OVERT Covert Change ◦ Is hidden or occurs without the individual‟s awareness Overt Change ◦ Change about which a person is aware.
  • 23.  Kurt Lewin ◦ Identified three phases through which the change agent (a person skilled in the implementation of planned change) must proceed before a planned change becomes part of the system and recognize forces which interplay any potential change  Driving forces – factors that encourage or facilitate the change  Restraining forces – factors that obstruct change.
  • 24.  Unfreezing ◦ The change agent unfreezes forces that maintain the status quo ◦ People become discontented and aware of a need to change ◦ Necessary because before any change can occur, people must believe the change is needed ◦ Unfreezing occurs when the change agent convinces members of the group to change or when guilt, anxiety, or concern can be elicited.
  • 25.  Moving ◦ The change agent identifies, plans, and implements appropriate strategies, ensuring that driving forces exceed restraining forces ◦ Because change is such a complex process, change should be implemented gradually therefore it requires a great deal of planning and intricate timing.
  • 26.  Refreezing ◦ During this stage, the change agent assists in stabilizing the system change so it becomes integrated into the status quo ◦ If refreezing is incomplete, the change will be ineffective and the pre-change behaviors will be resumed ◦ Because change needs at least 3 to six months before it will be accepted part of the system, change should never be attempted unless the change agent can make a commitment to be available until the change is complete.
  • 27.  Moving Unfreezing  Develop a plan ◦ Gather data  Set goals and objectives ◦ Diagnose the problem  Identify areas of support and ◦ Decide if change is needed resistance  Include everyone who will ◦ Make others aware of the be affected by the change need change  Set target dates  Develop appropriate strategies Refreezing  Implement the change  Support others so the  Use strategies to overcoming resistance change remains.  Evaluate the change  Modify the change, if necessary
  • 28.  Equilibrium ◦ Characterized by high energy and emotional and intellectual balance Denial ◦ Individual denies reality of the change. Negative changes occur in physical, cognitive, and emotional functioning Anger ◦ Energy is manifested by rage, envy, and resentment Bargaining ◦ In an attempt to eliminate the change, energy is expended by bargaining Chaos ◦ Characterized by diffused energy, feelings of powerlessness, insecurity, loss of identity.
  • 29.  Depression ◦ Defense mechanisms are no longer operable. No energy left to produce results Resignation ◦ Change accepted passively but without enthusiasm Openness ◦ Some renewal of energy in implementing new roles or assignments that have resulted from the change Readiness ◦ Willful expenditure of energy to explore new event Reemergence ◦ person again feels empowered and begins initiating projects and ideas.
  • 30.  Innovators ◦ Enthusiastic, energetic people who thrive on change Early adopters ◦ Open top receive new ideas but are less obsessed to changes Early majority ◦ “Be not last to start, nor the first by which the new is tried”.
  • 31.  Late majority ◦ Skeptical to innovations, frequently express their negative views Laggards ◦ Last to adopt an innovation because they are accustomed to tradition Rejecters ◦ Openly oppose innovation and actively encourage others to do so.
  • 32.  The tendency for something to resist change even when a surprisingly large amount of effort is applied.
  • 33.  Process of reaching organizational goals by working with and through people and other organizational structures Series of systematic, sequential, or steps directed towards the achievement of organizational goal The process of planning, organizing, directing , coordinating and influencing the operation of an organization to obtain desired result and enhanced total performance.
  • 34.  Top Level Managers ◦ Develop goals, strategic plans, company policies, and make decisions on the direction and make decisions on the direction of the business ◦ Board of directors, presidents and vice presidents.
  • 35.  Middle Level Managers ◦ Accountable to the top management for their department‟s functions and devote more time to organizational and directional function ◦ Directors of nursing, supervisory staff, department heads.
  • 36.  First Level/Front Line Managers ◦ Focus on controlling and directing, possess the responsibility of assigning tasks, guiding and supervising employees‟ day to day activities ◦ Head nurse.
  • 37.  Interpersonal ◦ Connects one person to another, as a leader who hires, trains, encourages ◦ Figurehead ◦ Liaison ◦ Influencer.
  • 38.  Informational ◦ Disseminates about existing rules and regulation as the representative or spokesperson of the organization ◦ Monitor ◦ Disseminator ◦ Spokesperson.
  • 39.  Decision Role ◦ A trouble shooter who handles unexpected situations such as resignation of subordinates, firing and losses clients and negotiator when conflict arise ◦ Entrepreneur ◦ Disturbance handler ◦ Resource allocator ◦ Negotiator.
  • 40.  Technical Skills ◦ Proficiency in performing an activity in the correct manner with the right techniques Human relation Skills ◦ Dealing with people and how to get along with them Conceptual Skills ◦ Ability to see individual matters as they relate to the total picture and to develop creative ways.
  • 41.  Scientific Management ◦ Frederick Winslow Taylor known as the father of scientific management ◦ Focuses on principles on increasing the productivity of workers based on managing time, materials, and work specialization based on scientific manner ◦ Tao – get right person ◦ Training ◦ Tool ◦ Treatment.
  • 42.  Behavioral Theories ◦ Elton Mayo known for his HAWTHORNE EFFECT ◦ Believes that increasing employees productivity deals with overtime pay, rest day, day off ◦ Provides physical needs of workers like rest and recreation.
  • 43.  Bureaucratic Management ◦ Max Weber a German sociologist who developed what was known as the “ideal bureaucracy” ◦ Whoever is on top would perform management functions ◦ Centralized.
  • 44.  General Administrative Theory ◦ Henri Fayol believes in certain principles of management ◦ Unity of command ◦ Unity of direction ◦ Subordination ◦ Esprit de corps ◦ Chain of command ◦ Channels of communication ◦ Command responsibility ◦ Security of tenure ◦ Remuneration.
  • 45.  Japanese Management Style ◦ The theory Z of William Ouchi who introduced Japanese management to the western world ◦ He believes in lifetime management, slow evaluation and promotion, collective decision making, collective responsibility, and holistic concern for employees.
  • 46.  Theory X and Y ◦ Formulated by Douglas McGregor who believes that there two types of employees ◦ Theory X is the negative worker ◦ Theory Y are positive workers.
  • 47.  Motivation-Hygiene Theory ◦ Also called two-factor theory formulated by Frederick Herzberg  Intrinsic (Motivator) – growth, advancement, responsibility, work itself, recognition, achievement  Extrinsic (Hygiene) – status, relationship with subordinates, personal life, work conditions, and administration.
  • 48.  Planning ◦ Determining the long-term and short-term objectives (ends) of the institution or unit and the actions (means) that must be taken to achieve these objectives ◦ The first and fundamental function of management because all other management functions are dependent on it ◦ Deciding what is done, when it is done, how it is done and who is to do it.
  • 49.  Long-term Planning ◦ Strategic planning are specified for three to five years ◦ Determine the direction of the organization, allocates resources and determine time frame ◦ Done by top managers ◦ Involves SWOT analysis (Strength, Weakness, Opportunities, and Threat).
  • 50.  Intermediate Planning ◦ 6 months to 3 years ◦ Done by the middle manager.
  • 51.  Short Range ◦ Deals with the day to day maintenance activities ◦ Done by the first level manager.
  • 52.  Mission – a brief statement identifying the reason that an organization exists Vision – the future aim or function of the organization Philosophy – states the purpose and delineates the set of values and beliefs that guide all actions of the organization Goals – ends to be accomplished Objectives – something aimed at or strived for things done to achieve goal Rules and regulations – plans that define specific action or non-action.
  • 53.  A plan for all the allocation of resources and a control for ensuring that results comply with the plans.
  • 54.  Capital Budget ◦ Estimates of expenditure for adding, replacing or improving buildings or equipments for the budget period ◦ Buildings, major equipments.
  • 55.  Operating Budget ◦ Also known as recurrent budget which is the estimates of operating expenses, estimates of operating revenues, and estimates of activity ◦ Supplies, electricity expenses, water expenses, repairs and maintenance.
  • 56.  Cash Budget ◦ Also referred to as cash-on-hand and petty cash ◦ Budget planned to make adequate funds available as needed and to use any extra funds.
  • 57.  Personnel Budget ◦ Also called labor budget ◦ Budget which estimates the cost of direct labor necessary to meet the organization‟s objectives ◦ It includes recruitment, hiring, assignment, lay off and discharge of personnel.
  • 58.  Terminologies ◦ Cost Containment – to keep cost within acceptable limits for volume, inflation, and other acceptable parameters ◦ Cost Awareness – focuses on employees‟ attention on cost ◦ Cost Monitoring – focuses on how much will be spent, where, when, and why.
  • 59.  The act of planning and exercising conscious control over the amount of time spent on specific activities ◦ TIME IS A NON-RENEWABLE RESOURCE ◦ Set goals ◦ Ranked goals and plan strategies to achieve them ◦ Plan schedule.
  • 60.  Principle of Time Management ◦ Effective communication ◦ Ability to plan effectively ◦ Delegation  Efficiency – doing the right task  Effectively – doing the right task correctly.
  • 61.  Organizing ◦ Mobilizing human and material resources so that institutional objectives can be achieved ◦ The arranging of component parts into functioning wholes.
  • 62.  An organization is a group of people working together, under formal and informal rules of behavior, to achieve a common purpose.
  • 63.  An organizational chart provides the „blueprint‟ of depicting formal relations, functions, and activities Used to clarify chain of command, span of control, official communication process, and linkage for all department personnel.
  • 64.  Interconnecting lines ◦ Line – indicates direct authority or command giving relationship ◦ Broken line – indicates consulting relationship with no prescribed frequency of the structure to collaborate for planning or control purpose.
  • 65.  Status – rank given to person Accountability – the internalized responsibility whereby an individual agrees to be morally for the consequences of his actions Responsibility – the obligation to perform the assigned tasks Authority – the official power to act Power – capacity to act or potency to accomplish something.
  • 66.  Unity of Command - there can only be one superior to avoid confusion Scalar Principle – flow from higher to lower authority Departmentalization- grouping of workers with similar assignment Span of Control – number of people that can be directly supervised (4-6) Decentralization – proper delegation of authority.
  • 67.  The management activity that provides for appropriate and adequate personnel to fulfill the organization‟s objectives The nurse manager decides how many and what type of personnel are required to provide care for patients.
  • 68.  Centralized chief nurse– done by the Decentralized – done by supervisors or head nurse Cyclical – covers a designated number of weeks and repeated there on.
  • 69.  Patient Care Classification ◦ Level I – (minimal) for discharge/convalescing patient ◦ Level II – (moderate) needs some assistance of activities of daily living ◦ Level III – (complete) completely dependent; those who need close attention throughout the shift ◦ Level IV – (specialized) continuous monitoring .
  • 70.  Total patient care/case method ◦ The oldest mode of organizing patient care ◦ Nurses assume total responsibility during their time on duty for meeting all the needs of assigned patients.
  • 71.  Primary Nursing/relationship-based nursing ◦ Nursing care directed by a nurse in a 24-hour basis ◦ Increase job satisfaction, improves continuity of care, allows independent decision making, supports direct nurse-client communication, encourages discharge planning, improves quality care ◦ Increase personnel costs, requires properly trained nurses to carry out system principles.
  • 72.  Functional Nursing ◦ Task oriented and very useful in emergency situation ◦ Reduces personnel costs ◦ Fragments nursing care, decreases job satisfaction, decrease personal contacts with patients, limits continuity of care.
  • 73.  Team Nursing ◦ One nurse will lead a group of nurses ◦ Increases job satisfaction, increase cost effectiveness ◦ Decreases personal contact with client, limits continuity of care.
  • 74.  Case Management ◦ Focuses on attainment of outcomes within effective time frame by a case manager and this is done prior to admission and spans for about 2-3 weeks discharge ◦ Improves nurse responsiveness to clients changing needs, improves continuity of care, increase nurse‟s job satisfaction ◦ Increase personnel costs.
  • 75.  The study of how people perform and function within a group structure The group becomes a unit when it shares a common goal and acts in union to either achieve or thwart the accomplishment of the goal ◦ Primary Groups – composed of individuals who interact on “face-to-face” basis, and the relationships are personal ◦ Secondary Groups – are larger and more impersonal groups who are organized around formal rules, procedures, policies and other regulations.
  • 76.  Aggressor - expresses disapproval of others‟ values or feelings through jokes, verbal attacks, envy Blocker – Persists in expressing negative points of view and resurrects dead issues Recognition Seeker – works to focus positive attention on himself Playboy – remains uninvolved with everything Dominator – attempts to control and manipulates the group Help Seeker – use expressions of personal insecurity, confusion, or self-deprecation.
  • 77.  Forming – during the initial stage the group forms and learns the behavior acceptable to the group Storming – as the group becomes more comfortable with one another they begin to assert their individual personalities Norming – the conflicts that arouse in the previous stages are addressed and hopefully resolved Performing – is a stage by which a group begins to operate as a unit Adjourning – is a time for a temporary group to wrap up activities.
  • 78.  Stimulate the production and generation of creative ideas of groups ◦ Generate new ideas about an issue ◦ Welcomes free thinking and facilitate open expression ideas ◦ Withhold any evaluation or criticism of the ideas that are expressed ◦ Build and improve on ideas already expressed.
  • 79.  Directing ◦ The function of the manager that gets work done through others which involves giving direction, supervising, leading, motivating, and communicating.
  • 80.  Transferring a tasks to a component individual What Cannot Be Delegated ◦ Overall responsibility, authority, accountability, and completion of all activities in the unit ◦ Authority to sign one‟s name ◦ Jobs that are too technical ◦ Sterile procedure ◦ Initial and terminal assessment ◦ Unstable patient.
  • 81.  Right person Right task Right amount of time Delegate in advance Delegate gradually Consult first before delegating Avoid gaps and overlaps .
  • 82.  Decision Making ◦ A choice made between two or more alternatives wherein the manager chooses the best alternative to reach the predetermined objective.
  • 83.  Ends-Means ◦ Ends – deals with the determination of desired individual or organizational results to be achieved ◦ Means – decisions deal with strategic or operational programs, activities that will accomplish desired results.
  • 84.  Administrative-Operational ◦ Administrative – decisions made by senior management, which have significant impact throughout the organization ◦ Operational – generally made by mid level and first line managers and address day to day operational activities of a particular organization.
  • 85.  Programmed-Non-programmed ◦ Programmed – repetitive and routine in nature ◦ Non-programmed – unique and non-routine.
  • 86.  Staff Development ◦ Formal Education ◦ In-service Education ◦ Specialty Course ◦ Orientation.
  • 87.  The transfer or information and understanding from one person to another ◦ Verbal – use of spoken words ◦ Non-verbal – facial expressions, gestures, body language and touch.
  • 88.  Ideation – the idea or thought to be conveyed to an individual or group Encoding – the manner in which the message is conveyed Transmission – actual expression of the message Receiving – the manner in which the receiver gets the message Decoding – receivers understanding of the message Response – or feedback.
  • 89.  Elements of communication ◦ Sender – a person or group who wishes to convey a message to another ◦ Message – that which is being conveyed ◦ Receiver – the listener, observer ◦ Feedback – response, message that the receiver returns to the sender.
  • 90.  Vertical Communication ◦ Downward – information and other types of communication are sent by superiors to subordinates ◦ Upward – when employees or managers who are subordinate to top level management send message up through the chain of command Horizontal Communication ◦ When people communicate on the same level in the organization structure Diagonal Communication ◦ Interactions of different levels in the organization.
  • 91.  Formal Communication ◦ Follows the formal line of authority in the organization‟s hierarchy Informal Communication ◦ Occurs between people at the same or different levels of the organizational hierarchy but do not represent formal lines of authority.
  • 92.  Proxemics – the study of distance between people in their interaction ◦ Intimate – physical contact – 1.5 ft ◦ Personal – 1.5 – 4 ft ◦ Social – 4 – 12 ft ◦ Public – 12 ft and beyond.
  • 93.  Assertive ◦ Says directly and clearly what is on your mind based on self- respect and consideration for other people Passive ◦ Communicating viewed as being uninvolved or unable to share thoughts which may be withdrawn, shy or purposely withholding Aggressive ◦ Concerned only with the rights of one position and may be loud, inappropriate, confronting or hostile.
  • 94.  Clarify your ideas before communicating to others Consider the setting, both physical and psychological Consult with others when necessary to be exact and objective Be mindful of the overtones as well as the message itself Take the advantage to convey something to help, value, or praise the receiver Follow up your communication Be sure your actions support communication Be an active listener Give credit for the contributions of others Be assertive when expressing your views.
  • 95.  An expressed struggle between at least two interdependent parties, who receive incompatible goals, scarce rewards, and interference from the other party in achieving their goals.
  • 96.  Win-Lose ◦ It is not the optimal way of resolving conflicts because one of the participants losses Lose-Lose ◦ The strategy which everyone would like to avoid, lose-lose is not an intentional choice, but they end up with this outcome when other strategies fail Win-Win ◦ Strategy which allows both individuals to feel they have accomplished all or part of their goal.
  • 97.  Intrapersonal ◦ Conflict within an individual Interpersonal ◦ Those that arise between two individuals Intragroup ◦ Those that arise from the members of the same group Intergroup ◦ Those that arise between groups.
  • 98.  Methods employed to resolve or suppress a conflict by all parties‟ agreement or else by the defeat of one party.
  • 99.  Avoidance ◦ A style characteristic of individuals who are passive and who do not want to recognize a conflict ◦ These person generally prefer to ignore conflict situations rather than confront them directly.
  • 100.  Competition ◦ A conflict style characteristic of individuals who are highly assertive about pursuing their own goals but uncooperative in assisting others to reach their goals ◦ These individuals attempt to resolve a struggle by controlling or persuading others in order to achieve their own ends.
  • 101.  Accommodation ◦ A conflict style that is unassertive but cooperative ◦ Attends very closely to the needs of others and ignores his or her own needs ◦ A way for individuals to move away from the uncomfortable feelings of struggle that conflict inevitably produces.
  • 102.  Compromising ◦ Compromise is a positive conflict style because it requires that individuals attend to others‟ goals as well as their own ◦ Compromise reminds us of the golden rule: “Do unto others as you would have them do unto you”.
  • 103.  Collaborating ◦ The most preferred of the conflict styles, which requires both assertiveness and cooperation ◦ It involves attending fully to other‟s concerns while not sacrificing or suppressing one‟s own concern ◦ Although this is the most preferred style, it is still the hardest to achieve.
  • 104.  Conflict Resolution ◦ Smoothing ◦ Other persons are involved trying to “smooth” the conflict to reduce emotional component of the conflict.
  • 105.  Controlling ◦ The regulation of activities in accordance with the plan which ensures that the tasks to be accomplished is appropriately executed.
  • 106.  Performance Appraisal ◦ A systemic review of an individual employee‟s performance on the job, which is used to evaluate the effectiveness of his/her work using: ◦ Rating scales ◦ Checklist ◦ Peer review ◦ Ranking ◦ Patient survey ◦ Management by objective.
  • 107.  System Standard ◦ Refers to the instrumentalities like equipment and setting Process Standard ◦ Refers to the nursing care given to clients Outcome Standard ◦ Refers to the desired results.
  • 108.  A process of continuously improving a system by data gathering Total quality management – involvement of all employees in the improvement of the quality of every product or service Benchmarking – comparing your institution with the best.
  • 109.  Quality Assurance ◦ Evaluation of services to make sure that it meets the standard ◦ Nursing audit – review of patients chart ◦ Peer review – evaluation between staff nurses ◦ Quality circle – a group of workers who meet regularly under the leadership of a supervisor who analyze and solve work related problems.
  • 110.  The manager administers; the leader innovates The manager maintains; the leader develops The manager focuses on system and structure; the leader focuses on people The manager relies on control; the leader inspires trust The manager has short-range view; the leader has long- range perspective The manager asks how and when; the leader asks what and why.
  • 111.  The manager has his eye on the bottom line, the leader has his eye on the horizon The manager accepts the status quo; the leader challenges it The manager is the classic good soldier; the leader is his own person The manager does things right; the leader does the right thing.