Leading Teams Through Delegation and Collaboration

Leading, Delegating, and
Collaborating
Chapter 16
C O P Y R I G H T © 2 0 1 4 , 2 0 0 9 B Y M O S B Y , I N C . , A N
I M P R I N T O F E L S E V I E R I N C .

LEADERS, MANAGERS, AND FOLLOWERS
Characteristics of a leader
 Competence
 Trustworthiness
 Self-assuredness
 Decision-making ability
 Prioritizing skills
2

Management
 Provides the structure and direction necessary to accomplish goals and
outcomes that are known and, where there is a system in place, to achieve the
outcomes
3

Managers
 Any staff member who bears responsibility for the work of others
 Anyone who must ensure the completion of an organizational process
 One who guides the processes necessary to accomplish tasks necessary to
achieve organizational outcomes
4

Followership
 Not a passive process
 Uses personal behaviors that contribute to the health care team’s goals
 Demonstrates collaboration, influence, and action with the leader or manager to
accomplish goals and outcomes
 Should be willing to question, debate, compromise, collaborate, and act as well
as be accountable for those actions
5

LEADERSHIP CHARACTERISTICS
Leadership
 Ability to influence outcomes through positive interactions with team members
Characteristics
 Recognizes the strengths and weaknesses within the team
 Manages them to affect a positive outcome from a plan of care
 Empowers all team members to do the jobs of which they are most capable
 Delegates assignments, tasks, and duties to the best individuals for the
particular jobs
6

LEADERSHIP CHARACTERISTICS (CONT'D)
Defining the leadership role
 Managing: directing or supervising others as a means to control a situation
 Managing patient care
 Overseeing the plan of care
 Directing others to implement the plan toward achievement of the desired
outcomes
 A manager has leadership qualities, acts as an advisor, and influences the
beliefs of others.
7

LEADERSHIP CHARACTERISTICS (CONT'D)
Defining the leadership role
 Both an expectation and an earned role
 Decisiveness, sound judgment, and ability to articulate fluently
 Self-knowledge, respect, trust, integrity, vision, participation, learning,
communication, and catalyzing change
 Display of integrity
8

LEADERSHIP STYLES (CONT'D)
Servant leadership
 Emphasizes service to others, including employees, customers, and the
community
as a first priority
 Focuses on the needs of others, empathizes with them, and is attentive to the
concerns of followers
 Involves listening, empathy, healing, persuasion, awareness, foresight,
conceptualization, commitment to the growth of people, stewardship, and
building community
9

LEADING AND EMOTIONAL INTELLIGENCE
Four major domains
 Self-awareness
 Self-management
 Social awareness
 Relationship management
Refers to recognizing and regulating emotions in ourselves and others
 Can improve staff relationships, improve patient outcomes, motivate others,
resolve conflict, create a healthy work environment
10

ETHICS AND LEADERSHIP
Leadership has a moral or ethical dimension.
Five principles of ethical leadership
 Serving others
 Showing justice
 Respecting others
 Honesty
 Building community
11

ETHICS AND LEADERSHIP (CONT'D)
Leaders’ ethical responsibilities
 Treat followers with dignity and respect.
 Be sensitive to their interests, needs, and concerns.
12

CULTURE AND LEADERSHIP
Cultural competence extends to workplace as well
Four generations in the workforce
 Veterans
 Value loyalty, respect authority, want reward for hard work
 Baby Boomers
 View future with optimism and promise and desire to prosper
financially and contribute meaningfully
 Generation X
 Loyal to profession, but unwilling to sacrifice for employer
 Millennials
 Open-minded, collaborating, civic-minded
13

DELEGATION
Definitions
 Assigning tasks or duties to an entrusted individual
 Getting work done through others
 Directing the performance of one or more people to accomplish organizational
goals
Principles of delegation
 The RN takes responsibility and accountability for the provision of nursing
practice.
 The RN directs care and determines the appropriate utilization of any assistant
involved in providing direct patient care.
14

DELEGATION (CONT'D)
Principles of delegation
 Assessment, planning, evaluation, and nursing judgment cannot be delegated.
 The decision of whether or not to delegate or assign is based on the RN’s
judgment.
 The RN delegates only those tasks that the health care worker has the
knowledge and skill to perform.
 The RN delegates the right task, under the right circumstances, to the right
person, with the right direction and communication, and with the right
supervision.
15

DELEGATION (CONT'D)
Issues in delegation
 Patient safety must always be maintained by understanding the scopes of
practice and the skills and abilities of the other health care team members.
 Delegating fairly does not mean delegating equally.
16

DELEGATION (CONT'D)
 According to the ANA, three elements may not be delegated.
 Initial and subsequent nursing assessments that require professional
judgment
 Determination of nursing diagnoses, goals, plans of care, and progress
 Interventions that require the application of professional knowledge and skills
17

DELEGATION (CONT'D)
 If a person resists
 Provide deadlines.
 Avoid oversupervising.
 First assess the reason for the resistance or refusal to perform a specific
task.
 Then take appropriate action to remedy the situation.
 Remember that if the patient has not been assessed by an RN, delegation
should not occur.
18

COLLABORATION
Definition
 Partnership arrangement between two or more individuals who have a mutual
agreement to work together
Successful collaboration
 Team must agree on the plan of care and the prioritization of the components of
the plan
 Excellent communication among the team members
 Mutual recognition and respect
19

ACCOUNTABILITY
The RN must ensure that the plan of care
is implemented, evaluated, and possibly modified so that the patient
outcomes are
the best they possibly can be.
20

PROFESSIONAL ADVOCACY
Advocacy
 One individual promotes someone else or someone’s idea.
As a patient advocate
 The RN promotes the patient’s decisions in a nonjudgmental manner.
RN’s responsibilities
 Assess patient’s understanding of the plan of care and ensure that the patient
has all the information needed to make informed decisions.
21

PROFESSIONAL ADVOCACY (CONT'D)
RN’s responsibilities
 Caring
 Has a commitment to preserving the patient’s humanity, personal worth, and
dignity
 Speaking up concerning unsafe conditions because patient safety is paramount
 Advocating for the public and the nursing profession
 Involvement with professional organizations and becoming active in legal
issues concerning health
care policy
 Extending advocacy to self
22

COLLABORATING AND ADVOCATING THROUGH THE
MEDICAL PLAN OF CAREThe physician is the manager of the medical plan of care.
 The RN must anticipate the medical direction, understand the orders written,
and foresee how they will affect the patient and patient care.
 The RN must understand the complexities of patient care management in order
to advocate for the patient.
23

DECISION-MAKING AND PROBLEM SOLVING
Decision-making
 Involves making a decision that is focused on trying to solve an immediate
problem
Problem solving
 Is a purposeful and goal-directed process aimed at identifying and selecting
options as part of problem solving, planned change, or improvement
24

(CONT'D)
Decision-making process
 Defining objectives
 Identifying options
 Identifying the advantages and disadvantages of each option
 Selecting an option
 Implementing the option
 Evaluating the result
25

(CONT'D)
Effective decision-making and problem-solving
process
 Gather data from many sources.
 Learn different approaches to problem situations.
 Observe positive role models in action.
 Talk to a colleague or superior who is an effective problem
solver and decision maker.
 Perform research to increase your knowledge base.
 Take risks using new approaches to problem solving.
26

CONFLICT MANAGEMENT
Conflict
 Opposition of feelings, beliefs, desires, or goals
Types
 Intrapersonal: within one individual
 Interpersonal: between or among two or more individuals
 Intragroup: within one group
 Intergroup: between or among two or more groups
Guidelines
 Need privacy
 Willing to talk calmly and rationally
 If not, stop the process and discuss at another time; ask for help if
needed.
27

CONFLICT MANAGEMENT (CONT'D)
Sacrifice resolution
 Someone accommodates the other by essentially sacrificing his
or her position, thus allowing the other to have his or her way.
Competition resolution
 One or both of the parties work competitively, instead of
cooperatively, toward resolution.
 One side wins and the other loses.
28

CONFLICT MANAGEMENT (CONT'D)
Win-win resolution
 Collaborative method
 Two opposing parties coming together to decide on mutual goals
 Designing interventions to meet these goals
 Working together to evaluate the outcomes
29

Leading Teams Through Delegation and Collaboration

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