LEADERSHIP AND MANAGEMENT
o Good management: strong planning,
Leadership vs. Mgt
- L:
o maximizing workforce effectiveness
o empower
o needed to implement system wide
changes
o visioning, motivationing, inspring
- M
o the organization and coordination of
the activities of a business in order to
achieve defined objectives.
o consists of the interlocking functions of
creating corporate
policy and organizing, planning,
controlling, and directing an
organization's resources in order to
achieve the objectives of that policy.
o A tactical focus on aspects of the
organization's strategy
o Executing on specific areas within their
responsibilities
o Formulating and enforcing the policies
of a business to achieve its goals
o Directing and monitoring their team to
achieve their specific goals
o Management and containment of risks
in an organization
o Short term focus with attention to the
details
o Process of leading, directing thru
deployment or manipulation of
resources
o CONTROL; hours, costs, salaries
o Guides, direct
organizational skills, intervene when
goals are threatened
- Managers
o Assigned position within formal orgs
o Legitimate source of power
o Specific functions, duties and
responsibilities
o Greater formality responsibility and
accountability for control
- Leaders
o Strategic focus on the organization's
needs
o Establishing goals and the strategic
direction
o Establishing principles
o Empowering and mentoring the team to
lead them to their
goals
o Risk engagement and overall
identification
o Long term, high level focus
o Out front, taking risks, attempting to
achieve shared goals, inspiring others to
action, challenging the status quo
o Interpersonal behaviour to motivate
followers to commit
o Only a persons behaviour determines if
she is a leader
o No delegated power , obtained thru
influence
o May or may not be a part of a formal
org
o More on group process, info gathering,
feedback and empowering others
o Interpersonal rel
o Direct willing followers
o May have goals that may not reflect
those of the organization
o Stop leadership: stop following you
Management Theories
- Scientific Management
o Frederick W. Taylor: father of scientific
management
 o one best way to accomplish a task
o Increase in productivity
o Four overriding principles:
Use of time and motion studies
and the expertise of
experienced workers: greatest
efficient time and energy
Scientific personnel system
established: workers can hired,
trained and promoted based on
their technical skills
Workers should be able to view
how they fit into the
organization and how they
contribute to overall
organizational productivity:
common goals and mission ->
use of financial reward
according to level of production
rather than wage (Humans as
economic animals)
Relationship between managers
and workers should be
cooperative and
interdependent and work
should be shared EQUALLY,
different roles. Manager: plan,
prep, supervise.
o Lacked humanism, not in best interest
of workers
- Bureaucracy
o Max Weber
o What made workers more efficient than
others
o Legalized, formal authority and
consistent rules and regulations for
personnel in different positions
- Henri Fayols Management Functions
o Planning, organization, command,
coordination and control.
o Gulicks : Planning, Organizing, Staffing,
Directing, Coordinating, Reporting,
Budgeting
o Management Process:
Planning: determining goals,
objectives, policies, procedures
and rules
Organizing: structure to carry
out plans, most appropriate
type, grouping activities, use of
power appropriately
Staffing: recruiting,
interviewing, hiring and
orienting staff. Scheduling, staff
devt, employee socialization,
team building
Directing: human resource
management responsibilities:
motivating, managing conflict,
delegating
Controlling: performance
appraisals, fiscal acct, QC
Motivational Theories
- Maslows Hierarchy of Needs
o Physio
o Safety
o Love and Belongingness
o Esteem
o Self Actualization
- Two Factor Theory (Motivation-Hygiene)
o Herzberg 1968
o Factors that make people stay: inc
salary does not mean inc satisfaction
o Hygiene factors: factors that contribute
to dissastisfaction
- Theory X and Theory Y dichotomy
o McGregor 1960
o X: employees are basically lazy, needs
constant supervision
o Y: workers are self motivated
- Theory Z
o Ouchi 1981
o Motivate employee to share the
managers vision
Leadership Theories
- Great Man Theory (1840s)
o popularized by Thomas Carlyle
o Aristotelian
 o Some people are born to lead
o Great leaders will rise if the situation
demands it
o Some Characteristics:
Intelligence
Judgement
Adaptability
Personal integrity
Interpersonal skills
Prestige
Self-confidence
- Trait Theory (1930s 1940s)
o Gordon Allport identified almost 18,000
English personality-relevant terms
(Matthews, Deary & Whiteman, 2003,
p. 3)
- Behavioral Theories (1940s 1950s)
o Emphasis on what leader does
o Lewin White and Lippits styles:
o Authoritarian: predictable, reduced
frustration in grp, + feeling of security :
high productivity but autonomy,
creativity is low
Strong control 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
o Democratic: for extended periods:
autonomy and growth; quantitatively
less efficient; more time needed to
decide
Less control is maintained
Communication: up and down
Decision making involves others
Emphasis on we
Criticism is constructive
o Laissez Faire: group apathy and
disinterest can occur but inc
productivity when all members are
highly motivated
Permissive little or no control
Motivates by support
Provides little or no direction
Disperses decision making
Places emphasis on the group
Does not criticize
o The Managerial Grid Model/
Leadership Grid
o Role Theory
- Situational and Leadership Theories 1950-1980s
o Leadership style should vary according
to situation
o Law of the Situation (Mary Parker
Follet) the situation should determine
the directives given after allowing
everyone to know the problem
o Contingency Leadership (Fieldler) no
one leadership style is ideal for every
situation
o Leadership Effectiveness Model (Hersey
and Blanchard) leadership style is
based on the level of the followers
maturity
o Tannenbaum and Schmidt: varying
autocratic and democratic
- Interactional Leadership Theories 1970
present
- Leadership behavior = leaders personality +
specific situation
- SCHEIN
o Human beings as complex being whose
working environment was an open
system to which they responded
o 5 Assumptions of a system theory
1. People are very complex and
highly variable
2. Peoples motives do not stay
constant but change over
time
3. Goals differ in various
situations
 4. A persons performance and
productivity are affected by
the nature of the task and by
his or her ability, experience,
and motivation
5. No single leadership strategy
is effective in every situation
- HOLLANDER
o Both leaders and followers have roles
outside of the leadership situation and
that both may be influenced by events
occurring in their roles
o Leadership effectiveness: ability to use
problem solving process, communicate
well, fairness, competence, grp
identification
o Leadership as a two way process
o A leadership exchange has 3 basic
elements:
1. The leader, including his/her
personality, perceptions, and
abilities
2. The follower, including
his/her personality,
perceptions, and abilities
3.The situations within which
the leader and the followers
function
- OUCHI
o Used the term Theory Z for this type of
management
o Characteristics of Theory Z: consensus
decision making, fitting employees to
their jobs, job security, slower
promotions, examining the long-term
consequences of management decision
making, quality circles, guarantee of
lifetime employment, establishment of
strong bonds of responsibility between
superiors and subordinates, and holistic
concern for the workers
- KANTER
o Structural aspects of the job shape a
leaders effectiveness
o Leader must develop relationships with
a variety of
o people within the organization in order
to maximize job empowerment
o 3 major work empowerment structures
1. Opportunity
2. Power
3. Proportion
- NELSON AND BURNS
o Four developmental levels
o 1. Reactive focuses on past, crisis
driven
o 2. Responsive able to mold
subordinates to work as a
o team
o 3. Proactive future-oriented, hold
common driving
o values
o 4. High performance teams maximum
productivity and worker satisfaction
- BRANDT
o Interactive leadership model leaders
develop a work environment that
fosters autonomy and creativity
o Affirms uniqueness of each individual
- WOLF, BOLAND AND AUKERMAN
o Collaborative practice Matrix
highlights ongoing support of
relationships between and among
professionals working together
o Emphasis on social architecture
Transactional and Transformational Leadership
- Burns 2003
- Transactional leaders traditional managers,
emphasizes process in setting goals and giving
directions and seeks to control both situations
and followers
- Transformational leader seeks to infect and
re-infect the followers with a high level of
commitment to the vision
- NOTE: The transformational leader sill fail
without traditional management skills. (Bass et
al.) This was readily apparent in Johnsons
research suggesting that highly effective
managers need both vision as well as a specific
plan able to carry out their plan if goals are to
be achieved.
LEADERSHIP SKILLS: Motivation, Assertive
Communication

Motivation

- The force within the individual that influences

or directs behavior. - INTRINSIC MOTIVATION
- Involves the action people take to satisfy unmet o Comes from within the individual
needs. o Often influenced by family unit and
- Factors Affecting Employee Motivation cultural values
o Rewards o Directly related to apersons level of
o Empowerment & organization aspiration
performance o Recognition, self-esteem, and self-
o Dobre (2013 actualization.
- EXTRINSIC MOTIVATION
o Comes from outside the individual
o Rewards and reinforcements are given
to encourage certain behaviors
o Enhanced by the job environment or
external rewards
o Improves performance and
productivity
o Both extrinsic and intrinsic rewards are
necessary for high productivity and
worker satisfaction.

- Motivational Theory
o Maslow
Humans as people with
complex psychological needs
Meet lower level needs first
o Skinner

Creation of Motivating Climate
Operant Conditioning and
Behavior Modification
Reward and punishment
o Herzberg
Workers can be motivated by
the work itself; internal need to
meet organizational goals
Absence of dissatisfaction does
not mean satisfaction
Organization must build on
motivation and hygiene factors,
greater responsibilities to
worker and recognition.
Hygiene is needed for workers
to move on higher level needs
o Vroom
Expectancy model: preference
based on social values
All actions with cause and effect
Conscious decision with
anticipation for reward
o McClelland
3 basic needs
Achievement Oriented
Affiliation Oriented
Power Oriented
o Gellerman
Methods to motivate people
positively:
Stretching: assigning
tasks that are more
difficult than they used
to do. Not a daily
activity. Build up on
confidence and learn
thru mistakes
Participation: actively
drawing employees into
decisions affecting work
o McGregor
No better mgt between X and Y
- Incentives and Rewards
o Perceived threshold
o Offering rewards in different categories
o Can be complicate by competition : low
morale : ALL should be recognized
o Rewards should be spontaneous ;
whenever, wherever
o Rewards must represent a genuine
accomplishment
o Making progress toward goals
- Promotion
o Internal or external
Higher cost in external
o Promotion and selection criteria
Interview panel
o Pool of candidates that exist
Identify and prepare the pool
o Handling rejected candidates
Talk first to them before
announcing
o How employee release will be handled
- Promote self care
o When managers create fun workplace
and enjoy their work
o Burnout
Manifested by illness,
absenteeism, turnover,
performance deterioration,
decreased productivity, and
job dissatisfaction
Self-care and intrinsic
motivation is important to
prevent burnout

ASSERTIVE COMMUNICATION
- Communication: begins when two or more
people become aware of each others presence
- Internal Climate: values, feelings, temperament
- External Climate: weather, temperature,timing,
power, authority
- Verbal Communication
o Advising others regarding an
appropriate course of action
o Annunciating clearly
o Anticipating the concerns of others
o Asking for clarification
o Asking open-ended questions to
stimulate dialogue
o Assertiveness
o Calming an agitated customer by
recognizing and
o responding to their complaints
o Conveying feedback in a constructive
manner
o emphasizing specific, changeable
behaviors
o Conveying messages concisely
o Disciplining employees in a direct and
respectful manner
o Emphasizing benefits of a product,
service or proposal to
o persuade an individual or group
o Encouraging reluctant group members
to share input
o Explaining a difficult situation without
getting angry
o Explaining that you need assistance
o Giving credit to others
o Introducing the focus of a topic at the
beginning of a
o presentation or interaction
o Noticing non-verbal cues and
responding verbally to verify
o confusion, defuse anger, etc.
o Paraphrasing to show understanding
o Planning communications prior to
delivery
o Posing probing questions to elicit more
detail about
o specific issues
o Projecting your voice to fill the room
o Providing concrete examples to
illustrate points
o Receiving criticism without
defensiveness
o Recognizing and countering objections
o Refraining from speaking too often or
interrupting others
o Requesting feedback
o Restating important points towards the
end of a talk
o Selecting language appropriate to the
audience
o Showing an interest in others, asking
about and
o recognizing their feelings
o Speaking calmly even when you're
stressed
o Speaking at a moderate pace, not too
fast or too slowly
 o Speaking confidently but with modesty
o Stating your needs, wants or feelings
without criticizing or
o blaming
o Summarizing key points made by other
speakers
o Supporting statements with facts and
evidence
o Tailoring messages to different
audiences
o Telling stories to capture an audience
o Terminating staff
o Training others to carry out a task or
role
o Using affirmative sounds and words like
uh-huh, got you, I
o understand, for sure, I see, and yes to
demonstrate
o understanding
o Using humor to engage an audience
o Utilizing self-disclosure to encourage
sharing
- Non Verbal Comm
o Avoiding a slouching posture
o Avoiding smiling or laughter when
messages are serious
o Displaying some animation with hands
and facial
o expressions to project a dynamic
presence
o Dont bring your phone, a drink or
anything else to an
o interview or meeting that could distract
you
o Dont interrupt your interviewer
o Eliminating fidgeting and shaking of
limbs
o Establishing frequent but not
continuous or piercing eye
o contact with interviewers
o Focusing on the on conversation
o Introducing yourself with a smile and a
firm handshake
o Keeping hands away from the face and
hair
o Leaning slightly forward to indicate
interest
o Listening carefully
o Maintaining open arms, folded arms
can convey
o defensiveness
o Modulating vocal tone to express
excitement and
o punctuate key points
o Nodding to demonstrate understanding
o Observing the reaction of others to your
statements
o Paying attention to the conversation
o Reading the nonverbal signals of others;
providing
o clarification if they look confused,
wrapping up if they
o have heard enough
o Refraining from forced laughter in
response to humor
o Refraining from looking at the clock,
your phone or
o displaying any other signs of disinterest
o Respecting the amount of personal
space preferred by
o your communication partners
o Rotating eye contact to various
speakers in group
o interviewing or networking situations
o Shaking hands firmly without excessive
force
o Showing that youre interested in what
the interviewer is
o telling you
o Smiling to indicate that you are amused
or pleased with a
o communication
o Staying calm even when youre nervous
o Steering clear of monotone delivery
o Waiting until the person is done talking
to respond
- 4 Types of Communication:
 o Passive communication - occurs when a
person suffers in silence although he or
she may feel strongly about theissue.
They often avoid conflict but is
at risk of bottlingtheir feelings
which may lead to eventual
explosion.
o Aggressive communication - generally
direct, threatening, and condescending.
It infringes on another person's
rights and intrudes into that
person's personal space.
This behavior is also oriented
towards winning at all costs or
demonstrating self-excellence.
A bullying type of
communication and a form of
dominance. Thiscommunication
creates enemies and leads to
unstable relationship.
o Passive-aggressive - aggressive message
presented in a passive way that involves
limited verbal exchange (often with
incongruent nonverbal behavior) by a
person who feels strongly about a
situation
o Assertive communication - way of
communicating that allows people to
express themselves in direct, honest,
and appropriate ways that do not
infringe on another person's rights.
Use of pronoun '"I"
Uses direct eye contact
calm voice
congruent verbal and non-
verbal messages
- Misconceptions
o There are only two types of
communication.
o Those who communicate or behave
assertively gets everything they want.
o Unfeminine
o The terms assertive and aggressive
aresynonymous.
- When under attack by an aggressive
person, an assertive person can do
several things:
o Reflect
Reflect the speakers message
back to him/her
Focus on the affective
components of the aggressors
message
o Repeat the assertive message
Repeated assertions focus on
the messages objective content
Especially effective when the
aggressor overgeneralizes or
seems fixated on a repetitive
line of thinking
o Point out implicit assumptions
Listen closely.
Let the aggressor know that
youve heard him/her.
o Restate the message by using assertive
language
Rephrase the aggressors
language to defuse the emotion
Paraphrasing helps the
aggressor to focus more on the
cognitive part of the message
o Question
When the aggressor uses
nonverbal cues to be
aggressive, the assertive person
can put this behavior in the
form of a question.
This will help the other person
become aware of an
unwarranted reaction.
VERBAL COMMUNICATION TOOLS
 - SBAR/ISBAR tool that provides o Grapevine: quickly and haphazardly at
structured, orderly approach in all hierarchical levels, little actability
providing accurate, relevant
information in emergent patient
situations and handoffs; reduces
communication errors
- Assertiveness Techniques:
o Behavior Rehearsal
Events
Feelings
Needs
Consequences
o Repeated Assertion (Broken Record)
o Negative Inquiry
o Negative Assertion
o Workable Compromise
o I statements
o Empathy
o Escalation
o Ask for More Time
o Change Your Verbs
Use 'won't' instead of can't'
Use 'want' instead of 'need' Group Dynamics
Use 'choose to' instead of 'have
- Stages of Group Comm:
to'
o Forming: identify interpersonal
Use 'could' instead of 'should'.
behaviors, establish dependency
Organizational Communication Strategies: relationships
o Storming: becomes comfortable enough
- Assess to disagree with each other: inc trust,
- Recognize structure positive competition, easy bargaining
- Not a one way channel: feedback o Norming: establish rules
- Clear, simple and precise o Performing: work gets done
- Feedback to check accuracy - Group Task Roles
- Multiple communication methods should be o Initiator
used o Info seeker
- Not overwhelm subordinates with unnecessary o Info giver
information o Opinion seeker
- Channels of Communication o Elaborator
o Upward: manager as subordinate o Coordinator
o Downward: manager relay info to sub o Orienter
o Horizontal: manager to manager; same o Evaluator
level, peer to peer o Energizer
o Diagonal: interact with other o Procedural Technician
departments : not of the same level, o Recorder
less formal - Group Building and Maintenance Roles
o Encourager
 o Harmonizer within the organization
o Compromiser
o Gatekeeper
o Standard setter Types of Power
o Group commentator - Position Power
o Follower o Legitimate Power
- Ind roles Authority
o Aggressor power granted to an individual/
o Blocker group by virtue of position
o Recog seeker o Informational Power
o Self confessor most transitory
o Playboy based on data and knowledge
o Doninator that can be used to attain goals
o Help seeker o Reward Power
o Special interest pleader obtained by ability to grant
favors or reward other/s with
POWER
whatever they value
- Act which enables one to accomplish goals o Coercive Power
- Strength and potency too do something based on fear of punishment if
- Authority: right to command expectation are not met
- Personal Power
o Expert Power
- Capacity of A to influence the behavior of B based on knowledge, expertise
so that B does things he/she would not or experience.
otherwise do o Referent Power
- Powerlesness may yield more powerlessness: role model
rigid, petty mgt power that stems from being
- Power is evident in respect and cooperation of liked, admired and respected
followers o Charismatic Power
- Exert influence on behalf of someone not over intense form of referent
someone stems from individuals
- Neither good nor evil personality/physical or other
- Sources of Individual Power ability, which includes others to
o Personal Power believe in and follow that
Individual unique person
qualities and o Rational Persuasion Power
characteristics ability to mount logical
o Position Power arguments and factual evidence
Individuals title to convince others an ideas as
acceptable
o Exploitative Power
most destructive
subjects people to whatever
use the power holder chooses
o Manipulative Power
 influence over another person
that may have been invited
because of the persons
desperation and anxiety
ACQUIRING POWER: SKILLS (CHERIE A. & GEBREKUDAN
A. B., 2005)
- Peer Skillcommunication and interaction
skills by which a person builds a network of
supporters from whom to obtain help in a crisis.
- Leadership Skill-communication and motivation
skills with which one resolves problems arising
from power, authority, and dependenc
phenomena.
- Information Processing skillreceiving,
encoding, grouping, storing, retrieving,
translating, and sending information by which
one interprets the world and transmits
interpretation to others.
- Conflict resolution skillskills by which a person
finds agreement between candidates and
persuades disputants to collaborate in the
interest of mutual gain.
- Decision making skillanalyze problems for the
cause and effect relationships, generate
possible solutions,select the most effective
course of action, and assign responsibility for
plan implementation.
- staff to provide learning opportunities
Authority Power Gap
- The right to command does not ensure that
employees will follow orders
- Manager power: may explain subordinates
purpose
o The more power subordinates perceive
a manager to have, the smaller the gap
between the right to expect things and
the resulting fulfilment by others.
o Large gap: chaos, poor productivity
o Smaller gap: unconditional obedience,
impaired independence
- Bridging the gap
o Know and care for each subordinate
o Provide info abt the organizations goals
o Manager must be seen as credible
o Future promising: best to underpromise
Empowerment
- Hallmark of transformational leadership
- Decentralization of power
- When leaders communicate their vision,
employees are given the opportunity to make
the most of their talent
- Ensure that all are treated with dignity
- Not the relinquishing of rightful power; actions
of staff are freely chosen, owned and
committed to without any requests or reqs to
do so
- Minimize org barriers, be a role model, assist
staff in building their personal power base
- Involved in planning and implementing change
- COMPONENTS OF EMPOWERMENT
o Has professional traits
o He/she is continuing education
o He/she participated in professional
organizations and political activism
o He/she has a sense of value about their
work
o Has been working in an environment
encouraging empowerment
o Has a leader-manager who nurtures the
development of empowered staff
o He/She delegates assignments to their
- BARRIERS OF EMPOWERMENT
o Beliefs about authority and status
Empowerment is blocked if
authority and power is the ends
of achieving the organizations
mission and planning
o Rigid rules and policy
Empowerment is hindered in a
controlling environment
Queen Bee Syndrome
(Spengler,1976)
Manifested by a person
who wants to be the
main attraction and
desires a powerless
subordinate
o Organizational Inertia
 Empowerment only happens
when there is an organizational
allotment of resources to
empower people
o Departmental Rivalries
The more time managers spend
their resources in defending
their turfs, the less
organizational emphasis is given
to empowerment
o Increasing number of employees
Diverse employees pose a
greater challenge in developing
focused and flexible
empowering strategies
o Unwillingness for assuming
responsibility
Identification of job roles can
narrow down areas of
improvement and
empowerment
o Managerial Incompetence
Managers should possess skills
that empower people
- Strategies for Building A Personal Power Base
o Maintain personal energy: self care
o Present a powerful picture to others
Stand tall, poised, assertive,
articulate and well groomed
o Pay the Entry Fee
Do more, work harder and
contribute to the organization
Team player
o Determine the Powerful
Be cognizant of their limitations
and seek counsel appropriately
o Learn the language and symbols of the
organization
o Learn how to use the orgs priorities
o Inc skills and knowledge
o Maintain broad vision
o Use experts and seek counsel
o Be flexible: compromise
o Develop visibility and voice in an
organization
o Learn to toot your own horn: praises
being grateful
o Maintain a sense of humor
o Empower others
Advocacy
- Helping others to grow and self actualize
- Inform others of their rights and to ascertain
that they have sufficient information on which
to base their decisions
- Protecting and defending what one believes in
for both self and others
- ROLE OF THE NURSE
o Help others make informed decisions
o Act as an intermediary in the
environment
o Directly intervene on behalf of others
- Patient Advocacy
o Appropriate action regarding illegal,
unethical and inapp behaviour that can
jeopardize the best interest of the
client.
o The assumption that the health
professionals are the best judges of
treatment: stip patient of right to
autonomy
- Subordinate and Workplace Advocacy
o Workplace advocacy
Environment is both safe and
conducive to professional and
personal growth
o Ways
Invite collaborative decision
making
Listen to staff needs
Get to know staff
Face challenges and solve
problems together
Promote shared governance
Promote autonomy
Provide staff with workable
systems
- Professional Advocacy
o Legal recognition, culture of
professional nursing