I am working as a nurse in a diabetic unit. I have been a nurse for the past two years in this diabetic unit.

During these years, there are many changes in the diabetic unit that I have seen. The Diabetic have to face the large number of the patients everyday. In the diabetic unit, there are three medical officer (MO) in charged, one sister, five registered nurses and two assistant medical officers (AMO), and all of them work side by side to make this diabetic unit runs smoothly each and every day. With these small numbers of staff and large number of patients everyday, which is around 70 to 100 number of patients in the morning duty everyday seems to be a difficult task to encounter. Here, there are lots of health programs provided for the patients. As one organisation, we must work together and have a good leadership and management to achieve the organisational objectives. There are various programs done, such as diabetic education, foot care education, dietician, and exercise teaching. All diabetic patients must seen the nutritionist at least once a year to gain their knowledge and awareness about the balance diet. Healthy life style and balance diet is most important for the diabetic patient. To run this diabetic clinic successfully, team work is important for the staff. For maintaining and gaining organisational stability, we must be working together and have good leadership and management to achieve organisational objectives. Nurses work together with great number of people such as physicians, therapist, pharmacist, social worker, technicians and others. These include variety of people hierarchy of profession.

Nurses have to manage the staff wisely with variety of different personnel. Effective nurse leadership and management create good qualities and behaviours on how to work with other people. Leadership is an essential part of effective management. Leadership and management is not the same thing. They have are lot of differences. According to Yukl (1998) Leadership is generally defined that process of influence, which include variety of personnel positions of authority in which the leader influences others to move in the direction of achieving the goals. I am just at the beginning of my career in nursing. The expectation for me to be a leader or manager are still far but not an impossible one. For someone who is new, I need time to develop my clinical skills and get ready to supervise others as well which include supervising new staff or students nurses. As DeCrane (1996) sees it, Leadership is not just at the high level in our organisations but the most important is leadership throughout all levels. In the diabetic unit, nurses, make critical thinking everyday which involve the life of the patients and patients families to accomplish part of the ordinary work. As leaders our expertise and leadership will give the satisfaction to the patients and it is something extraordinary. To accomplish our objective, we must care for our patients and implement an internal program for our new graduate nurses. Every new nurse provided by a mentor, as a leader must be given support and guidance on how to be professional, to be a good leader and competent as well. I agree with this program which really helps new nurses to be successful and will have an advantage in the organization.

To achieve organizational mission, effective management is very important. According to Mintzberg (1973); McCall, Morrison and Hannian (1978); Hales (1986) management can be defined as a process of coordinating an actions and assign resources to reach the organisational missions. This position could be further strengthened by considering the evidence presented by two other individuals, Gulick & Urwick (1937) The management process according to seven principles. The principles are from this word POSD-CORB which stands for planning, organising, staffing, directing, coordinating, reporting and budgeting ( Henry, 1992 ). In our diabetic unit, our staffs and patients very happy with the clinic operation. They work smoothly and systematically. Staff selecting to run the clinic have done their work successfully. Selection of nurses are based on their knowledge, skill and experiences. Beside that, the number and types of patients needing care are also included. Administrative theory recognises that, the power of the informal structure in organisations identifies that, the role of natural forming social groups. Managers must recognise and work with others to achieve the best outcomes for the organisation ( Barnad, 1938 ). They are a lot of comparison between of leadership and management. Managers have their own formal authority to direct the work. They set of employess and responsible for the work quality and costing. Management can improve these by the use of effective leadership skill. On the other hand, leadership is an essential part of effective management. As a nurse, they still have opportunities to be a leader even though they are new and least experience. A good leader must have good qualities and good behaviour on how to work with others. Costello-Nickitas (1997) distinguishes that, effective nurse leaders are excellent team players and almost be an important person of teams in organisation.
3

In our diabetic unit, our leader have been here for the past for seven years Which is junior than the registered nurse which have been on ten years in services in the diabetic unit. Nevertheless, that nurse have shown the effective nurse leader. My nurse leader have those leadership charisma. She is able to make an emotional connection with the followers. She have shown herself confidence and get others to have confidence in her. She is also a good listener. Any suggestions and problems will be settle together collaboratively. House ( 1997 ) found that, according to charismatic theory, the leader who have charisma have their own quality and ability that I spire followers self devotion. Organisations which is run by leadership and management have different roles. As a leader, she try to focus on the skills and help people to develop their abilities. On the other hand, managers are more focus on organisation to make sure that, it is running well as possible. According to Bennis and Nanus (1985) leader do the right thing, while managers do things right. Further support for this argument has come from Covey & Merril (1994) contends that, manager manage things but leader leads people. In our clinic, which was establish more than twenty years ago, the department size and organisation structure are still in good manner. They have multicultural staff, variety of personnel and authority. The service have their own specialisation like hypertension clinic, diabetic clinic, outpatient clinic, laboratory, and x-ray department. Unfortunately, the facilities and equipments are inadequate. Most of the equipments were out of date and not efficient to the new technologies. This kind of problem may interfere to the outcomes of the patients and organisation. According to

Maslows ( 1970 ) hierarchy of needs noted that we must satisfied physical needs before the psychological needs itself. In our clinic practice, there are three most powerful influence people that I know which have special qualities to be a leader. They have good interactions between staff member and leaders. Indirectly, she have good relationship among leaders and followers. This can be seen on their communication skill, ideas and respect to others. All of them have their own integrity, ability to support others. They have their self-confident in which our staff member are able to trust her abilities and her decisions. According to Bennis & Nanus ( 1985); McCall ( 1998 ) based on Core traits of leader, leadership not only show feature good qualities but the most important effective leader are have core values. My leader is my sister who is in charge of the diabetic unit. She always spend her time on the unit observing the activities in the diabetic clinic. She was fifteen years in service in the hospital before posted to the oncology unit. She is now a sister in our unit. She gives order to the staff on the responsibility that they have to carry out during those working hours. She wants to have work done fast and use her autocratic approach to make others to participate. The diabetic unit must be running smoothly because , the nurses must council and educate patient to get effective diabetic care. The best of leadership style in diabetic unit that I prefer is a democratic leadership. In this type of leadership, that we have use during the previous sisters allows others to participate in the decision making. In that way, leaders and followers maintain positive relationships whether in her presents or not.

According to Lewin ( 1939) behavioural theories, there are four leadership styles which are being use up for today. Autocratic leadership, laisser-faire leadership, democratic leadership and lastly, employee-cantered leadership. According to Burn ( 1978 ) transformational leadership definition is a process in which both of leaders and followers act on the another to achieve their motivation to get to the higher levels. To develop learning organisations, the contemporary theories of leadership, transformational leadership has been a popular approach in nursing. By introducing transformational leadership, it allow to innovation and change. It give benefits in our team and our services. Improve patient outcome, develop communication skill and personality able to give decision and build up their role and network. Transformational leader motivated us with good values. Effective nurse leaders are like change agents who believe in people, value driven and able to deal with various situation ( Tichy & Devanna, 1986 ). All staff member work together, to the best of their ability to achieve the organisation vision. In my working place, there are lots of effort to achieve quality outcomes. Nurses are sent to further their education and training, For example, now there are five staff members in the diabetic unit that have gone through their diabetic post basic. This will give positive impact in the patients care and organisation. Staff are also encourage to attend Continuous Professional Development ( CPD ) to gain knowledge and experience. Beside that, to improve our quality of management, suggestion box is provided for the patients response. By doing so it is hope that the service in the diabetic unit is supervised and changes can be made for the good of others as well. For future direction, hopefully the advance of the technology

provided. Technology help built up our knowledge and easy to us to access the latest information to perform our work effectively. Knowledge workers are those who bring specialised and expertise to an organisation. They are have their own valued. According to Drucker ( 1994 ) as a knowledge organisation future, which composed of knowledge workers. Motivation is part of learning (Skinner, 1953). According to reinforcement theory, effective leader can manipulate follower behaviour for example give reward to all staff like free lunch coupon. Beside that, giving award excellent staff services. This will encourage our staffs to achieve organisation goal. A team is more important than a group (Shaw, 1981). Effective team working is when everyone work together. Barriers are obstacles to effective team working. Team leader must ensure that all team members have a chance to participate and focus on their areas of expertise which will accomplish on a specific goal. The most important implication is that leaders and managers must aware of organisation aim which influence the socialisation process. Staff member expectations to get the best task regarding their expertises to do their roles as well. Relationship should be good, shared knowledge and experiences to develop respect and responsibility. The other major implication are leaders and managers must understand their function as role model. Effective leadership and management may help staff members to produce the best outcome for the organisation. In conclusion, leaders and managers have their own different roles. Leaders are more focussing on their develops skills but managers are more on managing organisation. In the future, nurses need both leadership and management skill.

Combination of leadership and management are important to make it runs effectively to achieve the organisation goal.