SCHOOL OF ALLIED MEDICINE

NURSING DEPARTMENT

CONCEPTS OF LEADERSHIP & MANAGEMENT

A. MANAGEMENT

Definition/ Description

 The verb manage comes from the Italian maneggiare (to handle — especially tools), which in
turn derives from the Latin manus (hand). The French word mesnagement (later ménagement)
which means “the directing”, influenced the development in meaning of the English word
management in the 17th and 18th centuries.

 Organization and coordination of the activities of an enterprise in accordance with certain

policies and in achievement of clearly defined objectives. Management is often included as a
factor of production along with machines, materials, and money.

 As a discipline, management comprises the interlocking functions of formulating corporate policy

and organizing, planning, controlling, and directing the firm's resources to achieve the policy's
objectives.

 The task of getting results through others by coordinating their efforts is known as management.
Just as the mind coordinates and regulates all the activities of a person, management
coordinates and regulates the activities of various members of an organization.

 Management is principally the task of planning, coordinating, motivating and controlling the
efforts of others towards specific objectives.

 The act of planning, organizing, staffing, direction, and controlling.

Characteristics of a Manager

Managers typically:
a. Have assigned positions within the formal organization.
b. Have a legitimate source of power due to the delegated authority that accompanies their
positions.
c. Are expected to carry out specific functions, duties, and responsibilities.
d. Emphasizes control, decision making, decision analysis, and results.
e. Manipulate people, the environment, money, time, and other resources to achieve
organizational goals.
f. Have a greater formal responsibility and accountability for rationality and control than leaders.
g. Direct willing and unwilling subordinates.
 SCHOOL OF ALLIED MEDICINE
NURSING DEPARTMENT

B. LEADERSHIP

Definition/ Description

 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.

 Define as point of polarization for group cooperation (Chapin 1924).

 A management skill that focuses on the development and deployment of vision, mission, and
strategy as well as the creation of a motivated workforce (Bitpipe 2006).

 To examine the word leader, however, is to note that leaders lead. A job title alone does not
make a person a leader. Only a person’s behavior determines if he or she occupies a leadership
position.

 The manager is the person who brings things about—the one who accomplishes, has the
responsibility, and conducts. A leader is the person who influences and guides direction,
opinion, and course of action.

Leadership Roles

Decision maker Coach Forecaster Communicator

Evaluator Counselor Teacher Critical thinker
Facilitator Buffer Mentor Energizer
Risk taker Advocate Visionary Influencer
Role model Change agent Creative problem solver Diplomat

Characteristics of a Leader

a. Leaders often do not have delegated authority but obtain their power through other means
such as influence.
b. Leaders have a wider variety of roles than do managers.
c. Leaders may or may not be part of the formal organization.
d. Leaders focus on group process, information gathering, feedback and empowering others.
e. Leaders emphasizes interpersonal relationship
f. Leaders direct willing followers.
g. Leaders have goals that may or may not reflect those of the organization.
 SCHOOL OF ALLIED MEDICINE
NURSING DEPARTMENT

Nursing Management

 Is performing leadership functions of governance and decision-making within organizations

employing nurses. It includes processes common to all management like planning, organizing,
staffing, directing and controlling.
 It is common for RNs to seek additional education to earn a Master of Science in Nursing or
Doctorate in Nursing to prepare for leadership roles within nursing. Management positions
increasingly require candidates to hold an advanced degree in nursing.

UNIVERSAL PRINCIPLES OF MANAGEMENT

Henri Fayol was an industrialist of the early twentieth century. He developed fourteen principles of
management that are still taught today. The definition of management is taken as "The process of
coordinating and integrating work activities so that they are completed efficiently and effectively with
and through other people." The principles are the universal truths of management that can be taught.

The 14 Management Principles from Henri Fayol (1841-1925) are:

1. Division of Work.

 Specialization allows the individual to build up experience, and to continuously improve

his skills. Thereby he can be more productive.

 This principle is the same as Adam Smith's 'division of labour'. Specialization increases
output by making employees more efficient. A principle of work allocation and
specialization in order to concentrate activities to enable specialization of skills and
understandings, more work focus and efficiency.

2. Authority.

 The right to issue commands, along with which must go the balanced responsibility for its
function.

 Managers must be able to give orders. Authority gives them this right. Note that
responsibility arises wherever authority is exercised.

 If responsibilities are allocated then the post holder needs the requisite authority to carry
these out including the right to require others in the area of responsibility to undertake
duties.

 A manager should never be given authority without responsibility--and also should never
be given responsibility without the associated authority to get the work done.
 SCHOOL OF ALLIED MEDICINE
NURSING DEPARTMENT

3. Discipline.

 Employees must obey, but this is two-sided: employees will only obey orders if
management plays their part by providing good leadership.

 The generalization about discipline is that discipline is essential for the smooth running of
a business and without it - standards, consistency of action, adherence to rules and
values - no enterprise could prosper. Employees must obey and respect the rules that
govern the organization.

 Good discipline is the result of effective leadership, a clear understanding between

management and workers regarding the organization's rules, and the judicious use of
penalties for infractions of the rules.

4. Unity of Command.

 Each worker should have only one boss with no other conflicting lines of command.

 The idea is that an employee should receive instructions from one superior only. This
generalization still holds - even where we are involved with team and matrix structures
which involve reporting to more than one boss - or being accountable to several clients.

5. Unity of Direction.

 People engaged in the same kind of activities must have the same objectives in a single
plan. This is essential to ensure unity and coordination in the enterprise. Unity of
command does not exist without unity of direction but does not necessarily flows from it.

 Each group of organizational activities that have the same objective should be directed
by one manager using one plan. The unity of command idea of having one head (chief
executive) with agreed purposes and objectives and one plan for a group of activities is
clear.

6. Subordination of individual interest (to the general interest).

 Management must see that the goals of the firms are always paramount.

 Fayol's line was that one employee's interests or those of one group should not prevail
over the organization as a whole. This would spark a lively debate about who decides
that the interests of the organization as a whole are.

 The interests of any one employee or group of employees should not take precedence
over the interests of the organization.
 SCHOOL OF ALLIED MEDICINE
NURSING DEPARTMENT

7. Remuneration.

 Payment is an important motivator although by analyzing a number of possibilities, Fayol

points out that there is no such thing as a perfect system.

 "The Price of Services Rendered". The general principle is that levels of

compensation should be "fair" and as far as possible afford satisfaction both to the staff
and the firm (in terms of its cost structures and desire for profitability/surplus).

8. Centralization (or Decentralization).

 This is a matter of degree depending on the condition of the business and the quality of
its personnel.

 Centralization refers to the degree to which subordinates are involved in decision making.
Whether decision making is centralized (to management) or decentralized (to
subordinates) is a question of proper proportion. The task is to find the optimum degree
of centralization for each situation.

9. Scalar chain (Line of Authority).

 A hierarchy is necessary for unity of direction. But lateral communication is also

fundamental, as long as superiors know that such communication is taking place.

 Scalar chain refers to the number of levels in the hierarchy from the ultimate authority to
the lowest level in the organization. It should not be over-stretched and consist of too-
many levels.

 The scalar chain of command of reporting relationships from top executive to the ordinary
shop operative or driver needs to be sensible, clear and understood.

 The line of authority from top management to the lowest ranks represents the scalar
chain. Communications should follow this chain. However, if following the chain creates
delays, cross-communications can be allowed if agreed to by all parties and superiors are
kept informed.

10. Order.

 Both material order and social order are necessary. The former minimizes lost time and
useless handling of materials. The latter is achieved through organization and selection.

 People and materials should be in the right place at the right time. The level of
generalization becomes difficult with this principle. Basically, an organization "should"
provide an orderly place for each individual member - who needs to see how their role fits
into the organization and be confident, able to predict the organizations behavior towards
them. Thus policies, rules, instructions and actions should be understandable and
understood.
 SCHOOL OF ALLIED MEDICINE
NURSING DEPARTMENT

 Orderliness implies steady evolutionary movement rather than wild, anxiety provoking,
unpredictable movement.

11. Equity.

 In running a business, a “combination of kindliness and justice” is needed. Treating

employees well is important to achieve equity.

 Equity, fairness and a sense of justice "should" pervade the organization - in principle and
practice. Managers should be kind and fair to their subordinates.

12. Stability of Tenure of Personnel.

 Employees work better if job security and career progress are assured to them. An
insecure tenure and a high rate of employee turnover will affect the organization
adversely.

 High employee turnover is inefficient. Management should provide orderly personnel

planning and ensure that replacements are available to fill vacancies. Time is needed for
the employee to adapt to his/her work and perform it effectively. Stability of tenure
promotes loyalty to the organization, its purposes and values.

13. Initiative.

 Allowing all personnel to show their initiative in some way is a source of strength for the
organization. Even though it may well involve a sacrifice of 'personal vanity' on the part
of many managers.

 Employees who are allowed to originate and carry out plans will exert high levels of effort.
At all levels of the organizational structure, zeal, enthusiasm and energy are enabled by
people having the scope for personal initiative.

14. Esprit de Corps.

 Management must foster the morale of its employees. He further suggests that: "real
talent is needed to coordinate effort, encourage keenness, use each person's abilities,
and reward each one's merit without arousing possible jealousies and disturbing
harmonious relations."

 Here Fayol emphasizes the need for building and maintaining of harmony among the
work force, team work and sound interpersonal relationships. Promoting team spirit will
build harmony and unity within the organization.
 SCHOOL OF ALLIED MEDICINE
NURSING DEPARTMENT

“NURSING IS A CALL TO LEADERSHIP”

• By its very nature, the professional nurse role is one of leadership. Across the healthcare
continuum, regardless of our role or practice setting, we are looked to as leaders.

• As nursing students, we are taught we will lead colleagues from other ancillary groups, oversee
care teams and be accountable for patient care outcomes.

• Some nurses spend years leading in an informal leadership capacity, while others take on formal
management and leadership roles.

• However, all management and leadership roles are not the same, and although the titles often
are used interchangeably, they are not synonymous.

THE NURSE MANAGER ROLE UP CLOSE

Whether managing a unit, division or service line, at its core the nurse manager role is to ensure
everything functions like a well-oiled machine.

• The nurse manager is involved in myriad daily tasks and details related to patient care planning,
quality improvement, goal setting and budgeting.
• Nurse Managers also oversee staff schedules and assignments, performance, professional
growth and the ongoing provision of educational and career enhancement opportunities.
• The manager is responsible for ensuring the staff carries out all assignments and is held
accountable if they’re not.

And staff members — nurses, CNAs, techs, etc. — have certain expectations for their nurse managers:

• They look to their managers for clear communication, direction and support in fulfilling their roles
and responsibilities.
• They also want their managers to be available, open and honest.
• Nurse Managers are their source for information, advice and guidance, but they also want —
and deserve — encouragement, clear expectations and directions, and some teaching and
coaching.
• Most of all, they want to be included in decision-making, recognized for their contributions and
considered important to the team.

“Nurse Managers are their source for information, advice and guidance, but they also want — and
deserve — encouragement, clear expectations and directions, and some teaching and coaching.”
 SCHOOL OF ALLIED MEDICINE
NURSING DEPARTMENT

THE NURSE LEADER ROLE UP CLOSE

• Upper-level nurse leaders, in most instances, are less task-oriented than nurse managers. They
are less hands-on and more focused on setting standards, spearheading transformation and
inspiring and influencing their teams. They are charged with fulfilling the organization’s mission,
vision and strategic long-range plans.

• Their role involves:

➢ policy setting and overseeing quality measures;

➢ dealing with regulatory compliance,
➢ taking on fiscal responsibilities
➢ responsibility and accountability for the overall quality of patient care delivery, patient and
staff satisfaction, and organizational outcomes.

Both staff and management look to them for their knowledge, experience and vision. Their role is an
expansive one that touches the entire organization.

MANAGERS AND LEADERS COMPLEMENT EACH OTHER

Managers function best in the company of good leaders, but both roles should be filled by individuals,
who earn the respect and admiration of their staff, are passionate about their work and instill that
passion in their staff. Both managers and leaders:

❖ Must be motivators who positively influence their staff and set positive examples.
❖ Must have excellent decision-making skills and should be able to coordinate teams and delegate
duties.
❖ Must be committed to the organization and those they lead.

Title aside, ALL NURSES ARE CALLED TO LEADERSHIP

The call to leadership moves all of us to a higher plane of responsibility and accountability, with or
without a management title; it is inherent in all nursing positions from staff nurse to CEO. We all have
similar goals and responsibilities for patient care.

“The call to leadership moves all of us to a higher plane of responsibility and accountability, with or
without a management title; it is inherent in all nursing positions from staff nurse to CEO.”

With all the changes currently underway in our healthcare delivery system and the nursing profession,
all nurses must strive to emulate the hallmarks of good management and leadership and never stop
 SCHOOL OF ALLIED MEDICINE
NURSING DEPARTMENT

working on our professional growth. We all need to stay informed and be politically savvy; we need to
know what our professional journals and nursing organizations are saying and advance our education.

In the end, all nurses must be visionaries, critical thinkers, skilled communicators and teachers.
And the good news is you do not need a formal manager or leader title required to do any of these
things.

Prepared by:

Annabelle B. Ruiz
Instructor