School of Nursing & Allied Health Sciences Tutorial 1 (topic 1 & 2) Tutorial 1 (topic 1...

Preview:

Citation preview

School of Nursing & Allied Health Sciences

Tutorial 1 (topic 1 & 2)Tutorial 1 (topic 1 & 2)

NBBS1104NBBS1104

MANAGEMENT AND MEDICO LEGAL STUDIES BMANAGEMENT AND MEDICO LEGAL STUDIES B

School of Nursing & Allied Health Sciences

• Grouping ….• What is management ?• What is administration ?• What is leadership ?• What is Motivation ?

School of Nursing & Allied Health Sciences

Topic 1: Learning Outcomes Topic 1: Learning Outcomes

1. Distinguish between management and leadership in nursing

2. Discuss the principles and process of management3. Describe the strategic planning and SWOT analysis4. Describe different types of leadership styles5. Discuss the motivation theories6. Describe the role and responsibilities of a nurse as

team leader, team member in ward or clinic

School of Nursing & Allied Health Sciences

Content

a) Introduction to management

b) Process of management

c) Management theories

d) Motivational theories

e) Leadership styles

School of Nursing & Allied Health Sciences

School of Nursing & Allied Health Sciences

a. Introduction to Management in Nursing

Dr Kithsiri EdirisingheMBBS, MSc, MD ( Medical Administration )

Master Trainer Australia

School of Nursing & Allied Health Sciences

What is management

“ Getting things done through and with

people by using resources effectively end

efficiently to achieve organizational goals.”

- Peter Drucker -

School of Nursing & Allied Health Sciences

Health Services Management

• Managing Healthcare services effectively

and efficiently with a view to achieve

patient care standards, goals & objectives.

• Health services produced by Healthcare

Process

School of Nursing & Allied Health Sciences

Health care process

Input Healthcare process Output

• Input - Resources

• Healthcare process – Hospitals , Public Health

• Out put - Healthcare services

School of Nursing & Allied Health Sciences

Healthcare Resources

• Infrastructure - Space • Men - Human Resources • Machines - Equipments • Money - Finance • Material - Supplies • Methods - Policies , Procedures , Protocols • Minutes - Schedule

• Information - Health / hospital Information system (HIS)

School of Nursing & Allied Health Sciences

Healthcare Services

• Preventive - Public Health Services

• Investigative services

• Curative services

• Rehabilitative services

• Health sector Project management

School of Nursing & Allied Health Sciences

Efficiency

• More Output with the same input

• Productivity

School of Nursing & Allied Health Sciences

Effictiveness

• Outcome of the production

• Quality

School of Nursing & Allied Health Sciences

Quality in Healthcare Services

• Services quality

– On stage players

– Non medical staff & services

• Technical quality

– Back stage players

– Medical staff & services

School of Nursing & Allied Health Sciences

Goals and Objectives

• Goals

– Broad statement of achievement in future

• Objectives

– Milestones

– SMART - Specific - Measureable - Achievable -

Realistic - Timely

School of Nursing & Allied Health Sciences

Administration

• Making sure that the set of

rules and regulations

are adhered to by the people !

– Rules & regulations

– Policies & Circulars

– Protocols & Guidelines

School of Nursing & Allied Health Sciences

Administration

• Making sure that the set of

– Rules and regulations

are adhered by the people !

– Rules & regulations

– Policies & Principles and Ethics

– Protocols & Guidelines

School of Nursing & Allied Health Sciences

School of Nursing & Allied Health Sciences

Activity 01Critically analyze the following statement : PP presentation

for each group ( one topic for two groups – 10 Munities )

Gr. 01 & 08 “ Hospitals in Sri Lanka is more efficient than effective “

Gr. 02 & 07 “ Nurses are not suitable for managerial position in the hospitals in Sri Lanka “

Gr. 03 & 05 Productivity is an essential component than quality in healthcare

Gr. 4 & 06 “Medical administrators are not good administrators in Sri Lankan hospitals”

School of Nursing & Allied Health Sciences

b. Process of Management

School of Nursing & Allied Health Sciences

Meaning and principles of managementMeaning and principles of management

School of Nursing & Allied Health Sciences

Process of Management

• Planning

• Organizing

• Staffing

• Directing

• Controlling

of the resources Efficiently Effectively,

to achieve organizational goals and objectives

School of Nursing & Allied Health Sciences

PlanningPlanning

““The greatest thing in the world is not so The greatest thing in the world is not so much much where we arewhere we are, but in what , but in what directiondirection we are we are movingmoving” ”

Oliver Wendell HomesOliver Wendell Homes

School of Nursing & Allied Health Sciences

1. Planning

School of Nursing & Allied Health Sciences

• From here to there !

• Preparation – forecast

• Two categories in planning

• Operational planning

• Strategic planning

– It gives the direction

Planning

School of Nursing & Allied Health Sciences

“If you don’t know where

you are going, any road

will take you there.”

The Koran

School of Nursing & Allied Health Sciences

• Strategic planning

– Maximum consideration of the environment

– Long term – 03 – 10 years

– Broader details

– It gives the direction

– Performed by top level managers –CEO, COO

• Operational planning

– Minimal consideration of the environment

– Short term 1-2 years

– Detailed

– Done by nursing managers

Planning

School of Nursing & Allied Health Sciences

• Comprehensive management process ,

• Performed by considering

– the dynamic external environment ,

– Internal environment

• organizing a comprehensive plan

to achieve organizational goals & objectives .

Strategic Management

School of Nursing & Allied Health Sciences

The trip

School of Nursing & Allied Health Sciences

Strategic planning process

• Developing a Vision

• Developing a Mission

• Situational analysis

• Environmental assessment

– External environment

– Internal environment

– SWOT analysis

– Strengths , Weakness , Opportunities and Threats

School of Nursing & Allied Health Sciences

• A strategic vision concerns a organization’s

future path ; the road map!!

• “Where we are going”

Vision

School of Nursing & Allied Health Sciences

• Wyeth

“Our vision is to lead the way to a healthier world”

• Nike

“ To bring innovation & inspiration to every athlete in the

world”

• IIHS

“To bring innovation to the training of healthcare professional”

Vision examples

School of Nursing & Allied Health SciencesDeveloping Mission

• The vehicle that

drives the

organization to the

destination…. …

School of Nursing & Allied Health Sciences

The Canadian Red Cross mission is to improve the lives of

vulnerable people by mobilizing the power of humanity in

Canada and around the world

Canadian Red cross

School of Nursing & Allied Health Sciences

“ We are a Healthcare training organization born to bring

innovation to healthcare training at a green campus,

infusing the traditional values of Healthcare

professionalism, whilst adhering to international training

standards to improve the quality of lives of healthcare

professionals through developing their personalities, by

partnering with international organizations, to provide a

total solution to the global need of healthcare professional.”

IIHS

School of Nursing & Allied Health Sciences

Key Steps in strategic planning

School of Nursing & Allied Health Sciences

• Strengths

– What are we good at?

• Weaknesses

– Where do we need improvement?

• Opportunities

– Where/What is the next big thing?

• Threats

– What can kill us?

SWOT Analysis

School of Nursing & Allied Health SciencesExternal Environment Assessment

Opportunities Threats

Markets

Competition

Healthcare trends

Social factors

Economic factors

Educational factors

School of Nursing & Allied Health SciencesInternal Environment Assessment

Strengths Weakness

Patient care

Financial resources

Human resources

Information systems

Research & Development

Educational systems

School of Nursing & Allied Health Sciences

Steeps in strategic planning

School of Nursing & Allied Health Sciences

2. Organizing

School of Nursing & Allied Health Sciences

Meaning and principles of managementMeaning and principles of management

School of Nursing & Allied Health Sciences

OrganizingOrganizing

Three sequential activities:Three sequential activities:

A.A. Work specializationWork specialization

B.B. DepartmentalizationDepartmentalization

C.C. Planning Delegating authorityPlanning Delegating authority

School of Nursing & Allied Health Sciences

A. Work Specialization

School of Nursing & Allied Health Sciences

Work specialization

• Process analysis

• Job design– Job analysis – Job description – Job specification

School of Nursing & Allied Health Sciences

B. Departmentalization

School of Nursing & Allied Health Sciences

Organizing structures

• Establishing structures to carryout activity plans

• Determining the most suitable method to deliver

patient care

• Reporting organizational and reporting

structures

School of Nursing & Allied Health Sciences

Organizational Structures for hospitals

School of Nursing & Allied Health SciencesFew words

• Authority

– The formal right to act as a manager

• Responsibility

– The duty to act on the authority delegated

• Power

– Capacity to influence the behaviour of others

School of Nursing & Allied Health SciencesOrganizational Structure

• How human beings are distributed in an organization

• Where each person is competent in the particular field to

hold their positions

• To achieve organization goals and objectives

School of Nursing & Allied Health Sciences

Top management

Middle management

Front line management

Levels of management

School of Nursing & Allied Health SciencesOrganizational Chart

MANAGING DIRECTOR

OTHER DIRECTORS

MANAGERS

SUPERVISORS/TEAM LEADERS

Operational WORKERS

accountability authority

School of Nursing & Allied Health Sciences

Few words in organizational structures

• Tall structure

– Long chains of

command while

organisations

• Flat structure

– Few layers or levels of

hierarchy are

• The chain of command

– line of communication

and authority existing

within an organization

• Employees prefer

– The flat structure

– Faster and effective

communication

School of Nursing & Allied Health Sciences

Levels of Hierarchy

Number of layers

within an organisation,

that is how many levels

exist between the chief

executive and a shop-

Operational employees

School of Nursing & Allied Health SciencesFeatures of a good OS

• Alignment with the organizational functional units

• Lean & Agile

– Leanness : More productive, avoid red tapes & bottle necks

– Agility : Agile, fast & Mobile

• Efficient & effective work process

– Minimizing cost & Reduction of wastage

– Reliable processes

– Measurable outcomes

• Efficient & effective Information flow

– Evidence based & Quick decision making

School of Nursing & Allied Health SciencesFeatures of a good OS

• Clear demarcation of authority

• Decision making authority should be at operational level

• Room for change

• Minimize the cost of the structure

• Relevant people should occupy key areas

• Span of control - ideal 7 or less

School of Nursing & Allied Health Sciences

Manager A

Staff a Staff b Staff c

Manager B

Staff a Staff b Staff c Staff d

Staff e Staff f

Narrow span of control

Wide span of control

School of Nursing & Allied Health Sciences

C. Delegation

School of Nursing & Allied Health Sciences

What is Delegation?

• It is process

• By which the Managers,

– Assign tasks activities and responsibilities

– Transfer authority & accountability,

– Set up monitoring & control systems

• To subordinates

– with the intention of improve the organizational efficiency and

effectiveness.

School of Nursing & Allied Health Sciences

5- Golden rules in Delegation

1. What to delegate ?

2. What not to delegate?

3. To whom delegate ?

4. How much to delegate ?

5. How to delegate?

School of Nursing & Allied Health Sciences

1.What to Delegate

• Activities that are :

1. Repeated

2. Frequently

3. Takes more time

4. Causes least damage if

make a mistake

5. Subordinate more

equipped with

6. Enjoys frequently

7. Adds Varity

8. Relate to work

9. Improves skills

10.Needs minimum control

School of Nursing & Allied Health Sciences

2.What not to Delegate

• Making policies

• Training

• Discipline

• Monitoring results

• External Communication work

• Upward delegation

School of Nursing & Allied Health Sciences

3. Whom to Delegate

• Most experienced person

• One who has the best orientation of work

• Maintain the chain of command

• To a group than an individual

School of Nursing & Allied Health Sciences

4. How much to delegate

• Full – responsibility

• Partial responsibility

School of Nursing & Allied Health Sciences

5. How to Delegate

• Prior approval needed

• Identify the right person

• Specify the scope of activities

– Determine the tasks

– Specify the authority

– Set Parameters & guidelines

– Expected level of performance

– Set up control systems

• Provide resources

• Decide and inform

• Minimum interference

• Tolerate mistakes

• Feed back

• Minimum interference

School of Nursing & Allied Health Sciences

Meaning and principles of managementMeaning and principles of management

School of Nursing & Allied Health Sciences

3.Staffing

School of Nursing & Allied Health Sciences

Human Resource management (HRM)

• “ Getting things done through and with

people to achieve organizational goals

and objectives .”

• Human resource management activities

School of Nursing & Allied Health SciencesScope of HRM

School of Nursing & Allied Health Sciences

The Human Resource Management ActivitiesThe Human Resource Management Activities

School of Nursing & Allied Health Sciences

Turnover of the staff • Work related issues• Personnel reasons • Social reasons• Economic reasons • Professional reasons • Shortage of nurses • Malaysia – 100,000 nurses needed • Nurse to patient ratio – 1: 200• Sri Lanka – 30,000 State / Private 8000??

School of Nursing & Allied Health Sciences

Activity

Find out the different Nursing staff needs

1. For a bed –Ward, ICU, OT

2.Per patient visit – Clinic, OPD

3. Per population

School of Nursing & Allied Health Sciences

4. Directing

School of Nursing & Allied Health Sciences

DirectingDirecting

• Human resource management responsibilities

• Assigning responsibilities, authorities , accountability holding

School of Nursing & Allied Health Sciences

Directing functions

I. Implement delegation

II. Supervision

III. Motivation

IV. Managing conflicts

V. Counseling

VI. Decision making

VII.Training & development

School of Nursing & Allied Health Sciences

II. Superior Supervision

School of Nursing & Allied Health Sciences

A Person : Who is always be there, at the workstation.

This is the best practice that should not be broken

No substitution for the supervisor

Myth : Super- Vision – “Seeing from above”

Who is a Supervisor ?

School of Nursing & Allied Health Sciences

Who excel in upper 10% performance;

- Greater impact on your carrier - “Rise in the ladder”

Rather than;

- Doing middle 80% of the performance-

“Normal activities” every day

- Failing in : bottom 10% performance- “Free fall”

Who is the Superior Supervisor ?

School of Nursing & Allied Health SciencesHow to be in the top 10% of performance?

• “Be a front line batsman”……….Forward

• “Be up to date”………………… Awareness

• “Set priorities correct”…………. Focused

• “Have shorter span of control”…Few bites

• “Get away from Grey area”…….Black or white

School of Nursing & Allied Health SciencesBasic Truth ?

“ Ensuring planned results are achieved

by

those who report directly to the supervisor…

School of Nursing & Allied Health Sciences

11 Habits to become a Superior Supervisor

1. Planning ahead

2. Delegating

3. Giving instructions

4. Developing team work

5. Continuous Improvement

6. Solving problems

7. Training staff

8. Motivating them

9. Counseling

10. Handling pressure

11. Give performance feed back

School of Nursing & Allied Health Sciences

II. Motivation

Will be done later

School of Nursing & Allied Health Sciences

Motivation Motivation

What is motivation?What is motivation?

Motivation is a process that occurs Motivation is a process that occurs internallyinternally to influence and to influence and direct direct our behaviorour behavior in order to in order to satisfy satisfy needs needs (Lussier,1999)(Lussier,1999)

School of Nursing & Allied Health Sciences

III. Managing conflicts

Will be done in topic 06

School of Nursing & Allied Health SciencesConflict Resolution- the methods

1. Smoothening – calm things down

2. Avoidance – minor

3. Authoritative command – use rules & regulation

4. Altering attitudes – training

5. Compromise – collective bargaining

6. Conciliation – reunion

7. Third party mediation - Negotiation

School of Nursing & Allied Health Sciences

IV. Counseling

Please read !!!!!

School of Nursing & Allied Health Sciences

V. Decision making

Please read !!!!!

School of Nursing & Allied Health Sciences

V. Training & Development

School of Nursing & Allied Health Sciences

• “Increasing abilities of the employee to contribute to

organizational effectiveness and efficiency “

• Training – improving skills in the present job

• Development – prepare employee for promotion

Training & Development

School of Nursing & Allied Health SciencesTraining & Development

Training

• Mainly for new recruits

• Technical mechanical

operations / more operational /

Specific job related purpose

• Mainly Non managerial

• To improve current job

performance

• Short term

Development

• Existing employees

• Theoretical /conceptual ideas

• Managerial ,supervisory

• To upgrade to a next level

• Long term

School of Nursing & Allied Health Sciences

1. Training needs analysis - TNA – Gap analysis

2. Developing a programme

3. Conduction the programme

4. Evaluation of the programme

5. Continuous improvement

The process of organizing training programmes

School of Nursing & Allied Health Sciences

5.Controlling

School of Nursing & Allied Health Sciences

ControllingControlling• Attempt to ensure that actual results Attempt to ensure that actual results

come as closely to plan result as come as closely to plan result as possible.possible.

School of Nursing & Allied Health Sciences

Four (4) steps in controlling Four (4) steps in controlling responsibilitiesresponsibilities

School of Nursing & Allied Health Sciences

Thank you !

School of Nursing & Allied Health Sciences

School of Nursing & Allied Health Sciences

c. Management theories

School of Nursing & Allied Health Sciences

Management TheoriesManagement Theories

1.1. Scientific ManagementScientific Management

2.2. BureaucraticBureaucratic

3.3. Administrative PrinciplesAdministrative Principles

4.4. Organizational BehaviorOrganizational Behavior

School of Nursing & Allied Health Sciences

1. Scientific Management1. Scientific Management

School of Nursing & Allied Health Sciences

• Scientific • Productivity was the area of focus in this theory.• It can be achieved by preparing staffs with adequate

skills and knowledge, and using advanced equipments to emphasize efficiency.

• For example, in the ICU unit, all the nurses should be well-trained and cutting edge equipments should be used to provide maximum care for the patients.

School of Nursing & Allied Health Sciences

2. Bureaucratic Theory2. Bureaucratic Theory

School of Nursing & Allied Health Sciences

• Bureaucratic

• Weber believed efficiency is achieved through impersonal relations within a formal structure.

• Such as from matron-sister-staff nurse. Competence was the basis for hiring and promoting an employee.

• Decision was made in an orderly and rational way based on rules and regulations.

• The bureaucratic–organisation was a hierachy with clear superior–subordinate communication and relations. Based on positional authority, in which orders from the top such as matron and transmitted through the organisation via clear chain and command.

School of Nursing & Allied Health Sciences

3. Administrative Theory3. Administrative Theory

School of Nursing & Allied Health Sciences

• Administrative

• Focusing on general principles of management such as in a management process eg: planning, organising, directing, coordinating and controlling.

• Another aspect of this theory attributed by Barnard who is emphasised on the concept of the informal organisation.

• He believed the informal organisation consists of naturally forming social groups that can become strong and powerful contributors to an organisation.

• This theory also identified people as having free will and they actually choose to comply with orders they are given.

School of Nursing & Allied Health Sciences

4. Organisational Behaviour4. Organisational Behaviour

School of Nursing & Allied Health Sciences

• Orgnizational

• Focused on the effect individuals have on the success or failure of an organisation.

• The chief concerns of the human relations movement are individuals, group process, interpersonal relations, leadership and communication.

• Instead of concentrating on the organisation’s structure, nurse managers encourage staffs to develop their potential and help them meet their needs for recognition, accomplishment, and sense of belonging.

School of Nursing & Allied Health Sciences

Thank you !

School of Nursing & Allied Health Sciences

School of Nursing & Allied Health Sciences

d. Motivational theories

School of Nursing & Allied Health Sciences

Motivation ?

• Stimulus

• Incentive

• Inspiration

• Impulse

• Drive

• Enthusiasm

School of Nursing & Allied Health Sciences

Motivation Motivation

What is motivation?What is motivation?

Motivation is a process that occurs Motivation is a process that occurs internallyinternally to influence and to influence and direct direct our behaviorour behavior in order to in order to satisfy satisfy needs needs (Lussier,1999)(Lussier,1999)

School of Nursing & Allied Health Sciences

Definition of motivation

• “Motivation represents those psychological

processes that cause arousal, direction

and persistence of voluntary actions that

are goal directed”

School of Nursing & Allied Health Sciences

Knowledge as the theoretical paradigm, the “what to do” and the “why”

Skills as the “how to do”

Desire as the motivation, the “want to do”

Steven Covey,1989

School of Nursing & Allied Health Sciences

Motivation TheoriesMotivation Theories

• Hierachy of human needsHierachy of human needs

• Two-factor TheoryTwo-factor Theory

• Theory X and YTheory X and Y

• Theory ZTheory Z

School of Nursing & Allied Health Sciences

Abraham Maslow

• People’s behaviors are guided by a sequence of needs

• Humans possess unique qualities that enable them to make independent choices which control of their future

School of Nursing & Allied Health Sciences

Maslow’s Hierarchy of Needs

School of Nursing & Allied Health Sciences

Description of the Needs TheoryDescription of the Needs Theory

School of Nursing & Allied Health Sciences

Two factor theory - Herzberg’s Motivational and Hygiene Factors

• Motivational factors: – Motivates people by if present – Achievement, recognition, the work itself, responsibility,

advancement, and growth, which produce job satisfaction

• Hygiene factors:– Cause dissatisfaction if not present, but do not

motivate workers to do more. – Examples include larger salaries, more supervision, and a more

attractive work environments

School of Nursing & Allied Health Sciences

• Theory X and YTheory X and Y

• Theory ZTheory Z

Please read …………………!Please read …………………!

School of Nursing & Allied Health Sciences

What cause success or failure of work process

• More likely to succeed when managers influence with– expertise– work challenge

• More likely to fail when managers rely too heavily on– authority– money– penalty

School of Nursing & Allied Health Sciences

How to motivate employees

Needs Skill Enhancement

Problem

Employees

Needs

Empowerment

Waiting

for Motivation

High

Low High

Level of Ability

Level of motivation

School of Nursing & Allied Health Sciences

Improving Effectiveness - Covey’s 7 Habits

• Anyone can apply Covey’s 7 habits to improve effectiveness at work place

1. Be proactive ( Practical)

2. Begin with the end in mind

3. Put first things first

4. Think win/win

5. Seek first to understand, then to be understood

6. Synergize

7. Sharpen the saw

School of Nursing & Allied Health Sciences

Thank you !

School of Nursing & Allied Health Sciences

School of Nursing & Allied Health Sciences

Topic 02

• LEARNING OUTCOMES• By the end of this topic, you should be able to:• 1. Describe different types of leadership styles;• 2. Discuss the motivation theories;• 3. Describe the role and responsibilities of a nurse as

team leader; and team member in ward or clinic.

School of Nursing & Allied Health Sciences

1. Leadership

School of Nursing & Allied Health Sciences

Management in NursingManagement in Nursing

• ““ManagersManagers are people who are people who do things right ( WAY)do things right ( WAY)

• leadersleaders are people who do the are people who do the right thingsright things” ” (Bennis & Nanus, 1985) (Bennis & Nanus, 1985)

• ““Management Management is is efficiencyefficiency in in climbing the ladder of climbing the ladder of success;success;

• leadershipleadership determinesdetermines whether the whether the ladder is leaning ladder is leaning against the right wall” against the right wall” (Stephen (Stephen Covey, 2005)Covey, 2005)

School of Nursing & Allied Health Sciences

Leadership

• Leadership is the inspiration for desired responses and getting work done through others.

• Leaders focus on purpose and doing the right thing.• Future oriented• Challenged by change• Plan strategies to facilitate human potential.• Use their power to motivate people to act • Manage conflict.• Go to unknown territories

School of Nursing & Allied Health Sciences

Leadership

• Inspirational and lead the way • Leaders have followers• Informal relationship • Leadership relies more on personality traits and people

skills.• Leadership can be developed by gaining experience,

having a mentor or attending classes.

School of Nursing & Allied Health Sciences

EFFECTIVE LEADERSHIP IN

HEALTHCARE ORGANIZATIONS

School of Nursing & Allied Health Sciences

131

LEARNING OBJECTIVES1. Define leadership.

2. Describe leadership approaches.

3. Discuss the most important leadership traits and skills as well as functions of effective leadership.

4. Determine sources of leaders’ power & importance of influence.

5. Describe the different leadership styles.

6. Explain leadership development.

School of Nursing & Allied Health Sciences

132

Introduction:1. Effective leadership is essential if a health services

organization (HSO) is to provide high-quality care and

succeed financially.

2. All managers at all levels of the organization, who

depend on other people for efficient and effective

work performance, require leadership ability.

3. The quality of leadership is crucial to how work gets

done.

School of Nursing & Allied Health Sciences

133

Another important definition is that:

• Leaders are agents of change, persons

whose acts affect other people more

than other people’s acts affect them

School of Nursing & Allied Health Sciences

134

Leadership Approach:

•Proactive approach take responsible initiatives to change situations and attitudes through people. This approach is the essence of modern leadership,

• Reactive approach where a leader responds only to events and instructions from outside.

School of Nursing & Allied Health Sciences

135

EXERCISE (1)

• From your experience, try to describe a leader you worked with or had contact with; whom you consider a role model of a successful leader & why?

• What in your opinion are the main traits ,skills & behaviours of a successful leader?

School of Nursing & Allied Health Sciences

136

Table1: Traits and skills found most successful leaders

Traits • Adaptable to situations• Alert to social environment• Ambitious and achievement-

oriented.• Assertive• Cooperative• Decisive • Dependable• Dominant(desire to influence others)• Energetic (high activity level)• Persistent• Self-confident• Tolerant of stress• Willing to assume responsibility

Skills• Clever(intelligent)• Conceptually skilled• Creative

• Diplomatic and tactful• Fluent in speaking• Knowledgeable about

group task• Organized

(administrative ability)

• Persuasive

• Socially skilled

School of Nursing & Allied Health Sciences

137

Leader’s Power and Influence

• Influence is important to the leadership process because it is the means by which leaders “successfully persuade others to follow their advice, suggestion or order”.

• The essence of leadership is the ability to influence others.

• To have influence, however, one also must have power.

School of Nursing & Allied Health Sciences

Power & Leadership

Behavior I Behavior II

Power

School of Nursing & Allied Health Sciences

139

Sources of Power:• 1.Legitimate Power :This is the power a leader

has as a result of his / her position in the organization.

• 2. Coercive Power : Is the power to punish or control.

• 3. Reward Power : Is the power of giving positive benefits or rewards whether financial or otherwise.

School of Nursing & Allied Health Sciences

140

• 4. Expert Power : Influence that’s based on expertise,

special skills or knowledge.

• 5. Referent Power : Arises because of a person’s

personal traits or desirable resources, e.g. admiration

of another & a desire to be like that person, in this case

that person has referent power over you.Most effective leaders rely on several different forms of

power e.g. giving orders (legitimate), praising (reward), & disciplining (coercive).

School of Nursing & Allied Health Sciences

141

• Also power must be used wisely to influence

people e.g. abuse of coercive power may lead to weakening or loss of referent power.

• Effective leaders understand the costs, risks, and benefits of using each kind of power and are able to recognize which to draw on in different situations and with different people.

School of Nursing & Allied Health Sciences

142

Interpretation of leader decision-making authority

Use of authority by the manager Area of freedom

for subordinates

Manager “sells” decision.

Manager presents tentative decisions subject to change

Manager defines limits, asks group to make decisions.

Manager presents ideas and invites questions

Manager presents problem, gets suggestions, makes decisions

Manager makes decision and announces it

Manager permits subordinates to function within limits defined by superior.

(1)

AUTOCRATIC

(2) (3)

CONSULTATIVE

(4) (5)

PARTICIPATIVE

(6)

DEMOCRATIC

(7)

LAISSEZ-FAIRE

School of Nursing & Allied Health Sciences

Autocratic:

– Leader makes decisions without reference to anyone else

– High degree of dependency on the leader– Can create de-motivation and alienation

of staff– May be valuable in some types of business where

decisions need to be made quickly and decisively

School of Nursing & Allied Health Sciences

144

School of Nursing & Allied Health Sciences

Democratic:

• Encourages decision making from different perspectives – leadership may be emphasised throughout the organisation

• Consultative: process of consultation before decisions are taken

• Persuasive: Leader takes decision and seeks to persuade others that the decision is correct

School of Nursing & Allied Health Sciences

Democratic:

– May help motivation and involvement– Workers feel ownership of the firm and its

ideas– Improves the sharing of ideas

and experiences within the business– Can delay decision making

School of Nursing & Allied Health Sciences

Laissez-Faire:– ‘Let it be’ – the leadership responsibilities

are shared by all– Can be very useful in businesses

where creative ideas are important– Can be highly motivational,

as people have control over their working life– Can make coordination and decision making

time-consuming and lacking in overall direction– Relies on good team work– Relies on good interpersonal relations

School of Nursing & Allied Health Sciences

Paternalistic:

• Leader acts as a ‘father figure’

• Paternalistic leader makes decision but may consult

• Believes in the need to support staff

School of Nursing & Allied Health Sciences

Developing leadership in Nursing practice

School of Nursing & Allied Health Sciences

• Nurse leadership is vital. • Nurses depend on their leaders to set goals for

the future and the pace for achieving them. • The leader, not the manager inspires others to

work at their highest level. • The presence of strong Leadership sets the

tone for achievement in the work environment.

School of Nursing & Allied Health Sciences

• Traditional View - Leader is in the position of authority, exerting command

control and using power over subordinates. Nurses as professional they

function as leaders when they influence others toward goal achievement.

• Formal Leadership - A person is in position of authority or in assigned role

within an organisation that connotes influence, such as Head Nurse or Nurse

Manager.

• Informal Leadership - A person is considered to have emerged as a leader

when she is accepted by others and is perceived to have influence.

School of Nursing & Allied Health Sciences

Covey’s Eight Habits of the Effective Leader Adapted for

Nurses

School of Nursing & Allied Health Sciences

153

Leadership Behaviour• In the 1950s, the study of leadership and leaders shifted from traits to behaviour. • Trait theories maintained that leaders are born ; Either you have it or you don’t. The behaviour theories believed that leaders are made!

• Behavior theory leader behaviour explained leadership effectiveness,

–Leadership could be taught– since behaviour can be learned – programs can be designed to develop effective leaders.

School of Nursing & Allied Health Sciences

154

Leadership Development

Leadership development means the improvement and strengthening of abilities and effectiveness of both current and prospective leaders.

Functions to be developed for effective leadership ?

School of Nursing & Allied Health Sciences

155

Table 2: Functions of Effective Leadership:

1. The provision of a vision that influences all who work in the organization.

2. Confidence in one’s vision and oneself.

3. Projecting / communicating the vision.

4. Initiating / guiding change.

5. Mobilizing commitment and support for change.

6. Resolving conflict.

7. Building of trust.

8. Building sustainability

• Developing others.

School of Nursing & Allied Health Sciences

School of Nursing & Allied Health Sciences

Transformational Leadership Competencies

1. Individual Consideration

2. Charisma

3. Intellectual Stimulation

School of Nursing & Allied Health Sciences

Nurse as leader

School of Nursing & Allied Health Sciences

Staff Nurse as Leader

School of Nursing & Allied Health Sciences

Nurse manager as a leader

School of Nursing & Allied Health Sciences

Tips for becoming a good leader

School of Nursing & Allied Health Sciences

162

I suppose that leadership at one time meant muscle but today it means getting along with people.

… Indira Ghandi

I suppose that leadership at one time meant muscle but today it means getting along with people.

… Indira Ghandi

School of Nursing & Allied Health Sciences

Think of This Statement Think of This Statement

When we look through the lens of each others When we look through the lens of each others weaknesses, we make others` strengths irrelevant weaknesses, we make others` strengths irrelevant and their weakness more evident.and their weakness more evident.

School of Nursing & Allied Health Sciences

Activity 05

Debate 08 groups

School of Nursing & Allied Health Sciences

Presentations Presentations • Learning to be a better manager is easier than be a better

leader? Group 01

• People just born to be a leaders and they cannot be be taught and learned? Group 02

• All Leaders will definitely get “burning out?” Group 03

• There is no one best way to lead? Group 04

• “ Autocratic leadership is ideal for hospitals “ Group 05• “ A nurse is an effective leader than doctors “ group 06

School of Nursing & Allied Health Sciences

166

EXERCISE (2)• Debate

1. Group 01 & 02

2. Group 03 & 04

School of Nursing & Allied Health Sciences

Topic 7 : Introduction to Law

Learning Outcomes

1. Define basic concepts and principles of law;

2. Describe the sources and types of law; and

3. Relate tort law with issues in nursing practice.

School of Nursing & Allied Health Sciences

The Role of professional nursing has expanded rapidly within the past few years

• increased expertise– specialization– autonomy – accountability,– legal and an ethical perspectives. – This has forced new concerns among– nurses and a heightened awareness of the interaction of legal and ethical issues.– Areas of concern include legal issues– professional acts – regulations,– employment rules – ethical principles.

School of Nursing & Allied Health Sciences

School of Nursing & Allied Health Sciences

Introduction to Ethics

School of Nursing & Allied Health Sciences

Introduction to Ethics

• 8.1 Standardisation of Professional Conduct • 8.1.1 Licensure • 8.1.2 Board of Nursing • 8.1.3 Contract of Employment• 8.2 What Kind of Law Apply to Nurses • 8.2.1 Intentional and Unintentional Tort • 8.3 Basic Ethical Concepts • 8.3.1 Ethical Theories • 8.3.2 Ethical Principles • 8.4 Ethical Dilemmas • 8.4.1 Ethical Decision Making Process

School of Nursing & Allied Health Sciences

What is Law

• Humans ------ choice • Earliest notion of law - divine right. • A workable definition

– rules of human conduct– established and enforced by authority

– which prohibit extremes in behavior– so that one can live without fear for oneself or ones

property.

School of Nursing & Allied Health Sciences

Law

• Article 160 of the Federal Constitution provides a three-fold

• classification of the different types and sources of Malaysian Law

School of Nursing & Allied Health Sciences

Sources of Law

School of Nursing & Allied Health Sciences

1. Written Law (Statutory Law/Public Law)

• Federal Constitution which is the supreme law of the land and the Constitution of each State of the Federation.

• The acts are passed by Parliament and various State Assemblies.

• The subsidiary rules and regulations are made by Ministers and other persons by virtue of powers given to

them by Acts of Parliament of State enactments.

School of Nursing & Allied Health Sciences

2. Common Law • A body of law developed from an accumulation

of judgments arising from• particular cases. • The body of case law that developed from

adjudication of kings and later of judges is known as Common Law.

School of Nursing & Allied Health Sciences

3.Customs or Practices

• Customs or Practices deal with any custom or usage having the force of

• law in the Federation. Usage derived from personal laws of different

• communities e.g. adats of the Malays and the Hindu and Chinese

• customary laws.

School of Nursing & Allied Health Sciences

Malaysian courts

School of Nursing & Allied Health Sciences

Courts

• A court is a gathering, presiding over by a judge or other person invested with judicial power, which follows the rules of procedure prescribed for that court

• some cases assisted by a jury. The judge, or where there is a jury, the

• judge and jury, determines such matters as: Whether certain facts have been established.

• Where required, the legal obligations and rights of a party or parties.• The punishment appropriate for criminal or other offences.

Recommended