Directing Directing includes delegation of
Introduction
Direction represents one of the
essentials functions of management
because it deals with human relations.
Direction is also, infrequently and by
some, labeled as ‘actuating’. Once the
organizational plans have been laid
down, the structure being designed
and competent people brought in to fill
various positions in organization.
Direction is the managerial function of
guiding, motivating, leading,
supervising the subordinates to
accomplish desired objectives.
Acquiring physical and human assets
will not suffice; what is more important
is that people must be directed toward
organizational goals. Without proper
direction and supervision employees
become inactive, dull and inefficient
and consequently the physical assets
like machinery and plant will be put to
ineffective use.
Definition
It is the directing style wherein
managers tell their personnel what to
do, how to do it and when to have it
completed by. They assign roles and
responsibilities, set standards, and
define expectations.
Directing is the fourth phase of
the management process. This phase
could also be referred as coordinating,
or activating. It is the action phase of
management, requiring the leadership
and management skills necessary to
accomplish the goals of the
organization
It is the issuance of orders,
assignments and directions that
enable the nursing personnel
understand what are expected of
them. Directing includes supervision
and guidance so that in doing their job
well, nurses can maximally contribute
to the organization’s goal in general
and into nursing service objective in
particular.
work to be performed, utilization of
policies and procedures, supervision of
personnel, coordination of services,
communication, staff development,
and making decisions.
• Communications - It is one way. The
manager speaks, employees listen
and react. The only feedback
managers ask for is - "Do you
understand what needs to be done?"
• Goal-Setting - The manager
establishes short-term goals with
specific deadlines.
• Decision-Making - The manager
makes most if not all decisions. When
problems arise the manager
evaluates options, makes decisions
and directs employees as to what
actions to take.
• Providing Feedback - The manager
provides candid, detailed instructions
as to what changes the employee
needs to make.
• Rewards and Recognition - Managers
reward and recognize people for
following directions.
Basic Concepts about Directing
 Direction consists of the process
and techniques utilizing in issuing
instruction and making certain that
operations are carried out as
originally planned.
 Direction is a complex function
that includes all those activities
which are designed to which
encourage subordinates to work
effectively and efficiently in both
short and long run.
 Direction is telling people what
to do and seeing that they do it to
the best of their ability.
 Directing deals with the steps a  Provide subordinates with
manager takes to get subordinates enough time to learn.
and others to carry out plans.
 Delegate gradually.
 Direction provides link between
different functions in an organization.  Delegate in advance.

Points to Remember When Using the  Consult before delegating

Directing Style
1. Organize your thoughts before  Avoid gaps and overlaps
you begin to speak. Nursing Care Assignments
2. Start with the big picture, and Nursing care assignments can be
then discuss the details. called by various terms this is
sometimes called modalities of nursing
3. Make sure your directions are care, systems of nursing care, or
clear and specific. patterns of nursing care.
Functional Nursing
4. If possible show employees the  Task-oriented
desired output. Take the mystery and
guess work out of what you want.  A particular nursing function is
assigned to each worker
5. Assign due dates.
 Best system when there are
6. Provide written instructions if the
many patients and many nurses
directions are complex or lengthy.
available
7. Get feedback -test the transfer.
Ask the employee to explain in his or  For short term use
her own words what you want done. Advantage:
Elements of Directing  Allows work to be done in
The directing functions of the manager shortest time
include the following:
1. Delegation  Worker learns to work fast
2. Supervision  Learn skills faster
3. Leadership Disadvantage:
4. Motivation  Wholistic care is not achieved
5. Communication
 Nurses accountability and
6. Coordination responsibility are diminished

7. Orientation  Patients cannot ‘identify’ their

real nurse
Principles of Delegation
 Select the right person to whom  Nurse-patient relationship is not
the job is to be delegated. fully developed

 Delegate both interesting and  Evaluation of nursing care is

uninteresting tasks. poor and evaluation are rarely
documented
 Difficult to find a specific person
who can answer patient’s
relatives’ question
Total Care or Case Nursing
 One nurse is assigned for the
delivery of total care
 The nurse plans, coordinate,
implements, evaluate, and document
the nursing care she has given during
the shift.
 Commonly used in private
nursing, special care units, isolation
units and on nursing students
 Nurses are accountable for
his/her actions
 Provides wholistic care
 Works only when there are
plenty of nurses and patients are few
Team Nursing
 Decentralized system of care
 A nurse leads a group of nursing
personnel in providing patient care
through participative effort.
 The team leader assigns patients
and tasks to team members
according to job description
 The team leader is responsible
for coordinating the total care of a
group of patients.
 The heart if team nursing is team
conference
 Team plan recognize and
prioritize strength and weakness of
all team members
 The team leader supervises the
nursing care goals and focuses on
attaining them through guidance and
setting of high standard of care.
Primary Nursing
or  A form of assigning
responsibilities for patient care,
 A decentralization authority
 Each registered nurse is
responsible for the care of small
group of patients from admission to
discharge.
 The primary nurse asses the
patient’s needs for care, set care
goals, writes a nursing care plan,
administer care according to that
plan, evaluates the outcome of care,
and make the necessary adjustment
and revision as necessary. He/She
provides pre-discharge planning and
teaching
 Assumes 24-hour responsibility—
the secondary or associate nurse
execute the nursing plan during the
afternoon and night shifts and on
days that the primary nurse is off
duty
 Primary and secondary nurses
are freed from administrative and
housekeeping responsibilities to
maximize their time for patient care.
 Authority, accountability, and
autonomy are values of primary
nurse
Modular Method
 It is the modification of team and
primary nursing
 Unlike in team nursing, a nurse
provides direct care with the
assistance of aides. The professional
nurse provides leadership, support
and instruction t the non-professional
aide.
 It is similar in primary nursing in
that each pair or trio of nursing
personnel is responsible for the care
of patients from admission to
discharge
 It is customary to assign the two public health nurse, and
or three-worker team full interdisciplinary staff must be
responsibility for a case load of 8 – 12 established and nurtured.
patients
Communication
 The same in primary nursing, The word communication comes
another group of nurses will care on from the Latin word communis,
the patient on alternating shifts and meaning commonness. Communication
day off. is a two-way process by which
information exchanged between or
 Responsibility is to assess among individuals through a common
patient needs, plans and implement system of symbols, signs and behavior.
care, and assess outcomes including Communication is the process to
guiding and instructing her partners. impart information from a sender to a
receiver with the use of a medium.
Case Management Communication requires that all parties
 A system of patient care delivery have an area of communicative
that focuses on the achievement of commonality. Chitty (2001) defines
outcomes with effective an communication as the complex
appropriate time frames and exchange of thoughts, ideas, or
resources. information on at least two levels:
verbal and nonverbal.
 Focuses on entire episode of
• Verbal Communication- the
illness, crossing all settings in which
transmission of ideas, opinions,
the patient receives care
feelings, emotions or attitudes through
 Care is directed by case the use of words. Ex: comments,
manager who ideally is involved in a question, reactions
group practice. She is responsible for • Nonverbal Communication- refers to
assessment of patient and family, the sending of messages to another
establishes the nursing diagnosis, person utilizing methods or means
develops nursing care plan, other then words. Ex: facial
delegates nursing care to associates, expression, gesture, eye contact
activates intervention, coordinates Communication is a process by
and collaborates with which we assign and convey meaning in
interdisciplinary team, and evaluate an attempt to create shared
outcomes of care understanding. This process requires a
vast repertoire of skills in intrapersonal
 In institution these activities are and interpersonal processing, listening,
done prior to admission and observing, speaking, questioning,
continues to 2-3 weeks after analyzing, and evaluating. Use of these
discharge processes is developmental and
transfers to all areas of life: home,
 In communities, activities occur school, community, work, and beyond.
in different setting- the home; clinic, It is through communication that
hospital-as long as necessary. collaboration and cooperation occur.
Examples are prepaid health care
plans and health maintenance Communication Process (Diagram on
(HMOs). the last page)
As a process, communication is
 Relationship between the case dynamic, adaptive, and continuous.
manager, physicians, primary nurse, Communication helps us to develop to
be unique persons, relating and Formal organization structure has
cooperating with others. an impact on communication. People at
An internal and an external lower levels of organizational hierarchy
climate also exist in communication. are at risk for inadequate
The internal climate includes the values, communication from higher levels. This
feelings, temperament, and stress occurs because of the number of levels
levels of the sender and the receiver. communication must filter through in
Weather conditions, temperature, large organizations. As the numbers of
timing, and the organizational climate employees increases, the quantity of
itself are parts of the external climate. communication generally increases;
The external climate also includes however, employees may perceive it as
status, power, and authority as barriers increasingly closed.
to manager-subordinate In addition, in large organizations,
communication. it is impossible for individual managers
Internal climate External climate to communicate personally with each
person or group involved in
organizational decision making. Jackson
Sender
(1984) has identified the following
Message
Internal characteristics of large organizations
External that make communication particularly
difficult:
Written • Spatial distance within an
Receiver
organization can be a barrier to
Non-verbal communication.
Verbal • Different subgroups or
Both sender and the receiver subcultures within the organization
must be sensitive to the internal and have their own value systems and
external climate, because the identities. Members within that
perception of the message is altered subgroup form an allegiance to their
greatly depending on the climate that own members. This results in different
existed at the time the message was translations of messages from the
sent or received. Example, an insecure management, depending on the
manager who is called to meet with significance of the message to the
superiors during a period of stringent things the subgroup values and is
layoffs will probably view the message striving to accomplish.
with more trepidation than a manger • People are structured into
who is secure in his or her role. different systems of relationships in
In assessing the internal climate, organizations. A work structure exists
remember that the human mind in which certain people are expected
perceives only what it expects to to complete tasks with other people.
perceive. The unexpected is generally An authority structure exists when
ignored or misunderstood. In other some workers are in charge of
words, receivers cannot communicate if supervising others. A status structure
the message is incompatible with their determines which people have rights
expectations. Therefore, effective and privileges. A prestige structure
communication requires the sender to allows some people to expect
determine what receivers see and hear. deferential treatment from others. The
friendship structure encourages
Variables Affecting Organizational interpersonal trust. All of these
Communication systems influence who should
 communicate with whom and in what continue to affect tremendously the
manner. types and quality of organizational and
• Organizations are in constant unit-level communication.
state of flux. Relationships (subgroups
or subcultures) and geographical Organizational Communication
locations constantly change. It is Strategies
difficult to communicate decisions to Although organizational
all people who are affected by them communication is complex, the
because of this constant state of following strategies can increase the
change. likelihood of clear and complete
communication:
Gender is also a significant factor  Managers must understand the
in organizational communications since organization’s structure and recognize
men and women communicate and use who will be affected by decisions that
language differently. Indeed, Hall and are made. Both formal and informal
Roter’s (1998) study of communication communication networks need to be
patterns of male and female physicians considered.
found that the communication style of o Formal Communication
female physicians included more focus networks follow the formal line of
on the patient’s emotional and authority in the organization’s
psychosocial concerns, more positively hierarchy.
toned communication, and a more o Informal Communication
egalitarian style reflected in increase networks occur between people at
levels patient participation. the same or different levels of the
Complicating the picture further is organizational hierarchy but do not
the historical need in the healthcare represent formal lines of authority or
industry for a predominantly male responsibility. Although there may be
medical profession. Chitty (2001) states a significant exchange of information
that during female-dominated nursing about unit or organizational
school experiences, most nurses are functioning, this communication
encouraged to view physicians as network would not be apparent on
teammates and to collaborate with the organization chart. It is
them whenever possible. Male- imperative, then, that managers be
dominated medical schools, however, very careful of what they say and to
tend to instill in their graduates the whom until they have a good
hierarchal model of teamwork with the understanding of the formal and
physician at the top of the hierarchy. informal communication networks.
The combination of difference in use of  Communication is not a one-way
language and difference in status often channel. If another departments or
results in patterns of male disciplines will be affected by the
predominance and female deference in communication, the manager must
communication. consult with those areas for feedback
In addition, majority of healthcare before the communication.
administrators continue to be male.  The communication must be
Therefore, male physicians and male clear, simple and precise. The
administrators may feel little incentive manager (sender) is responsible for
to seek a more enlightened, ensuring the message is understood.
collaborative approach in  Managers should seek feedback
communication that female nurses regarding whether their
often desire. These differences in communication was accurately
gender and in power and status
 received. One way to do this is to ask
the receiver to repeat the
communication or instructions. In
addition, the sender should continue
follow-up communication in an effort
to determine if the communication is
being acted upon.
 Multiple communication methods
should be used when possible if a
message is important. Using variety of
communication methods in
combination increases the likelihood
that everyone in the organization who
needs to hear the message will.
 Mangers should not overwhelm
subordinates with unnecessary
information. Although information and
communication are different, they are
interdependent. Information is formal,
impersonal and unaffected by
emotions, values, expectations and
perceptions. Communication, on the
other hand, involves perception and
feeling. It does not depend on
information and may represent shared
experiences. In contrast to information
sharing, superiors must continually
communicate with subordinates.
Channels of Communication
• Upward Communication, the manager
is a subordinate to higher
management. Needs and wants are
communicated upward to the next
level in the hierarchy. Those at this
higher level make decisions for a
greater segment of the organization
that the lower-level manager.
• Downward Communication, the
manager relays information to
subordinates. This is the traditional
form of communication in
organizations and helps coordinate
activities in various levels of the
hierarchy.
• Horizontal Communication, managers
interact with other on the same
hierarchical level as themselves who
are managing different segments of
the organization.
• Diagonal Communication, the
manager interacts with personnel and
managers of other departments and
groups, such as physicians, who are
not on the same level of the
organizational hierarchy.
• Grapevine, the most informal
communication network. Usually
involves three or four people at a time.
It is subject to error and distortion
because of the speed at which it
passes and because the sender has
little formal accountability for the
message. Ribeiro and Blakely (1998)
suggest this distortion occurs because
transmitters using this often do one of
the following: (1) elaborate on the
original story but convey its original
intent, (2) distort the message either
deliberately or unintentionally, or (3)
start a contradictory message because
they disagree with the original
message received.
Communication Modes
• Written communication. Written
messages allow for documentation.
They may, however, be open to
various interpretations and generally
consume more managerial time. Most
managers are required to do a
considerable amount of this type of
communication and therefore need to
be able to write clearly.
• Face-to-face communication. Oral
communication is rapid but may result
in fewer people receiving the
information than necessary. They also,
communicate verbally in formal
meetings, with people in peer work
groups, and when making formal
presentations.
• Nonverbal communication. Nonverbal
communication includes facial
expression, body movements, and
gestures and is commonly referred to
as body language. Because nonverbal
communication indicates the
emotional component of the message,
it is generally considered more reliable
than verbal communication. There is
 significant danger, in misinterpreting
nonverbal messages if they are not
assessed in context with the verbal
message.
• Telephone communication. A place in a superior’s office is generally
telephone call is rapid and allows the
receiver to clarify the message at the
same time it is given. Accents may be
difficult to understand as well in a
multicultural workforce.
INTERPERSONAL COMMUNICATION IN A
MULTICULTURAL WORKPLACE
Because it is impossible for the
individual manager to communicate
face to face with each member in the
large organization, managers must
develop other interpersonal
communication skills. These skills
include nonverbal communication,
verbal communication skills, and
listening skills. Perhaps even more
importantly, the manager must have
the sensitivity and leadership skills to
communicate in today’s multicultural
workplace.
NONVERBAL COMMUNICATION SKILLS
Much of our communication
occurs through nonverbal channels that
must be examined in the context of the
verbal content. Generally, if verbal and
nonverbal messages are incongruent,
the receiver will believe the nonverbal
message.
Because nonverbal behavior can
be frequently is misinterpreted,
receivers must validate perceptions
with senders. The incongruence
between verbal and nonverbal leads to
many communication problems.
The following is a partial list of
nonverbal clues that can occur with or
without verbal communication:
 Space. The space between the
sender and receiver influence what is
communicated. Although distance
implies a lack of trust or warmth,
inadequate space, as defined by
cultural norms, may make people feel
threatened or intimidated.
 Environment. The area where the
communication takes pace is an
important part of the communication
process. Communication that takes
taken more seriously than that which
occurs in the cafeteria.
 Appearance. Mush is
communicated by our clothing,
hairstyles, cosmetics, and
attractiveness. The phrase “dressing
for success” appropriately designs the
impact of dress and appearance on
role perception and power, however;
again, care should be exercised to
establish dress policies that
incorporate both cultural and gender-
related sensitivities.
 Eye contact. This nonverbal clue
is often associated with sincerity. Eye
contact invites interaction. Likewise,
breaking eye contact suggests that
the interaction is about to cease.
Bohannon (200,p.21) states that
making eye contact is one f the key
components of effective body
language. Blinking, staring, or looking
away when you begin speaking makes
it hard for you to connect with another
person emotionally.
 Posture. Posture and the way you
control the other parts of your body
are extremely important. In addition,
the weight of a message is increased if
the sender faces the receiver, stands
or sits appropriately close, and, with
head erect, leans toward the receiver.
 Gestures. A message accented
with appropriate gestures takes on
added emphasis. Too much gesturing
can, however, be destructing. Indeed,
the use of touch is one gesture that
often sends messages that are
misinterpreted by receiver’s fro
different cultures.
 Facial Expression. Effective
communication requires a facial
expression that agrees with your
message. Managers who present a
pleasant and open expression are
 perceived by staff as approachable. generally involves limited verbal
Likewise, a nurse’s facial expression exchange (with incongruent nonverbal
can greatly affect how and what behavior) by a person who feels
clients are willing to relate. strongly about a situation. This person
 Timing. Hesitation often feigns withdrawal in an effort to
diminishes the effect of your manipulate a situation.
statement o implies untruthfulness. The second misconception is that
 Vocal clues such as tone, volume, those who communicate or behave
and inflection. All of these clues add to assertively get everything they want.
the message being transmitted. This is untrue because being assertive
Tentative statements sounds more like involves rights and responsibilities.
questions than statements, leading The third misconception about
listeners to think you are unsure of assertiveness is that it is unfeminine.
yourself. Speaking rapidly implies Although the ole of women in the
nervousness, and speaking in society in general has undergone
monotone voice implies disinterest. tremendous change in the last 100
The goal, then, should always be to years, nursing continuous to find great
convey confidence and clarity. difficulty in accepting that the nurse
plays an assertive, active, decision
VERBAL COMMUNICATION SKILLS making role.
One of the most important verbal A fourth misconception is that the
communication skills is the art of terms assertive and aggressive are
assertive communication. Assertive synonymous. To be assertive is to not
behavior is a way of communicating be aggressive, although some cultures
that allows people to express find the distinction blurred. Even when
themselves in direct, honest, and faced with someone else’s aggression,
appropriate ways that do not infringe on the assertive communicator does not
another person’s rights. To be become aggressive. When under attack
successful in the directing phase of by an aggressive person, an assertive
management, the leader must have well person can do several things:
developed skills in assertive  Reflect. Reflect the speaker’s
communication. message back to him or her. Focus on
There are many misconceptions the affective components of the
about assertive communication. The aggressor’s message. This helps the
first is that all communication is either aggressor to evaluate whether the
assertive or passive. Actually, at least intensity of his or her feelings is
four possibilities for communication appropriate to the specific situation or
exist: passive, aggressive, indirectly event.
aggressive or passive-aggressive, or  Repeat the assertive message.
assertive. Passive communication Repeated assertions focus on the
occurs when a person suffers in silence, messages objective content. They are
although he or she may feel strongly especially effective when the
about the issue. Aggressive people aggressor over generalizes or seems
express themselves in a direct and fixated on a repetitive line of thinking.
often hostile manner that infringes on  Point out the implicit assumptions.
another person’s right; this behavior is This involves listening closely and
generally oriented toward “winning at letting the aggressor know that you
all cost” or demonstrating self have heard him or her. In these
excellence. Passive-aggressive situations, managers might repeat
communication is an aggressive major points or identify key
message presented in a passive way. It assumptions to show that they are
 following the employee’s line of individuals creates a diversity of
reasoning. interactions, values, experiences, and
 Restate the message by using beliefs.
assertive language. Rephrasing the
aggressor’s language will defuse the LISTENING SKILLS
emotion. Paraphrasing helps the The active process of listening is
aggressor focus more on the cognitive as important as verbal skills. These
part of the message. The manager listening skills are so important that
might use restating by changing a Kerfoot (1998) suggests, “Listening and
“you” message to an “I” message. hearing what people are saying to you
 Question. When the aggressors is a science and an art.” It is important
uses nonverbal clues to be aggressive, that the leader/manager approach
the assertive person can put this listening as an opportunity to learn
behavior in the form of a question as appreciation for a cultural perspective
an effective means of helping the of the organization that is different on
other person become aware of an his or her own.
unwarranted reaction. To become better listeners,
leaders must first become aware of how
Andrews (1998) suggest the following their own experiences, values,
strategies to promote effective verbal attitudes, and biases affect how they
communication in the multicultural receive and perceive messages.
workplace: Second, leaders must overcome the
 Use proper titles of respect. Do information and communication
not call a person by his or her first overload inherent in the middle
name until given permission to do so. management role. It easy for
 Be aware of subtle linguistic overwhelmed managers to sop listening
messages that may convey bias or actively to the many subordinates who
inequality. need and demand their time
simultaneously.
 Avoid slang, pejorative, or
Finally, the leader must
derogatory terms when referring to
continually work to improve listening
persons from a particular ethnicity,
skills. The leader who actively listens
race, or religious group.
gives genuine time and attention to the
 Avid making remarks to staff that
sender, focusing on verbal and
they should consider themselves
nonverbal communication. The leader’s
fortunate to be employed by the
primary purpose, then, is to receive the
organization. Do not compare their
message being sent rather than forming
employment opportunities and
a response before the transmission of
conditions to people in their country of
the message is complete.
origin.
 Avoid using phrases such as GROUP COMMUNICATION
“culturally disadvantaged,” Managers must communicate with
“socioeconomically disadvantaged,” large and small groups, as well as
and culturally deprived” as they individual employees. Because a group
suggest inferiority and may be communicates differently than
offensive to others. individuals do, it is essential that the
 Do not expect a staff member to manager have an understanding of
know or get along well with all other group dynamics, including the sequence
staff members of the same ethnicity. each group must go through before
Although they share the same work can be accomplished.
ethnicity, their uniqueness as
 Juckman and Jenses (1977)
labeled theses stages forming,
storming, norming and performing.
When people are introduced, they must
go through a process of meeting each
other: the forming stage. They then
progress through a stage where there is
much competition and attempts at the
establishment of individual identities:
the storming stage. Next, the group
begins to establish rules and design its
work: the norming stage. Finally, during
the performing stage, the work actually
gets done.
Some experts suggest there is
another phase: termination or closure.
In this phase, the leader guides
members to summarize, express
feelings, and come to closure.
Because a group’s work develops
over time, the addition of new members
to a committee can slow productivity. It
takes some time for the group to accept
new members. Some developmental
stages will be performed again or
delayed if several new members join a
group. Therefore, it is important when
assigning members to a committee to
select those who can remain until the
work is finished or until their
appointment is over.
GROUP DYNAMICS
In addition to forming, storming,
and norming, two other functions of
groups are necessary for work to be
performed. One has to do with the task
or the purpose of the group, and the
other has to do with the maintenance of
the group or support functions.
Managers should understand how
groups carry out their specific tasks and
roles.
TASK ROLES OF GROUPS
There are 11 tasks that each
group performs. A member may
perform several tasks, but for the work
of the group to be accomplished, all the
necessary tasks will be carried out,
either by members or by the leader.
These roles or tasks follow:
1. Initiator. Contributor who
proposes or suggests group goals or
redefines the problem. There may be
more than one initiator during the
group’s lifetime.
2. Information seeker. Searches for a
factual basis for the group’s work.
3. Information giver. Offers an
opinion of what the group’s view of
pertinent values should be.
4. Opinion seeker. Seeks opinions
that clarify or reflect the value of other
members’ suggestions.
5. Elaborator. Gives examples or
extends meanings of suggestions
given and how they could work.
6. Coordinator. Clarifies and
coordinates ideas, suggestions and
activities of the group.
7. Orienter. Summarizes decision
and actions, identifies and questions
departures from predetermined goals.
8. Evaluator. Questions group
accomplishes and compares them to
standard.
9. Energizer. Stimulates and prods
the group to act and raises the level of
it actions.
10. Procedural technician. Facilitates
group action y arranging the
environment.
11. Recorder. Records the group’s
activities and accomplishments.
GROUP BUILDING and Maintenance
Roles
The group task roles contribute to
the work to be done; the group-building
roles provide for the care and
maintenance of the group. Examples of
group-building roles include:
 Encourager. Accepts and praises
all contributions, viewpoints, and ideas
with warmth and solidarity.
 Harmonizer. Mediates,
harmonizes, and resolves conflicts.
 Compromiser. Yields his or her
position in a conflict situation.
 Gatekeeper. Promotes open communication and productivity within
communication and facilitates the organization. However, the
participation by all members. leadership roles have an even greater
 Standard setter. Expresses or impact on group effectiveness. Dynamic
evaluate standard to evaluate group leaders inspire followers toward
process. participative management by how they
 Group commentator. Records work and communicate in groups
group process and provide feedback to leaders keep group members on course,
the group. draw out shy, politely cut off garrulous,
 Follower. Accepts the group’s and protect the weak.
ideas and listens to discussion and
decision. PRINCIPLES OF EFFECTIVE
COMMUNICATION
INDIVIDUAL ROLES OF GROUP 1. Clear lines of communication
MEMBERS serve as the linking process by which
Group members also carry out parts of the organization are unified
roles that serve their own needs. Group toward goal achievement.
leaders must be able to manage Synchronization of efforts is facilitated
member roles so that individuals do not when proper lines of communication
disrupt group productivity. The goal, are identified and utilized.
however, should be management and 2. Simple, exact, and concise
not suppression. Not every group messages ensure understanding of the
member has a need that results in the message to be conveyed. Sine
use of one of these roles. The eight effective communication starts with
individual roles follow; the perception of the recipient,
1. Aggressor: expresses disapproval overloading or under loading of
of other’s values or feelings through messages should be avoided to
jokes, verbal attacks, or envy. prevent distortion and
2. Blocker: persist in expressing misunderstanding.
negative points of view and resurrect 3. Feedback is essential to effective
dead ideas. communication. Mutual interaction is
3. Self-confessor: uses the group required. There is little or no
setting as a forum for personal communication when there is no
expression. feedback. Listening, openness to the
4. Recognition seeker: works to other person’s point of view and being
focus positive attention on her/him. supportive provide the means to
5. Playboy: remains uninvolved and effective feedback.
demonstrate cynicism, nonchalance or 4. Communication thrives best in a
horseplay. supportive environment which
6. Dominator: Attempts to control or encourages positive values among its
dominate the group. personnel. Communication is used to
7. Help seeker: uses expression or support the vision, mission, and goals
personal insecurity, confusion or self- of the organization and the nursing
depreciation to manipulate sympathy service.
from other members. 5. A manager’s communication skill
8. Special interest pleader: cloaks is vital to the attainment of the goals
personal prejudices or biases by of the organization. Successful
ostensibly speaking for others. managers utilize various mode s of
Managers must be well grounded in communication. It may be for the mal
group dynamics and group roles or informal, written or verbal.
because of their need to facilitate group Meetings interviews, counseling, turn-
 of-the shift reports, memos, charts,
and official publications are examples
of written communication. Body
language affects he effectively of
communication.
6. Adequate and timely
communications of work-related issues
or changes that may affect jobs
enhance compliance. People resist
change if they do not understand the
reason for it. Such announcements
should be factual and comprehensive
and given face to face for better
reception and understanding.
TYPES OF COMMUNICATION
Mainly, there are three types of
communication: spoken words, written
words, and physical expression or
significant gestures.
Verbal communication involves
spoken words. The speaker must be
able to speak slowly, enunciating the
words clearly. Choose words that can be
clearly understood instead of using too
technical ones. Only relevant
information should be conveyed to
prevent confusion. It ascertains
immediate response when time is short.
Written communication must be
clear, correct, complete and concise.
This should be written in words that are
clearly understood by the reader.
Written communication comes in the
form of memoranda, hospital orders,
documentation, records and reports,
policies, procedures, and the like.
Ambiguous terms should be voided to
prevent misunderstanding.
Non-verbal communication is
transmission of message without the
use of words. People oftentimes
unconsciously use facial expressions,
gestures, touch, body language, or
vocal tones.
1. PERSONAL APPEARANCE – The
appearance of a person gives the
general impression of his personality
and self-concept. Nurses should
always appear neat and clean. Nurses
should sport a neat hair style which
does not touch the collar line. Male
nurses must be clean-shaven. They
must carry their uniforms with pride
and dignity.
2. INTONATION OF THE VOICE – The
information of the nurses’ voice should
be soft and gentle. It should not be
irritating to the ear.
3. FACIAL E XPRESSION – A friendly
smile establishes immediate rapport
with the client and invites trust and
confidence in the nurse.
4. POSTURE and GAIT – The nurse’s
posture and gait indicate his physical
wellness, his emotions, and attitude
towards his clients.
5. TOUCH – Touch is a way of caring.
A gentle touch conveys a caring
person. A rough person indicates
insensitivity to the patients and
unresponsiveness to their needs.
LINES OF COMMUNICATION
Communication is described as a
two-way process, yet in an organization,
it is four-dimensional.
Downward Communication
The traditional line of
communication is from superior to
subordinate which may pass trough
various levels of management. The
communication is primarily directive
and activities are coordinated at various
levels of the organization.
Communication aims to impart what the
personnel need to know. What they are
to do and why they are to do these.
Downward communication
includes policies, rules and regulations,
memoranda, handbooks, interviews, job
descriptions, and performance
appraisal.
Upward Communication
Upward communication emanates
from subordinates and goes upward.
This is usually in the form of feedback
to show the extent to which downward
communication has been received,
accepted, and implemented.
 Upward communication does not Outward communication also
flow as easily as downward involves how employees value their
communication. Subordinates may not work. This may be directly or indirectly
have the ability to express their communicated to their families. If they
thoughts or maybe too shy to express think highly of their jobs, their families
them. Supervisors and head nurses become very supportive. It is common
have a big role to ply in ensuring the to hear “My mom works in that hospital.
effectiveness of communication. That is our hospital.”
Through tactful questioning or Job satisfaction to open
observation any misinterpretation can communication lines. Positive
be detected to avoid difficulty in communication between employees and
implementation. This maybe ironed out their immediate supervisors, and
at their level or referred to higher personal feedback on job performance.
management if necessary. All personnel should have access
Examples of upward to information when they need it most
communication are discussions between such as availability of supervisors, of
subordinates and superiors, grievance procedure manual, job descriptions and
procedures, written reports, incident work schedules. Such open access will
reports, and statistical reports. enable them to do their jobs in the most
Horizontal Communication effective and efficient manner.
Horizontal or lateral Communication should be clear and
communication flows between peers, understandable.
personnel or departments on the same Personnel should be able to
level. It is used most frequently in the receive adequate and timely
form of endorsements, between shifts, information regarding wok related
nursing rounds, journal meetings and issues or changes that may affect their
conference, or referrals between jobs. Communication overload or under
departments or services. load should be avoided as these may
Coordination of duties and cause confusion, distrust, and
cooperation among the various misunderstanding.
departments will be maximized if Communication can be enhanced
communication is open to ensure by carefully choosing the words of
smooth work flow. information anyone wishes to convey,
Outward Communication by creating an environment that
Outward communication deals promotes it’s acceptance, by avoiding
with information that flows from the preconceived opinions and biases about
caregivers to the patients, their a person, by listening to and
families, relatives, visitors and the understanding the other person’s point
community. Patients should understand of view, and by being open and
the nature of heir illness, the medical supportive. Most people learn to
and the prescribed nursing plans of care communicate through example. Nurse
so that they cold participate in the Managers should promote a responsive
decisions regarding these. communication climate in their units.
The image of the organization to
the public depends on the employee’s COMMUNICATION ROLE OF SUPERVISOR
understanding of its philosophy, vision, As a nursing supervisor, your role
mission and objectives, and how these involves a lot of key responsibility and
are communicated to the public. Clear dedication. Nursing supervisors need to
explanations of policies, rules and be motivated, dedicated within their line
regulations promote good public of work, team players and team leaders,
relations. and have the ability to work effectively
with staff and employers alike. Nursing supervisor. The nursing supervisor must
supervisor’s are appointed with a BA ensure that the patients’ needs are
degree and relative experience within catered for at all times and he or she
the nursing field, individuals who rank must ensure that the nursing care and
to this position are unique in that they performance that is offered is of top
possess desired qualities, such as the standard. As a nursing supervisor, you
ability to be a nurse and a friend, a are leading and directing the work of
confidant and a leader, a hard worker others and therefore, one must be
and a person with diverse abilities. For prepared for a very challenging and
many nurses, their positions fulfill them hard work when applying for such a
as individuals, however, many nurses position. The nursing supervisor usually
strives to be executives and supervisors reports to the head of the hospital unit
and it is this striving that leads them to for whom he or she works
achieve their goals.
The task of a nursing supervisor is Strategies in Creating Motivating
to oversee the other nurses, to ensure Climate
that everyone is performing optimally in 1. Have clear expectations for
their work and to ensure that patients workers, and communicate these
are receiving the best possible care. expectations effectively.
When any problems occur in a certain 2. Be fair and consistent when
nursing unit, the nursing supervisor is dealing with all employees.
called to inspect and repair the 3. Be a firm decision maker using an
situation. The task of a nursing appropriate decision-making style.
supervisor is therefore very stressful 4. Develop the concept of teamwork.
and demanding and it is typical for a 5. Integrate the staff’s needs and
nursing supervisor to suffer from stress, wants with the organization’s interest
burnout and fatigue. The task of the and purpose.
nursing supervisor is to also ensure 6. Know the uniqueness of each
success of the nursing team that he or employee.
she is in charge of; this is done by being 7. Remove traditional blocks
a team leader, encouraging between the employee and the work
communication and openness and to be done.
increasing the spirit of the nurses. 8. Provide experiences that
People enjoy their work when they feel challenge the employee and allow
happy with what they are doing and opportunities for growth.
with whom they are working; it is your 9. When appropriate, request
duty to achieve this. participation and input from all
As a nursing supervisor, you are subordinates in decision making.
required to work with other highly 10. Be certain that employees
ranked, lead nurses in the hospital. understand the reason behind
Together with the other lead nurses, decisions and actions.
you are provided with the responsibility 11. Reward desirable behavior,
of allocated units and wards, this would be consistent in how you handle
be according to your fields of undesirable behavior.
experience. It would then be your duty 12. Let employees exercise
to coordinate the activities within the individual judgment as much as
patient care unit and to assign nurses to possible.
their units along with their shift 13. Create a trustful and
schedules etc. Critical thinking and helping relationship with employees.
creative skills are therefore two key
aspects required of a nursing
 14. Let employees exercise as  Asking questions discretely to find out
much control as possible over their the problems they encounter in the
work environment. wards
15. Be a role model for  Drawing out suggestions from the
employees. workers for improvement of their work
Supervision or work situation
 “supervise” comes from the word Delegation
“supervide” which means to oversee  It is the process by which the
or view directly manager assigns specific tasks/duties
 It means personally observing a to workers with commensurate
function or activity, providing authority to perform the job.
leadership in the process of nursing  By delegating well defines tasks
care, delegating functions or activities and responsibilities, the nurse
while retaining the accountability, manager can be freed of valuable time
evaluating and ensuring that the that can well be spent on planning and
nursing care provided is adequate and evaluating nursing programs and
delivered appropriately. activities.
 It also trains and develops staff
Principles of Good Supervision members who desire greater
1. Good supervision requires opportunities and challenges in their
adequate planning and organization work making them more committed
which facilitate cooperation, and satisfied in their jobs.
coordination, and synchronization of
services. Common Delegation Errors
2. Good supervision gives autonomy Underdelegating – frequently stems
to workers depending on their from the manager’s false assumption
competency, personality and that delegation may be interpreted as a
commitment. lack of ability on his part to do the job
3. Good supervision stimulates the correctly or completely; the manager’s
worker’s ambition to grow into desire to complete the whole job
effectiveness. personally due to lack of trust in the
4. Good supervision creates an subordinates; the manager believes
atmosphere of cordiality and trust. that he or she needs the experience or
5. Good supervision considers the that he can do it better and faster than
strengths and weaknesses of anyone else.
employees. Overdelegating – because they are poor
6. Good supervision strives to make managers of time, spending most of it
the unit an effective learning situation. just trying to get organized; they feel
insecure in their ability to perform a
Techniques in Supervision task.
 Observation of the worker while Improper delegating – delegating at the
making the rounds wrong time, to the wrong person, or for
 Spot checking of charts through the wrong person.
nursing audits *Legal implication that pertains to
 Asking the patients about the care delegation and supervision
they receive o “respondeat superior” meaning “let
 Looking into the general condition of the superior answer for the acts of the
the units subordinate”
 Getting feedback from co-workers or o The nurse who delegates is
other supervisors or relatives responsible for the acts of the
 subordinate and may incur liability if
found negligent in the process of
delegating and supervising.
o If the task is delegated to a competent
worker and the latter commits a
mistake, then the latter is accountable
for the assessment of the situation,
supervision, follow-up, intervention,
and corrective action.
What cannot be delegated?
1. Overall responsibility, authority
and accountability for satisfactory
completion of all activities in the unit.
2. Authority to sign one’s name is
never delegated.
3. Evaluating the staff and/or taking
necessary corrective or disciplinary
action.
4. Responsibility for maintaining
morale or the opportunity to say a few
words of encouragement to the staff
especially the new ones.
5. Jobs that are too technical and
those that involve trust and
confidence.
Coordination
 Unites personnel and services
toward a common objective
 Enhances collaborative efforts
resulting in efficient, smooth and
harmonious flow of work
 Prevents overlapping of functions,
promotes good working relationships
and work schedules are accomplished
as targeted
 Convey clearly defined polices,
standard operating procedures,
policies and guidelines using the
proper channels of communication.
Decision Making
 Decision is a course of action that
is consciously chosen from available
alternatives for the purpose of
achieving a desired result.
 It involves a choice utilizing
mental processes at the conscious
level and is aimed at facilitating a
defined objective.
Problem Solving
 Problem Solving is part of decision
making, a systemic process that
focuses on analyzing a difficult
situation.
5 Steps in Decision Making Process
1. Definition of the Problem
o Pre-determined objectives provide
the focus for the decision. He should
gather all relevant data so as to
recognize the real problem.
2. Analysis of the Problem
o This means getting to the cause of
the problem.
o It produces an explanation that can
be verified because the event or
cause has already taken place.
*The Supervisor/head Nurse
proceeds to investigate, gather data,
and evaluate the results.
*He should be careful not to let his
prejudices or biases color the
evaluation of facts.
*She should be open-minded and
flexible.
3. Development of Alternative
Solutions
o It focuses on the search for and
analysis of alternatives and their
possible consequences.
o It involves the premises “if we do
this, the result will be…”.
o Sufficient information enables the
decision maker to arrive at rational
decisions.
Factors to be considered in evaluating
alternative solutions: time, available
resources, labor, cost of tools and
equipments to be used, and the moral
and legal implications.
4. Selection of a Solution
o The Head Nurse chooses the best
course to follow considering advice
from others, experience, and logical
reasoning; weigh the advantages
and disadvantages of each.
5. Implementation and Follow-up
Traditional Problem-Solving Process –
effective model; weakness lies in the
amount of time needed for proper
implementation; les effective when time
constraints are a consideration; lack of
an initial objective-setting step that
helps to prevent the decision maker
from becoming sidetracked.
1. Identify the problem.
2. Gather data to analyze the causes
and consequences of the problem.
3. Explore alternative solutions.
4. Evaluate the alternatives.
5. Select the appropriate solution.
6. Implement the solution.
7. Evaluate the results.
Managerial Decision-Making Models –
added an objective setting step;
suggested by Sorach (2000)
1. Determine the importance and
the context of the decision. Problem
solvers must consider the possible
consequences of the decision, time
period involved, and who needs to be
involved in the decision process.
2. Determine the objectives for the
decision. Primary and secondary goals
are outlined.
3. List all options. Problem solvers
must attempt to identify as many
alternatives as possible.
4. Explore promising options.
Alternatives are analyzed by the use
of SWOT (strengths, weaknesses,
opportunities, and threats).
5. Establish decision-making criteria.
Objectives are rank ordered or
qualified so that problem solvers are
clear regarding which criteria will be
weighted most heavily in making their
decision.
6. Evaluate the options against the
criteria. Apply quantitatively decision-
making tools to objectively review the
desirability of alternatives.
7. Select the options to pursue.
Desirable alternatives or combinations
of alternatives are selected for
implementation.
8. Analyze the risks. Challenges to
successful implementation of chosen
alternatives are identified and
strategies are developed to manage
those risks.
Nursing Process – developed by Ida Jean
Orlando; the greatest strength of this
process may be its multiple venues for
feedback; the weakness is like of the
traditional problem-solving model, not
requiring clearly stated objectives.
1. Assessment
2. Planning
3. Implementation
4. Evaluation
The IDEALS Model – developed by
Facione (2006)
Identify the What’s the real question
problem. we’re facing here”
Define the What are the facts and
context. circumstances that frame
this problem?
Enumerate What are our most
the choices. plausible three or four
opinions?
Analyze What is our best course
options. of action, all things
considered?
List reasons Let’s be clear. Why are
explicitly. we making this particular
choice?
Self-correct. Okay, let’s look at it
again. What did we miss?
Intuitive Decision-Making Model
 Andrews (2006) suggests that
“one of the critical skills separating
good leaders from great leaders is the
conscious use of intuition in daily
decision making”.
Gary Klein developed the Recognition-
Primed Decision (RPD) Model for
intuition decision making to explain
how people can make effective
decisions under time pressure and
uncertainty. This model attempts to
understand how humans make
relatively quick decisions in complex,
real world setting without having to
 compare options. Many individuals act
on their first impulse if the “imagined
future” looks acceptable.
 Aloi (2006) suggests that many
expert nurses use intuition in solving
problems. He warns that the dark side
of intuition is misjudgment and that
intuition should serve only as an
adjunct to decision making founded on
nursing’ scientific knowledge base.
LEADERSHIP THEORIES
Many believe that the critical
factor needed to maximize human
resources is leadership. A more in-depth
understanding of leadership can be
gleaned from a review of leadership
theories.
The Great Man Theory
Set forth the premise that certain
people are born to be leaders, having
inherited a set of innate characteristics
that endow with unique ability to lead
others. This theory grew because the
ability to lead others was often seen to
royal and prominent families. Others e
not allowed to become leaders, a fact
that also helps explain its demise.
Currently, most people do not accept
the idea that an individual is born to
lead.
Trait or Attribute Theory
Evolve from great man theory of
leadership when soil and economic
barriers no longer prevented members
of the general public from occupying
leadership roles. Behavioral scientists
began to identify the common traits of
great leaders throughout the ages.
These traits frequently included
assertiveness, ambition, charisma,
creativity, decisiveness, enthusiasm,
intelligence, initiative, integrity,
persistence, physical characteristics,
sense of self and other more. The trait
theory approach to leadership appeal
because it failed to look at the situation
in which action is occurring, neglected
the role of the follower, and did not
consider the importance of group
situation. Leaders in one situation may
function as follower in another. In
addition, leaders who are effective in
some circumstances are ineffective in
others.
Behavioral theories
During the human elation era,
many behavioral and social scientist
studying management also study
leadership. For example, McGregor’s
(1960) theories had as much influence
on leadership research as they did on
management science. As leadership
theory developed, researchers move
away from studying what traits the
leader had and placed emphasis on
what he or she did- the leader’s style of
leadership.
A major break through occurred
when Lewin (1951) and White and
Lippitt (1962) isolated common
leadership style. Later, this styles came
to be cold Authoritarian, democratic,
and Laissez-faire.
The authoritarian leader is
characterized by the following
behaviors:
 Strong control is maintained over
the work group.
 Others are motivated by coercion.
 Others are directed with
commands.
 Communications flows downward.
 Decision making does not involve
others.
 Emphasize is on difference in
status (“I” and “you”).
 Criticism is punitive
Authoritarian leadership results in
well-define group actions that are
usually predictable, reducing frustration
in the work group and giving members
a feeling of security. Productivity is
usually high, but creativity, self
motivation, and autonomy are reduced.
Authoritarian leadership useful in crisis
situation is frequently found in very
large bureaucracies such as armed productivity. Laissez-faire is appropriate
forces. when problems are purely defined and
brain storming is needed to generate
The democratic leader exhibits the alternative solutions.
following behaviors:
 Less control is maintained. Situational and Contingency Theories
 Economic and ego awards are These were based largely on the
used to motivate. premise that the leadership style that
 Others are directed through would prove successful in one set of
suggestions and guidance. circumstances may not be effective in
 Communication flows up and another. According to Follett (1918), the
down. situation should determine the
approach to be followed. Fiedler’s
 Decision making involves others.
(1967) contingency approach reinforced
 Emphasis is on “we” rather than
these findings, suggesting that no one
“I” and “you”
leadership style is ideal for every
 Criticism is constructive. situation. Fiedler’s felt that
Democratic leadership, appropriate interrelationship between the group’s
for groups who work together for leader and its member wee most
extended periods, promotes autonomy influenced by manager’s ability to be
and growth in individual workers. This good leader.
type of leadership is particularly Hersey and Blanchard (1977) also
effective when cooperation and developed a situational approach to
coordination between groups are leadership. Their tri-dimensional
necessary. Studies have shown, leadership effectiveness model predicts
however, that the democratic which leadership style is most
leadership is less efficient quantitatively appropriate in each situation based on
than authoritative leadership. the level of the follower’s maturity. As
people mature, leadership style
The Laissez-faire is characterized by the becomes less focused and more
following behaviors: relationship oriented.
 Is permissive, with little or no
control Path-Goal Theory
 Motivates by support when In this leadership approach, the
requested by the group or individuals. leaders work to motivate followers and
 Provides little or no direction. influential goal accomplishment. By
 Uses upward and downward using the appropriate style of leadership
communication between members of for the situation, the leader makes the
the group. path toward the goal easier for the
 Disperses decision making follower. The path goal theory is based
through out the group. on expectancy theory, which holds that
 Places emphasize on the group. people are motivated when they believe
 Does not criticize. they are able to carry out the work, they
think their contribution will lead to
Because it is non directed expected outcome, and they believe
leadership, the laissez-faire style can be that the rewards for their effort are
frustrating; group apathy and valued and meaningful.
disinterest can occur. However, when all
group members are highly motivated Charismatic Theory
and self-directed, this leadership style A charismatic leader has an
can result in much creativity and inspirational quality that promotes an
emotional connection from the
followers. House (1971) developed
theory of charismatic leadership that
describe how charismatic leader behave
as well as distinguishing characteristic
and situation in which such a leaders
would be effective. Charismatic leaders
display self confidence, have strength in
their conviction, and communicate high
expectations and their confidence in
others. They have been described as
emerging during a crisis,
communicating vision, and using
personal power and unconventional
strategies.
Interactional Leadership theories
The basic premise of interactional
theory is that leadership behavior is
generally determined by the r between
the leader’s personality and the specific
situation.
Schein (1970) was the first to
propose a model of humans as complex
human being whose working
environment was an open system to
which they responded. A system may
be defined as a set of objects, with
relationship between the objects and
between their attributes. A system is
considered open if it exchanges matter,
energy, or information with its
environment. Schein’s model based on
theory has the following assumption:
 People are very complex and high
variable. They have multiple motives
for doing things. For example, a pay
raise might mean status to one
person, security to another, and both
to a third.
 People’s motives do not stay
constant but change over time.
 Goals can differ in various
situations. For example, an informal
groups goal maybe quite distinct from
a formal group’s goal.
 Person’s performance and
productivity are affected by nature of
he tasks and by his or her ability,
experience and motivation.
 No single leadership strategy is
effective in every situation.
Transformational leadership theory
Often reflected in nursing
literature and practice. It is based on
the idea of empowering other to engage
in pursuing a collective purpose by
working together to achieve a vision
and preferred future. This kind of
leadership can influence both the leader
and the follower to a higher level of
conduct and achievement that
transform them both. Essentially, a
transformational leader may be define
as a leader who motivates followers to
perform at their full potential by
influencing changes in perception and
by providing a sense of direction to the
group. The group is encouraged to set
aside personal interests for the good of
the group. Group members are
empowered and motivated and provide
input to decision making, and leaders
and followers raise one another to
higher levels of performance.
Servant leadership theory- developed
by Greenleaf (1995), in which he
pictured successful leaders as being
able to influence others as a result of
dedicating their lives to serving others.
Attributes for Effective Leader
1.Honesty
Leaders have to be honest. If those
under your charge do not trust you,
then they won’t follow you. Common
sense, if you ask me.
2. Responsibility
If you are going to make decisions, then
you should take responsibility for the
decisions that you make. Good leaders
don’t pass the buck or blame other
people – they deal with situations that
arise and take responsibility for the
results. Oh, and if you delegate a
responsibility to someone under your
charge and they screw it up, then it is
YOU who have screwed up. That’s what
leadership and responsibility is all
about.
3. Confidence
You have to believe in yourself. I know it
sounds corny, but confidence makes the
leader. You have to believe every word
that comes out of your mouth. If you
don’t your charges will begin to
question whether or not you know what
you are talking about.
This literally means that even when a
situation is hopeless, you have to give
off an air of confidence. Your charges
will look to YOU for guidance when
times get tough. If they see panic or
uncertainty in your eyes, then all is lost.
4. Enthusiasm
How do you make someone do
something that they don’t want to do?
Enthusiasm! Get psyched about the
task that you’re assigning. Emphasize
its importance, and rollup your sleeves
and demonstrate. Enthusiasm is
contagious – if your charges see you all
excited and ready to have at it, they’ll
get excited too. If you give off an “I just
don’t give a hoot” attitude, then your
charges won’t give a hoot either.
5. Reliability
Saying that you’re going to do
something means that you will actually
have to do it. Nobody likes an unreliable
person, even if they’re not a leader.
After your first time going back on your
word, people just aren’t going to trust
you anymore. I guarantee that if you
are unreliable, you won’t be a leader for
long (if ever).
6. Patience
Don’t underestimate the importance of
patience. If you explain a task or
situation to you charge and they don’t
understand, then clarify it for them. It’s
not their fault that they don’t
understand your instructions – it’s YOUR
fault. Take the time to help out your
charges so that they can perform their
assigned tasks as you intended. Answer
their questions and make sure that they
understand by asking a few yourself!
7. Decisiveness
Some politicians should pay careful
attention to this. Don’t waffle on see-
saw on decisions. Go through this
exactly once: gather relevant
information, gather input from your
charges, and make a safe and
reasonable decision based on the
information that you have available.
Never second-guess yourself unless new
and important information is available.
Often, leaders have to make important
decisions very quickly. Make sure that
you’re psychologically prepared to do
this – it’s not as easy as it seems.
8.Determination
This pretty much amounts to “finish
what you start.” See tasks through to
the bitter end, and keep your charges
motivated to continue.
9.Loyalty
This is something that you expect of
your charges. It is also something that
your charges expect from you. The first
time that you stab your charges in the
back will also be the last.
10.Courage
This could be the most important of the
list, since it encompasses so much. As a
leader, you must have courage in order
to be decisive. You can’t be afraid of
failure, or else you will not be able to
function as a leader. Have the courage
to stick to your convictions or go with a
gut instinct. Don’t be afraid to try a new
approach.
Most importantly, don’t be afraid to
admit that you made a mistake. This is
what separates the true leaders from
the wanna-bees. If you messed up,
admit that you messed up, and then
take corrective action to fix your
mistake. Your charges won’t think less • A leader who uses coercion in the
of you for it – in fact, they’ll think more exercise of his/her powers
of you because you didn’t insist that • Has increased concern for task
black was white when both you and accomplishment but less concern
your charges know you’re wrong. for people who perform these tasks
• Has no confidence or trust in
Leadership Styles his/her subordinates
I. Authoritarian leadership • Thinks all workers are lazy, need to
Characteristics: be coerced, threatened with
1. Strong control is maintained over punishment, indifferent to
the workgroup organizational goals, resistant to
2. Others are motivated by coercion change, not very bright and cannot
3. Others are directed with be trusted, want to avoid
commands responsibility and are more
4. Communication flows downward interested in financial incentives
5. Decision making does not involve than personal achievement
others
6. Emphasis is on difference in II. Democratic leadership (participative
status ( I and You) leadership)
7. Criticism is punitive Characteristics:
 Results in ell-defines group actions 1. Less control is maintained
that are usually predictable, reducing 2. Economic and ego awards are
frustration in the work group and used to motivate
giving the members a feeling of 3. Others are directed through
security suggestion and guidance
 Subordinates are expected to follow 4. Communication flows up and
without questions down
 Provides strong motivation and 5. Decision making involves others
psychological regard for the leader 6. Emphasis is on we rather than “I
 Most effective in crisis situations and you”
 It is appropriate when there is a need 7. Criticism is constructive
for immediate action and the  Appropriate fro groups who work
manager is the individual with the together for extended periods
best understanding of the situation.  Promotes autonomy and growth for
Example: emergency department individual workers
setting  Particularly effective when
 Used to bring order out of chaos cooperation and coordination
 “centric” – the leader makes decision between groups are necessary
for the group  According to studies, it is less
 Also called “theory X” by McGregor efficient quantitatively than
 Boss-centered authoritative leadership
 Often results in high productivity  People-oriented
 Creativity, self-motivation and  Focuses on human aspects and builds
autonomy are reduced effective teamwork
 Workers become blind followers and  Interaction between the leader and
sometimes they avoid their leaders subordinates is open, friendly and
 Useful in crisis situations trusting
 E.g. bureaucracies (armed forces)  Cooperative spirit and joint effort
 Directive/bureaucratic exist
 Authoritative/autocratic leader
 Allows governance through group
participation in decision making
 Open communication prevails
 The leader consults his/her
subordinates in solving problems and
work-related decisions made by the
group
 Promotes cohesiveness among
members, greater job satisfaction,
few feelings of hostility and
frustration
 This style will satisfy high human
needs resulting in greater employee
responsibility which in turn leads to
high productivity
 The most desirable form of
management
 It is participatory with authority
delegated to others
 Consultative style of leadership
 Permit performance appraisal
 “Theory Y” according to McGregor
 Disadvantages: decision making can
become a lengthy process
 Advantage: coworkers are consulted
sand who have input into decisions
are more motivated to support such
decisions
 Democratic leadership is appropriate
when task or decision at hand is not
one that requires urgent action, when
subordinates can be expected to
make meaningful contributions, and
when their input can be taken into
account.
 Democratic Leader
• does not resist change, is
creative, exercises self-direction
and self-control
• Considers workers as ambitious
• “radic leader” – he radiates out
to encompass the needs of
others
III. Situational Leadership
 In this approach, the leader behaves
according to a given situation which
may vary from one setting to the
other.
 “Contingency Style of Leadership” –
one in which the leader matches the
situation and its needs
 Fiedler and Chemers state that in the
work situation, the manager’s
leadership style and expectation,
and the followers’ characteristics and
expectations blend together and
form a productive combination
 The nurse-manager assesses each
nurse’s needs and determine which
leadership behaviors will help the
nurse to do the work with the fewest
problems. The nurse-manager first
considers the staff nurse’s ability to
complete a given task. Then the
nurse-manager, in a particular
situation, either tells or teaches the
staff what to do and explains the
benefits of learning from a new
situation. He/she participates with
the subordinate in doing a special
procedure that the subordinate is not
familiar with. He or she delegates a
more experienced staff to work with
the employee until the latter gains
the skill and competence in
performing a new task.
 The situational leader must be
flexible enough to make adaptations
and changes.
 The theory considers a person’s
qualities and motivations, the role
expectations of the group, and the
social forces at work such as external
factors that bring forth the
leadership potential
 Five kinds of leader under this
theory:
• Natural Leader – becomes a hero in
spite of himself or herself; he/she
does not seek the role but the
group thrusts the leadership upon
him/her by the tide of events
• Charismatic Leader – an authentic
hero in the eyes of his followers; to
them he/she can do no wrong;
inspires people to make sacrifices
for the cause they represent
 • Rational Leader – consistent and
persistent in what he/she thinks is
right.
• Consensus Leader – is perceived to
be acceptable to all; rises in the
absence of the above three leaders
• Leader by Force – dominates by
force and fear; he/she is ruthless in
suppressing opposition; he/she
does not reign long; this type of
leadership contains within itself the
seeds of self-destruction; examples
are Hitler and Idi Amin
IV. Laissez-faire Leadership (permissive
leadership)
 Also referred to as “delegating
approach”
 Little or no direction is provided
 Coworkers develop their own
goals, make their own decisions,
and take responsibility for their
own management
 Managers concentrate on
providing maximum support and
freedom for coworkers
 Decision making is dispersed
throughout the group
 Uses upward and downward
communication with the group
 Does not criticize
 Appropriate when problems are
poorly defined and brainstorming
is needed to generate alternative
solutions
 Advantages:
• Providing maximum freedom for
individuals
• Increased motivation of the
subordinates to perform at high
levels because of independence
• When all members are highly
motivated and self-directed, this
leadership style can result in
much creativity and productivity
 Disadvantage:
• Group apathy and disinterest
can occur
 Example: inpatient psychiatric
unit
 Leadership vacuum
• this may occur in circumstances
in which a laissez-faire approach
to leadership is inappropriately
attempted
• An informal leader will arise and
give direction to the group
• Coworkers recognize an implicit
authority or degree of expertise
in the informal leader
• This may temporarily allow the
group to continue to function
while the informal leader
provides the necessary direction
and assistance
Authority and Power
Authority
Authority identifies the source of
power to act. Authority occurs when a
person who has been given the right to
delegate, based on the state nurse
practice act, also has an official power
from an agency to delegate.
Authority comes with the job as
authority given by an agency
legitimizes the right of a nurse to give
direction to others and expect that they
will comply. An understanding of the
level of authority at the time the task is
delegated and the level of authority that
is identified by the state nurse practice
act and the agency’s job description
prevents each party from making
inaccurate assumptions about authority
for delegated assignments. (Kelly-
Heidenthal & Marthaler, 2005)
Power
According to Neufeldt, power is
the ability to do, act or produce; the
ability to control others; an authority,
sway, or influence. Power is not a static
phenomenon; it can change and shift,
increase or decrease. Bass (1990)
points out that difference in power in a
group, organization, or society influence
the kind of leadership that can be
effective. When there are great
differences in power among individuals
or groups, a more directive leadership is
likely; when the differences in power
are small, a more participative
leadership is likely.
Forms of power
 Reward power
• Obtained by the ability to grant
favors or reward others with
whatever they value.
• The arsenal of rewards that a
manager can dispense to get
employees to work toward meeting
organizational goals is very broad.
• Positive leadership through rewards
tends to develop a great deal of
loyalty and devolution towards
leaders.
 Punishment or coercive power
• The opposite of reward power, is
based on fear of punishment if the
manager’s expectations are not met.
• The manager may obtain compliance
through threats (often implied) of
transfer, layoff, demotion, or
dismissal.
• The manager who shuns or ignores
an employee is exercising power
through punishment; as is the
manager who berates or belittles an
employee.
 Legitimate power
• Is also called position power.
Authority also is called legitimate
power.
• It is the power gained by a title or
official position within an
organization. Legitimate power has
inherent in it the ability to create
feelings of obligation or
responsibility.
• As previously discussed, the
socialization and culture of
subordinate employees will influence
to some degree how much power a
manager has due to his or her
position.
 Expert power
• Is gained through knowledge,
expertise, or experience.
• Having critical knowledge allows a
manager to gain power over others
who need that knowledge. This type
of power is limited to a specialized
area. For example, someone with
vast expertise in music would be
powerful only in that area, not in
another specialization.
• Fralic (2000) feels that Florence
Nightingale was the first nurse to
effectively use this expert power.
When Nightingale used research t o
quantify the need for nurses in
Crimea (by showing that when
nurses were present, fewer soldiers
died), she was using her research to
demonstrate expertise in the health
needs of the wounded.
 Referent power
• A power a person has because others
identify with that leader or with what
that leader symbolizes.
• Referent power also occurs when one
gives another person feeling of
personal acceptance and approval. It
may be obtained through association
with the powerful.
• People may also develop referent
power because others perceive them
as powerful. This perception could be
based on personal charisma, the way
the leader talks or acts, the
organization to which he or she
belongs, or the people with whom he
or she associates.
• People others accept as role models
or leaders enjoy referent power.
Physicians use referent power very
effectively; society as a whole, views
them as powerful, and they carefully
maintain this image. Some theorists
distinguish charismatic power from
referent power. Willey (1990) states
that charisma is a type of personal
power, whereas referent power is
gained only through association with
powerful others.
Sources of power

Type Source
Referent Association with
others
Legitimate Position
Coercive Fear
Reward Ability to grant
favors
Expert Knowledge and skill
Charismatic Personal
Informational The need for
information
Self Maturity, ego
strength