Leadership

Skills of Staff
Nurses in
Private Health
Care Facilities,
Calbayog City.
 A Research Proposal
Presented
to the Dean and the
Faculty of the
College of Nursing
Christ the King College
Calbayog City
In Partial Fulfilment
Of the Requirements
for the Degree
Bachelor of Science
in Nursing
Chapter 1
 Problem
and
Background
Introductio
n
 Leadership is a
position of one
who guides his
subordinates. It
covers a great
responsibility,
which includes
setting up the
vision, tone,
direction and
doing the right
 Perhaps you
have heard
many people
say that
nursing is a
vocation,
while some
say that it is
 Webster defines
profession as “an
occupation or calling
requiring advanced
training and
experience in some
specific or
specialized body of
knowledge which
provides service
to society in that
special field”.
 It is an
occupation
requiring a
unique body
of knowledge
and skills,
which serves
society.
 It is said that
private
hospitals
offer better
possibilities
in terms of
health care
services.
 But in spite of the
respectable image
maintains by private
hospitals today, it is
undeniably true that
the occurrence of
some problems
greatly affect the
effectiveness
of the delivery of
basic health services.
 There is a
continuous process
and effort done by
private
administration in
adopting measures
and strategies to
put their respective
institution always at
a competitive
edge in
providing efficient
and equitable
 Performance
appraisal is a
major
responsibility
in the
controlling
functions of
the
 The ability to
conduct
meaningful,
effective
performance
appraisals requires
an investment
of time,
effort and
practice on the
part of the
 Although
performance
appraisal is
never easy, if used
appropriately
it
produces growth
in the employee
and increases
productivity in
 To increase the like
hood of successful
performance appraisal,
managers should
use system of
appraisal and
gather data about
employee
performance in a
systemic
manner, using many
The managers
also should
attempt to be as
objective as
possible, using
established
standards
for the
appraisal.
 The result of the
appraisal process
should provide
the manager with
information for
meeting training
and educational
needs of
the employees.
 By following up
conscientiously on
identified
performance
deficiencies,
employees’ work
problems can be
corrected
before they
become habits.
 Integrating
leadership into this
part of the
controlling phase of
the management
process provides an
opportunity for
sharing,
communicating and
growing. The
integrated leader is
self-aware
regarding his or
 This self-
awareness leads
to fairness and
honesty in
evaluating
performance.
This, in turn,
increases trust in
the manager and
promotes a team
spirit among
 When anxiety is
reduced during the
appraisal interview,
the leader is able to
establish a relationship
of mutual goal
setting, which has
a greater
potential to result in
increased motivation
and corrected
deficiencies.
 The result of the
integration of
leadership and
management is a
performance
appraisal that
facilitates
employee growth and
increases
organizational
productivity.
 The
aforementioned
scenario inspired
the researcher to
conduct this
particular study
with the hope that
the findings may
pave the way to
improve the
leadership
skills of staff
Theoretical
Framework
 The study includes
different theories
pertaining to
leadership, the
theory of behavioural
approach by Kurt
Lewin at Iowa State
University (1930) and
Contingency theory
 The theory of Lewin
focuses on the
leadership styles, which
are Autocratic
Leadership,
Democratic
Leadership and
Laissez-faire leadership.
Autocratic leadership
involves centralize
decision making, with
the leader making
decisions and
using power
to command
and control
others.
 Democratic
leadership is
participatory, with
authority
delegated to
others.
Laissez-faire
leadership
is passive
and
permissive and
the leader defers
decision-making.
Fielder’s contingency
theory views the pattern
of leader behaviour as
dependent upon the
interaction of the
personality of the leader
and the needs of the
situation.
Leader-member
relations are the
feelings and the
attitude of followers
regarding acceptance,
trust, and credibility of
the leader.
Good leader-
member
relations exist
when followers
respect, trust, and
have confidence in
the leader.
Poor leader-member
relations reflect
distrust, a lack of
confidence and
respect, and
dissatisfaction with
the leader by the
followers.
Task structures refer
to the degree to
which work is defined,
with specific
procedures, explicit
directions, and goals.
High task structures
involve routine,
predictable, clearly
defined work
tasks.
 Low task
structures
involve work
that is not routine,
predictable, or
clearly defined, such
as creative, artistic,
or qualitative
research activities.
Position power is
the degree of
formal
authority and
influence
associated with
the leader.
High position
power is
favourable for the
leader and
low position
power is
unfavourable.
Fielder
showed
that a task-directed
leader, concerned
with task
accomplishment,
was effective.
When the range of favourableness is
intermediate or moderate, a
human relations leader,
concerned about people, was
most effective.
Fielder’s contingency
theory is an approach
that matches the
organizational situation
to the most
favourable leadership
style for that
situation.
 Much of the
early work on
leadership
focused on
the leader.
This research was
directed toward
identifying intellectual,
emotional, and physical
and other personal
traits of effective
leaders.
The underlying
assumption was
that are born,
not made.
After many years of
research, no particular
set of traits has been
found that predicts
leadership potential.
There are several
possible reasons for this
failure.
According to McGregor,
Research findings
to date suggest
that it is more fruitful to
consider leadership as a
relationship is a human
relations function and that
different situations may
require quite different
characteristics from a
leader.
Is not to a large degree
universally
accepted in nursing that
authoritarian power is
effective in times of crisis
but that it otherwise
promotes instability.
In spite of the
shortcomings of
the trait
theory, some traits
have been identified
that are common to
all good leaders.
Dunphy and Stace describe
about resistance to change.
Resistance to change or
attempting to maintain the
status quo when efforts are
being made to alter it, it is a
common response. Change
evokes stress that in turn
evokes resistance.
Factors that stimulate
resistance at change include
habits, complacency, fear of
disorganization, set patterns
of response to change,
conservatism, perceived loss
of power, ego involvement,
insecurity, perceived loss of
current or meaningful
personal relationship, and
perceived lack of rewards.
People are afraid of
change because of lack
of knowledge,
prejudices, resulting
from a lifetime of
personal experience and
expose to others, and
fear of the need for
greater effort or a
higher degree of
difficulty.
People have developed fears,
biases and social inhibitions
from the cultural
environment in which they
live. Since they cannot be
separated from these
cultural factors, it is
necessary to find ways of
managing them within a
system.
Schein (1970) was
the first to
propose a
model of humans
as complex beings
whose working
environment was an
open system to which
they responded.
Leadership effectiveness,
According to Hollander,
requires the ability to use the
problem - solving process; maintain
group effectiveness; communicate
well; demonstrate leader fairness,
competence, dependability, and
creativity; and develop group
identification.
Nelson and Burns (1984)
suggested that
organizations and their
leaders have four
developmental levels and
that these levels influence
productivity and worker
satisfaction. The first of
these levels is reactive.
The reactive leader focuses on
the past, crisis driven, and is
frequently abusive to
subordinates. In the next level,
responsive, the leader is able
to mould subordinates to work
together as a team, although
the leader maintains most
decision – making
responsibility.
At the proactive leader, the
leader and followers become
more future – oriented and hold
common driving values.
Management and decision –
making are more participative.
At the last level, high
performance teams, maximum
productivity and worker
satisfaction are apparent.
Conceptual
Framework
of the
Study
 The diagram
indicated below
illustrates the flow
of the variables
that are used in the
study as conceived
by the researcher.
 Leadership Skills

Human Relations Administrative Institutional

skills

Factors
affecting
Leadership
Skills

Skills
Enhancement
Programs
Staff Nurses in Private
Health Care Facilities,
Calbayog City. As seen in
the diagram, the study
determines the leadership
traits of the staff nurses
particularly in terms of
their intelligence,
personality and abilities.
 It also tries to
find out the
factors affecting
the leadership
skills of staff
nurses.
Statemen
t of the
Problem
Leadership Skills
of Staff Nurses
in Private
Health
Care Facilities,
Calbayog City.
The study
seeks to
determine the
Leadership
Skills of Staff
Nurses in
Private Health
Care
 ly it
seeks to
answer
the
following
questions
1.What is the profile
of respondents in
terms of:
1.1 Age,
1.2 Gender,
1.3 Civil Status,
1.4 Employment
Status
1.6
MonthlyIncome;
1.7 Length of
Service;
1.8 Distance from
work and
1.9 Work
2. What are the leadership skills of
staff nurses in Private Health
Care Facilities as perceived by
themselves and the student
nurses in terms of:
2.1 Human Relations, 2.2
Administrative and 2.3
Institutional Skills?
3. Is there a significant
relationship between
the demographic
profile and
the factors
affecting the
leadership skills
of respondents?
4. What are the
factors affecting
the Leadership
Skills of Staff
Nurses in Private
Health Care
Facilities?
5. What recommendation
can be proposed to
improve the
Leadership Skills of
Staff Nurses in Private
Health Care Facilities
based on the findings of
the study?
 Null
hypothe
sis
There is no significant
relationship between
the leadership skills of
the staff nurses in
health care facilities in
Calbayog City towards
the following
respondent’s socio-
demographic profile.
Scope
and
Delimitation
This study will focus
on leadership skills
of staff nurses in
Private Health Care
Facilities, Calbayog
City.
The respondents of the
study is composed of
staff nurses in Private
Health Care Facilities,
Calbayog City. Likewise,
it is limited to the use of
survey questionnaires as
research instrument in
collecting data.
Significan
ce of
The
Study
 Private Health Care
Facilities in Calbayog
City and leadership
skills of staff nurses is
very important
because all action
undertaken by these
people will affect the
entire organization.
 The results
of the study
are,
therefore,
intended to
benefit the
following:
 Hospital
Administrations
. This would
motivate them to
maintain a
satisfactory
performance in
their respective
departments,
which serves as
inspiration to
their
Staff
Nurses. The
result of this
study would
encourage
them to
perform their
leadership
skills and do
their job
well.
 Nursing
Students.
The findings of
this study would
encourage them
to be more
diligently in
their studies
and develop
their leadership
 Future
Researchers.
This study will help
serve as a
reference for
future researches
to conduct studies
that focuses on
intervention that
enhance the
leadership skills of
staff nurses.
Definition
of terms
 For better
understanding and
clarity of the terms
used, the following
key terms were
defined
conceptually and
operationally.
 Factors – there
are

conditions or
situation that
influence the
occurrence of
something. In this
study, it includes
those that affect the
leadership skills of
 Leadership – It is
a position of a
leader and an act of
leading. In this
study, it refers to
the skills of staff
nurses in managing
situations and
people in private
health care
facilities.
 Profession – it
is an occupation
that requires
extensive education
or specialized
training. In this
study, it refers to
the registered
nurses.
 Profile – it is a
demographic
representation of
important
characteristics of an
individual. In this study,
it refers to the age, sex,
civil status, employment
status and position of
respondents.
 Skills – it is the
ability to do
something well,
usually gained
through experience
and training. In this
study, it refers to the
ability of the staff
nurses to lead.
 Staff Nurses – They
are professionals
trained to care for
the sick and disabled
under the Supervisions
of a physician. As used
in this study, they are
the nurses who are
utilized as respondents
of the study.
Review of
Related
Literature
and
Studies
This Chapter
contains
literature and
studies which
the
Researchers
believed
related to the
present
Related
Literature
What leadership
styles should
senior nurses
develop? This is
an extended
version of the
article published
in Nursing Times;
Senior nurses are
likely to engage in
a range of leadership
activities in their daily
routine. Some will naturally
adopt an effective
leadership style, while
others may find the
concept of leadership or
seeing themselves as
Effective leadership is
critical in
delivering high-quality
care, ensuring patient
safety and facilitating
positive staff
development.
This article
outlines the
characteristics
of an effective
leader, the political
context and various
leadership activities
for senior nurses.
It also discusses
mentorship,
different
leadership models
and the process of
professional
socialization
(Frankel, 2003).
Leadership can
be defined as a
multifaceted
process of identifying a
goal or target,
motivating other people
to act, and providing
support and motivation
to achieve mutually
In the daily life of
a senior nurse,
this could refer to
coordinating the
day/night shift and the
team of nurses and
support staff on
duty under the
The successful
operation of the
shift, staff morale
and managing difficult
or challenging
situations depends
largely on the senior
nurse's leadership skills
(Porter-O'Grady,
Leaders are
often described
as being visionary,
equipped with
strategies, a plan and
desire to direct
their teams and
services to a
Effective
leaders are
required to use
problem-solving
processes, maintain
group effectiveness
and develop group
identification.
They should
also be dynamic,
passionate, have a
motivational influence
on other
people, be
solution-focused
and seek to inspire
others (Mahoney,
Nurses should adopt
a supportive leadership
style with mentorship,
coaching and supervision as
core values showed that
high levels of support from
supervisors reduced
emotional exhaustion
and buffered negativeffects
of the job environment.
Consequently, it
would be particularly
beneficial for
supervisors to provide
emotional support to nurses
and give them
adequate feedback
about performance
to increase self-
esteem(Constable
Senior nurses
should also
apply
leadership
skills in
encouraging
staff to use
critical
reflection to
facilitate new
Nurse leaders
are often
vulnerable
to stress as
experienced in the
work environment,
including long hours,
patient overloads,
and challenging work
If ignored, these
stressors may lead
to physical,
emotional and behavioral
symptoms with possible
reporting medical errors,
absenteeism, health
challenges, and
job burnout
(Cynthia J. Brown,
Ultimately, a
goal of any
healthcare
organisation should
be to influence the
quality of
patient care
through good
Good leaders
should
encourage
junior staff to gain a
better
understanding
of patients and
their needs and
Overall, these
strategies will
lead to increased
patient satisfaction,
more effective nurse-
patient relationships
and quicker recovery
times.
Empowered nurses are
eager to implement
evidence-based
practice. They are
highly motivated, well
informed and
committed to
organisational goals,
and thus deliver patient
care with greater
effectiveness
Good leadership
could produce
better patient
outcomes by
promoting greater
nursing
expertise through
increased staff
ability and a new
The hospital practice
environment has a
significant effect
on patient outcomes.
Junior nurses should be
encouraged to seek maximum
rather than minimum
standards, and be
expected to
achieve and maintain high-
quality benchmarks
The role of senior
nurses is dynamic
and multifaceted.
Nurse leaders in practice
settings have unique
opportunities to influence
and even create the
environment in which
professional nursing
practice can flourish.
In this highly
influential role,
nurse leaders
have a major
responsibility to change
behaviour to provide an
environment that
supports the preparation
of competent and expert
It is part of nurse
leaders' role to
serve as a model in
providing effective
socialisation experiences
that impart the
appropriate values,
beliefs, behaviours and
skills to staff (Marriner-
This is a
democratic
model of
leadership, in which
there is
consideration
for the opinions
of those who
Individuals and
groups are
involved in
decision-making
processes concerning
their work. The valuing
of people, their
knowledge, experience
and skills is central
Leadership models
are a useful tool for
senior nurses and help
to put the function of
leadership activity into
perspective. These nurses
should not be concerned
about using concepts from
various models and
developing an eclectic
The models should
be used as a
framework on
which to build an
effective leadership
style which suits the
individual leader and
those whom
they are leading
The way to empower
people is to leave
them alone and let
them manage themselves.
He also emphasized that
empowerment goes beyond
expecting professionals to
be self-starting high
performers who pretty
much manage
Many proponents
of what he calls
“false
empowerment”
will say that managers
shouldn’t keep close
track of staff, and they
definitely shouldn’t zero
in on employees failures.
Staff should be made
to feel they “own”
their work and should
be set free to make
their own decisions.
Managers are merely
facilitators, there to align the
natural talents and desires of
staff with fitting role in the
workplace. Managers shouldn’t
tell people how to do their jobs,
but rather let staff come up
The idea is make
staffs feel good
inside and results
will take care of
themselves. According to
him, the best managers are
people who learn proven
techniques diligently until
they become skills and
continue practicing them
He presented eight
steps for nurse
managers to be
guided in setting up
staff nurses for success
every step of the way
by practicing highly
engaged hands-on
management, these are:
(a) get in the habit of managing
everyday by setting aside one
hour every day as you dedicated
time for managing up-front on your
initiative,
(b) lean to talk like a performance
coach by talking about the work,
(c) take it one person at a time,
(d) make accountability a real
process,
(e) clarify what to do and
how to do,
(f) follow performance
every step of the way,
(g) solve small problems before
they turn into big problems,
(k) do more for some people and
less for others by giving every
person the chance to meet the
basic expectations of his or her
job and then the chance to
go above and beyond – and to
be rewarded accordingly (Bruce
Relate
d
Studie
Student-researchers
had conducted
some studies
concerning leadership
skills Mendoza (2000)
studied the factors
affecting the
managerial
performance of the
bank executives in
Results of the study
revealed that among
the factors that
promote very
satisfactory performance of
respondents are managerial
abilities possess which is
acquired through seminars and
training, company policies that
enhance employees’ productivity
and consumer’s satisfaction,
favorable business environment
The investigation of
Mendoza has
similarities with the
present study because
it also focuses on
leadership skills. The
difference of this study lies in
the group being studied.
Mendoza placed emphasis on
skills of Bank executives in
Calbayog City, whereas the
Another similar
study was
undertaken by
Delos Reyes (2000) who
made an evaluation of the
work performance of the
officials in Barangay
Tarabucan, Oquendo
District, Calbayog City
The findings showed
that as per
evaluation of
the resident-respondents,
the elected officials of the
said barangay, as a whole,
performs their functions
satisfactory and had
accomplished several
projects that benefited the
The study of
Delos Reyes
had similarity
with the present study
because it focuses on
leadership skills. The
difference lies in the
respondent being
studied and the time
Olares (2002)
made an
investigation
on the motivation
and job satisfaction
levels of government
employee in
Las Navas,
Her study showed
the government
employees are
highly motivated
in their respective tasks
and high job satisfaction
levels. The study further
revealed that there is a
significant relationship
between the respondent’s
motivation and job
The investigation of
Olares is related to
the present study
because they also
gave emphasis on motivation
and satisfaction of staff. The
difference lies in the group being
studied. Olares placed emphasis
on government employees on
their respective task whereas
the present study considers the
leadership skills of staff nurses.
Leadership Skills of Staff
Nurses in Private Health
Care Facilities, Calbayog
City.
QUESTIONNAIRE
Direction: Check
the boxes that
corresponds your
answer to the
questions.
I. Profile
of
Responden
ts
Name (optional):
_________________________________
Age: ____
Sex:
Female
Male
Civil Status:
Single
Married

Separated

Widowed
Employment
Status:
Permanent
Temporary
Contractual
Monthly income(Php):
Php 21,000.00 and above
Php 15,000.00 – Php
20,000.00
Php 10,000.00 – Php
14,999.00
Php 5,000.00 – Php
9,000.00
Php 5,000.00 and below
 Length of
service:
20 yrs. and
above
15 – 29 yrs.
10 – 14 yrs.
5 – 9 yrs.
 Distance from
work:
1 – 2 km
3 – 4 km
4 – 5 km
5 – 6 km
 Work assignment:
Emergency Room
Ward
Operating Room
Delivery Room
Out-Patient Department
School Clinic
Specify:__________
II. Leadership
Skills
of
Staff
Nurses
Direction:
Check the column that
corresponds to the leadership
skills of staff nurses in terms of
human relations, administrative
and institutional skills using the
numerical rating scale, as
follows:
Numerical Rating:
4 – Much Adequate
3 – Moderately Adequate
2 - Adequate
1 – Not Adequate
 A. Human Relations Numerical
Rating
4 3 2 1
1. Ability to handle
problems in times of
emergency.
2. Time to establish
rapport.
3. Ability to interact
with each member of
the health care team.
 A. Human Relations Numerical
Rating
4 3 2 1

4. Ability to show idea,

opinion in terms of difficult
problem of other staff.
5. Has the spirit of
cooperation with in and out
of the group.
6. Ability to work with other
member of the health team
effectively and efficiently
the salary is low beyond
family.
 B. Administrative Numerical
Rating
4 3 2 1

1. Ability to make
memorandum.
2. Has time to talk about
problems encountered by
different departments in
their institutions.
3. Ability to handle
problem and make
corresponding solutions on
time.
 B. Administrative Numerical
Rating
4 3 2 1

1. Able to develop
programs to enhance
skills of staff nurses.
2. Ability to supervise and
evaluate the performance
of staff within the
institution.
3. Able to enhance skills
within the level of
education attained.
 C. Institutional Skills Numerical
Rating

4 3 2 1
1. Involvement in the
making of hospital policies
for implementation.
2. Supervisions of hospital
facilities and equipments
ready for use.
3. Ability to recommend
and implement rules
regarding work
assignments and correct
work overloading.
 C. Institutional Skills Numerical
Rating

4 3 2 1
4. Ability to recommend
and give recognition and
merits for remarkable
performance.
5. Involvement of
interagency program
implementations
6. Ability to conduct
orientation to help the
staff and student nurses
III. Factors

affecting
the
leadership
 Direction:
Check the boxes
that corresponds
your answer to
the questions.
Are there
factors that
influence your
leadership
skills?
Yes
Factors:
A. Financial Incentives:
Salary not given on time
Frozen bonuses and other
benefits
Merits system and salary
standardization not
implemented
Night shift differential
not applied
Irregular payment for
overtime pay
B. Superior Relationship:
Heads involves policies
affecting staff nurses
Poor coordination between
subordinates and other staff
Superior favouritism; jealousy
and competition affect the
relationship of nurses
Inadequate plans for
professional advancement
Unfair selection of personnel
sent for training and seminars
Head can’t stand to nurses’
problems and difficulties related to
job.
C. Work Environment:
Lack of Facilities, supplies and
equipments
Insufficient spaces to operate
comfortably, safely and
efficiently.
Inadequate temperature and
humidity control,
creating excessive discomforts
and overcrowding
No place to interact with
colleagues
Superior behaviour does not
give a feeling of
IV. Recommendations to Improve
Leadership Skills
Continuous Education
Attending Seminar and
conventions to upgrade knowledge on
nursing leadership.
Take post-graduate studies to
improve
educational potentials.
Hospitals work situations must
be made
conducive to nursing duties.
Benefits from work must
commensurate with time
and effort.
Derive satisfaction from work.
Others, specify __________________________
Thank you and God Bless.
Chapter III
Methodolog
y
This chapter presents the
research design, research
locale, research
respondents, research
instrumentation, and
research procedure
and data
gathering, and
treatment
Research
Design
The descriptive
method will be
used to determine
the leadership
skills of staff
nurses in Private
Health Care
As a survey
research,
questionnaire will
be used to gather
data and
information from a
 Research
Responden
ts
The respondents of
this study consist
of all staff nurses
in all Private
Health Care
Facilities in
Calbayog
Research
Locale
This study will
be conducted
at all Private
Health Care
Facilities in
These will include three (3)
Private Hospitals, Our Lady
of Porziuncula Hospital,
Inc., located at Rueda
Street Calbayog City,
Calbayog Sanitarium
Hospital located at
Barangay San Policarpo
Purok 4 Calbayog City, and
St. Camillus Hospital
And three (3) Private School
Clinics, Christ the King
College located at
Magsaysay Boulevard
Calbayog City, St. Augustine
International School located
at Barangay Matobato Purok
2 Calbayog City, and New
Life Christian Faith Academy
located at Magsaysay
 Research
Instrumentati
on
 The instrument of
this study is a
questionnaire
designed to answer
the problem of this
study. It has four
(4) parts.
 The first part is the
profile of the
respondents which
includes age, sex, civil
status, employment
status, monthly
income, length of
service, distance from
 The second part is
the leadership
skills of staff
nurses in terms of
human relations,
administrative, and
institutional skills.
 The third part is the
factors affecting the
leadership skills of
staff nurses, in terms
of financial incentives,
superior relationships,
and work
environment.
And the last part is
the
recommendations
to improve the
leadership skills of
staff nurses in
private health
Research
Procedure
A letter of request to
the Chief Nurse of the
private health care
facilities was made to
ask permission to
conduct this study in
their respective
institution.
With the chief
nurses’ consent
and approval, the
questionnaires will
be distributed to
the staff nurses in
the said
The researcher will
personally conduct the
survey to ensure that
the data in the
questionnaires will be
answered properly and
to assist the
respondents whenever
they have some matters
After gathering
the data, the
responses will
be tallied and
analyzed.
Treatme
nt
Analysis
 Some of the data
that will be
gathered, and will
analyze using
the following
statistical
measures:
 1. Use of
frequency
distribution (f),
and ranking
2. Computation
for
Prepared by:
Mae O.
Allequir
Maria Neze
E. Dalimocon
Maribelle
Encomio
Jovina R. Tan
Thank
You!