nursing midterm notes

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Week 7: Environmental and Global HealthLeadership Defined: Definition: the ability to influence other people A leader is someone who sets direction and influences people to follow that direction A process which involves both the leader and the follower(s) Leaders are nothing without followers

Followership: Followership and leadership are separate but have common or shared roles. Without followers, there cannot be a leader. Without leaders, there are no followers. We all play the role of follower much of the time--regardless of our position.

Followership Defined: Followership is not a passive, unthinking role. The most valuable follower is a skilled, self-directed employee.

Qualities of Followership: A good follower: Participates actively Invests his/her time and energy in the work of the group Thinks critically and advocates for new ideas

Good Followership: Informs the team leader or manager about problems right away. Even better, includes a suggestion for solving the problem in the report. Freely invests interest and energy in their work. Is supportive of new ideas suggested by others. If you disagree, explain why you do not support an idea or suggestion. Listen carefully, and reflect on what your leader or manager says Continue to learn as much as you can about your specialty area. Share what you learn with others (steps from a follower to a leader)

Primary Tasks of a Leader: Sets the direction: mission, goals, vision, purpose Builds commitment: motivation, spirit, teamwork, development of self and others Confront challenges: innovation, change, turbulence, problem solving

Management: Management is a process used to achieve organizational goals. It involves planning, leading, organizing, and controlling. (Kelly, 2008) The managers function is to do whatever is necessary to make sure that employees do their work and do it well. (Tappen, 2004) 2/3 of their time is spent on people management Remainder: budget work, meetings, preparing reports, and other administrivia (Lombardi, 2001) Management: Potter & Perry (4th edition) Whereas leadership refers to a shared vision, values, organizational strategy and relationships, management most often refers to the competencies required to ensure that day-to-day delivery of nursing care according to available resources and standards of practice. More pressure on managers in recent years to learn new skills related to business financial and marketing (Kelly, 2008,p162). There has been a move towards more business management styles in health care.

Leadership vs. Management: Leadership: Visionary Inspirational Innovative Committed to challenging status quo Proactive Does the right thing Management: Bureaucratic Rigid Resistant to change Static Does things right

Leadership vs. Management: Can you be a manager and not a leader? Can you be a leader and not a manager? Management refers to the actions used to achieve goals, whereas leadership is the effort to envision, inspire, and facilitate change.

What Do Leaders Do? Individual Level: Mentor Motivate Group Level: Build teams Resolve conflict Organizational Level: Build culture

Leadership Characteristics: Able to see the big picture Listener Excellent communicator Confidence and trust in team members Seeks consensus Dependable Flexible Visible Integrity Good judgment Respect for others Imaginative Professionalism Energetic Knowledgeable Supportive Personal development Development of others Emotional Intelligence Fair

Development of Self as A Practical Nurse: Leadership Self-confidence Ability to influence significant people Initiative Visionary Critical thinker Charismatic Courageous Inquisitive Approachable Problem-solver Open-minded Humour Passion Goal-setter Positive thinker Challenges the status quo Creates and shapes change Detail-oriented

Emotional Intelligence: The most effective leaders demonstrate these 5 qualities: Self-awareness Self-regulation Motivation Empathy Social skills

Emotional Intelligence: Emotional Intelligence is the ability to recognize the meaning of emotions and their relationships AND to solve problems on the basis of emotions. - the emotionally intelligent nurse can identify, use and regulate emotions to maximize critical thinking resulting in sound decisions that support both positive outcomes and inter-professional collaboration. Characteristics of a leader are less important than what a leader chooses to do.

Leadership Behaviour: Initiating Structure: Organizes and defines work to be done Establishes work patterns Establishes channels of communication Consideration: Behaviour that conveys mutual: Trust Respect Warmth Rapport

Leadership Styles: Autocratic leadership Democratic leadership Laissez-Faire leadership Situational leadership

Autocratic Leadership: Leader retains authority Primary concern is task accomplishment Assigns clearly defined tasks One-way communication Decisions made by leader alone Stress prompt, orderly performance Uses power to pressure those who fail to follow expectations

Appropriate Use of Autocratic Leadership Style: Where most work group members are novices In situations in which immediate action is required No time for group decisions

Democratic Leadership: People-centred approach Primary concern human relations and teamwork Employees given more control and participation in decision-making Facilitates goal accomplishment while stressing the self-worth of each employee

Appropriate use of Democratic Leadership Style: Works best with mature employees Groups that work well together

Laissez-Faire Leadership Style: Permissive Leader gives up control Avoids responsibility by delegating decision-making to group No establishment of goals, policies Abstains from leading Provides little or no direction

Appropriate use of Laissez-Faire Leadership Style: Effective with mature groups who are: Confident, capable and highly motivated Skilled people, who have produced excellent work in the past

Situational Leadership: The most flexible style Combines four styles in one Leader adapts style to: Work situation Needs and abilities of staff Four styles: Directing, Coaching, Supporting and Delegating

Directing: Leader provides specific, detailed instructions Supervises the accomplishment of the task Enforces rules and policies

Coaching: Monitors accomplishment of task while explaining decisions Asks for feedback or suggestions Recognizes good performance

Supporting: Supports efforts of others Facilitates goal accomplishment Shares responsibility for decision-making Willing to try new ideas Values growth not perfection; collaboration not competition

Transformational Leadership Approach: A more recent and popular approach to the theory of leadership in nursing. An exchange process between individuals and leaders relationship is valued Motivates both parties to achieve more Leader is a visionary and inspires people to follow Reference RNAO 2006 BPG for Leadership

CNOLeadership: Each nurse demonstrates her/his leadership by providing, facilitating and promoting the best possible care/service to the public. CNO Professional Standard, 2002

Power A Definition: Power is the ability to create, acquire and use resources to achieve one`s goals. It comes from the ability to influence others or to affect their thinking or behaviour (Kelly, 2013). Power can be: Personal how the individual perceives power Professional (Experts) - authority Organizational - utilize all the mandatory resources in favor of organization development Power, regardless of level, comes from the ability to influence others or affect others thinking or behaviour Effective nurses view their ability to understand and use power as a significant part of their responsibilities to clients, their coworkers, the nursing profession, and themselves (Kelly, 2013)

Sources of Power: Expert power: derived from knowledge & skills ie expert nurses vs novice nurses Legitimate power: derived from the position of authority a person holds ie managers, CEO of an organization Referent (charismatic) power: derived from how much others respect & like a person Reward power: derived from a persons ability to bestow rewards on people ie offering incentives which greatly motivates employees Coercive (Forced) power: is the opposite of reward power. It is the ability of the power holder to remove something from a person or to punish them for not conforming with a request Connection power: derived from a persons connection to others with power ie networking for a job position with who you know Information power: derived from a persons ability to provide information

Power CNO, 2009: Power. The nurse-client relationship is one of unequal power. Although the nurse may not immediately perceive it, the nurse has more power than the client. The nurse has more authority and influence in the health care system, specialized knowledge, access to privileged information, and the ability to advocate for the client and the clients significant others. The appropriate use of power, in a caring manner, enables the nurse to partner with the client to meet the clients needs. A misuse of power is considered abuse.

Empowerment: The process by which we facilitate the participation of others in decision-making and taking action within an environment where there is an equal distribution of power. (Kelly, 2009, p 289) There are many reasons to empower nurses ineffective nurses are those who lack power - they lack job satisfaction and experience more burnout Empowerment for nurses should be exercised at all levels they are more engaged and involved in the decision making process in both their clients and their organization thus finding more fulfillment withi