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Leadership Theories in Practice

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Leadership Theories in Practice

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Peer responses apa format and make sure at least two resources for each peer and respond with good length paragraphs

 

6053

Peer 1

 

Leadership Theories in Practice

In today’s healthcare settings, nurse leaders must transform healthcare systems and improve quality of life. One of the key insights I gained from the scholarly resources selected is that nurses must be flexible in their leadership styles and adjust them to suit the different situations they face daily. Leaders should express hopefulness about the future, help followers realize their potential, and empower people to implement changes (Suratno, 2018). This insight aligns with the emotional intelligence characteristic, allowing leaders to deal with daily challenges in healthcare organizations (Broome & Marshall, 2021). The other insight gained from the resources is that the important goal of nurse leaders is to promote employee engagement and maintain a productive workforce. These effectively mitigate employee burnout (Wei et al., 2020). This supports theory Z that a leader fosters employee well-being to promote high morale, satisfaction, and production (Broome & Marshall, 2021).

I have seen these behaviors and skills used in practice in the psychiatric unit where there was a shortage of nurses. The nurses complained of lack of effective communication and insensitivity to their individual needs. Which left the nurses feeling frustrated and unmotivated to pick up extra shifts. When my nurse manager set up monthly meetings to listen to staff members and address their needs, the nurses began to demonstrate increased engagement. Furthermore, the nurses complaints decreased and they became more committed to pick up extra shifts.

In this situation, the nurse manager demonstrated authentic leadership skills emphasizing relationships between leaders and followers (Broome & Marshall, 2021). These skills were significantly effective because after the nurse manager established a good relationship with nurses, the complaining and uncommitted behaviors among nurses were reduced.

 

 

 

Peer 2

 

Nurse supervisors wear many hats daily. Their most important jobs include staying within budget and staffing. Being able to supply the hospital staff with the supplies needed to do their job is a skill they acquire from working closely with the charge nurses and the materials management coordinator.  For example, supervisors to make the correct decisions they meet with other staff.  Group decision and generated ideas by managerial staff, and non-managerial staff at all-staff meeting (Duggan, Aisaka, Tabak, et al, 2015) help to maintain a budget.

Keeping the hospital staffed adequately and staying within budget is another task that takes preparation. Using a grid to know how many nurses will be need for the day is very useful. It maybe more beneficial for supervisors to allow nursing staff to make their own schedule. Allowing nurses to do this helps nurses feel like they have better control of their time and are able to give better patient care (Leadership styles in nursing management … – wiley online library, n.d.).

Having an open line of communication in a workplace is what helps it run smoothly and effectively. When the nurse supervisor met with the house supervisor and materials management supervisor, she was able to see what supplies were needed as per the charge nurse and the materials management coordinator followed thru by letting them know what could be ordered and when supplies would arrive.  By allowing the nursing staff to make their schedule the nurse manager empowers them and frees up time for herself. Every nurse leader has a specific leadership style “that impact on nurses’ satisfaction, turnover, and the quality of patient care they deliver” (The impact of Nurse Managers’ leadership styles on Ward Staff, n.d.).

 

 

 

 

 

6052

Peer 1

 

This week we were asked to choose a healthcare issue topic of interest in order to formulate our PICOT question to lead us throughout the course. The healthcare issue that I have chosen as my topic for this course is increasing the accessibility to mental health services in the United States through telehealth.

In Case Management Monthly’s 2021 journal entry, it is learned that adults and children have accessed mental health services has declined by over 30% since the COVID-19 pandemic began in 2020 (p. 1). Because of this, mental health illness, crises and rates of suicide as well as substance use, abuse and overdoses are at an all-time high. One way to help this issue that I  have found in my research is through the increased access of telehealth. Telehealth allows for bridging the gaps between not having access to mental health services due to location, specifically rural areas, staffing and patients not being able to make in person appointments due to the pandemic, their own mental illness, and scheduling (Talarico, 2021, para. 2-3).

In my research, there were a few barriers that prevented me from finding articles that will best support my PICOT question. My first search involved me typing in “mental health accessibility” into the CINAHL database. When I did this, I was given a multitude of articles, however, they were incredibly broad and not exactly what I was looking for. The results that I got from this search included very specified results including mental health access in third world countries as well as mental health access specifically for the homeless population. I realized that these results were not really on the topic that I was looking for. Utilizing the Walden University Library n.d., I was able to find the importance of the use of ‘and’ searches (para.1). I then typed into the search bars ‘mental health’ AND ‘access to care’ AND ‘telehealth’ AND ‘United States.” With this, I was lead to a smaller group of about 30 articles to browse through that were incredibly specified to my topic of choice. I found that the best method to to increase the rigor and effectiveness of a database on my PICOT question is to use ‘and’, ‘or’ and ‘not’ searches to be able to narrow your search to finding articles that only support my question and my topic of choice (Walden, n.d., para.1).

 

 

 

Peer 2

 

The clinical issue is retained foreign objects after surgery and the impact on patients, providers, and hospitals. Retained objects can be sponges, needles, instruments, guidewires, small broken fragments from instruments, and blades (Weprin et al., 2021). The effect on patients include increase hospital stay, infection, bowel obstruction, re-operation, and death (Steelman et al., 2018). Hospitals have to incur charges because this is a preventable event not covered by insurance. Providers also experience second victim syndrome which is a feeling of guilt and responsibility for the harm caused to the patient (Weprin et al., 2021). There are various methods used to account for instruments and sponges such as manual counting with sponge counters, RF wanding, and x-ray.

For the search of the articles on the topic, databases such as CINAHL & MEDLINE Combined Search, Google Scholar, and PubMed were utilized. The term retained foreign objects in surgery was inputted on the search bar which provided numerous articles. Then full text, peer reviewed, and within the last five years narrowed down the reviews to about twenty articles. Adding and, or, and not to the search helped to find articles specifically on the topic of interest (Walden University Library, n.d.). Boolean operators and filters was useful in reducing the search results. Surgery or operating room was included in the search bar so that articles that used one term or the other can be shown.

The PICOT question is: In surgical patients the use of x-ray or radiofrequency identification device (RFID) effectively prevents unintentionally retained foreign objects. The population is surgical patients and the comparative intervention is RF wanding as opposed to x-ray. Looking for Level 1 evidence and searching for clinical trial as a filter on the databases will help to find useful articles pertaining to the topic.

 

 

Leadership Theories in Practice

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Leadership Theories in Practice

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Theory Box: Leadership Theories PAGE 9!! Theory/Contributor Key Idea Application to Practice Leaders have a certain set of physical and emotional characteristics that are crucial for inspiring others toward a common goal. Some theorists believe that traits are innate and cannot be learned; others believe that leadership traits can be developed in each individual. Self-awareness of traits is useful in self-development ( developing assertiveness) an in seeking employment that matches traits (drive, motivation, integrity, confidence, cognitive ability and task knowledge). Style theories focus on what leaders do in relational and contextual terms. The achievement of satisfactory performance measures requires supervisors to pursue effective relationships with their subordinates while comprehending the factors in the work environment that influence outcomes. To understand “style,” leade need to obtain feedback from followers, superiors, and pe such as through the Manage Grid Instrument developed by Blake and Mouton (198 Employee-centered leaders to be the leaders most able t achieve effective work environments and productiv Three factors are critical: (1) the degree of trust and respect between leaders and followers, (2) the task structure denoting the clarity of goals and the complexity of problems faced, and (3) the position power in terms of where the leader was able to reward followers and exert influence. Consequently, leaders were viewed as able to adapt their style according to the presenting situation. The Vroom-Yetton model was a problem-solving approach to leadership. Path-Goal theory recognized two contingent variables: (1) the personal characteristics of followers and (2) environmental demands. On the basis of these factors, the leader sets forth clear expectations, eliminates obstacles to goal achievements, motivates and rewards staff, The most important implications for leaders are these theories consider the challenge of a situation and encourage an adaptive leadership style to complem the issue being faced. In oth words, nurses must assess e situation and determine appropriate action based on people involved. Trait Theories Trait theories were first studied from 1900 to 1950. These theories are sometimes referred to as the Great Man theory, from Aristotle’s philosophy extolling the virtue of being “born” with leadership traits. Stogdill (1948)is usually credited as the pioneer in this school of thought. Style Theories Sometimes referred to as group and exchange theories of leadership, style theories were derived in the mid-1950s because of the limitations of trait theory. The key contributors to this renowned research were Shartle (1956), Stogdill (1963), and Likert (1987). Situational-Contingency Theories The situational-contingency theorists emerged in the 1960s and early 1970s to mid-1970s. These theorists believed that leadership effectiveness depends on the relationship among (1) the leader’s task at hand, (2) his or her interpersonal skills, and (3) the favorableness of the work situation. Examples of theory development with this expanded perspective include Fiedler’s (1967) Contingency Model, Vroom and Yetton’s (1973)Normative Decision-Making Model, and House and Mitchell’s (1974) Path-Goal theory. Theory/Contributor Key Idea Application to Practice and increases opportunities for follower satisfaction based on effective job performance. PAGE 10!! Transformational Theories… Transformational theories arose late in the past millennium when globalization and other factors caused organizations to fundamentally re-establish themselves. Many of these attempts were failures, but great attention was given to those leaders who effectively transformed structures, human resources, and profitability balanced with quality. Bass (1990), Bennis and Nanus (2007), and Tichy and Devanna (1997) are commonly associated with the study of transformational theory. Transformational leadership refers to a process whereby the leader attends to the needs and motives of followers so that the interaction raises each to high levels of motivation and morality. The leader is a role model who inspires followers through displayed optimism, provides intellectual stimulation, and encourages follower creativity. Transformed organizations responsive to customer need are morally and ethically int promote employee development, and encourage self-management. Nurse lea with transformational characteristics experiment w systems redesign, empower staff, create enthusiasm for practice, and promote scholarship of practice at th patient-side. Maslow is credited with developing People are motivated by a hierarchy of a theory of motivation, first human needs, beginning with physiologic published in 1943. needs and then progressing to safety, social, esteem, and self-actualizing needs. In this theory, when the need for food, water, air, and other life-sustaining elements is met, the human spirit reaches out to achieve affiliation with others, which promotes the development of self-esteem, competence, achievement, and creativity. Lower-level needs will always drive behavior before higher-level needs will be addressed. When this theory is applied staff, leaders must be aware the need for safety and secu will override the opportunit be creative and inventive, su as in promoting job change. Hierarchy of Needs Two-Factor Theory Herzberg (1991) is credited with Hygiene factors, such as working developing a two-factor theory of conditions, salary, status, and security, motivation, first published in 1968. motivate workers by meeting safety and security needs and avoiding job dissatisfaction. Motivator factors, such as achievement, recognition, and the Organizations need both hygiene and motivator facto to recruit and retain staff. Hygiene factors do not crea job satisfaction; they simply must be in place for work to Theory/Contributor Key Idea Application to Practice satisfaction of the work itself, promote job enrichment by creating job satisfaction. accomplished. If not, these factors will only serve to dissatisfy staff. Transformational leaders us motivator factors liberally to inspire work performance. Individuals’ perceived needs influence their behavior. In the work setting, this motivated behavior is increased if a person perceives a positive relationship between effort and performance. Motivated behavior is further increased if a positive relationship exists between good performance and outcomes or rewards, particularly when these are valued. Expectancy is the perceived probability of satisfying a particular need based on experience. Therefore nurse leadership roles need to pro specific feedback about pos performance. Expectancy Theory Vroom (1994) is credited with developing the expectancy theory of motivation. PAGE 11!! OB Modification…. Luthans (2011) is credited with establishing the foundation for Organizational Behavior Modification (OB Mod), based on Skinner’s work on operant conditioning. OB Mod is an operant approach to organizational behavior. OB Mod Performance Analysis follows a threestep ABC Model: A,antecedent analysis of clear expectations and baseline data collection; B, behavioral analysis and determination; and C,consequence analysis, including reinforcement strategies. The leader uses positive reinforcement to motivate followers to repeat construc behaviors in the workplace. Negative events that demotivate staff are negatively reinforced, and the staff is motivated to avoid certain situations that cause discom Extinction is the purposeful non-reinforcement (ignoring negative behaviors. Punishm is used sparingly because th results are unpredictable in supporting the desired behavioral outcome. in nursing terms, professional nurses can care for individual patients repeatedly, whereas each patient is a unique challenge. But with time and perspective, patterns emerge and nurses learn that these patterns lead to ways to control pain, engage family members in care at the end-of-life, and address a host of other issues. As healthcare providers are very focused on problems and predictable solutions, it is possible that reframing care to build on an individual, family, or community strengths presents quite a different perspective that unleashes solutions to complex problems and shifts human energy toward a positive outcome. Therefore complexity science expands the repertoire of nursing actions to include strategies that are multidimensional and with a different patient or organizational view. In adaptive leadership, consistent with the definition of leadership provided earlier, the goal in responding to patient and organizational problems is to examine a problem through a different lens. This view might examine the “whole” that includes potential threats, exposes conflict, or challenges norms as part of the art of improvising change. An adaptive leader understands that systems are ecological—they restore themselves—and that change can happen equally from the bottom up or from the top down. One leads by entering the stream, not observing it and sitting off to the side to critique it. Questioning, observing patterns, and generating new patterns through being involved is how change unfolds. Imagine the power of social networking where no top-down leader exists. Rather, a series of powerful interactions and messages constantly shift to first re-create reality and then major social change. Adaptive leaders appreciate that they have influence and can help shape direction, with no sense that absolute control is either necessary or possible. In complexity theory, traditional organizational hierarchy plays a less significant role as the “keeper of high-level knowledge.” It is replaced with decision making distributed among the human assets within an organization without regard to hierarchy. Less time is spent trying to control the future (which is not predictable anyway), and more time is spent moving toward and into energy while influencing, innovating, and responding to the many factors that are influencing health care. In complexity science, every voice counts and every encounter with patients and families emerge to co-create a desired outcome. Change is an important dimension of leadership. Eoyang and Holladay (2013) contrast three kinds of change, using performance appraisal as an example. The same example is used here, as each professional nurse is subject to an appraisal of performance. The first example is static change. A performance appraisal in this model is one where an annual overview of performance is described, with comparison to the performance of the previous year, against a set of defined goals and objectives. The second model is the dynamic change model. It is illustrated in the Research Perspective on p. 12. Contrary to the static model, this approach yields periodic feedback, enough that (Yoder-Wise 9-11) Yoder-Wise, Patricia. Leading and Managing in Nursing, 6th Edition. Mosby, 102014. VitalBook file. Table 1-1 Gardner’s Tasks of Leading/Managing Applied to Practice, Management, and Executive Positions Page 14 Behaviors Gardner’s Clinical Task Position Management Executive Position Position Envisioning Visioning goals patient outcomes for single patient/families; assisting patients in formulating their vision of future wellbeing Visioning patient outcomes for aggregates of patient populations and creating a vision of how systems support patient care objectives; assisting staff in formulating their vision of enhanced clinical and organizational performance Visioning community health and organizational outcomes for aggregates of patient populations to which the organization can respond Affirming values Assisting the staff in interpreting organizational values and strengthening staff members’ personal values to more closely align with those of the organization; interpreting values during organizational change Assisting other organizational leaders in the expression of community and organizational values; interpreting values to the community and staff Assisting the patient/family to sort out and articulate personal values in relation to health problems and the effect of these problems on lifestyle adjustments Behaviors Gardner’s Clinical Task Position Management Executive Position Position Motivating Relating to and inspiring patients/families to achieve their vision Relating to and inspiring staff to achieve the mission of the organization and the vision associated with organizational enhancement Relating to and inspiring management, staff, and community leaders to achieve desired levels of health and well-being and appropriate use of clinical services Managing Assisting the patient/family with planning, priority setting, and decision making; ensuring that organizational systems work in the patient’s behalf Assisting the staff with planning, priority setting, and decision making; ensuring that systems work to enhance the staff’s ability to meet patient care needs and the objectives of the organization Assisting other executives and corporate leaders with planning, priority setting, and decision making; ensuring that human and material resources are available to meet health needs Achieving workable unity Assisting patients/families to achieve optimal functioning to benefit the transition to enhanced health functions Assisting staff to achieve optimal functioning to benefit transition to enhanced organizational functions Assisting multidisciplinary leaders to achieve optimal functioning to benefit patient care delivery and collaborative care Sharing organizational information openly; being honest in role performance Representing nursing and executive views openly and honestly; being Developing Keeping trust promises to patients and families; being honest in role performance Behaviors Gardner’s Clinical Task Position Management Executive Position Position honest in role performance Explaining Teaching and interpreting information to promote patient/family functioning and well-being Teaching and interpreting information to promote organizational functioning and enhanced services Teaching and interpreting organizational and communitybased health information to promote organizational functioning and service development (Yoder-Wise 14-15) Yoder-Wise, Patricia. Leading and Managing in Nursing, 6th Edition. Mosby, 102014. VitalBook file. PAGE 15 Serving as symbol Representing the nursing profession and the values and beliefs of the organization to patients/families and other community groups Representing the nursing unit service and the values and beliefs of the organization to staff, other departments, professional disciplines, and the community at large Representing the values and beliefs of the organization and patient care services to internal and external constituents 1Representing Representing Representing Representing the group nursing and the nursing and the unit in task the organization Renewing forces, total quality initiatives, shared governance councils, and other groups organization on assigned boards, councils, committees, and task forces, both internal and external to the organization and patient care services on assigned boards, councils, committees, and task forces, both internal and external to the organization Providing selfcare to enhance the ability to care for staff, patients, families, and the organization served Providing self-care to enhance the ability to care for staff, patients, families, and the organization served Providing self-care to enhance the ability to care for patients, families, staff, and the organization served engage with others to assess the current reality, determine and specify a desired end-point state, and then strategize to reduce the difference. When this is done well, the nurse and the patient or nurses within an organization experience creative tension. Creative tension inspires the patient and others to work in concert to achieve a desired goal. Shared visioning gives direction to accelerate change. Affirming Values Values are the connecting thoughts and inner driving forces that give purpose, direction, and precedence to life priorities. An organization, through its members, shares collective values that are expressed through its mission, philosophy, and practices. Leaders influence decision making and priority setting as an expression of their values. People (either patients or peers being influenced by the leader) also use their values to achieve their goals, which are then manifested through behavior. The word value connotes something of worth; intentional actions reflect our values. A leader continuously clarifies and acknowledges the values that draw attention to a problem and the resources in human and material terms to solve it. Values are powerful forces that promote acceptance of change and drive achievement toward a goal. Motivating When values drive our actions, they become a source of motivation. Motivation energizes what we value, personally and professionally, and stimulates growth and movement toward the vision. Motivators are the reinforcers that keep positive actions alive and sustained, fueling the desire to engage in change. Theories of motivation identify and describe the forces that motivate people. Examples of motivation theory are presented in the Theory Box on Motivation on pp. 9–11. Managing The ability to manage is an important aspect of organizational functioning, because management requires determining routines and practices that offer structure and stability to others. This is especially true in certain positions of influence within a clinical setting, such as a nurse manager, clinical nurse specialist, or clinical nurse leader, all of whom share responsibility for creating effective structures that support clinical and organizational outcomes. Being effective as a manager requires behaviors different from those associated with effective leadership, and vice versa. Ideally, those charged with managing are good leaders and followers, because no organizational position is limited to one exclusive set of behaviors over another. Good leaders need management skills and abilities, and good managers need leading skills and abilities, and good followers need both skills too. (Yoder-Wise 15-16) Yoder-Wise, Patricia. Leading and Managing in Nursing, 6th Edition. Mosby, 102014. VitalBook file. Leadership Theories in Practice NSG/451 Version 2 Leadership Theories in Practice Review the leadership theories on pages 9-11 and Gardner’s Tasks of Leading/Managing on pages 14-15 in Leading and Managing in Nursing. Complete the table below: • • • Summarize the main points of the theory in your own words in the Summary Definition column. Provide an example where you witnessed the theory in practice or suggest a situation where it could be applicable in the Practice Example column. Do not restate the Application to Practice column in the textbook; provide a unique example or suggest a possible scenario. Correlate at least one of Gardner’s task to the theory and practice example in the last column. Use at least five in-text citations in the table to support your summaries, practice examples, or application of Gardner’s Tasks. In the References section below the table, create an APA-formatted list to cite each resource. Theory Name Summary Definition Practice Example Trait Theories Style Theories SituationalContingency Theories Transformational Theories Hierarchy of Needs Two-Factor Theory Expectancy Theory Copyright © 2016, 2018 by University of Phoenix. All rights reserved. Application of Gardner’s Tasks 1 Leadership Theories in Practice NSG/451 Version 2 Organizational Behavior Modification References Copyright © 2016, 2018 by University of Phoenix. All rights reserved. 2
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Leadership Theories in Practice

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  • Leadership Theories in Practice

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  • Leadership Theories in Practice NSG/451 Version 2 University of Phoenix Material Leadership Theories in Practice Review the leadership theories on pages 9-11 and Gardner’s Tasks of Leading/Managing on pages 14-15 in Leading and Managing in Nursing. Complete the table below: • • • Summarize the main points of the theory in your own words in the Summary Definition column. Provide an example where you witnessed the theory in practice or suggest a situation where it could be applicable in the Practice Example column. Do not restate the Application to Practice column in the textbook; provide a unique example or suggest a possible scenario. Correlate at least one of Gardner’s task to the theory and practice example in the last column. Use at least five in-text citations in the table to support your summaries, practice examples, or application of Gardner’s Tasks. In the References section below the table, create an APA-formatted list to cite each resource. Theory Name Summary Definition Practice Example Trait Theories Style Theories SituationalContingency Theories Transformational Theories Hierarchy of Needs Two-Factor Theory Expectancy Theory Copyright © 2016, 2018 by University of Phoenix. All rights reserved. Application of Gardner’s Tasks 1 Leadership Theories in Practice NSG/451 Version 2 Organizational Behavior Modification References Copyright © 2016, 2018 by University of Phoenix. All rights reserved. 2 Pages 9-15 Theory Box: Leadership Theories Theory/Contributor Key Idea Application to Practice Leaders have a certain set of physical and emotional characteristics that are crucial for inspiring others toward a common goal. Some theorists believe that traits are innate and cannot be learned; others believe that leadership traits can be developed in each individual. Self-awareness of traits is useful in self-development (e.g., developing assertivenes and in seeking employment that matches traits (drive, motivation, integrity, confidence, cognitive ability, and task knowledge). Style theories focus on what leaders do in relational and contextual terms. The achievement of satisfactory performance measures requires supervisors to pursue effective relationships with their subordinates while comprehending the factors in the work environment that influence outcomes. To understand “style,” leaders need to obtain feedback from followers, superiors, and peer such as through the Manageri Grid Instrument developed by Blake and Mouton (1985 Employee-centered leaders tend to be the leaders most able to achieve effective work environments and productivit Three factors are critical: (1) the degree of trust and respect between leaders and followers, (2) the task structure denoting the clarity of goals and the complexity of problems faced, and (3) the position power in terms of where the leader was able to reward followers and exert influence. Consequently, leaders were viewed as able to adapt their style according to the presenting situation. The Vroom-Yetton model was a problem-solving approach to leadership. Path-Goal theory recognized The most important implications for leaders are that these theories consider th challenge of a situation and encourage an adaptive leadership style to complemen the issue being faced. In other words, nurses must assess eac situation and determine appropriate action based on th people involved. Trait Theories Trait theories were first studied from 1900 to 1950. These theories are sometimes referred to as the Great Man theory, from Aristotle’s philosophy extolling the virtue of being “born” with leadership traits. Stogdill (1948)is usually credited as the pioneer in this school of thought. Style Theories Sometimes referred to as group and exchange theories of leadership, style theories were derived in the mid-1950s because of the limitations of trait theory. The key contributors to this renowned research were Shartle (1956), Stogdill (1963), and Likert (1987). Situational-Contingency Theories The situational-contingency theorists emerged in the 1960s and early 1970s to mid-1970s. These theorists believed that leadership effectiveness depends on the relationship among (1) the leader’s task at hand, (2) his or her interpersonal skills, and (3) the favorableness of the work situation. Examples of theory development with this expanded perspective include Fiedler’s Theory/Contributor Key Idea (1967) Contingency Model, Vroom and Yetton’s (1973)Normative DecisionMaking Model, and House and Mitchell’s (1974) Path-Goal theory. two contingent variables: (1) the personal characteristics of followers and (2) environmental demands. On the basis of these factors, the leader sets forth clear expectations, eliminates obstacles to goal achievements, motivates and rewards staff, and increases opportunities for follower satisfaction based on effective job performance. Application to Practice Transformational Theories Transformational theories arose late in the past millennium when globalization and other factors caused organizations to fundamentally re-establish themselves. Many of these attempts were failures, but great attention was given to those leaders who effectively transformed structures, human resources, and profitability balanced with quality. Bass (1990), Bennis and Nanus (2007), and Tichy and Devanna (1997)are commonly associated with the study of transformational theory. Transformational leadership refers to a process whereby the leader attends to the needs and motives of followers so that the interaction raises each to high levels of motivation and morality. The leader is a role model who inspires followers through displayed optimism, provides intellectual stimulation, and encourages follower creativity. Transformed organizations ar responsive to customer needs are morally and ethically intact, promote employee development, and encourage self-management. Nurse leaders with transformational characteristics experiment wi systems redesign, empower staff, create enthusiasm for practice, and promote scholarship of practice at the patient-side. Hierarchy of Needs Maslow is credited with People are motivated by a hierarchy of developing a theory of motivation, human needs, beginning with physiologic first published in 1943. needs and then progressing to safety, social, esteem, and self-actualizing needs. In this theory, when the need for food, water, air, and other life-sustaining elements is met, the human spirit reaches out to achieve affiliation with others, which promotes the development of self-esteem, competence, achievement, and creativity. Lower-level needs will always drive behavior before higher-level needs will be addressed. When this theory is applied to staff, leaders must be aware that the need for safety and security will override the opportunity to be creative and inventive, such as in promotin job change. Theory/Contributor Key Idea Application to Practice Two-Factor Theory Herzberg (1991) is credited with Hygiene factors, such as working developing a two-factor theory of conditions, salary, status, and security, motivation, first published in 1968. motivate workers by meeting safety and security needs and avoiding job dissatisfaction. Motivator factors, such as achievement, recognition, and the satisfaction of the work itself, promote job enrichment by creating job satisfaction. Organizations need both hygiene and motivator factors to recruit and retain staff. Hygiene factors do not create job satisfaction; they simply must be in place for work to b accomplished. If not, these factors will only serve to dissatisfy staff. Transformational leaders use motivator factors liberally to inspire work performance. Expectancy Theory Vroom (1994) is credited with developing the expectancy theory of motivation. Individuals’ perceived needs influence their behavior. In the work setting, this motivated behavior is increased if a person perceives a positive relationship between effort and performance. Motivated behavior is further increased if a positive relationship exists between good performance and outcomes or rewards, particularly when these are valued. Expectancy is the perceived probability of satisfying a particular need based on experience. Therefore nurses in leadership roles need to provide specific feedback about positive performance. OB Mod is an operant approach to organizational behavior. OB Mod Performance Analysis follows a threestep ABC Model: A,antecedent analysis of clear expectations and baseline data collection; B, behavioral analysis and determination; and C,consequence analysis, including reinforcement strategies. The leader uses positive reinforcement to motivate followers to repeat constructive behaviors in the workplace. Negative events that de-motivate staff are negatively reinforced, and the staff is motivated to avoid certain situations that cause discomfort. Extinction is the purposeful non-reinforcement (ignoring) of negative behaviors. Punishment is used sparingly because the results are unpredictable in supportin OB Modification Luthans (2011) is credited with establishing the foundation for Organizational Behavior Modification (OB Mod), based on Skinner’s work on operant conditioning. Theory/Contributor Key Idea Application to Practice the desired behavioral outcome. in nursing terms, professional nurses can care for individual patients repeatedly, whereas each patient is a unique challenge. But with time and perspective, patterns emerge and nurses learn that these patterns lead to ways to control pain, engage family members in care at the end-of-life, and address a host of other issues. As healthcare providers are very focused on problems and predictable solutions, it is possible that reframing care to build on an individual, family, or community strengths presents quite a different perspective that unleashes solutions to complex problems and shifts human energy toward a positive outcome. Therefore complexity science expands the repertoire of nursing actions to include strategies that are multidimensional and with a different patient or organizational view. In adaptive leadership, consistent with the definition of leadership provided earlier, the goal in responding to patient and organizational problems is to examine a problem through a different lens. This view might examine the “whole” that includes potential threats, exposes conflict, or challenges norms as part of the art of improvising change. An adaptive leader understands that systems are ecological—they restore themselves—and that change can happen equally from the bottom up or from the top down. One leads by entering the stream, not observing it and sitting off to the side to critique it. Questioning, observing patterns, and generating new patterns through being involved is how change unfolds. Imagine the power of social networking where no top-down leader exists. Rather, a series of powerful interactions and messages constantly shift to first re-create reality and then major social change. Adaptive leaders appreciate that they have influence and can help shape direction, with no sense that absolute control is either necessary or possible. In complexity theory, traditional organizational hierarchy plays a less significant role as the “keeper of high-level knowledge.” It is replaced with decision making distributed among the human assets within an organization without regard to hierarchy. Less time is spent trying to control the future (which is not predictable anyway), and more time is spent moving toward and into energy while influencing, innovating, and responding to the many factors that are influencing health care. In complexity science, every voice counts and every encounter with patients and families emerge to co-create a desired outcome. Change is an important dimension of leadership. Eoyang and Holladay (2013) contrast three kinds of change, using performance appraisal as an example. The same example is used here, as each professional nurse is subject to an appraisal of performance. The first example is static change. A performance appraisal in this model is one where an annual overview of performance is described, with comparison to the performance of the previous year, against a set of defined goals and objectives. The second model is the dynamic change model. It is illustrated in the Research Perspective on p. 12. Contrary to the static model, this approach yields periodic feedback, enough that Research Perspective Resource: Hauck, S., Winsett, R.P., & Kuric, J. (2012). Leadership facilitation strategies to establish evidence-based practice in an acute care hospital. Journal of Advanced Nursing, 69(3), 664-674. A prospective comparative design was used to assess the effect of leadership facilitation strategies on beliefs regarding change, and use of evidence-based practice (EBP) as well as organizational readiness for change. A strategic plan to implement EBP in an acute care hospital was designed. All currently employed registered nurses (RNs) were surveyed at baseline and 2 years later following implementation. Three measures were used to assess beliefs, use, and organizational culture regarding EBP in their hospital. Baseline results demonstrated that direct care RNs perceived limited support from their unit directors. In response, an educational program was developed specifically for those in formal nurse leader roles. The follow-up measures demonstrated statistically significant improvement from baseline on beliefs and readiness regarding EBP, as well as meeting performance goals that were established in the strategic plan. The overall use of EBP in nursing practice improved but was not statistically significant. Evidence-based practice use was significantly lower in direct care nurses than those nurses in non-direct care who were not considered part of the management team. Implications for Practice This is an example of dynamic change, requiring individual attributes consistent with leading, managing, and following behaviors as new processes are designed and implemented in practice. The use of a well-developed plan with specific target measures and engagement of all RNs enhanced the effectiveness of this study. This study demonstrates how important it is for nurses in leadership roles to be well versed in EBP in order to facilitate EBP use by direct care nurses. Though the results of this study cannot be generalized to all facilities implementing EBP, they do demonstrate the importance of a well-designed plan with measurable outcomes. it functions as a kind of thermostat and with work assignments that are marked with milestones, especially when meeting project deadlines or other work targets. The third change model is quite different. The dynamical model focuses on the interrelationship of the leader with feedback that is both regular (even daily) and summative (annually). The appraisal provides feedback relative to systems and interactions, and autonomy is given to move with opportunities that emerge, not just projects to be completed. These three change models represent that challenge in health care today: some work is static (predictable), much is dynamic (aimed at projects that interject incremental improvement), and some is dynamical (unpredictable and interactive). Adaptive leaders are driven by complexity science by nature of the shifting environment. Historically, Marion and Uhl-Bien (2001) identified five ways in which complexity science encourages individuals to lead, manage, and follow. Those who use complexity principles: Develop Networks A network is any related group with common involvement in an area of focus or concern. Social networks are found within organizations but also beyond organizational boundaries. For example, a nursing program is not considered a part of the hospital or agency setting where clinical experiences take place; however, common interests (supply and preparation of a qualified workforce and demand for clinical services) make this network critically important for both organizations. Encourage Non-hierarchical, “Bottom-up” Interaction Among Workers As noted earlier, those who lead, manage, and follow may have responsibilities that are not served within the traditional hierarchy. Shared governance is an example of a decision-making structure in which staff at any level in the hierarchy are engaged in shaping policy and practices that affect patient care. In this model, each nurse is a valued human resource with rich perspective and possesses a voice in shaping direction. Become a Leadership “Tag” The term tag references the philosophic, patient-centered, and values-driven characteristics that give an organization its personality, the “energy” that it has; a tag is sometimes called an attractor or a hallmark of culture, similar to values. Although clinical organizations often perform similar procedures and functions, an intangible sense that this particular organization has a “caring” or “good energy” attractor differs from one where the sense is the focus on efficiency and cost only. The term tag refers to these distinctions. Focus on Emergence The concept of emergence addresses how individuals in positions of responsibility engage with and discover, through active organizational involvement, those networks that are best suited to respond to problems in creative, surprising, and artful ways—those who think “outside the box.” Emergence is tied to unleashing constructive energy rather than constraining energy. Think Systematically The principles of systems thinking theory have been characterized classically by Anderson and Johnson (1997) as: • •Thinking of the “Big Picture” The nurse who looks past an individual assignment and comprehends the needs of all units of the hospital, or who can focus on the needs of all the residents in a long-term care facility, or who can think through the complications of emergency department overcrowding in an urban setting is seeing the big picture. These nurses have the ability to envision the context of their work beyond the immediate tasks. • •Balancing Short-Term and Long-Term Objectives The nurse who recognizes the consequences of actions taken today on the long-term effect of the organization or patient care, such as the decision of a patient to terminate clinical treatment, can guide thinking about how to balance decision making for quality outcomes. • •Recognizing the Dynamic, Complex, and Interdependent Nature of Systems All things are connected. Patients are connected to families and friends. Together, they are connected to communities and cultures. Communities and cultures make up the fabric of society. The cost • of health care is linked to local economies, and local businesses are connected to global industries. Identifying and understanding these relationships helps solve problems with full recognition that small decisions can have a large impact. •Using Measurable versus Nonmeasurable Data Systems This thinking triggers a “tendency to ‘see’ only what we measure.” If we focus our measuring on morale, working relationships, and teamwork, we might miss the important signals that only objective statistics can show us. On the other hand, if we consider only numbers, (e.g., number of patients seen), we might miss a big perspective, such as lack of engagement in the workplace. Exercise 1-3 Identify a clinical scenario in which a complex problem needs to be addressed. Who would you include in a network to engage in creative problem solving? How would you go about linking to other social networks if the problem was “bigger than” your immediate contacts? Identify one member of the network and map the potential connections of that individual that could influence problem resolution. Concentrate on the power of these influencing individuals. The patient/family is part of the network. What role would they play in co-creating the resolution strategies? How would you encourage non-hierarchical interaction among workers? Cite instances (personally or professionally) in which a small change in a system has had a big effect. Tasks of Leading, Managing, and Following When dealing with theory and concepts, we can lose sight of the practical behaviors that are needed to put these ideas into practice. Gardner (1990) was the first to recognize this. He described tasks of leadership in his seminal book, On Leadership. The purpose of describing tangible behaviors associated with leading, managing, and following is to facilitate an understanding of the distinctions between the tasks and the definitions of leadership, management, and followership presented earlier in the chapter. Gardner’s Tasks of Leadership Gardner’s leadership tasks are presented in Table 1-1 to demonstrate that leading, managing, and following are relevant for nurses who hold clinical positions, formal management positions, and executive positions. Note that each role represents the interests of the organization, although the locus of attention is different. Envisioning Goals Leading requires envisioning goals in partnership with others. At the point of care, leading helps patients envision their life journey when health outcomes are unknown. It might help a patient envision walking again, participating in family events, or changing a lifestyle pattern. In the case of leading peers (not dissimilar to working with patients and family members), leader competence, trustworthiness, self-assuredness, decision-making ability, and prioritization skills envision crafting solutions to care delivery problems. Imagine leading a change to an electronic health record from a traditional paper record: the leader uses the aforementioned abilities to engage with, convince, or persuade colleagues about the relevance of this change and proceeds with setting direction. Envisioning goals is contingent upon trustful relationships, shared information, and agreement on mutual expectations. Establishing a shared vision is an important leadership concept. “Visioning” requires the leader to Table 1-1 Gardner’s Tasks of Leading/Managing Applied to Practice, Management, and Executive Positions Behaviors Gardner’s Task Clinical Position Management Position Executive Position Envisioning goals Visioning patient outcomes for single patient/families; assisting patients in formulating their vision of future well-being Visioning patient outcomes for aggregates of patient populations and creating a vision of how systems support patient care objectives; assisting staff in formulating their vision of enhanced clinical and organizational performance Visioning community health and organizational outcomes f aggregates of patient populations to which the organization can respond Affirming values Assisting the patient/family to sort out and articulate personal values in relation to health problems and the effect of these problems on lifestyle adjustments Assisting the staff in interpreting organizational values and strengthening staff members’ personal values to more closely align with those of the organization; interpreting values during organizational change Assisting other organizational leaders in the expression of community and organizationa values; interpreting values to the community and staff Motivating Relating to and inspiring patients/families to achieve their vision Relating to and inspiring staff to achieve the mission of the organization and the vision associated with organizational enhancement Relating to and inspiring management, staff, and community leaders to achieve desired levels of health and well-being and appropriate us of clinical services Managing Assisting the patient/family with planning, priority setting, and decision making; ensuring that organizational systems work in the patient’s behalf Assisting the staff with planning, priority setting, and decision making; ensuring that systems work to enhance the staff’s ability to meet patient care needs and the objectives of the organization Assisting other executives and corporate leaders with plannin priority setting, and decision making; ensuring that human and material resources are available to meet health needs Behaviors Gardner’s Task Clinical Position Achieving workable unity Assisting patients/families to Assisting staff to achieve optimal achieve optimal functioning functioning to benefit transition to to benefit the transition to enhanced organizational functions enhanced health functions Developing trust Keeping promises to patients Sharing organizational Representing nursing and and families; being honest in information openly; being honest executive views openly and role performance in role performance honestly; being honest in role performance Explaining Teaching and interpreting information to promote patient/family functioning and well-being Teaching and interpreting information to promote organizational functioning and enhanced services Teaching and interpreting organizational and community based health information to promote organizational functioning and service development Serving as symbol Representing the nursing profession and the values and beliefs of the organization to patients/families and other community groups Representing the nursing unit service and the values and beliefs of the organization to staff, other departments, professional disciplines, and the community at large Representing the values and beliefs of the organization and patient care services to interna and external constituents Representing the group Representing nursing and the unit in task forces, total quality initiatives, shared governance councils, and other groups Representing nursing and the organization on assigned boards, councils, committees, and task forces, both internal and external to the organization Representing the organization and patient care services on assigned boards, councils, committees, and task forces, both internal and external to t organization Renewing Providing self-care to enhance the ability to care for staff, patients, families, and the organization served Providing self-care to enhance the ability to care for staff, patients, families, and the organization served Providing self-care to enhance the ability to care for patients, families, staff, and the organization served Management Position Executive Position Assisting multidisciplinary leaders to achieve optimal functioning to benefit patient care delivery and collaborativ care engage with others to assess the current reality, determine and specify a desired end-point state, and then strategize to reduce the difference. When this is done well, the nurse and the patient or nurses within an organization experience creative tension. Creative tension inspires the patient and others to work in concert to achieve a desired goal. Shared visioning gives direction to accelerate change. Affirming Values Values are the connecting thoughts and inner driving forces that give purpose, direction, and precedence to life priorities. An organization, through its members, shares collective values that are expressed through its mission, philosophy, and practices. Leaders influence decision making and priority setting as an expression of their values. People (either patients or peers being influenced by the leader) also use their values to achieve their goals, which are then manifested through behavior. The word value connotes something of worth; intentional actions reflect our values. A leader continuously clarifies and acknowledges the values that draw attention to a problem and the resources in human and material terms to solve it. Values are powerful forces that promote acceptance of change and drive achievement toward a goal. Motivating When values drive our actions, they become a source of motivation. Motivation energizes what we value, personally and professionally, and stimulates growth and movement toward the vision. Motivators are the reinforcers that keep positive actions alive and sustained, fueling the desire to engage in change. Theories of motivation identify and describe the forces that motivate people. Examples of motivation theory are presented in the Theory Box on Motivation on pp. 9–11. Managing The ability to manage is an important aspect of organizational functioning, because management requires determining routines and practices that offer structure and stability to others. This is especially true in certain positions of influence within a clinical setting, such as a nurse manager, clinical nurse specialist, or clinical nurse leader, all of whom share responsibility for creating effective structures that support clinical and organizational outcomes. Being effective as a manager requires behaviors different from those associated with effective leadership, and vice versa. Ideally, those charged with managing are good leaders and followers, because no organizational position is limited to one exclusive set of behaviors over another. Good leaders need management skills and abilities, and good managers need leading skills and abilities, and good followers need both skills too. The tasks of management are discussed on p. 18.
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  • Theory Box: Leadership Theories PAGE 9!! Theory/Contributor Key Idea Application to Practice Leaders have a certain set of physical and emotional characteristics that are crucial for inspiring others toward a common goal. Some theorists believe that traits are innate and cannot be learned; others believe that leadership traits can be developed in each individual. Self-awareness of traits is useful in self-development ( developing assertiveness) an in seeking employment that matches traits (drive, motivation, integrity, confidence, cognitive ability and task knowledge). Style theories focus on what leaders do in relational and contextual terms. The achievement of satisfactory performance measures requires supervisors to pursue effective relationships with their subordinates while comprehending the factors in the work environment that influence outcomes. To understand “style,” leade need to obtain feedback from followers, superiors, and pe such as through the Manage Grid Instrument developed by Blake and Mouton (198 Employee-centered leaders to be the leaders most able t achieve effective work environments and productiv Three factors are critical: (1) the degree of trust and respect between leaders and followers, (2) the task structure denoting the clarity of goals and the complexity of problems faced, and (3) the position power in terms of where the leader was able to reward followers and exert influence. Consequently, leaders were viewed as able to adapt their style according to the presenting situation. The Vroom-Yetton model was a problem-solving approach to leadership. Path-Goal theory recognized two contingent variables: (1) the personal characteristics of followers and (2) environmental demands. On the basis of these factors, the leader sets forth clear expectations, eliminates obstacles to goal achievements, motivates and rewards staff, The most important implications for leaders are these theories consider the challenge of a situation and encourage an adaptive leadership style to complem the issue being faced. In oth words, nurses must assess e situation and determine appropriate action based on people involved. Trait Theories Trait theories were first studied from 1900 to 1950. These theories are sometimes referred to as the Great Man theory, from Aristotle’s philosophy extolling the virtue of being “born” with leadership traits. Stogdill (1948)is usually credited as the pioneer in this school of thought. Style Theories Sometimes referred to as group and exchange theories of leadership, style theories were derived in the mid-1950s because of the limitations of trait theory. The key contributors to this renowned research were Shartle (1956), Stogdill (1963), and Likert (1987). Situational-Contingency Theories The situational-contingency theorists emerged in the 1960s and early 1970s to mid-1970s. These theorists believed that leadership effectiveness depends on the relationship among (1) the leader’s task at hand, (2) his or her interpersonal skills, and (3) the favorableness of the work situation. Examples of theory development with this expanded perspective include Fiedler’s (1967) Contingency Model, Vroom and Yetton’s (1973)Normative Decision-Making Model, and House and Mitchell’s (1974) Path-Goal theory. Theory/Contributor Key Idea Application to Practice and increases opportunities for follower satisfaction based on effective job performance. PAGE 10!! Transformational Theories… Transformational theories arose late in the past millennium when globalization and other factors caused organizations to fundamentally re-establish themselves. Many of these attempts were failures, but great attention was given to those leaders who effectively transformed structures, human resources, and profitability balanced with quality. Bass (1990), Bennis and Nanus (2007), and Tichy and Devanna (1997) are commonly associated with the study of transformational theory. Transformational leadership refers to a process whereby the leader attends to the needs and motives of followers so that the interaction raises each to high levels of motivation and morality. The leader is a role model who inspires followers through displayed optimism, provides intellectual stimulation, and encourages follower creativity. Transformed organizations responsive to customer need are morally and ethically int promote employee development, and encourage self-management. Nurse lea with transformational characteristics experiment w systems redesign, empower staff, create enthusiasm for practice, and promote scholarship of practice at th patient-side. Maslow is credited with developing People are motivated by a hierarchy of a theory of motivation, first human needs, beginning with physiologic published in 1943. needs and then progressing to safety, social, esteem, and self-actualizing needs. In this theory, when the need for food, water, air, and other life-sustaining elements is met, the human spirit reaches out to achieve affiliation with others, which promotes the development of self-esteem, competence, achievement, and creativity. Lower-level needs will always drive behavior before higher-level needs will be addressed. When this theory is applied staff, leaders must be aware the need for safety and secu will override the opportunit be creative and inventive, su as in promoting job change. Hierarchy of Needs Two-Factor Theory Herzberg (1991) is credited with Hygiene factors, such as working developing a two-factor theory of conditions, salary, status, and security, motivation, first published in 1968. motivate workers by meeting safety and security needs and avoiding job dissatisfaction. Motivator factors, such as achievement, recognition, and the Organizations need both hygiene and motivator facto to recruit and retain staff. Hygiene factors do not crea job satisfaction; they simply must be in place for work to Theory/Contributor Key Idea Application to Practice satisfaction of the work itself, promote job enrichment by creating job satisfaction. accomplished. If not, these factors will only serve to dissatisfy staff. Transformational leaders us motivator factors liberally to inspire work performance. Individuals’ perceived needs influence their behavior. In the work setting, this motivated behavior is increased if a person perceives a positive relationship between effort and performance. Motivated behavior is further increased if a positive relationship exists between good performance and outcomes or rewards, particularly when these are valued. Expectancy is the perceived probability of satisfying a particular need based on experience. Therefore nurse leadership roles need to pro specific feedback about pos performance. Expectancy Theory Vroom (1994) is credited with developing the expectancy theory of motivation. PAGE 11!! OB Modification…. Luthans (2011) is credited with establishing the foundation for Organizational Behavior Modification (OB Mod), based on Skinner’s work on operant conditioning. OB Mod is an operant approach to organizational behavior. OB Mod Performance Analysis follows a threestep ABC Model: A,antecedent analysis of clear expectations and baseline data collection; B, behavioral analysis and determination; and C,consequence analysis, including reinforcement strategies. The leader uses positive reinforcement to motivate followers to repeat construc behaviors in the workplace. Negative events that demotivate staff are negatively reinforced, and the staff is motivated to avoid certain situations that cause discom Extinction is the purposeful non-reinforcement (ignoring negative behaviors. Punishm is used sparingly because th results are unpredictable in supporting the desired behavioral outcome. in nursing terms, professional nurses can care for individual patients repeatedly, whereas each patient is a unique challenge. But with time and perspective, patterns emerge and nurses learn that these patterns lead to ways to control pain, engage family members in care at the end-of-life, and address a host of other issues. As healthcare providers are very focused on problems and predictable solutions, it is possible that reframing care to build on an individual, family, or community strengths presents quite a different perspective that unleashes solutions to complex problems and shifts human energy toward a positive outcome. Therefore complexity science expands the repertoire of nursing actions to include strategies that are multidimensional and with a different patient or organizational view. In adaptive leadership, consistent with the definition of leadership provided earlier, the goal in responding to patient and organizational problems is to examine a problem through a different lens. This view might examine the “whole” that includes potential threats, exposes conflict, or challenges norms as part of the art of improvising change. An adaptive leader understands that systems are ecological—they restore themselves—and that change can happen equally from the bottom up or from the top down. One leads by entering the stream, not observing it and sitting off to the side to critique it. Questioning, observing patterns, and generating new patterns through being involved is how change unfolds. Imagine the power of social networking where no top-down leader exists. Rather, a series of powerful interactions and messages constantly shift to first re-create reality and then major social change. Adaptive leaders appreciate that they have influence and can help shape direction, with no sense that absolute control is either necessary or possible. In complexity theory, traditional organizational hierarchy plays a less significant role as the “keeper of high-level knowledge.” It is replaced with decision making distributed among the human assets within an organization without regard to hierarchy. Less time is spent trying to control the future (which is not predictable anyway), and more time is spent moving toward and into energy while influencing, innovating, and responding to the many factors that are influencing health care. In complexity science, every voice counts and every encounter with patients and families emerge to co-create a desired outcome. Change is an important dimension of leadership. Eoyang and Holladay (2013) contrast three kinds of change, using performance appraisal as an example. The same example is used here, as each professional nurse is subject to an appraisal of performance. The first example is static change. A performance appraisal in this model is one where an annual overview of performance is described, with comparison to the performance of the previous year, against a set of defined goals and objectives. The second model is the dynamic change model. It is illustrated in the Research Perspective on p. 12. Contrary to the static model, this approach yields periodic feedback, enough that (Yoder-Wise 9-11) Yoder-Wise, Patricia. Leading and Managing in Nursing, 6th Edition. Mosby, 102014. VitalBook file. Table 1-1 Gardner’s Tasks of Leading/Managing Applied to Practice, Management, and Executive Positions Page 14 Behaviors Gardner’s Clinical Task Position Management Executive Position Position Envisioning Visioning goals patient outcomes for single patient/families; assisting patients in formulating their vision of future wellbeing Visioning patient outcomes for aggregates of patient populations and creating a vision of how systems support patient care objectives; assisting staff in formulating their vision of enhanced clinical and organizational performance Visioning community health and organizational outcomes for aggregates of patient populations to which the organization can respond Affirming values Assisting the staff in interpreting organizational values and strengthening staff members’ personal values to more closely align with those of the organization; interpreting values during organizational change Assisting other organizational leaders in the expression of community and organizational values; interpreting values to the community and staff Assisting the patient/family to sort out and articulate personal values in relation to health problems and the effect of these problems on lifestyle adjustments Behaviors Gardner’s Clinical Task Position Management Executive Position Position Motivating Relating to and inspiring patients/families to achieve their vision Relating to and inspiring staff to achieve the mission of the organization and the vision associated with organizational enhancement Relating to and inspiring management, staff, and community leaders to achieve desired levels of health and well-being and appropriate use of clinical services Managing Assisting the patient/family with planning, priority setting, and decision making; ensuring that organizational systems work in the patient’s behalf Assisting the staff with planning, priority setting, and decision making; ensuring that systems work to enhance the staff’s ability to meet patient care needs and the objectives of the organization Assisting other executives and corporate leaders with planning, priority setting, and decision making; ensuring that human and material resources are available to meet health needs Achieving workable unity Assisting patients/families to achieve optimal functioning to benefit the transition to enhanced health functions Assisting staff to achieve optimal functioning to benefit transition to enhanced organizational functions Assisting multidisciplinary leaders to achieve optimal functioning to benefit patient care delivery and collaborative care Sharing organizational information openly; being honest in role performance Representing nursing and executive views openly and honestly; being Developing Keeping trust promises to patients and families; being honest in role performance Behaviors Gardner’s Clinical Task Position Management Executive Position Position honest in role performance Explaining Teaching and interpreting information to promote patient/family functioning and well-being Teaching and interpreting information to promote organizational functioning and enhanced services Teaching and interpreting organizational and communitybased health information to promote organizational functioning and service development (Yoder-Wise 14-15) Yoder-Wise, Patricia. Leading and Managing in Nursing, 6th Edition. Mosby, 102014. VitalBook file. PAGE 15 Serving as symbol Representing the nursing profession and the values and beliefs of the organization to patients/families and other community groups Representing the nursing unit service and the values and beliefs of the organization to staff, other departments, professional disciplines, and the community at large Representing the values and beliefs of the organization and patient care services to internal and external constituents 1Representing Representing Representing Representing the group nursing and the nursing and the unit in task the organization Renewing forces, total quality initiatives, shared governance councils, and other groups organization on assigned boards, councils, committees, and task forces, both internal and external to the organization and patient care services on assigned boards, councils, committees, and task forces, both internal and external to the organization Providing selfcare to enhance the ability to care for staff, patients, families, and the organization served Providing self-care to enhance the ability to care for staff, patients, families, and the organization served Providing self-care to enhance the ability to care for patients, families, staff, and the organization served engage with others to assess the current reality, determine and specify a desired end-point state, and then strategize to reduce the difference. When this is done well, the nurse and the patient or nurses within an organization experience creative tension. Creative tension inspires the patient and others to work in concert to achieve a desired goal. Shared visioning gives direction to accelerate change. Affirming Values Values are the connecting thoughts and inner driving forces that give purpose, direction, and precedence to life priorities. An organization, through its members, shares collective values that are expressed through its mission, philosophy, and practices. Leaders influence decision making and priority setting as an expression of their values. People (either patients or peers being influenced by the leader) also use their values to achieve their goals, which are then manifested through behavior. The word value connotes something of worth; intentional actions reflect our values. A leader continuously clarifies and acknowledges the values that draw attention to a problem and the resources in human and material terms to solve it. Values are powerful forces that promote acceptance of change and drive achievement toward a goal. Motivating When values drive our actions, they become a source of motivation. Motivation energizes what we value, personally and professionally, and stimulates growth and movement toward the vision. Motivators are the reinforcers that keep positive actions alive and sustained, fueling the desire to engage in change. Theories of motivation identify and describe the forces that motivate people. Examples of motivation theory are presented in the Theory Box on Motivation on pp. 9–11. Managing The ability to manage is an important aspect of organizational functioning, because management requires determining routines and practices that offer structure and stability to others. This is especially true in certain positions of influence within a clinical setting, such as a nurse manager, clinical nurse specialist, or clinical nurse leader, all of whom share responsibility for creating effective structures that support clinical and organizational outcomes. Being effective as a manager requires behaviors different from those associated with effective leadership, and vice versa. Ideally, those charged with managing are good leaders and followers, because no organizational position is limited to one exclusive set of behaviors over another. Good leaders need management skills and abilities, and good managers need leading skills and abilities, and good followers need both skills too. (Yoder-Wise 15-16) Yoder-Wise, Patricia. Leading and Managing in Nursing, 6th Edition. Mosby, 102014. VitalBook file. Leadership Theories in Practice NSG/451 Version 2 Leadership Theories in Practice Review the leadership theories on pages 9-11 and Gardner’s Tasks of Leading/Managing on pages 14-15 in Leading and Managing in Nursing. Complete the table below: • • • Summarize the main points of the theory in your own words in the Summary Definition column. Provide an example where you witnessed the theory in practice or suggest a situation where it could be applicable in the Practice Example column. Do not restate the Application to Practice column in the textbook; provide a unique example or suggest a possible scenario. Correlate at least one of Gardner’s task to the theory and practice example in the last column. Use at least five in-text citations in the table to support your summaries, practice examples, or application of Gardner’s Tasks. In the References section below the table, create an APA-formatted list to cite each resource. Theory Name Summary Definition Practice Example Trait Theories Style Theories SituationalContingency Theories Transformational Theories Hierarchy of Needs Two-Factor Theory Expectancy Theory Copyright © 2016, 2018 by University of Phoenix. All rights reserved. Application of Gardner’s Tasks 1 Leadership Theories in Practice NSG/451 Version 2 Organizational Behavior Modification References Copyright © 2016, 2018 by University of Phoenix. All rights reserved. 2
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NSG/451 v3: Leadership Theories in Practice

Review the leadership theories located in the Theory Box on pages 40-48 and Gardner’s Tasks of Leading/Managing Table 1-1 on pages 49-50 in Leading and Managing in Nursing.

Complete the table below: Leadership Theories In Practice

  • Summarize the main points of the theory in your own words in the Summary Definition column.
  • Provide an example where you witnessed the theory in practice or suggest a situation where it could be applicable in the Practice Example column. Do not restate the Application to Practice column in the textbook; provide a unique example or suggest a possible scenario. Leadership Theories In Practice
  • Correlate at least one of Gardner’s task to the theory and practice examples in the last column.

Use at least five in-text citations in the table to support your summaries, practice examples, or application of Gardner’s Tasks. In the References section below the table, create an APA-formatted list to cite each resource.

Theory Name Summary Definition Practice Example Application of Gardner’s Tasks
Trait Theories      
Style Theories   Leadership Theories In Practice  
Situational-Contingency Theories      
Transformational Theories      
Hierarchy of Needs      
Two-Factor Theory      
Expectancy Theory   Leadership Theories In Practice  
Organizational Behavior Modification      

 

References

 

 

 

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Assignment Content

  1.     Initiating best practices and effective strategies for innovation begins with highly effective interprofessional communication. One way to begin to establish yourself as a leader is to stay abreast of theories and evolving strategies and then inviting others to help you realize them at work. Being informed requires the ability to perform and process research. Leadership Theories In Practice

    After investigating several leadership theories, you will have the opportunity to organize your understanding of five examples by completing a worksheet for future reference and professional use. This worksheet can serve as a springboard for a catalog of best practices and strategies. Leadership Theories In Practice

    As you learned in NSG/416: Theoretical Development and Conceptual Frameworks, theory-guided practice improves patient outcomes because of purposeful systematic application. As you grow in the nurse leader role, you will see that the same holds true for theory-guided leadership. This assessment is designed to link leadership theory to practice and connect your past and current experience to help you grow as a leader. Leadership Theories In Practice

    For this summative assessment, you will compile your own theory reference guide. This guide will help you facilitate interprofessional communications when discussing rationales and plans for changes you believe will improve quality of care and the work environment.

    Complete the Leadership Theories in Practice worksheet to create a customized resource that classifies the theories you find relevant. It is a succinct venue for itemizing meaningful and actionable guidance for application in the workplace. This guide is a tool that you can grow throughout your career as you stay current in best practices while navigating change and challenges. Leadership Theories In Practice

    Submit your worksheet that includes an APA formatted title page and reference page for your 5 citations.

Leadership Theories In Practice

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Leadership Theories In Practice

A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject. Leadership Theories In Practice

However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations.

Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization. Leadership Theories In Practice

To Prepare:

  • Review the Resources and examine the leadership theories and behaviors introduced.
  • Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
  • Reflect on the leadership behaviors presented in the three resources that you selected for review. Leadership Theories In Practice

QUESTION

Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace Leadership Theories In Practice

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Leadership is the ability to guide, motivate, and inspire a group or organization toward the achievement of a common goal (Marshall & Broome, 2017). Effective leadership is the key for an organization to thrive. “Transformational leadership is a process through which leaders influence others by changing the understanding of others of what is important (Marshall & Broome, 2017). They are role models and inspire others to achieve extraordinary goals with their charisma, commitment, communication, creativity, and credibility (Marshall & Broome, 2017). A few key insights to becoming a successful leader is to act with integrity, set realistic goals, use effective communication, encourage and inspire others, and recognize the successes of your team members (AANAC, 2013). Leadership Theories In Practice

Example of Behaviors and Skills of a Leader

I work as a critical care float nurse and my current manager oversees all of the float nurses in the hospital. Since everyone usually works in different units around the hospital, she usually spends her day walking around the hospital to visit each float nurse to see if they need help with anything or have any issues that need addressed. Her leadership style can be described as servant leadership. Servant leadership describes leaders that influence and motivate others by building relationships and developing the skills of each individual team members (AANAC, 2013). Servant leaders also address each individual’s needs (AANAC, 2013). As a float, sometimes it can get really stressful, but our manager does a great job making sure we get the help we need. She also tries to build a community within our organization by hosting team building events outside of the workplace. It has been less than a year since she took this new leadership position, and it has already positively impacted the staff. The float staff have a more positive attitude and are receptive to the new changes that have been implemented. Leadership Theories In Practice

References

AANAC. (2013). Nursing leadership management & leadership styles. Retrieved from https://www.aanac.org/docs/white-papers/2013-nursing-leadership—management-leadership-styles.pdf?sfvrsn=4 Leadership Theories In Practice

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer Leadership Theories In Practice

Leadership Theories in Practice

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Leadership Theories in Practice

Analyze the effectiveness and impact of leadership skills

· Assess personal leadership traits

· Analyze how leadership traits can be applied to personal leadership philosophies and behaviors

· Develop a personal leadership philosophy

· Create a development plan related to personal leadership philosophies

To Prepare:

· Review the Resources and examine the leadership theories and behaviors introduced.

· Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.

· Reflect on the leadership behaviors presented in the three resources that you selected for review.

Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace. Leadership Theories in Practice

References:

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

· Chapter 1, “Expert Clinician to Transformational Leader in a Complex Health Care Organization: Foundations” (pp. 7–20 ONLY)

· Chapter 6, “Frameworks for Becoming a Transformational Leader” (pp. 145–170)

· Chapter 7, “Becoming a Leader: It’s All About You” (pp. 171–194)

Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence-based practices: Lessons from the field in six local health departments across the United States. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0891-3. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0891-3

Analyze the effectiveness and impact of leadership skills

· Assess personal leadership traits

· Analyze how leadership traits can be applied to personal leadership philosophies and behaviors

· Develop a personal leadership philosophy

· Create a development plan related to personal leadership philosophies

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To Prepare:

· Review the Resources and examine the leadership theories and behaviors introduced.

· Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.

· Reflect on the leadership behaviors presented in the three resources that you selected for review.

Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace. Leadership Theories in Practice

References:

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

· Chapter 1, “Expert Clinician to Transformational Leader in a Complex Health Care Organization: Foundations” (pp. 7–20 ONLY)

· Chapter 6, “Frameworks for Becoming a Transformational Leader” (pp. 145–170)

· Chapter 7, “Becoming a Leader: It’s All About You” (pp. 171–194)

Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence-based practices: Lessons from the field in six local health departments across the United States. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0891-3. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0891-3

Analyze the effectiveness and impact of leadership skills

· Assess personal leadership traits

· Analyze how leadership traits can be applied to personal leadership philosophies and behaviors

· Develop a personal leadership philosophy

· Create a development plan related to personal leadership philosophies

To Prepare:

· Review the Resources and examine the leadership theories and behaviors introduced.

· Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.

· Reflect on the leadership behaviors presented in the three resources that you selected for review.

Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace. Leadership Theories in Practice

References:

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

· Chapter 1, “Expert Clinician to Transformational Leader in a Complex Health Care Organization: Foundations” (pp. 7–20 ONLY)

· Chapter 6, “Frameworks for Becoming a Transformational Leader” (pp. 145–170)

· Chapter 7, “Becoming a Leader: It’s All About You” (pp. 171–194)

Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence-based practices: Lessons from the field in six local health departments across the United States. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0891-3. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0891-3 Leadership Theories in Practice

Leadership Theories in Practice

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Leadership Theories in Practice

A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.

However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations.

Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization. Leadership Theories in Practice

To Prepare:

· Review the Resources and examine the leadership theories and behaviors introduced.

 

· Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.

 

· Reflect on the leadership behaviors presented in the three resources that you selected for review.

 

· Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.

READING RESOURCES

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

· Chapter 1, “Expert Clinician to Transformational Leader in a Complex Health Care Organization: Foundations” (pp. 7–20 ONLY)

· Chapter 6, “Frameworks for Becoming a Transformational Leader” (pp. 145–170)

· Chapter 7, “Becoming a Leader: It’s All About You” (pp. 171–194) Leadership Theories in Practice

ARTICLE

Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence-based practices: Lessons from the field in six local health departments across the United States. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-0891-3. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0891-3 Leadership Theories in Practice

Abstract

Background

Administrative evidence based practices (A-EBPs) are agency level structures and activities positively associated with performance measures (e.g., achieving core public health functions, carrying out evidence-based interventions). The objectives of this study were to examine the contextual conditions and explore differences in local health department (LHD) characteristics that influence the implementation of A-EBPs.

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Methods

Qualitative case studies were conducted based on data from 35 practitioners in six LHDs across the United States. The sample was chosen using an A-EBP score from our 2012 national survey and was linked to secondary data from the National Public Health Performance Standards Program. Three LHDs that scored high and three LHDs that scored low on both measures were selected as case study sites. The 37-question interview guide explored LHD use of an evidence based decision making process, including A-EBPs and evidence-based programs and policies. Each interview took 30–60 min. Standard qualitative methodology was used for data coding and analysis using NVivo software. Leadership Theories in Practice

Results

As might be expected, high-capacity LHDs were more likely to have strong leadership, partnerships, financial flexibility, workforce development activities, and an organizational culture supportive of evidence based decision making and implementation of A-EBPs. They were also more likely to describe having strong or important relationships with universities and other educational resources, increasing their access to resources and allowing them to more easily share knowledge and expertise.

Conclusions

Differences between high- and low-capacity LHDs in A-EBP domains highlight the importance of investments in these areas and the potential those investments have to contribute to overall efficiency and performance. Further research may identify avenues to enhance resources in these domains to create an organizational culture supportive of A-EBPs. Leadership Theories in Practice

Peer Review reports

Background

The tenets of evidence-based decision making (EBDM) in public health have been formally developed over the past 15 years in several countries. Evidence-based decision making is a process that involves the integration of the best available research evidence, practitioner expertise, and the characteristics, needs, and preferences of the community [1–9]. In local health departments (LHDs), this process includes the implementation of administrative evidence based practices (A-EBPs) [9]. Administrative evidence based practices are agency level structures and activities positively associated with performance measures (e.g., achieving core public health functions, carrying out evidence-based interventions) [10]. There are five broad domains of A-EBPs: leadership, workforce development, partnerships, financial processes, and organizational culture and climate (Table 1). These domains were previously developed from a literature review of evidence reviews that aimed to identify administrative practices of varying priority, determined by the length of time needed to modify them or the strength of their research support [10]. The five broad domains, and their 11 subdomains, are described as both high-priority and locally modifiable in a short to medium timeframe [10]. Use of A-EBPs in LHDs is important because these practices have been shown to be effective in boosting performance, contributing to accreditation efforts, and may ultimately lead to improved health of the population [9, 10]. In addition, the Public Health Accreditation Board requires that LHDs use and contribute to the evidence base, and likewise requires effective administrative practices – thus use of A-EBPs may fulfill multiple domains within the LHD accreditation process [11]. Since LHDs in the United States are using A-EBPs to varying degrees [12, 13], it is important to examine the contextual conditions that influence the implementation of A-EBPs. The purpose of this study, then, is to explore differences in LHD characteristics that may in part explain the differences in implementation of A-EBPs. In particular, this study will focus on contextual differences between high- and low-capacity LHDs, further defined below. Leadership Theories in Practice

Table 1 Administrative evidence-based practices (A-EBPs)a in local health departments

Full size table

Methods

A mixed methods approach was utilized to expand upon quantitative findings from the LEAD Public

Health National Survey (LEAD survey) and further examine differences in LHD characteristics that influence the use of A-EBPs [12, 13]. Qualitative case studies were conducted among a select number of LHDs, in conjunction with a set of quantitative studies on the definition and use of A-EBPs in LHDs [9, 10, 12, 14–17]. The case study sample was selected using an A-EBP score from the LEAD survey (described elsewhere) [12] and secondary data from the National Public Health Performance Standards Program (NPHPSP). A set of A-EBP scores were derived from thirteen 7-point Likert scale questions from the LEAD survey and sum scores were then ranked into quartiles. Secondary data from the NPHPSP was linked to the LEAD survey; in concordance with NPHPSP scoring methodology, an overall performance score was computed as a simple average of the 10 Essential Public Health Services scores and then ranked into quartiles. “High-capacity” was defined as A-EBP scores in the top quartiles and “low-capacity” defined as scores in the bottom quartiles for both the LEAD survey and the NPHPSP. Leadership Theories in Practice

Three LHDs that were in the top quartile and three from the bottom quartile of both measures were used as case study sites. The 6 sites were selected to provide a variation in geographic dispersion, governance structure and jurisdiction size. A goal of 6–8 interviews was used to achieve content saturation. Previous research shows that meaningful themes can be developed after 6 interviews and saturation is often present with 12 interviews [18]. All of the LHDs that were selected and approached agreed to participate in this research Leadership Theories in Practice