•
All participants in the organization are innovators who contribute to meeting the goals of the organization.•
Leaders/managers are involved in new developments while existing processes are maintained.•
People are a part of the systems, and they must be con-sidered together.•
Revenues and expenses must coexist within an organiza-tion; for example, expenses must be controlled to allow for financial solvency, but there must be trust that the funding will be present for required expenses.•
To be effective leaders, managers must possess both long- and short-term perspectives. They must manage daily operations while planning for the future.•
Leaders/managers determine the “what and why”; thus, the “how and when” follow naturally to accomplish the organization’s vision.•
Leaders/managers must be open to change and manage change effectively.•
Leaders/managers must always seek authenticity.•
Leaders/managers do the right things in the right way once a course of action has been determined.•
Leaders/managers lead people.•
Leaders/managers manage peers, competitors, and cus-tomers by developing collaborative relationships that result in outcomes that are positive for all yet tailored to meet the needs of the constituent groups.•
Leaders/managers use reflective journaling to facilitate reflection and think about patterns to gain a perspective of the work environment.•
Leaders/managers have an analytical mind-set. Data are collected and interpreted in the light of the organization’s mission, goals, and relationships.•
Leaders/managers have a worldly mind-set by under-standing the organization and its relationship to the community and world from diverse perspectives.02Jones Leadership(F)-ch 02 1/14/07 3:32 PM Page 24
greater the number of people whose views have been considered, the greater will be the support for the change. A paradox that exists within organ-izations is that frequently there is an artificial time constraint placed on decision making, suppos-edly to move the organization along more rapidly.
A decision made quickly without adequate consid-eration and input can often result in an excessive amount of time being required to respond to the problems associated with rapid, uninformed change. A wise leader negotiates for the time to make a well-informed decision and thus avoids the frustration and time associated with negative out-comes of hasty decision making.
COMMUNICATOR
Information is power. Current literature recognizes the importance of keeping the members of an organ-ization informed about issues with which they are involved. Many health-care organizations function around the clock, which can make the role of com-municator more complex. Personal face-to-face communication is optimal, so managers must make every effort to stagger their hours in the organ-ization to allow this communication on a regular basis. Both formal and informal communication is important. Managers who make time for informal communication will have a more accurate under-standing of the issues with which the knowledge workers are dealing; will develop more open, trust-ing relationships within the organization; as well as a greater understanding of factors affecting morale.
In the past, communication books were used as a way to enhance “asynchronous” communication among various shifts of workers. Today’s computer technology supports communication through list-serves, e-mail, and discussion boards. If an organi-zation is not taking advantage of the technology that is available, the manager should investigate the availability and understanding of that technology.
An important aspect of communication is that it must be mutual. In bureaucratic organizations information often flows only downward, and there is a propensity for the information to fail to reach the unit level. Moreover, information rarely moves from the unit level up the hierarchy, leaving the higher-ups out of touch. This type of communica-tion is a sure recipe for disaster. Under these cir-cumstances, the knowledge workers on the unit are
lacking important information about their environ-ment, and their contributions cannot be fully informed. Likewise, individuals responsible for guiding the overall vision of the organization are uninformed about day-to-day happenings, which makes it difficult to create realistic strategies.
NEGOTIATOR
The nurse manager must exhibit excellent negotia-tion skills. These skills are important in helping a team arrive at decisions, gaining organizational sup-port for a new plan, gaining the cooperation of another department or organization, and in many other facets of the manager’s role.
The first rule of negotiation is to understand the positions of the stakeholders, including nurses, patients, interdisciplinary professionals, community members, families of patients, unlicensed assistive personnel, and administration. Communication is an important part of negotiation, and one of the vital attributes of a negotiator is to encourage discussion and trust among group members. Many times, nego-tiation surrounds a decision in which it is perceived that there will be “winners” and “losers.”
Negotiation focuses on understanding who the per-ceived winners and losers are; the best negotiations result in win-win solutions. Ask the question,
“Under what circumstances do you think this goal can be accomplished?” This question frequently moves participants from a defensive position to one of creativity and innovation, and it uses the concept of establishing an attractor, which causes people to come together to discuss possibilities.
DELEGATOR
Delegation is no longer a “top-down” activity.
Instead, the leader will recognize the wisdom of members of the health-care team, support the inter-connectedness of team members in the health-care delivery system, and embrace a more fluid, innova-tive system. The manager will foster an environ-ment that supports the notion of associates (1) being partners in the delivery of health care, (2) being accountable for evaluating the outcomes of their interventions, (3) having the equity in the organization to make “point of service delivery”
decisions, and (4) feeling a sense of ownership in the organization (Wilson & Porter-O’Grady, 1999).
Management Theory 25
02Jones Leadership(F)-ch 02 1/14/07 3:32 PM Page 25
MENTOR
It is often said that effective managers are always in the business of replacing themselves so their profes-sional development and advancement can continue.
Mentorship is the process to accomplish this. The identification of potential protégés can occur through a variety of methods. Team members who express an interest in leadership, individuals who have recently taken on new leadership roles, and professionals who show promise in the area of lead-ership through their interactions with others are all likely candidates. Mentoring relationships can be formal (assigned through an organization) or infor-mal (simply a handshake agreement between a sea-soned leader and an aspiring one). Sigma Theta Tau International, the nursing honor society, is an example of an organization that seeks to foster for-mal mentoring relationships, as does the American Association of Colleges of Nursing.
Whether a mentoring relationship is formal or informal, there are a few guidelines for success.
Mutual respect, goal setting, accountability to each other, and open dialogue are hallmarks of an effec-tive mentoring relationship. The mentoring rela-tionship must be mutually rewarding; it must
involve the opportunity for real work and stimulat-ing challenges; there must be agreement on owner-ship of any projects created through the partnerowner-ship;
and the relationship must remain on professional grounds at all times. The mentor has the responsi-bility to create opportunities for professional growth and involvement, whereas the protégé is responsible for responding to these opportunities. The mentor has the responsibility to provide opportunities for the protégé to gain recognition for the work accom-plished; the protégé is accountable for being respon-sible and reliable with the work accepted. The mentor empowers, encourages, and challenges the protégé. All nurses have a professional respon-sibility to mentor new members of the profession.
See Table 2-5.
All Good Things…
Management has evolved from its emphasis on con-trol and measurement as conceptualized by Taylor, Fayol, and Weber. These strategies were helpful during the industrial revolution, but in the 21st cen-tury they are less useful for organizations that rely 26 Understanding the Theory of Leading, Following, and Managing
TABLE 2-5 Roles and Competencies of Nurse Managers
ROLES AND COMPETENCIES ACTIVITIES RELATED
OF THE MANAGER TO COMPETENCIES
Personal
Client
Organizational
Values clarification; lifestyle management; goal setting; alignment with organizational mission, goals, and objectives.
Nurtures relationships with organizational leadership and other key per-sonnel within the organization.
Develops strong liaisons with health-care leaders in the community.
Recognizes needs of clients in area of responsibility.
Maintains evidence-based practice behaviors.
Assesses and recognizes the needs of the client population and applies appropriate principles of delegation, interdisciplinary team care, educa-tion, and evaluation of outcomes.
Represents the organization to the community, serves as a mentor to new nurses, encourages professional behavior in others, role-models professional nursing, holds membership in professional organizations, and supports continuing education.
Communicates the organization’s mission, goals, and objectives to the staff and community; facilitates communication and negotiation among members of the organization.
Self-management Collaborator
Networking Advocate Provider of care Coordinator of care
Member of the profession Communicator
02Jones Leadership(F)-ch 02 1/14/07 3:32 PM Page 26
on the daily contributions of knowledge workers.
The evolving management theories recognize the complexity of the work involved in professions such as nursing. “The uncertainty of healthcare flows from the quantum and chaotic nature of the world over time. Therefore, we should stop trying to plan every step and predict each happening. Indeed, we must realize that we can never come close to knowing all there is to know about a topic or plan-ning every step. . . . Hence we have to accept that no matter how much we know about the world, there are far more questions than there are answers, and uncertainty is a natural part of our lives”
(Grossman & Valiga, 2005, p. 125).
NCLEX Questions
1. Which of the following theorists represents a tra-ditional management viewpoint?
A. Fayol.
B. Hock.
C. Ouchi.
D. Hawthorne.
2. The individual recognized as the “father of sci-entific management” is:
A. Fayol.
B. Weber.
C. Taylor.
D. Ouchi.
3. Traditional management theory was designed to provide control and structure to which types of organizations?
A. Hospitals.
B. Scientific laboratories.
C. Manufacturing industry.
D. Institutions of higher education.
4. Complexity science has developed from the field of:
A. Health professions.
B. Business.
C. Industry.
D. Quantum physics.
5. In complexity science, the movement of an organization as it changes from one attractor or mission statement to another is known as:
A. Leverage.
B. Bifurcation.
C. Chaos.
D. Order.
6. Japanese organizations are known for their:
A. Short-term commitment to their employees.
B. Individual approaches to decision making.
C. Rapid promotion of employees.
D. Development of consensus.
7. Fayol’s principle of esprit de corps refers to:
A. Subordination of individual interest to the common good.
B. Development of a high level of employee morale.
C. Encouragement of initiative and risk taking.
D. Emphasis on goal setting.
8. Max Weber is known for the development of which management theory?
A. Bureaucratic management.
B. Scientific management.
C. Humanistic management.
D. Transformational leadership.
9. Which of the following management theorists conducted the famous experiment at the Hawthorne Electric Plant in which employee productivity increased regardless of the type of intervention implemented at the plant?
A. Weber.
B. Mayo.
C. McGregor.
D. Hock.
10. Dee Hock recommends that managers spend what percentage of their time managing the employees for whom they have direct responsi-bility?
A. 0%.
B. 50%.
C. 75%.
D. 100%.
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