PROF. LUNALLY S.

PAYBA,RN MSN
MANILA TYTANA COLLEGES
MANILA DOCTORS COLLEGE OF
NURSING

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LEADERSHIP AND
MANAGEMENT THEORIES

How these are being

Applied in the Clinical
Setting

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Definition of Leadership
• The ability to obtain followers through
INFLUENCE.
•Proverbs: He who thinks he leads and has
no one following him is only taking a walk.

Definition of Management

•It is the process of assuring that

the program and objectives of the
organizations are implemented as
planned.

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Leader
- Provide vision
and motivates
people;
- Goal-oriented
- Inspiring others
to do better
Manager
- Make sure things
happen through
other people;
-Task-oriented
- Making sure the
work is done by
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others
 LEADERSHIP MANAGEMENT
setting a new direction or controls or directs
vision for a group that they people/resources in a group
follow, ie: a leader is the according to principles or
spearhead for that new values that have already been
direction established
creating change planning and budgeting
aligning people through
organizing and staffing
empowerment

motivate and inspire toward

producing useful change and problem solving
achieve the vision 5
 3 fundamental qualities of
an effective leader -Bennis
and Nanus (1985)
1. Guiding Vision
2. Passion
3. Integrity
Basic Ingredients:
1. Daring
2. Curiosity

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 Characteristics of
Managers:
•Assigned position
•Source of power
•Carry out specific functions, duties & responsibilities
•Control, decision making, decision analysis & results
•Manipulate people, the environment, money, time &
other resources
•Formal responsibility and accountability for
rationality and control than leaders
•Direct willing and unwilling subordinates 7
 Characteristics of a good
director/leader
•Mclure& Hinshaw, 2002
• visionary and enthusiastic
Stodgil 1948, • supportive
1974 &knowledgeable
• Intelligence •Have high standards
• Self- &expectations
confidence •Value education & prof
• Determination development
• Integrity •Demonstrate status &
• Sociability power in the org
•Visible &responsive
•Communicate openly
•Active in prof.
8 organizations
 Characteristics of a good
director/leader
Murphy&DeBack, Kirkpatrick& Locke,
1991 1991
. Caring . Drive
. Respectful . Desire to lead
. Trustworthy . Honesty&integrity
. Flexible . Self- confidence
. Managing the . Cognitive ability
dream . Knowledge of the
. Mastering org.
change
. Designing org.
structure
. Learning &
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taking initiative
Management Levels
Top Managers: Responsible for the
performance of all departments & have
cross-departmental responsibility. They
establish organizational goals and
monitor middle managers.

Middle Managers: Supervise first-

line managers. They are also
responsible to find the best way to use
departmental resources to achieve
goals.

First-line Managers: responsible

for day-to-day operation. They
supervise the people performing the
activities required to make the good
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or service.
 MAJOR LEADERSHIP
THEORIES
ACCORDING TO
APPROACHES:

 BEHAVIORAL APPROACH
 CONTINGENCY APPROACH
 CONTEMPORARY
APPROACH
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Behavioral Approach Leadership Styles:
Kurt Lewin, 1930

Autocratic Democratic

Laissez- faire
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Autocratic Leadership:

Centralized decision- making

Situations where AL is used:

1.
2. Task or outcome is relatively simple
Most team members would agree with

3. the decision and provide consensus

A decision has to be made promptly

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Democratic Leadership
Participatory
Leader:

1. Ask the opinion of

2. the entire team

Final decision lies

3.
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on the leader
Mutual decision
making
Laissez- faire Leadership
Passive and permissive
leadership

Leader:
1. Defers decision making

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2 basic leaders behaviors in
behavioral leadership style:

Moorhead & Griffin 2001

1. job- centered- focus is on schedule,

costs, and efficiency

2. Employee- centered- focus is on the

human needs of the subordinates

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 Two dimensions of leader behavior
Researchers at Ohio State

1. Initiating structure- emphasis is on work

to be done, tasks, and production
Thus: planning, directing others,
establishing deadlines and details of how
work is to be done
2. Considerations- focus on the employee
and emphasize relating and getting along
with people

HIGH INITIATING STRUCTURE,

HIGH CONSIDERATION
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5 leader styles in production and people concern:

1. Impoverished leader for low

production concern and low people

2. concern
Authority compliance leader for high
production concern and low people

3. concern
Country club leader for high people

4. concern and low production concern

Middle-of-the-road leader for moderate

5. concern in both dimensions

Team leader for high production
concern and high people concern

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Contingency approaches:
Different leader behavior patterns
will be effective in different
situation

1.
2. Fielder’s contingency theory
Situational theory of Hersey

3.
4.
and Blanchard
Path- goal theory
Idea of substitutes for
leadership

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CONTINGENCY APPROACHES:
1. Fielder’s contingency theory

Patterns of leader behavior as dependent

upon the interaction of the personality of
the leader and the need of the situation.
Leader- member relations are the feelings
and attitude of followers regarding
acceptance, trust, and credibility of the
leader.

2. Situational Theory- addresses follower

readiness as a factor in determining
leadership style. Considers task behavior

-
and relationship behavior
Telling leadership style- high task low

- relationship behavior
Selling leadership style- high task high
relationship
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 -
2. Situational Theory-

Participating leadership style- low task

- high relationship
Delegating leadership style- low task low
relationship

3. Path- goal theory- leader works to

motivate followers and influence goal

--
accomplishment
Directive- structure and direction

--Supportive- relationship oriented

Participative- involving followers
Achievement- oriented- high structure
and direction, high support thru
consideration behavior

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4. Substitute for Leadership
FOLLOWERS’ CHARACTERISTICS:
Structured routine task
Feedback provided by the task
Intrinsic satisfaction in the work
Org. characteristics; cohesiveness of the
group
Formal org, rigid adherence
Low position power

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CONTEMPORARY APPROACHES:
LEADERSHIP FUNCTIONS NECESSARY TO
DEVELOP LEARNING ORGANIZATION AND
LEAD THE PROCESS OF TRANSFORMING

1.
CHANGE
Charismatic leadership- inspirational

2. quality promotes emotional connection

Transformational leadership- leaders
and followers raise one another to
higher motivation and morality;
empowerment, converts followers to

3. leaders, innovation and change

Knowledge workers- advance and
promise of technology, specialized,

4. expert knowledge
Emotional intelligence- recognizes

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5. own feelings and that of others
Wheatley’s new science leadership-
optimizes autonomy
From your personal
experiences, identify a
nurse whom you believe as a
good leader based in any
leadership theory and
explain why.

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•Management- the process of assuring that the
program and objectives of the organizations are

-
implemented as planned.
The process of planning, organizing,
staffing, leading, and controlling actions

- to achieve goals.
1990’S ART OF ACCOMPLISHING THINGS
THROUGH PEOPLE

1.
MANAGEMENT ROLES (MINTZBERG 1073):

2. INFORMATION PROCESSING ROLES

3. INTERPERSONAL ROLES
DECISION MAKING ROLES

FAYOL 1916/1949- PLANNING,

ORGANIZING, COORDINATING, AND
CONTROLLING
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Manager Resources:
1.
2. Human resources

3.
4.
Financial resources
Physical resources
Information resources

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 Self
Actualization,

Self Esteem

Belongingness

Safety and Security

Physiologic Needs

MOTIVATIONAL THEORY
ABRAHAM H. MASLOW’S HIERARCHY OF HUMAN NEEDS.
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based on a HOLISTIC DYNAMIC THEORY
SITUATION:

ANA IS A VOLUNTEER NURSE AT THE

TWILIGHT GENERAL HOSPITAL FOR
ALMOST 5 MONTHS, BEING THE CHIEF
NURSE YOU ARE CONSIDERING HER
REGULARITY AS A STAFF NURSE. HOW
ARE YOU GOING TO UTILIZE THE
MOTIVATIONAL LEADERSHIP THEORY IN
ANA’S CASE?
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 Advanced Competent Proficient
NOVICE nurse Expert Nurses
Beginner Nurse Nurses
•Practitioners •Able to •Performing •Nurses who •They are
who are task demonstrate the same look at the nurses whose
oriented and marginally role for 2-3 situations as expertise is so
focused acceptable years who a whole embedded
performance developed rather than a in their
the ability to series of tasks practice as
view their they
action as a intuitively
part of long know what is
range goals happening
set for their to their
patients. patients and
the
environment.

5 levels or stages of EXPERTISE-

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BENNER’S model

Basic Assumption: A leader should help followers grow in their

readiness to perform new tasks as long as they are able and
willing to go.
 SITUATION:
The ICU of ST. Gabriel Hospital has 10 patients and full house. The manager has 5 staff
nurses; one is Nurse Nora, the newest member of the staff, she assisted the other
staff nurse in all the procedures thinking that she can’t do something without
proper guidance. She is always task oriented and focuses in all the things that they
are doing because she wants to learn everything.
Nurse Linda was hired 6 months ago and starting to become independent in her
work, she is mostly assigned in the night shift and able to perform her activities
very well but still needs guidance during the endorsement. She demonstrates
marginally acceptable performance. N
Nurse Marie is the charge nurse of the day upon arrival, she started to plan and
arrange everything in order and what are the things she needs to accomplish. She
is conscious and deliberately plans the tasks she does. She was hired last January
20.
Nurse Barbie at the ICU, prior to the endorsement and rounds started her plan of care
for all the clients she is in charge of. She is expecting that their patient will exhibit
changes in their condition anytime thus, she see to it that everything is complete
and in order. She looks into the ward situation as a whole rather than anticipating
only the series of tasks.
Neil has been working in the unit for 5 years and is so embedded in his practice and
just by looking at the patients ,he knows what is happening. He is taking his
masters degree and planning to become a clinical specialist.
What are the 5 levels or stages of expertise in BENNER”s model and their
characteristics based on the situation and, what theory of leadership is
applicable in the situation?
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MOTIVATION THEORIES

Maslow’s Hierarchy of Needs

Scientific Management
Bureaucracy
Human relations
THEORY OF MOTIVATION
HYGIENE (Herzberg)
THEORY X and Y
THEORY M
THEORY Z- PARTICIPATIVE MANAGEMENT
TQM (Total Quality Manangement)

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Scientific Management

Scientific Management theory of

management was developed by
Frederick Taylor (1856- 1915) to
replace the “OLD THUMB
METHOD” What does it mean? If
you are the chief nurse and
planning to hire new staff nurses.
How will you apply this
managerial theory?
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 1. SCIENTIFIC MANAGEMENT
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Scientific selection,
Adequate compensation
training and dev’t. of
accdg to his
workmen in order to
accomplishment and
achieve optimum
friendly cooperation
efficiency
between the
management and
workers make sure that
work is being done

Equitable division of work, and

responsibilities between management
and workmen, giving everyone the
functions in which they are best suited ;
preserving their own individuality in the
exercise of their initiative.
 After passing the Board Exam and 3 years
experience as an Emergency Nurse at the
Philippine General Hospital, you applied and is
hired as a staff nurse at the United Kingdom.
Would you prefer to work with BUREAUCRAT type
of management style? Why and why not?

LET US SEE…

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 2. BUREAUCRATIC MANAGEMENT
STYLE
Involves clear cut
Highly structured form
division integrated Role assignments are
of administration and
activities regarded as based on TECHNICAL
no participation by the
duties inherent in the QUALIFICATION.
governed.
office.

AUTHORITY STRUCTURE are trained

and salaried experts who are
governed by general abstract and Favouritism
clearly defined rules for the
issuance of specific instructions for is reduced
specific case.

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Characteristics :
Formality- written specification
Low autonomy- memoranda and minutes
A climate of rules and conventionality-
centralization
Division of works- control
Specialization- emphasis on high level of
efficiency
Standard procedures- production

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 IF YOU WILL BE HIRED AS A STAFF NURSE AFTER
PASSING THE BOARD EXAM, USING THE THEORY OF
MOTIVATION-HYGIENE... WHAT ARE THE FACTORS
THAT YOU WOULD LIKE YOUR COMPANY TO
ADDRESS?
 WOULD YOU CONSIDER HUMAN RELATIONS
THEORY? WHY? WHY NOT?

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Harmonious relationship
among employees ,they
work together in a most
pleasing manner

Integration of people into work situation in a

way that motivates them to work
productively, cooperatively and with
economic, psychological and social
satisfaction. 38
 4. THEORY OF MOTIVATION
HYGIENE (Herzberg)
Scientific management of motivational factors
like good working conditions, status, job
security and salary as hygienic so that
employees would perform adequately on the
job.
Other factors:

1. Recognition for achievement

2. Responsibility

3. Nature of work itself

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4. possible growth
What would you
prefer to apply
Theory X or Y or
M? WHY?
IF YOU ARE THE NURSE
MANAGER
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5. THEORY X AND Y
( THE HUMAN SIDE OF THE ENTERPRISE BY MC
GREGOR)

X- the traditional view of direction and

control
Y- integration of individual and operational
goals.

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Douglas McGregor: Theory Y
Born in the year 1906; - Consider effort at work
passed away 1964 as just like rest or play
-Ordinary people who do
not dislike work.
-work could be
considered a source of
Theory X satisfaction or
- dislike work punishment
- lack ambition, dislike
responsibility & prefer
- Individuals who seek
to be led responsibility (if they are
-desire security motivated)
-a business would need
to impose a
management system of
coercion, control and
punishment. 42
6.THEORY M FOR  Factors vary in relative
MANAGEMENT importance according to
conditions at the time .
1. Some people dislike
responsibility and prefer to
be led.
3. Majority fall somewhere in 2. Others are ambitious and
between. want to be leaders

Successful manager
recognizes that no persons nor
problems are the same,
therefore, different types of
behaviour are necessary at
different times in order to best 43
help the work group to
achieve team goals.
7. THEORY Z- PARTICIPATIVE MANAGEMENT
 CHARACTERISTICS
1. Long term (lifetime)
employment
 Model based on
JAPANESE concept of 2. Slowed down rates of
organization and of evaluation and promotion
recent appearance 3. More implicit and less
in American formalized control system
Management 4. Personal concern for the
 W.G Ouchi (1981) employee
estimated that the 5. Cross functional rotation
process might take
6. Some degree of participative
from 10 -15 years.- consensual decision making
and emphasize on the
individual responsibility,
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USING THE TQM
MANAGERIAL THEORY,
IDENTIFY ONE COMPANY
OR GROUP OF
COMPANIES WHERE IN THIS
IS APPLIED, STATE THE
REASON WHY YOU SAID
SO.

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8. TQM (TOTAL QUALITY MANAGEMENT)

 Referred as Quality Improvement (QI) and Performance

Improvement (PI)
 are systematic process to improve outcomes based on
customer’s needs.
 Pro active approach, emphasizes, doing the right thing for
customers, result of this method -to satisfy customers.
 Approaches (Contingency)
 Basic managerial roles (Leadership, informal, decisional role)

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 SITUATION:
Nurse Lyca is the Supervisor of Medical Surgical unit of Benidictine
Medical Center. As a nurse manager, she always expects her people
to work at their best and she see to it that everything is always correct
and in place, so she makes decisions alone. She is more concerned
with task accomplishment and with no concern for the people. If some
of her staff commit mistakes she tends to be hostile with aggressive.
In the OB-Gyne unit, Gwen is the unit manager and, all her staff like the
way she handles them because she involves them in the decision
making process. She is a person oriented leader and she focuses on
Human relations and teamwork that leads to increase productivity
and employees job satisfaction.
The Emergency room supervisor is Joy. She tends to leave her post most
of the time doing some business at the other floor for extra income.
She is very loose and permissive and abstain from leading her area.
She fosters freedom for all the staff cause she wants everyone to feel
good. Her leadership style results in increasing cases of death in her
area and staff frustration.
* What is the leadership theory applicable in these situations? What is the
leadership style of each nurse managers as displayed by their
behaviour.

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COLUMN 1 COLUMN 2
_____1. selection, training and dev’t. of workmen a. TQM
in order to achieve optimum efficiency
_________2. Highly structured form of administration b. Theory Z
where there is no unusual participation of
employees.
________3. Equitable division of work, and c. Theory M
responsibilities between management and
workmen, giving everyone the functions in which
they are best suited
__________4.Integration of people into a work d. Theory X
situation through motivation in terms of economic,
psychological and social satisfaction.
___________5. This theory assumes that the e. Theory Y
average person inherently dislikes works,etc.
___________6. Theory on the integration of f. Theory of motivation-
individual and operational goal. Hygiene
_________7.Refers to good working g. Human Relation
conditions,status job,security, and salary as
motivators for employees.
_________8. It means doing right towards quality h. Bureaucracy
improvement of services.