Transcript Leadership and Supervision

Leadership
and
Supervision
EFREN N. AQUINO M.D.
JUNE 16, 2008, JULY 7, 2009
Leadership and Management
 Leadership
The
art of getting others to want to
do something you are convinced
should be done
 Management
Handles
the day-to-day operations to
achieve a desired outcome
LEADER: A person who uses specific
skills, such as role modeling to
influence others to accomplish a task
or do the work.
 MANAGER: Coordinates and controls
the work of others. A manager is
involved with organizing, planning,
directing and controlling

LEADER = influences others
 MANAGER = controls others


LEADER = influences others

MANAGER = controls others
Leadership

Leadership involves qualities related to a
person's character and behaviors, as well as
roles within a group or organization. It
requires that a person have the ability to
guide and influence another person, group,
or both to think in a certain way, achieve
common goals, or provide inspiration for
change. Marquis and Huston (2003) state that
leaders:
 Often do not have delegated authority, but
obtain their power through other means,
such as influence.
 Have a wider variety of roles than do
managers.
 May not be part of the formal organization.
Leadership
 Leaders:
 Focus on group process, information
gathering, feedback, and empowering
others.
 Emphasize interpersonal
relationships.
 Direct willing followers.
 Have goals that may or may not
reflect those of the organization.
Leadership

Leaders:

Any healthcare provider has the potential
to be a leader in terms of influencing a
group or exercising power in a
particular situation. Accordingly, LPN/LVNs
also may be leaders, informally or formally.
For example, an LPN working on a medical–
surgical unit may assume responsibility for
organizing social events for fellow
employees. A more formal leadership role
would be acting as co-chairperson of the
unit's staffing policy committee.
STYLES OF LEADERSHIP
1. AUTOCRATIC
2. BUREAUCRATIC
3. DEMOCRATIC
4. LASSEZ-FAIRE
 AUTOCRATIC
Retains
Style
all authority and responsibility
Concerned primarily with tasks and
goal accomplishment
Assigns clearly defined tasks
Establishes one-way communication
with the group
Excels in times of crisis (cardiac
arrest) and in situation of disorder
(natural disasters)
Works well with newly graduates
 AUTOCRATIC
Tasks
Style
are accomplished without
questions.
Communication is directive and flows
downward.
Lines of authority and policies are
clear.
Decisions are made quickly.
 AUTOCRATIC
Style
DISADVANTAGES
 Subordinates
have little input into
decision- or policy-making and
receive little feedback or
recognition.
 Staff members are not invested in
management's goals.
 Leaders may create hostility and
dependency.
 Work is highly controlled and
dictated.
 BUREAUCRATIC:
Policy-minded
Leaders
rely on established
protocols for decision making.
The policy and procedure manual of
healthcare facility offers step-by-step
instructions; the leader will consider
them as rules.
This style like the Autocratic style is
often helpful for new graduates who
need detailed instructions.
 DEMOCRATIC
People-centered
approach
Allows employees more control and
participation in the decision-making
process
Emphasis is on team building and
collaboration
Works best with mature employees
who work well together as groups
 DEMOCRATIC
Disadvantages
 Decisions
may not occur in a timely
way.
 Staff members may fail to
acknowledge the manager's role.
 Employees do not recognize the
need for urgent decisions that are
made without staff input.
 LAISSEZ-FAIRE
“Free-run
style” or permissive
leadership
Relinquishes control completely
Chooses to avoid responsibility by
delegating all decision making to the
group
Wants everyone to feel free to “do
their own thing”
May work well with highly motivated
professional groups
Laissez-Faire Leadership
Unstructured leadership where a
manager gives subordinates direct
decision-making responsibilities.
 While this is the weakest form of
management style, it is consistent with
employee empowerment.
Laissez-Faire Leadership

Disadvantages
Employees receive little direction or
guidance.
Generally, decisions are not made
because managers are unable or
unwilling to make them
Staff members do not receive
feedback regarding their
performance.
Empowerment
Form of Participative Management where
employees share management
responsibilities, including decision
making. Self-directed work teams are an
outgrowth of empowerment where
employee groups establish and
implement their own work goals
Participative Management
An open form of management where
employees have a strong decisionmaking role.
 Participative management is developed
by managers who actively seek a strong
cooperative relationship with their
employees.
 The advantages of participative
management include increased
productivity, improved quality, and
reduced costs.
Participative Leadership
 Consultative management method that
encourages others to participate.
 Leadership decisions are achieved as
the end result of group participation.
Participative management is the
process of consultative management.
CHARACTERISTICS OF AN EFFECTIVE
MANAGER
 Being a good manager requires sound
communication, decision-making and
problem solving skills
 A desire to manage – comfort with the
position
 Trust in one’s own judgment – ability to
work without constant guidance from
others
 Skills in stress management
Motivation to guide and to work with
people, not just to attain power
 Ability to make competent decisions,
especially in emergencies
 Ability to channel others’ feelings and
hostility into constructive problemsolving
 Ability to handle different situations

QUALITIES OF AN EFFECTIVE LEADER
1. Self-confidence
2. Self-awareness
3. Strong personal values
4. Skills of Value Clarification (choosing
freely from alternatives, prizing the
choice and acting consistently on that
choice.
5. Advocacy (the act of arguing on behalf
of a particular issue, idea or person).
6. Accountability (taking responsibility for
values and actions)
Situational Leadership


Takes into account the style of the
leader, the maturity of the group, and
the situation at hand to form a
comprehensive approach
Four typical styles
1.
Directing
 Provides specific instructions and
supervises the accomplishment of
tasks
 New employees, employees with
repeated performance problems, and
crisis work situations
2. Coaching
 Monitors the accomplishment of
tasks while also explaining
decisions, asking for feedback or
suggestions, and recognizing good
performance
 Typically, leader and staff have
jointly developed a work plan.
3. Supporting
 Supports the efforts of others,
facilitates their goal accomplishment,
and shares responsibility for decision
making
 Values growth and not perfection,
collaboration and not competition
4. Delegating
 Gives responsibility for decision
making and problem solving to
mature staff who have demonstrated
their competence
LVN/LPN AS CHARGE NURSES
1. Responsible for getting shift reports
2. Assign clients to staff members
3. Determine client acuity
4. Handle emergencies
5. Assign staff breaks
6. Attend special meetings
7. Attends to client tests and procedures
8. Ensure availability of needed supplies
and equipments
9. Count narcotics at the beginning and
end of the shift
10. Check the crash cart
11. Report to the nursing supervisor
12. Check staffing for the next shift
13. Send client acuity reports to
administration.
Leadership and Management

Team Leading
Assisting and guiding the nursing team
in providing care for a select group of
patients
Duties
 Receive
reports on assigned patients
 Make assignments for team members
 Make rounds and assess all assigned
patients
 Assist in administering medications and
treatments
 Confer with team members on priority
patients
 Time
Management
Using
time to good advantage will be
of great value.
Learn effective time management
skills, and practice them frequently
until they become fully developed.
These skills will help you manage not
only at work but also in daily living.
 Anger
Management
Anger
gives you a cue that
something is wrong.
Justified
 Helps you get your needs met by
stimulating you to action
Unjustified or displayed
inappropriately
 Can get you and others in trouble
Burnout
Physical,
emotional, and spiritual
exhaustion
Occurs more often in people who
have excessively high expectations
of themselves
High-risk areas
 Intensive
care
 Hospice
 Oncology
 Emergency
department
 Burnout
(continued)
Signs
and symptoms
 Physical
Fatigue;
changes in sleeping and eating
Lack of energy; loss of interest in sex
 Psychologic
Irritability; hypersensitivity
Frustration; negative outlook
Forgetting
 Spiritual
Loss
of commitment, meaning, and
integrity
BURN OUT
SYNDROME
Symptoms of burnout.
 Transcribing
Physicians’ Orders
Written
 Recorded
on the chart by the
physician.
 NEVER GUESS: If in doubt, get a
second opinion.
 If it is a little different that “usual,”
clarify it with the physician.
Transcribing Physicians’ Orders
Written
 If
you still believe the orders to be
inappropriate, contact your
supervisor and document why the
orders are not being carried out.
 Nurses are responsible for their
own actions regardless of who told
them to perform those actions.
Clarifying the physician’s order.

Transcribing Physicians’ Orders (cont’d)
 Verbal
or via telephone
 They may only be taken from a physician
or a nurse.
 They are more subject to error.
 Clarify the order by repeating it to the
person giving it.
 Ask them to repeat it more slowly if
necessary.
 Write it down immediately.
 Be careful about medications that sound
alike.
For example, Zantac and Xanax
Computerized system for narcotic
distribution.
Giving a change-of-shift report.
 Change
The
of Shift Report
report provides the next shift with
pertinent information about the patient.
The quality of nursing care the patient
receives is contingent on how well each
shift communicates with the other.
The report may be given orally in
person, by audiotape recording, or with
rounds from patient to patient.
Before beginning the report, write down
all necessary information.
Malpractice Insurance:
Chemically Impaired Nurses
16. You are ready to give end-of-shift report to C.D., who will
be in charge of your unit for the next shift; when she
arrives, 15 minutes late, she does not have eye contact
with you, smells of mints, her hands are trembling, her
uniform is disheveled, and her shoes are untied. She asks
you no questions regarding any patients, and leaves the
room when your report is completed. What do you do?
A. Go home, your shift is completed.
B. Call the supervisor and report your observations.
C. Stay on the unit until you are sure C.D. has no
questions regarding the patients.
D. Call the state board of nursing and report C.D.'s
behavior.
17. After C.D. has begun,a substance abuse
outpatiert treatment program, she is allowed to
return to work, with supervision. Which statement
by C.D. indicates that she is recovering from her
substance abuse problem?
A. "I wish I knew who turned me in to administration; I would
like to give that nosy witch a piece of my mind!"
B. “Just because I had a glass of wine with a meal before I
came to work once or twice, I'm going to be watched
like a hawk. What a pain!"
C. "I realize that I'm going to have to regain the trust of my
co-workers and administrators, but I can do that, one
day at a time."
D. "If other people took their jobs as seriously as I take
mine, they wouldn't have time to rat on other people."
LEADERSHIP
 The nurse is a leader, not only in the
healthcare facility, but also in the
community.
 Take this responsibility seriously, for
other people look up to nurses.
 The nurse continues to learn throughout
the career and throughout life.
***
1. Which of the following roles of a nurse is an
example of legitimate power?
A) Director of nursing
B) Team leader making assignments
C) Head nurse scheduling vacations
D) Shift supervisor
1. Which of the following roles of a nurse is an
example of legitimate power?
A) Director of nursing
B) Team leader making assignments
C) Head nurse scheduling vacations
D) Shift supervisor
 Ans: A
 Difficulty: Easy
2. Which of the following are the advantages of
autocratic leadership styles?
A) Staff members are invested in management's
goals.
B) Lines of authority and policies are clear.
C) Communication is limited to memos.
D) Decisions may not occur on time.
2. Which of the following are the advantages of
autocratic leadership styles?
A) Staff members are invested in management's
goals.
B) Lines of authority and policies are clear.
C) Communication is limited to memos.
D) Decisions may not occur on time.
Ans: B
Difficulty: Moderate
3. When delegating tasks to unlicensed assistive
personnel (UAP), a licensed practical nurse
(LPN) should assess the situation. Which of the
following is the first step involved in assessing
the situation?
A) Communicate expectations clearly to UAP.
B) Identify the UAP who will best handle the
delegated tasks.
C) Know the client's needs and priorities.
D) Trust the UAP to complete the task.
3. When delegating tasks to unlicensed assistive
personnel (UAP), a licensed practical nurse
(LPN) should assess the situation. Which of the
following is the first step involved in assessing
the situation?
A) Communicate expectations clearly to UAP.
B) Identify the UAP who will best handle the
delegated tasks.
C) Know the client's needs and priorities.
D) Trust the UAP to complete the task.
Ans: C
Difficulty: Moderate
4. A licensed practical nurse (LPN) has delegated a
task to unlicensed assistive personnel (UAP).
Identify the person who is accountable for
evaluating the results of the tasks?
A) Physician
B) Shift supervisor
C) UAP
D) LPN
4. A licensed practical nurse (LPN) has delegated a
task to unlicensed assistive personnel (UAP).
Identify the person who is accountable for
evaluating the results of the tasks?
A) Physician
B) Shift supervisor
C) UAP
D) LPN
Ans: D
Difficulty: Easy
5. How do licensed practice nurses
(LPNs)/licensed vocational nurses (LVNs)
function as client advocates?
A) By knowing the client's need
B) By supporting the client's decision
C) By communicating expectations
D) By delegating tasks to unlicensed assistive
personnel (UAP)
5. How do licensed practice nurses
(LPNs)/licensed vocational nurses (LVNs)
function as client advocates?
A) By knowing the client's need
B) By supporting the client's decision
C) By communicating expectations
D) By delegating tasks to unlicensed assistive
personnel (UAP)
Ans: B
Difficulty: Easy
END