Nursing leadership and management phần 6

01Jones Leadership(F)-ch 01 1/14/07 3:30 PM Page chapter Leadership and Followership THERESA M VALIGA, EDD, RN, FAAN SHEILA GROSSMAN, PHD, APRN-BC CHAPTER MOTIVATION “Cautious, careful people always casting about to preserve their reputation and social standing, never can bring about a reform Those who are really in earnest must be willing to be anything or nothing in the world’s estimation.” Susan B Anthony CHAPTER MOTIVES ■ ■ ■ Distinguish between leadership and management Compare characteristics of effective followers with those of leaders Discuss how all nurses can provide leadership in and for the profession 01Jones Leadership(F)-ch 01 T 1/14/07 3:30 PM Page Understanding the Theory of Leading, Following, and Managing oday’s climate demands individuals who are flexible, creative, and able to empower others to be flexible and creative With the nursing shortage, managed care, higher patient acuity, fewer resources, highly diverse demographics, and outside influences, nurses need to be more effective leaders than ever as they manage patients in various settings But what is an effective leader without effective followers? This is also a time when nurses need to be effective followers, knowing who to follow, when to follow, how to follow, and how to use the follower role most powerfully Because most of us are followers more often than we are leaders, the art of followership is a concept that needs to be explored in any contemporary discussion of leadership and management Burns (2003) viewed leadership as “a master discipline that illuminates some of the toughest problems of human needs and social change” (p 3) Others suggest that leadership is about having a vision and getting people to follow, using the art of persuasion Then there are some who equate leadership with management and use the words interchangeably Bennis and Nanus (1985) described the phenomenon of leadership as well studied, with each interpretation providing a sliver of insight but none providing a holistic and adequate explanation Sashkin and Sashkin (2003) took a rather simplistic, but helpful, perspective on leadership, stating that leadership that matters is the critical factor that makes a difference in people’s lives and organizations’ success Many experts have described leadership as encompassing the leader’s personality, the leader’s behavior, the talents of the followers, and the situational context in which leadership takes place These experts also tend to agree that leadership can be learned Knowing that leaders are not necessarily born but made, therefore, is an important concept when one considers that all nurses must be looked to as leaders in and for the profession Nursing’s focus today is on delivering quality and cost-effective patient care rather than on accomplishing a list of nursing tasks This focus requires that nurses fulfill both leadership and follower roles effectively This chapter will explore the concepts of leadership and followership and discuss how nurses can improve their abilities to lead and follow Leadership Theories— Past and Contemporary In order to understand the phenomenon of leadership and how contemporary perspectives shape leadership behaviors, it is helpful to know how views about leaders and leadership have changed over time A brief outline of several of the more significant leadership theories provides such a context GREAT MAN THEORY Just by reading the name of this theory, Great Man, one can imagine that it is not widely accepted today Yet this was precisely how the world thought of leaders for many years This theory assumed that all leaders were men and all were great (i.e., of the noble class) Thus, those who assumed leadership roles were determined by their genetic and social inheritance It was not conceivable that those from the “working class” could be leaders, that leadership could be learned, or that women could be leaders TRAIT THEORIES During the early part of the 20th century, several researchers studied the behaviors and traits of individuals thought to be effective leaders Studies revealed that these leaders possessed multiple characteristics Although there were commonalities among them (e.g., they tended to be taller, be more articulate, or exude self-confidence), there was no standard list that fit everyone or that could be used to predict or identify who was or could be an effective leader SITUATIONAL OR CONTINGENCY THEORIES These theories embodied the idea that the right thing to depended on the situation the leader was facing The most well-known and used situational theory involves assessing the nature of the task and the follower’s motivation or readiness to learn and using that to determine the particular style the leader should use Despite widespread discussion and use of this theory, however, little research exists to support its validity 01Jones Leadership(F)-ch 01 1/14/07 3:30 PM Page Leadership and Followership TRANSFORMATIONAL THEORY A new way of thinking about leadership emerged in the mid-1970s when James McGregor Burns asserted that the true nature of leadership is not the ability to motivate people to work hard for their pay but the ability to transform followers to become more self-directed in all they Transformational leaders, therefore, “look for potential motives in followers, seek to satisfy higher needs, and engage the full person of the follower The result is a relationship of mutual stimulation and elevation that converts followers into leaders and may convert leaders into moral agents” (Burns, 1978, p 4) Barker (1990) asserted that transformational leaders need to have a heightened self-awareness and a plan for self-development This positive selfregard satisfies the leader’s self-esteem needs and tends to result in “self-confidence, worth, strength, capability, adequacy, and being useful and necessary” (Barker, 1990, p 159) NEW SCIENCE LEADERSHIP Wheatley (1999) took this paradigm a step further when she described leadership as a method of thinking in a different way, a way that is not standard, orderly, or goal-oriented, Instead, she suggests we think about leadership in a way that reflects naturally occurring events: free-flowing, dynamic, and accepting of an anything-can-happen philosophy She recommended we think of leadership through a new perspective Leadership comprises naturally occurring events in which leaders have knowledge and serve as leaders when needed Thus, there is no need for others to direct and control what we Practice to Strive For 1-1 Nurses who function as leaders in clinical practice are not necessarily in positions of authority They are not necessarily the charge nurses, nurse managers, or chief nursing officers, although they may very well be in such positions Nurse leaders, regardless of the position they hold in an organization, are the individuals who continually question the status quo, offer suggestions about how to improve patient care, and entice (not demand or require) colleagues to work toward a new level of excellence These individuals are familiar with what is being written by experts in the field and draw on this literature to formulate a vision for improving their own area of practice (e.g., care of cancer patients, the homeless, patients undergoing surgery, or poor children in school) These individuals have a high degree of energy and are passionate about practice In other words, they never give up They challenge our thinking, propose alternative approaches to care, and are creative In many ways, nurse leaders make people uncomfortable because they not allow others to remain in their “safe little corner of the world.” Instead, they challenge others to grow, seek out new experiences, strive for excellence in the care they provide, and expand their horizons (e.g., working with an interdisciplinary team, serving on institutional committees, or proposing new legislation) But leaders also help and support colleagues as they face these new challenges and opportunities These are the practices to strive for if nursing is to secure its rightful place in health care Every nurse has the potential to provide leadership We simply need to stop putting limits on ourselves and our nurse colleagues Leadership Practices and Tasks Kouzes and Posner (1995) asserted that leaders should follow five practices of leadership to assist in transforming followers to realize their own visions and become more self-directed: challenging the status quo, inspiring a shared vision, enabling others to act rather than to react, being a role model, and encouraging the heart These practices were identified from an analysis of the memoirs of hundreds of managers, who were asked to reflect on what they perceived as their own best leadership experience The findings from this research were similar to Bennis and Nanus’ (1985) notions of what constituted leadership strategies: the management of risk; the management of attention; the management of communication; the management of trust, or credibility; and the management of respect In addition, the work of Kouzes and Posner and Bennis and Nanus is consistent with that of Sashkin and Sashkin (2003) who, after 20 years of research, designed a four-dimensional model of transformational leadership that addresses communication leadership, credible leadership, caring leadership, and risk leadership (a concept they later renamed: creating opportunities) Gardner (1990) also researched the concept of leadership and identified several tasks that leaders perform Those tasks are as follows: 01Jones Leadership(F)-ch 01 1/14/07 3:30 PM Page Understanding the Theory of Leading, Following, and Managing ■ ■ ■ ■ ■ ■ ■ ■ ■ Envisioning goals—pointing the group in a new direction or asserting a vision Affirming values—reminding the group members of the norms and expectations they share Motivating—promoting positive attitudes Managing—keeping the system functioning and the group moving toward realizing the vision Achieving a workable unity—managing the conflict that inevitably accompanies change and growth Explaining—teaching followers and helping them understand why they are being asked to certain things Serving as a symbol—acting in ways that convey the values of the group and its goals Representing the group—speaking on behalf of the group Renewing—bringing members of the group to new levels These tasks provide specific guidelines for people interested in increasing their leadership ability, and they highlight the importance of leaders working closely with followers Perspectives on Followership Although Gardner (1990) and others have acknowledged the importance of leaders and followers working together in order to realize a vision, the literature typically pays little attention to the concept of followership, and there are no “theories” of followership Perhaps one of the earliest discussions of followership was presented by Kelley (1992, 1998), who outlined four types of followers: sheep, “yes” people, alienated followers, and effective or exemplary followers Sheep are passive individuals who comply with whatever the leader or manager directs but are not actively engaged in the work of the group “Yes” people, in comparison, are actively involved in the group’s work and eagerly support the leader; they not, however, initiate ideas or think for themselves Alienated followers think for themselves and often are critical of what the leader is doing; they not, however, share those ideas openly, they seem disengaged, and they “rarely invest time or energy to suggest alternative solutions or other approaches” (Grossman & Valiga, 2005, p 47) The individuals who are engaged, sug- gest new ideas, share criticisms with the leader, and invest time and energy in the work of the group are referred to as effective or exemplary followers Pittman, Rosenbach, and Potter (1998) also described four types of followers: subordinates, contributors, politicians, and partners Subordinates are similar to Kelley’s “sheep,” doing what they are told but not actively involved Contributors are like Kelley’s “yes people,” supportive, involved, and doing a good job, but not willing to challenge the ideas of the leader Politicians are willing to give honest feedback and support the leader, but they may neglect the job and have poor performance levels Like Kelley’s effective or exempry followers, the partners described by Pittman, et al (1998) are highly involved, perform at a high level, promote positive relationships within the group, and are seen as “leaders-in-waiting” (p 118) Because leaders cannot be leaders unless they have followers, the role of the follower is extremely important in any discussion of leadership In addition, the characteristics that describe effective/ exemplary followers or partners are quite similar to those outlined for effective leaders themselves Although the term “follower” “conjures up images of docility, conformity, weakness, and failure to excel” (Chaleff, 1995, p 3), those who are effective in the role are independent, critical thinkers, innovative, actively engaged, able and willing to think for themselves, willing to assume ownership, selfstarters, and able and willing to give honest feedback and constructive criticism (adapted from Grossman & Valiga, 2005, pp 49–50) Effective followers are not employees who simply “follow the rules” and accept whatever management decides In fact, the concept of effective followers may not even be compatible with perspectives on management that assume a complacent, nonquestioning employee But it is clearly aligned with the concept of leadership, because effective followers are seen as partners with the leader, working collaboratively to realize the vision they share Thus, it is helpful to outline the differences between leadership and management Differences Between Leadership and Management Leadership and management are related phenomena but they are not the same It is important to 01Jones Leadership(F)-ch 01 1/14/07 3:30 PM Page Leadership and Followership realize that (a) not all individuals in management positions are necessarily leaders, and (b) leadership is not necessarily tied to a position of authority While only those in management positions are expected to be managers, leadership can and needs to be exercised by each of us wherever we may be In other words, even though an individual does not hold a management position, she can still be a leader on a clinical unit, in an institution, in her community, or in the profession as a whole In a classic article written in 1977, Zaleznik asserted that “leaders and managers are very different kinds of people: they differ in their motivations, in their personal history, and in how they think and act; they differ in their orientation toward goals, work, human relations, and themselves; and they differ in their worldviews” (Zaleznik, as quoted in Grossman & Valiga, 2005, p 5) For example, leaders are creative, innovative, and risk-takers; managers often are more concerned with maintaining the status quo and taking few risks In addition, managers often have a short-range perspective and are concerned about the “bottom line,” whereas leaders have a long-range, visionary perspective and are concerned about moving toward realization of that vision It is important to remember that these distinctions point out the extremes of perspectives to illustrate the points that not all managers are leaders and not all leaders are managers Despite the differences outlined by Zaleznik and others, however, many individuals are able to function as both leaders and managers simultaneously and effectively Indeed, our practice world is greatly enhanced when leaders are able to manage and managers are able to lead Bennis and Nanus (1985, p 21) have been quoted often as saying “leaders the right thing, and managers things right.” In nursing practice, we must both the right thing and that thing right For example, we apply standards of care to our practice that must be followed and acuity quotients that, in most cases, must be assessed in order to make decisions about staffing, admissions, and supports needed Thus, we must the thing right But perhaps we also need to ensure that we are doing the right thing by evaluating if the standards fit our patient population and if the acuity and staffing ratios are relevant to our needs If they are not, leaders need to step forward to create standards that fit and that are relevant All nurses need to lead and manage effectively in patient care settings in order to accomplish tasks hot topic: Leader vs Manager Zaleznik (1977) wrote a classic piece on the comparison of leaders and managers, in which he described how each relates to other people, the organizations in which they work, and their goals These differences are explained in terms of how managers and leaders view work, solitary activity, conflict, and the status quo He concludes that managers are generally viewed in terms of the organization they represent and are influenced by others’ opinions Leaders are more individualistic and really not “belong” to organizations He does, however, agree that leaders can be managers, and managers can be leaders Grossman and Valiga (2005, p 7) summarized the differences between an “ideal” leader and an extremely “organization-focused” manager in terms of the following: position, power base, goals/vision, innovative ideas, risk level, degree of order, nature of activities, focus, perspective, degree of freedom, and actions and achieve maximum care quality All need to share their visions of how patient care can be improved, and all need to learn from the leaders who have gone before them Nursing Leaders The nursing profession claims many true leaders They have expressed bold visions, invested enormous amounts of energy to realize those visions, effectively engaged followers in the quest, been passionate about the futures they hoped to create, and absorbed criticism, setbacks, and opposition on the road to success Florence Nightingale, for example, demonstrated how a healthful environment could promote healing and recovery, fought for the proper care of soldiers, and provided careful documentation of interventions and outcomes that laid a foundation for future research activities Lillian Wald, who literally walked the rooftops of New York tenement buildings to provide care to the poor and helpless, created the concept of public health and demonstrated how nursing care could make a significant difference in the lives and well-being of individuals ... between leadership and management Differences Between Leadership and Management Leadership and management are related phenomena but they are not the same It is important to 01Jones Leadership( F)-ch... Past and Contemporary In order to understand the phenomenon of leadership and how contemporary perspectives shape leadership behaviors, it is helpful to know how views about leaders and leadership. .. of attention; the management of communication; the management of trust, or credibility; and the management of respect In addition, the work of Kouzes and Posner and Bennis and Nanus is consistent