Manager’s Leadership Style Assignment
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This a 3-5 page narrative defining and describing the leadership style of your immediate supervisor/manager. You want to use the language, theories and content of chapter one of your text and the attached article on leadership competencies. The student will demonstrate knowledge of the different leadership styles by:
Management Leadership Competencies: Knowledge, Skills, and Aptitudes Nurses Need to Lead Organizations Effectively Diana S. Contino, RN, MBA, CEN, CCRN T he healthcare workplace is comparable to what a person sees when looking through a kaleidoscope: as the moments pass, an endless variety of patterns emerges. Undesirable patterns that have materialized include the widely publicized shortage of nurses in the workforce and the high rates of turnover among nurses. Healthcare organizations increasingly depend on recruitment and retention of nurse-managers to reverse these trends. Critical care nurses become leaders through a variety of routes, many of which do not include formal managerial training or education. To produce positive results, critical care leaders need effective strategies to manage departmental operations and inspire staff. One strategy used by chief nursing officers, professional nursing associations, and employers is to design and implement formalized critical care leadership and managerial training programs that are evidence based and results oriented. In “Leadership Research in Business and Health Care,” Vance and Larson1 report an underuse of Author Diana S. Contino is the owner of Emergency Management Systems, Inc, in Laguna Niguel, Calif, and a consultant with MedAmerica. She has more than 16 years of leadership and management experience and provides acute care operational assessments, process redesign, and financial consulting. She is experienced in applying profiling tools, establishing collaborative relationships between nurses and physicians, and eliminating barriers between nurses and financial professionals. To purchase reprints, contact The InnoVision Group, 101 Columbia, Aliso Viejo, CA 92656. Phone, (800) 8092273 or (949) 362-2050 (ext 532); fax, (949) 362-2049; e-mail, reprints@aacn.org. 52 CRITICALCARENURSE Vol 24, No. 3, JUNE 2004 evidence-based research in the development of healthcare leaders. The evidence-based research that is available is largely descriptive and is poorly translated into healthcare. In this article, I provide a compilation of practical managerial skills for critical care nurses in formalized managerial roles, as well as leadership skills that are useful for all nurses. These skills are based on my managerial and leadership experience, the findings of numerous experts, and healthcare and business resources. The highly divergent and dynamic leadership skills described herein mirror the responsibilities of critical care managers. The skills also illustrate the need for open-minded leaders who collaborate with colleagues and peers to prepare for and respond to the multifaceted challenges that arise every day. For purposes of clarity, the leadership skills are grouped into 4 main categories: 1. organizational management 2. communication 3. analysis/strategy, and 4. creation/vision. Included in each of these categories are key skills and abilities that make leaders effective. Although the categories are an artificial separation of skills that intertwine and overlap, the skills are discussed separately for the purpose of explaining each skill and demonstrating its applicability. Despite the expansive nature of this topic, the examples are brief; the references cited provide additional information and resources. Administrative teams can use these leadership skills as the founda- tion to create competency-based job descriptions and development programs for nurse-leaders. Table 1 summarizes the skills reviewed in the following paragraphs. Organizational Management Skills Healthcare businesses can benefit from examples of other successful organizations. The book Built to Last,2 a study of successful corporate habits, indicates that continuity of leaders and ongoing leadership development contribute significantly to the success of an organization. Organizations and their shareholders benefit if employees are taught to manage time, information, human resources, change, revenue and expenses, information technology, and equipment. In a follow-up research book, Good to Great, Collins3 describes a level 5 leader as one who builds enduring greatness through the use of personal humility and professional will to mentor others to do the right thing, one who takes responsibility for failures while giving credit to others for their success, and one who relies on inspired standards to motivate others. He states that level 5 Table 1 Nurse-leader competencies Organizational management skills Manages time and prioritizes work appropriately Manages information to benefit the unit’s operations and personnel management Manages human resources through the promotion of individual and teamwork involvement and in accordance with policies and procedures Mentors and works collaboratively with members of all disciplines Manages and implements change to improve operations Manages revenue and expenses according to budget Manages technology and equipment to reduce errors, gain efficiencies, and comply with budget targets Communication skills Effectively communicates the unit’s goals and objectives and how they fit into the hospital’s mission and vision Communicates and supports the organizational structure and promotes trust and honesty through words and actions Sets and meets or exceeds personal, career, and education goals Mentors staff in setting and meeting personal, career, and education goals Communicates and promotes continuous learning Communicates and promotes effective change Data/operations analysis and strategic planning skills Uses appropriate internal data to evaluate operations Looks for solutions and new business opportunities both internally and externally Uses effective critical-thinking skills and decision-making strategies Evaluates and anticipates the effect of change before implementation and responds appropriately to unexpected outcomes Plans and evaluates the unit’s business plan Creation/visionary skills Creates opportunity for employees Creates a vision for the unit or division Creates value for customers Creates quality through continuous improvement, error reduction programs, and customer service initiatives Creates effective relationships with peers and business partners leadership is one of the key determinants of organizational greatness. The essence of “great” leadership is effective management of oneself and others in response to a variety of situations. Therefore it is essential that leaders learn to manage their emotional response to a variety of situations and others’ actions. How staff members perceive nurse-managers is critical to recruitment and retention efforts. Wieck et al4 suggest areas for the betterment of current and future leaders. They indicate that the entrenched and emerging workforce wants leaders who demonstrate honesty, integrity, and optimism. Workers want good communicators who are receptive to others and who are motivational, fair, approachable, and empowering.4 Results of “Reversing the Flight of Talent,” a survey of 1600 staff nurses conducted by the Advisory Board’s Nurse Executive Center, indicate that nurses want to work for effective nurse-leaders.5 Of the nurses surveyed, 84% had considered leaving their jobs because of dissatisfaction with their direct managers; however, only 43% of nurses surveyed who were very satisfied with their managers had still considered leaving nursing.5 Incorporating research findings on healthcare and business leadership into educational programs for nurse-leaders will expand and enhance their leadership skills. Managing Time Effective leaders use successful strategies for time management. Often leaders allow minutes and hours to be wasted on nonessential tasks such as opening mail, filing, CRITICALCARENURSE Vol 24, No. 3, JUNE 2004 53 Management and responding to noncritical requests from others. Effective leaders use self-discipline to organize these tasks and assign priority to projects that produce results. By learning from management experts such as Stephen Covey, nurses can perfect their time management skills. In his book, The 7 Habits of Highly Effective People,6 Covey eloquently describes a time management matrix that provides a guide for understanding the relationship between important, not important, urgent, and nonurgent activities (Table 2). This tool encourages leaders to focus most of their time on nonurgent activities (quadrant II).6 For example, a director’s budget (quadrant II planning and quadrant I deadline-driven projects) is due in 3 days and a friend calls to get advice on vacation plans. The director correctly responds by asking the person (quadrant III interruptions and quadrant IV some phone calls) to call the director in the evening at home. If a leader participates in activities in the upper right corner of the top part of the table, the results outlined in the upper right corner of the lower part of the table will ensue. Planning will result in vision and Table 2 Time management matrix Non Urgent Urgent II Not important Important I Activities Prevention Relationship building Recognizing new opportunities Planning, recreation Activities Crises Pressing problems Deadline-driven projects III Activities Interruptions, some calls Some mail, some reports Some meetings Proximate, pressing matters Popular activities IV Activities Trivia, busy work Some mail Some phone calls Time wasters Pleasant activities Urgent Not important Important I Non Urgent II Results Stress Burnout Crisis management Always putting out fires III Results Short term focus Crisis management Reputation–chameleon character Sees goals and plans as worthless Feel victimized, out of control Shallow or broken relationships Results Vision, perspective Balance Discipline Control Few crises IV Results Total irresponsibility Fired from jobs Dependent on others or institutions for basics Reprinted from Covey,6 with permission from Franklin Covey Co (www.franklincovey.com). All rights reserved. 54 CRITICALCARENURSE Vol 24, No. 3, JUNE 2004 perspective; whereas the continual management of crises will result in stress and burnout (Table 2). A leader can use this matrix to prioritize tasks and responsibilities, reducing time wasted on nonurgent activities. This example is an easy distinction; however, managers face much more subtle choices, making the disciplined use of the matrix even more important. A leader can use time efficiently while building staff members’ selfesteem, as exemplified by the concept of 1-minute praise described in the One Minute Manager.7 Finding creative, quick, and individual ways to thank staff members, colleagues, and customers is an important leadership skill. Effective time managers find easy ways to acknowledge staff, such as keeping thank-you cards tucked in their organizer or putting reminders in their personal digital assistant. While waiting for meetings to start, leaders write thank-you notes to staff members and others who exhibit exceptional behavior and mentoring activities. The personal acknowledgment of staff members builds morale and improves retention.8 Delegation skills are critical to a leader’s ability to manage time. Leaders do not have to do everything. Their role is to ensure completion, monitor ongoing progress, and affirm that interventions produce results.9 A leader’s effectiveness is maximized by assigning appropriate tasks and projects to staff nurses and other administrative support personnel. Ales10 describes a 4-step process that guides readers through the art and science of delegation: choosing a task that can be delegated, assigning it to the right person, communicating clear instructions, and soliciting feedback.10 Managing Information Managing information is critical to a leader’s success.9 Without timely statistics and outcomes data, managing in accordance with budget targets and performance measurements is difficult. Effective leaders are able to share statistical and outcomes data with staff members to gain the members’ participation in meeting budget targets. Additionally, comparing internal (benchmark) data with data from similar organizations is helpful. Resources such as the National Database of Nursing Quality Indicators11 provide data on a variety of benchmarks such as nursing skill mix, nursing hours per patient day, pressure ulcers, and falls. The Advisory Board12 is another resource that showcases a variety of best practices. Collaborating with colleagues, with peers, and within professional organizations is another way to gather information about trends and successful solutions to operational dilemmas. Critical care nurses manage large amounts of complex data about patients, and nurse-managers are required to do the same with operational data. Managing Human Resources An enormous part of the nurseleader’s role is the management of human resources, specifically nursing resources. Considerable attention is paid to the complexities of understanding people, because just as with a disease, it is easier to implement interventions if the diagnosis is known. Geddes et al13 conclude that a need exists for fiscal accountability, quality-enhancing management strategies, and personnel management. How to involve and engage critical care nurses should be included in the training of nurse-leaders. Kouzes and Posner14 concluded that genuine caring for people (critical care nurses) is at the heart of effective leadership. How critical care nurses interact with patients and with colleagues directly affects not only satisfaction among customers and employees but also the safety of patients. Therefore, teaching critical care leaders how to manage human resources is vital to an organization’s success. The human resources department and hospital policies guide nurseleaders in decision making. The current nursing shortage and high turnover rates indicate a need for collaboration and close working relationships with human resources professionals. Those professionals can track the reasons for high turnover, vacancies, and/or excellent retention of critical care nurses. Mark and Critten15 suggest that the future focus of human resources departments should be organizational central intelligence and the facilitation of organizational learning and creativity. Siddiqui and Kleiner16 reviewed human resources operational management and concluded that healthcare organizations should adapt the latest methods used by human resources professionals. These methods include encouraging diversity in the workplace, promoting from within the company, and cross-training personnel whenever possible.16 Ridenour17 reports that leadership competencies influence patients’ outcomes, continuous learning, relationships with customers, use of resources, strategic planning, and compliance. How employees are treated and mentored is critical to retention efforts; therefore, manage- ment training should include interpersonal skills and strategies for responding to different personalities. Leaders learn strategies to create a culture of understanding through the use of personality-profiling tools. Effective profiling tools are nonjudgmental, accurate, applicable, and easy to understand. One of the best-known tools is the Myers Briggs Type Indicator.18 This tool is an instrument for measuring a person’s preferences by using 4 basic scales: 1. extraversion/introversion, 2. sensate/intuitive, 3. thinking/feeling, and 4. judging/perceiving. Combinations of the different preferences can result in 16 personality types. An understanding of the personality type is crucial to a leader’s ability to empathize with another person and what that person may be experiencing. The Keirsey Temperament Sorter19 is a profiling tool based on the theory that every personality has 2 sides. Temperament is partially inherent at birth, whereas character is a set of learned habits or skills. With this tool, temperaments are sorted into 4 basic categories with multiple combinations. Persons with artisan temperaments are predisposed or born to impulsive action; those with guardian temperaments, to responsible service; those with idealist temperaments, to personal development; and those with rational temperaments, to objective analysis. The survey consists of 70 questions and results in a person’s profile of combinations. The temperament analysis is a method for understanding a person’s character through the identification of the person’s learned habits and skills. CRITICALCARENURSE Vol 24, No. 3, JUNE 2004 55 Management A newer profile that is nonjudgmental, accurate, applicable, and easy to understand is Time Typing.20 The titles “Past,” “Present,” and “Future” are metaphors for physical time and are used to explain that opportunity, knowledge, and control are reference points from which persons interpret situations and make decisions. This model also helps persons understand what motivates them, how they gain selfesteem, how they communicate, and what types of reward systems they prefer. Persons of the Past type are attuned to information and risk aversion. Past-oriented people are very comfortable with gathering and analyzing data and they seek the “truth.” Persons of the Present type are attuned to control. They create organization out of chaos and excel at creating and following a plan. They have patience and strive to create stable harmonious environments, often by maintaining the status quo. Persons of the Future type are attuned to opportunity. They thrive on chaos and change. They don’t want to miss an opportunity so they don’t turn anything down but will quickly abandon things that won’t work. Theorists think that people have some characteristics of all 3 types, but everyone has a primary or dominate perspective or “way of looking at the world.” Time Typing does not have complex combinations of “types” that require the learner to focus more on understanding the personality profile than understanding a person’s decision-making style. It is an ipsative tool that compares the person to himself or herself. Most of the other profiling tools are normative, ranking the person against others and creating a judgmental environment that contributes to selection bias. Time Typing also includes tools to help evaluate team dynamics and a decision wheel that helps leaders facilitate decision making. Its simplicity makes it a powerful corporate training tool. Table 3 is a comparative representation of the 3 types of tools: Myers Briggs Type Indicator, Keirsey Temperament Sorter, and Time Typing. Understanding cultural norms and diversity is just as important as understanding individuals. Dreher and Macnaughton21 contend that cultural competence is really nursing competence. As communities become more diverse, it is important that leaders adopt strategies to teach, provide feedback, and motivate persons from different cultural backgrounds and different skill mixes. For example, asking patients to participate in focus groups and report their feelings and perceptions of their treatment allows managers and staff to see the world from the patients’ eyes, including the patients’ cultural views and norms. Leadership mentoring bridges the regulatory and subjective aspects of human resources management through the pairing of experienced leaders with novice leaders. To illustrate a type of mentoring, Montgomery22 presents a descriptive method whereby an experienced professor mentors a doctoral student in the needed leadership and administrative experiences. The mentoring of new critical care managers by the chief nursing officer should occur over time and is enhanced through the resolution of increasingly complex situations. Table 3 Comparative profiling tools Meyers Briggs Type Indicator Keirsey Temperament Sorter Description A profiling tool that provides a way of describing people’s personalities by looking at their pre
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