Leadership is said to be a way of behaving that influence others to respond, not because they want to, but because they have to, it is seen as personal interactions between group of people which aim at improving personal interactions and focus on achieving a particular goals. Catalano (2006), define leadership as the ability of and individual to influence the behavior of others. A good leadership must possess some very important skills to be effective, this includes but not limited to critical thinking, problem solving, active listening, skillful communication, acknowledgment and respect for individual difference, establishment of clear goals and outcomes, and continue personal and professional development (Tappen 2001). While Management on the other can be define a problem oriented process with a focus on the activities needed to achieve a goal, it supply the structure, resources and direction for activities of the group. Management is aimed toward influencing employees to be as productive as humanly possible Catalano (2005). There is always a relationship between leadership and management in nursing, Malby (1996) indicates that developing and fostering leadership competencies could direct nurse managers to think beyond tradition and to coordinate multidisciplinary dialogue which articulates the needs of the system and the patients whilst empowering employee. Leadership has been defined by different scholars and it has been group into theory for better understanding of its relationship to management, in this essay I will concentrate on the effect of different leadership and management theory and how it is related to nursing and healthcare system.
Leadership theories
Relationship-tasks orientation and Management theory
Leadership and management
Leadership Theory
In authoritarian leadership style, the leaders maintain strong control over all aspects of the group and its activities, provide directions by giving others that the group are expected to carry out without questions (catalano 2006). This kind of leadership style should not be used in healthcare setting because of it negative influence on care giver, since healthcare is an interdisciplinary system in which group participation provide the best care for client and promote health. The mother of Nursing, Florence Nightingale has been said to use this style of leadership during her time. Her leadership and management style permeated nursing management for decades, and continued to dominate health care settings established and managed by the religious orders. Castigatory criticism, strong overt control, an ‘I’ and ‘you’ difference in status and a complete absence of individual consideration were the epitome of nursing management (Marquis & Huston 2000, Widerquist 2000). And this was also supported by Widerquist (2000) statement that whilst Nightingale may be considered a ‘Great Woman’ of the Victorian era, the undercurrents of her theories, ideologies and management style have had deleterious consequences for subsequent nursing practice and nursing management. Carney (1999) asserts that whilst evidence suggests that this approach is still employed in some health care settings, the autocratic leadership style should only be utilized in crisis situations.
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In Democratic style theory (Supportive or Participating), all aspects of the process of achieving a goal, from planning and goal setting to implementing and taking credit for the success of the project, are shared by the group (Catalano 2006). This allows members participation and control because of its freedom of expression altitude toward achievement of goals. Murphy (2005) stated that Democratic leadership is supportive of group interaction and decision-making. Staff is motivated by economic or ego awards and supported by direction and guidance.
Laissez- Faire leadership Style is also describe as permissive, non directive, or passive. The laissez-faire style leader allows the group he or she is leading to determine their own goals and the methods to achieve them. There is little planning, minimal decision making, and a lack of involvement by the leader (catalano 2006). The laissez-faire leader observes followers working from a distance and does not tend to intercede unless necessitated (Mullins 1994). Because of the leader little control and authority which can lead to variable efficiency and quality of output it is not commonly used in healthcare setting. Marquis and Huston (2000) caution that if this style of leadership is used inappropriately, it can precipitate apathy and disinterest in staff and a frenetic department.
Transformational theory recognizes that multiple intangibles exist whenever people interact. Factors such as sense of meaning, creativity, Inspiration, and vision all are involved in creating a sense of mission that exceeds good interpersonal relationships and reward. In many healthcare facilities, nursing leaders are expected to inspire excitement and commitment in nurses, who often must provide care to very ill clients in less than ideal circumstances (catalon 2006). Transformational leaders strive to elevate the needs of their followers which are congruent with their own goals and objectives through charisma, intellectual stimulation and individual consideration (Bass et al.1987a).
Leadership orientation and Management theory
In High Relationship- Low Task Orientation the leaders are usually well liked by the groups because of their acceptance of the group members as individuals, consideration of their feelings, encouragement, and promotion of good feelings among all the group members (catalano 2006). This relationship focuses more on the employee to elicit the high production ,and was supported by Human Interaction theory (management theory) in which management were required to develop a different set of management skills, including understanding human behavior, effective counseling , increase motivation using effective leadership skills and maintaining productive communication (catalano 2006). In Nursing, this relationship helps to get the best out of the health care team thereby increasing the quality of care giving to patients. These theories was also supported by the Michigan studies on the leadership behavior(Cole 1999) in which it reported that supervisors of high producing groups tended to be employee-oriented and exercised employee participation in decision making, thereby promoting team development and cohesiveness.
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High Task-Low Relationship describe a leader who does all the planning with little regard to the input or feelings of the group, gives order and expect them to be carried out without questions (Catalano 2006). This can be related to Time-Motion Theory (management theory), define as planning, organizing, commanding, and controlling the work of any particular group of employee (Catalannn2006). This can create a non productive environment if use in the health care setting because of it decrease in employee satisfaction. The Michigan studies (Cole 1999) conclude that the supervisors of low producing groups were task oriented and consequently were referred to as production-oriented leaders. These leaders focused more on the tasks than on the employee needs and tended to strictly monitor and control performance.
Leadership and Management
Leadership orientation and theory are used interchangeably, since environments and situations are constantly changing in healthcare settings. Factors such as member skills, the circumstances or problem at hand, the work environment are put into considerations. Fiedler (1967) identified the leader’s power; the leader-follower relationship and the task to be accomplished as the key variables which determine the particular leadership style required to militate various problems in diverse situations. Hence, the applicability of Fiedler’s (1967) leadership theory to contemporary nursing management is conceivable, as various approaches can be employed interchangeably to manage diverse situations. For example the authoritarian leadership is mostly used in emergency situations in which saving a life and obtaining maximum health is the highest goals of any group. And this is supported by Carney (1999), who asserts that whilst evidence suggests that this approach (authoritarian theory) is still employed in some health care settings, the autocratic leadership style should only be utilized in crisis situations. Catalano (2006) stated that a nurse manager on a hospital unit may use a highly democratic style in most of the routine activities of the unit, but when a client goes into cardiac arrest, she may revert to a highly authoritarian style while directing the staff through a code. Also in quality management, where the problems are often long term and complicated, the leader tends to be a nurse who is well organized and methodically sift through a mountain of information and statistics to develop a policy that covers the widest range of possibilities.
It can be argue that to be an effective manager, it is apparent to have the quality and highly develop skills of a good leadership, especially in healthcare to achieve optimum health and increase productivity. Whilst one does not have to be a leader to manage and a manager to lead, researchers in the 1960s began to recognize how these skills can be intertwined and employed synonymously to realize organizational goals (Marquis& Huston 2000). It could also be argued that unless managers are cognisance and competent in strategic planning development, which implicates on clinical practice, their efforts may be circumvented by more senior levels. In addition, to affect successful change management in a constantly changing environment, the nurse manager must be appropriately prepared to lead and manage the complexities and contingencies of this process (Dutton et al. 1997). Management and leadership skills complement each other, it can be learned and require practice and experience.
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