Leading, Delegating, and Collaborating

Chapter 16

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LEADERS, MANAGERS, AND FOLLOWERS Characteristics of a leader Competence Trustworthiness Self-assuredness Decision-making ability Prioritizing skills

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LEADERS, MANAGERS, AND FOLLOWERS Management Provides the structure and direction necessary to accomplish goals

and outcomes that are known and, where there is a system in place, to achieve the outcomes

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LEADERS, MANAGERS, AND FOLLOWERS Managers Any staff member who bears responsibility for the work of others Anyone who must ensure the completion of an organizational process One who guides the processes necessary to accomplish tasks

necessary to achieve organizational outcomes

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LEADERS, MANAGERS, AND FOLLOWERS Followership Not a passive process Uses personal behaviors that contribute to the health care team’s

goals Demonstrates collaboration, influence, and action with the leader or

manager to accomplish goals and outcomes Should be willing to question, debate, compromise, collaborate, and

act as well as be accountable for those actions

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LEADERSHIP CHARACTERISTICSLeadership Ability to influence outcomes through positive interactions with team

membersCharacteristics Recognizes the strengths and weaknesses within the team Manages them to affect a positive outcome from a plan of care Empowers all team members to do the jobs of which they are most

capable Delegates assignments, tasks, and duties to the best individuals for

the particular jobs

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LEADERSHIP CHARACTERISTICS (CONT'D)Defining the leadership role Managing: directing or supervising others as a means to control a

situation Managing patient care

Overseeing the plan of care Directing others to implement the plan toward achievement of the

desired outcomes A manager has leadership qualities, acts as an advisor, and influences

the beliefs of others.

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LEADERSHIP CHARACTERISTICS (CONT'D)Defining the leadership role Both an expectation and an earned role Decisiveness, sound judgment, and ability to articulate fluently Self-knowledge, respect, trust, integrity, vision, participation, learning,

communication, and catalyzing change Display of integrity

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LEADERSHIP STYLES (CONT'D)Servant leadership Emphasizes service to others, including employees, customers, and

the community as a first priority

Focuses on the needs of others, empathizes with them, and is attentive to the concerns of followers

Involves listening, empathy, healing, persuasion, awareness, foresight, conceptualization, commitment to the growth of people, stewardship, and building community

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LEADING AND EMOTIONAL INTELLIGENCEFour major domains Self-awareness Self-management Social awareness Relationship managementRefers to recognizing and regulating emotions in ourselves and

others Can improve staff relationships, improve patient outcomes, motivate

others, resolve conflict, create a healthy work environment

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ETHICS AND LEADERSHIPLeadership has a moral or ethical dimension. Five principles of ethical leadership Serving others Showing justice Respecting others Honesty Building community

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ETHICS AND LEADERSHIP (CONT'D)Leaders’ ethical responsibilities Treat followers with dignity and respect. Be sensitive to their interests, needs, and concerns.

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CULTURE AND LEADERSHIPCultural competence extends to

workplace as well Four generations in the workforce Veterans

Value loyalty, respect authority, want reward for hard work Baby Boomers

View future with optimism and promise and desire to prosper financially and contribute meaningfully

Generation X Loyal to profession, but unwilling to sacrifice for employer

Millennials Open-minded, collaborating, civic-minded

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DELEGATIONDefinitions Assigning tasks or duties to an entrusted individual Getting work done through others Directing the performance of one or more people to accomplish

organizational goalsPrinciples of delegation The RN takes responsibility and accountability for the provision of

nursing practice. The RN directs care and determines the appropriate utilization of any

assistant involved in providing direct patient care.

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DELEGATION (CONT'D)Principles of delegation Assessment, planning, evaluation, and nursing judgment cannot be

delegated. The decision of whether or not to delegate or assign is based on the

RN’s judgment. The RN delegates only those tasks that the health care worker has the

knowledge and skill to perform. The RN delegates the right task, under the right circumstances, to the

right person, with the right direction and communication, and with the right supervision.

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DELEGATION (CONT'D)Issues in delegation Patient safety must always be maintained by understanding the

scopes of practice and the skills and abilities of the other health care team members.

Delegating fairly does not mean delegating equally.

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DELEGATION (CONT'D)Issues in delegation According to the ANA, three elements may not be delegated.

Initial and subsequent nursing assessments that require professional judgment

Determination of nursing diagnoses, goals, plans of care, and progress

Interventions that require the application of professional knowledge and skills

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DELEGATION (CONT'D)Issues in delegation If a person resists

Provide deadlines. Avoid oversupervising. First assess the reason for the resistance or refusal to perform a

specific task. Then take appropriate action to remedy the situation.

Remember that if the patient has not been assessed by an RN, delegation should not occur.

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COLLABORATIONDefinition Partnership arrangement between two or more individuals who have a

mutual agreement to work togetherSuccessful collaboration Team must agree on the plan of care and the prioritization of the

components of the plan Excellent communication among the team members Mutual recognition and respect

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ACCOUNTABILITYThe RN must ensure that the plan of care

is implemented, evaluated, and possibly modified so that the patient outcomes are the best they possibly can be.

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PROFESSIONAL ADVOCACYAdvocacy One individual promotes someone else or someone’s idea.As a patient advocate The RN promotes the patient’s decisions in a nonjudgmental manner.RN’s responsibilities Assess patient’s understanding of the plan of care and ensure that

the patient has all the information needed to make informed decisions.

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PROFESSIONAL ADVOCACY (CONT'D)RN’s responsibilities Caring

Has a commitment to preserving the patient’s humanity, personal worth, and dignity

Speaking up concerning unsafe conditions because patient safety is paramount

Advocating for the public and the nursing profession Involvement with professional organizations and becoming active in

legal issues concerning health care policy

Extending advocacy to self

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COLLABORATING AND ADVOCATING THROUGH THE MEDICAL PLAN OF CAREThe physician is the manager of the medical plan of care.

The RN must anticipate the medical direction, understand the orders written, and foresee how they will affect the patient and patient care.

The RN must understand the complexities of patient care management in order to advocate for the patient.

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DECISION-MAKING AND PROBLEM SOLVINGDecision-making Involves making a decision that is focused on trying to solve an

immediate problemProblem solving Is a purposeful and goal-directed process aimed at identifying and

selecting options as part of problem solving, planned change, or improvement

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DECISION-MAKING AND PROBLEM SOLVING (CONT'D)Decision-making process Defining objectives Identifying options Identifying the advantages and disadvantages of each option Selecting an option Implementing the option Evaluating the result

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DECISION-MAKING AND PROBLEM SOLVING (CONT'D)Effective decision-making and problem-

solving process Gather data from many sources. Learn different approaches to problem situations. Observe positive role models in action. Talk to a colleague or superior who is an effective

problem solver and decision maker. Perform research to increase your knowledge base. Take risks using new approaches to problem solving.

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CONFLICT MANAGEMENTConflict Opposition of feelings, beliefs, desires, or goals Types Intrapersonal: within one individual Interpersonal: between or among two or more individuals Intragroup: within one group Intergroup: between or among two or more groupsGuidelines Need privacy Willing to talk calmly and rationally

If not, stop the process and discuss at another time; ask for help if needed.

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CONFLICT MANAGEMENT (CONT'D)Sacrifice resolution Someone accommodates the other by essentially

sacrificing his or her position, thus allowing the other to have his or her way.

Competition resolution One or both of the parties work competitively, instead

of cooperatively, toward resolution. One side wins and the other loses.

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CONFLICT MANAGEMENT (CONT'D)Win-win resolution Collaborative method Two opposing parties coming together to decide on mutual goals Designing interventions to meet these goals Working together to evaluate the outcomes

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