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    PAD.DR.D Y PATIL COLLEGE OF NURSING

    ON

    SUBMITTED TO: SUBMITTED BY:

    Mrs. Nisha Naik Mrs. Priyanka Pathak

    Lecturer 2ND

    Year M. Sc. Nursing

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    LEADERSHIP

    INTRODUCTION

    Leadership is that leadership is the art of motivating a group of people to act

    towards achieving a common goal. Put even more simply; the leader is the inspiration

    and director of the action. He or she is the person in the group that possesses the

    combination of personality and skills that makes others want to follow his or her

    direction. In business, leadership is welded to performance. Effective leaders are those

    who increase their companies' bottom lines.

    To further confuse the issue, we tend to use the terms "leadership" and

    "management" interchangeably, referring to a company's management structure as its

    leadership, or to individuals who are actually managers as the "leaders" of various

    management teams.

    leadership involves more. To be effective, a leader certainly has to manage the

    resources at her disposal. But leadership also involves communicating, inspiring and

    supervising - just to name three more of the main skills a leader has to have to be

    successful.

    CONCEPT OF LEADERSHIP

    Leaders typically are the ones who go first. They have vision and influence

    other by their actions and their comments. This ability is the essence of leadership like

    the word lead another word manage comes from meaning. Hand managing them

    means handling things . In essence managers get other people to do, but leaders get

    other people to want to do.

    Leaders are most often associated with times of turbulence innovation social

    transformation and change, whereas manager are more often assist anted with

    improving productivity, establishing order and stability and making thing run to

    smoothly management is the proceed of v getting work done through others . Nurse

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    Managers at agree hierarchical level are expected to lead subordinates towards

    institutional. Objectives as efficiently as possible.

    DEFINITION OF LEADERSHIP

    Although the term leader has been in use since the 1300s, the word leadership

    was not known in the English language until the first half of the 19th century.

    Leadership is the process of influencing people to accomplish goals, i.e. it is the

    ability to influence behaviors o f others, towards the achievements of a mutually

    establishes goal. The leader and follower roles are determined by peoples interaction

    within groups, in contrast, the role of managers or administrator are jobs within

    organization the role of manager is to coordinate the efforts of lower level employees

    i.e. subordinates to advance the goals of the organization.

    Leadership is a force that creates a capacity among a group of people to dosomething that is different or better

    Leadership what leaders do; the process of influencing a group to achievegoals

    An effective leader is a catalyst who facilitates effective interaction among

    manpower, material and time. A skilful leader is synergist, who co-ordinates the efforts

    of multiple workers with diverse skill. Leadership is social relationship in which one

    party has a greater ability to influenced b him or her. Thus, leadership is based on a

    powerful differential between interacting persons. Leadership is needed in cooperative

    enterprise to align employees in support of goals, to spark group interaction, to blend

    efforts of specialties. Thus nurse managers at every organizational level select

    leadership style and methods that suit work force requirements.

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    HISTORY OF LEADERSHIP PRACTICE IN NURSING

    NNIIGGHHTTIINNGGAALLEESS SSCCHHOOOOLL OOFF NNUURRSSIINNGG

    She considered first nurse executive. She integrated the functions of modern

    nursing as care provider, management interdisciplinary education and scientific

    research.

    EEAARRLLYY UUSS HHOOSSPPIITTAALL

    The better nursing school wanted superintendents, teachers and head nurse who

    were cultivated women and educators as well as practioners.

    11993300--11994400 TTHHEE BBUURREEAACCAACCYY

    Nurse experienced difficulty in returning bureaucrat hospital setting after

    functioning independently head nurses made in charges over staff nurses.

    11994400--11995500 TTEEAAMM NNUURRSSIINNGG

    As a mechanism for other nurses to share the supervision responsibility team

    leader was senior nurse.

    11996600 PPRRIIMMAARRYY NNUURRSSIINNGG

    Primary nursing delegates decision making to bed side nurses.

    11997700 DDEECCEENNTTRRAALLIIZZAATTIIOONN

    To move a way from vertical organization with authority and decision making

    task a t the top level.

    11998800 SSHHAARREEDD GGOOVVEERRNNAANNCCEE

    It recognizes the interdependence of every department in achieving quality

    product.

    1990 PATIENT CENTERED CARE.

    It recognizes the interdependence of every department in achieving quality

    product.

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    PRINCIPLES OF LEADERSHIP

    11.. VViissiioonn: (leadership begins with a vision.)A vision is a clear picture of what the

    leader sees his group being or doing. If followers grasp the vision, become cohesive

    and will be able to work towards common goal. A commitment to act on a vision a

    mission.

    22.. GGooaall setting: goals are a set of specific measurable steps designed to achieve the

    vision and the mission.

    Goals must be S-M-A-R-T; specific, measurable, attainable, realistic and tangible.

    Goal setting is an ongoing process.

    3. Love: An act of the will on which the leader works towards the highest good of

    others.

    44..HHuummiilliittyy: A humble person is free from pride and arrogance, helpful and courteous.

    55.. SSeellff ccoonnttrrooll:: essential attitude and characteristic of a leader.It brings freedom,

    confidence , joy , stability and strong sense of leadership.

    66..CCoommmmuunniiccaattiioonn: the ability to communicate effectively through speech and writing.

    77.. IInnvveessttmmeenntt:: to maximize its benefit to the group.

    8. Opportunity: obstacles as the key to opportunities, attitude to handle mistakes.

    99..EEnneerrggyy:: attracts attention and followers .A leader with energy and enthusiasm gains

    acceptance and confidence of others.

    1100.. SSttaayyiinngg ppoowweerr:: essential to overcome problems and discouragement. Indicates

    strong awareness to a commitment.

    1111.. AAuutthhoorriittyy:: - Internal authority- the charisma, self esteem, the personality that

    causes a person to command respect of others.

    1122.. AAwwaarreenneessss:: the leader must be aware of her leadership, constantly monitoring the

    performance against a standard that she has set for herself to achieve excellence.

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    TYPES OF LEADERSHIP

    TRANSACTIONAL VERSUS TRANSFORMATIONAL LEADERSHIP

    Outhwaite (2003) cites definitions of transactional and transformational

    leadership as posited by bass in 1990. Transactional leadership involves how an

    integrated team works together and the innovativeness of their approach to the work

    Outhwaite (2003). For example, a leader can empower team member by allowing

    individual to lead certain aspect of a project based on their areas of expertise. This will

    encourage to development of individual leadership skill. In addition, leaders should

    explore barriers and identify conflicts when they arise, and then work collaboratively

    with team, sharing in the work, thus remaining close to perspective (Outhwaite, 2003)

    Transactional leadership focuses on providing day to day care, while

    transformational leadership is more focused on processes that motivate followers to

    perform to their full potentential influencing change and providing a sense of

    direction (Cook2001). The ability of a leader to articulate a shared vision is an

    important aspect of transformational leadership (Faugier & Woolnough, 2002).

    Transactional leadership is most concerned with managing predictability and order,

    while transformational leaders recognize the importance of challenging the status quo

    (Faugier & Woolnough, 2002) .

    One group of authors described the use of transformational leadership by

    Magnet hospital (De Geest, Clsaessens, Longerich, & Schubert, 2003). This leadership

    style allows for solving, transmission of values and ethical principles, and ethical

    principles, and provision of challenging goals while communicating a vision for thefuture (De Geest, Clsaessens, Longerich, & Schubert, 2003). Transformational

    leadership is extremely important.

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    LEADERSHIP STYLES: THEORIES

    The wordstyle is the way in which the leader influences followers. Style is

    distinctive or characteristics manner of performance. Style is defined as the exclusive

    privilege of the expert. With style, the end is attained without side issues. Style

    implies an elegance and economy of effort to be sought by every professional manager.

    Style in general involves the way in which something is said or done, including

    particular behaviors associated with an individual. Leadership style specifically is the

    way that the leaders influence the group to accomplish goals. Let us have a look at the

    various studies that help us to understand the leadership styles..

    LEADERSHIP THEORIES

    1. Scientific leaders? Manager, style theory2. Human relation theory3. Henri fayol theory of managerial style4. Mcgregor theory5. Theory z6. Trait theory of leadership7. Behavioral theory of leadership style8. Situational theory

    TRANSACTIONAL AND TRANSFORMATIONAL LEADERS

    Transactional Leaders

    focuses in management tasks

    Is care taker

    Uses trade- offs to meet goals

    Shared values not indentified

    Examines causes

    Uses reward contingency

    Transformational Leaders

    Identifies common values

    Is committed

    Inspires- others within vision

    Has long-term vision

    Looks at effects

    Empowers others

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    1. SCIENTIFIC LEADERS? MANAGER, STYLE THEORYThis theory was developed by Fredrick Winslow Taylor (1856-1915). In

    1911, he emphasized technology as the basis of increasing productivity. He introduced

    time-and-motion studies to analyses tasks based on belief that improving the

    performance would improve the efficiency of the organization. He relied on scientific

    study of time and movement spent and used for a job to improve the performance of

    the worker and recommended careful selection and training of workers, who could

    meet the established work standard. The leaders utilize this Taylors principle.

    2. HUMAN RELATION THEORYThis theory was developed by Elton Mayo and Fritz Roethlisberger after

    conducting series of studies from 1924 to 1932 at Howthorne Western Electric plan,

    Chicago, to test several assumption of scientific management. They believe that real

    power centers within the organization are the interpersonal relationship established

    within the work organization.

    These studies aimed at finding out if changes in illumination, rest period

    and lunch breaks can affect the productivity of workers. It was found that less light,

    shorter and fewer rest periods and shorter lunch breaks resulted in increase in

    productivity. Increase in productivity was attributed to the attitude to the workers by

    researchers made them feel important which resulted in improvement in their work

    performance. It suggests that employees. The finding of this study concludes that a

    leader not only should plan, decide, organize, lead and control but also consider the

    human element.

    3. HENRI FAYOL THEORY OF MANAGERIAL STYLEHenry Fayol (1841-1925 defined functions of manager in they that has

    come to be known as the management process, which includes planning, organizing,directing and controlling. These functions are similar in many ways to the Nursing

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    process Manger/ Leader; assess the type and amount of work needed and capabilities

    of the employees to perform it. Manager also plan to organizes work duties ,direct staff

    and customers and finally control the quality work by evaluating and revising plans.

    This management function constitutes a set of behaviors expected of managers/leader.

    When it can be applied to nursing unit, where about nurses assess their clients needs,

    plans and organize client care, direct staff and clients, and control the quality of client

    care by evaluating and revising care plans.

    Fayol defines the essential activities needed to maintain of functioning

    organization and his experience led him to develop following management principles.

    1) There should be such a division of work and task specialization that differentworkers consistently carry out different job responsibilities.

    2) Each worker should be given authority commensurate with the amount of hisresponsibility.

    3) Each employee should receive orders from only one supervisor.4) One person should direct all activities that support simple activities.5) The interest of individual worker should be subordinated to interest of the total

    work group.

    6) There should be an unbroken scalar chain of authority extending from the topexecutive to the lowest level worker.

    7) All employees should be treated with equity and justice.8) Manager should help workers to develop team work and esprit De corps .

    4. McGREGOR THEORYDouglas McGregor (1960) categorized leadership style into two brand categories

    in his management theories, i.e. theory X and theory Y, having two different beliefs

    and assumption about subordinates.

    Manager, who believes in theory X and assumes that people inherently dislike work,

    will and avoid it when possible and the average individual prefers to be directed, wants

    to avoid responsibility and is more interested in financial incentives than personal

    achievement. Therefore, the style of leadership exercises strong controls and direction

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    s and wherever necessary punish people if they do not do the work of people do the

    work as desired, they may even get monetary or other rewards.

    In contrast to theory X, the theory Y provide a more accurate assessment of

    human nature, one that encourages workers to develop their full potential. This theory

    Y, assumes that employees can enjoy physical and mental work justly as they enjoy

    play and rest. Employees are capable of self motivation and job satisfaction if they are

    happy in the organization and committed to its goals. Under proper conditions, the

    average person learns both to seek and accept responsibility. The capacity to apply

    creativity to solving organizational problem is widely, not narrowly distributed among

    the workers. Theory Y leaders assume that people will work hard and assume

    responsibility if they can satisfy their personal needs, and the objectives or goals of

    their organization.

    It suggested that theory Y organization will satisfy higher human needs,

    resulting in greater employee responsibility and in turn, higher productivity

    5. THEORY ZJapanese have adapted the principle of human relation theory, is commonly

    known as theory Z the trust of this theory is participation in management

    involvement of the employees in decisions that affect them. This theory emphasizes

    group decision making, lifetime job security, and strong commitment to the goals of

    the organization. The desire results are a greater sense of a job commitment, higher

    productivity and lower turnover. Here as stressed in human relations theory, the

    importance of employee morale on productivity is reflected in the value placed group

    decision making.

    6. TRAIT THEORY OF LEADERSHIPThe great man theory trait theories were basis for most leadership research until

    the mid 1940s. The great man theory, from Aristotelian Philosophy, asserts tat some

    people are born to lead, whereas other is born to be led. Trait theories assume thatsome people have certain characteristics or personality traits the distinguish great

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    leaders; researchers studied the lives of prominent people through out history. The

    effect of followers and the impact of the situation were ignored.

    Although trait theories has obvious short coming (i.e. they neglect they impact

    of others or the situations on the leadership roles) they are worth examine many of the

    characteristics identified in trait theory are still used to describe successful leaders

    today.

    CHARACTERSTICS OF A LEADER

    7. BEHAVIORAL THEORY OF LEADERSHIP STYLEAccording to the theory, a leader behaves according to the role expectations of

    the group. This theorist believes that leadership style like other behaviors can be

    learned regulated and developed. There is no one best leadership style. The

    effectiveness of each leadership style depends upon the situation. As the situation

    changes, the effectiveness manager adapt by changing leader behaviour research has

    identified four styles of leadership in mangers from various fields; autocratic,democratic participative and laissez- faire.

    Intelligence Personality Ability

    Knowledge

    Judgment

    Decisiveness

    Oral fluency

    Adaptability

    Creativity

    Cooperativeness

    Alertness

    Self confidence

    Personal integrity

    Emotional balance &

    control

    Nonconformity

    independence

    Able to enlist

    cooperation

    Interpersonal skills

    Tact, diplomacy

    Prestige

    Social participation

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    AAuuttooccrraattiicc ssttyyllee::--

    In this autocratic style of leadership task oriented. Leader uses positional and

    personal power in authoritys manner, retaining responsibility for all goal setting and

    incision making. A leader of this type makes decision without the participation of

    people concerned.

    Autocratic style leader characterized by the following behaviors;

    1. Strong control is maintained over the group2. Others are motivated by the concerned3. Communication flow downward4. Decision making does not involve others5. Emphasis on difference and status6. Criticism is punitive.

    Democratic Style:-

    In the democratic style of leadership, the leader values the individual

    characteristics and abilities and subordinates

    Democratic style leader characterized by the following behaviors;

    1. Less control is maintained2. Economic and ego awards are used to motivate3. Others are directive through suggestion and guidance4. Communication flows up to down5. Decision making involve others6. Emphasis in We rather than I and you7. Criticism is constructive

    The Participative Leadership Style:-

    In this style, the manger presents her or his analysis of problems and proposal of

    action o employees, inviting their criticism and comments. Having weighed the

    subordinates response the manager makes final decisions about the group future

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    activities. Here the leader allows subordinates to participate in decision making;

    consequently the subordinates have the feeling of satisfaction and freedom.

    Laissez faire style/ abdicratic:-

    In this let alone style of leadership, the appointed manager abdicates

    leadership responsibility, leaving workers without direction, supervision or co-

    ordination and allows them to plan, execute, and evaluate the work in any way they

    like.

    Abdicratic style leader characterized by the following behaviors;

    1. He or she is permissive with little or no controle2. Motivate by support when requested by the group or individual3. Little or no direction provided4. Decision making is dispersed throughout the group5. Emphasis on the group6. Criticism not given

    8. SITUATIONAL THEORYIn this approach, a leader is the product of given situation and the behiour may

    infact, vary from one situation to another. This theory includes the traits of mani.e.

    qualities and motivcations, that bring forth and shape the leadership potential.

    According to this theory, we can find five kinds of leader as follows

    1. Natural leader:-Here person becomes a leader in spite of himself. He does not seek

    the role, it is thurstwed upon him byb the group and by the tide of events, e,g, Abraham

    Lincoline, Mahatma Gandhi, JP Naryan.

    2. Charismatic leader:-Here person is in authentic hero in the eyes of his followers for he can do no

    wrong. He/she inspire people to make any sacrifice even their lives for the cause e.g.

    Ashok, Akbar, Netaji Subhashchandr bose etc.3. Rational leader:-

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    Here the person is consistent and persistent, e.g. Karl Marx, Lenin, Mao, GK

    Gokhle.

    4. Consensus leader:-This leader is perceived as acceptable to all. He or she in the absence of

    the above three and this leader is in tenous position of walking atight rope for existence

    E.g. president of india, spekers of the assembly of parliament.

    5. Leader by the force:-Here the leaders power speaks through the nozzle of gun. She/he dominates

    others through fear. He is ruthless in suppressing opposition. He does not reign long as

    thus type of leadership contains within itself the seeds of its own destruction. E.g.

    Napoleon, Hitler, Staline Idi Amin etc.

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    LEADERSHIP SKILLS

    To be effective Leader the nurses need the primary leader shipskills that as foolws:

    1. Skills of personalI. Is sensitive to feelings of the groups.

    II. Identifies self with thee needs of the group.III. Does not ridicule or critcise another suggestionIV. Helps others feel important and needed.V. Does not argue

    2. Skills of communication.I. Listen attentively

    II. Make sure everyone understand what is needed and the reason why?III. Establishes positive communication with group as routine part of the jobIV. Recognizes that everyones contributions important

    3. Skills of organization: the effective leader helps the group to;I. Developing long and short range objectives

    II. Break big problem into small onesIII. Share responsibilities and opportunitiesIV. Plan act follow up and evaluativeV. Be attentive details

    4. Skills of self examinationI. Is aware of personal motivations

    II. Is aware of the group members; level of hospitals for taking appropriatecountermeasures

    III. Helps the group to be their attitudes and values.

    S=self reliantE=enthusiastic

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    L=loyal

    F=factual

    LEADERSHIP ACTIVTIES

    1. DIRECTING: - it is the process by which actual performances of staff and people,is guided towards common goals. A leader uses assignments, order, policies,

    procedure, rules. Regulations, standard, opinions, suggestions and questions to

    direct subordinates behaviour.

    2. SUPERVISING: - supervision is continuous administrative and educative processwhich enables the supervisor through the medium of his relationship with

    supervisors to contributes towards the continuous growth of the supervision which

    includes inspecting anothers work, evaluating her or his performance, and

    approving or correcting performances.

    3. CO- ORDINATING: - Co-coordinating includes all the activities that enable workgroup members to work together harmoniously.

    QUALITIES OF A NURSE LEADER

    1. KNOWLEDGE OF SELF2. PERSONAL QUALITIES3. INITIATIVE QUALITIES4. TECHNICAL QUALITIES5. TEACHING QUALITIES6. ADMINISTRATIVE QUALITIES7. INTELLECTUAL SKILLS8. ENTHUSIASM9. TACTFUL10.EMOTIONAL CONTROL11.

    AWARENESS OF RESPONSIBILITIES

    12.QUALITY OF BUILDING HUMAN RELATIONS

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    CHARACTERISTICS OF EFFECTIVE LEADERSHIP:

    1. Initiates action- Leader is a person who starts the work by communicating thepolicies and plans to the subordinates from where the work actually starts.

    2. Motivation- A leader proves to be playing an incentive role in the concernsworking. He motivates the employees with economic and non-economic rewards

    and thereby gets the work from the subordinates.

    3. Providing guidance- A leader has to not only supervise but also play a guiding rolefor the subordinates. Guidance here means instructing the subordinates the way they

    have to perform their work effectively and efficiently.

    4. Creating confidence- Confidence is an important factor which can be achievedthrough expressing the work efforts to the subordinates, explaining them clearly

    their role and giving them guidelines to achieve the goals effectively. It is also

    important to hear the employees with regards to their complaints and problems.

    5. Building morale- Morale denotes willing co-operation of the employees towardstheir work and getting them into confidence and winning their trust. A leader can be

    a morale booster by achieving full co-operation so that they perform with best of

    their abilities as they work to achieve goals.

    6. Builds work environment- Management is getting things done from people. Anefficient work environment helps in sound and stable growth. Therefore, human

    relations should be kept into mind by a leader. He should have personal contacts

    with employees and should listen to their problems and solve them. He should treat

    employees on humanitarian terms.

    7. Co-ordination- Co-ordination can be achieved through reconciling personalinterests with organizational goals. This synchronization can be achieved through

    proper and effective co-ordination which should be primary motive of a leader.

    Critical thinking & decision making in leadership

    Application of critical thinking to nursing practice:

    Nurse leader function effectively some part of every day without thinkingcritically. Many small decisions are based primarily on habits with minimal thinking

    involved; example include selecting what cloths to wear, choosing which route to take

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    work, and deciding what to eat for lunch. The nurse clinician and nurse manager seeks

    to be aware of their thinking while they are thinking, as they apply standards forthinking, and as thinking progresses.

    A.Problem solving:Nurse leader use critical thinking to rationally resolve problems related to

    direct client care. Nurse Manager use critical thinking to resolve problemsrelated to overall client care, unit administration, and staff interpersonal issues.Strader 1992 defines problem solving as the process used when a gap is

    perceived between an existing state and a desired state.

    - Trial and error: One way to solve problems is trial and error, in which anumber of approaches are tried until a solution is found.

    - Intuition: Intuition as a problem solving method has not been consideredeither sound or legitimate. Rather, it has been viewed as a form of guessing

    and as such an inappropriate basis for nursing decisions.

    B.Decision making:Tschikota 1993 states that, effective clinical decision making is critical

    to the future of professional nursing practice. Nurses make decisions in the

    course of solving problems, for example, in each step of nursing process.

    Decision making, however, is also used in situations that do not involveproblem solving. Nurses make value decisions; time management decision;

    scheduling decisions and priority decisions.

    Strader 1992 describes seven steps of decision making process:

    1. Identify the purpose.2. Set the criteria.3. Weight the criteria.4. Seek alternatives.5. Test alternatives.6. Troubleshoot.7. Evaluate the action.

    The decision making process and the nursing process share similarities. The

    nurse use decision making in all steps of the nursing process.C.Clinical decision making:

    When a nurse approaches a clinical problem, such as a client who has

    developed a pressure ulcer or who is anxious about having surgery; the nurse

    collaborates with the client to make a decision that identifies the problem andthen chooses those nursing interventions that will meet the mutually established

    goals of care. Nurses make clinical decision all the time in an attempt to

    improve a clients health or to maintain ongoing wellness. This may mean

    resolving the problem completely. The clinical decision making processrequires careful reasoning so that the options for the best client outcomes are

    chosen on the basis of the clients condition and the priority of the problem.

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    D.Scientific method:The scientific method is one approach to reasoning that is used in

    nursing, and a variety of other disciplines. It is approach to seeking the truth or

    verifying that a set of facts agrees with reality. Nurse researcher uses the

    scientific method when testing research questions in nursing practice situations.For example, a nurse researcher might observe that clients in a hospice programoften have difficulty communicating their feelings to family members. The

    nurse learns more about what cause this problem and consider this possibility

    that family members might have ineffective communication skills. The nurse

    might design a study that involves formal instruction in communication skills

    and use a support group to help family members practice and apply the skill.

    E.Diagnostic reasoning:As soon as a nurse receives information about a client in a particular clinicalsituation, diagnostic reasoning begins. It is a process of determining a clients

    health status after the nurse assigns meaning to the behaviors, physical signs,

    and symptoms presented by the client. Part of diagnostic reasoning is inference,that is, the process of drawing conclusions fro drawing conclusions from related

    pieces of evidence. For example, when a client presents symptoms of

    restlessness, guarded posturing and abnormal discomfort, the nurse must

    retrieve knowledge regarding pain in the abdomen and the reason in a direct and

    precise way to determine the specific nature of clients pain.

    F. Nursing process:Nurses apply the nursing process as a competency when delivering client care.

    The nursing process consists of five steps: assessment, diagnosis, planning,

    implementation and evaluation. The purpose of the nursing process is to

    diagnose and treat human responses to actual and potential health problems.

    Nursing process: Critical thinking and decision

    making process:

    Assessment

    Diagnosis

    Plan

    Implement

    Evaluation

    Identify the Purpose.

    Set a criteria

    Weigh the criteria

    Seek alternatives

    Test alternatives

    Evaluate the action

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    Leader As A Critical Thinking

    1. Leadership provides progressive environment.2. Leader should encourage.3. Leader should believe in compassion4. Leader should be sensitive5. Leader should possess energy more than member6. Leader should consider suggestion and criticism.7. Leader should believe in justice .

    Stress Management In Leadership

    1. Take a Deep BreathWhen you feel uptight try taking a minute to slow down and breathe deeply.

    Breathe in through your nose and out through your mouth. Try to inhale enough

    so that your lower abdomen rises and falls. Count as you exhaleslowly.

    2. Practice Specific Relaxation TechniquesRelaxation techniques are extremely valuable tools in stress management. Most

    of the techniques like meditation, self hypnosis, and deep muscle relaxation

    work in a similar fashion. In this state both the body and the mind are at rest and

    the outside world is screened out for a time period. The practice of one of these

    techniques on a regular basis can provide a wonderfully calming and relaxing

    feeling that seems to have a lasting effect for many people.

    3. Manage TimeOne of the greatest sources of stress is poor time management. Give priority to

    the most important ones and so those first. If a particularly unpleasant task faces

    you, tackle it early in the day and get over with it; the rest of your day will

    include much less anxiety.

    Most importantly, do not overwork yourself, schedule time for both work and

    recreation.

    4. Connect with OthersA good way to combat sadness, boredom and loneliness is to see out activities

    involving others.

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    5. Talk it OutWhen you feel something, try to express it. Share your feelings. Bottled Up

    emotions increase frustration and stress. Talking with someone else can help

    clear you mind of confusion so that you can focus on problem solving. Also

    consider writing down thoughts and feelings. Putting problems on paper can

    assist you in clarifying the situation and allow you a new perspective.

    6. Take a Minute Vacationmagining a quiet country scene can take you out of the turmoil of a stressful

    situation. When you have the opportunity, take a moment to close your eyes and

    imagine a place where you feel relaxed and comfortable. Notice all the details

    of your chosen place, including pleasant sounds, smells and temperature or

    change your mental channel by reading a god book or playing relaxing music

    to create a sense of peace and tranquility.

    7. Monitor Your Physical ComfortWear comfortable clothing. If its too hot, go somewhere where its not. If your

    chair is uncomfortable, change it. If your computer screen causes eye-strain or

    backaches, change that, too. Dont wait until your discomfort turns into a real

    problem. Taking five minutes to arrange back support can save you several days

    of back pain.

    8. Get PhysicalWhen you feel nervous, angry or upset, release the pressure through exercise or

    physical activity. Running, walking or swimming are good options for some

    people, while others prefer dance or martial arts. Working in the garden,

    washing your car, or playing with children can relieve that uptight feeling,

    relax you and often will actually energize you. Remember, your body and mind

    work together. Most experts recommend doing 20 minutes of aerobic activity

    daily will reduce stress.

    9. Take Care of Your BodyHealthy eating and adequate sleep fuels you mind as well as your body. Avoidconsuming too much caffeine and sugar. Take time to eat breakfast in the

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    morning, it really will help keep going through the day. Well nourished bodies

    are better prepared to cope with stress. If you are irritable and tense from lack of

    sleep or not eating right, you will be less able to go the distance in dealing with

    stressful situations. Increase the amount of fruits and vegetables in daily diet.

    Take time for personal interests and hobbies. Listen to ones body.

    10.LaughMaintain your sense of humor, including the ability to laugh at yourself.

    11.Know Your LimitsThere are many circumstances in life beyond your control, consider the fact that

    we live in an imperfect world. Know your limits. If a problem is beyond your

    control and cannot be changed at the moment, dont fight the situation. Learn to

    accept what is, for now, until such time when you can change things.

    12.Think PositivelyRefocus the negative to be positive. Make an effort to stop negative thoughts.

    13.Have a Good CryA good cry during periods of stress can be a healthy way to bring relief to your

    anxiety, and it might prevent a headache or other physical consequences of

    bottling things up.

    14.Avoid Self MedicationAlcohol and other drugs do not remove the conditions that cause stress.

    Although they may seem to offer temporary relief, these substances only mask

    or disguise problems. In the long run, alcohol use increases rather than

    decreases stress, by changing the way you think and solve problems and by

    impairing your judgment and other cognitive capacities. Medications should be

    taken only on the advice of a doctor.

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    Group dynamic in leadership

    Individual Role Of Group Members

    1. Aggressor: expresses disapproval of others values2. Blocker: expressing negative points of view3. Recognition seeker:works to focus positive attention4. Self confessor: uses the group setting as a forum for personal expression5. Dominator:attempts to control and manipulate the group6. Help seeker:uses expressions of personal insecurity, confusion7. Special interest pleader:cloaks personal prejudices or biases

    Conclusion:-

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    REFERENCES

    Basawanthappa BT, Nursing administration, Jaypee brothers medical publishers (p)

    ltd 2004, edition 1st , Pp:43- 49, 258-259

    Bernhard LA, Walsh M: Leadership the key to the professionalization of nursing.

    3rd edition. Missouri: Mosby publishers 1995, Pp:36- 47

    Marquis L.Bessiel, Leadership roles and management functions in Nursing theory

    and application, Lippincott Williams and Wilkins publications 2000, edition 3rd,

    Pp:67-73

    Marriner Ann, Guide to nursing management, Mosby publishers 1988, edition 4th

    Pp: 29-31, 273- 274, 287.

    Swansburg. C. Russell, Swansburg J. Richard, Introduction to management and

    leadership for nurse managers, Jones and Barlett publishers 2002, edition 3rd ,

    Pp:68- 70

    Journal of Clinical Nursing2000,9(4) Pp: 545-548

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    Journal of Holistic Nursing1999, 30(6),Pp: 1375-82

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