Directing Directing includes delegation of

Introduction work to be performed, utilization of

Direction represents one of the policies and procedures, supervision of
essentials functions of management personnel, coordination of services,
because it deals with human relations. communication, staff development,
Direction is also, infrequently and by and making decisions.
some, labeled as ‘actuating’. Once the
organizational plans have been laid
down, the structure being designed • Communications - It is one way. The
and competent people brought in to fill manager speaks, employees listen
various positions in organization. and react. The only feedback
Direction is the managerial function of managers ask for is - "Do you
guiding, motivating, leading, understand what needs to be done?"
supervising the subordinates to
• Goal-Setting - The manager
accomplish desired objectives.
establishes short-term goals with
Acquiring physical and human assets
specific deadlines.
will not suffice; what is more important
is that people must be directed toward • Decision-Making - The manager
organizational goals. Without proper makes most if not all decisions. When
direction and supervision employees problems arise the manager
become inactive, dull and inefficient evaluates options, makes decisions
and consequently the physical assets and directs employees as to what
like machinery and plant will be put to actions to take.
ineffective use.
• Providing Feedback - The manager
Definition provides candid, detailed instructions
It is the directing style wherein as to what changes the employee
managers tell their personnel what to needs to make.
do, how to do it and when to have it
completed by. They assign roles and • Rewards and Recognition - Managers
responsibilities, set standards, and reward and recognize people for
define expectations. following directions.
Directing is the fourth phase of Basic Concepts about Directing
the management process. This phase
 Direction consists of the process
could also be referred as coordinating,
and techniques utilizing in issuing
or activating. It is the action phase of
instruction and making certain that
management, requiring the leadership
operations are carried out as
and management skills necessary to
originally planned.
accomplish the goals of the
organization  Direction is a complex function
It is the issuance of orders, that includes all those activities
assignments and directions that which are designed to which
enable the nursing personnel encourage subordinates to work
understand what are expected of effectively and efficiently in both
them. Directing includes supervision short and long run.
and guidance so that in doing their job
well, nurses can maximally contribute  Direction is telling people what
to the organization’s goal in general to do and seeing that they do it to
and into nursing service objective in the best of their ability.
particular.
 Directing deals with the steps a  Provide subordinates with
manager takes to get subordinates enough time to learn.
and others to carry out plans.
 Delegate gradually.
 Direction provides link between
different functions in an organization.  Delegate in advance.

Points to Remember When Using the  Consult before delegating

Directing Style
1. Organize your thoughts before  Avoid gaps and overlaps
you begin to speak. Nursing Care Assignments
2. Start with the big picture, and Nursing care assignments can be
then discuss the details. called by various terms this is
sometimes called modalities of nursing
3. Make sure your directions are care, systems of nursing care, or
clear and specific. patterns of nursing care.
Functional Nursing
4. If possible show employees the  Task-oriented
desired output. Take the mystery and
guess work out of what you want.  A particular nursing function is
assigned to each worker
5. Assign due dates.
 Best system when there are
6. Provide written instructions if the
many patients and many nurses
directions are complex or lengthy.
available
7. Get feedback -test the transfer.
Ask the employee to explain in his or  For short term use
her own words what you want done. Advantage:
Elements of Directing  Allows work to be done in
The directing functions of the manager shortest time
include the following:
1. Delegation  Worker learns to work fast
2. Supervision  Learn skills faster
3. Leadership Disadvantage:
4. Motivation  Wholistic care is not achieved
5. Communication
 Nurses accountability and
6. Coordination responsibility are diminished

7. Orientation  Patients cannot ‘identify’ their

real nurse
Principles of Delegation
 Select the right person to whom  Nurse-patient relationship is not
the job is to be delegated. fully developed

 Delegate both interesting and  Evaluation of nursing care is

uninteresting tasks. poor and evaluation are rarely
documented
 Difficult to find a specific person Primary Nursing
who can answer patient’s or  A form of assigning
relatives’ question responsibilities for patient care,

Total Care or Case Nursing  A decentralization authority

 One nurse is assigned for the
delivery of total care  Each registered nurse is
responsible for the care of small
 The nurse plans, coordinate, group of patients from admission to
implements, evaluate, and document discharge.
the nursing care she has given during
the shift.  The primary nurse asses the
patient’s needs for care, set care
 Commonly used in private goals, writes a nursing care plan,
nursing, special care units, isolation administer care according to that
units and on nursing students plan, evaluates the outcome of care,
and make the necessary adjustment
 Nurses are accountable for and revision as necessary. He/She
his/her actions provides pre-discharge planning and
teaching
 Provides wholistic care
 Assumes 24-hour responsibility—
 Works only when there are the secondary or associate nurse
plenty of nurses and patients are few execute the nursing plan during the
afternoon and night shifts and on
days that the primary nurse is off
Team Nursing duty

 Decentralized system of care  Primary and secondary nurses

are freed from administrative and
 A nurse leads a group of nursing housekeeping responsibilities to
personnel in providing patient care maximize their time for patient care.
through participative effort.
 Authority, accountability, and
 The team leader assigns patients autonomy are values of primary
and tasks to team members nurse
according to job description
Modular Method
 The team leader is responsible  It is the modification of team and
for coordinating the total care of a primary nursing
group of patients.
 Unlike in team nursing, a nurse
 The heart if team nursing is team provides direct care with the
conference assistance of aides. The professional
nurse provides leadership, support
 Team plan recognize and and instruction t the non-professional
prioritize strength and weakness of aide.
all team members
 It is similar in primary nursing in
 The team leader supervises the that each pair or trio of nursing
nursing care goals and focuses on personnel is responsible for the care
attaining them through guidance and of patients from admission to
setting of high standard of care. discharge
 It is customary to assign the two public health nurse, and
or three-worker team full interdisciplinary staff must be
responsibility for a case load of 8 – 12 established and nurtured.
patients
Communication
 The same in primary nursing, The word communication comes
another group of nurses will care on from the Latin word communis,
the patient on alternating shifts and meaning commonness. Communication
day off. is a two-way process by which
information exchanged between or
 Responsibility is to assess among individuals through a common
patient needs, plans and implement system of symbols, signs and behavior.
care, and assess outcomes including Communication is the process to
guiding and instructing her partners. impart information from a sender to a
receiver with the use of a medium.
Case Management Communication requires that all parties
 A system of patient care delivery have an area of communicative
that focuses on the achievement of commonality. Chitty (2001) defines
outcomes with effective an communication as the complex
appropriate time frames and exchange of thoughts, ideas, or
resources. information on at least two levels:
verbal and nonverbal.
 Focuses on entire episode of
• Verbal Communication- the
illness, crossing all settings in which
transmission of ideas, opinions,
the patient receives care
feelings, emotions or attitudes through
 Care is directed by case the use of words. Ex: comments,
manager who ideally is involved in a question, reactions
group practice. She is responsible for • Nonverbal Communication- refers to
assessment of patient and family, the sending of messages to another
establishes the nursing diagnosis, person utilizing methods or means
develops nursing care plan, other then words. Ex: facial
delegates nursing care to associates, expression, gesture, eye contact
activates intervention, coordinates Communication is a process by
and collaborates with which we assign and convey meaning in
interdisciplinary team, and evaluate an attempt to create shared
outcomes of care understanding. This process requires a
vast repertoire of skills in intrapersonal
 In institution these activities are and interpersonal processing, listening,
done prior to admission and observing, speaking, questioning,
continues to 2-3 weeks after analyzing, and evaluating. Use of these
discharge processes is developmental and
transfers to all areas of life: home,
 In communities, activities occur school, community, work, and beyond.
in different setting- the home; clinic, It is through communication that
hospital-as long as necessary. collaboration and cooperation occur.
Examples are prepaid health care
plans and health maintenance Communication Process (Diagram on
(HMOs). the last page)
As a process, communication is
 Relationship between the case dynamic, adaptive, and continuous.
manager, physicians, primary nurse, Communication helps us to develop to
be unique persons, relating and Formal organization structure has
cooperating with others. an impact on communication. People at
An internal and an external lower levels of organizational hierarchy
climate also exist in communication. are at risk for inadequate
The internal climate includes the values, communication from higher levels. This
feelings, temperament, and stress occurs because of the number of levels
levels of the sender and the receiver. communication must filter through in
Weather conditions, temperature, large organizations. As the numbers of
timing, and the organizational climate employees increases, the quantity of
itself are parts of the external climate. communication generally increases;
The external climate also includes however, employees may perceive it as
status, power, and authority as barriers increasingly closed.
to manager-subordinate In addition, in large organizations,
communication. it is impossible for individual managers
Internal climate External climate to communicate personally with each
person or group involved in
organizational decision making. Jackson
Sender
(1984) has identified the following
Message
Internal characteristics of large organizations
External that make communication particularly
difficult:
Written • Spatial distance within an
Receiver
organization can be a barrier to
Non-verbal communication.
Verbal • Different subgroups or
Both sender and the receiver subcultures within the organization
must be sensitive to the internal and have their own value systems and
external climate, because the identities. Members within that
perception of the message is altered subgroup form an allegiance to their
greatly depending on the climate that own members. This results in different
existed at the time the message was translations of messages from the
sent or received. Example, an insecure management, depending on the
manager who is called to meet with significance of the message to the
superiors during a period of stringent things the subgroup values and is
layoffs will probably view the message striving to accomplish.
with more trepidation than a manger • People are structured into
who is secure in his or her role. different systems of relationships in
In assessing the internal climate, organizations. A work structure exists
remember that the human mind in which certain people are expected
perceives only what it expects to to complete tasks with other people.
perceive. The unexpected is generally An authority structure exists when
ignored or misunderstood. In other some workers are in charge of
words, receivers cannot communicate if supervising others. A status structure
the message is incompatible with their determines which people have rights
expectations. Therefore, effective and privileges. A prestige structure
communication requires the sender to allows some people to expect
determine what receivers see and hear. deferential treatment from others. The
friendship structure encourages
Variables Affecting Organizational interpersonal trust. All of these
Communication systems influence who should
 communicate with whom and in what continue to affect tremendously the
manner. types and quality of organizational and
• Organizations are in constant unit-level communication.
state of flux. Relationships (subgroups
or subcultures) and geographical Organizational Communication
locations constantly change. It is Strategies
difficult to communicate decisions to Although organizational
all people who are affected by them communication is complex, the
because of this constant state of following strategies can increase the
change. likelihood of clear and complete
communication:
Gender is also a significant factor  Managers must understand the
in organizational communications since organization’s structure and recognize
men and women communicate and use who will be affected by decisions that
language differently. Indeed, Hall and are made. Both formal and informal
Roter’s (1998) study of communication communication networks need to be
patterns of male and female physicians considered.
found that the communication style of o Formal Communication
female physicians included more focus networks follow the formal line of
on the patient’s emotional and authority in the organization’s
psychosocial concerns, more positively hierarchy.
toned communication, and a more o Informal Communication
egalitarian style reflected in increase networks occur between people at
levels patient participation. the same or different levels of the
Complicating the picture further is organizational hierarchy but do not
the historical need in the healthcare represent formal lines of authority or
industry for a predominantly male responsibility. Although there may be
medical profession. Chitty (2001) states a significant exchange of information
that during female-dominated nursing about unit or organizational
school experiences, most nurses are functioning, this communication
encouraged to view physicians as network would not be apparent on
teammates and to collaborate with the organization chart. It is
them whenever possible. Male- imperative, then, that managers be
dominated medical schools, however, very careful of what they say and to
tend to instill in their graduates the whom until they have a good
hierarchal model of teamwork with the understanding of the formal and
physician at the top of the hierarchy. informal communication networks.
The combination of difference in use of  Communication is not a one-way
language and difference in status often channel. If another departments or
results in patterns of male disciplines will be affected by the
predominance and female deference in communication, the manager must
communication. consult with those areas for feedback
In addition, majority of healthcare before the communication.
administrators continue to be male.  The communication must be
Therefore, male physicians and male clear, simple and precise. The
administrators may feel little incentive manager (sender) is responsible for
to seek a more enlightened, ensuring the message is understood.
collaborative approach in  Managers should seek feedback
communication that female nurses regarding whether their
often desire. These differences in communication was accurately
gender and in power and status
 received. One way to do this is to ask • Diagonal Communication, the
the receiver to repeat the manager interacts with personnel and
communication or instructions. In managers of other departments and
addition, the sender should continue groups, such as physicians, who are
follow-up communication in an effort not on the same level of the
to determine if the communication is organizational hierarchy.
being acted upon. • Grapevine, the most informal
 Multiple communication methods communication network. Usually
should be used when possible if a involves three or four people at a time.
message is important. Using variety of It is subject to error and distortion
communication methods in because of the speed at which it
combination increases the likelihood passes and because the sender has
that everyone in the organization who little formal accountability for the
needs to hear the message will. message. Ribeiro and Blakely (1998)
 Mangers should not overwhelm suggest this distortion occurs because
subordinates with unnecessary transmitters using this often do one of
information. Although information and the following: (1) elaborate on the
communication are different, they are original story but convey its original
interdependent. Information is formal, intent, (2) distort the message either
impersonal and unaffected by deliberately or unintentionally, or (3)
emotions, values, expectations and start a contradictory message because
perceptions. Communication, on the they disagree with the original
other hand, involves perception and message received.
feeling. It does not depend on
information and may represent shared Communication Modes
experiences. In contrast to information • Written communication. Written
sharing, superiors must continually messages allow for documentation.
communicate with subordinates. They may, however, be open to
various interpretations and generally
Channels of Communication consume more managerial time. Most
• Upward Communication, the manager managers are required to do a
is a subordinate to higher considerable amount of this type of
management. Needs and wants are communication and therefore need to
communicated upward to the next be able to write clearly.
level in the hierarchy. Those at this • Face-to-face communication. Oral
higher level make decisions for a communication is rapid but may result
greater segment of the organization in fewer people receiving the
that the lower-level manager. information than necessary. They also,
• Downward Communication, the communicate verbally in formal
manager relays information to meetings, with people in peer work
subordinates. This is the traditional groups, and when making formal
form of communication in presentations.
organizations and helps coordinate • Nonverbal communication. Nonverbal
activities in various levels of the communication includes facial
hierarchy. expression, body movements, and
• Horizontal Communication, managers gestures and is commonly referred to
interact with other on the same as body language. Because nonverbal
hierarchical level as themselves who communication indicates the
are managing different segments of emotional component of the message,
the organization. it is generally considered more reliable
than verbal communication. There is
 significant danger, in misinterpreting  Environment. The area where the
nonverbal messages if they are not communication takes pace is an
assessed in context with the verbal important part of the communication
message. process. Communication that takes
• Telephone communication. A place in a superior’s office is generally
telephone call is rapid and allows the taken more seriously than that which
receiver to clarify the message at the occurs in the cafeteria.
same time it is given. Accents may be  Appearance. Mush is
difficult to understand as well in a communicated by our clothing,
multicultural workforce. hairstyles, cosmetics, and
attractiveness. The phrase “dressing
INTERPERSONAL COMMUNICATION IN A for success” appropriately designs the
MULTICULTURAL WORKPLACE impact of dress and appearance on
Because it is impossible for the role perception and power, however;
individual manager to communicate again, care should be exercised to
face to face with each member in the establish dress policies that
large organization, managers must incorporate both cultural and gender-
develop other interpersonal related sensitivities.
communication skills. These skills  Eye contact. This nonverbal clue
include nonverbal communication, is often associated with sincerity. Eye
verbal communication skills, and contact invites interaction. Likewise,
listening skills. Perhaps even more breaking eye contact suggests that
importantly, the manager must have the interaction is about to cease.
the sensitivity and leadership skills to Bohannon (200,p.21) states that
communicate in today’s multicultural making eye contact is one f the key
workplace. components of effective body
language. Blinking, staring, or looking
NONVERBAL COMMUNICATION SKILLS away when you begin speaking makes
Much of our communication it hard for you to connect with another
occurs through nonverbal channels that person emotionally.
must be examined in the context of the  Posture. Posture and the way you
verbal content. Generally, if verbal and control the other parts of your body
nonverbal messages are incongruent, are extremely important. In addition,
the receiver will believe the nonverbal the weight of a message is increased if
message. the sender faces the receiver, stands
Because nonverbal behavior can or sits appropriately close, and, with
be frequently is misinterpreted, head erect, leans toward the receiver.
receivers must validate perceptions  Gestures. A message accented
with senders. The incongruence with appropriate gestures takes on
between verbal and nonverbal leads to added emphasis. Too much gesturing
many communication problems. can, however, be destructing. Indeed,
The following is a partial list of the use of touch is one gesture that
nonverbal clues that can occur with or often sends messages that are
without verbal communication: misinterpreted by receiver’s fro
 Space. The space between the different cultures.
sender and receiver influence what is  Facial Expression. Effective
communicated. Although distance communication requires a facial
implies a lack of trust or warmth, expression that agrees with your
inadequate space, as defined by message. Managers who present a
cultural norms, may make people feel pleasant and open expression are
threatened or intimidated.
 perceived by staff as approachable. generally involves limited verbal
Likewise, a nurse’s facial expression exchange (with incongruent nonverbal
can greatly affect how and what behavior) by a person who feels
clients are willing to relate. strongly about a situation. This person
 Timing. Hesitation often feigns withdrawal in an effort to
diminishes the effect of your manipulate a situation.
statement o implies untruthfulness. The second misconception is that
 Vocal clues such as tone, volume, those who communicate or behave
and inflection. All of these clues add to assertively get everything they want.
the message being transmitted. This is untrue because being assertive
Tentative statements sounds more like involves rights and responsibilities.
questions than statements, leading The third misconception about
listeners to think you are unsure of assertiveness is that it is unfeminine.
yourself. Speaking rapidly implies Although the ole of women in the
nervousness, and speaking in society in general has undergone
monotone voice implies disinterest. tremendous change in the last 100
The goal, then, should always be to years, nursing continuous to find great
convey confidence and clarity. difficulty in accepting that the nurse
plays an assertive, active, decision
VERBAL COMMUNICATION SKILLS making role.
One of the most important verbal A fourth misconception is that the
communication skills is the art of terms assertive and aggressive are
assertive communication. Assertive synonymous. To be assertive is to not
behavior is a way of communicating be aggressive, although some cultures
that allows people to express find the distinction blurred. Even when
themselves in direct, honest, and faced with someone else’s aggression,
appropriate ways that do not infringe on the assertive communicator does not
another person’s rights. To be become aggressive. When under attack
successful in the directing phase of by an aggressive person, an assertive
management, the leader must have well person can do several things:
developed skills in assertive  Reflect. Reflect the speaker’s
communication. message back to him or her. Focus on
There are many misconceptions the affective components of the
about assertive communication. The aggressor’s message. This helps the
first is that all communication is either aggressor to evaluate whether the
assertive or passive. Actually, at least intensity of his or her feelings is
four possibilities for communication appropriate to the specific situation or
exist: passive, aggressive, indirectly event.
aggressive or passive-aggressive, or  Repeat the assertive message.
assertive. Passive communication Repeated assertions focus on the
occurs when a person suffers in silence, messages objective content. They are
although he or she may feel strongly especially effective when the
about the issue. Aggressive people aggressor over generalizes or seems
express themselves in a direct and fixated on a repetitive line of thinking.
often hostile manner that infringes on  Point out the implicit assumptions.
another person’s right; this behavior is This involves listening closely and
generally oriented toward “winning at letting the aggressor know that you
all cost” or demonstrating self have heard him or her. In these
excellence. Passive-aggressive situations, managers might repeat
communication is an aggressive major points or identify key
message presented in a passive way. It assumptions to show that they are
 following the employee’s line of individuals creates a diversity of
reasoning. interactions, values, experiences, and
 Restate the message by using beliefs.
assertive language. Rephrasing the
aggressor’s language will defuse the LISTENING SKILLS
emotion. Paraphrasing helps the The active process of listening is
aggressor focus more on the cognitive as important as verbal skills. These
part of the message. The manager listening skills are so important that
might use restating by changing a Kerfoot (1998) suggests, “Listening and
“you” message to an “I” message. hearing what people are saying to you
 Question. When the aggressors is a science and an art.” It is important
uses nonverbal clues to be aggressive, that the leader/manager approach
the assertive person can put this listening as an opportunity to learn
behavior in the form of a question as appreciation for a cultural perspective
an effective means of helping the of the organization that is different on
other person become aware of an his or her own.
unwarranted reaction. To become better listeners,
leaders must first become aware of how
Andrews (1998) suggest the following their own experiences, values,
strategies to promote effective verbal attitudes, and biases affect how they
communication in the multicultural receive and perceive messages.
workplace: Second, leaders must overcome the
 Use proper titles of respect. Do information and communication
not call a person by his or her first overload inherent in the middle
name until given permission to do so. management role. It easy for
 Be aware of subtle linguistic overwhelmed managers to sop listening
messages that may convey bias or actively to the many subordinates who
inequality. need and demand their time
simultaneously.
 Avoid slang, pejorative, or
Finally, the leader must
derogatory terms when referring to
continually work to improve listening
persons from a particular ethnicity,
skills. The leader who actively listens
race, or religious group.
gives genuine time and attention to the
 Avid making remarks to staff that
sender, focusing on verbal and
they should consider themselves
nonverbal communication. The leader’s
fortunate to be employed by the
primary purpose, then, is to receive the
organization. Do not compare their
message being sent rather than forming
employment opportunities and
a response before the transmission of
conditions to people in their country of
the message is complete.
origin.
 Avoid using phrases such as GROUP COMMUNICATION
“culturally disadvantaged,” Managers must communicate with
“socioeconomically disadvantaged,” large and small groups, as well as
and culturally deprived” as they individual employees. Because a group
suggest inferiority and may be communicates differently than
offensive to others. individuals do, it is essential that the
 Do not expect a staff member to manager have an understanding of
know or get along well with all other group dynamics, including the sequence
staff members of the same ethnicity. each group must go through before
Although they share the same work can be accomplished.
ethnicity, their uniqueness as
 Juckman and Jenses (1977) either by members or by the leader.
labeled theses stages forming, These roles or tasks follow:
storming, norming and performing. 1. Initiator. Contributor who
When people are introduced, they must proposes or suggests group goals or
go through a process of meeting each redefines the problem. There may be
other: the forming stage. They then more than one initiator during the
progress through a stage where there is group’s lifetime.
much competition and attempts at the 2. Information seeker. Searches for a
establishment of individual identities: factual basis for the group’s work.
the storming stage. Next, the group 3. Information giver. Offers an
begins to establish rules and design its opinion of what the group’s view of
work: the norming stage. Finally, during pertinent values should be.
the performing stage, the work actually 4. Opinion seeker. Seeks opinions
gets done. that clarify or reflect the value of other
Some experts suggest there is members’ suggestions.
another phase: termination or closure. 5. Elaborator. Gives examples or
In this phase, the leader guides extends meanings of suggestions
members to summarize, express given and how they could work.
feelings, and come to closure. 6. Coordinator. Clarifies and
Because a group’s work develops coordinates ideas, suggestions and
over time, the addition of new members activities of the group.
to a committee can slow productivity. It 7. Orienter. Summarizes decision
takes some time for the group to accept and actions, identifies and questions
new members. Some developmental departures from predetermined goals.
stages will be performed again or 8. Evaluator. Questions group
delayed if several new members join a accomplishes and compares them to
group. Therefore, it is important when standard.
assigning members to a committee to 9. Energizer. Stimulates and prods
select those who can remain until the the group to act and raises the level of
work is finished or until their it actions.
appointment is over. 10. Procedural technician. Facilitates
group action y arranging the
GROUP DYNAMICS environment.
In addition to forming, storming, 11. Recorder. Records the group’s
and norming, two other functions of activities and accomplishments.
groups are necessary for work to be
performed. One has to do with the task GROUP BUILDING and Maintenance
or the purpose of the group, and the Roles
other has to do with the maintenance of The group task roles contribute to
the group or support functions. the work to be done; the group-building
Managers should understand how roles provide for the care and
groups carry out their specific tasks and maintenance of the group. Examples of
roles. group-building roles include:
 Encourager. Accepts and praises
TASK ROLES OF GROUPS all contributions, viewpoints, and ideas
There are 11 tasks that each with warmth and solidarity.
group performs. A member may  Harmonizer. Mediates,
perform several tasks, but for the work harmonizes, and resolves conflicts.
of the group to be accomplished, all the  Compromiser. Yields his or her
necessary tasks will be carried out, position in a conflict situation.
 Gatekeeper. Promotes open communication and productivity within
communication and facilitates the organization. However, the
participation by all members. leadership roles have an even greater
 Standard setter. Expresses or impact on group effectiveness. Dynamic
evaluate standard to evaluate group leaders inspire followers toward
process. participative management by how they
 Group commentator. Records work and communicate in groups
group process and provide feedback to leaders keep group members on course,
the group. draw out shy, politely cut off garrulous,
 Follower. Accepts the group’s and protect the weak.
ideas and listens to discussion and
decision. PRINCIPLES OF EFFECTIVE
COMMUNICATION
INDIVIDUAL ROLES OF GROUP 1. Clear lines of communication
MEMBERS serve as the linking process by which
Group members also carry out parts of the organization are unified
roles that serve their own needs. Group toward goal achievement.
leaders must be able to manage Synchronization of efforts is facilitated
member roles so that individuals do not when proper lines of communication
disrupt group productivity. The goal, are identified and utilized.
however, should be management and 2. Simple, exact, and concise
not suppression. Not every group messages ensure understanding of the
member has a need that results in the message to be conveyed. Sine
use of one of these roles. The eight effective communication starts with
individual roles follow; the perception of the recipient,
1. Aggressor: expresses disapproval overloading or under loading of
of other’s values or feelings through messages should be avoided to
jokes, verbal attacks, or envy. prevent distortion and
2. Blocker: persist in expressing misunderstanding.
negative points of view and resurrect 3. Feedback is essential to effective
dead ideas. communication. Mutual interaction is
3. Self-confessor: uses the group required. There is little or no
setting as a forum for personal communication when there is no
expression. feedback. Listening, openness to the
4. Recognition seeker: works to other person’s point of view and being
focus positive attention on her/him. supportive provide the means to
5. Playboy: remains uninvolved and effective feedback.
demonstrate cynicism, nonchalance or 4. Communication thrives best in a
horseplay. supportive environment which
6. Dominator: Attempts to control or encourages positive values among its
dominate the group. personnel. Communication is used to
7. Help seeker: uses expression or support the vision, mission, and goals
personal insecurity, confusion or self- of the organization and the nursing
depreciation to manipulate sympathy service.
from other members. 5. A manager’s communication skill
8. Special interest pleader: cloaks is vital to the attainment of the goals
personal prejudices or biases by of the organization. Successful
ostensibly speaking for others. managers utilize various mode s of
Managers must be well grounded in communication. It may be for the mal
group dynamics and group roles or informal, written or verbal.
because of their need to facilitate group Meetings interviews, counseling, turn-
 of-the shift reports, memos, charts, does not touch the collar line. Male
and official publications are examples nurses must be clean-shaven. They
of written communication. Body must carry their uniforms with pride
language affects he effectively of and dignity.
communication. 2. INTONATION OF THE VOICE – The
6. Adequate and timely information of the nurses’ voice should
communications of work-related issues be soft and gentle. It should not be
or changes that may affect jobs irritating to the ear.
enhance compliance. People resist 3. FACIAL E XPRESSION – A friendly
change if they do not understand the smile establishes immediate rapport
reason for it. Such announcements with the client and invites trust and
should be factual and comprehensive confidence in the nurse.
and given face to face for better 4. POSTURE and GAIT – The nurse’s
reception and understanding. posture and gait indicate his physical
wellness, his emotions, and attitude
TYPES OF COMMUNICATION towards his clients.
Mainly, there are three types of 5. TOUCH – Touch is a way of caring.
communication: spoken words, written A gentle touch conveys a caring
words, and physical expression or person. A rough person indicates
significant gestures. insensitivity to the patients and
Verbal communication involves unresponsiveness to their needs.
spoken words. The speaker must be
able to speak slowly, enunciating the LINES OF COMMUNICATION
words clearly. Choose words that can be Communication is described as a
clearly understood instead of using too two-way process, yet in an organization,
technical ones. Only relevant it is four-dimensional.
information should be conveyed to
prevent confusion. It ascertains Downward Communication
immediate response when time is short. The traditional line of
Written communication must be communication is from superior to
clear, correct, complete and concise. subordinate which may pass trough
This should be written in words that are various levels of management. The
clearly understood by the reader. communication is primarily directive
Written communication comes in the and activities are coordinated at various
form of memoranda, hospital orders, levels of the organization.
documentation, records and reports, Communication aims to impart what the
policies, procedures, and the like. personnel need to know. What they are
Ambiguous terms should be voided to to do and why they are to do these.
prevent misunderstanding. Downward communication
Non-verbal communication is includes policies, rules and regulations,
transmission of message without the memoranda, handbooks, interviews, job
use of words. People oftentimes descriptions, and performance
unconsciously use facial expressions, appraisal.
gestures, touch, body language, or Upward Communication
vocal tones. Upward communication emanates
1. PERSONAL APPEARANCE – The from subordinates and goes upward.
appearance of a person gives the This is usually in the form of feedback
general impression of his personality to show the extent to which downward
and self-concept. Nurses should communication has been received,
always appear neat and clean. Nurses accepted, and implemented.
should sport a neat hair style which
 Upward communication does not Outward communication also
flow as easily as downward involves how employees value their
communication. Subordinates may not work. This may be directly or indirectly
have the ability to express their communicated to their families. If they
thoughts or maybe too shy to express think highly of their jobs, their families
them. Supervisors and head nurses become very supportive. It is common
have a big role to ply in ensuring the to hear “My mom works in that hospital.
effectiveness of communication. That is our hospital.”
Through tactful questioning or Job satisfaction to open
observation any misinterpretation can communication lines. Positive
be detected to avoid difficulty in communication between employees and
implementation. This maybe ironed out their immediate supervisors, and
at their level or referred to higher personal feedback on job performance.
management if necessary. All personnel should have access
Examples of upward to information when they need it most
communication are discussions between such as availability of supervisors, of
subordinates and superiors, grievance procedure manual, job descriptions and
procedures, written reports, incident work schedules. Such open access will
reports, and statistical reports. enable them to do their jobs in the most
Horizontal Communication effective and efficient manner.
Horizontal or lateral Communication should be clear and
communication flows between peers, understandable.
personnel or departments on the same Personnel should be able to
level. It is used most frequently in the receive adequate and timely
form of endorsements, between shifts, information regarding wok related
nursing rounds, journal meetings and issues or changes that may affect their
conference, or referrals between jobs. Communication overload or under
departments or services. load should be avoided as these may
Coordination of duties and cause confusion, distrust, and
cooperation among the various misunderstanding.
departments will be maximized if Communication can be enhanced
communication is open to ensure by carefully choosing the words of
smooth work flow. information anyone wishes to convey,
Outward Communication by creating an environment that
Outward communication deals promotes it’s acceptance, by avoiding
with information that flows from the preconceived opinions and biases about
caregivers to the patients, their a person, by listening to and
families, relatives, visitors and the understanding the other person’s point
community. Patients should understand of view, and by being open and
the nature of heir illness, the medical supportive. Most people learn to
and the prescribed nursing plans of care communicate through example. Nurse
so that they cold participate in the Managers should promote a responsive
decisions regarding these. communication climate in their units.
The image of the organization to
the public depends on the employee’s COMMUNICATION ROLE OF SUPERVISOR
understanding of its philosophy, vision, As a nursing supervisor, your role
mission and objectives, and how these involves a lot of key responsibility and
are communicated to the public. Clear dedication. Nursing supervisors need to
explanations of policies, rules and be motivated, dedicated within their line
regulations promote good public of work, team players and team leaders,
relations. and have the ability to work effectively
with staff and employers alike. Nursing supervisor. The nursing supervisor must
supervisor’s are appointed with a BA ensure that the patients’ needs are
degree and relative experience within catered for at all times and he or she
the nursing field, individuals who rank must ensure that the nursing care and
to this position are unique in that they performance that is offered is of top
possess desired qualities, such as the standard. As a nursing supervisor, you
ability to be a nurse and a friend, a are leading and directing the work of
confidant and a leader, a hard worker others and therefore, one must be
and a person with diverse abilities. For prepared for a very challenging and
many nurses, their positions fulfill them hard work when applying for such a
as individuals, however, many nurses position. The nursing supervisor usually
strives to be executives and supervisors reports to the head of the hospital unit
and it is this striving that leads them to for whom he or she works
achieve their goals.
The task of a nursing supervisor is Strategies in Creating Motivating
to oversee the other nurses, to ensure Climate
that everyone is performing optimally in 1. Have clear expectations for
their work and to ensure that patients workers, and communicate these
are receiving the best possible care. expectations effectively.
When any problems occur in a certain 2. Be fair and consistent when
nursing unit, the nursing supervisor is dealing with all employees.
called to inspect and repair the 3. Be a firm decision maker using an
situation. The task of a nursing appropriate decision-making style.
supervisor is therefore very stressful 4. Develop the concept of teamwork.
and demanding and it is typical for a 5. Integrate the staff’s needs and
nursing supervisor to suffer from stress, wants with the organization’s interest
burnout and fatigue. The task of the and purpose.
nursing supervisor is to also ensure 6. Know the uniqueness of each
success of the nursing team that he or employee.
she is in charge of; this is done by being 7. Remove traditional blocks
a team leader, encouraging between the employee and the work
communication and openness and to be done.
increasing the spirit of the nurses. 8. Provide experiences that
People enjoy their work when they feel challenge the employee and allow
happy with what they are doing and opportunities for growth.
with whom they are working; it is your 9. When appropriate, request
duty to achieve this. participation and input from all
As a nursing supervisor, you are subordinates in decision making.
required to work with other highly 10. Be certain that employees
ranked, lead nurses in the hospital. understand the reason behind
Together with the other lead nurses, decisions and actions.
you are provided with the responsibility 11. Reward desirable behavior,
of allocated units and wards, this would be consistent in how you handle
be according to your fields of undesirable behavior.
experience. It would then be your duty 12. Let employees exercise
to coordinate the activities within the individual judgment as much as
patient care unit and to assign nurses to possible.
their units along with their shift 13. Create a trustful and
schedules etc. Critical thinking and helping relationship with employees.
creative skills are therefore two key
aspects required of a nursing
 14. Let employees exercise as  Asking questions discretely to find out
much control as possible over their the problems they encounter in the
work environment. wards
15. Be a role model for  Drawing out suggestions from the
employees. workers for improvement of their work
Supervision or work situation
 “supervise” comes from the word Delegation
“supervide” which means to oversee  It is the process by which the
or view directly manager assigns specific tasks/duties
 It means personally observing a to workers with commensurate
function or activity, providing authority to perform the job.
leadership in the process of nursing  By delegating well defines tasks
care, delegating functions or activities and responsibilities, the nurse
while retaining the accountability, manager can be freed of valuable time
evaluating and ensuring that the that can well be spent on planning and
nursing care provided is adequate and evaluating nursing programs and
delivered appropriately. activities.
 It also trains and develops staff
Principles of Good Supervision members who desire greater
1. Good supervision requires opportunities and challenges in their
adequate planning and organization work making them more committed
which facilitate cooperation, and satisfied in their jobs.
coordination, and synchronization of
services. Common Delegation Errors
2. Good supervision gives autonomy Underdelegating – frequently stems
to workers depending on their from the manager’s false assumption
competency, personality and that delegation may be interpreted as a
commitment. lack of ability on his part to do the job
3. Good supervision stimulates the correctly or completely; the manager’s
worker’s ambition to grow into desire to complete the whole job
effectiveness. personally due to lack of trust in the
4. Good supervision creates an subordinates; the manager believes
atmosphere of cordiality and trust. that he or she needs the experience or
5. Good supervision considers the that he can do it better and faster than
strengths and weaknesses of anyone else.
employees. Overdelegating – because they are poor
6. Good supervision strives to make managers of time, spending most of it
the unit an effective learning situation. just trying to get organized; they feel
insecure in their ability to perform a
Techniques in Supervision task.
 Observation of the worker while Improper delegating – delegating at the
making the rounds wrong time, to the wrong person, or for
 Spot checking of charts through the wrong person.
nursing audits *Legal implication that pertains to
 Asking the patients about the care delegation and supervision
they receive o “respondeat superior” meaning “let
 Looking into the general condition of the superior answer for the acts of the
the units subordinate”
 Getting feedback from co-workers or o The nurse who delegates is
other supervisors or relatives responsible for the acts of the
 subordinate and may incur liability if Problem Solving
found negligent in the process of  Problem Solving is part of decision
delegating and supervising. making, a systemic process that
o If the task is delegated to a competent focuses on analyzing a difficult
worker and the latter commits a situation.
mistake, then the latter is accountable
for the assessment of the situation, 5 Steps in Decision Making Process
supervision, follow-up, intervention, 1. Definition of the Problem
and corrective action. o Pre-determined objectives provide
the focus for the decision. He should
What cannot be delegated? gather all relevant data so as to
1. Overall responsibility, authority recognize the real problem.
and accountability for satisfactory 2. Analysis of the Problem
completion of all activities in the unit. o This means getting to the cause of
2. Authority to sign one’s name is the problem.
never delegated. o It produces an explanation that can
3. Evaluating the staff and/or taking be verified because the event or
necessary corrective or disciplinary cause has already taken place.
action. *The Supervisor/head Nurse
4. Responsibility for maintaining proceeds to investigate, gather data,
morale or the opportunity to say a few and evaluate the results.
words of encouragement to the staff *He should be careful not to let his
especially the new ones. prejudices or biases color the
5. Jobs that are too technical and evaluation of facts.
those that involve trust and *She should be open-minded and
confidence. flexible.
3. Development of Alternative
Coordination Solutions
 Unites personnel and services o It focuses on the search for and
toward a common objective analysis of alternatives and their
 Enhances collaborative efforts possible consequences.
resulting in efficient, smooth and o It involves the premises “if we do
harmonious flow of work this, the result will be…”.
 Prevents overlapping of functions, o Sufficient information enables the
promotes good working relationships decision maker to arrive at rational
and work schedules are accomplished decisions.
as targeted Factors to be considered in evaluating
 Convey clearly defined polices, alternative solutions: time, available
standard operating procedures, resources, labor, cost of tools and
policies and guidelines using the equipments to be used, and the moral
proper channels of communication. and legal implications.
Decision Making 4. Selection of a Solution
 Decision is a course of action that o The Head Nurse chooses the best
is consciously chosen from available course to follow considering advice
alternatives for the purpose of from others, experience, and logical
achieving a desired result. reasoning; weigh the advantages
 It involves a choice utilizing and disadvantages of each.
mental processes at the conscious 5. Implementation and Follow-up
level and is aimed at facilitating a
defined objective.
Traditional Problem-Solving Process – 8. Analyze the risks. Challenges to
effective model; weakness lies in the successful implementation of chosen
amount of time needed for proper alternatives are identified and
implementation; les effective when time strategies are developed to manage
constraints are a consideration; lack of those risks.
an initial objective-setting step that
helps to prevent the decision maker Nursing Process – developed by Ida Jean
from becoming sidetracked. Orlando; the greatest strength of this
1. Identify the problem. process may be its multiple venues for
2. Gather data to analyze the causes feedback; the weakness is like of the
and consequences of the problem. traditional problem-solving model, not
3. Explore alternative solutions. requiring clearly stated objectives.
4. Evaluate the alternatives. 1. Assessment
5. Select the appropriate solution. 2. Planning
6. Implement the solution. 3. Implementation
7. Evaluate the results. 4. Evaluation

Managerial Decision-Making Models – The IDEALS Model – developed by

added an objective setting step; Facione (2006)
suggested by Sorach (2000) Identify the What’s the real question
1. Determine the importance and problem. we’re facing here”
the context of the decision. Problem Define the What are the facts and
solvers must consider the possible context. circumstances that frame
consequences of the decision, time this problem?
period involved, and who needs to be Enumerate What are our most
involved in the decision process. the choices. plausible three or four
2. Determine the objectives for the opinions?
decision. Primary and secondary goals Analyze What is our best course
are outlined. options. of action, all things
3. List all options. Problem solvers considered?
must attempt to identify as many List reasons Let’s be clear. Why are
alternatives as possible. explicitly. we making this particular
4. Explore promising options. choice?
Alternatives are analyzed by the use Self-correct. Okay, let’s look at it
of SWOT (strengths, weaknesses, again. What did we miss?
opportunities, and threats).
5. Establish decision-making criteria. Intuitive Decision-Making Model
Objectives are rank ordered or  Andrews (2006) suggests that
qualified so that problem solvers are “one of the critical skills separating
clear regarding which criteria will be good leaders from great leaders is the
weighted most heavily in making their conscious use of intuition in daily
decision. decision making”.
6. Evaluate the options against the Gary Klein developed the Recognition-
criteria. Apply quantitatively decision- Primed Decision (RPD) Model for
making tools to objectively review the intuition decision making to explain
desirability of alternatives. how people can make effective
7. Select the options to pursue. decisions under time pressure and
Desirable alternatives or combinations uncertainty. This model attempts to
of alternatives are selected for understand how humans make
implementation. relatively quick decisions in complex,
real world setting without having to
 compare options. Many individuals act consider the importance of group
on their first impulse if the “imagined situation. Leaders in one situation may
future” looks acceptable. function as follower in another. In
 Aloi (2006) suggests that many addition, leaders who are effective in
expert nurses use intuition in solving some circumstances are ineffective in
problems. He warns that the dark side others.
of intuition is misjudgment and that
intuition should serve only as an Behavioral theories
adjunct to decision making founded on During the human elation era,
nursing’ scientific knowledge base. many behavioral and social scientist
studying management also study
LEADERSHIP THEORIES leadership. For example, McGregor’s
Many believe that the critical (1960) theories had as much influence
factor needed to maximize human on leadership research as they did on
resources is leadership. A more in-depth management science. As leadership
understanding of leadership can be theory developed, researchers move
gleaned from a review of leadership away from studying what traits the
theories. leader had and placed emphasis on
what he or she did- the leader’s style of
The Great Man Theory leadership.
Set forth the premise that certain A major break through occurred
people are born to be leaders, having when Lewin (1951) and White and
inherited a set of innate characteristics Lippitt (1962) isolated common
that endow with unique ability to lead leadership style. Later, this styles came
others. This theory grew because the to be cold Authoritarian, democratic,
ability to lead others was often seen to and Laissez-faire.
royal and prominent families. Others e
not allowed to become leaders, a fact The authoritarian leader is
that also helps explain its demise. characterized by the following
Currently, most people do not accept behaviors:
the idea that an individual is born to  Strong control is maintained over
lead. the work group.
 Others are motivated by coercion.
Trait or Attribute Theory  Others are directed with
Evolve from great man theory of commands.
leadership when soil and economic  Communications flows downward.
barriers no longer prevented members  Decision making does not involve
of the general public from occupying others.
leadership roles. Behavioral scientists  Emphasize is on difference in
began to identify the common traits of status (“I” and “you”).
great leaders throughout the ages.
 Criticism is punitive
These traits frequently included
Authoritarian leadership results in
assertiveness, ambition, charisma,
well-define group actions that are
creativity, decisiveness, enthusiasm,
usually predictable, reducing frustration
intelligence, initiative, integrity,
in the work group and giving members
persistence, physical characteristics,
a feeling of security. Productivity is
sense of self and other more. The trait
usually high, but creativity, self
theory approach to leadership appeal
motivation, and autonomy are reduced.
because it failed to look at the situation
Authoritarian leadership useful in crisis
in which action is occurring, neglected
situation is frequently found in very
the role of the follower, and did not
large bureaucracies such as armed productivity. Laissez-faire is appropriate
forces. when problems are purely defined and
brain storming is needed to generate
The democratic leader exhibits the alternative solutions.
following behaviors:
 Less control is maintained. Situational and Contingency Theories
 Economic and ego awards are These were based largely on the
used to motivate. premise that the leadership style that
 Others are directed through would prove successful in one set of
suggestions and guidance. circumstances may not be effective in
 Communication flows up and another. According to Follett (1918), the
down. situation should determine the
approach to be followed. Fiedler’s
 Decision making involves others.
(1967) contingency approach reinforced
 Emphasis is on “we” rather than
these findings, suggesting that no one
“I” and “you”
leadership style is ideal for every
 Criticism is constructive. situation. Fiedler’s felt that
Democratic leadership, appropriate interrelationship between the group’s
for groups who work together for leader and its member wee most
extended periods, promotes autonomy influenced by manager’s ability to be
and growth in individual workers. This good leader.
type of leadership is particularly Hersey and Blanchard (1977) also
effective when cooperation and developed a situational approach to
coordination between groups are leadership. Their tri-dimensional
necessary. Studies have shown, leadership effectiveness model predicts
however, that the democratic which leadership style is most
leadership is less efficient quantitatively appropriate in each situation based on
than authoritative leadership. the level of the follower’s maturity. As
people mature, leadership style
The Laissez-faire is characterized by the becomes less focused and more
following behaviors: relationship oriented.
 Is permissive, with little or no
control Path-Goal Theory
 Motivates by support when In this leadership approach, the
requested by the group or individuals. leaders work to motivate followers and
 Provides little or no direction. influential goal accomplishment. By
 Uses upward and downward using the appropriate style of leadership
communication between members of for the situation, the leader makes the
the group. path toward the goal easier for the
 Disperses decision making follower. The path goal theory is based
through out the group. on expectancy theory, which holds that
 Places emphasize on the group. people are motivated when they believe
 Does not criticize. they are able to carry out the work, they
think their contribution will lead to
Because it is non directed expected outcome, and they believe
leadership, the laissez-faire style can be that the rewards for their effort are
frustrating; group apathy and valued and meaningful.
disinterest can occur. However, when all
group members are highly motivated Charismatic Theory
and self-directed, this leadership style A charismatic leader has an
can result in much creativity and inspirational quality that promotes an
emotional connection from the  No single leadership strategy is
followers. House (1971) developed effective in every situation.
theory of charismatic leadership that
describe how charismatic leader behave Transformational leadership theory
as well as distinguishing characteristic Often reflected in nursing
and situation in which such a leaders literature and practice. It is based on
would be effective. Charismatic leaders the idea of empowering other to engage
display self confidence, have strength in in pursuing a collective purpose by
their conviction, and communicate high working together to achieve a vision
expectations and their confidence in and preferred future. This kind of
others. They have been described as leadership can influence both the leader
emerging during a crisis, and the follower to a higher level of
communicating vision, and using conduct and achievement that
personal power and unconventional transform them both. Essentially, a
strategies. transformational leader may be define
as a leader who motivates followers to
Interactional Leadership theories perform at their full potential by
The basic premise of interactional influencing changes in perception and
theory is that leadership behavior is by providing a sense of direction to the
generally determined by the r between group. The group is encouraged to set
the leader’s personality and the specific aside personal interests for the good of
situation. the group. Group members are
Schein (1970) was the first to empowered and motivated and provide
propose a model of humans as complex input to decision making, and leaders
human being whose working and followers raise one another to
environment was an open system to higher levels of performance.
which they responded. A system may Servant leadership theory- developed
be defined as a set of objects, with by Greenleaf (1995), in which he
relationship between the objects and pictured successful leaders as being
between their attributes. A system is able to influence others as a result of
considered open if it exchanges matter, dedicating their lives to serving others.
energy, or information with its
environment. Schein’s model based on Attributes for Effective Leader
theory has the following assumption: 1.Honesty
 People are very complex and high
variable. They have multiple motives Leaders have to be honest. If those
for doing things. For example, a pay under your charge do not trust you,
raise might mean status to one then they won’t follow you. Common
person, security to another, and both sense, if you ask me.
to a third.
 People’s motives do not stay 2. Responsibility
constant but change over time.
 Goals can differ in various If you are going to make decisions, then
situations. For example, an informal you should take responsibility for the
groups goal maybe quite distinct from decisions that you make. Good leaders
a formal group’s goal. don’t pass the buck or blame other
 Person’s performance and people – they deal with situations that
productivity are affected by nature of arise and take responsibility for the
he tasks and by his or her ability, results. Oh, and if you delegate a
experience and motivation. responsibility to someone under your
charge and they screw it up, then it is
YOU who have screwed up. That’s what charges so that they can perform their
leadership and responsibility is all assigned tasks as you intended. Answer
about. their questions and make sure that they
understand by asking a few yourself!
3. Confidence
You have to believe in yourself. I know it 7. Decisiveness
sounds corny, but confidence makes the Some politicians should pay careful
leader. You have to believe every word attention to this. Don’t waffle on see-
that comes out of your mouth. If you saw on decisions. Go through this
don’t your charges will begin to exactly once: gather relevant
question whether or not you know what information, gather input from your
you are talking about. charges, and make a safe and
This literally means that even when a reasonable decision based on the
situation is hopeless, you have to give information that you have available.
off an air of confidence. Your charges Never second-guess yourself unless new
will look to YOU for guidance when and important information is available.
times get tough. If they see panic or Often, leaders have to make important
uncertainty in your eyes, then all is lost. decisions very quickly. Make sure that
you’re psychologically prepared to do
4. Enthusiasm this – it’s not as easy as it seems.
How do you make someone do
something that they don’t want to do? 8.Determination
Enthusiasm! Get psyched about the This pretty much amounts to “finish
task that you’re assigning. Emphasize what you start.” See tasks through to
its importance, and rollup your sleeves the bitter end, and keep your charges
and demonstrate. Enthusiasm is motivated to continue.
contagious – if your charges see you all
excited and ready to have at it, they’ll 9.Loyalty
get excited too. If you give off an “I just This is something that you expect of
don’t give a hoot” attitude, then your your charges. It is also something that
charges won’t give a hoot either. your charges expect from you. The first
time that you stab your charges in the
5. Reliability back will also be the last.
Saying that you’re going to do
something means that you will actually 10.Courage
have to do it. Nobody likes an unreliable This could be the most important of the
person, even if they’re not a leader. list, since it encompasses so much. As a
After your first time going back on your leader, you must have courage in order
word, people just aren’t going to trust to be decisive. You can’t be afraid of
you anymore. I guarantee that if you failure, or else you will not be able to
are unreliable, you won’t be a leader for function as a leader. Have the courage
long (if ever). to stick to your convictions or go with a
gut instinct. Don’t be afraid to try a new
6. Patience approach.
Don’t underestimate the importance of
patience. If you explain a task or Most importantly, don’t be afraid to
situation to you charge and they don’t admit that you made a mistake. This is
understand, then clarify it for them. It’s what separates the true leaders from
not their fault that they don’t the wanna-bees. If you messed up,
understand your instructions – it’s YOUR admit that you messed up, and then
fault. Take the time to help out your take corrective action to fix your
mistake. Your charges won’t think less • A leader who uses coercion in the
of you for it – in fact, they’ll think more exercise of his/her powers
of you because you didn’t insist that • Has increased concern for task
black was white when both you and accomplishment but less concern
your charges know you’re wrong. for people who perform these tasks
• Has no confidence or trust in
Leadership Styles his/her subordinates
I. Authoritarian leadership • Thinks all workers are lazy, need to
Characteristics: be coerced, threatened with
1. Strong control is maintained over punishment, indifferent to
the workgroup organizational goals, resistant to
2. Others are motivated by coercion change, not very bright and cannot
3. Others are directed with be trusted, want to avoid
commands responsibility and are more
4. Communication flows downward interested in financial incentives
5. Decision making does not involve than personal achievement
others
6. Emphasis is on difference in II. Democratic leadership (participative
status ( I and You) leadership)
7. Criticism is punitive Characteristics:
 Results in ell-defines group actions 1. Less control is maintained
that are usually predictable, reducing 2. Economic and ego awards are
frustration in the work group and used to motivate
giving the members a feeling of 3. Others are directed through
security suggestion and guidance
 Subordinates are expected to follow 4. Communication flows up and
without questions down
 Provides strong motivation and 5. Decision making involves others
psychological regard for the leader 6. Emphasis is on we rather than “I
 Most effective in crisis situations and you”
 It is appropriate when there is a need 7. Criticism is constructive
for immediate action and the  Appropriate fro groups who work
manager is the individual with the together for extended periods
best understanding of the situation.  Promotes autonomy and growth for
Example: emergency department individual workers
setting  Particularly effective when
 Used to bring order out of chaos cooperation and coordination
 “centric” – the leader makes decision between groups are necessary
for the group  According to studies, it is less
 Also called “theory X” by McGregor efficient quantitatively than
 Boss-centered authoritative leadership
 Often results in high productivity  People-oriented
 Creativity, self-motivation and  Focuses on human aspects and builds
autonomy are reduced effective teamwork
 Workers become blind followers and  Interaction between the leader and
sometimes they avoid their leaders subordinates is open, friendly and
 Useful in crisis situations trusting
 E.g. bureaucracies (armed forces)  Cooperative spirit and joint effort
 Directive/bureaucratic exist
 Authoritative/autocratic leader
 Allows governance through group  “Contingency Style of Leadership” –
participation in decision making one in which the leader matches the
 Open communication prevails situation and its needs
 The leader consults his/her  Fiedler and Chemers state that in the
subordinates in solving problems and work situation, the manager’s
work-related decisions made by the leadership style and expectation,
group and the followers’ characteristics and
 Promotes cohesiveness among expectations blend together and
members, greater job satisfaction, form a productive combination
few feelings of hostility and  The nurse-manager assesses each
frustration nurse’s needs and determine which
 This style will satisfy high human leadership behaviors will help the
needs resulting in greater employee nurse to do the work with the fewest
responsibility which in turn leads to problems. The nurse-manager first
high productivity considers the staff nurse’s ability to
 The most desirable form of complete a given task. Then the
management nurse-manager, in a particular
 It is participatory with authority situation, either tells or teaches the
delegated to others staff what to do and explains the
benefits of learning from a new
 Consultative style of leadership
situation. He/she participates with
 Permit performance appraisal
the subordinate in doing a special
 “Theory Y” according to McGregor procedure that the subordinate is not
 Disadvantages: decision making can familiar with. He or she delegates a
become a lengthy process more experienced staff to work with
 Advantage: coworkers are consulted the employee until the latter gains
sand who have input into decisions the skill and competence in
are more motivated to support such performing a new task.
decisions  The situational leader must be
 Democratic leadership is appropriate flexible enough to make adaptations
when task or decision at hand is not and changes.
one that requires urgent action, when  The theory considers a person’s
subordinates can be expected to qualities and motivations, the role
make meaningful contributions, and expectations of the group, and the
when their input can be taken into social forces at work such as external
account. factors that bring forth the
 Democratic Leader leadership potential
• does not resist change, is  Five kinds of leader under this
creative, exercises self-direction theory:
and self-control • Natural Leader – becomes a hero in
• Considers workers as ambitious spite of himself or herself; he/she
• “radic leader” – he radiates out does not seek the role but the
to encompass the needs of group thrusts the leadership upon
others him/her by the tide of events
• Charismatic Leader – an authentic
III. Situational Leadership hero in the eyes of his followers; to
 In this approach, the leader behaves them he/she can do no wrong;
according to a given situation which inspires people to make sacrifices
may vary from one setting to the for the cause they represent
other.
 • Rational Leader – consistent and  Example: inpatient psychiatric
persistent in what he/she thinks is unit
right.  Leadership vacuum
• Consensus Leader – is perceived to • this may occur in circumstances
be acceptable to all; rises in the in which a laissez-faire approach
absence of the above three leaders to leadership is inappropriately
• Leader by Force – dominates by attempted
force and fear; he/she is ruthless in • An informal leader will arise and
suppressing opposition; he/she give direction to the group
does not reign long; this type of • Coworkers recognize an implicit
leadership contains within itself the authority or degree of expertise
seeds of self-destruction; examples in the informal leader
are Hitler and Idi Amin • This may temporarily allow the
group to continue to function
IV. Laissez-faire Leadership (permissive while the informal leader
leadership) provides the necessary direction
 Also referred to as “delegating and assistance
approach”
 Little or no direction is provided Authority and Power
 Coworkers develop their own Authority
goals, make their own decisions, Authority identifies the source of
and take responsibility for their power to act. Authority occurs when a
own management person who has been given the right to
 Managers concentrate on delegate, based on the state nurse
providing maximum support and practice act, also has an official power
freedom for coworkers from an agency to delegate.
 Decision making is dispersed Authority comes with the job as
throughout the group authority given by an agency
 Uses upward and downward legitimizes the right of a nurse to give
communication with the group direction to others and expect that they
 Does not criticize will comply. An understanding of the
level of authority at the time the task is
 Appropriate when problems are
delegated and the level of authority that
poorly defined and brainstorming
is identified by the state nurse practice
is needed to generate alternative
act and the agency’s job description
solutions
prevents each party from making
 Advantages:
inaccurate assumptions about authority
• Providing maximum freedom for for delegated assignments. (Kelly-
individuals Heidenthal & Marthaler, 2005)
• Increased motivation of the
subordinates to perform at high Power
levels because of independence According to Neufeldt, power is
• When all members are highly the ability to do, act or produce; the
motivated and self-directed, this ability to control others; an authority,
leadership style can result in sway, or influence. Power is not a static
much creativity and productivity phenomenon; it can change and shift,
 Disadvantage: increase or decrease. Bass (1990)
• Group apathy and disinterest points out that difference in power in a
can occur group, organization, or society influence
the kind of leadership that can be
effective. When there are great • Is gained through knowledge,
differences in power among individuals expertise, or experience.
or groups, a more directive leadership is • Having critical knowledge allows a
likely; when the differences in power manager to gain power over others
are small, a more participative who need that knowledge. This type
leadership is likely. of power is limited to a specialized
area. For example, someone with
Forms of power vast expertise in music would be
 Reward power powerful only in that area, not in
• Obtained by the ability to grant another specialization.
favors or reward others with • Fralic (2000) feels that Florence
whatever they value. Nightingale was the first nurse to
• The arsenal of rewards that a effectively use this expert power.
manager can dispense to get When Nightingale used research t o
employees to work toward meeting quantify the need for nurses in
organizational goals is very broad. Crimea (by showing that when
• Positive leadership through rewards nurses were present, fewer soldiers
tends to develop a great deal of died), she was using her research to
loyalty and devolution towards demonstrate expertise in the health
leaders. needs of the wounded.
 Punishment or coercive power  Referent power
• The opposite of reward power, is • A power a person has because others
based on fear of punishment if the identify with that leader or with what
manager’s expectations are not met. that leader symbolizes.
• The manager may obtain compliance • Referent power also occurs when one
through threats (often implied) of gives another person feeling of
transfer, layoff, demotion, or personal acceptance and approval. It
dismissal. may be obtained through association
• The manager who shuns or ignores with the powerful.
an employee is exercising power • People may also develop referent
through punishment; as is the power because others perceive them
manager who berates or belittles an as powerful. This perception could be
employee. based on personal charisma, the way
 Legitimate power the leader talks or acts, the
• Is also called position power. organization to which he or she
Authority also is called legitimate belongs, or the people with whom he
power. or she associates.
• It is the power gained by a title or • People others accept as role models
official position within an or leaders enjoy referent power.
organization. Legitimate power has Physicians use referent power very
inherent in it the ability to create effectively; society as a whole, views
feelings of obligation or them as powerful, and they carefully
responsibility. maintain this image. Some theorists
• As previously discussed, the distinguish charismatic power from
socialization and culture of referent power. Willey (1990) states
subordinate employees will influence that charisma is a type of personal
to some degree how much power a power, whereas referent power is
manager has due to his or her gained only through association with
position. powerful others.
 Expert power
Sources of power

Type Source
Referent Association with
others
Legitimate Position
Coercive Fear
Reward Ability to grant
favors
Expert Knowledge and skill
Charismatic Personal
Informational The need for
information
Self Maturity, ego
strength