LEADERSHIP IN

NURSING

K.RAJESWARI,MSc(N)
Faculty of Nursing
CON,MMC,CHENNAI-03
 OBJECTIVES
• After this session the participants should be
able to:
• ■ Define the terms leadership and Manager . ■
Discuss the importance of effective leadership
and followership for the new nurse. ■ Discuss
the qualities and behaviors that contribute to
effective leadership.
• ■ Discuss the qualities and behaviors that
contribute to effective leadership.
Introduction
Are you ready to be a leader?
Definition
Importance of leader/nursing leadership
Formula for a successful nurse leader
performance
Need of nursing leadership/portrait of a leader
Defference between boss/leader
Characteristics leaders
Function of leader
Qualities of leader/keys to effective leader
Leader competencies
Types of leadership styles
Trait theories
Behavioral theories
Task versus relationship
Motivation theorie
Emotional intelligence
Situational theories
Transformative leadership; definition,elements(4: i's), 5 personality
traits, quality of transformal nurs,steps,characteristics, 4 leadership
differentiators for transformational leaders, must have quality,
Moral leadership
Distinctive styles of leadership
The top 10 requirements for leader behavior
Difference between manager and leader
Began today to see the bright tomorrow
Ooth for leadership
Activity
Conclusion
 INTRODUCTION
“Leaders are made, not born”
Great leaders make a HUGE difference, compared
to good leaders.
The Institute of Medicine (IOM) and the Robert
Wood Johnson Foundation (RWJF) agree that without
exceptional nursing care and leadership, readily
available high-quality care cannot be attained.
Charge nurses have the central role in ensuring high
quality, person-centered, safe and effective care.
Nurses study leadership to learn how to work
well with other people. We work with an
extraordinary variety of people: technicians,
aides, unit managers, housekeepers, patients,
patients’ families, physicians, respiratory
therapists, physical therapists, social workers,
psychologists, and more.
 LEADERSHIP

Are You Ready to Be a Leader?

You may be thinking,
“I’m just beginning my career in nursing.
How can I be expected to be a leader now?”
This is an important question.
You will need time to refine your clinical skills and learn how to
function in a new environment.
But you can begin to assume some leadership functions right
away within your new nursing roles.
In fact, leadership should be seen as a dimension of nursing
practice.
 DEFINITION
• “Leader is a force” who creates a capacity
among a group of people to do something
that is different or better
 IMPORTANCE OF LEADER

• Inmost cases, people will

perform at about 60% of their
potential with no leadership at all.
• Thus, an additional 40% can be
realized if effective leadership is
available.
 Nursing Leadership
 • It is a process whereby a nurse influences two
or more persons to achieve specific goal in the
provision of nursing care for one or more clients.
• Gardner (1986) believes that 90% of leadership
can be taught.
• When nurses graduate they are not ready to
assume a leadership role. They require
opportunities for self-discovery to understand
their strengths for skill building.
 Formula for a successful nurse leader performance

 SKILLS: Technical, behavioral, conceptual

+
VARIABLES: Motivational, Abilities, Role Clarity

= SUCCESSFUL NURSE MANAGER

 Need Of Nursing Leadership
– High expectation of patient
– New technology
– Increased diversity in the workplace
– Greater accountability for practice
– A new spiritual focus on the mind and body
connection
– Increase in physical facilities and decrease in
nursing personnel in the hospital
– Emerging social problems.
 PORTRAIT OF A LEADER

• “If anything goes bad ‘I’ did it .

• If anything goes semi bad then ‘we’ did it

• If anything goes really good then ‘you’ did it”. -

-Bear Bryan
 DEFFERENCE BETWEEN BOSS/LEADER

BOSS LEADER
1. DRIVES OTHERS 1. INSPIRES ENTHUSIASM

2. INSPIRES FEAR 2. HELPS TO FIX IT

3. BLAMES OTHERS 3. COACHES OTHERS

4. SAYS ‘I’ 4. SAYS ‘WE’

5. KNOWS HOW IT IS DONE 5. SHOW HOW IT IS DONE

6. DEPENDS ON AUTHORITY 6. DEPENDS ON GOODWILL

7. USES PEPOLE 7. DEVELOPS PEOPLE

8. TAKES CREDIT 8. GIVES CREDIT

9. MICROMANAGE 9. DELEGATES WORK

 CHARACTERISTICS LEADERS
■ They respect their coworkers as individuals.
■ They listen to other people’s opinions and
preferences,giving them full consideration.
■ They maintain awareness of their own and others’
feelings.
■ They empathize with others, understanding their
needs and concerns.
■ They develop their own and their team’s capacities.
■ They are competent, both in leadership and in clinical
practice. This includes both knowledge and skill in
leadership and clinical practice.
 CHARACTERISTICS LEADERS

• A leader should maintain separate identity

among the group to continue to lead.
• a leadership is a dynamic & ever-evolving
process, and he must lead continuously.
• Effectiveness of leadership varies in different
situation.
• leadership involves directing ,guiding and
influencing the behavior of individual &groups.
• leadership involves sharing of interest
between the leader and his followers.
 FUNCTION OF LEADER

 setting goals: A leader provide guidance to the

group by setting goals to his sub ordinates
he acts as a guide of his followers by setting
objectives of the group.
 Develop team spirit: A leader develops a sense
of collectivism in the employees to work as a team.
 Interest :individuals within the group may be
shown varied interest and multiple goals a leader
as to reconcile their conflicting goals and restore
equilibrium.
 FUNCTION OF LEADER

• REPRESENTATION: good leader is the

guardian of the interest of the subordinates.
he is the personal embodiment of the
impersonal organization inside and outside the
organization.
• COUNSELLER; A leader may render advice
and tries to over come barrier, real or imaginary
and instills confidence in the employees.
• STRIVES FOR EFFECTIVENESS: A leader
provides adequate reward to improve the
performance of employees.
 QUALITIES OF LEADER
 SEVEN QUALITIES OF LEADERSHIP
 1 Enthusiasm: try naming a leader without it!
 2 Integrity: meaning both personal wholeness
and sticking to values outside yourself, primarily
goodness and truth – this quality makes people
trust a leader
 3.Toughness: demanding, with high standards,
resilient, tenacious and with the aim of being
respected (not necessarily popular)
 4 Fairness: impartial, rewarding / penalizing
performance without ‘favorites', treating
individuals differently but equally
• 5 Warmth: the heart as well as the mind being
engaged, loving what is being done and caring
for people – cold fish do not make good leaders

• 6 Humility: the opposite of arrogance, being a

listener and without an overwhelming ego

• 7 Confidence: not over-confidence (which

leads to arrogance), but with self-confidence
which people know whether you have or have
not got it
 KEYS TO EFFECTIVE LEADER
QUALITIES BEHAVIORS
• Integrity • Think Critically
• Courage • Solve Problems
• Initiative • Communicate
• Energy • skillfully
• Optimism • Set Goals
• Perseverance • Share vision
• Balance • Develop self and others.
• Ability to handle stress
• Self Awareness
 LEADER COMPETENCIES

• Adaptive capacity,
• An ability to engage others in shared meanings,
• A compelling voice and integrity.
• They claimed that one of the most reliable
indicators and predictors of ‘true leadership’ is an
individual’s ability to find meaning in negative
situations and to learn from trying circumstances.
 Types of Leadership Styles

•Autocratic Leadership
•Democratic Leadership
•Strategic Leadership Style
•Transformational Leadership
•Team Leadership
•Cross-Cultural Leadership
• Facilitative Leadership
•Laissez-faire Leadership 
•Transactional Leadership
•Coaching Leadership
 Trait Theories
At one time or another, you have probably
heard someone say, “She’s a born leader.”
Many believe that some people are natural
leaders, while others are not.
 It is true that leadership may come more
easily to some than to others, but everyone
can be a leader, given the necessary
knowledge and skill.
 These traits hold true today:
1. Management of attention. These leaders
communicated a sense of goal direction that
attracted followers.
2. Management of meaning. These leaders created and
communicated meaning and purpose.
3. Management of trust. These leaders demonstrated
reliability and consistency.
4. Management of self. These leaders knew themselves
well and worked within their strengths and weaknesses.
 Behavioral Theories

The behavioral theories focus on what the

leader does.

One of the most influential behavioral

theories is concerned with leadership style.

 1.Autocratic leadership
Autocratic leadership (also called directive,
controlling, or authoritarian). The autocratic
leader gives orders and makes decisions for the
group. For example, when a decision needs to
be made, an autocratic leader says, “I’ve
decided that this is the way we’re going to solve
our problem.” Although this is an efficient way
to run things, it squelches creativity and may
reduce team member motivation.
 2. Democratic leadership
(also called participative). Democratic leaders
share leadership. Important plans and decisions
are made with the team . Although this appears
to be a less efficient way to run things, it is more
flexible and usually increases motivation and
creativity. In fact, involving team members,
giving them “permission to think, speak and act”
brings out the best in them and makes them
more productive, not less
 3. Laissez-faire leadership
(also called permissive or nondirective). The laissez-faire (“let
someone do”) leader does very little planning or decision making
and fails to encourage others to do it. It is really a lack of
leadership.
For example, when a decision needs to be made, a laissezfaire
leader may postpone making the decision or never make the
decision at all. In most instances, the laissez-faire leader leaves
people feeling confused and frustrated because there is no goal,
no guidance, and no direction.
Some mature, self-motivated individuals thrive under laissez-faire
leadership because they need little direction. Most people,
however, flounder under this kind of leadership
Amount of High control Moderate Little control
control control
Decision making By the leader Leader and By the group
group together or by no one

Leader activity High High Minimal

level
Assumption of Leader Shared Abdicated
responsibility
Output of the High quantity, Creative, high Variable, May
group Good Quality quality be poor
quality
Efficiency Very Efficient Less efficient Inefficient
than autocratic
style
 Task Versus Relationship
Another important distinction is between a task focus and a
relationship focus.
Some nurses emphasize the tasks (e.g., administering medication,
completing patient records) and fail to recognize that
interpersonal relationships (e.g., attitude of physicians toward
nursing staff, treatment of housekeeping staff by nurses) affect
the morale and productivity of employees.
Others focus on the interpersonal aspects and ignore the quality
of the job being done as long as people get along with each other.
The most effective leader is able to balance the two, attending to
both the task and the relationship aspects of working together
 Motivation Theorie
• The concept of motivation seems simple: we will act to get what we want
but avoid whatever we don’t want to do. However, motivation is still
surrounded in mystery. The study of motivation as a focus of leadership
began in the 1920s with the historic
• Hawthorne studies. Several experiments were conducted to see if
increasing light and, later, improving other working conditions would
increase the productivity of workers in the Hawthorne, Illinois, electrical
plant.
• This proved to be true, but then something curious happened: when the
improvements were taken away, the workers continued to show increased
productivity.
• The researchers concluded that the explanation was found not in the
conditions of the experiments but in the attention given to the workers by
the experimenters.
 LAEDING MOTIVATION THEORIES
Maslow, 1954
Categories of Need:Lower needs (listed first below) must be
fulfilled before others are activated.
Physiological
Safety
Belongingness
Esteem
Self-actualization
Herzberg, 1959
Two factors that influence motivation. The absence of hygiene
factors can create job dissatisfaction, but their presence does not motivate or
increase satisfaction.
1. Hygiene factors: Company policy, supervision, interpersonal
relations, working conditions, salary
2. Motivators: Achievement, recognition, the work itself,
responsibility, advancement
 Motivational Theory
Mc Clelland, 1961
Motivation results from three dominant
needs. Usually all three needs are present in each individual
but vary in importance depending on the position a person has
in the workplace. Needs are also shaped over time by culture
and experience.
1. Need for achievement: Performing tasks on
a challenging and high level
2. Need for affiliation: Good relationship
with others.
3. Need for power .Being in change.
 Emotional Intelligence
• Emotional Intelligence The relationship aspects of leadership are also the
focus of the work on emotional intelligence and leadership (Goleman,
Boyatzes, & McKee, 2002).
• From the perspective of emotional intelligence, what distinguishes ordinary
leaders from leadership “stars” is that the “stars” are consciously addressing
the effect of people’s feelings on the team’s emotional reality. How is this
done?
• First, the emotionally intelligent leader recognizes and understands his or
her own emotions. When a crisis occurs, he or she is able to manage them,
channel them, stay calm and clearheaded, and suspend judgment until all
the facts are in (Baggett & Baggett, 2005).
• Second, the emotionally intelligent leader welcomes constructive criticism,
asks for help when needed, can juggle multiple demands without losing
focus, and can turn problems into opportunities.
Third, the emotionally intelligent leader listens
attentively to others, recognizes unspoken concerns,
acknowledges others’ perspectives, and brings people
together in an atmosphere of respect, cooperation,
collegiality, and helpfulness so they can direct their
energies toward achieving the team’s goals. “The
enthusiastic, caring, and supportive leader generates
those same feelings throughout the team,” wrote
Porter-O’Grady of the emotionally intelligent leader
(2003, p. 109).
 SITUATIONAL THEORIES
Situational Theories People and leadership situations are far more complex
than the early theories recognized. Situations can also change rapidly,
requiring more complex theories to explain leadership (Bennis, Spreitzer, &
Cummings, 2001). Instead of assuming that one particular approach works
in all situations, situational theories recognize the complexity of work
situations and encourage the leader to consider many factors when
deciding what action to take.
Adaptability is the key to the situational approach (McNichol, 2000).
Situational theories emphasize the importance of understanding all the
factors that affect a particular group of people in a particular environment.
The most well-known is the Situational Leadership Model by Dr. Paul
Hersey. The appeal of this model is that it focuses on the task and the
follower
Transactional leader Transformational leader
 Focuses on • Identifies common
management tasks values
 Is a caretaker • Is committed
 Uses trade-offs to • Inspires others with
meet goals vision
 Does not identify • Has long-term vision
shared values • Looks at effects
 Examines causes • Empowers others
 Uses contingency
reward
 Transformative Leadership
• Transformative Leadership really shines, as an all-
around effective approach.
• It encourages employees to think critically and the
leaders is often inspiring.
• These leaders have a big vision, and they are charismatic
and motivating.
• A Transformative leader will require dedicated managers
• The Transformative leader is a visionary with a large
audience that's receptive to innovative thinking.  
• Augments transactional in predicating effects on
follower satisfaction and performance
 Transformational Leadership

• As a process where leaders and their followers

raise one another to higher levels of morality
and motivation.
-James McGregor Burns,1978
ELEMENTS
•

The  4 Elements / 4: I's

Idealized Influence (II):
- The leader serves as an ideal role model for high
ethical behaviour, instills pride, gains respect and trust
- A transformational leader embodies the qualities that
he/she wants in his/her team.
- In this case, the followers see the leader as a model to
emulate.
- For the followers, it is easy to believe and trust in a
transformational leader.
Inspirational Motivation (IM) :
-

Leaders have the ability to inspire and motivate

followers through having a vision and presenting that
vision.
- A transformational leader manages to inspire the
followers easily with clarity.
- The transformational leader convinces the followers
with simple and easy-to-understand words as well as
with their own image.
.
Individualized Consideration (IC) :
-leaders demonstrate genuine concern for the needs and
feelings of followers and help them self-actualize. - personal
attention to each follower assists in developing trust among
the organization's members and their authority.
-An important element because teams are able to rely on and
work together so decisions can be made more quickly, the
transformational leader increases their buy
-The leader gives empathy and support, keeps communication
open and places challenges before the followers.
-This also encompasses the need for respect and celebrates the
individual contribution that each follower can make to the
team.
-The followers have a will and aspirations for self
development and have intrinsic motivation for their tasks.
Intellectual Stimulation (IS) –

- the leader challenges followers to be inno vative and creative, they encourage their followers to challenge the status quo.
A common misunderstand ing is that transformational leaders are "soft ," but the truth is that they constan tly challenge followers to higher levels of performan ce

.
 5 Personality Traits of a Transformational
Leader
• Extraversion: The two main characteristics of extraverts are affiliation and
agency, which relate to the social and leadership aspects of their personality,
respectively. Extraversion is generally seen as an inspirational trait usually
exhibited in transformational leadership.

• Neuroticism: Neuroticism generally gives an individual an anxiety related to

productivity which, in a group setting can be debilitating to a degree where they
are unlikely to position themselves in a role of transformational leadership due
to lower self-esteem and a tendency to shirk from leadership responsibilities.

• Openness to Experience: Creative expression and emotional responsiveness

have been linked to a general tendency of openness to experience. This trait is
also seen as a component of transformational leadership as it relates to the
ability to give big-picture visionary leadership for an organization.
•Agreeableness: Although not a trait which specifically points to
transformational leadership, leaders in general possess an agreeable
nature stemming from a natural concern for others and high levels of
individual consideration. Charisma and idealized influence is a classic
ability of individuals who possess agreeability.
•Conscientiousness: Strong sense of direction and the ability to put
large amounts of productive work into tasks is the by-product of
conscientious leaders. This trait is more linked to a transactional form of
leadership given the management-based abilities of such individuals and
the detail oriented nature of their personality
Transformational Leadership Characteristics
1. Keep their ego in check
2. Self-management
3. Ability to take the right risks
4. Make difficult decisions
5. Share collective organizational consciousness
6. Inspirational
7. Entertain new ideas
8. Adaptability
9. Proactive
10. Lead with vision
4 Leadership Differentiators for Transformational
Leaders
1. Purpose-Driven  
You motivate and inspire people with the strong sense of purpose you bring to the task at hand.

You articulate a vision that connects the purpose of the organization to that of the people you
lead.

You have strong communication skills that engage people in the vision so that followers are
willing to invest more discretionary effort in the work, are deeply engaged, no matter how
challenging the task at hand.
 

2. People-Driven  

You understand that each person is unique and play the role of mentor and coach to the people around you.

You are empathetic and support the individual contributions of team

members while at the same time challenging them to high standards.

You understand the intrinsic motivations of others.

.
This requires strong emotional intelligence
3.Innovating  
You are a change agent and encourage others to be the same.
As you drive change, you provide intellectual stimulation, by
encouraging curiosity, discovery, dialogue and debate so the best ideas
can emerge.
In the process, your people bring their full creativity and engagement to
the process.
You nurture and develop people who think independently and encourage
risk taking and learning in the organization.
4. Inspiring
  
You instill trust. You role model integrity and ethical behavior.
People understand your values and you walk the talk.

Ask yourself, which of the behaviors above do you exhibit most

frequently and how you can start bringing more of these behaviors to
your work and community activities.
 MUST HAVE QUALITIES

• A clear vision:
Transformational leaders have a vision of what they want to
achieve and the ability to clearly communicate this vision so that
everyone in the organization understands what is needed to
achieve this vision. Is your vision clear? Does it need to be refined?
• Courage:
An effective leader needs courage; a willingness to take on new
challenges, take calculated risks, make tough decisions, and be
willing to go out on a limb for something they believe in.
Transformational leaders have the courage to create a vision and
make the difficult decision necessary to achieve their vision.
• Self-motivation:
Leaders need to fuel their passion from within. 
Are you passionate about your vision and willing
to do the hard work needed to see your vision
achieved?
• Inspiration:
Transformational leaders, based on their personal
passion, have the ability to inspire others and get
them to buy into their vision and execute it on all
levels of the company. How do you inspire your
people to create change? Are you effective at
motivating and inspiring your team?
• Know your people:
Personal interaction is important. The impact of a simple
“hello” in the hallway or conversation in the lobby goes a
long way into getting people to feel important and want to
be part of the vision a leader has created for the company. 
You have the ability to impact each of your team on a
personal level. When was the last time you took the time
to listen to your team and get to know them as individuals?
• Set a company standard:
Transformational leaders model a company standard they
expect everyone to follow. They clearly communicate their
vision, expectations, and how this standard is to be carried
out throughout the organization. What is your company
standard? What standard are you setting by example?
• Follow through:
While it is a bit cliché, actions do speak louder
than words — and when leaders live according
to the standard they set, people take notice.
Leaders often promise a lot, but it is the follow
through that has a true impact on a leader’s
ability to evoke change and get buy in. How do
you follow through and ensure your standards
are met?
 Nursing
Transformational leaders should:
• Serve as role models
• Motivate the team
• Demonstrate concern for individual follower's
needs
• Challenge followers to be creative
 Moral Leadership
• A series of highly publicized corporate scandals redirected
attention to the values and ethics that underlie the practice
of leadership as well as that of patient care (Dantley, 2005).
• Moral leadership involves deciding how one ought to remain
honest, fair, and socially responsible (Bjarnason & LaSala,
2011) under any circumstances.
• Caring about one’s patients and the people who work for
you as people as well as employees (Spears & Lawrence,
2004) is part of moral leadership.
• This can be a great challenge in times of limited financial
resources.
 Distinctive Styles of Leadership
• 1. Adaptive: flexible, willing to change and devise new approaches.
• 2. Emotionally Intelligent: aware of his/her own and others’ feelings.
• 3. Charismatic: magnetic personalities who attract people to follow
them.
• 4. Authentic: demonstrates integrity, character, and honesty in
relating to others.
• 5. Level ; ferociously pursues goals but gives credit to others and
takes responsibility for his/her mistakes.
• 6. Mindful: thoughtful, analytic, and open to new ideas.
• 7. Narcissistic: doesn’t listen to others and doesn’t tolerate
disagreement but may have a compelling vision
. 8. No Excuse: mentally tough, emphasizes accountability and
decisiveness.
9. Resonant: motivates others through their energy and
enthusiasm.
10. Servant: “empathic, aware and healing,” leads to serve others.
11. Storyteller: uses stories to convey messages in a memorable,
motivating fashion.
12. Strength-Based: focuses and capitalizes on his/her own and
others’ talents.
13. Tribal: build a common culture with strong sharing of values
and beliefs.
 Caring Leadership Caring leadership in nursing
comes from two primary sources:
servant leadership and emotional intelligence in the
management literature, and caring as a foundational value in
nursing. While it is uniquely suited to nursing leadership, it is hard
to imagine any situation in which an uncaring leader would be
preferred over a caring leader. Servant-leaders choose to serve
first and lead second, making sure that people’s needs within the
work setting are met .
Emotionally intelligent leaders are especially aware of not only
their own feelings but others’ feelings as well . Combining these
leadership and management theories and the philosophy of caring
in nursing, you can see that caring leadership is fundamentally
people-oriented.
 The top 10 requirements for leader behavior

• 1. Shows enthusiasm.
• 2. Supports other people.
• 3. Recognizes individual effort.
• 4. Listens to individuals’ ideas and problems.
• 5. Provides direction.
• 6. Demonstrates personal integrity.
• 7. Practices what they preach.
• 8. Encourages teamwork.
• 9. Actively encourages feedback.
• 10. Develops other people.
 DIFFERENCE BETWEEN MANAGER AND
LEADER
Managers Leaders
Administer and copy Administer and copy
Maintain Maintain
Focus on systems & structure Focus on systems & structure
Rely on control Rely on control
Short-range view - bottom line Short-range view - bottom line
Ask how and when Ask how and when
Accept the status quo Accept the status quo
Classic good soldier Classic good soldier
Do things right Do things right
 BEGAN TODAY

TO

SEE THE BRIGHT TOMORROW

 CHANGE AGENT

Some one who

promotes and enables change

to

happen within
a group or organization
 CHARACTERISTICS
A clear vision

Diversified knowledgeable

Leads by examples

Strong relation built on trust

Ownership
 HOW TO BENCH MARK
• Select a service or product to bench mark

• Identify key performance metrics

• Collect data on service / practices or product

• Analyse the data

• Identify opportunities for improvements

BENCH MARKING

Evaluation by comparison
with a standard
 CAREER PATHWAYS
• It helps in transition from education
to work force

• Spell out the series of manageable

steps for higher credentials and
employment oppertunities
CAREER PATHWAYS IN NURSING
• Inhouse training in hospitals
• Post graduation
• Doctoral and post doctoral
• Speciality training
• Nurse practitioner
• Nurse run clinics
• Entrepreneur
NURSING PROFESSION DEMAND

Emerging diseases
Emerging specialities
Ample opportunities abroad
Ranked the best profession
 FUTURE OF NURSING

Build personal and professional

leadership qualities of young nurses
from various health sectors
to
raise the visibility of nurses by
participating in the Nursing Challenge
for 2020.
Case Study to Promote Critical Reasoning Two new associate-degree graduate nurses
were hired for the pediatric unit. Both worked three 12-hour shifts a week, Jan on the
day-to-evening shift and Ronnie at night. Whenever their shifts overlapped, they would
compare notes on their experience. Jan felt she was learning rapidly, gaining clinical
skills, and beginning to feel at ease with her colleagues. Ronnie, however, still felt
unsure of herself and often isolated. “There have been times,” she told Jan, “that I am
the only registered nurse on the unit all night. The aides and LPNs are really
experienced, but that’s not enough. I wish I could work with an experienced nurse as
you are doing.” “Ronnie, you are not even finished with your 3-month orientation
program,” said Jan. “You should never be left alone with all these sick children. Neither
of us is ready for that kind of responsibility. And how will you get the experience you
need with no experienced nurses to help you? You must speak to our nurse manager
about this.” “I know I should, but she’s so hard to reach. I’ve called several times, and
she’s never available. She leaves all the shift assignments to her assistant. I’m not sure
she even reviews the schedule before it’s posted.” “You will have to try harder to reach
her. Maybe you could stay past the end of your shift one morning and meet with her,”
suggested Jan. “If something happens when you are the only nurse on the unit, you
will be held responsible.”
1. In your own words, summarize the problem that Jan and Ronnie are
discussing. To what extent is this problem due to a failure to lead?
Who has failed to act?
2. 2. What style of leadership was displayed by Jan, Ronnie, and the
nurse manager? How effective was their leadership? Did Jan’s
leadership differ from that of Ronnie and the nurse manager? In
what way?
3. 3. In what ways has Ronnie been an effective follower? In what ways
has Ronnie not been so effective as a follower?
4. 4. If an emergency occurred and was not handled well while Ronnie
was the only nurse on the unit, who would be responsible? Explain
why this person or persons would be responsible.
5. 5. If you found yourself in Ronnie’s situation, what steps would you
take to resolve the problem? Show how the leader characteristics
and behaviors found in this chapter support your solution to the
problem.
 CONCLUSION

Celebrate what you’ve accomplished,

but
raise the bar a little higher
each time you succeed