LEADERSHIP AND MANAGEMENT AND RESEARCH

LEADERSHIP AND MANAGEMENT

Management – art of getting things done with and through people so that
the goals of the organization can be achieved.
- Pag Management ang tanong, it’s always about reaching a goal.

Leadership – the use of one’s skills to influence others to perform to the

best of their ability toward goal achievement.
- Leaders use different influence tactics (“AIRCUBES”) – can be
used consciously or unconsciously by the leader to motivate the
members to work
a. A – Assertiveness: sending direct messages; standing up for your
own right without stepping on the rights of others; considers the
feelings of others
b. I – Ingratiation: making others feel/look good before making a
request
c. R – Rationality: use of reason
d. C – Coalition: backing up a request together with co-members
e. U – Upward appeal: using the name of a superior formally or
informally
f. B – Blocking: threatening somebody to damage his opportunity
for advancement or not being friendly to another person until he
grants a request; aka blackmail
g. E – Exchange: reminding somebody of a previous favor or return
of favors; utang na loob
h. S – Sanction: can either be positive/negative; anything given to
you by an organization; can either be giving or preventing
incentives, benefits, or promotions
- Types of leaders:
a. Formal leaders
 People who hold a position in the organization
 Three levels:
1. Top leaders: monitors the entire organization
Example: President, VP, CEO, Chairman, Chief Nurse,
Nursing Directors, etc.
2. Middle leaders: coordinates with the top and first level
leaders
Example: Supervisors, Coordinators, Department heads
3. First level leaders: focuses on the operations/job
Example: Head nurses, unit managers

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 b. Informal leaders
 Do not hold a position in the organization but can motivate
members to perform
 Example: Senior staff, Charge nurse
- 3 Styles of Leaders
 These are the styles that leaders OFTEN use in problem
solving and decision making
 **Bureaucratic is mostly rules
a. Autocratic – leader focused; leader lang lagi nasusunod; best used
during emergency/crisis situation
b. Democratic – members have a voice in decision making; leader
acts as a facilitator; best used when you need the compliance of
the members
c. Laissez-Faire – member focused; member ang nasusunod,
nagdedecide; best used when the members are matured enough;
also applicable when the manager is new in the unit
 Contingency theory – leadership style will be effective or
ineffective depending on the situation

Authority – legitimate right to give command and to act on the interest of

an organization; an officially sanctioned responsibility
Power – ability to obtain, retain, and motivate other people to perform and
to organize informational and material resources to accomplish a task
**ALL leaders have power but NOT ALL leaders have authority

Sources of Power (“LR CCRIES”)

a. L – Legitimate power: people who holds a position
b. R – Reward power: ability to give incentives and benefits
c. C – Coercive power: ability to give fear and punishment
d. C – Connection power: people you know; maraming kakilala
e. R – Referent Power: charisma
f. I – Information Power: held by people who knows
g. E – Expert Power: special skills and abilities
h. S – Self Power: emanates from self d/t maturity, experience, gender

Function of Management
a. Planning: knowing where you are and where you want to be
- 2 types of planning
1. Strategic/long-term planning: applicable for 3-5 years
 Benefits the whole organization
 Done by the top-level leaders

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 2. Operational/short-term planning: usually changed annually;
may also be changed monthly, weekly, daily
 Benefits the operation
 Done by the first level leaders
- SWOT analysis
1. S – Strengths
2. W – Weaknesses
3. O – Opportunities
4. T – Threats

- Planning formula (done through a meeting)

1. WHAT – “What action is necessary?”
2. WHERE – “Where will it take place?”
3. WHEN – “When will it take place?”
4. WHO – “Who will do it?”
5. HOW – “How will it be done?”

- Hierarchy of Planning/Tools in Planning: guide in creating the plan

1. Mission: reason for existence
2. Vision: what the agency wants to achieve; futuristic
3. Philosophy: statement of beliefs, values, and principles (“We
believe…”); value-centered; core values
4. Goal: general statements of aims and purposes
5. Objectives: more specific statements of aims and purposes
that are used to carry out the goals.
6. Policies: plans reduced to statements that help the organization
in decision-making; affects the entire organization including
the stakeholders
7. Procedures: step-by-step instructions
8. Rules: guidelines for action and non-action; subject to regulation;
affects the employees ONLY
- Budget: systematic way of meeting with expenses; involves past,
present, and future expenses; focuses on revenues/income and
expenses/cost
- 4 types of budget:
1. Capital budget: expensive; usually high amount; long-term use
2. Operational budget: day-to-day expense; consumable; bills
payment; salary of part-time employees; pati pag ang tanong is
both full-time and part-time
3. Personnel budget: salary of full-time employees; prepared
ahead of time but is only available on the day of salary

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 4. Cash budget: available all the time for emergency purpose;
emergency fund; cash-on-hand

b. Organizing: involves establishing a formal structure that provides

the coordination of resources to accomplish objectives and determine
position and description
 Purpose of organizational structure: Work distribution
- 3 ELEMENTS OF AN ORGANIZATIONAL STRUCTURE
1. Levels of Authority
 Depends on the size of the organization
2. Lines of Communication
 Unity of Command – isa lang naguutos
 Chain of Command – follow the hierarchical order; always
REPORT to your immediate superior; pag COMPLAINT, address it
to the IMMEDIATE SUPERIOR of the PERSON YOU’RE
COMPLAINING
 Span of control – number of workers that directly report to a
superior; number of workers that a superior handle
 2 lines of communication
 Solid line – direct relationship; superior-subordinate
relationship
 Broken/Dotted Line – indirect; no superior-subordinate
relationship
 Organization of nurses and doctors are different;
DOCTORS ARE NOT YOUR BOSS except if these are
doctors’ order pertaining to patient care
3. Major forms of Organizational Structure
 Centralized models
 Responsibility is assumed and confined only to one
authority
 ADVANTAGES: Highly cost effective; makes
management easier
 DISADVANTAGES: as the organization becomes bigger
and complex; hierarchical arrangement becomes
cumbersome; the attention of the manager becomes
diluted d/t many responsibilities; arrangement doesn’t
readily adapt to change;
 Better for small organizations
 Decentralized models
 the large structures are broken down into small units and
authority is delegated to those closer to the majority of
workers

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  ADVANTAGES: reflects the interest of the workers and
have a voice in decision-making; promotes better
interpersonal relationship; communication departmentally
and interdepartmentally; allows problem to be solved with
greater imagination and creativity
 DISADVANTAGES: not cost-effective; communication
breakdown; problems with role communication can occur
 Better for bigger organizations
- Job description
1. Also termed performance responsibility
2. Spell out the precise job content including duties, activities to be
performed, responsibilities and results expected from the various
roles of the agency.
3. Purposes of job description:
 Prevent malpractice (professionals commit malpractice)
 Used for delegation
 Used for evaluation
 Used for staffing
 The most important thing to know is your job description
- Staffing
1. Process of assigning competent people to fill the roles designed
for the organizational structure through recruitment, selection, and
development of personnel
2. Staffing Process:
 Conventional – oldest method of staffing; manager could either
use centralized or decentralized
 Cycling – the schedule repeats itself; manager creates a base
schedule
 **Forty hours – 8 hours work, 5 days a week, and 2 days
off; mandated by the law in the Ph; Labor Code of the
Philippines; *you may work on the 6 th day during emergency
provided that the 6th day is overtime.
 **Seven days – work for min. 10 hrs/day, 7 days a week with
7 days off; in normal days pwede tumanggi if they called you
during day off, pero pag national emergency like now, you can’t
say “no”
- Nursing Care System: system that is used to manage nursing care
delivery; another term is “Modalities of Nursing Care”, “Patterns
of Nursing Care”.
1. Case Nursing – total care nursing; 1:1 usual Nurse:Patient ratio
 Ex: Private duty nursing; ideal to be used in the ICU

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 2. Functional – tasks are delegated among the staff; kanya-kanyang
trabaho; act according to function
3. Team nursing – group of nurses assigned to a group of patients;
with team leader
 Ex: duties of student nurses
4. Primary Nursing – 24-hour continuous, coordinated,
comprehensive nursing service of 5-6 patients from admission to
discharge; 1:5/6
 Primary nurse (kung kanino in-endorse) will rest and will be
relieved by associate nurses.
 Nurse assigned per shift: 1; pero madami nurses sa care
 Primary nurse is responsible for the NCP which will be utilized by
associate nurses
 Associate nurse cannot change NCP except if there is sudden
change in patient’s condition provided the primary will be
informed of the change immediately
 Ideal in the ward
5. Modular Nursing – combination of team nursing and primary
nursing; the difference is geographical location; sending nurses in
areas devastated by calamities, for case finding, for caring of
patients with same disease
6. Case Management – utilizes the Health Care Delivery System
 Goal: utilizing the healthcare delivery system wherein the goals
are to deliver quality care, to promote quality of care, to
decrease fragmentation, and contain cost
 EX: Nursing homes, occupational therapy
 Usually utilized for long term treatment
 Decrease fragmentation; decrease feelings of isolation

c. **Directing – delegation, decision-making and problem-solving

- The issuance of orders, assignments, and instructions that permits the
employees to know what is expected of them so that they can
contribute to the attainment of the goals and objectives of the
organizations
- May also be termed as delegation
- Known as the “doing” phase or implementing phase of the
management
- **2 aspects:
1. Technical – Tasks, procedures, materials, and equipment
 if the problem is technical (hindi alam gagawin, incompetent,
having difficulty, no experience) show them how to do it,

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 teach/demonstrate, supervise, do or perform it with the
nurse
2. Interpersonal – attitudes, behaviors, and styles of direction giving
 If the problem is a staff’s attitude or behavior, verbalization of
feelings, because you will not be able to solve the problem
without knowing the problem
 If the problem is styles of direction giving/communicating, the
answer is always assertiveness
3. Sometimes the problem falls on the “WHAT” (What are you going to
delegate?) and “WHO” (To whom are you going to delegate it to?) of
delegation
 4 pointers of delegation
 Consider the position of the staff: determine if licensed
or unlicensed
 Consider the ward: where did they come from? Or where
are they going?
 Consider the capabilities of the staff: depends on the
position & the ward
 Consider the condition of the patient
- Communication
1. sender and receiver are not elements; they are the people involved
in communication
2. sending of message from sender to receiver and vise-versa and
hoping to have an understanding
3. Elements of Communication:
**Shown in a linear form
 Message
 Encoding
 Transmitting (via channels of communication) aka “mode of
transmission”
 Decoding
 Feedback/Action
4. Barriers in Communication
 Hindrances in communication
 Physical Barriers – usually environmental (ex: noise,
distance, etc)
 Social-Psychological barriers – relationship with other
people including the state of the mind (ex: lack of trust, autism
with echolalia, etc)
 Semantic barriers – misinterpretation of signs and symbols
5. Grapevine communication – locally known as chismis; may be
75% accurate; can be harmful or beneficial; beneficial because it

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 gives the manager an opportunity to solve the problem
immediately (priority)
- Conflicts
1. Misunderstanding/disagreement between two or more persons,
agencies, or organization
2. To solve the problem the manager uses Conflict Resolution
Strategies
 Avoidance – “let us not talk about it”
 Dominance and suppression – “I’m the manager here, you
have no choice…” (negative)
 Restriction and power – “I’m the manager here, I will do what
is best for everybody” (positive)
 Majority rule – “Let us divide the house”
 Smoothing – the unacceptable appears to be acceptable
 Compromise – meeting halfway
 Collaboration – working hand-in-hand to solve a problem;
brainstorming; #1 rule in brainstorming: ALL IDEAS ARE
WELCOME
 BOARD EXAM TIP: in conflict resolution questions, if there is a
choice na “REPORT/REPORTING”, it’s automatically wrong
- Approaches in problem solving
1. The first part pertains to the manager or you; the second part
pertains to members or others
2. In all approaches, the manager is able to solve the problem
 Win-lose – manager was able to solve the problem at the
expense of others; dominance and suppression
 Lose-win – manager was able to solve the problem at the
manager’s own expense; restriction and power, smoothing
 Lose-lose – both parties sacrificed in the solution of the
problem; compromise
 Win-win – both parties benefit from the solution of the problem;
collaboration
- Change Management
1. Any alteration in the status quo (present situation)
2. The Change Process
 Perceive the need to change – identify the problem, issue
 ***Initiate a group interaction – key to problem solving;
planning; finding the best solution; bringing the group together;
meeting
 Identify internal and external forces
 State the problem
 Identify the constraints

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  List change strategies
 Develop plan for implementation
 Select or develop tools for evaluation
 **the key in group interaction is the group; without the
group’s approval problem solving will not be successful
 Implement the plan one step at a time – gradually to prevent
resistance
 Evaluate the over-all results
d. **Controlling – evaluation, reviewing, checking, determining,
comparing
- Seeing to it that what is planned is done
- 4 basic steps of controlling
 Develop standards and criteria – standard is the pre-
determined level of care; criteria are the characteristics used
to meet the level of care; basis for evaluation; basta
evaluation ang tanong ang sagot ay STANDARDS
 3 types of standards
1) Structure – facilities, equipment, materials, and
management system; pag si manager gumawa
2) Process – plans and procedure; pag si nurse gumawa
3) Outcome – results
 Determine compliance to standards and criteria
 Nursing audit – patient focused
2 types of Nursing audit:
1) Concurrent – evaluate as the care is given
2) Retrospective – evaluate care provided; done during
discharge
 Performance appraisal – staff focused
2 types of Performance appraisal:
1) Informal – incidental performance appraisal
2) Formal – systematically done based on the
procedure, usually ends up in review sessions; start sa
positive news muna if you’re the evaluator
 Identify strengths and weaknesses – always focus on both;
delegation & evaluation complement each other
 Act to reinforce the strengths and take corrective actions for the
weaknesses
**Directing & Controlling both entail CRITICAL THINKING