Management and Leadership Styles in Nursing Team Leaders

This assignment will focus on the different management and leadership styles and the benefits and shortfalls will be discussed. Definition of the management and leadership styles will be included along with a brief discussion on trait theories This will be achieved by studying a working nurse team and concentrating on the nurse in charge and how she delegates, leads and organises the team.

Firstly, this assignment will look at the different management and leadership styles followed by the analyst on how the nurse in charged relates these management and leadership styles in practice whilst managing a multi- disciplinary team within a hospital ward setting along with a conclusion of what I have learnt observing leadership style and how I was influenced from this form of leadership and how it may effect me in my future practice as qualified nurse

According to Marquis & Hudson (2000) leadership is a process of persuading and influencing others towards a goal as is composed of a wide variety of roles. .However Bowles And Bowles(2000) Define leadership as an interpersonal relationship of influence the product of personal characteristics rather than mere occupation of managerial positions. it is these personal characteristics which attract enthuse and motivate followers toward organizational goals.

Each nurse has their own styles and leadership, their style depends on their values, traits. Characteristic, along with experience it is these individuals that changes began to come about.

Trait theory of leadership is based on the assumption that people inherited specificate characteristics traits abilities and skills that make more suitable leaders than others Trait approach tries to identify traits and characteristics to distinguish leaders from followers Marquires and Huston (2006) suggested the great man theory is that people are born to lead and others are born to be led. Doyle and smith (2001) argues that Gandhi along with Napoleon inheritated the great man trait and highlight that they took control when needed .As suggested the term great man and not great woman ,This happened as in those times leadership was considered to be a males job only .Since trait theory was not enough to identify leaders from non leaders new theories of leadership began to appear such as are leaders developed through education and special training along with being learnt from observation and teaching creating the behaviour trait .

A nurse leader must have a variety of leadership styles depending on the situation. Leaders are sought after for their expertise in their respective specialties and staff nurses look up to these individuals for guidance.

Management is defined as a process about an improvement in knowledge skills, habits and attitudes of the employee in an organisation (sing 2008)

Historically management has been given a greater importance in healthcare settings (marquis & Huston 2006).However (McCallin2003) states The role of management in the time of Florence Nightingale was authoritarian and focused on rules, hierarchy and systems of punishment or reward to motivate workers. The characteristics of historic management would endeavour autocratic leaders. This type of management may of being accepting in the 19th century but today it no longer reflects the needs or values of the nursing profession

Modern health care settings are complex and requires the registered nurse to have the ability to perform a multitude of roles and responsibility requires highly developed skills in decision making ,critical thinking along with the adherence to professional ,moral and legal standards .In addition to these skills leadership and management are considered essential for professional practice all are included in the Nursing & Midwifery Council(2008) standards and are required for competent practice .the ability of register nurses to be effective leaders will impact on staff ,resources and setting and achievement of goals .this will in turn have implications for the quality of care

Drucker (1999) cited in Weick and Evans(2003) stated today’s nurses are graduates who have been described as knowledge workers who want to be led not managed .

The word management and leadership are often interchangeable this is based on that they use similar skills bowman1997 and greenwood 1997 effective leadership is critical in any organisation and the key to effective is having the staff focused and working towards achieving the desired goal

Convey (2006) argues the view that management is about doing things right and leadership is about doing the right thing ………………student hand book

Leaders and managers are not the same though they act in similar ways. A manager is responsible for setting objectives and using resources efficiently. A leader is responsible for motivating a group of people (team) to use their individual skills; therefore leadership is a vital skill of any successful manager

There are several different leadership styles Three will be chosen and the advantage and disadvantages will be discussed.

Bureaucratic leadership- bureaucratic leaders work by the book and ensures they follow protocols and procedures in accordance to how they are set bureaucratic leaders, expect team members to adhere to the protocols and procedures and follow he rules perfectly . ,this form of leadership can demoralise staff as well as put up barriers when needing to use their own initiative in addition place restraints on any changes that are needed. In acute workplaces where procedures save lives, a bureaucratic management style can help enforce health and safety rules.

Autocratic leadership- Autocratic leaders sets objectives and allocates tasks and demands obedience they make as many decisions as possible and seek to have authority and control in decision making .Autocratic leaders tend to respond quickly and effectively and give the task a direction .However research claims that autocratic leaders can be disliked creating lack of faith and trust along with demotivated staff leading to stress within the relationship with work colleagues Marquis and Huston (2006)

Democratic leadership —democrat leaders encouraged participation in the decision making by consulting team members ,delegating where possible and explaining their decisions along with sharing the responsibility Adaire(2002) Democratic leaders tend to have a good rapour with their team as work colleagues will tell a democratic leader when something has gone wrong. While employees simply hide it from an autocrat .democratic leadership is effective in professional organisations where the emphasis on training, professional and leadership development needs to be optimistic.(tomey 2004)

Laizzez-Faire leadership —Laizzez faire leaders are ones that leaves the employee to get on with their work with little or no interference, By giving the employee freedom it gives them the opportunity to show responsibility and initiative Marquris and Huston (2006)suggest that laizzez-faire leaders only motivate others when requested to do so .This form of leading can be effective if the leader monitors what is being achieved and communicates it back to the team regularly .regrettably ,it can also refer to situations where leaders are not exerting sufficient control

I have chosen a nurse that through her compassion and leadership style as inspired me throughout my transition from a healthcare assistant to a student nurse .For the purpose of the confidentiality of this nurse she will be identified as C.B

C.B has being a registered nurse for 9 years working in a busy public hospital in many departments including orthopaedic and surgical wards and now currently is a band 6 in the Accident and Emergency Department (A/E) She has decided to advance her knowledge and has undertaken many course .This has enabled her to increase her knowledge to enable her to gain confidence in her leadership role, as a band 6 in the A/E department

I was fortunate not only to know C.B as a work colleague but to have the honour to have her as my mentor whilst I was a student in the A/E department.

In the A/E department one member of the nursing team is chosen by the ward manager to become co-ordinator .The role involves delegating teams , communicating jobs needed to done, organising bed state in accordance to admission and discharges performing ward round an organisation of staff such as break times .The event being analysed will be communicating jobs from the ward round to different team members and how the coordinator deals with them .Research evidence suggests that an effective manager should have a detailed knowledge of all patient in his/her care and one way to achieve this is by hands on nursing(Douglas;1992, Lles 1997)

Prioritizing becomes part of a nurses routine in every day practice (Waterworth 2003 ). Using her management skill of decision making C.B looked at the skill mix of the staff to be able to decide how nursing skills are best used (Humphreys 1996). This can be done by using your clinical judgement of the staff and by looking at the grades of the staff available. McElroy et al (1996) agrees with the using clinical judgement to ensure you make the best use of a nurse’s time. It should be recognised that skill mix research is vague. There is research on this area but it mainly looks at grade mix rather than skill mix (Spilsbury and Meyer 2005). One could question skill is more than just a grade, as the grade of the person does not always reflect the experience of the person. C.B had to break the tasks down. Ensuring she makes sufficient use of the skill mix available to ensure that adequate staff fulfils the tasks to ensure the quality of patient care given is of the highest standard. From a management point this is a very important decision to make as it means that you can try to get the best out of your staff and that it is a way of ensuring all your tasks get complete and the management of clinical risk is not affected (Smith and Valentine 1999). This was achieved by using delegation skills.

Delegation is the process from which responsibility for performing a task is transferred to another person who accepts responsibility for the task. Although Delegation is the process from which responsibility for performing a task is transferred to another person who accepts responsibility for the task. But although you have asked someone else to do the task overall the person delegating the task is still actually accountable (Sullivan and Decker 2005) NMC 2008 Delegation is an important management process and allow organization and leadership to function through others .Ellis and Hartley (2004) . Delegating a task to others have been found to be challenging for some nurses Hansen and Washburn (1996)

As C.B has being allocated to be shift coordinator she needed to participate in regular ward round that occurred within the A/E department in addition to have control of any emergency situation that was happening within the A/E .

During the ward round the C.B as the co-ordinator employs a bureaucratic approach as she is with the consultant and junior doctors In this situation she must ensure that everything is done correctly both by herself as well as the consultant and junior doctors After completion of the ward round C.B handed over to the relevant nurses the information that had been discussed during the ward round .There has been a lot of research on handovers which have looked at the contents Hesse (1983) Liukkonen (1993) and McMahon (1990), duration Matthews (1986), Sherlock (1995) Thurgood (1995). This literature all conclude that handovers. influences the delivery of care efficient handovers mean better patient care. Meisser et al (2007) suggested that leadership may be the one quality needed to improve handover Research conducted by Sexton et al (2004) argues that not all the relevant information is discussed during handover, preventing the delivery of care. Yet again C.B delegates ,jobs that have being requested on the ward round .in this situation she employs the transactional form of leadership style as she needs to ensure that all the correct information has been passed on and that the nurses looking after the appropriate team get the jobs done effectively and efficiently .This means the staff of the delegated teams agree to do the job request and do not changed any aspect of the job required .After delegating the new jobs to her staff the C.B than adopts a laissez-faire approach and allows the nurses to get on with their own jobs .However ,communication was still essential in the laissez-faire approach and the C.B regularly calls staff into an area to handover and update herself on the jobs being done ensuring the original job that was requested to herself on the ward round was being carried out. By means of discussing the handover with the delegated nurse C.B allowed them to put themselves forward for the patient Involving her work colleagues allow them to be involved in patient care this form of delegation can be highlighted from a democratic leader

An emergency call came through to the A/E and C.B responsibility was to ensure the correct emergency team would be present for when the patient arrived C.B was in control due to her knowledge and was able to identify follow out this task as a leader of this emergency call C.B made decisions for the group .This type of leadership is autocratic and is appropriate when a dealing in emergency situations Research by Greenwood (1997 ) has found that leaders should adopt the style in which they find most comfortable to be an effective leader.

Leadership styles vary according to various situations. One leadership style may be ineffective where another one is extremely successful. we are now able to see that leaders vary according to situations and their traits. Leaders are able to express themselves fully Bennis.(1998) they also know what they want and why they want it and how to communicate what they want in order to gain cooperation and support achieving goals to be met Bennis (1998) states leaders can find way to make a difference

All nurse are in a position to become change agent but most importantly nurse leaders have the greatest influence on changed. The nurse act as the change agent when assisting patients in changing or altered behaviour .kozier et al (2000) states nurse often act to make changes in the system ,such as clinical care along with helping patient return back to good health. According to Marquis and Huston (2000) what distinguishes a successful changed agent is a person skilled in theory and implementation of planned changed to deal appropriately with these changes and connect all organisations that will be effected by the changed. This is achieved by means of good leadership and management skills