Chapter 19: The Gerontological Nurse as Manager and Leader
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Transcript of Chapter 19: The Gerontological Nurse as Manager and Leader
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Chapter 19: The Gerontological
Nurse as Manager and Leader
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Learning Objectives• Identify characteristics of effective nurse
managers and leaders.• Compare various leadership styles and
strategies.• Describe effective communication strategies.• Describe the process of delegation, including how
it is used in the management of unlicensed assistive personnel.
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Learning Objectives (cont’d)• Compare various leadership roles available to
nurses who care for older adults.• Analyze the characteristics of the major
generations of nurses.• Recognize the value of professional associations
to the nurse manager and leader.• Evaluate one’s own strengths and weaknesses as
a future nurse manager or leader.
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The Nurse Manager
• Nurse Manager Leadership Partnership (NMLP) Learning Domain Framework (Figure 19-1, p. 676)
– The Leader Within: Creating the Leader in Yourself• Self assessment• Goal setting
– The Art of Leadership: Leading the People• High-performance work team• Conflict resolution• Culture of safety• Delegation (Box 19-1, p. 680)
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The Nurse Manager (cont’d)– The Science of Leadership: Managing the
Business• Financial management• Human resource management• Performance improvement• Foundational thinking skills• Technology• Strategic management• Clinical practice knowledge
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The Nurse Manager (cont’d)• Tasks Associated with the Role of Nurse Manager (T. 19-1)
1. Staffing for patient care2. Developing goals and objectives
for the unit3. Establishing standards of care4. Developing budgets and using
resources in a cost-effective manner
5. Implementing quality improvement activities to affect patient outcomes
6. Engaging in problem solving7. Planning, organizing, managing,
controlling, and directing unit activities
8. Hiring, orienting, evaluating, and educating staff
9. Mentoring and developing staff10. Identifying systems problems
and suggesting solutions11. Acting as a resource for clinical
issues12. Ensuring compliance with
policies, procedures, and accrediting or regulatory agencies
13. Recruiting and retaining staff14. Participating in organizational
committees and task forces15.Acting as a corporate supporter
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Comparison between Managers and Leaders
Managers Leaders
AdministerAsk how and whenFocus on systems
Do things rightMaintain
Rely on controlShort-term perspective
Accept status quoHave eye on the bottom line
ImitateClassic “good soldiers”
A copy
InnovateAsk what and whyFocus on people
Do the right thingsDevelop
Inspire trustLong-term perspective
Challenge status quoHave eye on the horizon
OriginateOwn personThe original
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The Nurse Leader• Leader develops and articulates clear vision of
the future of the organization• Performance improvement catalyst• Interpersonal relations facilitator• Human resources developer• Resource and financial manager• Standards and compliance expert resource• Customer service advocate
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Leadership Qualities and Theories
• Qualities of effective leaders (Table 19-2, p. 689)
• Transactional leadership• Behavior theory: automatic leadership, bureaucratic
leadership, democratic l. , laissez-faire, situational l.
• 21st century leadership (Table 19-3)• Transformational/charismatic leadership(T
19-4)
• Servant leadership• Complexity leadership
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Effective Communication• Role of the nurse leader in establishing effective
communication– Facilitates collegial relationship among team members,
whether all nurses or interdisciplinary.– Sets clear expectations for professionalism, respect, and
collegiality to foster effective communication and patient safety.
– Role model for effective communication and promotes opportunities for ongoing education about effective communication strategies.
• Patient safety and quality care flourish in an environment where leader actively pursues establishing effective communication among the team.
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Nursing Leadership Roles in Caring for Older Adults
• Executive Roles• Director of Nursing• Charge Nurse• Staff Nurse• Gerontological Nurse Practitioner• Clinical Nurse Leader• Registered Nurse Assessment Coordinator:
Minimum Data Set (MDS) coordinator
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Multigenerational Workforce Issues• Veterans – born before 1945
– Bring a lifetime of experience, respect for authority, dedication, loyal, and sacrifice.
• Baby boomers – born 1946-1964– Value personal growth, interpersonal communication,
often question the status quo, strong work ethic
• Generation X – born 1965-1980– Value independence, informality, technological literacy,
and having fun
• Millennials (Generation Y) – born 1981-1999– Confident, bring a mastery of all things technical, adept at
multitasking, collaborative decision making
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Professional Associations• Coalition of Geriatric Nursing Organizations• National Gerontological Nursing Association• National Association of Directors of Nursing
Administration in Long Term Care (NADONA)• American Association for Long Term Care Nursing• American Association of Nurse Assessment Coordinators• American Health Care Association• Leading Age• National Association of Health Care Assistants• American Medical Directors Association (AMDA)• American College of Health Care Administrators
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Summary• Both nurse managers and nurse leaders are
needed in gerontological nursing
– Managers focus on direction of the details of a unit
– Leaders are visionaries who see the larger picture
• Engaged staff means better, safer care for patients and residents
• Developing sound management strategies requires the desire to change and maintain a constant state of self-reflection