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Nursing Leadership Theories

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Danika Warfield

on 4 November 2013

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Transcript of Nursing Leadership Theories

Neuman: Systems Model Theory
Benner: Novice to Expert Theory
o Patricia Benner R.N., Ph.D, is a professor at the University of California in San Francisco. She has been involved in research since 1979 and has published nine books and several articles. She published the “Novice to Expert Theory in 1982.
o The “Novice to Expert Theory” is described as five clinical competences as; novice, advanced, beginner, competent, proficient, and expert.
o These skills are developed through experience and education over time. Nursing skills and experience are prerequisites for becoming an expert.

Lakiesha Ross: rosslm01@students.ipfw.edu,
BreAnn Johnson: johnbl04@students.ipfw.edu,
Danika Warfield: warfda01@students.ipfw.edu

Novice to Expert Theory
o Novice- First year of education
• No experience
• Lacks confidence to demonstrate safe practice
• Requires continual cues
• Taught general rules to help with tasks
• Ex. Given “ Tell me what I need to do and Ill do it”

o Advanced Beginner- New Graduate
• Gained some experience in actual situation
• Knowledge is developing
• Requires occasional, supportive cues
• Feel they can make their own decisions on what to do without consulting another nurse

o Competent-one-two years of practice
• Care is provided in a timely manner without supportive cues
• More aware of long-term goals
• Plans are more organized and structured and critical thinking

o Proficient-A transitional stage on the way to expertise
• Holistic view of situations
• Knows from past experiences what to expect and how to act accordingly
• Nurse becomes a change catalyst

o Expert- four or more years
• No longer relies on rules, principles, and guidelines to direct them
• Much more experience and knowledge
• Proficient and flexible
• More of a natural grasps on clinical situations

Importance of the Novice to Expert Theory
Any nurse able to demonstrate expert skills can act as a nurse leader and better help novice nurses reach their full potential
The professional nurse utilizes independent decision-making, critical thinking, and problem solving skills to facilitate change within the health care system and/or the nursing profession
Each step of this theory builds upon the previous step
Systems Model Theory
Optimal level of wellness through the three levels of prevention

Primary: Health promotion and disease prevention
Secondary: Early disease detection and prompt treatment
Tertiary: Prevent regression; treatment; rehabilitation

Importance of the Systems Model Theory
Importance of Caring Model
Addresses caring relationship between humans and deep experiences of life.

Is based on a holistic approach to patient care, and focuses on caring relationship between the patient and nurse.

Allow nurses to look beyond the situation and show concerns towards the person’s experience.

It includes collaboration and problem solving between nurses and other staff members.

Leadership practice can be cultivated by the caring theory by interacting and connecting with others.

10 Factors for Caring
Watson believed these ten factors are necessary for providing patient centered care.
These factors can be used by leaders to help develop trusting relationships with patients.

1. Forming humanistic value systems
2. Instill faith and hope
3. Being sensitive to self and others.
4. Developing helping-trust relationship.
5. Acceptance of positive and negative feelings
6. Using problem solving for decision-making,
7. Provide interpersonal teaching-learning.
8. Creating a spiritual and physical healing environment
9. Assist with basic needs (physical, emotional, spiritual).
10. Allowing miracles to occur.

Importance of Nursing Process Theory
Remember the 5 steps to the nursing process
Those who are better at managing get promoted, and those who are promoted have the opportunity to be a great leader
We all have a back ground in management
Ex. Medication errors on a RN’s fifth night shift in a row.

Quantum Leadership
Quantum leadership encompasses the chaos and complexity theory.

Its about learning to understand relationships, behaviors, and change.

Changing into a new era of time: The Quantum Age.

To be competent as a quantum leader you must engage in conflict resolution and understand the complexity of change

Several traits and principles to help guide a quantum leader.

Transformational Theory
Transformational leadership theory (TFL) was first introduced in 1978 by James MacGregor Burns.

James received his B.A from Williams College and his Ph.D. in political science from Harvard. He also attended the London School of Economics.

James is considered a pioneer in the study of leadership.

He wrote more than two dozen books and received many awards for his work.

He devoted his professional life to the study of leadership and its various forms.

Work Empowerment Theory
The Work Empowerment theory’s organizational structures include: structure empowerment, psychological empowerment, and positive work behaviors and attitudes
Importance of the Work Empowerment Theory
o Betty Neuman received her BS in nursing in 1957 and her MS in Mental Health Public health consultation in 1966 as well as her Ph.D. in clinical psychology
o Her theory was first published in 1972 and consists of four Nursing Paradigms
o Neuman's systems model provides a comprehensive flexible holistic and system based perspective for nursing.

Actions of nursing are aimed to retain attain, and maintain optimal client health.
Care provided will be influenced by the nurse’s perceptions.

Emotional intelligence
is executed by the nurses assess their own perceptions in addition to assessing the clients in order to provide an optimal level of wellness.
Orlando: Nursing Process Theory
• Ida Jean Orlando received her nursing diploma from New York Medical College , and her BS in public health nursing from Columbia University also in New York.
• She published The Nursing Process Theory in 1961. It may also be know as the Nurse-Patient Relationship.

Nursing Process Theory
• So we all know what the nursing process is.
o Assessment
o Diagnosis
o Planning
o Implementation
o Evaluation
• Leader and follower exchanged are dynamic
o Both leader and follower are essential to the unit’s success, and both action and reactions are influenced by this.
o Leader provides direction, not control, to encourage participation by employee
o Instills motivation and commitment

Nurse leads can instill empowerment into staff nurses which will lead to nurse autonomy and an increase in satisfaction of their work and a commitment to their organization.
Staff nurse empowerment
Span of control
Look at those HCAHPS rise!
Watson: Caring Model
Jean Watson published the “Human Caring Theory” in 1979.
She was born in 1940 in West Virginia.
She received her BSN, MS, and PhD at the University of Colorado.
She has received 6 Honorary Doctoral Degrees.
Her research has been in the area of human caring and loss.

Importance of Transformational Leadership
Transformational leadership is focused on recognizing and engaging followers.

The leaders are able to engage the followers in a way that raises their level of performance and motivation.

A study also found that the highest number of positive outcomes were associated with the use of transformational leadership.

Leaders who demonstrated transformational leadership qualities were reported to be associated with patient satisfaction, patient quality of life, unit effectiveness, and extra effort.

1. Leader serves as a role model.

2. Inspire motivation in their followers by having a strong vision about their work.

3 Concerned about the individual and demonstrate a concern for their needs and feelings.

4. Leader challenges and develops the followers to be innovative and creative nurturing independent thinking.

References Cont.

Bouska. (2011). Quantum Leadership: Advancing Innovation, Transforming Health Care (3rd Edition). Kansas Nurse, 86(6), 18-19.
Current Nursing. ( 2012, January 26). Jean Watson’s philosophy of nursing. Nursing Theories. Retrieved from http://currentnursing.com/nursing_theory/Watson.html
Curtin, L. (2011). Quantum Leadership: Succeeding in Interesting Times. Nurse Leader, 9(1), 35-38. doi:10.1016/j.mnl.2010.11.004
Field, P. A. (2007). The impact of nursing theory on the clinical decision making process. Journal of Advanced Nursing, 12(5), 563-571. doi:10.1111/j.13665-2648.1987.tb03046.x
Feather, R. (2009). Emotional intelligence in relation to nursing leadership: does it matter? Journal of Nursing Management, 17, 376-382
Giltinane, C. (2013). Leadership styles and theories. Nursing Standard, 27(41), 35-39.
Hastings, J. (2002). Modern nursing and modern physics: does quantum theory contain useful insights for nursing practice and healthcare management?. Nursing Philosophy, 3(3), 205-212.
Laurent, C. (2000). A nursing theory for nursing leadership. Journal Of Nursing Management, 8(2), 83-87. doi:10.1046/j.1365-2834.2000.00161.x
Lyon. J.A. (2011). Watson’s Human Caring Theory. Retrieved from http://jalyon.wordpress.com/scholarly-works/watsons-human-caring-theory/
Marble, S. (2009). Five-step model of professional excellence. Clinical Journal Of Oncology Nursing, 13(3), 310-315. doi:10.1188/09.CJON.310-315

Marriner, T. A., Raile, M. (2008). Nursing Theorists and Their Work (6th ed.). WY: Mosby, Inc.
Pearson, A., Laschinger, H., Porritt, K., Jordan, A., Tucker, D., & Long, L. (2007). Comprehensive systematic review of evidence on developing and sustaining nursing leadership that fosters a healthy work environment in healthcare. International Journal of Evidence-Based Healthcare, 5, (2).
Pipe, T. (2008). Illuminating the inner leadership journey by engaging intention and mindfulness as guided by caring theory. Nursing Administration Quarterly, 32(2), 117-125.
Sarmiento, T. P., Laschinger, H. K., & Iwasiw, C. (2004). Nurse educators’ workplace empowerment, burnout, and job satisfaction: Testing kanter’s theory, Journal of Advanced Nursing, 46(2), 134-143. doi:10.1111/j.1365-2648.2003.02973.x.
Sherman, R. O. (2012). Becoming a transformational nurse leader.Emerging RN Leader. Retrieved from http://www.emergingrnleader.com/transformational- nurse-leader/
Tim Porter-O’Grady & Kathy Malloch (2011). Quantum Leadership: Advancing Innovation, Transforming Health Care (3rd ed.). Jones & Bartlett Learning, LLC.
Whitehead, D., Weiss, S., & Tappen, R. (2010). Essentials of nursing leadership and management. (5th ed.) Philadelphia, Pennsylvania: F.A. Davis Company.
Williams College. (2012). James MacGregor Burns. Political Science. Retrieved from http://political-science.williams.edu/profile/jburns2/

Four Key Attributes of Transformational Nurse Leaders
Educate student nurses and nurse professionals on theories integrated in the leadership role.
Student nurses and nurse professionals will better understand social skills and can better themselves in the leader role by use of already established theories.
Investment into leadership mastery can serve beneficial to the entire organization.
Nursing students and health professionals
Nursing Leadership Theories Group 12
Importance of leadership
Staff nurse intention to stay was positively correlated to their perceptions of their manager's leadership. (Cowden, T., Cummings, G., & Profetto-mcgrath, J. 2011)
Intent to stay
Effective leadership
Effective leadership, from an emotional intelligence perspective, is associated with self-awareness self-control, awareness of others and social skills. (Feather, 2009)
This can also lead to an increase in meeting care standards as well as patient expectations.
If goals are to be accomplished, effective leaders need to have a vision, plan, and structure.
(Whitehead et. al 2009)
Job satisfaction
Work quality
Patient satisfaction
HCAHP scores
Monetary gain
If effective leadership is not practice, the organization will see an increase in nurse turn around. This leads to adverse effects such as:
Decrease in scores
No bonus
Full transcript