Leadership In Nursing
LEADERSHIP IN NURSING
Preliminary
Nursing
management essentially focuses on human behavior. To
achieve the highest level of productivity in nursing care, patients need a
nurse manager who trained in the knowledge and skills of human behavior for
nurses manage nursing professional and non-professional workers.
Mc. Gregor
states that every human being is an individual's life as a whole is always
interaction with the world of other individuals. What
happened to these people is a result of the behavior of others. Attitudes
and emotions of others influence people. Subordinates
depends on the leadership and desire to be treated fairly. A
relationship will succeed if desired by both parties.
Subordinates
need a sense of security and will fight to protect themselves from the threats
that are false or true - true threat to unmet needs in the work situation.
Tops
/ leaders create the conditions to bring effective leadership to form an
atmosphere that can be accepted by subordinates, so that subordinates do not
feel threatened and frightened.
To
be able to do the things mentioned above, both superiors and subordinates need
to understand about the kind of leadership management, which in turn formed the
motivation and attitude of professional leadership.
1. Definition
of Leadership
There
are some limitations on leadership, among others:
a. Leadership
is a combination of the behaviors of a person so that that person has the
ability to encourage others willing and able to complete tasks - specific tasks
entrusted to it (Ordway Tead).
b. Leadership
is a process that affects the activity of a person or group of people to want
to do and achieve certain goals that have been established (Stogdill).
c. Leadership
is a relationship created by the influence of a person to another person so
that the other person voluntarily and are willing to work together to achieve
the desired goal (Georgy R. Terry).
d. Leadership
is a process that affects the activity of a person or group of people to
achieve certain goals that have been set out in a particular situation (Paul
Hersay, Ken Blanchard).
Can
be understood from the above four constraints that leadership will come when
someone because of nature - the nature and behavior have the ability to
encourage others to think, act, and or do something according to what he wants.
Leadership
in the context of major organizational emphasis on the function of the
direction that includes telling, showing, and motivate subordinates. Management
function is closely related to the human factor in an organization, which
includes the interaction between humans and focuses on a person's ability to
influence others.
In
the nursing leadership is a leader's use of skills (nurses) in influencing
nurses - nurses who are under supervision for the division of tasks and
responsibilities in providing nursing care services so that the goal of nursing
is reached. Each
nurse has a different potential for leadership, but these skills can be learned
so it can always be applied and improved.
2. Leadership
Theory
There
are some who have argued, among other things:
a. Great
man theory or the theory of talent
Theory
of a great man (the great men theory) or the theory of talent (Trait theory) is
a classical theory of leadership. It
says that a leader is born, that talent - talent that needed someone to be the
leader gained since birth.
b. Theory of situation
Contrary
to the theory is the theory of the talent situation (situational theory). This
theory grew out of the observation, where a person though not a descendant of a
leader, it can also be a good leader. Observations
concluded that an ordinary person who became the leader is because of a
situation that benefits him, so he has a chance to emerge as a leader.
c. Ecological Theory
Although
the situation is now widely embraced theory, and therefore became the problems
of leadership many studies, but in daily life - a day often found that after
successfully molded into a leader, it does not have good leadership. Such
observations gave birth to ecological theory, which states that a person can
indeed be set up to be a leader, but to be a good leader does have the talent -
talent that there is in a person derived from nature.
3. Leadership
Style
It
has been mentioned that the leadership style is influenced by the nature and
behavior of which is owned by the leader. Because
of the nature and behavior of the person with the other person is not exactly
the same, the style of leadership (leadership style) are also not the same
diperlihatkanpun. Based
on the opinion of the relationship between the leadership styles of behavior,
then in discussing leadership styles to the field of administration is often
associated with the management pattern (pattern of management), often
associated with talk about behavior.
Tegantung
of the nature and behavior encountered in an organization and or owned by the
leader, the leadership style exhibited by a leader can differ from one another.
Different
leadership styles can be distinguished if the simplified into four types,
namely:
a. Leadership
Style Dictators
In
dictatorial leadership style (dictatorial leadership style) is done in pursuit
ketakutanserta pose the threat of punishment. There
is no relationship with a subordinate, because they are considered only as
implementers and workers.
b. Autocratic
leadership style
In
this leadership style (autocratic leadership style) all decisions in the hands
of the leader. Opinion or
criticism of subordinates is never justified. Basically
the properties owned by the same dictator leadership style but in a somewhat
less weight.
c. Democratic
Leadership Style
In
a democratic leadership style (democratic leadership style) discovered the role
of subordinates in decision making by consensus. Relationships with
subordinates well constructed. Positive
aspect of this leadership style brings advantages, among others: decisions and
actions that are more objective, growing sense of belonging, as well as high
moral terbinanya. The
disadvantage: decisions and actions sometimes - sometimes slow, lacking a sense
of responsibility, and decisions are made sometimes not the best decisions.
d. Leadership
Style Casual
In
the relaxed style of leadership (laissez - faire leadership style) is barely
visible leadership role because all the decisions left to subordinates, so
every member of the organization can conduct their activities - in accordance
with the will of each individual - each well.
4. Effective
leader
An
effective leader is a leader who can influence others to work together to
achieve a satisfactory outcome for the beneficial changes. There are
a number of effective leadership among others by:
a. Ruth M. Trapper (1989), divided
into 6 parts:
1)
Define clear objectives, appropriate, and meaningful to the group. Choosing
knowledge and skills in the field of leadership and profession.
2)
Have a sense of self and use them to understand their own needs and the needs
of others.
3) Communicate
clearly and effectively.
4)
Mobilizing sufficient energy for leadership activities
5) Take action
b. Hellander
(1974)
Said
to be effective when followers see the leader as one who shared - the same goal
identifying and determining alternative activities.
c. Bennis (Lancaster and
Lancaster, 1982)
Identifies
four essential skills for a leader, namely:
1)
Have knowledge of the vast and complex system of humans (human relationships).
2)
Applying knowledge of the development and coaching subordinates.
3)
Have the ability of human relationships, especially in influencing others.
4)
Having a bunch of values and skills that enable a person to know others well.
d. Gibson (Lancaster and
Lancaster, 1982)
A leader should
consider:
1) Vigilance (self
awarness)
Vigilance
means being aware of how a leader affects others. Sometimes
a leader felt he had to help others, but in fact it has been slow him down.
2) Characteristics of the group
A
leader must understand the characteristics of the group include: norms, values -
the value of his abilities, communication patterns, goals, expression and
intimacy groups.
3) Characteristics of the
individual
An
understanding of the individual characteristics are also very important because
each individual is unique and each - each have a different contribution.
5. Leadership
and power
According
to Gardner cited by Russell (2000) defines power as a capacity ffor ascertain
the result of a desire and to hinder those who do not have the desire.
Basic - basic power
Franch
and Raven proposed five basic interpersonal power, namely:
a. Legitimate
power
Legitimate
power is the ability to influence with respect to the position. Legitimate power
is not dependent on subordinates. Someone
with a higher position in the organization has the power to people - people
underneath.
b. The power
of appreciation
Leaders
who use legitimate power to use the award to gain the cooperation of
subordinates. Subordinates
may be responding to instructions or requests if leaders can provide valuable
rewards, such as: salary increases, bonuses, and other holiday gift - another.
c. The power of
coercion
Coercive
power is the power to sentence. Shirts will be subject to fear. Although
the power of coercion may be used to correct unproductive behavior in the
organization, but often produces the opposite effect.
d. The power of
charisma
Someone
whice charismatic leader can affect people as true - right from the personal
and the behavior of the leaders.
e. Power expert
A
person who has special skills have a higher value. This power is not
tied to the order of precedence.
All
five of the above types of interpersonal power are interdependent because of
the type - the type can be used in a way combined in various ways and each -
each can affect the other.
6. Leaders
and leadership
The
manager or person in charge of leadership is the process or management
functions. Under
the leadership hierarchy of tasks grouped as follows:
a. The first-level leaders
(Lower Manager)
Leadership
is directly related to the workers who run the machinery equipment or provide
services directly to consumers. This
leadership role preferred proportions of the greatest technical skill and
conceptual skills are the smallest.
b. Mid-level leaders (Middle
Manager)
It is
the leadership that is one level above the Lower Manager. Leadership
is a channel of information and communication tradeoffs between Lower Manager
and Top Manager, the top management (in the Middle Manager) is preferred so
that the leader has the ability to make contact between the two. Conceptual
skill is ketramp [ilan in the preparation of concept - the concept, the
identification and delineation of things - the abstract. While
techmnical skill is skill in doing the job in engineering. The
relationship between human beings is a skill in communicating with other human
beings.
c. Top
management (Top Manager)
Top
management is the manager who occupied the highest authority of the
organization and the primary responsibility of the administration. This
leadership role has a greater proportion of the biggest conceptual skills and
technical skills are the smallest.
Human relations are of two
types:
a. Human Relations
Is
the internal human relations in organizations in order to foster smooth
teamwork.
b. Public Relations
Is
the relationship between human beings out of the organization externally.
Task - the task of leadership:
a. As
decision-makers
b. As
the bearer of responsibility
c. Mobilize
resources to achieve goals as a conceptual thinker
d. Working with and through others
e. As a mediator, politician,
and diplomat.
The role of the leader
of the group:
a. As
liaison interpersonal, which is a symbol of a group in performing duties
legally and socially, has the responsibility and motivate, manage people and
organize the development of connective tissue and is working outside the group.
b. As
an innovator or reformer
c. As
an information provider, which monitors the information in the organization's
environment, disseminate information from the outside to subordinates and
mewakilikelompok as speakers.
d. Gathering
strength
e. Stimulate
public debate
f. Creating the position of
nurses in the media
g. Choosing
a strategy that is most effective, acting at the right time
h. Maintaining
activity
i. Maintaining formaf
decentralized organization
j. Acquiring
and developing the best research data
k. Studying
the experience
l. Do
not give up without trying.
7. Conflict
management
Conflict,
according to Deutsch (1969) is defined as a dispute or struggle that arises when
the balance between feelings, thoughts, desires, and behaviors that are
threatened. The
cause of the conflict, Edmund (1979) mentions nine common factors related to
all possible causes of the conflict, namely:
a. Specialization
A
group that is responsible for a specific task or a specific service area
separates itself from other keompok. Often result in
conflict between groups.
b. The
role assigned to many
Nursing
role requires someone to be a manager, a skilled caregiver, an expert in human
relationships, a negotiator, counselor, and so on. Each
sub role with duties - duties require different orientations - differences that
can lead to conflict.
c. Interdependence
role
The
role of the nurse practitioner in private practice would not be as complex as
the role of the nurse in the multidisciplinary health care team, which task one
needs to be discussed with others who may be competing for the area - a
particular area.
d. The blurring of
duties
It
is caused by an ambiguous role and failure to assign responsibility and
accountability for a task on an individual or group.
e. Difference
A
group of people can fill the same role but behavioral attitudes, emotions, and
cognitive people - these people of their role can be different.
f. Lack of
resources
Economic
competition, patient, position, is the absolute source of conflict between
individuals and between groups.
g. Change
When
change becomes more apparent, it is likely the level of conflict will increase
proportionally.
h. Conflict
of reward
When
people get rewarded differently - different, it is often a conflict, unless
they are involved in the reward system works.
i. Communication
problems
Ambiguity,
distortion of perception, language failure, and use of communication channels
incorrectly, it will cause konfllik.
Management
or conflict management can be done through the following efforts:
a. Discipline
The
endeavors are used to organize or prevent conflict, nurse managers need to know
and understand the provisions of its constitution. If
the provision is not clear it is necessary to clarify. Discipline
is a way to correct or repair unwanted staff.
b. Maintain
stages of life
Conflicts
can be resolved by helping individuals achieve nurses according to the stages
of life, which include:
1) Phase young adults
2) Phase adult medium
3) Phase humans above 55
years
c. Communication
Communication
is an art that is essential to maintain a therapeutic environment. Through
increased communication effectively, conflict can be prevented.
d. Assertive
training
Assertive
nurses know that they are responsible for our thoughts, feelings, and actions. Increased
awareness, sensitivity training and assertiveness training to improve the
ability of nursing managers in dealing with conflict behavior.
Conflict management techniques:
a. Setting goals
If
you want to get involved in conflict management, the nurses need to understand
the whole picture of the problem or conflict to be resolved. The
objectives include: improving alternative conflict resolution issues, if
necessary motivation involved parties to discuss settlement alternatives that
may be taken so that the parties involved in the conflict can be responsible
for the decision selected.
b. Choosing a
strategy
1) Evade
To
prevent more serious conflict that culminated in the situation, the strategy is
an alternative dispute resolution to avoid a temporary right to choose.
2) Accommodation
Accommodate
the parties involved in the conflict by increasing cooperation and balance and
develop appropriate problem solving skills by collecting accurate data and take
a collective agreement.
3) Compromise
Done
by taking the middle ground between the two parties to the conflict.
4) Competition
As
leaders, nurses can use the power associated with the task of staff through
improving motivation among staff, which raised the sense of competition.
5) Cooperation
If
the parties - the parties involved in the conflict to work together to resolve
the conflict, the conflict can be resolved satisfactorily.
cover
Nursing
is a profession that continues to change, more extensive functions, either as
executor of care, managers, experts, educators, and researchers in nursing. Seeing
a broad functions as described above, then the nurse should be prepared to gain
knowledge and skills about leadership. Nursing
leaders are needed both as implementing nursing care, educators, managers,
experts, and the field of nursing research.
With
a model of effective leadership, it is expected in the future of the nursing
profession can be accepted with a good image in the community as a profession
that was developed based on science and emerging technologies.
REFERENCES
- 1. Azrul Anwar (1996), Introduction to health administration, Binarupa Literacy, Jakarta.
- (1996), Leadership in nursing in nursing innovation movement (paper presented at a seminar at the PAM nursing Nursing Soetopo, Surabaya).
- 3. Djoko Wiyono (1997), Management leadership and health organizations, Airlangga University Press, Surabaya.
- He Monika Elaine L (1998), Leadership and nursing management, EGC, Jakarta.
- 5. Prayitno Lush (1997), Basic - basic public health administration, Airlangga University Press, Surabaya.
- 6. Swanburg Russel C. (2000), Introduction to nursing leadership and management, EGC, Jakarta.
- 7. Nursalam (2002) Nursing Management; applications in professional nursing practice, Medika Salemba, Jakarta
