November 28, 2012
Grand Canyon University
Nursing Leadership and Management
An increase in patient acuities, readmissions, and requirement for patient satisfaction among other issues has created a greater need for more registered nurses in the hospital setting. Quality and safe patient care is a direct correlation to the number of staff. With the demand of nurses on the rise, some health care institutions have not readjusted the nurse-patient ratios and the result is decreased patient satisfaction, increased mortality/morbidity in patients, more health care associated infection, and decreased employee satisfaction; leading to burnout and decreased staff retention. (Welton, 2007). Some states have enabled mandatory regulations in order to meet the needs of patients and ensure adequate staffing. Based on the complex needs for more staffing and better budgeting, managers and leaders may have different ideas on the best approach to meet the needs.
Leadership and management are both necessary for the success of an organization. While they share the same fundamental characteristics of a type of authority figure, leadership and management can be considered very different. According to Kotter, managers focus on planning, controlling, and creating appropriate structures and systems while leadership is about inspiration, motivation, developing employee credibility, and anticipating and coping with change. (1990). In addition, managers focus on goals out of necessity while leaders focus on making positive changes and create interpersonal relationships. (Marquis and Houston, 2009). According to Warren, the main difference between a leader and manager is their vision. Managers focus on analyzing, solving problems, and planning. A leader’s vision is values, communication, and creating cohesive environments to facilitate success. (2005). Because of their different roles, nursing leaders and managers can be expected to approach an issue such as nurse-patient ratios indifferent ways. Management is a relationship between authoritative figures and their followers. They focus on the purpose or need of an organization and direct the followers to meet the need. Management functions include planning, organizing, staffing, directing, and problem solving while enabling optimal care and maintaining fiscal responsibility. (Marquis and Houston, 2009). A management perspective of mandatory staffing would be that having mandatory nurse-patient staffing ratios would increase the quality of care, and positive outcomes in hospitalizations, but would be associated with the overall cost, without the absolute guarantee for quality improvement or higher outcomes. Managers would need to consider the balance between optimal staffing levels and cutting down the cost. (Welton, 2007). A manager approach would argue that there is an issue with mandatory staffing without mandatory reimbursement for patient care. Leadership can be described as a transformational process that “involves emotions, motives, ethics, and long term goals of those who follow. Leaders are required to influence and move followers to accomplish more than is usually expected of them.” (Northouse, 2004). “Leaders motivate, console and work with people, to keep them bonded and eager to move forward. This means setting direction, communicating it to everyone and keeping people on track when times are tough.” (Stanley, 2006). While management and administration needs to focus on the “what, who, why, how” of the health care system, leaders have the task of working with the staff and motivating them to try and problem solve various issues in health care. With the need for more staffing, leaders can work to try and figure out what it takes to retain the current level of nurses by preventing burnout and compassion fatigue in the work place, creating a cohesive environment where the staff works well together and create...