Nursing Leadership and Management


Within the factions of healthcare organizations, nurses work alongside a great number of other professional and non-professional staff members. Similarly, a majority of the nurses are expected to manage a wide variety of personnel in roles of supervisors or nurse managers among others. According to Kelly (2012), the essence of leadership is the ability to influence others to work more efficiently in a state of independence. This means leaders should be able to control their teams to work towards achieving the organizational goals. Effective nurse leaders inspire others to work in pursuit of a common purpose without exerting their authority or intimidating their subordinates. Unfortunately, for Henry, he is pleasant with his patients, but his behavior is disturbing. Henry’s behavior and his relation with the employees can be best described using Henri Fayol theory of management.

Henri Fayol’s Management Theory in relation to Henry’s behavior

In the early 1900s, managers had very few resources to draw upon to guide them and develop their management practice. Henri Fayol coined the tools needed to lead and manage change more effectively in organizations, bringing to life, the popular Henri Fayol’s theory, which lays the foundation for modern management theories (Cole, 2004). The model considers the functions of planning, organizing, directing, and controlling, which although they are still relevant today, the complexity of the complexity of today’s healthcare systems makes it hard to apply them. In light of the nature of Fayol’s theory of management, several principles can be used to illustrate why Henry’s behavior correlates with Fayol’s theory. Firstly, and to understand the relationship between Henry’s behavior and this management theory, it is important to consider Fayol’s principles of management. For instance, the second principle asserts that managers have the authority to order their employees, but also know that this comes with responsibility. However, the fifth principle, which talks about the unity of direction, it gives the manager powers to use only one plan, and that teams should work under the direction of one manager. For Henry, although the 14 principles of Henri Fayol also directs those in authority to treat employees in kindness, promote team unity and spirit, and give orders to the best interests of employees at heart, he fails to consider these. Rather, he believes in an authoritarian style of leadership, where he gives orders and makes decisions without regard to the input of the rest of the group.

Recommended Theory

Effective leadership is one of the primary factors that determine whether an organization fails or succeeds. Nurses in management levels are called upon to exercise all skills of an effective leader to ensure organization goals are attained, without being authoritative towards their teams. In the case of Henry, the most appropriate theory is the adoption of contemporary theories and in particular the concept of shared leadership. As Sullivan (2013) notes, contemporary theories recognize the complexity of health systems and the need for integration, as well as the importance of cooperation and coordination of personnel within managerial and clinical positions. Similarly, the shared leadership model is based on empowerment initiatives for participative and transformational leadership. The concept eliminates the notion of a single nurse being the heroic leader and recommends the collaboration of several individuals working at different levels within the system.

How to build managerial skills in managers

Every nurse must be prepared to manage. However, in the case of Henry, even after eight years in the position of a supervisor, it seems that he is not an effective leader. In this case, specific training in managerial skills is necessary for the work setting. Training can be delivered in the form of workshops or seminars, where a group of people in administrative positions are picked and grilled through what makes an effective leader.

Desirable skills in a Leader

Within the healthcare settings, nurse managers must be able to exhibit leadership skills alongside professionalism. According to Sullivan (2013), these skills include the ability to exercise foundational thinking skills, ability to initiate change, manage time, set goals and adhere to them, determine priorities, and above all practice emotional leadership with teams.

Change in Healthcare

In the 21st century, healthcare has had a major significant change, mostly attributed to demographic and societal shifts. The population is getting older alongside increased demands for health care. Previously, health providers only dealt with acute illness; however, in today’s healthcare system, more people are being diagnosed with chronic diseases such as diabetes, hypertension, cancer, cardiovascular diseases, and obesity. Alongside the chronic illness, the cost of health has gone extremely high as the cost of treatment goes up. More and more people are now at the mercy of the overrated treatment options or death. All these changes bring up the ultimate question; what does the future hold for healthcare systems?

Changes to reduce the cost of healthcare without compromising patient health

Healthcare expenses in the United States and all over the world poses one of the major challenges to attaining improved healthcare outcomes and positive patient experiences. Another problem is presented by the inability to reduce cost in exchange for compromised patient health. According to Melynk & Gallagher-Ford (2016), use of the evidence-based procedures in clinical settings empowers clinicians and reduces errors resulting in improved patient outcomes and low health costs. The other way is by enhancing patient safety, which seeks to eliminate medical errors and cut down on complications, injuries, and readmission costs (Stanton & Agency for Healthcare Research and Quality, 2002). In addition to the above, Goodman (2016) notes, that change can also be introduced in the form of cost-sharing, where patient pay out of the pocket for some of their healthcare, while insurance coverage takes care of the rest. The goal is to reduce demand for health services and ensure patients seek medical attention only when necessary.

Nurse Manager Role in Reducing Medical Errors

Nurses are often the gatekeeper in the administration process and their role in preventing medical errors is critical. As nurses, it is important to ensure patient safety as a way of reducing medication errors, which can be devastating to the patient and families and costly to the organization. Studies show that, when nurses are interrupted during medication administration, a substantial percentage of errors were evident. In light of this, nurses can reduce medical errors by eliminating any forms of disruptions during the management of medications. Another way involves adoptions of information systems to ensure proper drug prescriptions and administrations.

Emerging Technologies in Healthcare

 In this era of rapid technological changes, healthcare organizations are also embracing evolving technology in their operations to manage patient data, compare data across platforms, and provide care when they are miles away among others. Within the practice of nursing, nurses could take advantages of these emerging technologies in healthcare through several ways (Sullivan, 2013). For instance, clinical information systems provide data to allow care providers to track patient wait times in admission. Nurses can take advantage of this technology by monitoring delays so that appropriate staff and resources can be redirected to this point for increased efficiency and patient satisfaction. Another way that nurses can take advantages of emerging technologies is through virtual care. The system allows monitoring of patients remotely, and nurses can watch video screens monitoring ICU patients when they are miles away from the hospital. This way nurses can then serve other patients, as they monitor others through the virtual care health system.

Critical Thinking

Critical thinking involves the ability to examine underlying assumptions, interpreting, and evaluating arguments to develop a reflective criticism for the purpose of coming up with a justified conclusion. Not to be confused, critical thinking is not the same as criticism. Critical thinking also represents an important element in decision-making and involves a higher-level of the cognitive process such as creativity, problem-solving, and decision-making.

Personal Experience

A few weeks my colleague and I were assigned the responsibility of taking care of 8 patients in the hospital general medical-surgical ward. However, a few hours later, my partner was summoned to the delivery room to assist with the workload. This left me alone to take care of the patient all night. Jane, an unlicensed assistive personnel, was going out, but seeing me alone, she offered to help as she was free the next day. While I had seen Jane work alongside a registered nurse, I was not sure of her competency. Unfortunately, she was my only option as there as a probability of my colleague taking several hours in the delivery unit.

Personal Critical Thinking Attributes

As a nurse, and in support of the above experience, I must say that my strongest attribute in critical thinking is the ability to make decisions. Decision making in nursing is a useful procedure that involves selecting one of the several alternatives to come up with practical choices. Virtually, there are different types of decision-making conditions such as making decisions under certainty or uncertainty. In my case, the decision to delegate Jane to assist me in the ward was made under uncertainty. According to Sullivan (2013), decisions made under this criterion do not allow all the alternatives or possible consequences. The individual making the decision relies on probability estimates to assess the likelihood of an event occurring or not occurring. In essence, the key element is to use probability to predict expected risk and decide if the decision is worth making. In this case, delegating unlicensed assistive personnel can have legal implication on the hospital as well as pose potential risks for the patient. For instance, in case I delegate aspects of patient care outside the scope of Unlicensed Assistive Personnel practice, the health of patient would have been compromised, jeopardizing the life of the patient and the hospital’s reputation. On the other hand, if I failed to delegate to the only individual available at the moment, who would help me with the workload, the tasks would have been overwhelming for me with possible patient risks.

Outcome of the Decision Making

Problem-solving is a process used by individuals when they perceive a gap within an existing system that needs to be filled. The way a person perceives a situation determines how the problem will be solved. The process of problem-solving involves several techniques such as trial-and-error, experimentation, and some people rely on intuition or experience. In light of this, and since I was faced with eight patients and no nurse to assist me, my only option was to delegate Jane to help me in the unit. The decision was by far influenced by the fact that I had previously observed her working alongside registered nurses, which was one thing that enabled me to trust her and delegate her. With close supervision and proper communication from both of us, the night went on well without any strange incidents.


Cole, G. A. (2004). Management theory and practice. London: Thomson Learning.

Goodman, J.C. (2016). The most powerful force for reducing healthcare costs: The Marketplace. Forbes. Retrieved from:

Kelly, P. (2012). Nursing leadership & management. Clifton Park, NY: Cengage Learning.

Melnyk, B. M., & Gallagher-Ford, L. (2016). Implementing the Evidence-Based Practice (EBP) Competencies in Healthcare. Indianapolis: Sigma Theta Tau International.

Stanton, M. W., & Agency for Healthcare Research and Quality. (2002). Reducing costs in the health care system: Learning from what has been done. Rockville, Md: Agency for Healthcare Research and Quality.

Sullivan, E. J. (2013). Effective leadership and management in nursing. New York, NY : Pearson.

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