Forms of Power

1. Legitimate Power. This comes from the authority of your rate and position in the chain of command.
2. Reward Power. Power comes from the ability to give out rewards.
3. Coercive Power. This results from the expectation of a negative reward if one’s wishes are not followed.
4. Expert Power. This comes from your knowledge in a specific area by which you influence others.
5. Referent Power. This power is derived from your subordinates’ identification or association with you.
6. Connection Power. This power is obtained through the use of one’s connections.

Types of Leaders

• Formal or appointed leader
• Informal leader

Theories of Leadership

1. Great Man Theory. This theory states that few are born with the necessary characteristics to be great. Leaders are born not made.
2. Charismatic Theory. Charisma is a quality possessed by some people that makes others feel better in their presence. Charismatic theory advocates a vision. The leader arises during a crisis, assesses the situation, uses his personal power or influence, makes a self-sacrifice and uses unconventional strategies.
3. Trait Theory. Traits are inherited. Unlike the Great Man Theory, this theory believes that traits could be obtained through learning and experience.
4. Contingency Theory. There is no best way to organize a corporation, to lead a company, or to make decisions. The optimal course of action is dependent upon the internal and external situation.
5. Transactional Theory. Based on the economy and uses the give-and-take strategy.
6. Transformational Theory. Based on empowering you and the people you lead and are elevated.
7. Path-Goal Theory. Principle of motivation. The leader believes he has the capacity to achieve the goals. The leader’s performance will allow the unit to participate.

Leadership Styles

1. Autocratic Leadership. Centralized decision making with the leader making the decisions and using power to command and control others. The leader keeps the power to himself, motivates through threats, and insists on making most, if not all, of the decisions. this type of leadership discourages upward communication.
2. Democratic Leadership. Is a participatory style, with authority delegated to others. The leader involves workers in the decision making process and allows the workers the freedom to work within constrained set of tasks. This type of leadership style encourages upward communication.
3. Laissez-Faire or Ultra-Liberal. The leader is passive and permissive. Abdicate the right to lead and does not know or care about what goes on in the work unit. The leader provides little or no guidance or direction for workers to set goals, motivate themselves, and acquire the training or information necessary to make decisions.

Leadership Roles

• Decision-maker
• Communicator
• Evaluator
• Facilitator
• Risk taker
• Mentor
• Role model
• Energizer
• Critical-thinker
• Visionary
• Influence
• Problem-saver
• Change agent

Characteristics of a Good Leader

• Self-confidence
• Personal integrity
• Creative
• Adaptability
• Interpersonal skills
• Prestige
• Non-conformity
• Tact
• Alertness
• Personable
• Independence

Decision-Making Styles

• Scientific Approach Three stages:
  1. Intelligence
  2. Design
  3. Choice
• Intuitive Approach
• Emotional Approach
• Nursing Process Approach

Ethical Aspects of Decision-Making

Ethical Theories

1. Teleological Theory. Consequence oriented.
2. Deontological Theory. Duty oriented.
3. Aretaic Theory. Virtue oriented.
4. Divine Command Theory.

Ethical Principles

• Autonomy. This refers to the capacity of a rational individual to make an informed, un-coerced decision.
• Veracity. Truth.
• Beneficence. “Do good and avoid evil”. It involves the physician making the decisions that are best for the patient, without regard to personal gain or the interests of others.
• Non-maleficence. “First, do no harm.”
• Confidentiality. Ensuring that information regarding the client and his illness is accessible only to those authorized to have access.
• Justice. Is concerned with the proper order of things and persons within a society.
• Role fidelity. Representing your abilities to a patient truthfully.

Principles of Communication

1. People are more likely to hear messages that are compatible with their expectations and are more likely to listen to messages on topics about which they have read.
2. Effectiveness of various media differs with educational level.
3. Majority opinion is more effective in changing attitude than expert opinions.
4. People with low self-esteem are more easily influenced by persuasive communication than people with high self-esteem.
5. The more trustworthy the speaker, the less manipulative he is perceived to be.

Steps in Communication

1. Ideation. The sender decides to share a message with someone.
2. Encoding. Putting meaning into symbolic forms.
3. Transmission of message.
4. Receiving.
5. Decoding. The receiver defines words and interprets gestures during transmission of speech.
6. Response or feedback.

Levels of Communication

• Intrapersonal. The communication occurs within the person.
• Interpersonal. Communication occurs between two persons.
• Transpersonal. Occurs within a person’s spiritual domain.
• Small-group communication. The communication occurs between a small-group of people.
• Public communication. Communication occurs in a large group of people.

Communication Systems

• Downward communication. Communication flows from the superiors to its subordinates.
• Upward communication. The communication flows from the subordinates to its superiors.
• Lateral communication. Communication flows from functional areas at a given level of the organization or hospital.
• Diagonal communication. The communication flows from a subordinate of a certain level to the superior of another level and vice versa.
• Grapevine. It stretches throughout the organization in all directions irrespective of authority.