Contemporary Nursing Theories
Contemporary Nursing Theories
Contemporary Nursing Theories
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of being human, servant-leaders recognize that they have an opportunity to help
make whole those with whom they come in contact.
4. Awareness = General awareness, and especially self-awareness, strengthens
the servant-leader. Awareness helps one in understanding issues involving
ethics, power and values. It lends itself to being able to view most situations from
a more integrated, holistic position.
5. Persuasion = Another characteristic of servant-leaders is a reliance on
persuasion, rather than on one's positional authority, in making decisions within
an organization. The servant-leader seeks to convince others, rather than coerce
compliance.
6. Conceptualization = The ability to look at a problem or an organization from a
conceptualizing perspective means that one must think beyond day-to-day
realities. For many leaders, this is a characteristic that requires discipline and
practice. The traditional leader is consumed by the need to achieve short-term
operational goals. The leader who wishes to also be a servant-leader must
stretch his or her thinking to encompass broader-based conceptual thinking.
7. Foresight = Foresight is a characteristic that enables the servant-leader to
understand the lessons from the past, the realities of the present, and the likely
consequence of a decision for the future. It is also deeply rooted within the
intuitive mind.
8. Stewardship = Servant-leadership, like stewardship, assumes first and foremost
a commitment to serving the needs of others. It also emphasizes the use of
openness and persuasion, rather than control.
9. Commitment to the growth of people = The servant-leader is deeply committed to
the growth of each and every individual within his or her organization. The
servant-leader recognizes the tremendous responsibility to do everything in his or
her power to nurture the personal and professional growth of employees and
colleagues.
10. Building community = The servant-leader senses that much has been lost in
recent human history as a result of the shift from local communities to large
institutions as the primary shaper of human lives. This awareness causes the
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servant-leader to seek to identify some means for building community among
those who work within a given institution. Servant-leadership suggests that true
community can be created among those who work in businesses and other
institutions.
MOTIVATIONAL THEORIES
All human beings are motivated by different goals, ambitions, and aspirations. A
motive is a need or desire that incites and directs a person's actions. Motivation
according to Mills, is a force within the individual that influences strength or direction of
behavior.
In setting a motivating climate, the manager must create conditions that
encourage interdependent work; competitive environment that recognizes and rewards
work well done. The good manager inspires teamwork, considers the uniqueness of
each worker. He/she provides challenging experiences and opportunities for continuing
growth and development. A good leader utilizes positive feedback or reinforcement to
the event as much as possible to determine unmet needs that cause dissatisfaction.
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• Intrinsic Motivation comes from within the person driving him to be more
productive. It is directly related to person's aspiration and goals. Internal
motivations are focused on on intrinsic needs for recognition, self esteem, and
self actualization
Organization should provide a climate that stimulates both intrinsic and extrinsic
drives to meet the individual and organizational goals.
Motivational Theories
A. Need Theory
1. Abraham Maslow's Hierarchy of Needs- shows that people are motivated to
satisfy certain needs to complex psychological needs. He contends that people seek
higher level needs only when the lower needs have been achieved.
• First level: food, sleep, clothing, and shelter.
• Second level: safety, security and protection.
• Third level: need to belong which relates to affiliation or sense of belonging,
affection, closeness, and intimacy.
• Fourth level: esteem and ego needs. These are needs to achieve Independence,
respect, and recognition from others.
• Fifth level: self actualization - the need to maximize one's potential and achieve a
sense of personal fulfillment, competence, and accomplishment.
2. The Two-Factor Way- Frederick Herzberg (1991) developed this theory. Hygiene
factors relate to the working conditions such as salary, quality of supervision, job
security, interpersonal relations policies, and supervisions. These factors are growth-
producing productivity due to dissatisfaction. These hygiene factors are called
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dissatisfiers. Motivitating factors relate to the job itself and include opportunities fro
growth and development and advancement; added responsibilities, challenging
aspects of work, recognition, and achievement. These are called satisfiers.
3. McClelland's Three Basic Needs Theory- David McClelland identifies the three
basic needs that people possess in varying degrees: achievement, power, and
affiliation.
• The need to achieve is a strong desire to overcome challenge, to excel, to grow,
to advance, or to succeed.
• The need for power is the desire to be in control and to get others to behave
contrary to what they would naturally do. They spend much time thinking how to
gain authority, dominate decisions and change other's behavior and control the
environment around them. They are articulate, demanding and manipulative in
dealing with peers and subordinates.
• The need for affiliation is the desire to work in a pleasant environment and the
desire for friendly, close relationships, want to be respected and liked, avoid
decisions that oppose the group, and are more interested in high morale than
productivity.
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• Operant behavior occurs in the absence of any apparent external
stimulation.
SITUATIONAL THEORY
In this approach, the leader behaves according to a given situation which may
vary from one setting to other. The theory considers the person's qualities and
motivations, the role expectations of the group, and the social forces at work such as
the external factors that bring forth leadership potential.
The situational style of a leadership is one in which the leader's style matches the
situation and its needs. The nurse manager assesses each nurse's needs and
determines which leadership behaviors will help the nurse to do the work with the
fewest problems. The nurse manager first considers the staff nurse's ability (knowledge,
experience, and skills) then determines the nurse's willingness (confidence,
commitment, motivation, and energy) to complete a given task. To accomplish the
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management process , the leader must know himself/herself, his/her followers and the
character of the work situation. The situational leader must be flexible enough to make
adaptations and changes. The leader acts according to the call of the situation.
INTERACTIONAL THEORIES
The basic premise of interactional theory is that leadership behavior is generally
determined by the relationship between the leader’s personality and the specific
situation.
Schein (1970) was the first to propose a model of humans as complex beings
whose working environment was an open system to which they responded. A system
may be defined as a set of objects, with relationships between the objects and between
their attributes. A system is considered open if it exchanges matter, energy, or
information with its environment. Schein’s model, based on systems theory, had the
following assumptions:
• People are very complex and highly variable.
• People’s motives do not stay constant but change over time.
• Goals can differ in various situations.
• A person’s performance and productivity are affected by the nature of the task
and by his or her ability, experience, and motivation.
• No single leadership strategy is effective in every situation.
To be successful, the leader must diagnose the situation and select appropriate
strategies from a large repertoire of skills.
Hollander (1978) was among the first to recognize that both leaders and followers
have roles outside of the leadership situation and that both may be influenced by events
occurring in their other roles. With leader and follower contributing to the working
relationship and both receiving something from it, he saw leadership as a dynamic two-
way process. According to him, a leadership exchange involves three basic elements:
• The leader, including his or her personality, perceptions, and abilities.
• The followers, with their personalities, perception, and abilities.
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• The situation within which the leader and the followers function, including formal
and informal group norms, size, and density.
Leadership effectiveness requires the ability to use the problem-solving process;
maintain group effectiveness; communicate well; demonstrate leader fairness,
competence, dependability, and creativity; and develop group identification.
Kanter (1977) developed the theory that the structural aspects of the job shape a
leader’s effectiveness. She postulated that the leader becomes empowered through
both formal and informal systems of the organization. A leader must develop
relationships with a variety of people and groups within the organization in order to
maximize job empowerment and be successful.
Three Major Work Empowerment Structure within the Organization:
• Opportunity
• Power
• Proportion
Nelson and Buns (1984) suggested that organizations and their leaders have four
developmental levels and that levels influence productivity and worker satisfaction.
• Reactive – focuses on the past, is crisis driven and is frequently abusive to
subordinates
• Responsive – leader is able to mold subordinates to work together as a team,
although leader maintains most decision-making responsibilities
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• Proactive – leader and followers becomes more future oriented and hold
common driving values
• High-performance teams – maximum productivity and worker satisfaction are
apparent
Brandt’s (1994) interactive leadership model suggests that leaders develop a work
environment that fosters autonomy and creativity through valuing and empowering
followers. This leadership “affirms the uniqueness of each individual,” motivating them
to “contribute their unique talents to a common goal.” The leader must accept
responsibility for quality of outcomes and quality of life for followers. He states that this
type of leadership affords greater freedom while simultaneously adding to the burdens
of leadership. The leader’s responsibilities increase because priorities cannot be limited
to the organization’s goals, and authority confers not only power but also responsibility
and obligation.
CHARISMATIC THEORY
Charisma - (most agree) is an inspirational quality possessed by some people that
makes others feel better in their presence.
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• sets an example by their own behavior, communicate high expectations to
followers and express high confidence in them and arouse motives for the
group's mission
Followers - trust the leader's beliefs; have similar beliefs; exhibit affection for,
obedience to, and unquestioning acceptance on the leader; and are emotionally
involved in and believe they can contribute to the mission.
• this blind obedience can lead to bad outcomes such as group suicide
TRANSFORMATIONAL THORY
• cooperative, process-focused networking
• promotes employee development
• attends to needs and motives of followers
• inspires through optimism
• influences changes in perception
• provides intellectual stimulation
• encourages follower creativity
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"Leaders focus on effectiveness; managers deal with efficacy."
4 Strategies For Taking Charge
1. attention through vision - reason should be clear, attractive, and attainable
2. meaning through communication - stories, fables, parables analogies helps give
meaning to vision
3. trust through positioning - associates are more likely to be trusting when they
know the leader's view of the organization
• open communication + honesty + consistency = TRUST
4. deployment of self - fosters a learning environment
- leaders are continuous learners and use the organization as
a learning environment
TRANSACTIONAL THEORY
Transactional leadership is an exchange posture that identifies needs of
followers and provides rewards to meet those needs in exchange for expected
performance. It is a contract for mutual benefits that has contingent rewards. The leader
is a caretaker who sets goals for employees, focuses on day-to-day operations and
uses management by exception. It is a competitive, task-focused approach that takes
place in a hierarchy.
CONTINGENCY THEORY
This was introduced by Fred Fiedler during the 1960s. He argued that a leadership
style will be effective or ineffective depending on the situation. According to this theory,
no one leadership style is ideal for every situation.
He identified three (3) aspects of a situation that structure the leader’s role:
a. leader-member relations – involve the amount of confidence and loyalty the
followers have with regard to their leader. Leadership is assessed by a group-
atmosphere scale. A high score describes the person in favorable terms and
a low score is a negative rating. Fiedler suggests that high scores are
relationship oriented and low scorers are mostly task oriented.
Group – Atmosphere Scale
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Describe the atmosphere of your group by checking the ff items:
8 7 6 5 4 3 2 1
1. Friendly __ __ __ __ __ __ __ __
Unfriendly
2. Accepting __ __ __ __ __ __ __ __
Rejecting
3. Satisfying __ __ __ __ __ __ __ __
Frustrating
4. Enthusiastic __ __ __ __ __ __ __ __
Unenthusiastic
5. Productive __ __ __ __ __ __ __ __
Nonproductive
6. Warm __ __ __ __ __ __ __ __ Cold
7. Cooperative __ __ __ __ __ __ __ __
b. task structure – Fiedler used 4 criteria to determine the degree of task
structure ( goal clarity, extent to which a decision can be verified, multiplicity
of goal paths, specificity of solution). Technical nursing which focuses on
procedures, may have a high task structure but situations involving human
relations and value judgements may have numerous solutions with no specific
correct answer and consequently have a low task structure.
c. position power – refers to the authority inherent in a position, the power to use
rewards and punishment, and the organization’s support of one’s decisions.
Those with high position power are directors, managers, and sometimes
patient care coordinators with the right to hire and fire, promote and adjust
salaries. People with low position power may be elected, function in an acting
position, or be subject for removal by peers or subordinates. Team leaders
and staff nurses usually have low position power.
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REFERENCES
Asperas, Carlito M., et. al. Leadership and Management in Nursing. 1st Edition.
Philippines: Giuani Prints House. © 2005.
Marquis, Bessie L. and Huston, Carol J. Leadership Roles and Management Functions
in Nursing: Theory and Application. 4th Edition. Philadelphia, U. S. A.: Lippincott
Williams & Wilkins. © 2003.
Tomey, Ann Marriner. Guide to Nursing Leadership and Management. 6th Edition.
U.S.A.: Mosby, Inc. © 2000.
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