LEADING, MANAGING, FOLLOWING 41
M anagers are essential to any organization. A manager’s functions are vital, com-plex, and frequently difficult. They must be directed toward balancing the needs of patients, the health care organization, employees, physicians, and self. Nurse managers need a body of knowledge and skills distinctly different from those needed for nurs- ing practice, yet few nurses have the education or training necessary to be managers. Frequently, managers depend on experiences with former supervisors, who also learned supervisory tech- niques on the job. Often a gap exists between what managers know and what they need to know.
Today, all nurses are managers, not in the formal organizational sense but in practice. They direct the work of nonprofessionals and professionals in order to achieve desired outcomes in patient care. Acquiring the skills to be both a leader and a manager will help the nurse become more effective and successful in any position.
Leaders and Managers Manager, leader, supervisor, and administrator are often used interchangeably, yet they are not the same. A leader is anyone who uses interpersonal skills to influence others to accomplish a specific goal. The leader exerts influence by using a flexible repertoire of personal behaviors and strategies. The leader is important in forging links—creating connections—among an organiza- tion’s members to promote high levels of performance and quality outcomes.
The functions of a leader are to achieve a consensus within the group about its goals, main- tain a structure that facilitates accomplishing the goals, supply necessary information that helps provide direction and clarification, and maintain group satisfaction, cohesion, and performance.
A manager, in contrast, is an individual employed by an organization who is responsible and accountable for efficiently accomplishing the goals of the organization. Managers focus on coordinating and integrating resources, using the functions of planning, organizing, supervising, staffing, evaluating, negotiating, and representing. Interpersonal skill is important, but a man- ager also has authority, responsibility, accountability, and power defined by the organization. The manager’s job is to:
● Clarify the organizational structure ● Choose the means by which to achieve goals ● Assign and coordinate tasks, developing and motivating as needed ● Evaluate outcomes and provide feedback
All good managers are also good leaders—the two go hand in hand. However, one may be a good manager of resources and not be much of a leader of people. Likewise, a person who is a good leader may not manage well. Both roles can be learned; skills gained can enhance either role.
Leadership Leadership may be formal or informal. Leadership is formal when practiced by a nurse with legitimate authority conferred by the organization and described in a job description (e.g., nurse manager, supervisor, coordinator, case manager). Formal leadership also depends on personal skills, but it may be reinforced by organizational authority and position. Insightful formal lead- ers recognize the importance of their own informal leadership activities and the informal leader- ship of others who affect the work in their areas of responsibility.
Leadership is informal when exercised by a staff member who does not have a speci- fied management role. A nurse whose thoughtful and convincing ideas substantially influ- ence the efficiency of work flow is exercising leadership skills. Informal leadership depends primarily on one’s knowledge, status (e.g., advanced practice nurse, quality improvement coordinator, education specialist, medical director), and personal skills in persuading and guiding others.