UNIT 1:INTRODUCTION

TO LEADERSHIP,
MANAGEMENT &
GOVERNANCE

MR.MWELWA RN.RPCHN.BSc N
GENERAL OBJECTIVES
• At the end of the lecture, students are
expected to gain knowledge and
understanding on introduction to
leadership, management and
governance.
SPECIFIC OBJECTIVES
Definition of terms
State the reasons for studying leadership
and management.
State 14 principles of management
according to Henri fayol
Explain theories of management
INTRODUCTION
• Today the nurse assumes leadership and
management responsibilities regardless
of the activities one is handling.
• The nurse also finds her or himself
playing various roles that demand skills
and knowledge in leadership and
management.
• In order for the nurse to provider efficient
and effective leadership, one needs skills
and knowledge.
DEFINITION OF TERMS
LEADERSHIP:Leadership is the art of
influencing and directing people in such a
way that you win their obedience,
confidence, respect and loyal cooperation
in achieving organization
objectives/goals.
• Leadership involves influencing other
people, usually in some type of group,
to work toward towards the
achievement of common goals.
CONT…
• Effective nurse leaders are those who
inspire others to work together in pursuit
of a shared goal.
• This goal may be providing excellent
patient care, designing a cost-saving
procedure, or challenging the ethics of a
new policy.
LEADER OR BOSS
CONT…
MANAGEMENT: Management is the
process of planning, organizing, leading
and controlling the work of organizational
members and using all available
resources to reach stated organizational
goals (Stoner, 1987).
• Management is also defined as a
process by which managers create,
direct, maintain and operate purposive
organizations, through systematic
coordinated cooperative human efforts
(Koontz 1968).
CONT…
GOVERNANCE
• This is the act or process of overseeing
the control and direction of something
(such as a country or an organization)
(Merriam-Webster,2022)
• Governance encompasses the system by
which an organisation is controlled and
operates, and the mechanisms by which
it, and its people, are held to account.
Ethics, risk management, compliance and
administration are all elements of
governance.
CONT…
ADMINISTRATION:This is the
organization and running of an institution
or a business.
POLICY:A policy is a set of plans which
shows an agreement made (Collins
Dictionary, 2007).
LEADER:A person or something that
leads.
MANAGER:This is a person who is
responsible for running the affairs of an
organization, a group of staff or a sports
CONT…
PLANNING:This is a systematic
approach to attaining explicit objectives
for the future through efficient and
appropriate use of resources available
now and in the future.
ORGANIZATION:It is a social unit of
people that is structured and managed to
meet a need or to pursue collective goals.
CONT…
DIRECTING:This is the giving of
instructions, guiding and counseling,
motivating and leading the staff in an
organization in doing work to achieve
Organizational goals.
CONTROLLING:This is determining
what is being accomplished if necessary,
applying corrective measures so that
performance takes place according to
plans.
CONT…
STAFFING:This is the process of
acquiring, developing, employing,
appraising, remunerating and retaining
people so that the right type of people are
available in right positions and at the right
time in the organization.
TOP MANAGEMENT:The term top
management usually refers to
management above departmental level
and is loosely applied to directors.
CONT…
EXECUTIVE:The word executive is
correctly used when referring to a person
who carries out policy.
THE TOP OR CHIEF EXECUTIVE:The
phrase top executive refers to people of
high status, who in fact do no execute
work at all, spend their time formulating
policy and supervisory role.
BENEFITS OF STUDYING
LEADERSHIP AND MANAGEMENT
YOU LEARN HOW TO WORK WELL
WITH OTHER PEOPLE.
• Nurses rarely work alone. Most often they
are part of a healthcare team composed
of other nursing personnel and members
of other health related disciplines.
IT WILL ASSIST IN BRINGING ABOUT
CHANGE.
• Gaining acceptance of needed changes
is vital to the improvement of health care.
CONT…
IT HELPS TO LEARN HOW TO
ADVOCATE FOR PATIENTS AND
CLIENTS.
• Sometimes nurses find that other
members of the health care team are
neglectful of patient needs or rights.
Nurses are often in a position to see that
those needs are met and people’s rights
respected.
CONT…
IT HELPS TO UNDERSTAND NURSES
POSITION IN THE HEALTHCARE
SYSTEM:To function effectively, nurses
need to understand the forces that affect
their ability to provide the highest quality
care possible.
IT HELPS NURSES TO TAKE
CONTROL OF THERE PRACTICE,
ETHICS, BEHAVIOUR AND CONTROL
OTHERS:It gives an opportunity to learn
on how to provide support to the nursing
profession.
THEORIES OF MANAGEMENT
MANAGEMENT THEORY
• This is a collection of ideas which set
forth general rules on how to manage a
business or organization. The following
are examples of theories;
Administrative theory
The Scientific Management theory
(Classical Management Theory).
The Behavioral Theory.
The Contingency Management Theory.
CONT…
The Quantitative Management Theory.
The System Management Theory.
The X and Y theory.
CONT…
THE ADMINISTRATIVE THEORY
• The administrative theory is the important
one of administrative theories. Henri
Fayol created it. It is also known as the
14 principles of management.
• Most managers base the day to day
running of their organizations on Henri
Fayol’s principles of management.
• Henry Fayol, known as the father of
management.
CONT…
1.UNITY OF COMMAND: Workers should
receive orders from only one manager.
2.UNITY OF DIRECTION: The entire
organization should be moving towards a
common objective/goal and in a common
direction.
3.DIVISION OF WORK:This means that
work should be divided among individuals
and groups to ensure that effort and
attention are focused on special portions of
the task.
CONT…
• Fayol presented work specialization as
the best way to use the human resources
of the organization.
4.DISCIPLINE:This principle is about
obedience. It is often a part of the core
values of a mission and vision in the form
of good conduct and respectful
interactions.
5. AUTHORITY:Fayol defined authority as
the right to give orders and the power to
exact obedience. Whoever assumes
authority also assumes responsibility.
CONT…
6.EQUITY:All employees should be treated
as equally as possible.
7.SCALAR CHAIN:The Top Manager
possesses the most authority; the first line
supervisor the least. Lower level
managers should always keep upper
level managers informed of their work
activities.
CONT…
8. SUBORDINATION OF INDIVIDUAL
INTEREST:Personal interests are
subordinate to the interests of the
organization (ethics).
• The interests of one person should not
take priority over the interests of the
organization as a whole.
• This is a difficult area of management.
CONT…
9.REMUNERATION
• This means that workers should
receive a pay for the work done.
Motivation and productivity are close to
one another as far as the smooth running
of an organization is concerned.
CONT…
10.THE DEGREE OF
CENTRALIZATION:Centralization implies
the concentration of decision making
authority at the top management
(executive board). Sharing of authorities
for the decision-making process with
lower levels (middle and lower
management), is referred to as
decentralization by Henri Fayol.
CONT…
11. ORDER:Employees in an organization
must have the right resources at their
disposal and be assigned to one task so
that they can function properly in an
organization.
CONT…
12. STABILITY OF TENURE OF
PERSONNEL
• Management strives to minimize
employee turnover and to have the right
staff in the right place.
• Employee turnover is the term used to
describe the workers who leave the
organization for various reasons.
CONT…
13. INITIATIVE
• Employees should be allowed to express
new ideas.
• This encourages interest and involvement
and creates added value for the
company.
• Employee initiatives are a source of
strength for the organization according
to Henri Fayol. This encourages the
employees to be involved and interested.
CONT…
14. ESPRIT DE CORPS
• Is a French phrase that translates into
'group spirit'. The principle states that
an organization must make every effort to
maintain group cohesion in the
organization. It notes that dividing your
competition is a clever tactic, but dividing
your own team is a serious error.
• Management should encourage harmony
and general good feelings among
employees.
ACRONYM TO REMEMBER
CONT…
THE SCIENTIFIC MANAGEMENT
THEORY (CLASSICAL MANAGEMENT
THEORY).
• The scientific management theory was
postulated by Frederick Taylor which
proposed careful specification and
measurement of all organizational tasks.
• Tasks were standardized as much as
possible.
CONT…
• Workers were rewarded and punished
according to the job performance in order
to increase production or performance of
an organization.
• The classical management theory
focuses on finding the best way to
perform and manage tasks.
APPLICATION TO NURSING
• In Nursing, an in-charge can do task
allocation to Nurses on duty and follow up
their task completion afterwards.
 CONT…
• Nurses who deliver required services to the
patients can be rewarded in form of formal
appraisals and awards.
• On the other hand, if a Nurse is not able to
carry out the designated tasks, counseling
can be done and Disciplinary measures
instituted according to the Code of Conduct.
• Such a management approach like the
classical managements theory makes an
organization deliver quality services to its
clients and the organization earns a good
name in the market environment.
CONT…
THE BEHAVIORAL THEORY.
• The Manager who adopts the behavioral
management theory believes that the
workers conditions affect the quantity and
quality of their works.
• Therefore, management should be
concerned with the workers conditions in
order to improve the quantity and quality
of work output.
CONT…
APPLICATION TO NURSING
• A nurse manager who applies the
behavioral management theory
addresses the workers’ poor performance
by finding out the possible causes so that
work output is improved.
CONT…
THE CONTINGENCY MANAGEMENT
THEORY.
• The contingency theory postulates that
before managers make a decision, they
must take into account all aspects of the
current situation and act on those aspects
that are key to the situation at hand.
• In other words, the way a person
manages changes depending on the
circumstances.
CONT…
• It’s the approach that states that “it
depends.”
• For example, the continuing effort to
identify the best leadership or
management style might now conclude
that the best style depends on the
situation.
CONT…
APPLICATION TO NURSING
• In this case, A Nurse Manager who is a
leader may need to employ different
Managerial Theories taking into
consideration a prevailing situation,
because there are no two situations
which may be exactly the same.
• Further, a management/leadership style
that is effective in one situation may not
be successful in another.
CONT…
THE SYSTEM MANAGEMENT THEORY
• The system management theory
conceptualized that a system has
interrelated parts.
• These parts work or operate as one or as a
whole in order to achieve a specific goal.
• This theory signifies that the manager of
an organization should be able to
understand the various parts or systems
that make up the entire operation.
CONT…
APPLICATION TO NURSING
• In this case a Nurse Manager who
applies the System Management Theory
should understand that different workers
in different departments at the Hospital
lead to quality Health service delivery,
because all departments contribute to the
recovery of a patients.
• Team work is encouraged in all Health
Care Organizations.
CONT…
THE QUANTITATIVE MANAGEMENT
THEORY.
• The quantitative management theory,
uses quantitative tools to help plan and
control nearly everything in an
organization.
APPLICATION TO NURSING
• A Nurse Manager who adopts this Theory
will try to Quantify the Nursing Tasks in her
Planning of task allocation and tries to
control everything for the wellbeing of the
CONT…
X AND Y THEORIES
• These two theories were propounded by
Douglas McGregor.
• According to him, the traditional
manager operates on assumptions that
the human being has an inherent dislike
of work and avoids work and such a
person needs to be coaxed, controlled,
directed, threatened with punishment for
them to work. He called such a theory X
theory.
CONT…
• The X theory assumes that human being
is lazy, lacks ambition to work, resist
change, non creative and cheats easily.
• The manager who adopts such a
theory (x) always considers threats,
close supervision and always on site.
• On the other hand, the Y theory believes
that a human being is creative,
innovative, kind and hard working.
CONT…
• Y theory further believes that external
controls and threats of punishment
doesn’t increase the morale for human
to like or work harder.
• The Y theory underlines the importance
of maintaining an organization where
people feel confident, encouraged and
motivated with good words and
appreciations.
• The Y theory states that if people are
well treated a quality service and high
productivity will be attained.
CONT…
TRAIT THEORY
• This theory postulates that people are
either born or not born with the qualities
that predispose them to success in
leadership roles. Thus certain inherited
qualities, such as personality and
cognitive ability, are what underlie
effective leadership.
CONT…
• There have been hundreds of studies to
determine the most important leadership
traits, and while there is always going to
be some disagreement, intelligence,
sociability, and drive (aka determination)
are consistently cited as key qualities.
CONT…
SKILLS THEORY: This theory states
that learned knowledge and acquired
skills/abilities are significant factors in the
practice of effective leadership.
• Skills theory by no means disavows the
connection between inherited traits and
the capacity to be an effective leader – it
simply argues that learned skills, a
developed style, and acquired
knowledge, are the real keys to
leadership performance.
CONT…
• It is of course the belief that skills theory
is a tool that warrants all the effort and
resources devoted to leadership training
and development
CONT…
PATH-GOAL THEORY:This theory is
about how leaders motivate followers to
accomplish identified objectives.
• It postulates that effective leaders have
the ability to improve the motivation of
followers by clarifying the paths and
removing obstacles to high performance
and desired objectives.
CONT…
• The underlying beliefs of path-goal theory
(grounded in expectancy theory) are that
people will be more focused and
motivated if they believe they are capable
of high performance, believe their effort
will result in desired outcomes, and
believe their work is worthwhile.
CONT…
TRANSFORMATIONAL THEORY: This
theory states that leadership is the
process by which a person engages with
others and is able to create a connection
that results in increased motivation and
morality in both followers and leaders.
• It is often likened to the theory of
charismatic leadership that espouses that
leaders with certain qualities, such as
confidence, extroversion, and clearly
stated values, are best able to motivate
followers.
CONT…
• The key in transformational leadership is
for the leader to be attentive to the needs
and motives of followers in an attempt to
help them reach their maximum potential.
• In addition, transformational leadership
typically describes how leaders can
initiate, develop, and implement important
changes in an organization.
• This theory is often discussed in contrast
with transactional leadership.
CONT…
TRANSACTIONAL THEORY: This is a
theory that focuses on the exchanges that
take place between leaders and
followers.
• It is based on the notion that a leader’s
job is to create structures that make it
abundantly clear what is expected of
his/her followers and also the
consequences (i.e. rewards and
punishments) for meeting or not meeting
these expectations.
CONT…
• This theory is often likened to the concept
and practice of management and
continues to be an extremely common
component of many leadership models
and organizational structures
CONT…
SERVANT LEADERSHIP THEORY :This
conceptualization of leadership reflects a
philosophy that leaders should be servants
first.
• It suggests that leaders must place the
needs of followers, customers, and the
community ahead of their own interests in
order to be effective.
CONT…
BUREAUCRATIC THEORY (MARX
WEBER 1922):Marx expanded Taylor’s
theories and wrote an essay entitled
“Bureaucracy” which emphasized the
need for more rules, regulations and
structure within the organization to further
improve efficiency and productivity.
• This approach encouraged the
establishment of internal hierarchy with
clear lines of responsibility and authority.
• This has really dominated the health care
organizations today and is largely used.
 UNIT 1:ORGANISATIONS

MR.MWELWA RN.RPCHN.BSc N
INTRODUCTION
• An organization exists in order to facilitate
goal achievement through mechanisms
that saves time.
• Each organization has both formal and
informal structures.
• The other name of informal structure
in an organization is called the grape
vine(rumour).
CONT…
• The formal structure of an organization is
the official arrangement of positions into
patterns of working relationships that will
coordinate the effort of many workers of
diverse interests and abilities.
• All organizations formal or informal
structures are put together and kept
together by a group of people who see that
there are benefits available from working
together towards some common goal.
CONT…
• The nurse manager should always make
decisions based on formal and legal
information.
• The manager should never act on
rumors, but it is also important to
investigate the rumors raised.
SPECIFIC OBJECTIVES
Definition of terms .
State the purpose of an organization.
Explain four (4) types of an organization.
Describe organizational self assessment.
Discuss organizational culture.
DEFINITION
ORGANIZATION
• An organization is a social unit of people
that is structured and managed to meet a
need or to pursue collective goals.
• An organization is a social structure
designed to coordinate the activities of
two or more people through a division
of Labour and hierarchy of authority
for the achievement of a common
purpose or goal (Trewartha R. L and
Newport M.G, 1989).
PURPOSE OF AN ORGANIZATION
TO ACHIEVE ORGANIZATIONAL
GOALS
• An organization exists to achieve the
overall goals and objectives of a firm.
TO PERFORM MANAGERIAL
FUNCTIONS
• Management functions such as planning,
organizing, staffing, directing and
controlling cannot be implemented
without a proper organization.
CONT…
TO FACILITATE GROWTH AND
DIVERSIFICATION
• A good organization structure is essential
for expanding business activity.
• An organization structure determines the
input resources needed for expansion of
a business activity.
• Similarly an organization is essential for
product diversification, such as,
establishing a new product.
CONT…
OPTIMUM USE OF RESOURCES
• To make optimum use of resources such
as human resource ,material, money,
machine and methods, it is necessary to
design an organization. Some
organizations exist to make profit.
ORGANIZATION PROVIDES SCOPE
FOR TRAINING AND DEVELOPING
MANAGERS.
• Encourages individual growth and
development of personnel according to the
CONT…
TO INCREASE THE MANAGERIAL
EFFICIENCY.
• It provides the structure within which the
functions of administration and
management are performed.
• It avoids delays, duplication or confusion
in performance and removes confusion or
rivalry among personnel and also trains
managers to carry out tasks within
stipulated period of time.
TYPES OF ORGANIZATION
• There are a lot of types of organizations
that exists but for the sake of this course,
will look at four and these are:
Pyramids/hierarchies.
Committees/juries.
Matrix organizations.
Ecologies.
CONT…
HIERARCHY/PYRAMID
ORGANIZATION
• This type of organization highly values an
efficient and predictable delivery of
products or services.
• It is very effective in a relatively stable
environment and is strictly guided by
rules and procedures.
CONT…
CONT…
A JURY/ COMMITTEE
• A Committees/Jury consist of a group of
peers who decide collectively, such as by
voting.
• The difference between a jury and a
committee is that members of a
committee usually perform further
actions after the group reaches a
decision, while members of a jury stop
performing when the decision has
been reached.
CONT…
MATRIX
• Matrix organizations assign two bosses to
each worker, with each boss representing
a different hierarchy.
• One boss is "functional" and assures that
experts in the organization are well-trained
and assessed by bosses who are highly-
qualified in the same areas of expertise.
• The other direction is "executive" and
works to have the experts bring specific
projects to completion.
CONT…
ECOLOGICAL ORGANIZATION
• Ecology organizations is one that function
and strategies to absorb intense
competition and are designed to hold
all employees accountable for their
areas of responsibility.
• Ineffective parts of the organization are
allowed to starve and thriving parts are
rewarded with more work. Everyone is
paid for the actual work they perform.
CONT…
• Organizations that use this organizational
structure usually rigidly define the roles
and responsibilities of the workers.
• An organizational self assessment is a
process by which organizations look at
their performance and the factors that
support or hinder the performance and
compare the performance to the set
goals.
• Organizational self assessment provides
feedback to an organization on how it is
doing.
ORGANIZATION CULTURE
Organization culture are the values and
behaviors that contribute to the unique
social and psychological environment of
an organization.
Organizational culture includes an
organization's expectations, experiences,
philosophy, and values that hold it
together, and is expressed in its self-
image, inner workings, interactions with
the outside world, and future
expectations.
CONT…
BUILDING AN ORGANIZATION
CULTURE
• Organizational culture affects the way
that organizations make decisions,
think, feel and act in response to
opportunities and threats.
• An organization culture also influences
the selection of people for particular
jobs which in turn affects the way
tasks are carried out and decisions are
made.
CONT…
• Hence organizational culture is so
fundamental that it affects behavior
unconsciously.
• When people reconnect with their own
commitment to make a difference in the
world and find that they play a meaningful
role in building an organization and
culture they want to comply and help to
achieve the organizational goals.
CONT…
• Their own language and behavior - word
by word and deed by deed inevitably
create a culture that truly and
meaningfully enhances and strengthens
their capacity to actualize the mission of
the organization.
• Organization culture contributes to
organizational effectiveness and
achievement.
CONT…
• Organizational culture is possibly the
most critical factor determining an
organization's capacity, effectiveness,
and longevity.
• It can also contribute significantly to the
organization's brand image and brand
promise, which can have both positive
and negative implications.
CONT…
• To keep organizational culture vital and
relevant, people need a deep
understanding of why the organization
was created, what brought its
members together in the first place,
and why the group still exists today.
CHARACTERISTICS OF
ORGANISATIONAL CULTURE
It is learned: It is not genetic or
biological but it is learned.
It is shared: That is it is not special to
one individual.
It is time generational: Culture builds
up over time, it is cumulative in its
development and is passed on from
one generation to the other.
Innovative and risk taking: It means
that employee are encouraged to be
creative and take notes.
CONT…
Stability:Stability emphasizes
maintaining of the status rather than
growth.
People orientation:It is culture that
takes into account the effect of outcomes
on people within the organization.
Team oriented:This is a culture where
work activities are organized around
teams rather than individuals.
BUILDING ORGANISATIONAL
CULTURE
• Organisational culture can be built through
the following ways;
Selection: selection of individual who
have the knowledge, skills, and abilities to
perform the job well
CONT…
Actions of top management: Actions
of top management have a major impact
an organization culture in terms of;
What they say and how they behave.
What they pay attention to
How they react to ethical incidents in the
organization
How they allocate resources.
KEY CONSIDERATIONS IN
CULTURE BUILDING
Job satisfaction: Reflects the extent to
which people find gratification or fulfilment
in their work. It is the extent to which a
person is gratified or fulfilled by this or her
work.
Organizational commitment: Reflects an
individual’s identification with and
attachment to the organization and its
goals.
CONT…
Job involvement: Degree to which an
employee identifies himself with his/her
job and actively participates in it. They
are proud about work, they care about
what they do, and are rarely absent from
work.
ORGANIZATION CULTURE
• For a nurse leader to build the culture of
an organization, one need to carefully
observe the following:
How the manager allocates rewards
as it can affect the culture of the
organization – do you just promote
anyone or those people who put in
extra effort?
CONT…
How the nurse manager recruits,
select and promote staff can either
build or destroy organizational culture.
How the nurse manager socializes
new members, that is the process of
bringing new members into the
organizational and orient them to the
organizational culture.
Socialization can also take place
through formal training or by
observing the actions of higher level
managers.
CONT…
How the manager recommends
subordinates for short or long term
training can either build or destroy the
organizational culture.
How the manager allocates tasks that
involve remuneration (money) can
either build or destroy organizational
culture
CONT…
That which the organization does, how
its done, what its members do, how its
members do it, its image to the public,
how the public has branded it, how the
public views its services and whether
they are satisfied or not is its
organizational culture.
TO EVERY CLOUD, THERE IS A SILVER
LINING
THANK YOU.