Nurses lead and manage nursing care for patients, families, aggregates, and communities in a variety of settings, ranging from ambulatory to community to inpatient. Nurses also lead and manage care across the health-care continuum, including primary health promotion and prevention; secondary skilled, long term, and rehabilitative; and tertiary: emergent, urgent, and acute care. Strategies are drawn from both leadership and management theories. Leadership involves both the leader and the follower. In this text, we have defined Leadership as the process of envisioning a new and better world, communicating that vision to others, motivating others and enticing them to join in efforts to realize the vision, thinking in a different way,
challenging the status quo, taking risks, and facilitating change (Valiga and Grossman). Effective Followers are individuals who work with and support leaders in their efforts to realize a vision by being engaged rather than alienated, suggesting new ideas and options, providing critical feedback on the ideas of others (including the leader), promoting positive relationships within the group, and acting as potential “leaders-in-waiting” (Valiga and Grossman). Management, one of the responsibilities of leadership, is a five-step process that comprises planning, organizing, directing, coordinating, and controlling (Garrison, Morgan, and Johnson).
The nurse’s approach to leadership and management reflects the dynamic state of nursing practice and health care. Leadership has evolved from theories of the past, which pronounced that only great and noble men could be leaders, to more current theories that look at leadership as a learned process or a changing role depending on the situation. Management has evolved from competing managerial activities in a hierarchical, bureaucratic organization to complexity theory involving both the physical and social sciences. We have included a discussion of each of these concepts and theories in this textbook.