Leadership Skills Of Staff Nurses In Private Health Care Facilities, Calbayog City

Leadership Skills of Staff Nurses in Private Health Care Facilities, Calbayog City.

A Research Proposal Presented to the Dean and the Faculty of the College of Nursing Christ the King College Calbayog City

In Partial Fulfilment Of the Requirements for the Degree Bachelor of Science in Nursing

Chapter 1

Problem and Background

Introductio n

Leadership is a position of one who guides his subordinates. It covers a great responsibility, which includes setting up the vision, tone, direction and doing the right

Perhaps you have heard many people say that nursing is a vocation, while some say that it is

Webster defines profession as “an occupation or calling requiring advanced training and experience in some specific or specialized body of knowledge which provides service to society in that special field”.

It is an occupation requiring a unique body of knowledge and skills, which serves society.

It is said that private hospitals offer better possibilities in terms of health care services.

But in spite of the respectable image maintains by private hospitals today, it is undeniably true that the occurrence of some problems greatly affect the effectiveness of the delivery of basic health services.

There is a continuous process and effort done by private administration in adopting measures and strategies to put their respective institution always at a competitive edge in providing efficient and equitable

Performance appraisal is a major responsibility in the controlling functions of the

The ability to conduct meaningful, effective performance appraisals requires an investment of time, effort and practice on the part of the

Although performance appraisal is never easy, if used appropriately it produces growth in the employee and increases productivity in

To increase the like hood of successful performance appraisal, managers should use system of appraisal and gather data about employee performance in a systemic manner, using many

The managers also should attempt to be as objective as possible, using established standards for the appraisal.

The result of the appraisal process should provide the manager with information for meeting training and educational needs of the employees.

By following up conscientiously on identified performance deficiencies, employees’ work problems can be corrected before they become habits.

Integrating leadership into this part of the controlling phase of the management process provides an opportunity for sharing, communicating and growing. The integrated leader is self-aware regarding his or

This selfawareness leads to fairness and honesty in evaluating performance. This, in turn, increases trust in the manager and promotes a team spirit among

When anxiety is reduced during the appraisal interview, the leader is able to establish a relationship of mutual goal setting, which has a greater potential to result in increased motivation and corrected deficiencies.

The result of the integration of leadership and management is a performance appraisal that facilitates employee growth and increases organizational productivity.

The aforementioned scenario inspired the researcher to conduct this particular study with the hope that the findings may pave the way to improve the leadership skills of staff

Theoretical Framework

The study includes different theories pertaining to leadership, the theory of behavioural approach by Kurt Lewin at Iowa State University (1930) and Contingency theory

The theory of Lewin focuses on the leadership styles, which are Autocratic Leadership, Democratic Leadership and Laissez-faire leadership.

Autocratic leadership involves centralize decision making, with the leader making decisions and using power to command and control others.

Democratic leadership is participatory, with authority delegated to others.

Laissez-faire leadership is passive and permissive and the leader defers decision-making.

Fielder’s contingency theory views the pattern of leader behaviour as dependent upon the interaction of the personality of the leader and the needs of the situation.

Leader-member relations are the feelings and the attitude of followers regarding acceptance, trust, and credibility of the leader.

Good leadermember relations exist when followers respect, trust, and have confidence in the leader.

Poor leader-member relations reflect distrust, a lack of confidence and respect, and dissatisfaction with the leader by the followers.

Task structures refer to the degree to which work is defined, with specific procedures, explicit directions, and goals.

High task structures involve routine, predictable, clearly defined work tasks.

Low task structures involve work that is not routine, predictable, or clearly defined, such as creative, artistic, or qualitative research activities.

Position power is the degree of formal authority and influence associated with the leader.

High position power is favourable for the leader and low position power is unfavourable.

Fielder showed that a task-directed leader, concerned with task accomplishment, was effective.

When the range of favourableness is intermediate or moderate, a human relations leader, concerned about people, was most effective.

Fielder’s contingency theory is an approach that matches the organizational situation to the most favourable leadership style for that situation.

Much of the early work on leadership focused on the leader.

This research was directed toward identifying intellectual, emotional, and physical and other personal traits of effective leaders.

The underlying assumption was that are born, not made.

After many years of research, no particular set of traits has been found that predicts leadership potential. There are several possible reasons for this failure.

According to McGregor, Research findings to date suggest that it is more fruitful to consider leadership as a relationship is a human relations function and that different situations may require quite different characteristics from a leader.

Is not to a large degree universally accepted in nursing that authoritarian power is effective in times of crisis but that it otherwise promotes instability.

In spite of the shortcomings of the trait theory, some traits have been identified that are common to all good leaders.

Dunphy and Stace describe about resistance to change. Resistance to change or attempting to maintain the status quo when efforts are being made to alter it, it is a common response. Change evokes stress that in turn evokes resistance.

Factors that stimulate resistance at change include habits, complacency, fear of disorganization, set patterns of response to change, conservatism, perceived loss of power, ego involvement, insecurity, perceived loss of current or meaningful personal relationship, and perceived lack of rewards.

People are afraid of change because of lack of knowledge, prejudices, resulting from a lifetime of personal experience and expose to others, and fear of the need for greater effort or a higher degree of difficulty.

People have developed fears, biases and social inhibitions from the cultural environment in which they live. Since they cannot be separated from these cultural factors, it is necessary to find ways of managing them within a system.

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.

Leadership effectiveness, According to Hollander, 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.

Nelson and Burns (1984) suggested that organizations and their leaders have four developmental levels and that these levels influence productivity and worker satisfaction. The first of these levels is reactive.

The reactive leader focuses on the past, crisis driven, and is frequently abusive to subordinates. In the next level, responsive, the leader is able to mould subordinates to work together as a team, although the leader maintains most decision – making responsibility.

At the proactive leader, the leader and followers become more future – oriented and hold common driving values. Management and decision – making are more participative. At the last level, high performance teams, maximum productivity and worker satisfaction are apparent.

Conceptual Framework of the Study

The diagram indicated below illustrates the flow of the variables that are used in the study as conceived by the researcher.

Leadership Skills

Human Relations

Administrative

Factors affecting Leadership Skills

Skills Enhancement Programs

Institutional skills

Staff Nurses in Private Health Care Facilities, Calbayog City. As seen in the diagram, the study determines the leadership traits of the staff nurses particularly in terms of their intelligence, personality and abilities.

It also tries to find out the factors affecting the leadership skills of staff nurses.

Statemen t of the Problem

Leadership Skills of Staff Nurses in Private Health Care Facilities, Calbayog City.

The study seeks to determine the Leadership Skills of Staff Nurses in Private Health Care

ly it seeks to answer the following questions

1.What is the profile of respondents in terms of: 1.1 Age, 1.2 Gender, 1.3 Civil Status, 1.4 Employment Status

1.6 MonthlyIncome; 1.7 Length of Service; 1.8 Distance from work and 1.9 Work

2. What are the leadership skills of staff nurses in Private Health Care Facilities as perceived by themselves and the student nurses in terms of: 2.1 Human Relations, 2.2 Administrative and 2.3 Institutional Skills?

3.

Is there a significant relationship between the demographic profile and the factors affecting the leadership skills of respondents?

4. What are the

factors affecting the Leadership Skills of Staff Nurses in Private Health Care Facilities?

5. What recommendation can be proposed to improve the Leadership Skills of Staff Nurses in Private Health Care Facilities based on the findings of the study?

Null hypothe sis

There is no significant relationship between the leadership skills of the staff nurses in health care facilities in Calbayog City towards the following respondent’s sociodemographic profile.

Scope and Delimitation

This study will focus on leadership skills of staff nurses in Private Health Care Facilities, Calbayog City.

The respondents of the study is composed of staff nurses in Private Health Care Facilities, Calbayog City. Likewise, it is limited to the use of survey questionnaires as research instrument in collecting data.

Significan ce of The Study

Private Health Care Facilities in Calbayog City and leadership skills of staff nurses is very important because all action undertaken by these people will affect the entire organization.

The results of the study are, therefore, intended to benefit the following:

Hospital Administrations . This would motivate them to maintain a satisfactory performance in their respective departments, which serves as inspiration to their

Staff Nurses. The result of this study would encourage them to perform their leadership skills and do their job well.

Nursing Students. The findings of this study would encourage them to be more diligently in their studies and develop their leadership

Future Researchers. This study will help serve as a reference for future researches to conduct studies that focuses on intervention that enhance the leadership skills of staff nurses.

Definition of terms

For better understanding and clarity of the terms used, the following key terms were defined conceptually and operationally.

Factors – there are conditions or situation that influence the occurrence of something. In this study, it includes those that affect the leadership skills of

Leadership – It is a position of a leader and an act of leading. In this study, it refers to the skills of staff nurses in managing situations and people in private health care facilities.

Profession – it is

an occupation that requires extensive education or specialized training. In this study, it refers to the registered nurses.

Profile – it is a demographic representation of important characteristics of an individual. In this study, it refers to the age, sex, civil status, employment status and position of respondents.

Skills – it is the ability to do something well, usually gained through experience and training. In this study, it refers to the ability of the staff nurses to lead.

Staff Nurses – They are professionals trained to care for the sick and disabled under the Supervisions of a physician. As used in this study, they are the nurses who are utilized as respondents of the study.

Review of Related Literature and Studies

This Chapter contains literature and studies which the Researchers believed related to the present

Related Literature

What leadership styles should senior nurses develop? This is an extended version of the article published in Nursing Times;

Senior nurses are likely to engage in a range of leadership activities in their daily routine. Some will naturally adopt an effective leadership style, while others may find the concept of leadership or seeing themselves as

Effective leadership is critical in delivering high-quality care, ensuring patient safety and facilitating positive staff development.

This article outlines the characteristics of an effective leader, the political context and various leadership activities for senior nurses.

It also discusses mentorship, different leadership models and the process of professional socialization (Frankel, 2003).

Leadership can be defined as a multifaceted process of identifying a goal or target, motivating other people to act, and providing support and motivation to achieve mutually

In the daily life of a senior nurse, this could refer to coordinating the day/night shift and the team of nurses and support staff on duty under the

The successful operation of the shift, staff morale and managing difficult or challenging situations depends largely on the senior nurse's leadership skills (Porter-O'Grady,

Leaders are often described as being visionary, equipped with strategies, a plan and desire to direct their teams and services to a

Effective leaders are required to use problem-solving processes, maintain group effectiveness and develop group identification.

They should also be dynamic, passionate, have a motivational influence on other people, be solution-focused and seek to inspire others (Mahoney,

Nurses should adopt a supportive leadership style with mentorship, coaching and supervision as core values showed that high levels of support from supervisors reduced emotional exhaustion and buffered negativeffects of the job environment.

Consequently, it would be particularly beneficial for supervisors to provide emotional support to nurses and give them adequate feedback about performance to increase selfesteem(Constable

Senior nurses should also apply leadership skills in encouraging staff to use critical reflection to facilitate new

Nurse leaders are often vulnerable to stress as experienced in the work environment, including long hours, patient overloads, and challenging work

If ignored, these stressors may lead to physical, emotional and behavioral symptoms with possible reporting medical errors, absenteeism, health challenges, and job burnout (Cynthia J. Brown,

Ultimately, a goal of any healthcare organisation should be to influence the quality of patient care through good

Good leaders should encourage junior staff to gain a better understanding of patients and their needs and

Overall, these strategies will lead to increased patient satisfaction, more effective nursepatient relationships and quicker recovery times.

Empowered nurses are eager to implement evidence-based practice. They are highly motivated, well informed and committed to organisational goals, and thus deliver patient care with greater effectiveness

Good leadership could produce better patient outcomes by promoting greater nursing expertise through increased staff ability and a new

The hospital practice environment has a significant effect on patient outcomes. Junior nurses should be encouraged to seek maximum rather than minimum standards, and be expected to achieve and maintain highquality benchmarks

The role of senior nurses is dynamic and multifaceted. Nurse leaders in practice settings have unique opportunities to influence and even create the environment in which professional nursing practice can flourish.

In this highly influential role, nurse leaders have a major responsibility to change behaviour to provide an environment that supports the preparation of competent and expert

It is part of nurse leaders' role to serve as a model in providing effective socialisation experiences that impart the appropriate values, beliefs, behaviours and skills to staff (Marriner-

This is a democratic model of leadership, in which there is consideration for the opinions of those who

Individuals and groups are involved in decision-making processes concerning their work. The valuing of people, their knowledge, experience and skills is central

Leadership models are a useful tool for senior nurses and help to put the function of leadership activity into perspective. These nurses should not be concerned about using concepts from various models and developing an eclectic

The models should be used as a framework on which to build an effective leadership style which suits the individual leader and those whom they are leading

The way to empower people is to leave them alone and let them manage themselves. He also emphasized that empowerment goes beyond expecting professionals to be self-starting high performers who pretty much manage

Many proponents of what he calls “false empowerment” will say that managers shouldn’t keep close track of staff, and they definitely shouldn’t zero in on employees failures.

Staff should be made to feel they “own” their work and should be set free to make their own decisions. Managers are merely facilitators, there to align the natural talents and desires of staff with fitting role in the workplace. Managers shouldn’t tell people how to do their jobs, but rather let staff come up

The idea is make staffs feel good inside and results will take care of themselves. According to him, the best managers are people who learn proven techniques diligently until they become skills and continue practicing them

He presented eight steps for nurse managers to be guided in setting up staff nurses for success every step of the way by practicing highly engaged hands-on management, these are:

(a) get in the habit of managing everyday by setting aside one hour every day as you dedicated time for managing up-front on your initiative, (b) lean to talk like a performance coach by talking about the work, (c) take it one person at a time, (d) make accountability a real process,

(e) clarify what to do and how to do, (f) follow performance every step of the way, (g) solve small problems before they turn into big problems, (k) do more for some people and less for others by giving every person the chance to meet the basic expectations of his or her job and then the chance to go above and beyond – and to be rewarded accordingly (Bruce

Relate d Studie

Student-researchers had conducted some studies concerning leadership skills Mendoza (2000) studied the factors affecting the managerial performance of the bank executives in

Results of the study revealed that among the factors that promote very satisfactory performance of respondents are managerial abilities possess which is acquired through seminars and training, company policies that enhance employees’ productivity and consumer’s satisfaction, favorable business environment

The investigation of Mendoza has similarities with the present study because it also focuses on leadership skills. The difference of this study lies in the group being studied. Mendoza placed emphasis on skills of Bank executives in Calbayog City, whereas the

Another similar study was undertaken by Delos Reyes (2000) who made an evaluation of the work performance of the officials in Barangay Tarabucan, Oquendo District, Calbayog City

The findings showed that as per evaluation of the resident-respondents, the elected officials of the said barangay, as a whole, performs their functions satisfactory and had accomplished several projects that benefited the

The study of Delos Reyes had similarity with the present study because it focuses on leadership skills. The difference lies in the respondent being studied and the time

Olares (2002) made an investigation on the motivation and job satisfaction levels of government employee in Las Navas,

Her study showed the government employees are highly motivated in their respective tasks and high job satisfaction levels. The study further revealed that there is a significant relationship between the respondent’s motivation and job

The investigation of Olares is related to the present study because they also gave emphasis on motivation and satisfaction of staff. The difference lies in the group being studied. Olares placed emphasis on government employees on their respective task whereas the present study considers the leadership skills of staff nurses.

Leadership Skills of Staff Nurses in Private Health Care Facilities, Calbayog City.

QUESTIONNAIRE

Direction: the boxes corresponds answer to questions.

Check that your the

I. Profile of Responden ts

Name (optional): _________________________________ Age: ____ Sex: Female Male

Civil Status: Single Married Separated Widowed

Employment Status: Permanent Temporary Contractual

Monthly income(Php): Php 21,000.00 and above Php 15,000.00 – Php 20,000.00 Php 10,000.00 – Php 14,999.00 Php 5,000.00 – Php 9,000.00 Php 5,000.00 and below

Length of service: 20 yrs. and above 15 – 29 yrs. 10 – 14 yrs. 5 – 9 yrs.

Distance from work: 1 – 2 km 3 – 4 km 4 – 5 km 5 – 6 km

Work assignment: Emergency Room Ward Operating Room Delivery Room Out-Patient Department School Clinic Specify:__________

II. Leadership Skills of Staff Nurses

Direction: Check the column that corresponds to the leadership skills of staff nurses in terms of human relations, administrative and institutional skills using the numerical rating scale, as follows: Numerical Rating: 4 – Much Adequate 3 – Moderately Adequate 2 - Adequate 1 – Not Adequate

A. Human Relations

Numerical Rating 4 3 2 1

1. Ability to handle problems in times of emergency. 2. Time to establish rapport. 3. Ability to interact with each member of the health care team.

A. Human Relations 4. Ability to show idea, opinion in terms of difficult problem of other staff. 5. Has the spirit of cooperation with in and out of the group. 6. Ability to work with other member of the health team effectively and efficiently the salary is low beyond family.

Numerical Rating 4 3 2 1

B. Administrative

Numerical Rating 4 3 2 1

1. Ability to make memorandum. 2. Has time to talk about problems encountered by different departments in their institutions. 3. Ability to handle problem and make corresponding solutions on time.

B. Administrative

Numerical Rating 4 3 2 1

1. Able to develop programs to enhance skills of staff nurses. 2. Ability to supervise and evaluate the performance of staff within the institution. 3. Able to enhance skills within the level of education attained.

C. Institutional Skills

1. Involvement in the making of hospital policies for implementation. 2. Supervisions of hospital facilities and equipments ready for use. 3. Ability to recommend and implement rules regarding work assignments and correct work overloading.

Numerical Rating

4 3 2 1

C. Institutional Skills

Numerical Rating

4 3 2 1

4. Ability to recommend and give recognition and merits for remarkable performance. 5. Involvement of interagency program implementations 6. Ability to conduct orientation to help the staff and student nurses

III. Factors affecting the leadership

Direction: Check the boxes that corresponds your answer to the questions.

Are there factors that influence your leadership skills? Yes

Factors:

A. Financial Incentives: Salary not given on time Frozen bonuses and other benefits Merits system and salary standardization not implemented Night shift differential not applied Irregular payment for overtime pay

B. Superior Relationship: Heads involves policies affecting staff nurses Poor coordination between subordinates and other staff Superior favouritism; jealousy and competition affect the relationship of nurses Inadequate plans for professional advancement Unfair selection of personnel sent for training and seminars Head can’t stand to nurses’ problems and difficulties related to job.

C. Work Environment: Lack of Facilities, supplies and equipments Insufficient spaces to operate comfortably, safely and efficiently. Inadequate temperature and humidity control, creating excessive discomforts and overcrowding No place to interact with colleagues Superior behaviour does not give a feeling of

IV. Recommendations to Improve Leadership Skills Continuous Education Attending Seminar and conventions to upgrade knowledge on nursing leadership. Take post-graduate studies to improve educational potentials. Hospitals work situations must be made conducive to nursing duties. Benefits from work must commensurate with time and effort. Derive satisfaction from work. Others, specify __________________________

Thank you and God Bless.

Chapter III

Methodolog y

This chapter presents the research design, research locale, research respondents, research instrumentation, and research procedure and data gathering, and treatment

Research Design

The descriptive method will be used to determine the leadership skills of staff nurses in Private Health Care

As a survey research, questionnaire will be used to gather data and information from a

Research Responden ts

The respondents of this study consist of all staff nurses in all Private Health Care Facilities in Calbayog

Research Locale

This study will be conducted at all Private Health Care Facilities in

These will include three (3) Private Hospitals, Our Lady of Porziuncula Hospital, Inc., located at Rueda Street Calbayog City, Calbayog Sanitarium Hospital located at Barangay San Policarpo Purok 4 Calbayog City, and St. Camillus Hospital

And three (3) Private School Clinics, Christ the King College located at Magsaysay Boulevard Calbayog City, St. Augustine International School located at Barangay Matobato Purok 2 Calbayog City, and New Life Christian Faith Academy located at Magsaysay

Research Instrumentati on

The instrument of this study is a questionnaire designed to answer the problem of this study. It has four (4) parts.

The first part is the profile of the respondents which includes age, sex, civil status, employment status, monthly income, length of service, distance from

The second part is the leadership skills of staff nurses in terms of human relations, administrative, and institutional skills.

The third part is the factors affecting the leadership skills of staff nurses, in terms of financial incentives, superior relationships, and work environment.

And the last part is the recommendations to improve the leadership skills of staff nurses in private health

Research Procedure

A letter of request to the Chief Nurse of the private health care facilities was made to ask permission to conduct this study in their respective institution.

With the chief nurses’ consent and approval, the questionnaires will be distributed to the staff nurses in the said

The researcher will personally conduct the survey to ensure that the data in the questionnaires will be answered properly and to assist the respondents whenever they have some matters

After gathering the data, the responses will be tallied and analyzed.

Treatme nt Analysis

Some of the data that will be gathered, and will analyze using the following statistical measures:

1. Use of frequency distribution (f), and ranking 2. Computation for

Prepared by: Mae O. Allequir Maria Neze E. Dalimocon Maribelle Encomio Jovina R. Tan

Thank You!