CSCC Changing Clinical Practice or Staff Behavior Discussion Textbooks:
Sullivan (2017) Chapters 1, 4, 5, 7, 9, 11.
Panait, C., & Bucinschi, V. (2018). Emotional Intelligence In Leadership. Scientific Research & Education in the Air Force-AFASES
Click here to download the article.
Valiga, T. M. (2019). Leaders, managers, and followers: Working in harmony. Nursing 2019, 49(1), 45-48.
Click here to download the article.
For this discussion, you will use information from your assigned readings and the literature to answer the following:
Changing clinical practice or staff behavior can be challenging. Please describe Lewin’s Theory of Change. Give an example where you or organization used this theory to implement change. Was the change successful or unsuccessful? Why? Include change theory elements in your rationale. If the change was unsuccessful, what could the organization have done differently (include utilization of a different change theory)?
Your initial post must be posted before you can view and respond to colleagues, must contain minimum of two (2) references, in addition to examples from your personal experiences to augment the topic. The goal is to make your post interesting and engaging so others will want to read/respond to it. Synthesize and summarize from your resources in order to avoid the use of direct quotes, which can often be dry and boring. No direct quotes are allowed in the discussion board posts.
Initial Post: Minimum of two (2) total references: one (1) from required course materials and one (1) from peer-reviewed references.
Initial Post: Minimum 200 words excluding references (approximately one (1) page) New Horizons
Leaders, managers, and followers:
Downloaded from https://journals.lww.com/nursing by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3ZI03TR16A96Z3fPxVuSTat+DrdDWm2VJ+0pV3Z561Q4= on 03/13/2019
Working in harmony
BY THERESA M. VALIGA, EdD, RN, CNE, ANEF, FAAN
Abstract: All nurses have the potential and responsibility to effect
positive change in nursing practice
and healthcare. This article details
the characteristics of leaders and
effective followers and clarifies
that one does not need to be in a
management position to function
as a leader.
ANDREYPOPOV / ISTOCK
Keywords: followers, leaders,
managers, transactional leaders,
OVER THE COURSE of their prelicensure program, many
nurses had a class titled something along the lines of Leadership
in Nursing. Typically, this course is taken in the final semester,
along with a precepted clinical experience. It may have been
taught by a former nurse manager or another healthcare administrator, focusing on the following:
• organizational structures
• delegation to certified unlicensed assistive personnel
• roles and responsibilities of nurse managers or charge nurses
• workings of the healthcare team
• performance evaluation
• job descriptions
• unit budgets
• personnel issues.
While these courses are valuable, they do not necessarily
prepare nurses to be effective leaders or followers. But that is
what all nurses should strive to be: leaders and effective followers. This article examines the differences between leaders
January l Nursing2019 l 45
Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
and managers, describes the role of
effective followers, and applies those
qualities to nurses across the spectrum of healthcare.
Leadership literature is plentiful both
inside and outside of the healthcare
industry, but these often focus on the
role of a CEO or another manager
or administrator who deals with employees. This suggests that the term
leader applies only to individuals in
top-level administrative positions,
that only a small number of individuals might be considered leaders, and
that those who are led have a limited
impact on the success or future direction of their organization. In reality, nothing could be further from the
truth. Leaders can be found in every
walk of life, any position or role, and
every field. Those expected to follow
leaders must know how, when, and
whom to follow for success.
Over the years, evolving leadership theories provided new perspectives on leadership, but they failed
to acknowledge the complexity of
leadership and the importance of
followers (see Changing perspectives
on leadership). More contemporary
theories acknowledge that effective
leadership depends on the person,
the situation, and the qualities and
maturity of the followers.1-4 Leadership is not a random occurrence in
these theories; rather, it is purposeful
and involves communication, vision,
engagement, and inspiration to energize a group.
One of the best-known perspectives on the complexity of leadership came from James MacGregor
Burns in 1978.5 His influential
work, Leadership, addressed the
importance of followers and urged
appreciation for the two forms of
leadership: transactional and transformational. According to Burns,
transactional leaders “approach followers with an eye to exchanging
one thing for another: jobs for votes
or subsidies for campaign contributions.” In contrast, transformational
leaders “[recognize] and [exploit] an
existing need or demand of a potential follower… [seek] to satisfy [their]
higher needs, and [engage] the full
person…” to pursue “compelling
causes.”5 This distinction, along with
the acknowledgment of transformation and collaboration, has led to
a careful analysis of the similarities
and differences between leadership
Leadership vs. management
When many talk about leadership,
they refer to individuals in positions
of authority, such as the president of
a professional association, a CNO,
the dean of a school of nursing, and
so on. Followers are often thought
of as sheep expected to accomplish
whatever tasks the leader sets. A
careful assessment of the distinctions
between leaders and managers, as
Changing perspectives on leadership12
Views on leadership have changed over the years. Initially, only individuals born into
a noble family were thought of as leaders, having inherited those roles, but leadership involves more than having noble blood.
• The great man theory did not resonate well with the rest of the population, and
scholars started to determine different characteristics possessed by those viewed
• Trait theories evolved from this and identified some common leadership characteristics, but none were universal because the qualities of a leader varied based
• Situational theories recognized the significance of an individual’s environment or
situations. These events may lead him or her to step up as a leader.
well as those between sheep and effective followers, is required for an
awareness and effective execution of
these different roles.
Many have built on the themes
of Managers and Leaders: Are They
Different? by Abraham Zaleznik in
1981.6 His work helped to distinguish leaders from managers:
• Leaders have a vision and draw on
passion to engage others.
• Managers typically work with others to realize the goals of an organization—often with great skill, but
not always with passion.
Leaders communicate their vision
to inspire others to effect change for
the benefit of those around them. The
vision for leaders in nursing may result in patients being admitted to the
unit in a more effective and compassionate way, families being integrated
into the patient-care process for a
more positive experience, and staff
having greater input on the policies
and practices that affect them.
By comparison, managers often
communicate policies and expectations that have been established by
the organization for compliance. Typically, the task is still accomplished,
but sometimes due to fear rather than
a healthier motivator. It may also
be that the staff feels as though they
have no choice in the matter. Effective followers choose to follow because they also see value in the vision
and are inspired by the passion with
which an idea is communicated.
In their relationships, leaders utilize the strengths and talents of those
around them to influence positive
change, often empowering others
to take on leadership roles of their
own. They encourage, support, and
mentor their followers. In turn, followers challenge leaders and suggest
alternatives to their ideas. Managers
also work effectively with teams but
are expected to accomplish tasks and
stay on budget by directing others.
Leaders achieve their status because followers have allowed them
46 l Nursing2019 l Volume 49, Number 1
Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
to take the lead; managers are appointed to their positions. As such,
leaders’ power comes from their
credibility, passion, and knowledge.
Managers are in a position of authority, with their power coming from
the ability to hire, fire, evaluate, and
Knowing their vision will not
be achieved easily or overnight,
leaders are creative and comfortable
with disorder, take risks, and stay
focused on their goals. By comparison, managers seek to limit risks,
often preferring order to maintain
the status quo. As evidenced by
“The Best Performing CEOs in the
World 2017,” an article in the Harvard Business Review that ranked
CEOs based on their company’s
success in production and financial
returns, the primary objective of
management is the health and future of the organization.7
Areas such as employee performance, organizational structure
and operations, branding, big data,
strategic planning, and the longevity of an organization weigh heavily
into management decisions. These
are important factors to consider, but
they are not always of great significance to leaders. Leaders focus on
getting people involved to develop
and realize a vision based on passion,
rather than just the bottom line, and
they are exactly what is needed in
Despite seemingly opposite characteristics, the two are not mutually
exclusive. Many nurses who are effective leaders serve in management
positions, but leaders do not require
a position of authority. Given the
current state of healthcare, increasingly diverse patient populations,
the complexities of practice, and the
tremendous explosions in knowledge and technology, all nurses must
accept responsibility to be leaders
in their respective organizations,
communities, and professional
Leaders direct the
strengths and talents of
those around them to
Taking up the mantle
Assuming a leadership role may
seem overwhelming, and many think
they do not have the time, energy,
or qualities to take on the challenge.
But those who hesitate can still rise
to the challenge with some guidance.
Consider the following:
• Engage in honest self-reflection
regarding individual strengths
and weaknesses, including clinical expertise and proficiency, communication skills, or mentoring
• Attend seminars or workshops on
leadership development and allow
time for careful reflection.
• Read books, articles, and blogs on
• Carefully observe leaders both inside and outside of the nursing field
to identify their habits and characteristics, then work to develop or
strengthen those abilities.
• Speak up in the presence of
injustice, disrespectful behavior,
clinical errors, or ineffective practices. This means clearly identifying
an issue, offering a solution, and
suggesting approaches to improve
• Seek out mentors and apply to participate in leadership development
academies, such as those offered by
Sigma Theta Tau International.8
• Start small in familiar areas. Leadership does not mean becoming
president of the American Nurses
Association or tackling a major issue.
Instead, it can be achieved by being
an active, contributing member of a
committee, submitting a proposal on
a different way to do things, or writing an article for your institution’s
• Ask for feedback from peers and
colleagues regarding how particular
situations were handled.
• Function as an effective and exemplary follower by supporting colleagues who are attempting to shape
a better future.
Being an effective follower is one
route to becoming a leader. Followers are often thought of as sheep,
yes-people, or cheerleaders, and
some do play those parts. But realizing a vision and addressing compelling causes cannot be accomplished by the leader alone.5 In fact,
there would be no leaders without
Individuals who are effective as
followers think critically about ideas,
proposals, and problems; offer different points of view; invest in the
group and its goals; and know who
and when to follow.9 They both give
and receive counsel and support,
share responsibility for the group,
uphold high values and standards,
understand their strengths and
weaknesses, and stay true to their
own values; in addition, they will
not abide individuals who abuse
January l Nursing2019 l 47
Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
their position as a leader. These individuals are strong, actively engaged,
and primed to take on leadership
roles. Like leaders, they are willing
to take risks, communicate effectively, take initiative, and think for
Time to step up
Nurses who have served as effective
followers and attended to strengthening and developing their leadership qualities and characteristics may
be ready to take on a more active
role. Nurses can provide leadership
in their units or organizations in several ways, including:
• chairing a unit-based team or
council for professional governance
• providing alternate approaches for
process improvement initiatives
• identifying practice or care issues
to peers and supervisors to ensure
that they are not ignored
• seeking out and advocating for the
development of evidence-based approaches to resolve an issue
• promoting the professional development of nurses and volunteering to help orchestrate these
• standing up to injustice or inequity
and working to create a culture that
will not tolerate such behaviors
• serving as a preceptor and
mentor for new staff members or
Many paths to leadership
There are many ways to identify,
develop, and strengthen leadership
skills. Sometimes an educator, nurse
manager, or colleague will see leadership potential in an individual and
provide the encouragement, support,
and opportunity for him or her to
develop in that role. Nurses in this
position should consider themselves
fortunate and take full advantage of
the situation. More often, however,
nurses are not tapped by someone
else and must take the initiative to
could have if even half of them truly
functioned as leaders. Who would be
in a better position to make significant changes in healthcare? ■
1. Arnold F. What Makes Great Leaders Great:
Management Lessons from Icons Who Changed
the World. New York, NY: The McGraw-Hill
2. Cain S. Quiet: The Power of Introverts in a World
that Can’t Stop Talking. New York, NY: Random
House, Inc.; 2013.
3. Gardner WL, Avolio BJ, Luthans F, May DR.
“Can you see the real me?” A self-based model
of authentic leader and follower development.
Leadersh Q. 2005;19:343-372.
4. Yukl GA. Leadership in Organizations. 5th ed.
Upper Saddle River, NJ: Pearson/Prentice Hall;
5. Burns JM. Leadership. New York, NY: Harper &
6. Zaleznik A. Managers and leaders: are they
different? J Nurs Adm. 1981;11(7):25-31.
7. McGinn D. The best-performing CEOs in the
world 2017. Harv Bus Rev. 2017;95(6):66-77.
leaders and managers
are not mutually
Each nurse makes a difference in
the lives of patients and their families, but they should also seize the
opportunity to have a broader impact on healthcare and the nursing
profession as a whole for the benefit
of patients and colleagues alike. Consider what kind of difference can be
made by advocating for:
• local quality improvement projects
• access to follow-up care for the
homeless population after discharge
from acute care settings
• representation of clinical nurses
on all major boards and committees
within an institution
• a new approach to scheduling that
allows nurses to pursue advanced
education or research.
There are approximately three
million nurses in the US.10 They are
trusted and valued by the public
and guided by their commitment to
others.11 Imagine the impact nurses
8. Sigma Theta Tau International Honor Society of
Nursing. 2018. www.sigmanursing.org.
9. Chaleff I. The Courageous Follower: Standing
up to and for our Leaders. 3rd ed. Oakland, CA:
Berrett-Koehler Publishers; 2009.
10. Occupational outlook handbook: registered
nurses. Bureau of Labor Statistics. 2018. www.bls.
11. Brenan M. Nurses keep healthy lead as most
honest, ethical profession. Gallup. 2017. http://
12. Bass BM. The Bass Handbook of Leadership:
Theory, Research, and Managerial Applications.
4th ed. New York, NY: Free Press; 2008.
Grossman S, Valiga TM. The New Leadership
Challenge: Creating the Future of Nursing. 5th ed.
Philadelphia, PA: F.A. Davis; 2017.
Huston CJ. The Road to Leadership. Indianapolis,
IN: Sigma Theta Tau International; 2018.
Kouzes JM, Posner BZ. The Leadership Challenge: How
to Make Extraordinary Things Happen in Organizations.
6th ed. Hoboken, NJ: John Wiley & Sons; 2017.
Lapierre LM, Carsten MK. Followership: What Is It
and Why Do People Follow? Bingley, United Kingdom:
Emerald Publishing Limited; 2014.
Marshall ES. Transformational Leadership in Nursing:
From Expert Clinician to Influential Leader. 2nd ed.
New York, NY: Springer Publishing Company;
Theresa M. Valiga is professor emerita at Duke University
School of Nursing in Durham, N.C.
The author has disclosed no financial relationships
related to this article.
48 l Nursing2019 l Volume 49, Number 1
Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
SCIENTIFIC RESEARCH AND EDUCATION IN THE AIR FORCE – AFASES2018
EMOTIONAL INTELLIGENCE INFLUENCE IN LEADERSHIP
Cristian PANAIT, Vasile BUCINSCHI
”Henri Coandă” Air Force Academy, Braşov, Romania (firstname.lastname@example.org)
Abstract: In this paper, I analysed the data obtained from an emotional intelligence test I
applied to a group of military students and related the results to a survey I applied to the same
group of students, which had the purpose to identify the members most qualified to occupy a
leadership position due to their qualities and attributes. The purpose of the study is to analyse the
importance and influence of emotional intelligence on a group’s leadership emergence and
The methods I used are both qualitative and quantitative research. The target group consists
of all senior military students of the Romanian Air Force Academy, the author of the study being
their direct commander. The Emotional Intelligence test was designed by Daniel Goleman, which
contains 10 items that represent different scenarios which puts the subjects in different critical
situations and the survey has 5 items with open answers that have the purpose to identify the
recognised group leaders.
The conclusions highlight the importance of emotional intelligence as a quality of a future
leader and verifies the hypothesis that someone who has the qualities of a leader is being
recognised by his group.
Keywords: emotional intelligence, leadership, leader
Emotional Intelligence as a concept, was formulated for the first time by Wayne Leon
Payne in 1985. He considered that Emotional Intelligence implies a creative relationship
with fear, pain and desire. In 1990, John Mayer and Peter Salovey, two american
professors, published two articles in which they tried to develop a scientific method to
measure the differences between individuals from abilities point of view. They discovered
that some individuals are more able to identify their own feelings and to those around
them and also in solving problems regarding emotions. Emotional Intelligence theory
started with those researches which combines feelings with rationality and rationality
Emotional Intelligence became one of the most discussed subjects in the United States
of America after Daniel Goleman, published his book with the title “Emotional
Intelligence”. Daniel Goleman combined the previous research available with his own
result from investigations and came up with a theory that succeeded to give definitions to
this concept. He defined Emotional Intelligence as “the ability to understand and control
our own emotions and those around us.”
Emotional Intelligence is a key ability of a leader. By the end of the studies in the Air
Force Academy, a graduate needs to be able to command a platoon. Accepting the
responsibility for himself and his subordinates in the military organisation according to
high standards requires competencies, initiative, self motivation and trust in his own
Emotional Intelligence Influence in Leadership
His behaviour, reactions, level of communication skills, decision making needs to be
done many times under stressful situations, therefore a high level of EQ (emotional
quotient) is in high demand.
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