Leadership
Leadership versus management
Management produces order and consistency; leadership produces movement and adaptive change. Executives need both, but exam items reward vision-setting, influence, and follower development over control behaviors.
Models to know. Full-range leadership: transformational (idealized influence, inspirational motivation, intellectual stimulation, individualized consideration), transactional (contingent reward, management by exception), and laissez-faire. Situational leadership (Hersey-Blanchard) matches style to follower readiness - directing, coaching, supporting, delegating. Servant leadership inverts the hierarchy of service. Kouzes and Posner's five practices - model the way, inspire a shared vision, challenge the process, enable others to act, encourage the heart - appear as "which behavior is this?" items.
Change. Lewin's unfreeze–change–refreeze and Kotter's sequential steps. The repeated trap: the first step is never training, a new policy, or a communication blast - it is creating urgency or dissatisfaction with the status quo (unfreezing).
Delegation. The ANA framework: right task, right circumstance, right person, right direction and communication, right supervision and evaluation. Delegation transfers authority to perform a task, not accountability; the nurse - and the executive - remains accountable for outcomes.
Succession and development. Coaching, mentoring, stretch assignments, and identifying high potentials. Retaining talent is a leadership outcome, not an HR afterthought.
Rule of thumb
When a stem asks for a leadership behavior, name the follower effect first. If the described action develops people, it is transformational; if it trades reward for compliance, it is transactional. If the organization is stuck, diagnose the unfreezing gap before choosing an intervention.
Worked example
A manager facing resistance to bedside shift report is told to "fix it fast." The first correct action is to surface staff dissatisfaction with the current handoff and build a shared case for change (unfreeze), then pilot, then hardwire - not to mandate attendance at a training session.