Management vs. leadership in nursing

Managers and leaders, though they are often thought to mean the same thing, are actually different people in an organization. Managers are involved in controlling and guiding the activities in the organization through effective supervision and handling while leaders are those who motivate their followers towards meeting a common goal. There are also significant differences in the characteristics and behavioral descriptions of managers and leaders. However, as stated by Marquis and Huston (2009)

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, it is important for an organization to have both managers and leaders in order for it to succeed towards meeting its goals and objectives.

How roles of managers and leaders differ in supporting the organization

Managers and leaders handle different responsibilities; however, they also share some responsibilities. Leaders and managers are both responsible for keeping track of the progress of the organization and keeping track of where the organization is in trying to meet its goals and objectives. As stated by McAlearney (2006)

also states that leaders identify needs and prepare an action plan for the organization to meet the goals and , delegation of roles towards meeting the needs of the organization and realizing its vision.Sama and Shoaf (2008)

argue that leaders are responsible for effectiveness of the organization while managers are responsible for the efficiencies in the organization. Together, managers and leaders ensure that the organization is both effective and efficient towards meeting the set goals and objectives. Marquis and Huston (2009)

, leaders are involved in paving the way for the members of the organization to meet the goal while managers are responsible for shouldering the responsibility of ensuring the various members of the organization function well together. Leaders thus look further ahead than managers and try to steer the organization towards the various phases to be ahead while managers ensure that throughout this way, the organization’s productivity remains high and that the milestones reached are stated clearly.

Another key difference in the responsibilities of managers and leaders come in the expectations that are set for them. Leaders are expected to be risk-takers and entrepreneurial in nature while managers are expected to be calm and . Therefore the managers are expected to provide vision and direction to the organization while managers are expected to and manage the team efficiently Vogus & Sutcliffe, 2007.

In the organization, leaders are also expected to drive the strategy towards achieving results in times when the organization is rocked with uncertainty while managers are meant to break down the strategy prepared by the leader to provide guidance to the team towards achievement of these goals. Therefore leaders and managers work hand in hand toward bettering the organization and providing better health outcomes for the patients Lu & Wedig, 2013.

They cannot be exclusive of each other and it is important for managers to realize the role of leaders and vice versa.

Since the roles of managers and leaders in an organization are different, the organization also places different ways of measuring their performance. Leaders are gauged based on their potential for driving success while managers are gauged on performance only. In a health care organization, the leader will be gauged on the ideas they develop for increasing and making service delivery better while managers will be assessed on the actual number of satisfied clients the hospital brings or increase in revenues Estryn-Behar et al., 2007()

Competencies unique to leadership and management

In a study that strived to differentiate the competencies unique to leadership and management, it was found that there are some overlaps in the most mentioned competencies but some were unique. The unique competencies for leaders were only developing people and setting the vision while for management, the unique competencies were human resources management and information management. The competencies that overlapped the two roles were personal qualities, interpersonal skills, thinking skills, management skills, communication skills, health care knowledge, management skills and business skills. The authors argued that though management and leadership serve different purposes, the overlap in their competencies reflects the dynamic nature of health care. They also emphasize the need for increased collaboration of both managers and nurses in order to consolidate their efforts and increase the benefit to the organization Jennings, Scalzi, Rodgers, & Keane, 2007()

According to Denehy (2008)

, leaders are expected to possess traits such as intellect, trust, courage, optimism and communication. Other characteristics that are mentioned include objectivity, flexibility, and consistency of behavior. They are also expected to have wide experience in their field in order to be mentors and to ensure the growth of the organization. They are agents of change in the organization and .

Specific examples from previous practice setting

In the organization where I used to work, we had both managers and leaders and they were both valued differently. However, before this became the case, the organization seemed to mistake the role of leaders and managers. One of the managers that were confused to be a leader was the head of the nursing department. The person who was appointed into this role was given the job of changing the nursing department to make the nurses work together better. He was meant to devise a strategic plan for the nursing department and at the same time to supervise the nurses towards achieving these goals. This created problems because he did not have the qualities of a leader. His qualities included being well organized, being cooperative with the team and being reactive to change. However, he lacked qualities such as taking responsibility for actions, creating teams, motivating people, persuasion, and the ability to develop the nurses. This made him fail in his role as the head of the nursing department which required a leader and not a manager. He became frustrated at his inability to discharge what was expected of him.

In the same nursing department, the person who was appointed as the shift leader of the nurses and was in charge of preparing the various shifts for the nurses was a leader and not a manager. This person was able to be innovative in developing the shift, was able to focus on the needs of the nurses and how they can work together efficiently in their shift, was able to challenge the status quo where some nurses were never allocated night shifts, and was able to develop a strategic plan for the department. However, this person was not able to focus the nurses towards meeting the various goals they were required to meet. This person also felt that their skills were being under-utilized since they felt they had the potential to achieve much more.

After a training that was conducted, the roles were reshuffled to reflect and take into consideration the various qualities that people had in order to give them suitable roles as either managers or leaders. This made the organization to become better in meeting its goals and objectives while striving to create better strategic plans.


Denehy, J. (2008). Leadership Characteristics. The Journal of School Nursing, 24(3), 107-110. doi: 10.1177/1059840512341234

Estryn-Behar, M., Heijden, B.I.J.M.V. d., Ogi-ska, H., Camerino, D., Nezet, O.L., Conway, P.M., . . . Hasselhorn, H.-M. (2007). The Impact of , Teamwork Characteristics, Burnout, and Personal Factors upon Intent to Leave among European Nurses. Medical Care, 45(10), 939-950. doi: 10.2307/40221534

Jennings, B.M., Scalzi, C.C., Rodgers, J.D., & Keane, A. (2007). Differentiating nursing leadership and management competencies. Nursing outlook, 55(4), 169-175.e164.

Lu, S.F., & Wedig, G.J. (2013). Clustering, Agency Costs and Operating Efficiency: Evidence from Nursing Home Chains. Management Science, 59(3), 677-694. doi: 10.2307/23359509

Marquis, B.L., & Huston, C.J. (2009). Leadership Roles and Management Functions in Nursing: Theory and Application. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

McAlearney, A.S. (2006). Leadership Development in Healthcare: A Qualitative Study. Journal of Organizational Behavior, 27(7), 967-982. doi: 10.2307/4093879

Sama, L.M., & Shoaf, V. (2008). Ethical Leadership for the Professions: Fostering a Moral Community. Journal of Business Ethics, 78(1/2), 39-46. doi: 10.2307/25075588

Vogus, T.J., & Sutcliffe, K.M. (2007). The Impact of Safety Organizing, Trusted Leadership, and Care Pathways on Reported Medication Errors in Hospital Nursing Units. Medical Care, 45(10), 997-1002. doi: 10.2307/40221541