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01Introduction

“Thought constitutes the greatness of man. Man is a reed, the feeblest thing

in nature but he is a thinking reed ”

Architect Personality

INTJ-A / INTJ-T

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in nature, but he is a thinking reed.

BLAISE PASCAL

It can be lonely at the top. As one of the rarest personality types – and one

of the most capable – Architects (INTJs) know this all too well. Rational and

quick-witted, Architects pride themselves on their ability to think for

themselves, not to mention their uncanny knack for seeing right through

phoniness and hypocrisy. But because their minds are never at rest,

Architects may struggle to �nd people who can keep up with their nonstop

analysis of everything around them.

A Pioneering Spirit

Architects question everything. Many personality types trust the status quo,

relying on conventional wisdom and other people’s expertise to guide their

lives. But ever-skeptical Architects prefer to make their own discoveries. In

their quest to �nd better ways of doing things, they aren’t afraid to break

the rules or risk disapproval – in fact, they rather enjoy it.

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But as anyone with this personality type would tell you, a new idea isn’t

worth anything unless it actually works. Architects want to be successful,

not just inventive. They bring a single-minded drive to their work, applying

the full force of their insight, logic, and willpower. And heaven help anyone

who tries to slow them down by enforcing pointless rules or o�ering poorly

thought-out criticism.

Architects, independent to the core, want to shake o� other

people’s expectations and pursue their own ideas.

This personality type comes with a strong independent streak. Architects

don’t mind acting alone, perhaps because they don’t like waiting around for

others to catch up with them. They also generally prefer making decisions

without asking for anyone else’s input. At times, this lone-wolf behavior can

come across as insensitive, as it fails to take into consideration other

people’s thoughts, desires, and plans.

It would be a mistake, however, to view Architects as uncaring. Whatever

the stereotypes about their stoic intellect, these personalities feel deeply.

When things go wrong or when they hurt others, Architects are personally

a�ected and spend much time and energy trying to �gure out why things

happened the way that they did. They may not always value emotion as a Pro�le Premium Toolkits Teams Resources

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decision-making tool, but they are authentically human.

A Thirst for Knowledge

Architects can be both the boldest of dreamers and the bitterest of

pessimists. They believe that, through willpower and intelligence, they can

achieve even the most challenging goals. But these personalities may be

cynical about human nature more generally, assuming that most people are

lazy, unimaginative, or simply doomed to mediocrity.

People with the Architect personality type derive much of their self-esteem

from their knowledge and mental acuity. In school, they may have been

called “bookworms” or “nerds.” But rather than taking these labels as

insults, many Architects embrace them. They recognize their own ability to

teach themselves about – and master – any topic that interests them,

whether that’s coding or capoeira or classical music.

Architects don’t just learn new things for show – they genuinely

enjoy expanding the limits of their knowledge.

Architects can be single-minded, with little patience for frivolity, distractions,

or idle gossip. That said, they’re far from dull or humorless. Many Architects

are known for their irreverent wit, and beneath their serious exteriors, they

often have a sharp, delightfully sarcastic sense of humor. Pro�le Premium Toolkits Teams Resources

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Social Frustrations

Architects aren’t known for being warm and fuzzy. They tend to prioritize

rationality and success over politeness and pleasantries – in other words,

they’d rather be right than popular. This may explain why so many �ctional

villains are modeled on this personality type.

Because Architects value truth and depth, many common social practices –

from small talk to white lies – may seem pointless or downright stupid to

them. As a result, they may inadvertently come across as rude or even

o�ensive when they’re only trying to be honest.

At times, Architects may wonder whether dealing with other people

is even worth the frustration.

But like any personality type, Architects do crave social interaction – they’d

just prefer to surround themselves with people who share their values and

priorities. Often, they can achieve this just by being themselves. When

Architects pursue their interests, their natural con�dence can draw people

to them – professionally, socially, and even romantically.

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Architects are full of contradictions. They are imaginative yet decisive,

ambitious yet private, and curious yet focused. From the outside, these

contradictions may seem ba�ing, but they make perfect sense once you

understand the inner workings of the Architect mind.

For these personalities, life is like a giant game of chess. Relying on strategy

rather than chance, Architects contemplate the strengths and weaknesses

of each move before they make it. And they never lose faith that, with

enough ingenuity and insight, they can �nd a way to win – no matter what

challenges might arise along the way.

How accurate is the introduction?

Architects You May Know

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I dedicate this book to the two most important

partnerships in my life: my husband, Don Marquis,

and my colleague, Carol Huston. Bessie L. Marquis

I dedicate this book to my husband Tom.

We have built an incredible life together and

I thank you for always being at my side. Carol J. Huston

Reviewers

Patricia Bishop, PhD, MSN, RN Dean and Chief Nurse Administrator Dean of Nursing Brookline College of Nursing Phoenix, Arizona

Barbara B. Blozen, EdD, MA, RN-BC, CNL Associate Professor New Jersey City University Jersey City, New Jersey

Linda Cole, DNP, RN, CCNS, CPHQ, CNE Assistant Professor Department of Graduate Studies Cizik School of Nursing The University of Texas Houston, Texas

Susan Davis, MSN, RN Senior Instructor Nursing Helen and Arthur E. Johnson Beth-El College of Nursing and Health Sciences University of Colorado Colorado Springs, Colorado

Elmer V. Esguerra, MAN, RN Faculty, Associate Degree Nursing Program South Texas College Nursing & Allied Health Weslaco, Texas

Cindy Farris, PhD, MSN, MPH, CNE Indiana University Fort Wayne Fort Wayne, Indiana

Teresa Faykus, DNP, MSN, BSN, RN, CNE Professor Nursing RN-BSN Coordinator West Liberty University West Liberty, West Virginia

Dawn Frambes, PhD, RN, MSA Assistant Professor Calvin University Grand Rapids, Michigan

Kristi Frisbee, DNP, RN Associate Professor and Master Advisor Pittsburg State University Pittsburg, Kansas

Rose A. Harding, MSN, RN Instructor JoAnne Gay Dishman School of Nursing Lamar University Beaumont, Texas

Janice Hausauer, DNP, APRN, FNP-BC Assistant Clinical Professor Montana State University College of Nursing

Bozeman, Montana

Renee Hoeksel, PhD, RN, MSN, ANEF Professor College of Nursing Washington State University Vancouver Vancouver, Washington

Janine Johnson, RN, MSN Associate Professor Clarkson College Omaha, Nebraska

Judy Kitchin, MS, RN, CNOR Clinical Lecturer Decker School of Nursing Binghamton University Binghamton, New York

Kathleen M. Lamaute, EdD, FNP-BC, NEA-BC, CNE, MA, MS, RN Professor of Nursing Barbara H. Hagan School of Nursing Molloy College Rockville Centre, New York

Diana Martinez Dolan, PhD, RN Assistant Professor St. David’s School of Nursing Texas State University Round Rock Campus Round Rock, Texas

Deborah Merriam, DNS, RN, CNE Assistant Professor of Nursing Daemen College

Amherst, New York

Missy Mohler, MS, RN Assistant Professor Mount Carmel College of Nursing Columbus, Ohio

Dona Molyneaux, PhD, RN, CNE Associate Professor Frances M. Maguire School of Nursing and Health Professions Gwynedd Mercy University Gwynedd Valley, Pennsylvania

Sue Powell, MS, RN, PhN, CNE Professor Nursing Department Century College White Bear Lake, Minnesota

Mark Reynolds, DNP, RN, COI Clinical Assistant Professor, RN-BSN/MSN Program Director The University of Alabama in Huntsville Huntsville, Alabama

Wendy Robb, PhD, RN, MSN, BSN, AND, CNE Dean School of Nursing Cedar Crest College Allentown, Pennsylvania

Joyce A. Shanty, PhD, RN Professor Coordinator, Allied Health Professions Indiana University of Pennsylvania

Indiana, Pennsylvania

Cynthia Shartle, MSN, RN ADN Program Instructor South Texas College McAllen, Texas

Ana Stoehr, PhD, RN, Post-MSN, MSN, BSN Coordinator of the Master’s in Nursing Administration Concentration George Mason University Fairfax, Virginia

Diana Tilton, MSN, RN Assistant Professor Saint Luke’s College of Health Sciences Kansas City, Kansas

Debra Wagner, DNP, RN Associate Professor Department of Nursing Saginaw Valley State University University Center, Michigan

Daryle Wane, PhD, ARNP, FNP-BC Professor, Nursing BSN Pasco-Hernando State College New Port Richey, Florida

Debra White-Jefferson, DNP, MSN, RN Assistant Professor University of Louisiana at Lafayette Lafayette, Louisiana

Mary B. Williams, MS, RN

Professor of Nursing School of Nursing and Health Sciences Gordon State College Barnesville, Georgia

Preface

Legacy of Leadership Roles and Management Functions in Nursing This book’s philosophy has evolved over 38 years of teaching leadership and management. We entered academe from the acute care sector of the health-care industry, where we held nursing management positions. In our first effort as authors, Management Decision Making for Nurses: 101 Case Studies, published in 1987, we used an experiential approach and emphasized management functions appropriate for first- and middle-level managers. The primary audience for this text was undergraduate nursing students.

Our second book, Retention and Productivity Strategies for Nurse Managers, focused on leadership skills necessary for managers to decrease attrition and increase productivity. This book was directed at the nurse-manager rather than the student. The experience of completing research for the second book, coupled with our clinical observations, compelled us to incorporate more leadership content in our teaching and to write this book.

Leadership Roles and Management Functions in Nursing was also influenced by national events in business and finance that led many to believe that a lack of leadership in management was widespread. It became apparent that if managers are to function effectively in the rapidly changing health-care industry, enhanced leadership and management skills are needed.

What we attempted to do, then, was to combine these two very necessary elements: leadership and management. We do not see leadership as merely one role of management or management as only one role of leadership. We view the two as equally important and necessarily integrated. We have attempted to show this interdependence by defining the leadership components and management functions inherent in all phases of the management process. Undoubtedly, a few readers will find fault with our divisions of management functions and leadership roles; however, we felt it was necessary first to artificially separate the two components for the reader and then to integrate the roles and functions. We do believe strongly that adoption of this integrated role is critical for success in management.

The second concept that shaped this book was our commitment to developing critical thinking skills with the use of experiential learning exercises. We propose that integrating leadership and management can be accomplished using learning exercises. Most academic instruction continues to be conducted in a teacher-lecturer–student- listener format, which is one of the least effective teaching strategies. Few individuals learn best using this style. Instead, most people learn best by methods that utilize concrete, experiential, self- initiated, and real-world learning experiences.

In nursing, theoretical teaching is almost always accompanied by concurrent clinical practice that allows concrete and real-world learning experience. However, the exploration of leadership and management theory may have only limited practicum experience, so learners often have little first-hand opportunity to observe middle- and top-level managers in nursing practice. As a result, novice managers frequently have little chance to practice their skills before assuming their first management position, and their decision making thus often reflects trial-and-error methodologies. For us, then, there is little question that vicarious learning, or learning through mock experience, provides students the opportunity to make significant

leadership and management decisions in a safe environment and to learn from the decisions they make.

Having moved away from the lecturer–listener format in our classes, we lecture for only a small portion of class time. A Socratic approach, case study debate, and small and large group problem solving are emphasized. Our students, once resistant to the experiential approach, are now enthusiastic supporters. We also find this enthusiasm for experiential learning apparent in the workshops and seminars we provide for registered nurses. Experiential learning enables management and leadership theory to be fun and exciting, but most important, it facilitates retention of didactic material. The research we have completed on this teaching approach supports these findings.

Although many leadership and management texts are available, our book meets the need for an emphasis on both leadership and management and the use of an experiential approach. More than 280 learning exercises, representing various health-care settings and a wide variety of learning modes, are included to give readers many opportunities to apply theory, resulting in internalized learning. In Chapter 1, we provide guidelines for using the experiential learning exercises. We strongly urge readers to use them to supplement the text.

New to This Edition The first edition of Leadership Roles and Management Functions in Nursing presented the symbiotic elements of leadership and management, with an emphasis on problem solving and critical thinking. This tenth edition maintains this precedent with a balanced presentation of a strong theory component along with a variety of real-world scenarios in the experiential learning exercises. We have also maintained the dual focus of leadership development with a balance of management content.

Responding to reviewer recommendations, we have added and deleted content. Specifically, we continue to increase the focus on quality and safety, interprofessional collaboration/team building, technology in health care, mandates for increased quality and value, healthy workplaces and civility, change management, and health- care reform. In addition, there is new content on elastic thinking; rebel leadership; agile leadership; stakeholder engagement; interprofessional education; and patient, family, and subordinate empowerment. We also have increased the use of outpatient/community settings in our learning exercises.

We believe we have retained the strengths of earlier editions, reflecting conten