Collaboration: Leader-Member Exchange Theory

1. The Situation/Challenge: Collaboration is an essential part of delivering optimal patient care because there is not a single profession that can treat all medical conditions by themselves. Therefore, different professions must work together in order to provide for the greater good of their patients. However, there is a common theme among physicians and nurses where they are unable to collaborate during the treatment process. This challenge is a cause for concern because it ultimately affects the care that the patients receive.
a. Who, What, When, Where, Why: This issue has been around since the beginning of time when “physicians were seen as the primary clinical leaders and decision makers and the nurses were seen as handmaidens

Theory/Approach 1: Leader-Member Exchange Theory
i. Background: George Graen and James Cashman created the phrase Vertical Dyad linkage (VDL), which laid the groundwork for the Leader-Member Exchange (LMX). VDL refers to the way that “leaders create unique “dyadic” relationships with their subordinates” and LMX takes these relationships and accounts for their group characteristics (Matta, Scott, Koopman, & Colon, 2015). These relationships are created through a three-step process: role-taking, role-making, and routinization.
Role-taking is the process where all the assigned members first join the group. During this step, the leaders assess the subordinates’ skills and abilities. Role-making occurs when the members begin to work on the designated task. Leaders expect the subordinates to be hard-working and loyal as they obtain their roles. The leaders are able to mentally assign their subordinates into one of two different groups by watching them work on the tasks. Through the subordinates’ characteristics and demeanors, they are assigned to either the “in-group” or the “out-group.” Members of the in-group are determined to be the hard-working and loyal members that will do anything for their leaders. The leaders value this group and often look to them for new opportunities such as training and advancement. Members of the out-group are the unmotivated, incompetent individuals who have defied their leaders in some way. These members have restricted work access and

Application: Nurses are experiencing many prominent factors that are aiding to their levels of job dissatisfaction and very few are leading to levels of satisfaction. They are experiencing issues with interpersonal relationships, recognition, and working conditions. Interpersonal relationships are the largest of the hygiene factors contributing to job dissatisfaction of the nurses, which is also causing issues with collaboration between the nurses and the physicians. Although there are relationships present between the nurses and other members of the staff such as technicians and administrators, these are not enough to outweigh the negative effects given from the minimal relationships with the