INTRODUCTION:

Today’s professional nurse assumes leadership and management responsibilities regardless of

the activity in which they are involved. Although leadership and management roles are
different, they are frequently intertwined. Leaders focus on people, whereas managers focus
on systems and structures. The ability to advocate for the client is linked to the nurse’s
leadership ability. The nurse may be a leader or manager in the care of the individual client,
the client’s family, groups of clients, or the community. Regardless of the setting, the nurse
must demonstrate leadership and management skill in interacting with nursing colleagues,
nursing student, physicians, and other health professionals.

DEFINITION:

“Leadership is the process of influencing and supporting others to work enthusiastically

toward achieving objectives”.

Alan Keith of Genentech states that "Leadership is ultimately about creating a way for people
to contribute to making something extraordinary happen."

According to Ken "SKC" Ogbonnia, "effective leadership is the ability to successfully

integrate and maximize available resources within the internal and external environment for
the attainment of organizational or societal goals."

FEATURES OF LEADERSHIP:

An analysis of the definition brings its certain features which are as follows:

1. Leadership is a continuous process of behaviour. It is not one-shot activity.

2. Leadership may be seen in terms of relationship between a leader and his followers
which arises out of their functioning for common goals.
3. By exercising his leadership, the leader tries to influence the behaviour of individuals
or group of individuals around him to achieve common goals.
4. The followers work willingly and enthusiastically to achieve those goals, thus there is
no coercive force which induces the followers to work.
5. Leadership gives an experience of help to followers to attain common goals. It
happens when the leader feels the importance of individuals, gives them recognition,
and conveys them about the importance of activities performed by them.
6. Leadership is exercised in a particular situation, at a given point of time, and under
specific set of circumstances.

VIEWS ON LEADERSHIP:

Leadership is viewed in diverse ways- sometimes as a position, sometimes as a personality

trait or a quality which causes other to follow, comply, or be persuaded to the leader’s point
of view, sometimes as a power relationship, and sometimes as a process. According to
Webster’s Third New International Dictionary of the English Language a leader may:

 Cause others to go along

 Guide others along the way.
 Cause others to live a particular kind of life.
  Head or direct operations.
 Bring others by reasoning or other influences to some conclusion.
 Be in the advanced position.
 Direct a blow against an opponent.

Older views of leadership include that it involves “interaction between members of a

group that initiates and maintains improved expectations & the competence of the group
to solve problems or attain goals” and that it is a process of influencing individual or
groups to take an active part in the process of achieving agreed- upon goals.”
Transactional outcomes were emphasized in these definitions. More recent definitions of
leadership emphasize mutuality, empowerment, and transformational processes.
Leadership as a democratic process that respects people, encourages self management,
and moves people in some direction. Leaders inspire commitment and empower people
by sharing authority. They are not satisfied with simply transactional outcomes; rather
they want to be transformational.

DIFERENCE BETWEEN LEADERSHIP AND MANAGEMENT:

Leadership and management are related but they are not the same. A person can be an
effective manager, a leader or both or neither. This is due to the fact that leadership differs
from management on some counts as follows:

Leadership Management

1. Leadership deals with the vision- 1. Management deals with establishing

keeping the mission in sight-and with structure and systems to get those
effectiveness and results. results. It focuses on efficiency, cost-
benefit analysis, logistics, methods,
procedures and policies.
2. Leadership focuses on the top line. 2. Management focuses on the bottom line.

3. Leadership derives its power from 3. Management organizes resources to serve

values and correct principles. selected objectives to produce the bottom
line.

4. Leadership inspires and motivates 4. Management involves controlling and

people to work together with a monitoring results against plans, identifying
common vision and purpose. deviations, and then planning and organizing
to solve the problems.

5. Leadership emphasizes 5. Management focuses on transactional

transformational aspect and therefore aspect and therefore transactional leadership
transformational leadership emerges. emerges.
PRINCIPLES OF LEADERSHIP 

In order to know own self, one have to understand his or her be, know, and do, attributes.
Seeking self-improvement means continually strengthening own attributes. This can be
accomplished through self-study, formal classes, reflection, and interacting with others. 

1. Be technically proficient - As a leader, he/she must know his/her job and have a solid
familiarity with employees' tasks. 
2. Seek responsibility and take responsibility for actions - Search for ways to guide
organization to new heights. And when things go wrong, they always do sooner or
later -- do not blame others. Analyze the situation, take corrective action, and move
on to the next challenge.
3. Make sound and timely decisions - Use good problem solving, decision making, and
planning tools. 
4. Set the example - Be a good role model for the employees. They must not only hear
what they are expected to do, but also see. ‘We must become the change we want to
see’ - Mahatma Gandhi 
5. Know the people and look out for their well-being - Know human nature and the
importance of sincerely caring for workers.
6. Keep workers informed - Know how to communicate with not only them, but also
seniors and other key people. 
7. Develop a sense of responsibility in workers - Help to develop good character traits
that will help them carry out their professional responsibilities.
8. Ensure that tasks are understood, supervised, and accomplished - Communication is
the key to this responsibility. 
9. Train as a team - Although many so called leaders call their organization, department,
section, etc. a team; they are not really teams...they are just a group of people doing
their jobs. 
10. Use the full capabilities of organization - By developing a team spirit, one will be able
to employ organization, department, and section, to its fullest capabilities. 

FACTORS OF LEADERSHIP 

There are four major factors in leadership: 

Follower: Different people require different styles of leadership. For example, a new hire
requires more supervision than an experienced employee. A person who lacks motivation
requires a different approach than one with a high degree of motivation. The fundamental
starting point is having a good understanding of human nature, such as needs, emotions, and
motivation. The leader must become to know employees' be, know, and do attributes. 

Leader: Leader must have an honest understanding of- who is he, what he knows, and what
he can do. Also, note that it is the followers, not the leader who determines if a leader is
successful. If they do not trust or lack confidence in their leader, then they will be uninspired.
To be successful leader have to convince his followers, not himself or superiors, that he are
worthy of being followed. 
Communication: leader lead through two-way communication. Much of it is nonverbal.
What and how to communicate it must be well known to the leader so that good relationship
is established between leader and group. 

Situation: All are different. What do in one situation will not always work in another
situation. So, judgment must be used to decide the best course of action and the leadership
style needed for each situation. For example, leader may need to confront an employee for
inappropriate behaviour, but if the confrontation is too late or too early, too harsh or too
weak, then the results may prove ineffective. 

ATTRIBUTES

 If anyone is a leader who can be trusted, then those around him will grow to respect him. To
be such a leader, there is a Leadership Framework to guide : 

BE, KNOW, DO 

 BE a professional. Examples: Be loyal to the organization, perform selfless service,

and take personal responsibility. 
 BE a professional who possess good character traits. Examples: Honesty, competence,
candor, commitment, integrity, courage, straightforwardness, imagination. 
 KNOW the four factors of leadership - follower, leader, communication, and
situation. 
 KNOW own self. Examples: strengths and weakness of own character, knowledge,
and skills. 
 KNOW human nature. Examples: Human needs, emotions, and how people respond
to stress.
 KNOW own job. Examples: be proficient and be able to train others in their tasks. 
 KNOW the organization. Examples: where to go for help, its climate and culture, who
the unofficial leaders are. 
 DO provide direction. Examples: goal setting, problem solving, decision making,
planning. 
 DO implement. Examples: communicating, coordinating, supervising, evaluating. 
 DO motivate. Examples: develop moral and esprit in the organization, train, coach,
counsel. 

IMPORTANCE OF LEADERSHIP:

Leadership is an important factor for making any type of organizations successful.

Throughout the history, it has been recognized that the difference between success and
failure, whether in a war, a political movement, a business, or a team game, can be attributed
largely to leadership. Without a good leader, organization cannot function efficiently and
effectively. The importances of good leadership are as follows:

1. Motivating Employees: Motivation is necessary for work performance. Higher the

motivation better would be the performance. A good leader, by exercising his
leadership, motivates the employees for high performance. Good leadership in the
organization itself is a motivating factor for the individuals.
 2. Creating confidence: A good leader may create confidence in his followers by
directing them, giving them advice, and getting through them good results in the
organization. Once an individual, with the help of a leader, puts high efficiency, he
tries to maintain it as he acquires certain level of confidence towards his capacity.

3. Building Morale: Morale is expressed as attitudes of employees towards

organization, management and voluntary cooperation to offer their ability to the
organization. High morale leads to high productivity and organizational stability.
Through providing good leadership in the organization, employees’ morale can be
raised high ensuring high productivity and stability in the organization.

THEORIES

Many of the research studies, particularly by behavioural scientists, have been carried on to
find out the answer of the question: what makes a leader effective? Is his success due to his
personality, or his behaviour, or the types of followers he has or the situation in which he
works or a combination of all these? These researches, however could not give a satisfactory
answer of the question. Instead their researches have resulted in various theories or
approaches of leadership, the prominent among these beings---

 Trait theory
 Behavioural theory
 Situational theory and
 Systems theory.
TRAIT THEORY:

Until the mid-1940s, the trait theory was the basis for most leadership research. Early work in
this area maintained that traits are inherited, but later theories suggested that traits could be
obtained through learning and experiences. Researchers identified the leadership traits as
energy, drive, enthusiasm, ambition, aggressiveness, decisiveness, self-assurance, self-
confidence, friendliness, affection, honesty, fairness, loyalty, dependability, technical
mastery, and teaching skill. Asking them what traits leaders possess, various researchers
arrived at different conclusions but identified some common leadership traits:

1. Leaders need to be more intelligent than the group they lead. However, a
highly intelligent person may not find leadership responsibilities challenging
enough, may prefer to work with abstract ideas and research, and may have
difficulty relating to the group.
2. Leaders must possess initiative, the ability to perceive and start courses of
action not considered by others.
3. Creativity is an asset. Having originality-the ability to think of new solutions
to problems and ideas of new ways to be productive-is helpful.
4. Emotional maturity with integrity-a sense of purpose and direction,
persistence, dependability, and objectivity-is another important trait. Mature
leaders do what they say they will and are consistent in their actions. They
often work long hours, apply themselves intensely, and spread enthusiasm to
followers. Energy, drive, and good health are necessary to endure the long
hours, overcome obstacles, and sustain continuous achievement. Self-
assurance is self-confidence. It is hoped that leaders perceive themselves as
effective problem solvers who can successfully handle the difficulties that
confront them.
5. Communication skills are important. The leader needs to understand others
and speak and write clearly.
6. Persuasion often is used by leaders to gain the consent of followers. The
leader may make suggestions, supply supportive data, ask penetrating
questions, make compromises, and request action to persuade others.
7. Leaders need to be perceptive enough to distinguish their allies from their
opponents and to place their subordinates in suitable positions.
8. Leaders participate in social activities. They can socialize with all kinds of
people and adapt to various groups. Approachable, friendly, and helpful, they
gain the confidence and loyalty of others in such a way that makes people
willing to cooperate.

The authoritarian leader maintains strong control, does the planning, makes the
decisions, and gives the orders. Autocratic leaders tend to be directive, critical,
and punitive. They may make decisions that are not in the best interest of the
group. They give themselves a higher status than the group members, which
reduces open communications and trust. They tend to get good quantity and
quality of output but little autonomy, creativity, or self-motivation. This can be
appropriate for an emergency situation when the leader knows what to do, but it
does not develop people.
IMPLICATION OF THE THEORY:

This theory has two very important implications.

 First, the theory emphasizes that a leader requires some traits and qualities to be
effective.
 Second many of these qualities may be developed in individuals through training and
development programmes.

LIMITATIONS:

The theory suffers from two sets of limitations---

1. Generalization of Traits—there are problems in identification of traits which

may be relevant for leader to be effective in all situations. From this point of
view, the theory suffers from the following limitations:
 There cannot be generalization of traits for a successful leader. This
was evident by various researches conducted on leadership traits.
 No evidence has been given about the degree of the various traits
because people have various traits with different degrees.
 There is a problem of measuring the traits. Though there are various
tests to measure the personality traits, however, no definite conclusion
can be drawn.
2. Applicability of Traits--- another set of problems that hinders the full
application of trait theory in practice, is that leadership as a process of
influence reflects in leader’s behaviour and not in his traits. There have been
many persons with traits specified for a leader, but actually they could not
become effective leaders. The reason for this phenomenon is that there is no
direct cause-effect relationship between a trait of a person and his behaviour.
The trait may be only one of the factors shaping behaviour; the other factors,
sometimes even more important, are situational variables. These situational
variables are not incorporated in trait theory.

BEHAVIORAL AND STYLE THEORIES

In response to the early criticisms of the trait approach, theorists began to research leadership
as a set of behaviours, evaluating the behaviour of successful leaders, determining behaviour
taxonomy, and identifying broad leadership styles. David McClelland, for example, posited
that leadership takes a strong personality with a well-developed positive ego. To lead, self-
confidence and high self-esteem are useful, perhaps even essential.

Kurt Lewin, Ronald Lipitt, and Ralph White developed in 1939 the seminal work on the
influence of leadership styles and performance. The researchers evaluated the performance of
groups of eleven-year-old boys under different types of work climate. In each, the leader
exercised his influence regarding the type of group decision making, praise and criticism
(feedback), and the management of the group tasks (project management) according to three
styles: authoritarian, democratic, and laissez-faire.
The managerial grid model is also based on a behavioural theory. The model was developed
by Robert Blake and Jane Mouton in 1964 and suggests five different leadership styles, based
on the leaders' concern for people and their concern for goal achievement.

IMPLICATIONS OF THE THEORY

Behavioural theory of leadership has some important implications for managers. They can
shape their behaviour which appears to be functional and discard the behaviour which
appears to be dysfunctional. Researchers who have taken behavioural theory for analyzing
leadership behaviour have prescribed various leadership styles which may be applied in
managing the people in organizations.

LIMITATIONS:

This theory suffers from two basic limitations----

1. A particular behaviour may be functional at a point of time but

it may be dysfunctional at another point of time.
2. Effectiveness of leadership behaviour depends on various
factors which are not in the leader but external to him like
nature of followers (subordinates) and the situations under
which the leader’s behaviour takes place.

SITUATIONAL AND CONTINGENCY THEORIES:

Situational leadership approach was applied, for the first time in 1920 in the armed forces of
Germany with the objective to get good generals under different situations. In the business
organizations, much emphasis on the leadership researches was placed on the situations that
surrounded the exercise of leadership since early 1950s.
The prime attention in Situational theory of leadership is given to the situation in which
leadership is exercised. Therefore, effectiveness of leadership will be affected by the factors
associated with the leader and factors associated with the situation.

Leader’s Leader’s

Characteristics hierarchical position

Leader’s behaviour Leadership effectiveness Group performance

S I T U A T I O N A L F A C T O R S

Subordinate’s Leader’s Group Organizational

Characteristics situation factors factors

Factors affecting leadership effectiveness

The various factors affecting leadership effectiveness may broadly be classified into two
major categories.

1. Leader’s behaviour.
2. Situational factors.

The combination of both these factors determines leadership effectiveness.

1.Leader’s behaviour:

Leader’s behaviour is affected by two variables – (i). Learder’s characteristic and (ii) his
hierarchical position in the organization.

Learder’s characteristic -- an individual’s behaviour is influenced by intelligence and

ability, his characteristics like his personality characteristics, attitudes, interest, motivation,
and physical characteristics such as age, sex and physical features. Thus, the behaviour of the
leader is also influenced by all these factors. All these factors are internal to the leader.
Hierarchical position--- Leader’s hierarchical position in the organization is important
because persons at different levels face different kind of problems which affect the degree of
participation between the superior and his subordinates in arriving at decisions to solve the
problems. Managers at higher levels are more concerned with long- run complex problems
which require more participation in decision making. Managers at lower levels are more
concerned with short- run problems involving the daily operations which may not require
high level of participation. The degree of this participation affects the leader’s behaviour.

2.Situational Factors

Besides the leader’s related factors, leadership effectiveness is affected by situational factors
as these factors affect the leader’s behaviour. To the extent, a leader matches the requirement
of these factors, his leadership will be effective. The various situational factors may be
grouped into four categories:

(i) Subordinate’s characteristics—various factors which affect an individual’s

behaviour.
(ii) Leader’s situation—the leadser’s situation in respect to his subordinate is an
important factor affecting leadership effectiveness. There are main two variables
which determine the leader’s situation: leader’s position power and leader-
subordinate relations. Leader’s position power helps or hinders in influencing
others. Thus, high –position power simplifies the leader’s task of influencing
others, while low- position power makes the leader’s task more difficult. Another
factor, that is, leader-subordinate relation is based on the classic exchange theory
which suggests that there is two-way influence in a social relationship. Thus good
followers need to succeed in their own jobs with the help of the leader while
helping their leaders to succeed at theirs. Thus if the leader has good subordinates
and good relations with them, he is likely to be more effective.
(iii) Group factors- various group factors like task design, group composition, group
norms, group cohesiveness, and peer- group relationship affect leadership
effectiveness and performance. If these factors are favourable , the leader will be
effective.
(iv) Organizational factors—Organizational factors like Organizational climate and
Organizational culture affect leadership effectiveness. If these are conducive, the
leader will be effective.

Implications of the theory

Situational theory has wide implications for managers in the sense that it offers clues why a manager
who is successful in one situation, falls when there is change in the situation. Therefore, the managers
may do better by adopting management practices including leadership which match with the
situational variables. In fact, the systems and contingency approach has become the way of thinking in
management and leadership is no exception.

This theory appears to be good on the surface but becomes quite complex in practice because of the
presence of numerous contingent factors. However, managers can overcome this problem by
diagnosing these factors suitably.
SYSTEM THEORY

The system theory of leadership suggests that leadership is an emergent phenomenon in the
form of integrative leadership out of interactions of agents (leaders and followers) within the
contextual variables lying within an organization and outside it. Integrative leadership is a
holistic approach to leading others in a reflective, thoughtful, and responsive way. Thus
leadership is a dynamically integrated process.

External environment

Efficacious adaptation

Integrative leadership

Task system Social system

Organizational Formal leadership Structural

constraints models

Emergent Influence Shared

leadership leadership

Task Agents

Requirements Interaction co-evolution

Task Many hetero-

Constraints geneous agents

Internal environment

An organization continuously interacts with its environment and adopts principles of

efficacious adaptation with a view to take suitable advantages of this interaction so as to
achieve its goals. Adaptation is a process through which a system makes itself suitable for
meeting its environmental requirements. Since the environment is dynamic, the organization
makes suitable changes in its working from time to time. With the result, the organization
devises its task and social systems keeping in view its external environment. There are
interactions within and between task and social systems. Task requirements of the task
system are affected by organizational constraints and task constraints in whose context a task
is performed. Agents’ co-evolution is affected by structural modes (organization structure,
rules, regulations, and other formal prescriptions) and existence of many heterogeneous
agents. Because of these interactions, four types of leadership patterns emerge in
organizations in stages.

(i)Formal leadership (ii) Emergent leadership (iii) Shared leadership (iv) Integrative
leadership.

Systems theory of leadership has opened a new thinking in analyzing leadership as it takes a
holistic approach. However, this theory is not very popular because of two reasons.

(i) This theory is still in evolutionary stage and many variables which affect
leadership have not been identified precisely.
(ii) This theory is quite complex because of involvement of numerous variables.

CONCLUSION:

As an individual the nurse must maintain her competence by continuing professional growth.
Effective nursing leadership is critically needed at all system levels. Through expert and
ethical use of leadership behaviours in conjunction with nursing and change processes, client
are empowered and thus enabled to achieve their goals for improved health, and nurses are
enriched in their practice and thus enabled to advance in their own career development.
SUBJECT:- NURSING MANAGEMENT

TOPIC:- LEADERSHIP CONCEPT,TYPE AND THEORY

VENUE: CLASS ROOM

GROUP: M.Sc. NURSING FINAL YEAR

NO. OF GROUP: 24

DATE:

TIME & DURATION: 2 HOURS

LANGUAGE: ENGLISH

T.L. METHOD: LECTURE & DISCUSSION

A.V. Aids USED: OHP, CHART, BLACK BOARD

NAME OF STUDENT TEACHER: PURNIMA MONDAL

NAME OF SUPERVISOR: MADAM A.BAGCHI

GENERAL OBJECTIVE: After the end of the discussion the student will be able to-

1) Gain knowledge on leadership, its type and leadership theory.

2) Develop positive attitude on effective nursing leadership.
3) Develop skill on effective leadership in nursing management.
TIME SPECIFIC T.L.ACTI A.V.A EVALUA
OBJECTIVE CONTENT VITY ids TION

2 Group will be
mint. able INTRODUCTION:
Today’s professional nurse assumes
leadership and management
responsibilities regardless of the
activity in which they are involved.
The ability to advocate for the client
is linked to the nurse’s leadership
ability.

1 ANNOUNCEMENT OF THE TOPIC

mint. Topic for discussion is leadership –
concept, type and theory.

DEFINITION Lecture Can you

2 To define Leadership has been described as the define
mint. leadership “process of social influence in which leadership
one person can enlist the aid and ?
support of others in the
accomplishment of a common task".

FEATURES OF LEADERSHIP:
5 Continuous process, seen in terms of
mints relationship, leader tries to influence
Discussio
the behaviour of individuals or group,
n
depend in particular situation, at a
given point of time.

VIEWS ON LEADERSHIP:
5 To describe Leadership is viewed in diverse
Mints the views on ways- sometimes as a position,
leadership sometimes as a personality trait or a
quality which causes other to follow,
comply, or be persuaded to the
leader’s point of view, sometimes as
a power relationship, and sometimes
as a process.
TIME SPECIFIC T.L.ACTIV A.V.Aids EVALUA
OBJECTIVE CONTENT ITY TION

OHP &
10 To list down DIFFERENCE BETWEEN Discussion black
mints the difference LEADERSHIP AND board
between MANAGEMENT :
leadership
and Leadership and management are related
management. but they are not the same. A person
can be an effective manager, a leader
or both or neither. This is due to the
fact that leadership differs from
management on some counts.

To describe PRINCIPLES OF LEADERSHIP 

8 the principles
mints. of leadership  Be technically proficient Lecture
Can you
 Seek responsibility and take tell some
responsibility for your actions principles
 Make sound and timely of
decisions leadership
 Set the example ?
 Know your people and look
out for their well-being
 Keep your workers informed
 Develop a sense of
responsibility in your workers
 Ensure that tasks are
understood, supervised, and
accomplished.
 Train as a team.
 Use the full capabilities of
your organization.
TIME SPECIFIC T.L.AC A.V.A EVALUATI
OBJECTIVE CONTENT TIVITY ids ON

10 Group will be FACTORS OF LEADERSHIP 

mints able There are four major factors in Can you
leadership:  describe
To describe major
the major factors of
 Follower
factors of leadership ?
leadership  Leader
 Communication
 Situation

5 IMPORTANCE OF LEADERSHIP :
mints
 Motivating employees.
 Creating confidence.
 Building morale.
Lecture

THEORY OF LEADERSHIP
To describe
the trait Trait theory Can you
10 theory Until the mid-1940s, the trait theory describe the
mint. was the basis for most leadership trait theory?
research. Early work in this area
maintained that traits are inherited,
but later theories suggested that traits
could be obtained through learning
and experiences.
OHP
Discussi
on
8 To explain Behaviours theory:
mints the behaviour In response to the early criticisms of
theory of the trait approach, theorists began to
leadership research leadership as a set of
behaviours, evaluating the behaviour
of successful leaders, determining
behaviour taxonomy, and identifying
broad leadership styles.
TIME SPECIFIC T.L.ACTI A.V.Aids EVALUA
OBJECTIVE CONTENT VITY TION

Lecture & OHP &

10 To describe Situational theory Discussio black board
mints the situational Situational theory also appeared as a n
theory reaction to the trait theory of
leadership. Social scientists argued
that history was more than the result
of intervention of great men as
Carlyle suggested.
10min
ts. To explain System theory
the system
theory The system theory of leadership
suggests that leadership is an
emergent phenomenon in the form of Lecture &
integrative leadership out of Discussio
interactions of agents (leaders and n
followers) within the contextual
variables lying within an
organization and outside it.
Can
2mint Summarization: Definition, anyone
s. concept, principles and different summariz
theory of leadership. e the
topic?
Conclusion:
1 Lecture
mints As an individual the nurse must &
maintain her competence by discussion
continuing professional growth.
Effective nursing leadership is
critically needed at all system levels.
Bibliography:

1. Prasad, L.M(2012) Principles and Practice of Management, eighth edition,

Sultan Chand and Sons educational publishers, 627-652.
2. Basavanthappa, BT (2009), Nursing Administration, second edition, jaypee
brothers medical publishers (p) LTD.
3.

 
 CONTENT
ON
Leadership----
Concept and Theory

Submitted to submitted by

Madam A. Bagchi Purnima Mondal

Reader final year M.Sc. Nursing Student

W.B.G.C.O.N
 LESSON PLAN
ON
Leadership---
Concept and Theory

Submitted to submitted by

Madam A. Bagchi Purnima Mondal

Reader final year M.Sc. Nursing Student

W.B.G.C.O.N