Essay on Leadership in Clinical Nursing and Management
Leadership is an important aspect of almost any industry. Most people would often think that leadership is only important in industries that are related to business or making profit. It is only logical to think that leadership is important in all aspects of managing an organization because an organization without an effective leader would not be able to survive the harsh business environment that is prevalent in a highly interconnected world economy. There are sources that suggest that leadership is part of a learning process. The objective of this paper is to discuss the importance of leadership and management in the field of nursing, particularly to support the idea that suggests that not all leadership is about changing or challenging people’s vision of the future. The author of this paper will draw on previously published literature on the topic of clinical leadership and management in the field of nursing to support the assumptions and inferences that will be made in this paper.
A leader, regardless of the type of organization or the processes and operations that it is involved in, is often described as someone who can easily inspire others to do orders and work together in order to achieve the goals of the company or organization. In this case, we are talking about an organization that is involved in the nursing industry. Examples of goals that a good leader in the nursing leadership can do are the enhancement of the quality of patient and healthcare, accessibility, and affordability, among others. This would of course vary from one organization to another, depending on the focus of the leader, and the current issues and problems that the nursing organization faces. Regardless, an effective clinical management and nursing leader should be able to know how to manage the available funds and financial resources, among others that can be used to fuel a project or any organization-related campaign, in order to achieve the organizational goals and objectives. This is where the effectiveness and skills of a leader in the nursing industry would be tested. Naturally, a leader who shows greater promise in meeting the organization’s clients and senior leaders’ expectations, or ideally, in outperforming them, would be considered as more effective compared to one that shows less promising results.
A common assumption in organizational management is the one that suggests that leadership is all about changing or challenging a group of people’s vision of the future. This assumption may pertain to the various changes that any leader of an organization would have to spearhead in order for the organization to reach its goals and objectives. This, at some point, may be considered to be true because after all, a company would not be able to grow without introducing significant changes to the way how things are organized from the chain of command down to the way how each small processes and operations are carried out (Stanley, Congruent Leadership: Values in Action, 2008). Often, the greater the changes that have been introduced, the better it would be for the organization in the long run, provided that everything from the planning process down to the part where the planned processes have to be implemented were properly executed. This is not to say, however, that all management-induced organizational changes lead to better results for the organization because there are surely other organizational change management plans that go awry. This is why there are indicators that can be used to access the effectiveness of a leader, regardless of the industry and one of such indicators is his ability to overcome the hindrances to meeting the organizational goals and objectives.
The idea of continuous innovation is not only used in the field of technology. It may also be considered important in other fields such as in the field of nursing in this case. Any nursing organization which has failed to continuously innovate either the delivery of its product and services or the quality of its products and services themselves would surely suffer from the negative consequences of being left out by its competitors who have managed to do the opposite — to continuously introduce innovations despite the often high price that organizations have to pay for it. Introducing innovation is not a one-night thing. It is rather a continuous process and most of the time, the leader of the organization plays a major role on whether an organization would be highly innovative or otherwise (Stanley, 2011). Also, the process of introducing innovation is often coupled with the process of introducing changes. Innovation is something that would not be made possible without introducing changes. This actually brings us back to the main question about the validity of the idea that suggests that leadership is all about introducing changes and challenging people’s vision of the future. An effective leader would surely be able to find a workaround on how to introduce innovations without having to make dramatic changes or even go to as far as challenge the people’s vision of the future (Howieson & Thiagarajah, 2011), unless the aspect of the organization that the leader would like to change is the vision of the organization itself.
In a nursing organization, the role of the leader is often geared at improving the quality of healthcare delivered by the entire nursing team or department or if its quality is already at par with the organizational performance, maintaining it (Marquis & Huston, 2014). Other goals that the nursing leader may participate may have something to do with increasing the affordability and the accessibility of health and patient care. An effective leader often exhibits a set of personal qualities that would help him surpass the hurdles involved in achieving the goals and objective of the organization, some of which include but may not be limited to persistence, initiative, integrity, courage, and his ability to handle stress. The leader’s ability to think critically, set goals and execute the necessary actions to meet those goals, communicate skillfully with other members of the team, be it a subordinate or someone who has a higher position, and collaborate with other people when it comes to nursing-related works and responsibilities are often the ones that would determine whether the organization’s vision and mission would be realized or not (Davidson, Becoming a nurse leader, 2010).
Nurses are often forced to be creative and innovative in their work. This is because they are the ones who usually have the first-hand experience in interacting with patients. They are often the ones who become compelled to make last minute decisions with regards to patient and healthcare (Marquis & Huston, Classical Views of Leadership and Management, 2012; Davidson, Elliott, & Daly, 2006). Nurses function as the front liners when it comes to patient care. At times, they often become required to do administrative works such as documenting the patients’ progressions and regressions. The same is, in fact, true for nurse leaders, except for the fact that they have the added responsibility of managing and leading people. Also, their co-nurses look up to their nurse leaders and often, an ineffective and highly inefficient nurse leader creates an equally ineffective and highly inefficient set of new nurse leaders as well. In the end, the purpose of the nursing leader would always have something to do with the ultimate goal of meeting the expectations of the entire department in meeting department and organizational goals and objectives.
In conclusion, the role of the nursing leader in a clinical leadership and management in the nursing industry is more concerned with the fundamental goal of effectively and efficiently executing the conceptualized plan of actions in order to reach the set organizational goals and objectives than changing and or challenging the people’s vision of the future. At some point this is true but there is more to being a leader than just introducing changes to the organization and stimulating changes among one’s subordinates. The idea is to see the bigger picture of being a leader and just by doing so, one would be able to determine that being a nursing leader is not just about changing or challenging the people’s vision of the future. In this case, being a nursing leader is more concerned with being a role model to the people, exhibiting the signs of being a leader such as having integrity and excellent communication skills, among other traits of being an effective nursing leader.
More notes
In addition to the changes in nursing practice and education discussed in Chapters 3 and 4 , strong leadership is required to realize the vision of a changed health care system. Although the public is not used to seeing nurses as leaders, and not all nurses start their careers thinking about becoming leaders, all nurses must be at the forefront of designing, implementing, and evaluating ongoing reforms and advocacy System that is needed. In addition, nurses need leadership skills and competencies to work as full partners with doctors and other health professionals to redesign and reform the health care system. In nursing research and practice, evidence-based improvements in nursing must continue to be identified and developed. These improvements need to be tested and adopted through policy changes across the healthcare system. Nursing directors must translate new research results into practice and nursing education, and from nursing education into practice and politics.
Being a full partner goes beyond all levels of the nursing profession and requires leadership skills and competences that must be used both within the profession and in collaboration with other health professionals. In care environments, as a full partner, it means taking responsibility for identifying problems and waste areas, creating and implementing a plan for improvement, tracking improvement over time, and making the necessary adjustments to achieve set goals. Nurses who are strong patient representatives need to be involved in making decisions about how to improve service delivery.
Being a full partner means more health policy. In order to be effective in redefined roles and to be seen and accepted as a leader, nurses need to see politics as something that they can shape and develop, not something that happens to them, be it at the local or national level , They have to speak the language of politics, be effectively involved in the political process and work coherently as a profession. Nurses should have a voice in health care decision-making and be involved in the implementation efforts related to health care reform. Nurses should also actively participate in advisory committees, commissions, and committees where policy decisions are made to improve health systems and improve patient care. Nurses need to build new partnerships with other clinicians, business owners, philanthropists, elected officials and the public to make these improvements happen.
This chapter focuses on key message # 3 in Chapter 1 : Nurses should be comprehensive partners in health care redesign in the United States, with doctors and other health professionals. The chapter begins by considering the new style of leadership that is required. The nurses are then called to respond to the challenge. The third section describes three ways in which nursing leadership programs, mentoring and political decision-making can be responded to. The chapter then calls for new partnerships to unlock the full potential of nurses for leadership in healthcare. The final section contains the Committee’s conclusions on the need to change leadership in the nursing profession.
A NEW STYLE OF LEADERSHIP
Those involved in the health system – nurses, doctors, patients and others – play an increasingly interdependent role. Problems arise every day for which there are no simple or unique solutions. Managers who only give instructions and expect them to be followed will not succeed in this environment. What is needed is a leadership style that includes working with others as full partners in a context of mutual respect and collaboration. This leadership style has been associated with improved patient outcomes, reduced medical errors, and lower staff turnover (Gardner, 2005; Joint Commission, 2008; Pearson et al., 2007). It can also reduce the extent of bullying and disruptive behavior in the workplace, which remains a problem in the health sector (Joint Commission, 2008; Olender- Russian, 2009; Rosenstein and O’Daniel , 2008). However, while the benefits of collaboration among health professionals have repeatedly been documented in terms of improved patient outcomes, reduced lengths of hospitalization, cost savings, increased job satisfaction and retention among nurses, and improved teamwork, interprofessional collaboration is often not the norm in the healthcare field. Changing this culture won’t be easy.
The new leadership style that is needed flows in all directions at all levels. Everyone, from the bedside to the boardroom, needs to involve colleagues, subordinates, and managers so that they can identify and achieve common goals together (Bradford and Cohen, 1998). All members of the health team must participate in the collaborative management of their practice. Doctors, nurses and other health professionals need to work together to break through the walls of hierarchical silos and be mutually accountable to improve quality and reduce avoidable adverse events and medication errors. Everyone must have the ability to adapt to the ever-evolving dynamics of the health system.
leadership skills
Nurses at all levels need strong leadership skills to contribute to patient safety and quality of care. But their history as a female-dominated profession can make it easier for policy-makers, other health professionals, and the general public to see nurses as “functioning doers” – those who follow the instructions of others – and not as “thoughtful strategists” who are informed decision-makers and whose independent action is based on education, evidence and experience. A 2009 Gallup – Survey of more than 1,500 national opinion leaders , 1 “Bedside Nursing Leadership to Session: Opinion Leaders’ Perceptions” identifies nurses as’ one of the trusted sources of health information ‘(see Box 5-1 ) (RWJF, 2010a) , The Gallup survey also identified nurses as healthcare professionals who should be more influential than currently in critical areas of patient care and safety quality. The executives interviewed felt that major obstacles prevent nurses from having a greater impact on health policy making. These results have a critical impact on frontline nurses who have critical knowledge and awareness of the patient, family and society, but who do not speak as often as they should.
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BOX 5-1
Results of the Gallup survey “Nursing leadership from bedside to boardroom: perception of opinion leaders”. Opinion leaders rate doctors and nurses first and second from a list of options for trustworthy information about health and health (more …)
In order to be more effective leaders and full partners, nurses need to have two key competencies: a common group that can serve as the basis for any leadership opportunity, and a more specific group tailored to a specific context, time, and location , The first sentence includes knowledge of the nursing system, working in teams, effective collaboration within and between disciplines, the basic principles of ethical nursing, the ability to work for patients, and theories of innovation as the basis for improving quality and safety , These skills are also recommended by the American Association of Colleges of Nursing as essential for high school programs (AACN, 2008). The leadership competencies recommended by the National League for Nursing and the National League for Nursing Accrediting Commission are being revised to reflect similar principles. More specific skills could include learning how to be a full partner in a health team, where members from different professions hold each other responsible to improve quality and reduce avoidable adverse events and medication errors. In addition, nurses interested in entrepreneurial and business development opportunities need skills in areas such as business and market forces, regulatory frameworks and funding policies .
Leadership in a collaborative environment
As mentioned in Chapter 1 , a growing body of research has started to identify the potential for teams of different people from different professions to work together (Paulus and Nijstad , 2003; Pisano and Verganti , 2008; Singh and Fleming, 2010; Wuchty et al. 2007). Practitioners and leaders have said that collaboration is a key strategy to improve problem solving and innovate in healthcare. Two nursing researchers who have examined the collaboration between health professionals define them as
A communication process that promotes innovation and progressive problem solving among people who come from different disciplines, organizational ranks or institutional environments and who combine to form progressive problem solving to recognize innovative solutions regardless of discipline, rank or position, institutional affiliation, based on changes to bring about higher standards of care or organizational results. ( Kinnaman and Bleich , 2004)
Much of what is called collaboration is more likely collaboration or coordination of care. Katzenbach and Smith (1993) argue that truly collaborative teams differ from highly functional groups that have a defined leader and direction, but lack the dynamics of real teamwork. The case study in Box 5-2 shows how important it is that health professionals work together in teams to ensure that care is accessible and patient-centered.
