Leadership is an inherent and an essential element within the role of the nurse (Patterson & Krouse, 2015). Whether in the academic or in the clinical milieu, the nature of the nursing work places her in a position to take a leadership role, first, in guiding patients in their personal or guided care, and, second, in taking initiatives to improve nursing services and quality patient care. I have interviewed a professional nurse in a leadership role within a large hospital with expectedly high volume of emergency patients. Retailing her case provides a good review on the extent a nursing leader should be prepared for the role, even in the absence of a mentor in those times they were still trying to make sense a role thrust into them by their professional obligations. I made an effort to integrate materials from peer-reviewed sources in order to affirm the nursing leader’s views as well as enrich the breadth of the word-efficient storyteller.
Description of a leader: The interview subject was the Interim Nurse Manager (thus, I will be referring to her thereafter as “INM”) for more than a year in a very large Emergency Department, supported by 300 healthcare professionals and support staffs. Here primary responsibilities include staff allocation and schedule management; overtime application approval; payroll distribution; staff discipline; coaching; staff training when necessary; implementation of suspension orders; conduct staff meetings; and attend department-level meetings, among others. Before her assignment to this post, she was Assistant Nurse Manager for five years, handling relative similar responsibilities with only a few upgraded responsibilities.
Qualities of an effective leader: INM’s descriptions of a leader appeared somewhat largely idealist because, as she admitted, she had encountered only a few leaders among the many managers she knew in her years in the profession. Based on her knowledge on the members of her leadership team, she felt her ideas diverge with that of her team mates. Although did not elaborate the extent of that divergence was. Nevertheless, she believed that a leader is not born but molded by her life experiences and family upbringing. In a sense, leadership cannot even solely develop from work or professional experiences.
Nevertheless, INM described effective leaders as primarily motivating to those the leader leads (Frandsen, 2014; Yuswanto, et al., 2013). If leaders could not motivate their team to work effectively; then, their resulting poor results and unmet goals would reflect to the leaders’ qualities. Logically, consistently poor results would redound to the morale of the team. Logically, if the leaders allow that to happen; then, they are not effective leaders. In essence, a leader’s results defines her effectiveness. Thus, a successful team brings on a successful leader in the same manner that a successful leader brings the best of its team.
Moreover, a “good” leader, she felt, can only be as good as the team that would follow the leader. In effect, she opined that the qualities of a leader will be defined by, associated with, and even strongly tied with the people who followed the leader. Nonetheless, she believe that leaders should be trustworthy (i.e., “with integrity”: Frandsen, 2014; Yuswanto, et al., 2013), accountable, enthusiastic, energetic, authentic, a great motivator (Frandsen, 2014), and skillful in “clearly communicating” (Frandsen, 2014) to the team its goals.
In addition, a good leader, INM said, would provide “praises and rewards” (Frandsen, 2014) where needed as well as “encouragements” to motivate her team to enhance its performance (Yuswanto, et al., 2013; Curtis, de Vries, & Sheerin, 2011), that is, in providing the best care services to patients (Frandsen, 2014; Yuswanto, et al., 2013). The leader also must have superb people skills; that is, interpersonal or relationship skills (Curtis, de Vries, & Sheerin, 2011). Without explicitly indicating whether or not these characteristics were her own, she described a “good” leader as a goal-definer (particularly, “realistic goals”: Frandsen, 2014), a provider of support and resources (Curtis, de Vries, & Sheerin, 2011) that the team needs to accomplish its goals.
Personal leadership style and philosophy: INM considered her leadership style as consistent with the path-goal theory, an approach that involves primarily behavioral medication of the leader in order to influence positively the behaviors of the followers, thus, stimulating satisfaction and work performance (Chavaglia, et al., 2013). Moreover, she contended that, each situation at work demands differently. Conversely, each leader has different needs in relation to their experiences and training. Frandsen (2014) agreed that the diverse situations occurring in the hospital, a variety of leadership styles may be used effectively to deal effectively with the situation at hand.
Moreover, INM’s leadership philosophy can be described in a single concept: positive role modeling. She believed that the leaders must lead by example; thus, a positive role model to her team. Frandsen (2014) and Curtis, de Vries, and Sheerin (2011) maintained that, whether positively or negatively, a nursing leader is always an example to others. This is so because demonstrated leadership has been known to foster leadership behaviors in others (Curtis, de Vries, & Sheerin, 2011), often without being consciously aware of it. Subsequently, INM admitted of learning so much from the members of the hospital administration and the kind of leaders they did not want to be. It is possible then that leadership by action is possible. In effect, opportunities to practice leadership can as valuable and developmental as observing and modeling leadership skills (Curtis, de Vries, & Sheerin, 2011).
Most influential leadership learning experiences: Perhaps due to the limited direct influences to her the leadership capabilities of others, INM had no awareness of a learning experiences, which influenced most her leadership approach. Consequently, she simply left out describing these learning experiences in specific details. Her case exemplifies the existence of the real gap between education and the demands for leadership in the clinical setting (Curtis, de Vries, & Sheerin, 2011).
The value of mentorship in nursing leadership: Although INM might have preferred to obtain a leadership mentor in her place of work, she never had one. In effect, she had to learn leadership on her own efforts, often through trial and error and, at times, by observing leaders outside the organization. She had to grow in her leadership knowledge and skill on her own efforts without any wise guide to consult with. Curtis, de Vries, and Sheerin, (2011) suggested that nursing leadership can be learned in three different channels: (1) educational activities (e.g. formal leadership training), which INM did not receive; (2) modelling, which INM also did not enjoy); and (3) actual practice of leadership, the route of learning leadership skills that INM followed with much fruits.
And, yet, that is of no surprise as many nurse leaders lack the formal education in leadership (Patterson & Krouse, 2015), a real gap between nursing education and leadership education (Curtis, de Vries, & Sheerin, 2011), which makes their leadership qualities hard-earned or, perhaps, an offshoot of raw leadership talent. Nevertheless, in her current managerial role, INM must provide mentorship support to her staff (Yuswanto, et al., 2013), at least to ensure that her lack of support will not be experienced by those aspiring leaders in her current service team.
Most challenging issues in the current post: INM responded outrightly about communication as the most challenging problem she observed being grappled together among members within the leadership team and with other healthcare employees. Of the 14 core competencies that the American Association of Colleges of Nursing for the clinical nursing leadership role (Curtis, de Vries, & Sheerin, 2011), perhaps communication is the most difficult to master, while representing the difficult obstacle to overcome at work. Clear communications require a cognitive sharpness that cannot be disturbed by the overwhelming clinical demands.
Current evolution of nursing leadership: INM observed that the current evolutionary trend in nursing leadership would be centered upon collaboration and partnering with other professional teams in the medical care institution.
An advice to nurses aspiring for a leadership role: INM advised aspirants to leadership opportunities to pick a unified team and members with strong communication skills; thus, an advice consistent with the observation of Frandsen (2014) that “behind every successful people” there exists a team who “supports their leader” and opens the way for “success through combined efforts”.
In any organization, success is highly dependent upon the competency of its leadership team (Patterson & Krouse, 2015). Institutions that provide nursing care is no exemption to this condition. Although many leaders were more made than born, nursing leader INM appeared to born a leader even if she disbelieved the possibility of being so. Growing in her leadership role without a formal education on leadership signals a raw talent potentially in-born to her.
Nevertheless, born or made, nursing leaders must embrace their leadership roles with generosity and gratitude on receiving a rare opportunity to lead others, which may not be available to others who wanted the role. Nurses, compared to other healthcare professionals, comprised the highest number of population in any healthcare institution (Curtis, de Vries, & Sheerin, 2011).
Above all, leadership is, at times, as much a calling as it is to be a nurse. Nurses should be brave enough to respond to that call and embrace it.
References
Chavaglia, S.R.R., Dela Coleta, M.F., Dela Coleta, J.A., Mendes, I.A.C., & Trevizan, M.A.
(2013). Adaptation and validation of the charismatic leadership socialized scale. Acta Paul Enfermaria, 26(5): 444-454.
Curtis, E.A., de Vries, J., & Sheerin, F.K. (2011). Developing leadership in nursing: Exploring
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Frandsen, B. (2014). Nursing leadership: Management & leadership styles. Denver, CO:
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Patterson, B.J. & Krouse, A.M. (2015, March/ April). Competencies for leaders in nursing
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Yuswanto, J.T.A., Yulifah, R., Nurrachmanh, E., Sitorus, R., & Darmawan. (2013, July-August).
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