Nursing
<Title of the academic institution>
Introduction
The issue of leadership in all its complexity has become a popular, if not fashionable, in various professional fields. The value that can be created throughout adaption and implementation of various leadership styles, techniques and paradigms, is now commonly acknowledged. In this regard Nursing is no exception. Appropriate forms of leadership may contribute positively both to daily routines of professionals and the long-term impact on the community development and their own professional progression.
This research will concentrate on theoretical description and analysis of the issue of leadership in Nursing, provide a respective literature review on the topic, identify key elements and respective practical approaches as well as provide some empirical data based on the cases which were outlined in academic literature.
Aim of the research
The purpose of this research is to assess various concepts of leadership regarding Nursing and define the ones which are the fittest for the nursing personnel throughout their professional duties.
Literature review
There are currently plenty of various academic sources concerning leadership in Nursing, so it would be reasonable to pick the ones that reflect a wide range of concepts and theories.
The other valuable academic source of information regarding leadership in Nursing is “Leadership and Nursing Care Management” by Jean Nagelkerk. Apart from assessment of the issue of leadership from similar positions as Loveridge, the author introduces a new aspect of the application of leadership skills, namely career management of the personnel. Such aspects of professional duties as time and stress management (p.25), advanced education and training (p.23), development of and adherence to certain ethical values (p.28) are considered to be a part of an individual leadership development system and need to be enhanced on a permanent basis. The author does not go too deep into the theory of the issue, yet he provides several effective tools for self-based assessment. This book is more of a practical interest and provides certain guidelines for development of leadership skills and techniques primarily in the context of professional and personal development.
The third book which has been used in this research is “Transformational Leadership in Nursing: From Expert Clinician to Influential Leader” by Elaine Marshall. This research is concentrated on a relatively narrow aspect of leadership – namely transformational leadership, which stands for the ability to transform the processes and attitudes throughout a set of certain specific social and professional skills. Such kind of leadership is the most prevalent for environments with a high extent of uncertainty and unpredictability, in which swift and influential decisions often need to be made. The book provides justification of such leadership style for the healthcare system (p.6) and defines the main traits of a successful transformational leader, even referring to him or her as “leaders among leaders” (p. 101). The aspects of analysis of transformational leadership in this context include assessment of the leader, evaluation of the team structure that allows to exploit the advantages of transformational leadership and create the fluently operating organizational and financial system in order to provide sufficient flexibility for the decisions to be carried out.
All three sources mentioned above provide valuable information regarding the concept of leadership in Nursing and offer several important theories to consider.
Uses of the concept of leadership in Nursing
There are two primary purposes of the practical application of concept of leadership in Nursing. The first one is improvement of the overall quality of service and increase in efficiency of solving professional tasks both at daily operational level and in the strategic perspective. Innovative methods of handling patient situations allows to reach a positive outcome in the areas of communication and medical treatment. Shared leadership, as described by Loveridge (p.110) provides a mechanism of establishing proper personal connection both with patients and peer medics, therefore increasing the flexibility of the decision-making process and allowing to manage delicate or complex situations in the most productive way. Behavioral patterns involving transformational leadership, although being perceived as a predominantly managerial domain (Marshall, p. 127), may also contribute to the increase of efficiency at all levels, is the values of such method are equally understood by all the stakeholders of the process, both Nursing professionals and patients.
Another usage of the leadership concept lies in the field of personal evolution and professional advancement. As demonstrated by Nagelkerk (p.25), the elements of strategic planning of career duties and perpetual personal and professional improvement also involve elements of leadership. In this case it would be reasonable to speak of transformational leadership which is more internal than external by nature. Various methods of evaluation of leadership capabilities, either imposed by the management (Loveridge, p.113) or peer or self-based (Nagelkerk, p.30) are an effective tool of diagnosing a leadership potential and creating a program of sustainable leadership development.
Defining attributes
There are several defining attributes of a leader in the professional field of Nursing, however there are two of those that appear to be most prominent. It may be said that those are ability to influence and strict adherence to ethical principles.
The first one is being presented in the shapes of shared and transformational leadership. Both these methods involve an ability of a professional to reach the planned goals and use the available resources in order to do so. While shared leadership is an organizational term which refers to the shared decision-making process and planning, transformational leadership is more of an operational concept, which involves adjusting or completely transforming the environment and respective operations and routines in order to increase efficiency, be it regarding any specific project or the lifecycle of the organization, in general. Due to this connotation of terms, one style of leadership does not automatically exclude the other, and they may easily overlap.
The ethical component of leadership in nursing is extremely important. Due to the delicate nature of the profession, Nursing professional may not use certain leadership styles, such as dictatorial leadership (Loveridge, p.121). Furthermore, even authoritative leadership, once prevalent in medical institutions is changing towards shared leadership due to the reasons of ethical, professional and legal nature.
Model cases
Leadership is not an easily quantifiable substance, therefore several attempts have been made in order to overcome this discrepancy and obtain the possibility to measure it in the least inefficient way.
The first case of leadership assessment is based on the Ohio system, which was developed in the second half of the 20th century and involves evaluation of an individual according to two criteria – initiating structure (compliance with the framework of the organization and ability to operate within it) and consideration (social skills and their effectiveness in leadership). According to these criteria respondents were divided into 4 quadrants (Loveridge,p.107), with Quadrant 1 (strong initiating structure and consideration) representing the strongest leadership skills and potential and Quadrant 3 (weak initiating structure and consideration) being the weakest.
The other case which helps to quantify the leadership potential and behavior of the Nursing personnel is the Leadership grid developed as a result of Michigan leadership studies (Loveridge, p. 110). The grid has 2 axes – Concern for people and Concern for results with grading from 1 to 10. The combination of results based on self-assessment and peer feedback allows to obtain a specific result for every given professional and determine his or her compliance with the leadership paradigm and adherence to the ethical paradigm.
Alternative cases
There are two cases which demonstrate the discrepancy between the original implementation of the leadership values and the final results. According to the Path-Goal concept, the means and original premises of the leadership incentive are not fixed and therefore may transform over time (Loveridge, p.111). On the other hand, the case of Contingency concept there is a possibility of implementing a complex leadership structure both for long-term and short-term managerial goals, and the role of formal management in this regard seems to be much higher than in any of the situations described above (Ibid., p.109).
Antecedent and consequence
The primary antecedent of the described concept was the theory of formal leadership. In the medical field there was a prevalence of strict, inflexible and often authoritarian leadership styles with a strong role of formal managerial hierarchy. The consequence of the new paradigm of leadership in Nursing is the implementation of completely new principles of internal and external interactions of the medical personnel, increase of efficiency of coordination of efforts and resources as well as a deeper involvement of all stakeholders into the process.
Empirical referents
Throughout the research papers provided above there have been several empirical examples of the evaluation of leadership skills and potential, as well as their impact on the overall professional operations. One of such practical endeavors was demonstrated by Nagelkerk throughout his attempts to analyze the main components of leadership development among Nursing professionals (p.2). The other example relates to the usage of the Leadership grid, which allowed to define certain categories of leaders by the means of an empirical research (Loveridge, p.108).
Conclusion
The topic of leadership in Nursing is extremely deep and interesting by nature. It involves components of the general theory of leadership as well as certain specific professional components. It is clear from the research that the leadership techniques are being developed rapidly, yet it is the matter of the future that the most effective leadership apparatus is at last discovered and implemented.
References
Loveridge, C.E.(1996). Nursing Management in the New Paradigm. Aspen Publishers, Inc.
Nagelkerk, J.(2006). Leadership in Nursing Care Management. Evolve.
Marshall, E.(2011). Transformational Leadership in Nursing: From Expert Clinician to Influential Leader. Springer Publishing Company, LLC.
