CNA417 Exploring Nursing Leadership

Leadership is seen as a multi-faceted process that entails the identification of goals, motivation of other people, and provision of support so as to attain a mutually negotiated objective (Porter- O’Grady, 2003). It suffices to mention that there several leadership theories and models that describes who is a good leader. The running and outstanding theme in these theories and models is that value of interpersonal skills. For instance, the “Great Man” theory portrays a leader as a totalitarian person who was born to lead. The trait theory asserts there are vital characteristics that identifies a good leader (Grimm, 2010). These traits include purpose, ethical considerations, confidence, courage, and the ability to compromise. As a nurse, I disagree with the assertions of this two theories. These theories are inevitable harsh in terms of suggesting that a leader ought to be the controller of all aspects. The two theories do not consider a leader to be someone who can motivate others to perform much better in their line of duties.  However much these traits are imperative to have, I think that the transformational theory that espouses the ideals of mutual stimulation and elevation to be very much appropriate. The transformational theory explains that a leader should be able to convert followers to become leaders and ultimately convert leaders to be moral agents.

It is imperative to note that a leader is tasked with realizing efficient performance form other people (Giltiname, 2013). The ability to influence other peoples’ performances is the ultimate goal of transactional theory, I strongly believe that a good leader should motivate his/her followers without necessary giving them reward. The attainment of set goals and objectives ought to be driven purely by motivation. It is my strong belief that an effective leader should be charismatic and possesses the right interpersonal skills. According to Marquis & Huston (2009) a leader influences and provides guidance to other people in terms of direction, course of action, and opinion. From my experience working in a surgical ward with several colleagues, I have realized that a leader might not always be the individual in a management role, but merely the person who can identify the duties that need to be completed as required. Such an individual should be able to motivate and support others to complete their tasks. I’ am of the opinion that a good leader should be in a position to acclimatize to different environment, grow, and change with the task requirements. In this regard, effective leaders should not be authoritarian and neither should they rely entirely on reward system to influence their followers.

The nursing practice requires management acumen. Nurses are expected to be great managers so that the professional can deliver the best health care. Sound management skills can be achieved through continued nurse education. It suffices to point out that it is imperative to prepare nurses to become managers through improving their leadership skills. This assertion is contracted by Newman et al. (2015) who opine that nurse managers are provided with inadequate preparation and limited support that contributes to increased levels of burnout, job satisfaction, and stress. In most cases, the organization demands influence the assigning of nursing managers, yet they are not adequately prepared to perform these tasks.

There are several obstacles that nurse managers go through in their daily activities. To curb these problems experienced by nurses, health organizations ought to prepare nurses adequately for leadership roles. Additionally, nurses should be encouraged to pursue additional courses that would enable them to acquire the requisite skills and competencies. Simulation classes can be used to help nurses to learn how to deal with challenges in their workstations. Simulation classes help nurses to be effective in decision-making, effective communication, and problem-solving (Thomas, Hodson-Carlton, & Ryan, 2011). Also, leadership competencies should be included in these programs to ensure that the nurses are well prepared and promoted to this position (McCallin & Frankson, 2010) as a result, nurses may not be experiencing any stress, low burnout and increase job satisfaction for nursing managers.

Management is a complex role.  I am still a novice nurse as far as management is concerned. I must opine that currently; I’m not required to perform management roles in my current position of registered nurse.  However, my career goal is to become a competent nurse who is a clinical leader.  This role also supports the Nurse Unit Manager in the running of the department, so I feel a good understanding of management will assist in this competent nurse position.

An organization requires proper management to achieve its objectives.  Management consists of the ability to create policy, plan, control and direct the organization. This needs managers with a wide variety of abilities to accomplish this. There are many attributes required of a manager, and those in management positions or contemplating leadership positions need to consider what attributes come naturally and what needs development.  According to Henriksen (2013), there are eight characteristics of a nurse manager. These characteristics include mentor, expert, participant, supporter, communicator, advocate, problem-solver/critical thinker, and arbitrator.  Frankel (2011) states the roles of nurses in senior positions have the following attributes: decision making, delegating appropriately, resolving conflict, acting with integrity, mentoring and coaching.  

It is imperative that managers have the knowledge of the system that they are working for. Additionally, it is essential for them to understand the duties that should be performed as part of their management role. Nurse managers are required to effectively manage people and the pertinent performance criteria that include financial targets and waiting time (Townsend, Wilkinson, Bamber & Cameron, 2011). I opine that managers are obligated to manage people effectively in addition to understanding core business of their undertakings. A study conducted by Townsend, Wilkinson, Bamber, & Allan, (2012) supports this notion by asserting that participative managerial style, quality of nursing, adequate consultation, resources, professional development, and personnel policies that support nursing are a prerequisite.

A not so recent article by Altman (1988) gives twelve criteria for evaluating the effectiveness of a manager.  These include: continuing management education, prioritizing, analyzing, power, human relations, availability, teaching/communications, receiving communications, concentration, planning, keeping in touch, listening.  This article aimed at lawyers; however, it also applies to management roles in general (Altman, 1988, p. 55-58).

I believe that a person’s background has no great influence on management skills. However, I strongly believe that good managers should have firm understanding as far as the departments that they manage are concerned. This experience includes clinical knowledge required for the department.  For example, my nursing unit manager doesn’t know how to triage; therefore, when it comes to making a managerial decision related to triage she seeks opinions and ideas from all staff that complete this task before making an informed decision on any changes.

Leaders play a significant role in the nursing care process. It is imperative to note that this position often affects nurses’ motivation and performance. Nurses can efficiently achieve the goals and objectives for any given health facility by ensuring that there is high-quality health care. According to Bennis (2010), there are four fundamental competencies for any successful leader. The first competency concerns management of attention. Numerous studies have shown that an effective leader requires a clear vision and goal for the attainment of set objectives. For instance, Patterson & Krouse (2015) demonstrated that a leader in nursing education ought to express and set goals to educate nurse who is incorporated with behavior and cognitive components. The second competency that is required of a nurse leader is the management of meaning. This skill calls for an efficient communication by a nurse leader in light of the goals and vision so as to make them real (Bennis, 2010). It is thus imperative that leaders should be able to convince nurses to adhere to the mission and vision of their health care facility. By doing this, nurses will be capable of understanding their roles and responsibilities towards the attainment of the goals. TuersFledman (2015) had a contrary opinion when he stated that if nurses cannot adhere to the goals and objectives of their leader, then the chances of achieving the mission are minimal and this will affect the results negatively.

Moreover, the leader is required to manage the trust among the nurses (Bennis, 2010). This assertion is supported by Gibson et al. (2014) who stated that the level of trust in a leader might affect the performance of nurses and the results of health facilities. Another competency that is required in nursing leadership is the management of self (Bennis, 2010). The self-management entails that ability of leaders to improve their leadership abilities and the capability to apply these skills in clinical environments. Nursing leaders ought to develop their capacities and skills at all times and ensure continuous application in the nursing setting. As such, there should be consistency in the area of education with the context of leadership. It is paramount to point out that a successful leader is capable of bringing positive results in the nursing practice as there is job satisfaction and improved health outcomes (Cummings, 2015).

References

Altman, M. (1988). What Makes a Good Manager? Legal Economics. Vol. 14. Issue 5, pp: 55-58. Retrieved From https://heinonline.org.ezp01.library.qut.edu.au/HOL/Page?men_tab=srchresults&handle=hein.journals/lwpra14&id=378&size=2&collection=journals&terms=what|a|A%20good%20manager|makes|manager&termtype=phrase&set_as_cursor=0

Bennis, W. (2010). Leadership competencies. Leadership Excellence, 27(2), 24.

Cummings, G. G. (2013). Nursing leadership and patient outcomes. Journal of nursing management, 21(5), 707-708.

Daly, J., Jackson, D., Rumsey, M., Patterson, K., & Davidson, P. M. (2015). Building Nursing Leadership Capacity: An Australian Snapshot. Nurse Leader, 13(5), 36-39.

Frankel, A. (2011). In order to be effective in their roles, senior nurses need to adopt a range of leadership characteristics and behaviours (1st ed., pp. 104: 35, 23-24). Nursing Times. Retrieved from https://www.nursingtimes.net/Journals/2011/08/24/j/n/i/Leadership-Skills-for-Nurses.pdf

Gibson, D., & Petrosko, J. (2014). Trust in leader and its effect on job satisfaction and intent to leave in a healthcare setting. New Horizons in Adult Education and Human Resource Development, 26(3), 3-19.

Giltinane, C. L. (2013). Leadership styles and theories. Nursing Standard, 27(41), 35-39.

Grimm, J. W. (2010). Effective leadership: making the difference. Journal of Emergency Nursing, 36(1), 74-77.

Henriksen, J. (2013). Exploratory study of nursing leadership: An inquiry of leadership attributes of nurse managers in acute care hospitals and the professional practice environment (Order No. 3561112). Available from ProQuest Dissertations & Theses Global. (1368212295). Retrieved from https://search.proquest.com/docview/1368212295?accountid=13380

Marquis, B. L., & Huston, C. J. (2009). Leadership roles and management functions in nursing: Theory and application. Lippincott Williams & Wilkins.

McCallin, A. M., & Frankson, C. (2010). The role of the charge nurse manager: a descriptive exploratory study. Journal of Nursing Management, 18(3), 319-325.

Newman, C., Patterson, K., & Clark, G. (2015). Evaluation of a support and challenge framework for nursing managers in correctional and forensic health. Journal of nursing management, 23(1), 118-127.

Patterson, B. J., & Krouse, A. M. (2015). Competencies for leaders in nursing education. Nursing Education Perspectives, 36(2), 76-82.

Porter-O’Grady, T. (2003). A different age for leadership, part 1: New context, new content. Journal of Nursing Administration, 33(2), 105-110.

Thomas, C., Hodson-Carlton, K., & Ryan, M. (2011). Preparing nursing students in a leadership/management course for the workplace through simulations. Clinical Simulation in Nursing, 7(3), e99-e104.

Townsend, K., Wilkinson, A., Bamber, G., & Allan, C. (2012). Accidental, unprepared, and unsupported: clinical nurses becoming managers. The International Journal of Human Resource Management, 23(1), 204-220.

TuersFeldman, D. M. (2015). Getting the horse to drink: a guide for nursing leaders. Nurse Leader, 13(4), 74-77.