22.01.2018 in Nursing
Nursing Leadership and Management Styles

Nurses are most likely to undertake a range of leadership roles in their day to day routine. Naturally, some adopt a leadership style that is effective, while others find the aspect of leadership difficult. In delivering a high quality healthcare, effective leadership is important. This involves ensuring the safety of patients and facilitating positive development of the healthcare staff. Effective leadership is essential to navigating the obstacles facing the healthcare system in the 21st century. The healthcare industry is suffering from a leadership gap that can be closed only by identifying and nurturing executives with the greatest potential to become strong, effective leaders.

Leadership can be described as a comprehensive process of “identifying a goal or target, motivating other people to act, and providing support and motivation to achieve mutually negotiated goals” (Porter-O’Grady, 2003). In the day to day activities of a nurse this could mean the process of organizing the day and the night shifts, the support staff and the team of nurses. An effective operation of the shifts, management of challenging or difficult situations and staff morale, to a great extent depends on the leadership skills of the senior nurse. It is essential to acknowledge that leadership responsibilities to a great extent vary from functions of management. In the book The Seven Habits of Highly Effective People by Stephen Covey (1999), Peter Drucker states that “Management is doing things right; leadership is doing the right things. Management is efficiency in climbing the ladder of success; leadership is about determining whether the ladder is leaning against the right wall” (Covey, 1999). This means that management is all about tasks, whereas leadership is all about judgment, perception, philosophy and skill. From this we can learn that it is difficult to be an effective leader than to be an effective manager.

An effective leader has various characteristics which comprise of being visionary, being a strategist and a planner whose desire is to direct services and teams towards achievement of future goals (Covey, 1999). Effective leaders need to employ problem solving processes, come up with group identification and uphold group effectiveness. Effective leaders should also be dynamic, have motivational influence on others, be passionate, seek to inspire others and be solution-focused. Senior nurses must employ these characteristics in their dealings so as to win the respect of their team members for the development of clinical practice. By upholding effective leadership styles, senior nurses get to be in powerful positions to influence the doing well of other members of staff, making sure that there is maintenance of professional standards and enhancing the development of competent practitioners.

Leaders who happen to be the driving forces win admiration and are regarded as a source for inspiration and role models for potential nurse leaders. Senior nurses leadership responsibilities include the following: making decisions; delegating appropriately; acting with integrity; and resolving conflicts. Their responsibilities also comprise of developing others and to be aware of how other team members feel by being psychologically in tune with team. These and other functions are the key elements that are necessary for connecting leadership with successful development of other members of the team. This is to a great extent achieved by working together them in a coaching and mentoring role. An effective leader endeavors to develop other staff by their leadership. The one-to-one managerial relationship is the most significant element in clinical order. “Mentorship facilitates learning opportunities, helping to supervise and assess staff in the practice setting. Terminology frequently used to describe a mentor includes: teacher; supporter; coach; facilitator; assessor; role model; and supervisor” (Hughes, 2004). There is great need for management instructions to always have clear support of leadership and supervision. Staff should first be shown how to undertake a task and then be guided through completing the task.

An organizational culture founded on continuous learning by way of support and best-practice methods empowers and motivates staff. Self-motivated clinical leaders and accommodating clinical environments are necessary in the progress and accomplishment of best practice models. Various key factors that have been described as effective in developing transformational healthcare leaders comprise of: “provision and access to effective role models; provision of career pathways; mechanisms for clinical and mentoring supervision; intentional succession planning; organizations that hold with significance clinical competence; and promotion of centers of excellence” (Bass, 1985).

Leadership models

There are various models of leadership that are useful to senior nurses and that can help them in leading their teams. The two most common leadership models are transformational and transactional models (Bass, 1985). The impact of transactional leadership can be experienced for a short time and it is intermittent and task based. In this model, the transactional leader only intervenes with a negative response whenever a thing goes wrong. This form of leadership could only be effective in a case where there is a particular short-term project that is directed or a piece of work that has to be finished.

In a healthcare ward, it is more advantageous to make out a model of leadership that punts forward longevity in the rapport between senior nurses and their junior colleagues. The transformational model is a complicated leadership model but it has effects that are positive on teambuilding and on communication than the transactional model. Transformational leadership entails the shaping and altering the values and goals of other team members so as to achieve a common goal to the advantage of the nursing profession and the healthcare organization. According to Bass (1985), transformational leadership dynamics were more greatly correlated with apparent group efficiency and job contentment, and “contributed more to individual performance and motivation, than transactional leaders” (Bass,1985).

Another proposal of a different model is by Adair (2002). This model entails a there circle strategic leadership with the circles representing the needs of the task, the person and the team respectively. Adair argues that expertise or knowledge alone is not sufficient to lead although it is important for an effective leadership. It is important that leaders are privy to both group and individual needs, and should match them to be in line with the common goals of an organization. In the model, each of the there needs interact with other needs and therefore one must be seen in relation to the other two (Adair, 2003). This can be described as a democratic form of leadership where opinions of various stakeholders who carry out various tasks are put into consideration. Individuals and teams are part and parcel of the decision-making process that concerns their work. The importance of individuals, their acquaintance, experience and skills is essential to this model.

The models of leadership are an important tool for the senior nurses. The models help them in their leadership roles to bring their functions of leadership activities into perspective. However, the senior nurses should not concern themselves with employing concepts from various leadership models and coming up with an eclectic approach. The models should be employed as a framework which is the foundation of an effective style of leadership which suits the individual person in charge and those whom they lead.

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