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Nursing is a challenging and dynamic profession, which requires inspiring and engaging leaders as well as role models. In the present demanding and ever-changing healthcare setting, identification and development of leaders among nurses remains one of the challenges facing the profession. Furthermore, the concept of leadership is multidimensional and complex; hence, there is a need to have a clear picture of what nursing leadership is in the real world, and how the concept is different from management (Pullen, 2016). Therefore, this paper describes findings from an interview with a nurse leader who has been in practice for seven years. The interviewee was asked a number of questions, which included but are not limited to the matters of leadership position, leadership roles, leadership styles, and characteristics of a nursing leader, employee empowerment and change. The essence of this research was to facilitate the interviewer’s learning about leadership. Hence, with appropriate identification, development and support of future nursing leaders, the ultimate goal of patient-centered care is achievable.
The senior nurse views leadership as a multifaceted process, which entails the identification of targets as well as motivation of colleagues and other staff members to act in line with these objectives. From the interview, it was also apparent that leadership encompasses empowerment, motivation and provision of institutional support to achieve common goals. In the regular work of the senior nurse, leadership involved coordination of shifts and various nursing teams on duty under the direction of the senior nurse. The latter pointed that a hybrid of leadership styles was used in the nursing environment, but the preference was given to relational leadership. The underlying rationale is that divergent situations demand the application of different leadership skills and styles. For example, the senior nurse claimed that morale and the ability of nursing teams to face challenging scenarios largely depended on the utilization of the most appropriate leadership skill. Therefore, there is a need for flexibility, creativity and collaboration, especially where ethical dilemmas emerge. The idea of flexibility is a variant of the situational approach theory, which anchors on the premise that different situations requires different forms of leadership (Malik, 2013; Pullen, 2016). From the senior nurse’s examples, one could infer the concepts of path-goal theory and contingency theory. Besides, this is largely attributed to the fact that the nurse’s leadership style, which integrates various approaches, has evolved within the last nine years. In line with the senior nurse’s perspective, Malik (2013) noted that the satisfaction of employees and colleagues greatly depends on the leadership style or activities of their leaders. Additionally, there is a significant correlation between the behaviors of path-goal leader, including participative, supportive, directive and achievement-oriented behaviors. The path-goal theory of leadership is illustrated by the fact that at times the senior nurse focused on nursing team motivation to improve employee performance and enhance their satisfaction (Malik, 2013). Lastly, the interviewee gave preference to relational leadership style because from experience, the nurse is contented that positive leadership outcomes are directly associated with high-quality relations. Moreover, this is true in the contemporary nursing environment where relations among nurses, as well as between caregivers and patients are needed to provide the patient-centered care.
Characteristics for Effective Leadership
The interview with the senior nurse has led to a new perspective regarding effective leadership in the nursing setting. Some of the traits that were linked to effective leadership include intelligence, integrity, charisma, confidence, determination and sociability.
Intelligence. In this context, the term intelligence covers the level of competency regarding knowledge and skills. Similarly to the case with effective managers, continuous education improves the critical thinking and judgment of leaders. In other words, effective leaders need to be knowledgeable about various subjects and willing to learn constantly because in the nursing profession even the roles and responsibilities are changing. Thus, intelligence supports the view that leadership is the ability.
Confidence. Confidence is essential, especially when articulating a vision, instituting change or formulating empowerment policies (Papathanasiou, Fradelos, Kleisiaris, Tsaras, & Kourkouta, 2014). Normally, change is often faced by resistance, which demands intelligence and confidence in its management. Additionally, confidence is infectious, and followers tend to trust confident leaders. In fact, confidence is a pivotal trait of transformational leaders who make a difference for both individuals and organizations.
Sociability. Change agents should be confident and possess good interpersonal skills. In other words, an effective leader should not only have remarkable communication skills, but should also be able to relate with different people. Effective leadership is a skill, as various leadership skill including socialization are crucial to inspire others and to induce the desired change.
Accountability. Accountability entails being answerable for personal actions or decisions. In most scenarios, the senior nurse faced cases, which required to make prompt decisions without sharing the experience with colleagues or staff members. Hence, senior nursing leaders are expected to be accountable for not only attaining team and institutional goal, but also ensuring positive outcomes for employees and patient. Accountability and integrity support the view that leadership is a trait.
Collectively, these qualities form effective and ethical leadership, which is pivotal in contemporary nursing settings. With regard to nursing care, nursing leaders play a critical role in securing ethical nursing practice, namely Code of Ethics and professional standards, through ethical leadership (Storch, Makaroff, Pauly, & Newton, 2013). It follows that the knowledge of ethical theories, principles and concepts is essential for effective nursing leadership. The underlying logic is that senior nurse leaders are allocated with the responsibility of leading others, and positive patient outcomes can only be achieved if medical providers are professionally and ethically competent in preset procedures. Furthermore, effective leaders make conscientious efforts in ensuring that desirable results are obtained.
Techniques Used to Empower Staff and Colleagues
As a senior nurse, the interviewee contended that senior nursing leaders should embrace a culture of continuous learning through evidence-based practices and institutional support to motivate and empower the staff. The interviewee gave weight to the application of leadership skills to encourage medical attendants and colleagues to proceed with learning and adopt critical thinking in order to facilitate creativity and understanding. According to Pullen (2016), nursing as a profession can be advanced through the permanent formal education. Additionally, the author asserts that in the future patient outcomes will be attained by furthering education and experience. In other words, nursing leaders are expected to continuously improve their knowledge and skills in order to formulate HR policies that empower their co-workers (Papathanasiou et al., 2014). For instance, a good background in law and ethics would enable leaders to defend their rights and introduce policies that enhance their development with minimal or no conflicts. Empowerment is multifaceted; hence, it requires resources from various subdomains including finances and human resource development (HRD). Formal nursing executive and nursing educator are also necessary to collaborate in the preparation of new nurses for executive leadership (Storch et al., 2013). Therefore, nursing leaders are to engage their colleagues and staff in the provision of HRD opportunities, continuous training, effective appraisal tools and reasonable compensation or reward schemes. Being consistent with the senior nurse, Storch et al. (2013) noted that the empowerment of nurses to assume various leadership roles would incorporate progressions of skills and knowledge in ethical leadership, as well as management development.
According to the postulation in the introduction of this paper, the given assignment served as an avenue for understanding leadership traits, styles and related concepts that are necessary to achieve a patient-centered care. Being a nurse leader is not only difficult but also exciting and rewarding. Challenges should be approached with a positive mindset, as they shape or condition nursing leaders to be effective in many responsibilities that come with leadership. It is quite clear that the delivery of high-quality care, facilitation of positive development of nursing personnel and patient safety depend on effective leadership. Additionally, the conducted interview has made it clear that while transformational leaders may try to establish their effective leadership style with regard to their followers, other staff members of the same institution many find it complicated to understand or naturally resist any implemented changes. For a nursing student, this assignment shed light on the fact that professional nurses are expected to be aware of the management expertise, as well as to acquire leadership skills to help in the management of the ever-changing nursing profession and healthcare settings. Furthermore, the multifaceted array of leadership skills, roles, functions and theories presented in this paper and the course in general have induced the urge to continuously refine what has been learnt in order to stay relevant. The underlying assignment was also pivotal in appreciating the difference between management and leadership. For instance, through the present research it became clearer that management is about tasks and efficiency, whereas leadership deals with philosophy, skills, ethics, perception and judgement. What was inferred from these observations is that being an effective and ethical leader is more challenging than being an effective manager. In summary, by ongoing learning and comprehending of the concepts and principles involved in nursing leadership graduate nurses can become successful managers and nursing leaders in future.
From the conducted interview with an experienced senior nurse and the provided discussion, it is apparent that the dynamic and ever-changing nursing environment requires effective and ethical leaders to deliver patient-centered care. Another conclusion is that there is no single leadership style that can respond to all challenges in nursing settings. While experience is crucial in decision-making, ethical leadership theories, concepts and skills are essential in the nursing environment where senior nurses face the tough decision, which if not well addressed might be detrimental to individual nurses or the entire organization in terms of reputational damage and legal liabilities. The main characteristics of effective nursing leaders include accountability, charisma, confidence, determination, sociability, intelligence and integrity. Meanwhile, employee empowerment entails a professional culture of continuous learning, support and motivation.
Malik, S. H. (2013). Relationship between leader behaviors and employees’ job satisfaction. Pakistan Journal of Commerce & Social Sciences, 7(1), 209-222.
Papathanasiou, I. V., Fradelos, E. C., Kleisiaris, C. F., Tsaras, K., & Kourkouta, M. A. (2014). Motivation, leadership, empowerment and confidence: Their relation with nurses’ burnout. Materia Socio-Medica, 26(6), 405–410.
Pullen, R. L. (2016). Leadership in nursing practice. Nursing Made Incredibly Easy, 14(3), 26-31.
Storch, J., Makaroff, K. S., Pauly, B., & Newton, L. (2013). Take me to my leader: The importance of ethical leadership among formal nurse leaders. Nursing Ethics, 20(2), 150-157.