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Leadership in Professional Nursing

Nathan Duffey
Frostburg State University











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Leadership in Professional Nursing
One of the fastest selling genres of books behind just thrillers/crime is the self
improvement and self help genre. Reports show that this genre is quickly becoming one of the
most popular books on the shelves in the bookstores. Whether trying to fix finances, get into
better shape, find your inner Zen or how to be a great leader, there is a book for you in this
section cleverly titled Self Improvement. This genre of books may to some seem boring, not-
needed, or not important. But for some of us these books hold the answers that plague us daily as
to how to become a better nurse, leader, lose the weight. The words of these books are magical to
many and could be a big reason why this genre is becoming the fastest growing genre. One book
in particular that was instrumental in the life of this writer is the books on leadership. Leadership
is defined as the process of influencing people to accomplish goals (Blais & Hayes, p.164).
However this is a definition that many people have different views on and define it in different
ways. To some leadership is nothing more than a position at work or a Im the Boss attitude
that goes along with a title of leader. How can one transcend to be something more than just a
boss or a leadership position how can one truly have people follow them into war (so to
speak) and completely respect their leader. Maybe the great leaders of our time read some books
on wisdom and are reading the books that this writer currently is skimming through. Either way a
leader in any organization is the heart and soul of that organization or business. Same applies to
the hospital setting. The leaders of certain units, floor leaders, directors, charge nurses and floor
nurses. All of these positions have a leadership need that depicts the way that hospital is viewed
and lead. The topic of leadership in nursing will be evaluated throughout this reading in hopes of
helping the reader have a better understanding of why leadership in the professional nurse is so
important.
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Being a great leader goes beyond the role of directing work flow, giving orders, and
having people follow the commands set forth by that leader. A true leader teaches, continues to
learn, stands up for their employees, and influences the peers to continue to grow and learn
themselves. Nurses may assume leadership roles in their work setting, their profession, and the
community, whether or not they have designated positions of management (Blais & Hayes, p.
165). In these roles nurses have the opportunity to influence not only the direct care staff but also
influence the patients that the nurses sees on a daily basis. This not only helps the patient but
also the community because if that nurse is to truly influence just one patient then think of the
butterfly effect it can have on the family of that patient, then the friends then the community. The
nurse is a leadership position that not only influences, but teaches, learns, and help others grow.
Nurses hold many unclassified leadership positions such as advocating for improvements to
technology at the hospital, policies, improvement in the care of the clients, and improvement in
the work environment. These are all great areas that showcase the power and influence as a
leadership in professional nursing.
Current options related to the leadership of nursing are the focus on styles of leaders.
Leaders are not all created equal, some leaders are complete authoritarian while others may be
more laissez-faire, whatever the case, leaders have options on how they choose to lead. The most
popular styles of leadership today are the charismatic leader, authoritarian leader, democratic
leader, and the non-directional/laissez faire leader. Each leader holds a different style of
leadership and pending on the group they are leading may be very effective as a leader. Now
given the fact picking a certain leadership style requires the leader to analyze the group that they
will lead. For instance a laissez faire leader may not be a great style of leadership for a pre-
school group; however it would be effective in working with a small group all working towards
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the same goal with the same idea of how that goal will look when complete. Besides just the
style of leadership there also comes characteristics that make a true leader stand out in a crowd,
those characteristics are empowerment, intuition, self-understanding, vision, and values
congruence. In the next body of text the reader will gain more insight into the styles and
characteristic of leadership.
A charismatic leader is defined in text as leadership based on personal characteristics
and beliefs (Blais & Hayes, p. 166). The enthusiasm that is created in the environment of this
style of leader is an awe-moving movement. The group is likely to face adversity but as a unit
comes through the adversity due to the amount of faith in their leader. This style of leader is a
style that many nurses desire. Nurses desire for a charismatic leader one that will get involved
emotionally and personally to know that the goals of the unit and person are met. Authoritarian is
another self explanatory style of leadership. This role of a leader is always in charge and in a
way the phrase my-way-or-the-highway is appropriate here. However this role of leader is very
effective in emergency situations, such as a car crash, acute myocardial infarction episode, stroke
etc. these are time in which this style of leader is much needed and desired. Democratic leaders
are the leaders that actively work with the group toward achieving the same goals. They are very
invested in the nature of the work and work hands on with the group as a team. Lastly the laissez
faire leader is a leader but does not act like one till its time for a decision to be made. This style
of leader is very hands off and allows the direction of the group to go where the group may
want to take it, only to be appointed at times for minimal direction. All of these leaders have
qualities that make them stand out for being leaders. The characteristics listed above are also
characteristics that many nurses hold and nurture to the patients. Empowerment is a
characteristics of a leader who gives the group a sense of achievement and gives corrective and
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positive feedback for jobs well done and uses opportunities for growth in their teaching. Vision
is another great leadership characteristic that keeps the group on track and working towards the
ultimate goal. All of these leadership styles and characteristics have a place in the world of
nursing. Some better than others, one way of viewing which may be the best style for a group is
to the view them in a pay off matrix or a view of pros/cons.
Pros of the current options of leadership style range with the group of nurses that the
leader may work with and what unit the leader may work. In the emergency department a laissez
faire leader would likely be chewed up and spit out. Many of the cases that come into an
emergency department are situations that require a tight hand on the situation and are able to
make quick decision as well as give clear orders. Authoritarian would be a great style of
leadership in this setting. Enthusiastic and democratic leaders are leadership styles could flourish
in almost in setting for nursing. As nurses work as charge nurses and clinical specialist the style
of leaders they posses then transcend the style of leader that they will choose in larger positions.
Many times these roles such as the democratic and enthusiastic leaders are pros for the other
nurses on their unit due to the feeling of help, empowerment, and vision that they receive from
this style of nursing.
Cons of leadership styles are vast and vague but require and are only cons when the style
of leadership does not match the style of work. One thing that makes a leader so effective is
choosing the style of leadership that may be appropriate for the style of nurses or unit of nurses
that you will be leading. As stated earlier a laissez faire leader in the emergency department will
likely not have many good reviews at the end of the year where as the authoritarian would excel.
Many times the cons of leadership style does not come from that style of leadership it comes
from the wrong choice of style in that setting. A true leader in the sense does not just pick a role
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or style of nursing out of a hat, rather determines the role of leader after closely evaluating the
role based on the unit and its vision of needs.
Leadership is a word that for many nurses will strike fear or joy into their hearts. The
word leadership alone is a word that makes many people immediately think of their boss and
they either dont mind thinking of their boss or they just now are having a bad day. The role of
leader is more than being just a boss or a position. However being a leader is not all sunshine and
rainbows. In todays economy and the ever changing infrastructure of healthcare system nurses
and nursing leaders face challenges that bring forth a slew of societal issues and problems.
Current leadership challenges for nurses in the U.S. range from limited access to healthcare
services, especially for the poor; limited resources for providing care; and the need for providing
care for high numbers of uninsured or underinsured individuals or families (Blais & Hayes,
p.165). These concerns and issues that are raised with many nurse leaders are ones that
unfortunately placed daily.
In order to keep up with the demands of society and the societal issues nurse managers
and administration are tasked with the role of keeping and maintaining professional nurses on
staff. It is estimated that in 2020 the baby boomer generation will retire and leave a significant
gap in the workforce, one of which is nursing. There will be an estimated nursing shortage
reaching into the hundreds of thousands of needed nurses in this time. One of the challenges that
is faced with the upcoming shortage is for strategic planning by the nursing leaders to make their
hospital a desired place of employment. These challenges provide opportunities to develop
innovative approaches to nursing care delivery and to redefine the roles of professional nurses
(Blais & Hayes, p.165). With these new innovations and changes that will be made by the
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nursing leaders the recruitment of new nurses into the field of nursing will be even greater than
just staying stagnant as a hospital. So with these shortages comes industry shaking changes.
As we can see in the above text the promotion of change in the area of nursing leadership
is looming. The need for more nurses requires for better perks in the hospitals to get the better
nurses to work those respective hospitals. Many of things that new recruits look for such as this
writer include nurse to patient ratio, electronic and technological savvy staff and equipment,
opportunities for growth, education, and of course competitive pay. With these new changes in
site for the healthcare industry and nurses the leaders of this new change will require heavy
promotion. Promotion of these new standards will ultimately be the leaders responsibility in the
enactment phase of these new programs. The leaders will oversee these new programs that will
be the key factor in hiring the best nurses for that hospital. And as a nurse we all know the
hospital is as only good as its nurses and their leaders. So its a great time for promotion of not
only great leaders in a hospital but also great nurses.
To revisit an earlier point indicating that a great leader can do two things: give
empowerment to the employees and vision. The leader needs to promote these two things from
within the hospital and have it reach outside the hospital with the ability to truly influence that
spirit of an employee/nurse. The leader is also at a pivotal role in promoting positive attitude and
culture within the hospital as well. The leader of the floor or unit needs to harbor positive attitude
and self esteem of the nurses working on those respective floors, because the attitude that is on
the unit and the nurses carry are the same attitude the patient get treated with while being treated
for their medical condition. The healthcare system is very much a business that requires much
needed improvement in overall patient satisfaction that first starts with the overall attitude of the
nurse that is being treated.
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Interdisciplinary leadership roles are great topics to cover when discussing the role of a
nurse leader and the aspects that go into a professional role. As a leader in an interdisciplinary
role the main focus is the team and steady promotion of team work and working towards that
common goal. The team, which is the core of interdisciplinary practice, is characterized by
mutual respect among disciplines and stakeholders, a sharing of leadership, investment in the
team process, and acceptance of responsibility and accountability for outcomes (Morgan &
Atwater, 2005). When the leader is directing a team of nurses with the same goals and synergy
and the team has high self esteem that team will be the team that is radiant and attracts people.
Why give false promotions of gimmes to get nurses at hospital, instead give them a feeling of I
want to be a part of that team and you will understand the true desire of wanting to be the best
nurse. These leaders that encapsulate these true interdisciplinary roles are the ones that excel.
The intra-disciplinary role varies slightly in that this role is more affected by the nurses.
The roles of the nurses play a big part in the intra-disciplinary role of the leader. This role is
different in its movements within the hospital. Many hospitals have floors that work closely
together such as the ICU and the ICU step down unit. Many times the manager of the ICU is also
the step down manager. This is a positive in the fact that it allows for charting of continuity of
care. This role also differs from interdisciplinary roles in the fact that it deals mainly with the
nurses of a certain floor and focus on the task that floor specializes in and would not be
appropriate for mass leadership style.
Leadership affects all parts of any organization, business, hospital and even personal life.
There are leaders that affect us all in many different ways. They can get the most out of their
employees or they can gain nothing and constantly pursue interviews because of the leadership
style not correlating with the employees desired level of leadership need. Leaders become great,
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not because of their power, but their ability to empower others (Maxwell, p.9). By doing this in
their employees not only do leaders like this become better leaders, but they also improve
relationships, increase productivity, and have invested employees.
Leadership is a key role in the production of nurses and the overall satisfaction that
makes the nurse that special nurse. If a nurse is not motivated, passionate, and does not feel
respected in their role then the likelihood of that nurse giving excellent customer care is not be
present. The empowered nurse is more likely to want to improve the satisfaction of the nurse,
willing to work the extra shifts, continue education and invest into their floor or even hospital.
This is the nurse that every director/leader wishes to hire but does not always get due to the lack
of leadership to keep this fire alive.
Hospitals are now more than ever a business and with any business you want repeat
customers. Repeat customers are what keep your business booming and alive. If you go to a
restaurant or a favorite clothing store and people dont greet you with warm smiles and chipper
greetings, or they fail to see if you need assistance or would like an extra hand or even if they
can get you something more than the likelihood of you coming back is very slim. Same applies
to the patients that enter that respective hospital they choose when going to be treated for an
illness that puts them in a very vulnerable state. These patients we treat are not healthy, they
dont feel good, they dont look good, they come to the hospital for treatment of an illness not to
buy food or clothes, but for medicine and professional help that nurses provide. If this patient
arrives and is not greeted with these positive characteristics listed above then already they are
even more on edge than before entering. One poll shows that the 2 most hated places to attend
are the dentist and doctors office/hospital. How can we change this attitude? By changing the
character in the hospital. How do we change the character in the hospital? By incorporating
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positive empowering leadership that will motivate our nurses to be more than just floor nurses
but to be leaders of their patients. Are we as nurses at that point yet in our professional world? I
do believe we are making strides to be there, Blais and Hayes said it best effective leadership is
a learned process involving understanding of the needs and goals that motivate others and
interpersonal skills to influence others (Blais & Hayes, p.181). As our education on the new
trends of healthcare continue to grow and a new wave of younger nurses and more educated
experience nurses continue to thrive and work together this writer does believe that, yes, this is
close.











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References
Blais, K. K., Hayes, J. S. (2010). Professional Nursing Practice: Concepts and Perspectives (6th
Ed.) Upper Saddle River, NJ. Pearson
Maxwell, J. (2011). The 5 Levels of Leadership: Proven Steps to Maximize Your Potential. New
York, NY. Hachette.
MCH Leadership Competencies. Retrieved April 26, 2013.
http://leadership.mchtraining.net/?page_id=132