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Running Head: Nursing Leadership Philosophy; Knowledge Management Theory

Nursing Leadership Philosophy Paper

Howard Derby

Delaware Technical Community College

NUR 400-6W1 Nursing Leadership

April 24, 2020

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Knowledge Management Theory (KMT) recognizes the importance of the worker and the

organizations, interprofessional collaboration, and accountability found in the information age.

Knowledge management combines routine work (e.g., providing immunizations or other routine

intervention procedures) and nonroutine work (e.g., altering care based on assessment data).

Routine work may require specialized knowledge that includes some level of predictability with

anticipated probable outcomes and nonroutine work is full of exceptions, lacks predictability,

requires interpretation and judgment and may not be fully understood (Finkleman, 2016).

In applying KMT to nurse managers, expertise and knowledge are critical in allowing the

nurse manager to appreciate their decisions and how they will impact their staff. The nurse

manager must take calculated risks in decision making when there is time to assess a situation.

In addition, the nurse manager must have a sense of fair play, commitment to collaboration,

willingness to share the limelight and a growing sense of self that considers strengths and

weaknesses (Finkleman, 2016). The nurse manager also must use different knowledge bases to

achieve the most effective performances. This is done individually and by collaborating with

staff while engaging them to participate in the decisions. For example, as a nurse manager, I

would assign tasks to the appropriate staff so that nurses are not doing functions that techs can do

which can save the nurses time for issues that arise. These types of functions include vitals,

transporting patients, certain paperwork and equipment stocking.

Using KMT as a nurse manager involves teamwork and communication. Communication

is key in all relationships and is not always verbal. Some communication is more affected by

body language, attitude, and tone. The spoken words contain the crucial content, but their

meaning can be influenced by the style of delivery and the way the speaker presents the

information (O’Daniel, 2008). However, critical information is often transmitted via handwritten
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notes, e-mails, or text messages, which can lead to serious consequences if there is a

miscommunication. Collaboration in health care is defined as health care professionals assuming

complementary roles and cooperatively working together, sharing responsibility for problem-

solving and making decisions to formulate and carry out plans for patient care (O’Daniel, 2008).

When a nurse manager applies trust, respect, and collaboration, they will build an effective team

of nurses. As a nurse manager, I would speak to my nurses with respect and talk to them the way

I would want to be talked to. I would control expressions and attitudes. When there is time, I

would want to gather my thoughts before responding to an issue and make sure I am not

overreacting or belittling my employees. Collaboration with other nurse managers is helpful to

gather how they dealt with situations that may be reoccurring.

Unfortunately, most nurses have become used to poor communication and lack of

teamwork and have developed low expectations of their nurse managers. Ineffective nurse

managers show signs of poor communication which can lead to tragic consequences in a

healthcare setting. This bad behavior also causes huge turnovers in the unit and hostility at work.

Effective communication can lead to the following positive outcomes: improved information

flow, more effective interventions, improved safety, and enhanced employee morale (O’Daniel,

2008). In applying KMT, the nurse manager needs to be aware of barriers such as cultural

differences and hierarchical power. Nurse managers that avoid conflict will not exhibit good

communication skills. Also, managers that are afraid to be wrong or afraid to go against their

bosses will lose trust of their nurse unit. Cultural differences affect communication and how one

deals with conflict. These barriers can hinder communication and the nurse manager can

become unapproachable. Nurse managers become unapproachable due to intimidation, fear, lack

of confidence in being taken seriously, and feeling like nothing will change. Also, nurses will
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also become fearful of retaliation if they speak up. The fact that most health professionals have

at least one characteristic in common, a personal desire to learn, and that they have at least one

shared value, to meet the needs of their patients or clients, is a good place to start (O’Daniel,

2008). As a nurse manager, I would promote communication by having monthly meetings and

asking my employees their opinions on day-to-day procedures and changes. I would also

encourage my nurses to address their conflict with each other before going to a manager if

possible. We could address any problems at the monthly meeting by having a “confessions box”

where they can write down any issues anonymously and we can talk about it at the meeting.

Being a nurse manager is about being a role model as well as a structured boss.

Commitment is followed when it comes from the top down. I believe the best nurse managers are

the ones that actually do the same work as their employees. The nurse managers that train with

their employees and that come on the floor and insert an IV one day or clean up a bedpan. The

nurse managers that stay in their office and tell nurses the way something needs to be done

without ever having performed that task, do not get respect from nurses. Applying KMT and

learning new information constantly will help the nurse manager apply the best and current

policies that work. Nurse managers must practice self-awareness when assessing their staff’s

behaviors. Doing an internal assessment will help pinpoint the seriousness of the situation and

provide clues to areas that need to be addressed. Assessment information can be gained from

formal methods such as incident reports, survey tools, focus groups, department meetings, task

forces or committees, direct observation, suggestion boxes, and hot lines. Informal methods such

as casual meetings and gossip can also provide valuable surface information and should be

evaluated more deeply as to the source, relevance, and significance of the events to determine
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next steps (O’Daniel, 2008). In addition, encouraging team building exercises and an occasional

happy hour can bring the unit closer and more familiar.

Often, nurse managers have to be the boss, and not a friend. It is the nurse managers job

to make sure employees are well versed on the existence, purpose, and intent of the policies and

procedures. When there is a problem or mistake, it is the nurse manager that must correct the

issue and take action on the employee. A zero-tolerance policy seems achievable but difficult to

maintain when you work with so many different situational outcomes. Action should not be

punitive but should make an impression that the mistake will not occur again. Depending on the

mistake, the proper action should be followed according to policy as well as the nurse managers

style. Reporting mechanism for mistakes should be available and easily understood without fear

of retaliation or remaining nameless. Hopefully, reporting can remain somewhat confidential

and give assurance that the complaint will be addressed and there will be an outcome. Issues that

are not addressed can cause employees to go against each other. As a nurse manager, I would

make sure all issues were addressed and a result given within a couple days depending on the

circumstance. I have had issues with nurse managers failure to respond to e-mails and hiding

behind broad language that directs my questions to another department.

Being an advocate for your employees and patients is critical as a nurse manager.

Sometimes that is difficult with the limits on resources and higher-up’s disapproval. Using KMT

are important in the field of health care, because we face enormous challenges, including the

COVID-19 current pandemic. This is a new way of nursing and nurse managers may not know

what is the clear answer. Nurse managers right now have to follow the ever-changing policies

while dealing with the questions and concerns from their staff. They have to adhere to their

management while attempting to keep their nurses safe. Having more financial resources into
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the health systems is always helpful. The health care systems face problems that may not have

current policies in place. Nurse managers need to provide information of how to perform more

efficiently. Knowledge management is important since it is the prerequisite for planning and

implementing more intelligent health policies and practices (Kaivo-oja, 2016).

KMT is a growing interest in todays business and academic community because of

improved theories and concepts put forward by peers. KMT is being recognized as a critical

success factor in todays dynamic borderless society by creating managerial positions and teams

with a structured framework for success (Lim, 1999). In applying KMT as a nurse manager, I

would be up to date on all the nurse manager literature and policies. I would promote posting

new advances and techniques in the healthcare field on our unit board. Any new knowledge in

the nursing field that applies to my unit could be incorporated into our daily practice when

applicable. Especially any bedside nursing techniques or transformations. I understand how

stressful bedside nursing could be since I was a floor nurse for over 8 years and a tech for 2

years. As a nurse manager I would initiate concerns with bedside nursing and incorporate new

ways to deal with the stressors. I would incorporate differences in my shift nurses. Some bedside

manners are very different during the day and in the middle of the night. Some teachings should

not be done during night shift and hopefully concerns with fairness would not arise. I would

incorporate lifelong learning through trainings and current legislation. My unit would keep up

with best practices and continued education to maintain nursing licenses and employer

educations. Our main concern is patient care and having the best experience possible. A goal as

a nurse manager is advocacy for the patients and for my nurses. Additionally, I would want my

unit to feel supported by their manager and that they have a voice that I will echo for them. I

would afford resources in compliance with budget.

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References

Finkleman, A. (2016). Leadership and Management for Nurses; Core Competencies for Quality

Care. Pearson 3rd Ed.

Hall, H. (2010). Principles of Knowledge Management: Theory, Practice, and Cases. Journal of

the American Society for Information Science & Technology, 61(2), 430–432. https://doi-

org.libproxy.dtcc.edu/10.1002/asi.21193

Kaivo-oja, J., et. Al (2016). KMO ’16: Proceedings of the 11th international knowledge

management in organizations conference on the changing face of knowledge

management impacting society. Future prospects for knowledge management in the field

of healthcare. 40:1-8. doi.org/10.1145/2925995.2926006 Retrieved from

https://dl.acm.org/doi/pdf/10.1145/2925995.2926006

Lim, K. K., Ahmed, P. K., & Zairi, M. (1999). Managing for quality through knowledge

management. Total Quality Management, 10(4/5), 615–621. https://doi-

org.libproxy.dtcc.edu/10.1080/0954412997596

Lohle, M., Terrell, S. (2017). Strange conceptual bedfellows: assessing grounded theory for

effective virtual student team project delivering via knowledge management, qualitive

research and management theory. Issues in information system, Volume 18, Issue 1, pp.

180-190. Retrieved from https://iacis.org/iis/2017/1_iis_2017_180-190.pdf

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O’Daniel M, Rosenstein AH. (2008) Professional Communication and Team Collaboration.

NCBI; Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Chapter 33.

Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK2637/