Leadership Styles in Professional Nursing - Research Paper Example

?Leadership Affiliation Nursing leadership has been ified differently by different researchers. Leadership in the nursing profession is not attained by training or certification. The professional nurse becomes a leader through growth in her profession. Time and experience are her teachers. This writer has obtained some interesting information by way of her search of relevant literature. The development of skills and alterations in her attitudes help the nurse become competent in her profession. The writer has selected the transformation leadership style for description. She noticed that features of this style could be included under the organization management style too. The clinical example that she relates is her experience in the palliative care ward which was newly set up. How she acquired new skills and attributes as a growing leader has been a revelation to her. Being a caring mentor to her junior nurses was an achievement. Providing the best care for her really ill patients was another. Key words: leadership, professional nurse, transformation leadership, organization management style, palliative care, caring mentor Leadership Professional nursing involves a number of complex responsibilities. Leadership which is visionary in nature with sufficient strength to face challenges apart from facilitating an environment of continuous learning should be the aptitude of all professional nurses (Rushmer et al, 2003). Individual skill development as professional experts involves the empowerment of staff, willingness to share knowledge with them and grow with them. Communication skills and the ability to release the skills of other staff is leadership. The ability to provide holistic care to patients is another characteristic (Jenkins et al, 2009). Creation of an evidence-based environment to provide the best care to patients and their families is another quality that progresses to an achievement of notable excellence in clinical practice (Hockenberry et al, 2007). Management skills are cultivated while practicing as professionals. A caring mentorship provides a well-bonded relationship with novice nurses (Wagner and Seymour, 2007). Being supportive and nurturing enables the conversion of the hospital environment into an evidence-based environment (Hockenberry). Leadership styles that have been described by various researchers include the social style, transactional, transformational, instrumental, participatory and consultative (Pearson et al, 2007). Five styles have been described by Blake, Mouton and Tapper (1981 cited in Rigolosi, 2005). They are the authority obedience style, the team management style, country club management style, impoverished management style and the organization management style. The nursing profession is intertwined through support for other nurses and the patients. Review of professional nursing literature Transformational leadership has leaders and followers (Carr, 2009). The following paragraphs provide information on the leadership of a case manager and the nursing administrator which can be classified under organizational management style too. Both jobs are essential in a hospital environment. Prior to the shortage of nurses, there was a vertical growth in the nursing profession. The nurses previously moved vertically up the traditional hierarchy of command. Relationships had been less and the vertical growth did not include many of the qualities that nurses needed to have as potential leaders in the health care profession. The growth has taken on newer concepts and is now both horizontally as well as vertically seen (Carr). The knowledge bases increase with the rise in status. The nurses and administration need to have a shared purpose with like-minded far-reaching goals. The collaboration must be a supportive working relationship which promotes mutual goals. Shared leadership qualities, respect for one another and loyalty to the profession must be the aims of the collaborative relationship (Carr). The nurses support delivery of patient- centered care. Care is continuously promoted and communication is enhanced. The goals of patient care are put together for easy achievement. The vision of the organization is held high. Clinicians are to possess five core competencies (Carr, 2009). The first is the delivery of patient-centered care. The second involves the competency of the combined teamwork of the interdisciplinary teams. The third competency involves the practice of evidence-based medicine. The fourth involves the means of improving quality of service. The fifth includes the use of information technology for the competent delivery of service. Every level of the hierarchy for care would require strong competent leaders (Carr). Effective leadership in a hospital would be equivalent to the provision of excellent patient care. Health care services that cater to the community and patients would be the goal of leadership. The mission of the organization would be held high. The clarity of vision for posterity will unite the team. Patient care must be delivered in all sincerity and integrity. In the hospital-based care, it is essential that the case manager and nurse administrator have a partnership for promoting successful patient care (Carr, 2009). The quality of establishing and sustaining partnerships or relationships is to be cultivated. Professional nurses become leaders as and when the situation demands. Nurses and nurse managers need to develop a shared purpose with similar goals. Partners model the way for others to follow. Fostering communication is inevitable in the collaborative partnership (Carr). The case manager practices the loftiest of professional ethics for case management (Carr, 2009). She attains professional development by continuing education. Optimal care is facilitated for the patient and family. Ensuring cost-effective care for the patients is her responsibility. Participation in the suggestions for personal improvement helps her keep moving up. Accountability is one of her upmost priorities (Carr). The administrator on the other hand develops goals for implementation. She ensures safe delivery of optimal patient care. Looking towards promoting professional growth of her staff, she ensures that they are familiar with the mission goal, the future vision and values to be upheld (Carr). Her openness, unbiased and unstinted support draws the staff closer to her. She also identifies the evidence-based care for the patients (Carr, 2009). A bit of humor can go a long way in breaking the ice for creating a relationship between the case manager and the client (Craig, 2009). Staff job satisfaction and patient satisfaction are associated with this style of leadership (Pearson, 2007). Quality of life of the patients is also better where the nurse leaders are of the organization management style. Unit effectiveness and organizational culture have been results of the transformational leadership style (Pearson). Transaction leadership has been associated with nurse administrators who did not participate in the actual nursing jobs. They would not inspire their followers through motivation as the transformational leaders do. Instead they offer benefits or packages for their work (Pedraja-Rejas, 2006). The managers have a direct influence on decision-making in the organization. The followers would be very much aware of the rewards offered. The followers would know the power hierarchy within the organization and they would also share the power systems (Pedraja-Rejas). A dialogue between the administration and the followers would be inevitable for negotiation and exchange relationships. Studies indicated that transactional leadership and effectiveness did not go together. Transactional however was dominant over transformational leadership style in a management. Application of clinical example When the hospital where I worked wanted to start a palliative care unit, I had to assume leadership as I was the senior nurse. Patients were waiting for admission and suddenly there was a burden on my head. The administrators and the directorial board had decided on a specific date and there was no way of postponing it. Quickly analyzing the situation and deciding the stepwise protocol that I was to follow, I entered my job with confidence. Motivating the system was my first duty (Rigolosi, 2005). Remembering to advice my junior novices, I stressed the point that the patients needed to be treated like porcelain as they were in the last throes of illness before death relieved them. The nurses were to delve deep into their duty and provide a humanistic and integrated care for the patients. Noticing the differences among the novices, I had to advice each one according to their drawbacks. Two were caring personalities and just needed my support for pushing them along with the right scientific knowledge. Caring mentorship were the words I recollected from my classes; this was what I offered my novices (Wagner and Seymour, 2007). Recognizing the abilities and skills of each, my guidance was focused to enable them to adjust to the new kind of work. Among us, we cultivated a relationship of trust, commitment and competence. For the patients we were all compassionate carers (Wagner and Seymour). I discovered perspectives of my behavior and practice that I never knew existed. Together we energized the environment in the palliative care unit. The work appeared to involve almost all that I encountered in all the wards that I covered in the course of my study. Each of the cancer patients had different problems needing our assistance. When one vomited, another would have a bout of dyspnea. The situation was enough to make us desperate but we never forgot that the patients were to be treated well. Our competence was being questioned with the unexpected events that occurred in the ward. However we never lost touch with our aim of giving the patients the best service that we could so that their journey was smooth. The quality of life had to be improved. Professional expertise helped us meet the challenges. I had to sharpen my acumen for teaching and counseling. Making myself available and approachable, I managed to get around my novices and other staff. My interpersonal skills were sufficient to impress the juniors and the patients and make them amenable to my help and advice. I realized that they were practically eating out of my hands very soon. Communications skills had to be polished to keep the mentees and patients humored and listening (Wagner and Seymour, 2007). The mentees were strong personalities with commitment to their work. They were respectful, compassionate and honest to the core (Wagner and Seymour, 2007). Not forgetting their professional ethics they were creative and energetic. They developed the ability to initiate actions. Their flexibility to receive help from me and other staff impressed us. Being observant, I encouraged their interpersonal and communication skills (Wagner and Seymour). Empowering the juniors was also my job as leader. Various theories had been suggested for empowerment: critical social theories, organization and management and social psychological theories (Rankinen, 2009). Work empowerment has been defined as “the process whereby the individual feels confident he or she can successfully execute a certain action during organizational change” (Rankinen). This has been divided into behavioral, verbal and outcome empowerments. Managing the job, working with colleagues and identification of problems are together termed as behavior empowerment. Verbal empowerment refers to the ability to speak, defend issues and debate for them (Rankinen). Outcome empowerment is the collaborative relationship which changes or improves the outcomes for causing an increase in the effectiveness of the hospital (Rankinen). Attempts have been made by me towards empowerment of the 3 entities described. The juniors have become smarter in the process. Establishing different sets of leadership teams, I was able to empower my staff towards leadership qualities (Hockenberry, 2007). Persistence, patience and perseverance were our mottos through the procedure (Hockenberry). We were able to provide an evidence-based environment for the patients (Hockenberry, 2007). Thankfully we had the support of the administration, decision makers, the clinicians and the stakeholders. Our success was ensured with this achievement. Our patients were in dire need of spiritual care. Knowing fully well that spiritual care had positive effects on terminal patients especially, I coached the juniors to practice it on them (Jenkins, 2009). The patients found peace and a sensation of well-being when stressed with problems, physical and mental. We expected better health outcomes and an improved quality of life (Jenkins, 2009). The patients could cope better. Social behaviors like holding a patient’s hand or hugging the patients at times or joking with them helped them smile even in times of extreme distress. They looked forward to us in the ward. The approach of holistic care in nursing must be attributed to Florence Nightingale, the great nurse. This was what she practiced even before the days of nursing theories and leadership styles. The patients with end-of-life issues need special care and their families need the bereavement care after their loved ones are lost. Grief and bereavement support need training. As I had the training, I was able to guide the novice nurses into providing this support (Ailey et al, 2008). Conclusion Leadership styles are many but the transformational leadership and the organizational management style seem to be the best for an organization like a hospital. The leader exhibits the task-related behavior and at the same time keeps the spirits of his followers up. The caring mentorship model of Wagner has made me discover my leadership qualities. The provision of palliative care for patients has helped me practice nearly all that I learnt during my study period. Searching through the literature was an experience that I am thankful for. I am already growing. 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Leadership, empowerment, protected time and reflective practice as core contextual conditions J. of Evaluation in Clinical Practice. 10(3): 399-405 Wagner, A.L. and Seymour, M.E. (2007). A model of caring mentorship for nursing. J. for Nurses in Staff Development. Vol. 23(5): 210-211 Wolters Kluwer Health/ Lippincott Williams and Wilkins. Appendix Each Appendix appears on its own page. Footnotes 1Complete APA style formatting information may be found in the Publication Manual. Table 1 Type the table text here in italics; start a new page for each table [Insert table here] Figure Captions Figure 1. Caption of figure [Figures – note that this page does not have the manuscript header and page number] Read More