Impact and Effectiveness of three Leadership Styles in Contemporary Clinical Practice - Research Paper Example

Identify and discuss, using current (i.e. 2004 onwards) academic literature, the applicability, impact and effectiveness of three (3) leadership styles in contemporary clinical practice, and how, where and why you could best use each of these styles in your future practice. Give rationales for leadership chosen. Introduction There are several theories about leadership and the effectiveness of leadership. It is generally accepted that in different clinical situations different types of leadership work. There is a great amount of research on this topic, which is evidenced by literature, and in this assignment, the answers to the questions about which type of leadership would be the best in certain clinical situations would be found through the review of them. It is evident that different leadership qualities and leader behaviours would be most important in dealing with different clinical situations that are faced by the leaders in practice. Thinking from the context of nursing, some clinical situations would demand fast actions and quick response and thinking. In contrast some others would need allowance of time due to its complex nature. The best solution then may come from careful consideration of different facets of the situation that poses a problem. Literature on leadership theories identifies different qualities and behavioural patterns of effective nurse leaders (Cummings et al., 2008). Autocratic The type of leadership or its style has been explained by the behavioural theories of leadership. According to this theory, the style of leadership is indicated by behavioural theories. The first of them is authoritarian leadership. This has also been called as autocratic, directive, or controlling leadership. As evident from the name, the authoritarian gives orders and thus would make the decision for the group as a whole. Therefore, there is a chance of imposition of her decision on that of the group. Consequently, most of the responsinbilies of outcome falls on her. This is an efficient way of leadership, but imposition would constrict the creativity and thoughts or ideas of the individual members of the group. Therefore new ways of executing the work would remain unexplored. Moreover, there can be an idea that since the leader is responsible and is taking decisions, there would be lack of ownership and inhibition of motivation. There are certain clinical situations where authoritarian leadership is necessary in the clinical practice, where the leader must ensure all the group members follow the same principles in care. For example if there is a high incidence of hospital acquired infection in the intensive care unit, and there is a perceived need to follow the infection control policy in practice which includes stringent hand washing of the nurses, the leader must enforce compulsory hand washing for the team. Depending on the gravity of the situation and implications on patient safety, the autocratic leader may decide to be either punitive or benign. In this style of leadership, the team members will have less freedom with the leader having high control. The leader will have to be very active with the decision being made by the leader with the responsibility being shouldered by her. Given the appropriateness of the situation, this type of leadership can be very suitable with a high quantity, good quality output with great efficiency. As indicated by Murphy (2005), contemporary nursing practice still believes in autocratic leadership styles leading to a disempowered staff. There is a need for transformation in the style of leadership of the nurse managers through education, training, and professional development ultimately leading to key leadership competencies. New nurse leaders will need to take recourse to intellectual stimulation of the group where each team member's opinion and empowerment are considered with great priority in order to get rid of the tradition of oppression imposed by autocratic style of leadership in order to be more efficiently performing in the changing and complicated healthcare environment (Murphy, 2005). In some cases, autocratic leadership leads to lack of role clarity and lack of teamwork, and from that perspective this traditional command and control leadership of autocratic decision making processes may prove to be a failure in certain situations. Autocratic style of work is very suitable for a stable environment where a lot of predictable work is to be done where guidelines set out the exactly expected performances. Democratic or Participative The democratic or participative leader, as opposed to the autocratic, would share the plan, responsibility, and decision making with the team. Therefore, the outcomes will also be shared by each member of the team. It has been argued that this is less efficient than the autocratic style, but it has been favoured by the team members due to its innate flexibility and ability to motivate people. This has also potential to foster creativity. This style is characterised by guidance, and control is imposed by the members themselves. A democratic leader attempts to move the group towards its goals. As an example, the scenario of eliminating medication errors in a ward can be taken. The leader can manage it democratically by explaining the impact of medication errors and requests the team to provide suggestions to eliminate them. The team was free to suggest, and they decided that for each medication, a junior nurse will always ask the senior member to confirm the medication. The senior nurse agreed to confirm it with pharmacy and the doctor. The action plan was designed by the team, and the end result was error free medication administration. It is thus evident that in democratic leadership there is an element of moderation with moderate freedom and moderate control. The decision making process is a joint phenomenon, both by the leader and the team members. In this the activity level of the leader is high with a component of shared responsibility. The team becomes very creative with a high quality output. However, the team will be less efficient than an authoritarian leadership (Cummings et al., 2008). As indicated by Henderson and Winch (2008) leadership strategies can facilitate optimum standards of practice in nursing. It has been stated that democratic leadership style can enhance the environment of care where best nursing practice can be fostered. With democratic leadership style, there is a possibility of relevant education and professional development, where evidence can be easily incorporated into practice and the team may be very much open and responsive to the need for change of practice and they may consider maintenance of standard and competent practice at the best possible level. Therefore the contemporary approach to leadership style is democratic which can add value to professional nursing (Henderson and Winch 2008). Democratic leadership is a transformational leadership where democratic inclusive decision making process is the main driving force of the strategy. This also involves an enabling and empowering approach to teaching, learning, and managing and hence would lead to an effective teamwork based on role clarity and involvement (Henderson and Winch, 2008). Delegative or Free Reign or Permissive Leadership Style By definition, this indicates minimally restricted freedom. In this style of leadership, the leader does very little planning or decision making. Either intentionally or by his personality, the end result is the leader fails to encourage others in the team to participate. This freedom is a result really of lack of leadership. Sometimes, this is a result of postponement of decision making and total absence of decision making. The result is confusion of the team members. Some members may feel confused and frustrated due to lack of goal or objective, absence of guidance and direction. This is suitable for experienced group of nurses in any care setting where little guidance is necessary. The problem with most other people is that under this kind of leadership often flounders. This type of leadership does not attempt to move the group. In this there is little control on the part of the leader and much freedom for the team members which they do not want. Sometimes the decision is made by the group, and sometimes no one makes a decision (Phillips, 2005). The leader activity level is minimal, and no one assumes responsibility, which is often abdicated. The output of the group is variable, often of poor quality due to lack of planning, goal, and coordination. This strategy of leadership is not suitable for complex clinical work in nursing, since the team often becomes inefficient. Obviously, this is an informal arrangement, and work in positions that are less predictable will have greater flexibility. It is clear that some staff members need to be led just due to the fact that they need to know what they are doing. Allocation of activities is necessary for that reason (Wong and Cummings, 2007). Conclusion Nursing leadership has important implications in patient outcomes. There is a recent attention to creation of high output and safe practice environments, and it has been proposed that nursing leadership has important contributions to make in that area. Different styles of nursing leadership produce different outcomes and different efficiency levels. Research has demonstrated that there is significant association between positive leadership behavioural styles and practices and increased patient satisfaction and reduced care related adverse events. Therefore development of work-specific nursing leadership strategy in the clinical practice area is necessary, and the nurse leader of the future time must have knowledge about this. Reference Cummings, G., Lee, H., MacGregor, T., Davey, M., Wong, C., Paul, L., and Stafford, E., (2008). Factors contributing to nursing leadership: a systematic review. J Health Serv Res Policy; 13: 240 - 248. Henderson, A and Winch, S., (2008). Managing the clinical setting for best nursing practice: a brief overview of contemporary initiatives. J Nurs Manag; 16(1): 92-5. Murphy, L., (2005). Transformational leadership: a cascading chain reaction. J Nurs Manag, 2005; 13(2): 128-36. Phillips, J., (2005). Knowledge is power: using nursing information management and leadership interventions to improve services to patients, clients and users. J Nurs Manag; 13(6): 524-36. Wong, CA and Cummings, GG., (2007). The relationship between nursing leadership and patient outcomes: a systematic review. J Nurs Manag; 15(5): 508-21. Read More