Nursing Leadership and Management as Essential Elements of the Nursing Profession - Article Example

?Running head: NURSING LEADERSHIP AND MANAGEMENT Nursing Leadership and Management (school) Nursing leadership and management refers to functions which refer to authoritative as well as assertive qualities. Leadership and management for nurses are founded on the implementation of essential health services for patients as well as the designation of tasks to subordinates. Various theories and functions are found in nursing leadership and management. The theories of Taylor and Weber form some of the foundations for nursing leadership, however in the contemporary context, the concept of interprofessional practice in the health delivery is the primary focus for nursing leadership and management. Nurses function as team-builders, decision-makers, communicators, negotiators, delegators, and mentors and they help in the planning, directing, leading, and implementation of health services in order to achieve strong and improved health outcomes. In effect, with these functions taken as a whole, nurses become effective leaders and managers. Nursing Leadership and Management Introduction Nursing leadership and management are essential elements of the nursing profession. They are tools for nurses to use in their practice as they help in the implementation of nursing interventions and in the establishment of clear goals for the patients. Nursing leadership and management requires various tools in their implementation and these tools may sometimes be difficult to develop for various practitioners. In some cases, these are elements required for each nurse to develop because these nurses are responsible for various activities and interventions often crucial to improved patient outcomes. There are various elements of this leadership. This paper shall provide an overview of nursing leadership and management, including the different elements involved in its incorporation into the practice as well as its impact in the efficacy of nursing care. This study is being carried out in order to establish a clear and comprehensive discussion of the various elements of nursing leadership, including its applications, and impact on the delivery of health care services. Management has long been in existence and has been a vital element for many organized communities. Managers impact on the different phases and activities of organizations (Clarkson, 2009). The primary role of managers is to guide organizations in the accomplishment of their essential goals. Most organizations and professions have a particular purpose and objective and the managers have the burden of ensuring that activities are implemented efficiently in order to reach such goals (Yoder, 2010). Managers propel organizations towards these goals by designing and planning activities, as well as assigning particular functions to particular competent individuals. Managers seek to support individual activities which would likely lead to the achievement of goals; and they also discourage individual activities which may interfere with the achievement of said goals (Clarkson, 2009). Nursing is one of the activities often under the supervision of managers. Nursing service administration is a well-coordinated activity and it often provides the services necessary for the fulfillment of nursing goals. Nursing service administration is a system of activities which is focused towards the care of clients and it includes the formation of goals based on the goals of the health agency (Clarkson, 2009). Nursing service administration includes the process of planning, organizing, and controlling human, material, financial, as well as informational resources (Clarkson, 2009). Nursing services includes interrelated social and technical functional activities which are seen in formal organizational health settings. Nursing service managers are individuals whose functions are based on positions of authority (Yoder, 2010). These positions may be top level, middle level, and first line or front line supervisors including head nurses and staff. These managers often assign individuals to positions of authority (Jasovsky and Kamienski, 2007). They are also tasked with directing and helping others accomplish work effectively. They are responsible for the application of resources and are often made accountable to superiors for results. The top level managers, including the nursing administrators usually have authority over the whole organization; the middle level managers, including the department heads have responsibility for specific departments of units; and the first line managers usually report to the middle managers and they are tasked with supervising the particular tasks of particular groups of individuals (Jasovsky and Kamienski, 2007). These managers need to possess different skills in order to be effective managers and leaders. These skills may be conceptual, human relations, and technical skills. Human relations skills are the most common and more essential skills required of these managers because these skills help achieve goals through interactions with people. These include motivation, leadership, and communication skills (Sullivan and Decker, 2001). How each skill is applied is often based on nature of the position, the responsibility assigned, the work involved, as well as the number, type and the skills of the subordinates. The senior managers use the conceptual skills in their work; and they also recognize and assess the complex issues as well as the relationships and planning involved in the problems being resolved (Sullivan and Decker, 2001). For first line managers, they usually apply the specific job-related skills, and these skills often require more technical training and knowledge. Managers are involved in planning, organizing, staffing, directing, controlling and decision-making. They also carry out other activities which are concerned with work accomplishment and organizational objectives which are not within the function classifications (Fralic and Denby, 20001). These roles are also based on behavior linked with management positions, and classifications include interpersonal, informational, and decisional roles. For interpersonal roles, managers first of all are the figureheads because they are involved in various activities like the greeting of guests and making of speeches (Jasovsky and Kamienski, 2007). Liaison roles involve the establishment of internal and external contacts. As influencers, interpersonal roles require inclusion in activities related to directing. Nurses have to consider themselves as leaders and as such, they have to develop their leadership abilities and they also have to embrace the challenges in the health care practice (Grossman and Valiga, 2005). In order for them to become effective leaders, these nurses must also learn about leadership via academic activities, including on-the-job trainings through mentors (Fagin, 2000). In order to enhance their leadership skills, they must also observe the different experts in the field and work collaboratively with these individuals in order to gain constructive feedback on their actions and activities. Through these leaders, they can understand the wider context of the organization they are involved in, they can enhance their negotiation and communication skills, they can collaborate more effectively and have a more empowered demeanor in their practice (Grossman, 2005). Nurses having a more personal involvement or immersion in any situation would likely learn by doing and by practicing in the clinical setting with more experienced nurses. For nurse leaders, efficacy can be gained by defining their uniqueness or in general, what makes them special (Grossman, 2005). These nurses must then continue to enhance their special skills and improve their expertise so that they can become better leaders who can have a greater impact on policy development, evidence-based practice, and policy-making. Various health institutions develop leadership programs for managers and prospective leaders. Leadership skills can also be learned based on the professional development of nurses and other health professionals (Sullivan and Decker, 2001). Various organizations and institutions have annual conferences and trainings. Through these trainings, skills enhancement and updates can be carried out and insured. Nurses implement care for clients and their families in the hospitals, in communities, in the outpatient settings, the long-term facilities, and sometimes in rehabilitation centers (Sullivan and Decker, 2001). The strategies employed in these centers are based on leadership theories. Effective leadership involves managers who have a specific vision, those who are able to utilize power in effective ways, and those who can then challenge others to coordinate with the team in the accomplishment of organization vision or goals (Wheeler, 2000). Leaders are usually innovative, and they are able to develop and maintain structures. They also focus on systems and structures and they inspire trust among their peers and subordinates (Wheeler, 2000). Leaders also often challenge the status quo and help ensure that favorable change structures in the organization are established. In the past, various leadership styles have been employed and implemented. Taylor’s Scientific Management has supported various principles, especially those which relate to scientific accuracy, productivity, and cooperation (Inman, 2000). This theory also focused on the management of time and on establishing work specialization. For nurses, this scientific management theory applies in the management of task-oriented work, however, in the nursing practice task-oriented work was not effective in capturing the critical thinking as well as decision-making capabilities required in patient care (Nixon, 2003). Weber’s Bureaucratic Management theory discussed the concept of division of labor, formal selection, formal rules and regulations, and career orientation (Nixon, 2003). He also evaluated how people responded to authority and that concentrating authority to only a few people can also ensure effective management (Inman, 2000). In the nursing setting, the application of the bureaucratic management process has not given room for collaborative practice. Although bureaucratic management has helped institutions run like well-oiled machines, it has separated the different health professions into distinct entities which do not coordinate with each other in patient care (Huber, 2000). Failures in collaboration often interfere with the delivery of efficient health services, moreover, they often cause repetition and redundancy of services. For nurse leaders and managers, there are various formal and informal roles they are often tasked with. These roles include team-building, decision-making, communication, negotiation, delegation, and mentorship (Garrison, et.al., 2007). As team-builders, these nurses must be able to take on qualities which enable them to establish a strong team. Health care delivery is a team practice because different individuals are often needed in order to fulfill a patient’s needs (Garrison, et.al., 2007). Various members of the health care team have differing training which fulfills particular elements of health care delivery. Nurses as team-builders are able to organize teams and ensure group activity. Managers must therefore recognize that the members of the team they supervise can make the right decisions about particular aspects of patient care (Garrison, et.al., 2007). These managers must therefore communicate with all the members of the team in order to develop an effective plan of care. Nurses also have to be decision-makers. Decision-makers are also transformational leaders because their actions are able to effect change in the organization and in the patient (Marquis and Huston, 2006). As decision-makers, they share information with other professionals, they make the important decisions pertinent to the patient’s care, and they gain the input of other health professionals before making the decisions. Oftentimes, in the medical setting, quick and effective decisions often have to be made, the nurses must be able to assess the patient’s situation quickly and know the right questions to ask from other health professionals attending to the patient’s care (Marquis and Huston, 2006). Once such information is gained, a coordinated plan of care can be discussed with the attending physician who will recommend the crucial interventions for the patient. Implementing such interventions would be the function of the nurses. Nurses are also communicators (Garrison, et.al., 2007). As communicators, they gather as much information as they can about the patient by communicating with the patient, as well as with other health professionals involved in the patient’s care. Personal contact among the health professionals is the best form of communication because it prevents misunderstandings and helps build camaraderie among the members of the team (Hock, 2000). Open, trusting and synchronous processes are needed in organizations in order to ensure effective nursing practice. Moreover, in order to effectively promote health functions and efficient health care delivery, the processes of communication must be dynamic (Hock, 2000). For nurses, their role is also to link the communication between the members of the health team, asking the pertinent questions with other health members and informing other members of the health team. As negotiators, nurses need to display the appropriate negotiation skills in order to help members of the team arrive at decisions, as well as to establish organizational support for the plans (Garrison, et.al., 2007). As negotiators, they also seek the cooperation of other departments and organizations. In negotiating, the nurses seek to understand the different stakeholders involved, including the nurses, the physicians, the pharmacists, therapists, social workers, dieticians, families of patients, and psychiatrists. Communication is also a vital tool in negotiation and one of the most important attributes of negotiators is to support discussions among group members (Garrison, et.al., 2007). Negotiations often occur with each decision, mostly where certain decisions need adjustments based on specific patient conditions. For example, the patient may have some preferences in his care, in which case, certain negotiations may take place in order to ensure that the most effective decisions are still implemented for the patient. Delegating is also an important element of nursing care and leadership. Good and effective leaders are effective delegators. Delegation is no longer based on the top-down approach, but is now based on skill and interprofessional working (Morgan, et.al., 2005). Nurse-leaders function to establish an environment which supports the idea that associates and colleagues are partners in the delivery of care, and that they are accountable for the assessment of outcomes and interventions (Morgan, et.al., 2005). It also means that these leaders have a greater sense of ownership and affinity with the organization. Finally, nurse managers and leaders are also tasked with the responsibility of training and mentoring their young. As mentors, they help guide future nurses, assisting them in learning the trade, and in developing skills which are essential for improved patient outcomes (Garrison, et.al., 2007). Mentorship can be established through mutual respect and the patience to assist the younger less experienced nurses. Goal setting and open dialogue are hallmarks of effective mentoring and they help provide stimulating challenges for nurse-mentors (Wheatley, 2001). By assuming the role of mentor, it is possible for nurses to gain better outlooks on the learning process involved in the nursing practice. Nursing leadership has a strong impact on the nursing profession. Nurse managers and leaders carry out administrative work which help ensure that the essential functions in the health care institution are carried out (Nixon, 2003). These leaders and managers are essential cogs in the health care system because they help in the establishment of health care plans for patients and for health institutions in general. These managers also collaborate with each other and with other health professionals in establishing patient health plans. Through these plans, the essential elements needed in the patient’s recovery can be established. Patients can benefit well from prior planning and from well-executed plans (Rowland and Rowland, 1997). They can gain efficient health services, avoid repetition or redundant services, and also avoid any medical errors. Nurse managers and leaders are also crucial in the implementation of interprofessional working in the delivery of health services. In caring for one patient, various health professionals are already needed or involved in his care (Joel and Kelly, 2002). For example, flu would require the health services of the attending physician, the nurse, the pharmacist, the medical technologist, and depending on the causes of the disease, other doctors with special training. Nurse managers and leaders help in the coordination of the interprofessional working between these professionals (Joel and Kelly, 2002). In interprofessional working, the relations is often based on a co-equal relationship where the members of the health care team acknowledge the expertise of the other members and then defer to their recommendations on pertinent health concerns (Kuokkanen and Katajisto, 2003). By establishing a strong interprofessional working, institutions are able to function well as a unit and are able to deliver accurate, timely, and efficient health services. Moreover, medical redundancies and repetitious interventions can also be avoided in the effective workings of nurse leaders and managers. In order to be effective leaders and managers, it is important for these leaders to keep the channels of communication open. Keeping the channels of communication open helps ensure that the information is flowing between and among the different health professionals, between the different nurses, and between the nurses and the patients (Harman, 2007). This process can be undertaken by regularly carrying out interdepartmental and departmental meetings and conferences. The daily shift rounds can also ensure that the lines of communication are open and that the different departments are informed about pertinent patient concerns. Keeping the lines of communication open must also be carried out as far as the patient is concerned (Harman, 2007). Discussing possible treatments and educating the patient about his illness can help ensure that the patient understands his illness and the interventions he needs in order to recover. As leaders and managers, it is also important for nurses to express their appreciation for the work of their colleagues. Establishing a culture of appreciation provides intangible value to work which can boost morale and foster healthy relations in the health care setting (Harman, 2007). Moreover, involving the subordinates in the planning process and in departmental decision-making also helps ensure health relations within the health care organization. Knowing that one’s contribution is valued often ensures loyalty and respect within the organization (Harman, 2007). These are functions which can only be secured if the leaders nurture an environment and organization culture. Conclusion Nursing management and leadership is founded on various elements and processes. These processes mostly involve interprofessional working, coordination, collaboration, communication, and mutual respect for each other’s functions within the organization. Leadership theories support the notion that nurse leaders must take on a more collaborative attitude to the healthcare practice in order to ensure the efficient delivery of health services and the improvement of patient health outcomes. Within the nursing setting, the nurse has to take on various roles in order to provide nurse leadership and effective management. These roles also form a part of the bigger picture of health care delivery and in the end, help fulfill the mission and vision of the health organizations. References Clarkson, M. (2009). Leadership and management. Institute of Technology. Retrieved from http://researcharchive.wintec.ac.nz/532/1/Research_Project_2009_HLNU902_FINAL.pdf Fagin, C. (2000). Preparing students for leadership. In C. Fagin (Ed.), Essays on nursing leadership. New York: Springer Publishing. Fralic, M. & Denby, C. (2000). Retooling the nurse executive for the 21st century practice: Decision support systems. 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