Interview: Nursing and Leadership Theory

Interview: Nursing and Leadership Theory Serving in a role of leadership is always a genuine challenge. However, this challenge takes on added importance when lives are stake. Therefore, for the nursing professional and especially for the nursing professional in a position of leadership, it is useful to understand some of the qualities, ideas and characteristics constituting a great leader. Beyond this, the achievement of organizational goals requires a sensible balance between managerial commitment to the strategic interests of the organization and to the human interests of its everyday operation at every level. Indeed, research and experiential evidence will tend to demonstrate that there is a symbiotic relationship between these aspects of organizational orientation which suggests that effective strategy must inherently consider the implications of the experience of the personnel who will implement said strategy. This is the essential position offered by the subject of my leadership interview. For the sake of anonymity, we will refer to the respondent as Nurse X. Nurse X is a female head nurse of 44 years of age. She works in an emergency room setting and is an ideal candidate for providing meaningful insight on the types of leadership demands which are incumbent upon one in such a high-pressure context. Thus, the interview would focus both on her leadership philosophy in a general sense and on the manner in which she has channeled this perspective into an actionable leadership style in the healthcare context. Nurse X would relate a brief bit of her background in response to the opening question. Though she works in a suburban context now, which she describes as something more organized and less stressful than prior experiences, she developed many of the skills on display today while working as a nurse in an inner-city hospital. In addition to encountering an array of conditions, injuries and individuals which would significantly broaden her horizons, she would find that she was naturally cool under pressure. She would seize situations aggressively in pursuit of organizational efficiency, often taking the initiative to distribute responsibilities and act upon decisions based on a sense of confidence and necessity. When she determined to move out of the city, she found that her experience and the relationships which she had established in the field had qualified her for a position as the Director of Nurses at her current place of employment. Here, she has thrived by her own account in the last 6 years, building a healthy relationship with a staff where morale is uniquely high and where the quality of care is distinguished. Nurse X would to some extent credit her own position and advancement in the nursing community on some understanding of that which is implied by leadership theory. Namely, she noted tha "I can see some ways in which the qualities discussed are applicable to my own abilities. Particularly, I am pleased to say that I have always been able to lead by example. I am a very firm believer that every great leader must always 'pay their dues.' Such is to say that no degree of leadership removes one from the practical responsibilities of an occupation. I take pride in the fact that even from a position of authority, I remain grounded in a practice of the basic labor applications of all that I do. This is true whether at work or at home, where I take pleasure in performing in even the smallest detail." We find that Nurse X is a perfect embodiment of the leadership principles encountered in our course materials, echoing the content's claim as to the inherency of great leadership in one's personal makeup. We enter into this discussion under the assumptive basis that an organization's performance success will be inherently based on the performance effectiveness of its personnel. Nurse X would endorse this position, responding to a question concerning leadership theory in a general sense by denoting that leadership it is a quality which can often mean the difference between effective management or authoritative impotence. Focusing on the humanist level, Nurse X offered a discussion of management roles and corporate hierarchy, leadership is an ability which, either inborn or, developed through hard work and ingenuity, presents the members of the organization with a paragon to forging action toward rational and collective goals. While it is the responsibility of managerial personnel to issue directives, instructions and clarifications on goal- orientation, she would argue, it is only a leader who can find ways to motivate the members of an organization to fulfill expectations. In the absence of proper leadership, it may be difficult to channel these responsibilities toward the fulfillment of organizational expectations. Thus, by finding ways to personally and professionally invest these members into the shared goals of the organization, a manager can evolve into a credible leader. This means that even not endowed with the inborn virtues of a leader, one with a dedication and sensitivity to the mores of an organization will likely find one's self inclined with more naturally and reflexive leadership ability than that necessarily implied by the theoretical discourse. For Nurse X, this is a condition which would be highlighted by her initial struggle as a leader to overcome a core personality trait. With respect to the biggest challenge to her leadership, she would note that it was often difficult for her to cede personal responsibilities. She would report that "as a result of my strong drive to take a direct part in leading organizational success, probably one of the greatest challenges for me is delegation. I had been raised according to the idea that the only way to get something done right is to do it one's self. Though this is an appealing mantra for ensuring the above-mentioned policy of engagement, I do require some balance to this perspective. I am still sometimes reminding myself to trust that those around me will be sufficiently endowed with knowledge and the ability to respond as effectively as could I to any given situation. I would truly learn through this position that a great leader is willing to see the abilities in others. In nursing, this is so important because you really cannot do it without the help of a qualified and dedicated staff of fellow nurses." Here, Nurse X would provide further endorsement to the idea that we have encountered through our course materials, which dictates that delegation and the maintenance of a motivated and effective staff are both key characteristic abilities of the qualified leader. For our interview subject, this is a revelation which would come about only through honing of cognizance and skill in this realm of leadership. For the aspiring leaders and nursing leaders of the future, Nurse X would highlight the overarching importance of proper team orientation where responsibilities and charges are clear. A sense of efficiency is central to the way the patient views those providing his healthcare, underscoring a connection between organizational efficiency and patient outcome. Efficiency and organization are important features of a nursing team, particularly as they impact the experience for patients. Quality outcomes in the hospital environment can have an essential impact on the quality of standards perceived by patients. This is important as quality outcomes are now seen to relate as much to patients' own perceptions and well being as to genuine changes in clinical status. There is a clear relationship between the patient perception and the standardization, or norming, of practices amongst nurses, which can only be dictated through a respected leader who is received with clarity and credibility and which can only be achieved through a staff that is informed and educated. On this point, Nurse X instructs the aspiring nursing leader that "nurse managers and leaders must encourage the academic and personal career development needs of nurses and healthcare providers, while also addressing service requirements of primary interest to patients and public standards. By educating the staff effectively, the hospital can ensure that its front line employees will possess the knowledge and skills required to assist in the proper administration of primary and emergency care." She would continue on to contend that a facility will also thereby increase the standard of care, improving the concurrence with quality standards which are now part of the basic requirements to administrating a nursing team. Education toward effective compliance with established standards will therefore have the optimum effect of increasing service productivity. The premise offered in her interview seems to denote opportunities for nurses under effective leadership administration to gain professional advancement within the healthcare facility. This will have a general impact on improving team performance and individual dedication. As current challenges in her working context are concerned, Nurse X did describe this issue of ongoing education problem, most particularly because a shortage of nurses on a national and international scale is causing greater demand for ready nursing professionals. The result is that, quite often, nursing standards must not be too stringent, lest they eliminate much-needed candidates. This is, Nurse X would indicate, a leadership challenge facing the whole of the healthcare industry, where the need for qualified personnel is often trumped by the simple need for personnel. On her own account, Nurse X would suggest that "a solution to that might be the administration of an effective training regiment for those to operate under my charge. Particularly if I am to face up to such challenges as those inherent to larger organizational settings, I must be prepared to generate meaningful support and to limit resistance within my core staff group. In the nursing context, it is certain that tasks and responsibilities are simply to great and too many for the approach to be otherwise. Therefore, if I am to find improvement in the ability to delegate comfortably, I could engage a more intensified hiring process and mandate a permeating training course." Nurse X would here show herself to be a leader in a constant state of evolution. She recognizes challenges, shortcomings and resolutions all in her desire to improve both her personal effectiveness and that of those over whom she presides. A closing remark in her interview speaks to this point. She would contend that "effecting positive change in the abilities of those serving beneath me would be a foundational step to instilling myself with a sense of security in the likely outcome of labor delegation, decision-making delegation or even my own abilities as a leader." The general thrust of the interview would suggest much of what would be resolved also in our primary texts. Such is to say that providing effective nursing care in a hospital setting, or in any large organization with an array of complex facets which impact many interested parties, is a task that cannot be met by any one individual, no matter how dynamic he or she might be. A hospital is a deeply complex and varied context in which to conduct one's self responsibly and effectively. In order for this to be possible, it is absolutely necessary that the hospital's nursing units develop effectively and according to organized group and leadership principals such as those offered by our interviewee.