Leadership Ethical Leadership in the Nursing Profession

Nursing leadership is uniquely challenging because of the practical, physical and philosophical demands placed on nursing professionals. When one considers the ethical implications that must also apply to this role, it becomes clear that the occupation requires a uniquely qualified individual. Indeed, as this discussion will show, in light of current challenges in the field, the achievement of ethical leadership in nursing is quite a demanding feat.

Ethical Leadership:

Leadership is a complex science. While it is critical that an effective leader understands the importance of commanding respect, delegating effectively and comporting one's self in a manner befitting of an organization's internal culture, these practical demands may say little about one's ethical orientation. Ethicality in leadership is a feature equally as important as those practical demands that define day-to-day responsibilities. Indeed, there is a close connection between ethical performance and high standards of operational quality. This is most especially true in the healthcare context, where positive ethical behavior is tantamount to humane treatment of those in need. Therefore, as this discussion proceeds, it will be with an interest in demonstrating the importance of ethical leadership in the nursing profession. Specifically, as we articulate a key issue facing the nursing profession, the discussion here will demonstrate that strong ethical leadership is one of our best resources in working toward improvements.

Issue Identification:

The key issue due for discussion is that of the national nursing shortage. There has been much discussion in recent years on the impact that high rates of professional turnover are having on the field of nursing. Specifically, this is resulting in long working hours, lowered morale and a poor ratio of nurses to patients in many healthcare contexts. To the point, "ccording to the text by Cullen et al. (2010), "in 2008, American Health Care Association's report of vacancies in long-term facilities and American Hospital Association's report of hospital vacancies combined relayed an even larger shortage of 8.1%. By 2025, the shortage in RNs is projected...

nursing shortage since the 1960's." (Cullen et al. 2010)
The result of this shortage is a potentially diminished quality of healthcare. Researchers have long traced a connection between better ratios of nurse to patient and positive treatment outcomes. This connection is what makes the nursing shortage both an issue of ethical requirement and of leadership challenge. To manage nursing shortage, improve conditions in healthcare contexts and to improve efforts at recruiting and most especially retaining high quality nursing hires, strong leadership is required. This applies both to Nursing Managers and to the Registered Nurses who have an opportunity to emerge as cultural leaders in a given context.

Key Strategies:

This is a considerable challenge and one with systemic implications. In reality, there is little that nurses can do to prevent the impact of demographic realities on the current healthcare equation. As the Baby Boomer population ages into retirement and its healthcare needs grow, the number of Medicare recipients will actually outnumber the population of America's working adults. This means an especially troublesome burden for nurses and the healthcare system as a whole. Again, nurses will be able to do little about these patterns.

But one key strategy is informed by the belief that there are opportunities to prepare for this reality. Ethical internal leadership and a patient-centered strategy of treatment can be combined to sustain the coming population change. According to the text by Schreiber (2004), it is incumbent upon nursing leaders to play a role in reducing the risk of turnover. Accordingly Schreiber asserts that "of particular interest in the assessment of turnover risk is the importance of leadership . . . due to the reliance of the team on that person. There is a large requirement for this person to apply their knowledge to many tasks." (Schreiber, 5)

Thus, a key strategy would be the reduction in the occurrence of turnover in nursing positions through the work of strong, compassionate and respected leadership. Improved leadership means a more nuanced distribution of labor and a recognition of how best to balance nursing needs,…