Leadership and Management Styles in Professional Nursing

Effective Leadership and Qualities

Today, increasing numbers of nurses are leaving the profession due to the burnout caused by the ongoing Covid-19 pandemic as well as the rigorous and sometimes-overwhelming demands placed on nurses, especially those working in tertiary health care facilities. Consequently, the shortage of nursing staff across the country has intensified, and there is a clear need to better engage nurses in their workplace. These trends also underscore the need and importance of effective nursing leadership to address these issues in meaningful ways. The purpose of this paper is to systematically review the relevant literature to provide a definition of leadership, a comparison and contrast of the leader and manager roles, and a reflection of leadership and/or management styles in practice. In addition, an examination of my personal leadership and/or management style is followed by a salient example of preferred leadership and/or management application. Finally, the paper presents a summary of the findings that emerged from the research concerning the foregoing issues in the conclusion.

Definition of leadership

From a personal perspective, a definition of leadership would include the ability and the willingness to organize, motivate, and direct a group of people to achieve a common vision for an organization in which they would otherwise have little incentive to do so. This means that leadership also involves developing an appropriate and informed vision for an organization. In addition, leadership also involves creating the direction for an organization, communicating effectively, and inspiring and empowering others to work towards achieving the articulated vision. Likewise, leadership also includes making difficult decisions, accepting responsibility for the actions and outcomes of the people they lead, and serving as a role model for others to follow.

Taken together, this definition of leadership is consistent with the guidance provided by many organizational behaviorists, and it underscores the importance of professional nurses to develop these leadership qualities and characteristics throughout their careers. In this regard, Sims (2019) emphasizes that, “In today's healthcare climate, there is a shortage of nurses and nursing faculty. We need effective leaderships to navigate through this crisis. Although all nurses are leaders, we must develop the necessary skills to be effective” (p. 272).

While every effective leader and leadership style is unique to the individual, some common characteristics and qualities of effective leaders in health care settings include the following:

Effective leaders clarify expectations and direction. When people know the rules of the game, they are more likely to follow the playbook. We need to articulate exactly what we want and need from teams and every individual. In addition, all goals must be tied to organizational objectives.

Effective leaders model expected behaviors. Leaders need to orchestrate opportunities for people to see them behaving in alignment with expectations and behaviors. Let others see you interact with people and handle a challenging assignment or situation. Not only will they learn from your experience, they will gain respect for what you have to offer.

Effective leaders create desire and opportunities for learning. Skills such as communicating information, demonstrating empathy, listening, asking objective questions, providing feedback and dealing with challenging people and situations can be taught to staff members if they are willing and able to learn. It is the leader's job, therefore, to create the business case and mindset for people to want to improve (Scott, 2019, p. 40).

Compare and contrast the leader and manager role

The fundamental concepts of leadership focus on “the big picture” in which organizations operate and how best to navigate external exigencies to move towards a future vision. By contrast, management involves organizing and directing people within the organization to achieve this future vision by performing the day-to-day “nuts and bolts” tasks that are required. Not surprisingly, these roles translate into several similarities and differences between the leader and manager as discussed further below.

The similarities and differences of the respective leader and manager roles may overlap in real-world settings, but there are some distinct differences between the two that are noteworthy, including the following:

Leaders create a vision; managers create goals. As noted above, one of the definitional criteria for leadership is developing and guiding others towards achieving a vision. Conversely, managers establish the step-by-step, day-by-day goals that are required to move their organization towards achieving that vision (Aruda, 2016).

Leaders are in it for the long haul, managers think short-term. Leaders are purposeful and determined in their work, remaining focused on achieving long-term goals despite the lack of immediate rewards. Conversely, managers tend to focus on shorter-term objectives and typically require more frequent recognition or praise to remain motivated (Aruda, 2016).

Leaders take risks, managers control risk. Leaders are willing to assume risks and attempt new approaches, even if they may result in failure. In other words, leader do something even if it is wrong. Leaders recognize that failure is frequently required on the path to eventual success. Managers, on the other hand, tend to focus on minimizing risk and avoiding problems, rather than embracing and resolving them (Aruda, 2016).

When individuals occupy an integrated leader-manager role, they must develop the ability to take risks and drive change which is reflective of the leadership component as well as the ability to effectively manage and execute on plans and goals which reflect the management aspects. This balance is critically important for achieving success in any organization (Aruda, 2016)

Reflection of leadership and/or management styles in practice

Applying effective leadership and management styles is almost always situation-specific. As many individuals quickly learn when they assume a leadership or management position, there is no “one size fits all” strategy that works equally well in all circumstances. Based on my empirical observations and personal experiences over the years, though, many people adopt a leadership or managerial style that brooks no change. The truly effective managers and leaders I have observed have consistently demonstrated concern for their followers’ welfare and interests, and ensure that they have the resources, training and other tools they need to do their jobs in an exemplary fashion.

Examine personal leadership and/or management style

Although it is difficult to pigeonhole my leadership style, a careful and thoughtful self-assessment indicates that I typically apply a transactional style to achieve my objectives in the workplace. As noted above, though, every leadership activity is situation-specific, and my personal leadership style may draw on my limited supply of charisma or even humor when it is appropriate. This occasional mix of leadership styles is justified because the bottom line for me is the compelling need to deliver the highest quality of patient care possible without compromising integrity or taking shortcuts that violate ethical codes of conduct.

Based on course content and the dictum that anything can be improved, an honest evaluation of the effectiveness of my current leadership style suggests that I may fail to “keep my eye on the prize” in terms of achieving an optimal outcome due to interpersonal miscommunications or conflict that could be resolved through better communications. Certainly, making substantive changes my leadership comfort zone will require significant effort, but improved interpersonal communications is key to professional success.

Provide example of preferred leadership and/or management application

A hypothetical situation that is loosely based on a real-world scenario concerns the reporting of medication errors made by nursing staff. The director of quality assurance, an MPH, objected to addition of the patient days of care to calculate the medication error rate on his ward and demanded that the program specialist in charge stop using this method. The program specialist requested guidance from the nursing supervisor who investigated further and determined that the addition of the patient days of care highlighted the comparatively high number of errors made on the complainant’s ward. It was also determined that the nursing supervisor was best friends with the complainant and the change was demanded on his behalf to protect his professional reputation and prevent potential disciplinary actions. After determining the facts, the nursing supervisor was disciplined and the program specialist instructed to continue using the patient days of care calculation method to report medication errors through the hospital to identify opportunities to further improve patient care.