Healthcare We can compare the healthcare workplace to what is seen by a person when he/she looks through a kaleidoscope: since there are numerous different patterns that appear as the moments pass by. The shortage of nurses which has been publicized widely and the high turnover rates amongst the nurses are some of the unwanted patterns which have occurred. The dependence of healthcare institutions on the nurse-managers for the retention and recruitment of nurses is steadily increasing (Contino, 2004).

There are a number of routes through which the critical care nurses have become the leaders. Most of these routes don't have any educational or managerial training as a part of the process. There is a need for effective strategies for the care leaders who provide critical care in order to inspire the staff and manage the departmental operations in an effective manner to get positive results. One of the strategies that are being used by the professional nursing associations, chief nursing officers and the employees is to create and implement a formalized sort of critical care leadership as well as managerial training programs which are based on evidence and are result oriented. When it comes to the development of healthcare leaders an under-use of the evidence-based research has been reported by Vance and Larson (2002) in "Leadership Research in Business and Health Care." What little evidence-based research is available regarding healthcare is poorly translated and mainly descriptive.

Practical managerial skills which are essential for the critical care nurses in the official managerial roles have been compiled by me in this article, along with some of the leadership skills that can prove to be very helpful for the nurses. These skills are based on the leadership and managerial experience as well as the findings of many experts' business resources as healthcare professionals (Contino, 2004).

The responsibilities of the critical care managers have been mirrored in the highly dynamic and divergent leadership skills. The requirement for the open-minded leaders who work alongside their peers and colleagues in order to prepare themselves for the multifaceted challenges which take place every day has also been illustrated in these skills. There are 4 categories that the leadership skills have been grouped into:

1. Organizational management

2. Communication

3. Analysis/strategy, and

4. Creation/vision.

There are key abilities and skills that have been included in each one of these categories which can help the leaders in becoming more effective. These skills have been separately discussed in order to explain each one of them in a better manner along with demonstrating the way that they can be applied. Even though the nature of this topic is very extensive but the examples that have been mentioned here are brief and additional resources and information can be achieved by making use of the cited references (Contino, 2004).

Competency-based development programs and job descriptions can be created for the nurse-leaders by the administrative teams if they make use of these leadership skills.

Organizational Management Skills

The experiences of other successful institutions and organizations can be used by the healthcare businesses to get benefit from. In the book Built to Last (Collins and Porras, 1997), there is a study that has been conducted on the successful corporate habits. In this study it has been shown that the continuity of the leadership and ongoing leaders' development is very important for the success of an institution.

When the employees are taught and they know how to manage the human resources, revenue, information, expense, time, change, equipment and information technology, it is the organization or institution and their shareholder that can benefit from this. The level 5 leader has been described by Collins (2001) in 'Good to Great' which is a follow-up research book as someone who has the ability to build lasting greatness by making use of professional will and personal humility to train employees to always do what is right. A leader is the sort of person who gives credit to the others for successes while takes the responsibility for failures. In order to motivate the other employees he trusts the inspired standards. It has been stated by Collins that one of the most important determinants of the organizational greatness is level 5 leadership. Effective management of others as well as your own self is the essence of "great" leadership. Therefore, for the leaders it is very important to know how to manage their own emotional response in different situations.

The retention...

The areas that can be worked on for the betterment of future and current leaders have been suggested by Wieck and colleagues (2002). It has been indicated by them that the emerging and entrenched workforce would like for their leaders to show optimism, honesty and integrity. Employees want their leaders to have good communication skills and receptive to the needs and wants of others. They want their leaders to be approachable, motivational, empowering and fair (Wieck et al., 2002).
"Reversing the Flight of Talent" was a survey that was conducted on 1600 staff nurses. The result of this survey shows that the nurses want to have effective nurse-leaders5 that they work for. From among the nurses who took part in the survey 84% of them were thinking of leaving their jobs as they were not satisfied with the managers that they had. 43% of the nurses considered leaving the job even though they were satisfied with their managers (Denby et al., 2000). The leadership skills of the leaders can be improved if the research findings are incorporated into the healthcare system.

Managing Time

Successful strategies are used by the effective leaders in order to manage the time. Most of the times precious hours and minutes are wasted by the leaders on insignificant tasks such as opening the mail, answering the noncritical requests or filing. Self-discipline is used by the effective leaders to organize these tasks and to prioritize various projects. The time management skills can be perfected by the nurses by following the instructions and experiences of experts like Stephen Covey (1998). A time management matrix has been described by Covey in the book written by him; The 7 Habits of Highly Effective People. This time management matrix helps in understanding the relationship with non-urgent, urgent, not important and important activities. With the help of this tool the leaders are better able to allot their time to the urgent matters, for example, a director's budget (quadrant II planning and quadrant I deadline-driven projects) has a deadline coming in 3 days and a friends calls up to ask about some advice regarding vacation plans. The call is received and responded to by the director in a correct manner as, he asks the friend (quadrant III interruptions and quadrant IV some phone calls) to give a call to the director when he is at home in the evening.

Time can be used in an effective manner by the leader when self-esteem of the employees is being built as it has been shown by the 1-minute praise concept that has been explained in One Minute Manager (Blanchard and Johnson, 1982). Another important skill of an effective leader is to come up with quick, creative and individual ways in which he can thank his colleagues, staff members and customers. Having personal knowledge of the staff members improves retention and builds their morale (Snow, 2002).

In order to manage the time it is very important for a leader to have delegation skills. Not everything has to be done by the leaders. Their main responsibilities are to monitor or look over the ongoing process, completion of projects and to make sure that results are produced by interventions (Gregg, 2002). When appropriate projects and tasks are provided by the leader to the nurses and employees belonging to the administration department, it helps him/her in maximizing effectiveness. A process comprising of 4 steps has been described by Ales (1995) which helps the readers by telling them about the science and art of delegation: deciding on a task which can be delegated, making sure that it is assigned to the correct person, conveying the message in a clear manner, and carrying on with the management of information as, this step plays a very important role in the success of a leader (Gregg, 2002).

Management of data with regards to the performance measurements and budget targets becomes very difficult in the absence of regular statistics. There has been a lot of data provided on various benchmarks like pressure ulcers, nursing skill mix, falls and hours per patient each day. Another resource through which the various practices are showcased is the Advisory Board (2004). There is large amount of data which is gathered by the critical care nurses regarding the patients and it is require by the nurse-managers to do the same thing with the operational data.

Managing Human Resources

The management of human resources especially the nursing resources is a very big part of the nurse-leader's role. A lot of time and attention is paid to the difficulties of understanding people since, exactly like a disease if a…