Applying Servant Leadership to a Nursing Practice

Servant leadership is a form of leadership that challenges the old top-down paradigm of leadership and suggests that the best leaders are those who work for their followers instead of having their followers work for them. This philosophy does not mean that servant leaders cannot delegate responsibilities or apply other effective management skills, but focuses strongly one two things: 1) the goal of the leader and 2) the benefits that the followers get from following the leader. "A servant-leader focuses primarily on the growth and well-being of people and the communities to which they belong. While traditional leadership generally involves the accumulation and exercise of power by one at the 'top of the pyramid,' servant leadership is different. The servant-leader shares power puts the needs of others first and helps people develop and perform as highly as possible" (Robert K. Greenleaf Center, 2014). According to Greenleaf, the best way to examine this goal is to focus on the people being served, not the leader. Do these people, while being served, become: "healthier, wiser, freer, more autonomous, more likely themselves to become servants?" (Robert K. Greenleaf Center, 2014). If the answers to those questions are yeses, then one is looking at a model of servant leadership. Furthermore, it is important to look at the power-structure in organizations or groups to determine whether servant-leadership is present. When there is servant-leadership, power is shared between leaders and followers, so that followers are oftentimes the driving force in any decision-making.

Incorporating servant leadership into a nursing practice is a natural and practical extension of a patient-centered philosophy of care. In a patient-centered philosophy of care, the patient's needs and concerns are going to inform all aspects of treatment. For some health-care providers, this position can be difficult to embrace because it may be easier and less time-consuming to dictate care to the patient, given the nurse's generally superior knowledge about healthcare. The first principle I choose to implement in my practice is a drive for patient autonomy. In the healthcare setting, it can be tempting to view patients as a set of disorders and medical conditions rather than as individual human beings. I will challenge myself to view each patient as an individual human being, and provide those individual human beings with the knowledge that they need to make choices that are best-suited for their lives, increasing their autonomy. The second principle I choose to implement in my practice is not to pursue power for the sake of power. In the traditional course of one's career, one can expect to be offered promotions. I think it will be important to consider whether a move up a ladder is one that will provide me with greater opportunities to exhibit servant leadership, and, if not, if it is a step that leads me towards that ultimate goal. If it does not, then that is not the upward that I need to follow to enhance my own career. Finally, one of the aspects of servant leadership is to ask whether people will become healthier as a result of following me as a leader. Clearly, as a nurse, my goal is to improve patient health. In some circumstances, improvements in health are not possible; some conditions are linked to continuing deterioration. I will then challenge myself to consider whether those patients are healthier than they would have been without my leadership, if not healthier than they were when we began to interact with one another. There are many scenarios, such as hospice care or long-term interventions with people with chronic debilitating diseases, where measuring success as a nursing leader by only looking at a patient's progressive health status would indicate failure. It is, therefore, important to consider what my leadership has mean to the individual's health.