Diversity Management and Nursing Leadership Philosophy

Introduction

A growing body of evidence in nursing practice reveals that healthy working environments enhance staff satisfaction, improved patient outcomes, staff retention, and organizational performance. Health organizations that intend to establish a healthy work environment should put in place strong nursing leadership practices at all levels of the organization, especially at the patient point of care. With recent changes in the healthcare environment over the last two decades, the influx of immigrant nursing professionals into the United States has increased responsibilities for staffing, diversity management, and regulatory compliance.

Faced with increased market competition and the aim of satisfying the needs of workers from different cultural backgrounds, healthcare organizations need effective nursing leaders to manage diverse cultural challenges. Essentially, diversity management drives market growth and unlocks innovation. Organizations that manage workforce diversity effectively have been shown to enjoy greater innovation within the work environment (Hewlett, Marshall, & Sherbin, 2013). Despite the benefits that healthcare organizations stand to derive from diversity leadership management, it remains challenging for contemporary nursing leaders to possess the skills, knowledge, and abilities needed to manage organizations with diverse workforces. A leader must be able to strike a balance between practicing efficient business operations and providing compassionate care in multicultural and diverse healthcare environments.

The objective of this paper is to develop a nursing leadership and diversity management philosophy using the Larry Purnell Model of Cultural Competence. The paper also discusses core values that include communication, integrity, and passion, as well as total quality management as a guiding management philosophy.

Nursing Leadership and Diversity Management Philosophy

The advent of a global economy and advances in technology have brought people from different parts of the world closer together, leading to changes in workplace diversity. An increase in workforce diversity has given nursing leaders new responsibilities for managing staff diversity in order to increase customer loyalty and retain and attract quality workers (Sherman & Pross, 2010).

As one indicator of the business value of diversity, research has found that "employees of firms with 2-D diversity are 45% more likely to report a growth in market share over the previous year and 70% more likely to report that the firm captured a new market" (Hewlett, Marshall, & Sherbin, 2013).

Leadership is broadly defined as the ability to influence others through interpersonal skills and effective communication. Avoka, Florence, Ofei, et al. (2016) define leadership as the process or art of influencing people to achieve organizational goals. Leadership involves different styles, and a leader must demonstrate effective leadership to drive innovation and enhance quality health systems within the healthcare environment. Leadership styles displayed by nursing managers play a significant role in job satisfaction within multicultural environments. Castle and Decker (2011) note that the Director of Nursing (DON) and the Nursing Home Administrator (NHA) form the leadership team that influences quality healthcare delivery within the multicultural health environment, with DONs demonstrating the ability to deliver better quality outcomes than Home Administrators.

Avolio and Bass (1994) argue that transformational leadership is one of the most effective leadership styles in diverse work environments. Transformational leadership encompasses inspirational motivation, individual consideration, idealized behavior, idealistic attributes, and intellectual stimulation. Transformational leadership behaviors must be reflected in nursing managers so that they can create and communicate cultural competence to their subordinates. A transformational leader inspires subordinates to achieve change by raising worker awareness to a higher level. Avolio and Bass (1994) also identify transactional leadership as another important style for managing diversity. Transactional leadership styles include management-by-exception, laissez-faire, and contingent rewards. The transactional leadership approach motivates employees through a system of punishment and rewards. In the United States, most nursing leaders incorporate transformational leadership styles to manage cultural diversity.

Despite these arguments, Souher and Shirley (2014) contend that nursing leaders face significant challenges in managing multicultural health environments. The authors draw an example from the healthcare environment in the United Arab Emirates, where nursing professionals from different parts of the world come to work. The King Fahad Hospital, ranked as the largest hospital in Saudi Arabia, employs nursing staff from countries including the United Kingdom, the United States, Nigeria, Canada, India, Singapore, and others. This diversity among nursing staff creates new challenges for leaders in managing cultural and communication differences in order to deliver culturally competent care.

Since understanding patients' symptoms depends on the cultural and linguistic knowledge of staff, nursing leaders bear the responsibility of ensuring that effective, culturally competent healthcare delivery is achieved. Culturally competent care is defined as the process by which nursing professionals strive to deliver quality care for clients within their cultural context. Achieving this goal is challenging in part because nearly all nursing staff in this setting are expatriates, with only a few from Arabic-speaking backgrounds. This creates a complex situation for leaders who are themselves non-Arabic speakers and are required to implement a Western biomedical healthcare model within the culturally diverse population of Saudi healthcare settings.

Conclusion

In healthcare organizations, nursing leaders face challenges managing diverse workplaces because some leaders are not culturally competent. This paper identifies transformational and transactional leadership as effective styles for managing diverse work environments. However, leaders must also be culturally competent to achieve organizational objectives. Nursing leaders should therefore deepen their understanding of the Purnell Model of Cultural Competence in order to manage their organizations effectively.