Annual Surveys and Nursing Leadership Strengths and Weaknesses

Introduction

Leadership is a challenge for all leaders across different realms, and being a nursing leader is no exception. This is particularly true given the circumstances and issues distinctive to the medical and healthcare profession. As a nursing leader, it is imperative not only to be accountable for matters specific to one's own department or team, but also to be responsible for organizing and facilitating interactions with other departments within the organization in order to attend to patient healthcare — both direct and indirect. The prevailing healthcare system is gradually developing and progressing into a new model founded on a vision of health advancement, primary care, and community-based home care, with hospitals continuing to be an essential pillar of the healthcare system but not its most important service (Gottlieb et al., 2012).

Considering the evolving healthcare landscape, a key issue in contemporary times is that nursing leaders are not fully cognizant of the areas of strengths and weaknesses within their departments and the organization as a whole. A key element that is bound to be of paramount importance in resolving this issue is that continued annual surveys of all members within a department and organization will help improve performance among nursing leaders.

Background: The Leadership Gap in Nursing

A key issue identified is that nursing leaders are not cognizant of their nursing management strengths and weaknesses. Yet, without such self-awareness, it can be quite challenging for them to provide effective leadership. It is also imperative for nursing leaders to understand that, even though they may be strong and effective in a number of areas, they are also weak in certain others. Therefore, a lack of understanding of both sides of their leadership decreases their overall level of effectiveness. By taking all these elements into consideration, nursing leaders can form a diverse nursing management team that is able to complement their strengths and at the same time improve on their weaknesses (Gottlieb et al., 2012).

The development and advancement of leadership skills ought to be perceived as a process. It is imperative for current and emerging leaders to assess and evaluate their strengths and weaknesses across the various dimensions of leadership. This need arises from the fact that it is challenging for present-day leaders to anticipate the knowledge, skills, and competencies that will be required to provide effective leadership in the future healthcare delivery system (Sherman and Pross, 2010).

Every nursing department and organization comprises individuals who serve the various roles necessary to meet the needs of residents. It is important to note that the presence of registered nurses, licensed practical nurses, and certified nursing assistants who share a nursing schedule and are assigned to function in a certain area of a nursing home does not necessarily mean that this group operates as a team. Nursing staff can be fragmented and led in different directions, or they can have a well-defined focus and work in tandem toward mutual goals and objectives. Ultimately, the level of success attained is frequently determined by the strength or weakness of the nurse leader and that leader's capability to motivate others (Frandsen, 2014).

With the changing environment in nursing, nursing leaders must take into consideration four key characteristics. The first is sense making, which encompasses the capacity to understand the constantly changing business environment and adapt to the consequences of changes within an organization (Al-Sawai, 2013). The second is relating, which involves the capacity to build trusting relationships, maintain balance between advocacy and inquiry, and nurture networks of supportive peers. The third is visioning, which encompasses forming a reliable and clear picture of a desired future toward which the organization can work (Al-Sawai, 2013). The fourth is inventing, which encompasses developing new ways of approaching everyday tasks or overcoming seemingly intractable problems. All four of these characteristics are mutually dependent, and therefore nursing leaders need to assess their own competencies, strengths, and weaknesses. The main objective of the nursing leader is to create an environment in which individuals are able to complement each other's strengths and offset each other's weaknesses (Al-Sawai, 2013).

The Importance of Annual Workplace Surveys

According to Morrel-Samuels (2002), there is considerable evidence that organizations can benefit from workplace surveys and questionnaires. A key element highlighted is the importance of making individual departments the key unit of analysis for organizational surveys. Although the need to maintain anonymity is paramount, large organizations still need to organize and examine the results of internal surveys at the department or functional unit level, because performance is ultimately evaluated at those levels. Surveys that are not broken down by department will be limited in their effectiveness and practical value (Morrel-Samuels, 2002).

The Denison Organizational Culture Survey

Organizational culture encompasses the deep-seated assumptions, beliefs, and values shared by members of an organization, which typically operate implicitly. The Denison Organizational Culture Survey is an instrument that, by design, provides a straightforward yet comprehensive analysis of an organization's culture by assessing fundamental cultural traits and management practices that impact business performance. According to Daniel Denison, the founder of the instrument, there are four underlying traits that form the basis of the model: consistency, involvement, mission, and adaptability (Denison and Neale, 2008). Effective organizations exhibit high levels of these particular cultural traits, which reflect their capacity to maintain stability while balancing the dynamic tension between the need for stability and the need for flexibility within the organization (Casida, 2008).

A rich understanding of organizational culture is imperative for all leaders because it shapes how their organizations respond to the shifting demands of the business environment. At any given point in time, an organization's culture is largely influenced by its previous achievements and prior learning regarding various aspects of adaptation and survival. As the business environment continually changes, it is imperative for leaders to anticipate necessary changes and actively monitor the relationship between the demands of the environment and the competencies of the organization (Denison and Neale, 2008).

The first trait of the Denison Survey is mission. Through this trait, nursing leaders can increase organizational performance by communicating to personnel why they do the work they do and how their daily work contributes to the organization. This encompasses three elements: strategic direction and intent, goals and objectives, and vision. The mission states the organization's purpose — what it is attempting to accomplish in the long run — establishes the goals and objectives that allow each employee to see how day-to-day activities are linked to the vision, and outlines the strategies instituted to operationalize that vision (Baker Strategy, 2016).

The second trait is adaptability. Through this trait, nursing leaders in high-performing organizations develop the capacity to recognize and respond to the environment and its consumers, and to reorganize behaviors and practices that allow them to adapt. The Denison Survey enables nursing leaders to embrace change by welcoming new ideas, being willing to try new approaches to tasks, and viewing the generation of change as an important element of how they conduct business. Another element of this trait is organizational learning, which enables nursing leaders and their staff to gain knowledge from both successes and failures (Baker Strategy, 2016).

The third trait is consistency, which defines the values and systems that are the foundation of a strong organizational culture. In particular, it provides a fundamental source of integration, collaboration, and control. Through this trait, nursing leaders are able to build internal systems of governance centered on mutual support. Organizations with high consistency tend to have highly committed employees, core fundamental values, a distinctive way of conducting business, a tendency to promote from within, and a clear set of relevant behaviors. This trait also creates a strong culture grounded in a shared system of principles, standards, and symbols understood by all members. This can be an effective means of achieving coordination and integration, particularly in unfamiliar circumstances, by emphasizing broad, value-based philosophies upon which actions can be grounded (Denison and Neale, 2008).

The fourth and final trait is involvement. This characteristic describes a highly engaged culture in which employee participation is strongly encouraged and a sense of ownership and accountability is instilled. In this type of culture, employees rely on informal, implicit control systems rather than formal, explicit administrative ones. From this sense of ownership emerges a high level of commitment to the organization and a capacity for independent action. Employees tend to be more engaged and committed to positive organizational outcomes. This cultural trait therefore emphasizes employee participation and empowerment as a response to rapidly changing external conditions. Employee satisfaction, dedication, and motivation are significant features of organizations with a strong involvement culture. Nurse managers should therefore focus on motivating staff nurses to be involved and to contribute collaboratively to decisions that influence organizational effectiveness (Denison and Neale, 2008).

The purpose of organizational feedback is to enhance an organization's effectiveness and performance, and to help people gain a clearer picture of their organization's strengths and challenges. The Denison Survey therefore serves a variety of management purposes within the broader domains of organizational development and change, functioning as a tool for analysis, feedback, and benchmarking. Organizational culture exerts a substantial influence on the behavior and performance of leaders and staff alike. Through the Denison Organizational Culture Survey, nursing leaders are able to measure staff opinions and perceptions regarding the fundamental beliefs, values, and assumptions held within the organization, as well as the practices and behaviors that exemplify them. This approach also facilitates meaningful conversations and promotes thoughtful actions that initiate change. Moreover, by examining both individual results and organizational outcomes, nursing leaders are better positioned to understand the influence their leadership has on organizational culture (University, 2011).

References

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