Leadership Styles in Nursing - Essay Example

Leadership styles in nursing Introduction Leadership is one of the most essential ingredients of effective management in terms of people, operations, control as well as change. Daniels (2004) explains leadership as the interpersonal process that involves motivating and guiding others to achieve goals; also, every nurse, regardless of title or position, is a manager, with a potential to be a leader by acquiring competencies that motivate, activate, and energize people around. To achieve the desired objectives, nurse managers use various approaches, which are termed as styles. In general, different leadership styles have been identified among people that are closely associated with factors like their background, culture, experiences, character and psychology. This discussion is based on observations of a leader nurse demonstrating democratic style of leadership, and its impact on team working, challenges of multiprofessional settings and collaboration in nursing practice. Five main leadership styles identified among nurses include autocratic, consultative, participative, democratic and laissez-faire. In short, autocratic style is exercised through strong control, decision making and problem solving by the leader only. Therefore, the leader does not give any opportunity for involvement by the people. The consultative style uses rationale to influence people in implementing the decisions made by the leaders themselves. Here, leaders attempt to explain logic or reasons for the decision to their members in order to gain acceptance. The democratic and participative styles are very similar in that both the styles involve participation from people in decision making, problem solving and goal achievement. The action that differentiates these two styles is the nature of participation by leader him/herself in situations. Democratic leaders act as facilitators to decision making and problem solving; however participative leaders tend to make decisions prior to discussion, and are open to changes proposed by members. In both the cases, individuals’ opinions are considered. Leaders of the Laissez-faire style are passive and unattached to the group; they provide no direction, and provide support only if asked. This style works well only in a high performing and well stabilized team, else may misdirect and frustrate the team members making goal attainment impossible and can be disastrous to the organisation and individuals. In short, the democratic and/or participative leadership styles are most effective in contemporary management settings that are based on team working concept. In addition, contemporary nursing care that requires utmost flexibility, creativity, experimentation and innovation demand these styles from leaders, in order for organisations to achieve the desired objectives and provide optimum nursing care (Walsh, 2000). Leadership style plays an important role in influencing patients and other nursing personnel to do what is expected and achieve the desired goals. Moreover, leadership style is greatly influenced by the culture; cultures that emphasize role regard rules, procedures and protocol as important. Hence, managers tend to behave in a manner that focuses on status quo, regulations, and the routine process. Such style corresponds to bureaucratic leadership style. Walsh (2000) compares the Zeus culture with this kind of authoritarian legacy, and contrasts it to the participative style of Athenae and Dionysus cultures which works on the fundamentals of team working. Walsh (2000) puts it as, ‘a team approach requires a more humanistic style that involves respect, democracy, valuing other members of the team’ (p.31). The leadership style demonstrated by our head nurse well corresponds with this (democratic) style, and the exemplary results achieved are commendable. In this scenario, the head nurse’s job is a complex one with challenges such as handling experienced nurses, training new recruits, and managing operations in critical care unit of the hospital while maintaining high level of quality and efficiency. Working in teams seemed to have simplified most of the critical tasks in this context. Designing formal teams does not ensure team work; team work is successful only when team-working spirit is fostered among every team member and team is able to collectively visualize the objective and work towards its achievement. The head nurse’s basic activities such as regular team meetings, information cascade, recognizing good performance, feedback and discussion sessions, and high involvement with her team laid a foundation to build and sustain a strong team. Team members were motivated through belongingness, importance, responsibilities and accountability. In nursing care practice, often nurses end up working long hours and extended periods. In such situations, exercising lesser control over members becomes necessary in order to avoid stress and frustration. Providing guidance and suggestion only when required too eases the members’ stress levels. Team members are motivated when their view points are considered in decision making. Also, providing the team members the authority to take critical decisions in time of need becomes a boost to their confidence, and in turn enhances commitment to work (Marquis & Huston, 2006). The NMC Code (2004) emphasizes the importance of attributes such as respect for each other for the skills, expertise and contribution by every individual; and every individual must use these attributes for the benefit of the patient. Nurse’s contribution and patient’s interests are mutually dependent on each other. As a two-way process, the patient’s interests are best served by a nurse who values the role of other health care providers but is also confident about his or her own skills and prepared to make his or her voice heard in order to make a full contribution within the team (Sander, 2009; p.21). Considering the different and diverse settings that nurses are expected to work, sharing experiences and learning is an effective way to enhance efficiency and quality service. Nurses are not only responsible for providing care, comfort, both physical and emotional, but also expected to educate people for healthy lifestyle; coordinating with other professionals such as dieticians, physiotherapists, occupational therapists, medical technicians, speech therapists etc. They are also required to provide supportive and continuing therapy/regimes; have thorough knowledge of technical aspects of treatment; perform diagnosis and treatment of health related problems and suggest appropriate investigations thereon. Considering these complexities in a nurse’s role, it is not justifiable for one to expect cent percent commitment and accuracy. Leadership can contribute significantly to foster such commitment and proficiency. In order to play such complex roles in a multi-professional setting, nurses must be given ample opportunity to display their learning, abilities and skills appropriately. It would also be impossible for a leader to be present in all situations and with all members at all times to assign responsibilities/tasks according to need and/or monitor the work. In such instances, empowering the nurses can help immensely to display their skills and abilities. The leader in context used this process also to motivate the team members, which further improved their confidence and trust in each other as well as the leader. Only a leader with democratic thought process and style will be able to harness the full potential of team members to meet all kinds of demands that arise in unanticipated and expected situations. Blumgart (1997) asserted that models of shared governance are predicated on collaborative leadership, open communication and transparency. Peter-O’Grady (1997) is of the opinion that leaders need to realize and accept the principle of constant change; should accept unpredictability of situations and demands; and also develop others on these grounds besides facilitating in resolving issues related to and resulting from the unpredictable situations (cited by Clare & Hofmeyer, 2004). Achieving these tasks by an individual leader would be impossible, and would certainly require involvement from people. Hence, leaders have to involve people in problem solving, which can be made more effective by allowing others to take decisions with support from leadership. Such leadership is possible through mutual respect and recognition of contributions that all workers make to the whole organisation (Clare & Hofmeyer, 2004). In order for leaders to involve their members in unanticipated situations/activities, connectedness with people is also very much necessary. Only a connected leader will be aware of team members’ strengths and weaknesses, areas of improvement and other needs (Gobillot, 2007). This awareness is important as it will help leaders to assign tasks/responsibilities to members accordingly. Lack of awareness or connectedness with people can be disastrous if strengths and responsibilities are mismatched. In a nursing care, such risk can be devastating to the patients, hospital as well as the nursing individuals. The leader created a sense of belongingness in every team member by assigning different responsibilities, which in turn reinforced their interdependence. Every team member was aware of the tasks to be performed, and that how each task would impact the team’s performance and success. In addition, every team member was made highly conscious of the task’s sensitivity associated with patient care and nursing. Hence, every task was considered equally important and hence accountability was with everyone, unlike its ownership. In line with Sirota, Mischkind and Meltzer’s (2005) proposition, this team worked with a sense of fairness, equity and camaraderie, the characteristics of high performing team (Burke & Cooper, 2008). Many researchers have indicated that traditional leadership styles that do not embrace inclusion and responsiveness of members fail to build trust and team work that values every member’s ability and contribution. However, collaboration is extremely important to tackle the pressures put forth by external environment and organisational objectives upon managers. On these lines, Applebaum et al. (1998) and others are of the opinion that a need for flexible and adaptive infrastructure and systems that can assist contemporary organisations to achieve optimum results is of utmost importance. For instance, the leader in context ensured all team members had goal clarity, what each one was expected to do, as well as role and rules clarity. A systematic conflict resolution protocol in place helped team members to, without hesitation, raise concerns and also participate in resolution process that was carried out in an unbiased manner. A strong process of information sharing and communication, upward and downward, reinforced clarity and transparency in work process. These processes enhanced overall collaboration among team members and the leader in ways described by Argyris (1999). All team members were highly cooperative, supportive, encouraging, and avoided confrontation; the team adopted rational approach in all critical decision making processes besides following a free and informed choices and decisions. These outcomes resulted because the leader gave the team members the liberty to make decisions; set grounding principles for team working; assigned responsibilities and held them accountable for actions/decisions. Meeting organisational demands in contemporary setting requires leaders to embrace change constantly. Besides change in technology and work processes, management has to focus on changing people’s attitude towards work and the organisation itself. For effective collaboration to occur, people should be made aware of how the changes will affect others and their lives. Conclusions and learning Considering the observations gathered from the nurse leader described in this context and the supporting literature, it can be concluded that leadership is an essential element and the essence of management. Like in many other professions, in nursing practice also leadership role is highly complex and challenging one owing to the complexities involved in nursing profession itself. However, these challenges can be effectively tackled through team work and appropriate direction. Innovation, creativity, support, commitment and trust are extremely important for team to sustain performance. Each of these factors requires involvement and contribution from every team member, and cannot be achieved or directed by one formal leader. Thus, a democratic style focuses on involving all members of the team in all activities of work including decision making, problem solving, supporting and encouraging each other, motivating, and also in providing constructive feedback for improvement. The challenge to this style is that it is time consuming, and can be ineffective in emergency situations. Emergency situations are common experiences in nursing practice. Hence, nurses and leaders have to be aware of this factor when emergency action and decision making is required. Nevertheless, democratic leadership style is highly effective for nursing staff groups because they work for extended periods; leaders can empower their members to take autonomous decisions according to situations and emergencies and avoid waiting for formal approval and/or guidance from higher levels. Considering the multi-professional nature of nursing practice, this style supports and also reinforces cooperation and coordination between different members and groups. The most important learning derived from this discussion is that democratic leadership style is particularly focused on motivating people through involvement, accountability, fostering belongingness and trust, and providing equal opportunity to all members of the group. References Argyris, C. 1999. Why Individuals and Organisations have Difficulty in Double-loop Learning. In On organisational learning. 2nd ed. Oxford: Wiley-Blackwell. (Ch.3,pp:67-91). Burke, R and Cooper, C.L. 2008. Building more effective organizations: HR management and performance in practice. Cambridge, U.K: Cambridge University Press. Clare, J and Hofmeyer, A. 2004. Nursing Leadership: Trust and Reciprocity. In Daly, J, Speedy, S and Jackson, D’s Nursing Leadership. Australia: Elsevier. (Ch.23,pp: 345-356) Daniels, R. 2004. Leadership, Delegation and Collaboration. In Nursing fundamentals: caring & clinical decision making. New York: Cengage Learning. Gobillot, E. 2007. The Connected Leader: Creating Agile Organisations for People, Performance and Profit. London: Kogan Page. Marquis B. L. & Huston C.J. 2006. Leadership roles and management functions in nursing: theory and application PA: Lippincott Williams & Wilkins Sander, R. 2009. Nursing and Multi-Professional Practice. In McCray, J’s Nursing and Multi- Professional Practice. London: SAGE Publications Ltd. (Ch.2, pp: 21-32). Walsh M.2000 Nursing Frontiers: accountability and the boundaries of care. London: Butterworth Heinemann. (Ch.2, pp:24-38). Read More