The Impact of Leadership and Management in Nursing

According to Porter-O’Grady, 2016 et al p 324, our healthcare systems today are at the center of what is considered major change. Much of the change today is directly related to the foundational principles, concepts and associated with complexity in systems and relationships, and an understanding by nurse leader and follower; of what it takes to make meaningful change. Nurse Leaders, registered nurses, advance practice nurses, and other followers, at every level of our organizations must be increasingly aware of meaningful and sustainable changes that improves our healthcare systems (Porter-O’Grady, 2016 et al p 324).

Observing and analyzing my leader opened my eyes to the amount of responsibility and knowledge one needs to be a great leader. These responsibilities that were witnessed during the shadowing project included aspects of role modeling, mentoring and educating fellow staff and colleagues alike. My leader possessed a well-rounded amount of experience, skills and knowledge about nursing and her management role. All of these aspects we observed and I feel my leader is not only strong nurse, manger and mentor; all these aspects contribute to making her a fine and valuable assets to our organization.

This paper aims to address and discuss about the leadership and management of the nurse leader interviewed. This experience was a great opportunity to witness first hand how a nurse leader cultivate and manage their staffs in real life setting. Moreover, it provides a great access to gain insight and knowledge about nurse leaders’ vital responsibilities and role diversities in the organizations they work with. Nurse leaders pay more specific and close attention in handling the staffs and most importantly, patient care.

The aim of this essay is to identify a significant event from the authors clinical

Nursing guidance is a complex but essential part of the nursing workforce. Guidance can come in the form of management and in the form of leadership. The two terms are often used interchangeably, but do not always mean the same thing. The nurse manager is often someone who has authority from the facility to be in management. The nursing leader may not have authority over other nurses, but may be a strong guide in the workplace for other nurses and nursing staff. Nursing as a profession is ever-changing and increasingly challenging. Nurse managers are tasked with an enormous variety of functions in their respective workplaces, budgeting, scheduling, hiring, disciplinary actions, implementing facility policies and procedures, and the

Now, the graduate level nurse’s leadership attributes have been described in scholarly sources. Based on the documents of the American Association of College of Nursing (AACN) (2013), essentials of graduate nursing must be skilled in organizational and systems leadership role. Specifically, they are supposed to assume leadership roles in quality improvement and patient safety initiatives while working in the interprofessional team context. APN must use communication in an effective way, with regards to speaking, scholarly writing, and group interaction. Nurse leaders should also demonstrate the working knowledge of the current healthcare system and its essential components, including delivery and payment models, sites of care, roles of various stakeholders in the process of care delivery (AACN, 2013).

After taking the Leadership quiz I discovered that my leadership style is Participative. Participative leaders often ask the opinion of group members and solving problems but ultimately make the final decision. I agree with my findings and I often apply this leadership style at work. I find myself asking other coworkers their opinion on how to troubleshoot a problem. In the nursing occupation it is very important to have teamwork. Being a participative leader exemplifies teamwork. This displays that I value the opinions of my coworkers and feel that everyone should be able to make recommendations and suggestions and as a leader I can take those ideas and make a final decision. On my unit I was a charge nurse and as a charge nurse I always tried to include the recommendations of my coworkers.

Transforming education is included in the second key message of IOM report. Nurses require top levels of education and training to function in ever more multifaceted health care structure. So it is vital for the nurses to advance the education and training without difficulties. Chances to improve education from Licensed Practice Nursing or Associate Degree in Nursing to Baccalaureate science in Nursing and then to advanced degrees must be accessible and available. Besides clinical skills, health policy, evidence based practice and research, quality improvement teamwork and leadership should be added in the competencies while developing educational programs. Program of study should be modified to make sure that the nurses are prepared their best to perform their tasks. In addition to that there should be opportunities available for cross training to improve teamwork and collaboration, to ensure patient safety ("ISNA Bulletin," 2011, p. 11).

As a nurse administrator, I have a distinct role to play in the healthcare sector. Preparation for this position commences at the graduate level; either masters or doctoral level. Prospective students at graduate level are expected to indicate a variety of roles across healthcare sector as stipulated in the legislative law. Factors such as the nature of the organization and its system of leadership provide credible knowledge that is critical for nursing management roles. As opposed to Gerontology Nurse Practitioners who are expected to have a wide array of technical and hands-on skills

Transforming education is included in the second key message of IOM report. Nurses require top levels of education and training to function in ever more multifaceted health care structure. So it is vital for the nurses to advance the education and training without difficulties. Chances to improve education from Licensed Practice Nursing or Associate Degree in Nursing to Baccalaureate science in Nursing and then to advanced degrees must be accessible and available. Besides clinical skills, health policy, evidence based practice and research, quality improvement teamwork and leadership should be added in the competencies while developing educational programs. Program of study should be modified to make sure that the nurses are prepared their best to perform their tasks. In addition to that there should be opportunities available for cross training to improve teamwork and collaboration, to ensure patient safety ("ISNA Bulletin," 2011, p. 11).

Nursing career is one of the few fastest growing fields in the health care industry not only in the United States but also in the world. Nurse practice has drastically changed in the last decade and as a result the need for changes in nursing practice is becoming more and more important. The Institute of Medicine report discusses so many aspects in nursing but this paper requires detailing the impacts on Nursing Practice (Transforming Practice), Nursing Education (Transforming Education), and the Nurse’s role as a Leader (Transforming Leadership). These three key aspects are discussed in the following pages.

There are many skills, traits, and behaviors one must possess in order to be an effective leader. The American Organization of Nurse Executives (AONE) has compiled a list of competencies and skills that nurse leaders should be proficient in. The five competency domains identified by AONE (2011) are “communication and relationship building, knowledge of health care environment, leadership skills, professionalism, and business skills” (p. 3). The competency domain I believe is essential for one to possess in order to be an effective executive nurse leader is communication and relationship building. The competencies AONE (2011) listed under the domain communication and relationship building are “effective communication, relationship management, influence of behavior, ability to work with diversity, shared decision-making, community involvement, medical staff relationship, and academic relationships” (p.3). I will discuss how Tom (nurse manager of a psychiatric unit) did not meet these specific characteristics under that domain.

Leadership and management are similar; however, have different definitions. Some leaders have an innate ability to learn whereas others may have to learn how to lead. A manager may not be an effective leader. A leader must possess certain characteristics to be effective. Communication, fairness, and leadership knowledge are the top three characteristics of an effective leader.

According to the IOM report, the nursing profession is undergoing fundamental changes within the underlying operations of the field. A new regulatory environment coupled with increased scrutiny of the profession will dramatically impact the nursing profession. As the report indicates nurses, in the near future, will have job requirements that are business oriented. Nurses will need to have a better understanding of quality management methods in addition to overall concepts of management. As the health care system continues its rapid reform nurses must also be cognizant of the effects these changes will have on their overall roles and responsibilities. This involves a transformation of the roles and responsibilities of nurses as they enter the profession. As the health care landscape continues to change, so too must the nurses of the future. A dedication to continual learning is therefore needed to help diminish the influence of antiquated and obsolete knowledge regarding the profession.

While many health care practitioners are willing to change, the issue is that change is often mismanaged by leaders whom are either incompetent or lack the resources to follow through in the implementation of change. An example was documented in a study of a California hospital unit where patient satisfaction scores rose and immediately fell. At the time, the hospital was going through transition. The nurses in the unit saw this as an opportunity to improve patient satisfaction score. They initiated the process by recommending that the new chief executive officer (CEO) change the current procedure to one that could led to the improvement of patients’ satisfaction. The result, in a few months