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According to Gibson, Ivancevich, Donnelly, & Konopaske (2012) a leader can be described as someone who influences another person to do something they normally would not do if not for the leader’s encouragement. How the leader achieves this level of influence depends on the situation and their own personal style of leadership.
Transformational leadership has been the buzz word in nursing since the Institute of Medicine’s [IOM] 2004 report identified this style of leadership as a significant predictor of improved quality and safety patient outcomes. The IOM report (2004) found that through transformational leadership the nursing work environment could be so changed that a corresponding reduction in adverse patient events would follow.
How it works
According to Gibson et al. (2012) a transformational leader is one who inspires, encourages and motivates employees, whereas transactional leaders motivates by conditional rewards and “management by exception” (p. 355). Other styles include Laissez-faire, which is defined as a passive style where the leader only intervenes when it is necessary, authoritarian, democratic and servant leadership to name a few (Merrill, 2015). While a leader will tend to favor one type of leadership style, this can change depending on the situation
After completing the leadership style survey (Clark, 2015) my predominant leadership style is participative or democratic, with authoritarian style being my least likely style to use. A participative style of leadership includes employee’s in the decision making process, however the leader still makes the final decision (Clark, 2015). This is the style that I am more comfortable with and is valuable when making decisions on how staff will accommodate a new process. One example of this style of leadership is when our nurses were involved in a pilot for receiving report from other units. After much discussion, it was decided to send out a survey to each nurse and have them list their top five must have’s for report. After collating these top five results, I was able to make a final decision on the necessary items to be included. This was a successful collaboration, as the nurses felt they had been heard and their opinions taken into consideration, and from a leadership point of view, a pilot that had been stalled for months, became active.
The authoritarian leader instructs the employee what to do or how to do it without any input, which is especially useful in a crisis (Clark, 2015). This style of leadership is often used by staff during a rapid response when, for instance, the nurse may direct the patient care technician (PCT) to collect a blood glucose from the patient without explaining why it is needed. Ellis & Abbott (2015) state different situations call for different leadership skills, so it is important for a leader to be able to use each style of leadership, depending on the circumstances
Personally, I feel that a mixture of servant and transformational leadership are the styles of leadership that I aspire to. Servant leadership is described by Waterman (2011) as one that respects, values and motivates, which is closely aligned to transformational leadership. The values of servant leadership also closely align with those of the Oncology nurse, values of caring and compassion. An example of servant leadership is in valuing employees and committing to their growth. One of our PCT’s has difficulty with close vision. Our unit was rolling out a phlebotomy competency for our PCT’s to learn to draw labs. This was going well, however, our one PCT was resisting. I was able to sit with her one to one and discuss her concerns. I asked her if she felt her vision would preclude her from completing this task. She said no, but that she felt she would need more assistance. I was able to arrange for her to follow along with a phlebotomist so that she could become more comfortable with the process. While it did take a little longer, this pct is now able to collect blood and has a great deal of pride in her new ability. If feel that if I was not committed to her growth, I could have just excused her from the task; instead we were able to work together, and she now has pride in herself and another skill to add to her repertoire.
Bennis (as cited in Ellis & Abbott, 2015) said “leaders create vision and set direction” (p. 97). As such, developing a personal vision as a nurse leader is important as if the leader doesn’t know where they are going, it will not be easy for others to follow. I believe my personal vision as a leader is to be an influencer of nursing practice in the Oncology setting. I believe through promoting a vision of excellence and innovative care, the leader can support employees as they put into practice new ideas and processes to improve care and outcomes. In the previous year I have been a leader for two separate evidence based practice (EBP) projects and am now facilitating another EBP project and a quality improvement project. These EBP projects have created a great deal of staff satisfaction, and excitement for the next project. If, as a unit leader I had not been involved, I think that the project may have taken more time, if it was completed at all.
I feel that by promoting innovation, staff are more engaged and committed to organizational vision and mission which in turn leads to an increase in satisfaction. I also believe that as employees see the leader engaged with them in their work, trust and morale increases while negative behavior decreases (Lindy & Schaefer, 2010). Our unit, while still having staffing issues, does not have a morale problem. Our staff are engaged and excited to be at work!
I think that most leaders can point to another leader that has influenced them. Having been in nursing for 30 years, I have had my fair share of leaders. When I was nursing in Australia, my Director of Nursing was a big influence on how I viewed leadership. I believe that she is the epitome of servant leadership, one who strives to meet the needs of their employees so that the employee in turn may strive to reach their potential (Waterman, 2011). Ms. Gilbertson made rounds on every unit on Wednesday mornings. When she came to the unit, she would meet with the Charge Nurse and ask her for report on each of her patients. As the Charge Nurse for a Medical-Surgical Unit, I would give her a brief report on the 18 patients I was responsible for.
Once report was finish, she would ask if there was anything I needed to complete my work, or anything that my patients needed. After that, she would thank me and then continue to the next area. While this may seem a small thing, it really made an impression upon me. A nurse leader, who was very busy, had the time to come and talk to her staff and see how they were doing, show interest in the patients and thank me for my work. Ms. Gilbertson exhibited the transformational leadership quality of individual attention before transformational leadership became a style (Gibson et al., 2012). Not only was I impressed by her leadership, she instilled a great deal of loyalty in the nurses that worked for her. She retired in 1998 and one of the last things that she did as the Director of Nursing, was to validate my training records for transcription for licensure in the United States. Even as she was leaving, she was thinking of others. She was a great leader and one that I admire and strive to emulate.
Gibson et al. (2012) lists leadership traits as “abilities, personality and motivation” (p. 315). These can be further expanded to included good communication, social skills, self-confidence, emotional intelligence, technical skills and sensitivity to others needs
(Gibson et al., 2012). In contrast to leaderships strengths, having a limited social network in the work place has the potential to decrease the perceived leadership of an individual leader (Chiu, Balkundi, & Weinberg, 2017).
One of my personal strengths is that of communication. As part of a team building initiative, I created a unit newsletter to help with morale and communication. The newsletter has had a big impact on our unit, so much so that when I asked if it was still necessary, I received an unequivocal yes from our staff. The newsletter has provided a great opportunity to integrate new staff to our unit, introduce new projects and to display the work of our Unit Based Council.
Another personal strength is that of technical skills. I feel that in my role of Assistant Nurse Manager (ANM), having technical skills is very important as staff look for guidance when a new process is implemented. As an example, in December 2018 our organization had a major upgrade of our computer charting system. As the ANM on shift for the upgrade, I was the champion for the changes in documentation. As we were also short staffed that day, I took a patient load. I feel that this demonstrated servant leadership in that I was able to support our staff through coaching and practical skills of caring for our patients (Waterman, 2011).
One personal limitation that I have, that I didn’t know about until taking this class, was a small circle of social influence in the workplace (Chiu et al., 2017). Chiu et al. (2017) found that leaders with a smaller social group were seen less often as leaders by their employees. While I have a good relationship with the providers and teams that work on our unit, I am less known throughout our organization. One thing that my manager has been encouraging me to do is to become more visible throughout the facility. To that end, I became the co-chair of a Shared Governance committee last year and am now the Chair. While this is not a comfortable position for me, if I want to be a leader, then stepping outside of my comfort zone is an important step to master. I have since joined another committee and am continuing to seek out opportunities that will help grow my perceived leadership ability.
Leaders influence, coach, develop, and inspire trust (Ellis & Abbott, 2015). They may be recognized with a title, such as Manager or Director, or they may be a bedside leader on their unit. As such, leadership is a skill that all nurses should undertake to understand and improve upon (Ellis & Abbott, 2015).
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