The Leadership in Nursing and Clinical Organizations

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Introduction

In every situation within the organization, the aspect of leadership is an essential element for the attainment of the organization goals (Alban-Metcalfe & Alimo-Metcalfe, 2000, p.159). One can best understand clinical leadership when its knowledge and insights are founded on the theoretical perspective or those paradigms that are particular to Clinical leadership. Developing leadership capabilities within the clinical organizations require that one take cognizance of the theoretical perspectives that have been developed relating to the clinical and nursing management (Storey, 2004, p.19). It has been found that one particular leadership theory is inadequate in the explanation of various perspectives of leadership in the health care. The application of various leadership theories best help health professionals to delve deeper in the understanding of clinical leadership capabilities (Stanley, 2008, p.519).

Theories such as the general theory of nursing, adaptation model by Roy, human caring theory by Watson so far have been developed and are essential in supporting and helping nurses understand some of the rationalities that are behind specific approaches to the caring of patients (Stanley, 2008, p.520). Basically, the nursing theories that have been developed are useful in the contextualization of the nursing practices, providing meaning and a base or a foundation on which nurses as well as other health care providers can build and develop therapeutically a relationship with the patients or the consumers of the health care (Barr & Dowding, 2008, p.213).

Furthermore, to actually understand the leadership processes that are required in clinics as well as other health facilities, one needs to look at suitable theory. Indeed, suitable theory will be useful in the implementation of leadership qualities and characteristics by the clinical health providers (Carroll, 2006, p.303). The current nursing leadership theories that have so far been developed are founded on the existing leadership concepts and frameworks, a majority of which have been borrowed from the management domain (Traynor et al, 2010, 1586). As such, they are best appropriately applicable in management and business functions. However, these theories and frameworks are put to carry out similar functions in nursing and other clinical functions (Stanley, 2008, p.520).

The meaning of clinical leadership

In as mush as new clinical leaders are required, it is essential to understand what the clinical leadership is all about and we should equally recognize their importance in the provision of health care services. Several definitions have been proposed overtime. Some of the definitions do not directly relate to the nursing practice in general but are more specific to various units of nursing such as the ward leadership (Stanley, 2008, p.110). Currently, the definition has put into consideration or retained some aspects of the older definitions.

The new definition is based on the current researches that have been conducted based on the newly developed theories. Taking into consideration the current research findings, clinical leader can be described as a clinician who is seen as an expatriate in the clinical field (Stanley, 2008, p.111). The clinical leader is also one who is easily approachable, empowered and is effective communicator. The leader is capable of acting as a role model to other practitioners, motivating the followers through identification of their principles, values and beliefs concerning nursing practice and the general care for the patients (Stanley, 2008, p.111).

Theories of leadership

Several prominent theories of leadership have been developed that relates to the clinical management. The most common types include transformational, authentic leadership, transactional leadership, servant leadership, contingency theory among others (Stanley, 2008, p.520). Though, it has been found that most of these types of leadership theories are less applicable in the health care management, the theory that has been cited to be most applicable in nursing and clinical management is the transformational theory (McGuire & Kennerly, 2006, p.181). This theory has been found to be capable of offering more insight as well as support to the workers in the nursing and clinical care fields (Bishop, 2009, p.101).

Transformational theory

Basically, this theory relates to a situation where there is a link between the independent workers and their leaders (Stanley, 2008, p.521). The theory has been applied in much of health care management as well as in academic fronts. According to Marquis and Huston (2000, p.554), the theory is the most favorable for clinical nursing and generally applicable in the medical and surgical ward setting. Indeed the theory is ideologically suitable for nursing. McNichol and Hamer (2006, p.95) assert that the transformational theory is the most suitable leadership approach that motivates and empowers not only nurses but also other health care providers. The theory is related to the process that looks into the needs of the healthy care employees so that the whole process of leadership follower interaction increases the follower motivation and energy to others (Stanley, 2008, p.521).

Transformational leadership is considered as the process that transforms and cause change to the followers (Collins, 1999, p.167). The transformation leadership process take into consideration the individual long-term goals as well as emotions, ethics and motives. The leadership style is understood to have an exceptional influence that enables followers to accomplish there tasks beyond everyone expectations (Daly et al, 2004, p.273). The type of leadership encompasses both visionary and charismatic forms of leadership. The leadership theory is about setting the direction one would want the organization to take, establish vision for the follower, developing all the people around the organization, organizing and building a good relationship among the health care staff (Collins, 1999, p.189). The leadership implementation requires properly effective communication, vision, self-knowledge and trust. The leadership style has also been considered most in the health care circles because of its relationship with the establishment of vision and its adaptation to change (Stanley, 2008, p.521).

The characteristics of clinical leaders in relation to transformational leadership

The transformational leadership has some of the traits that identify them as clinical or health care worker leaders (Thyer, 2003, p.74). Transformational clinical leaders are approachable and open. They are seen to be showing what they believe in or what they consider to be most important (Grojean, 2006, p.57). There stand are known and stick to their guiding principles. They are good communicators and show positive clinical role models. They are empowered decision makers and provide vision to their followers. Grojean (2006, p.59), further argues that these leaders are visionary and visible. Moreover the leaders are competent and knowledgeable in the clinical and other health care professions in most cases in particular areas where they work.

Clinical transformational leaders are identified easily by their stand and guiding principles especially when dealing with patients and other people. The principles they display is about the provisions of quality care to the patients. Most of these clinicians are experts in their field (Rohar-Murray & DiCroce, 2003, p.299). The actions of the leader are directed and their leadership qualities are defined by the values and believe about the services they provide and respect for others.

Most often the health professionals believe that transformational leadership would provide the best leadership model for clinical and health workers (Murphy, 2005, p.128). As indicated, they believe that the characteristics of the transformational leadership will be translated to the practices of the clinical leadership. They believe that these leaders would be enthusiastic, visionary, motivated and creative as in the transformational leadership. The transformational clinical leaders would provide vision where they would like their colleges to be and inspire their followers (Roussell, 2006, p.367).

In deed health care workers particularly nursing have looked for leaders who have academic credentials, managerial competence and politically awaken (Stanley, 2008, p.522). Leaders who are visionary are believed to be in a position to take the nursing and clinical profession forward. Contrary to the belief that transformational leaders exists within the nursing and clinical practice, most of those being identified does not possess the qualities of transformational leadership or display characteristics that are not congruent with the transformational leadership (Stanley, 2008, p.522).

Some nursing professional have the transformational leadership qualities but are not aware that they possess such kind of qualities and are not ready to take the roles of leadership. Majority in leadership positions appear to be disagreeing with the principles of transformational leadership (Swansburg & Swansburg, 2002, p.415). Transformational leaders are believed to have the idealized influence together with vision for the future and inspirational motivation (Stone et al, 2004, p.350). Since there is a gap that exists between the reality and what is held in theory other models are required to provide the type of leadership that is required in the nursing as well as other health profession.

Congruent leadership

Another theoretical model that tends to explain the leadership that is required in the health profession is the congruent leadership theory. This type of leadership is evidence when actions, deeds and activities of the leaders are driven by beliefs and values healthcare (Akerjordet & Severinsson, 2008, p.567). This type of leaders often has vision of what they want but that is not important. However the leadership is based on the shared principles, beliefs and values. Congruent leadership is about where the leaders stand and not where they want to go (Alimo-Metcalfe et al, 2008, p.588). Congruent leaders have motivational as well as the inspirational characters. They are organized and effective communicators. They also have the capability of building relationships among the followers. These kinds of leaders are found all over the organization structure and in most cases are not in the managerial positions (Collinson, 2006, p.82)

For those health care providers who are in most cases dealing with emergencies, bedside providers and community based clinics and care environments congruent leadership offers the best theoretical framework that explains the way they work (Taylor, 2007, p.31). Congruent leaders are directed by fervor, the quality of heart and sympathy. They build long-term relationship with others. They are capable of enduring tests of principles and are more concerned with empowering others rather than their own prestige (Caruana, 2008). This type of leadership explains the reason why healthcare providers and some of the non-titled leaders can function and be effective without any formal influence.

Even though there are many types of leadership theories they are not necessarily applied in the health care provision field. As indicated they are more applied in the business administration and management. Other elements of leadership such as engagement and motivation also play a big role in explaining the type of leadership that is required in the field of health science. These elements are essential in improving the health workers attitude towards their work which in turn contributes to greater performance (Allan, Smith & Lorentzon, 2008, p.546).

Engagement

It is important that the clinical workers became engage in their daily activities. Engagement is defined as the positive attitude workers have towards the organization as well as its values (Alimo-Metcalfe et al, 2008, p.588). Engaged workforce are fully cognizant of the organization context and works as a team to attain the organization goals by improving their performance in various tasks. Essentially engagement is related to the level of discretionary effort workers put in their daily tasks in order to achieve the required performance (Davies et al, 2000, p.90). It has been found out those firms with greater employees engagement have higher competitive advantage. Therefore it is essential to cultivate the culture of engagement within the hospital as a form of motivation to nurses and other clinical workers.

The most important thing about engagement is the influence of the line managers. There is indirect relationship between the behavior of line management and culture of the organization with that of engagement (Bishop & Scott, 2001, p.66). In as much as the employees within the organization demonstrate greater contribution at work it is the behavior of the line managers and the organization culture that discourages their efforts. Hence the relationship between the managers and the health workers determines the degree of engagement that the workers demonstrate (Edward, 2001, p.245).

Discussion

If nursing as well as other healthcare profession is to develop successfully, it should not lose focus on the guiding core values and principles (Stanley, 2008, p.524). Congruent leadership provides the best leadership model that does not lose focus on these guiding principles. Moreover it provides a foundation in which leaders in the health profession can begin and base their principles within the core values (Allan, Smith & Lorentzon, 2008). Congruent leadership also ensures that the dominant cultural dimension of healthcare provision is about patient-care and centered-care attributes are given first considerations.

Transformational leaders on the other hand, in their effort towards the attainment of their vision may under some circumstances relinquish the positions of power and influence and take up the positions of control in order to achieve the required goals (Bowles & Bowles, 2000). While undertaking such kind of decisions they risk losing sight of their guiding principles and core values. They also risk involved in the conflicting state as their professional and managerial or control demands are in a state of conflict. Even their personal desire may be conflicting with the patient care (Livsey, 2009, p.3).

Congruent leadership is also not power neutral as it can be believed. The power of congruent leadership is derived from the ability to unify followers around shared values and beliefs (Sullivan, 2005, p.243). Most health professional especially nurses tend to follow leaders who are more inclined to show or hold to the values or beliefs that are similar to their values and beliefs. The shared values and beliefs are essential in the identification for a common purpose of offering the patient care services (Caruana, 2008, p.653)

In contrary to the congruent leadership, transformational leadership derive their power and influence from the capability of articulating a vision that is acceptable and shared by the followers and acted upon by majority of the stakeholders (Bowles & Bowles, 2000, p.69). Transformational leaders are regarded highly since their self-belief is self evident. Transformational leaders visionary capabilities may make the leader take the followers forward and are seen as change oriented which could be attributable to many followers.

On the other hand, congruent leaders derive their power and influence from their ability to articulate and show their beliefs, values and principles. Majority of followers and other people will tend to align themselves with the same values and principles. This will in turn provide the support and promote the values and principles resulting into the increase of the leader credibility and significance over many people (Stanley, 2008, p.524). In this type of leadership change is not highly regarded. The results are achieved when the beliefs and values are highly promoted, exhibited and accepted.

Understanding, promoting identifying and relating to the clinical leadership is grounded on the insights many leaders in nursing gained from any theoretical approaches. The argument is that congruent leadership can offer the best leadership applicable in the profession since it is based on the actionable beliefs and values (Stanley, 2008, p.524). In addition congruent leaders like the transformational leaders are effective communicators, possess positive characteristics attributable to good role models and are empowered decision makers. Also the congruent leaders are visible in their profession and practices and are seen as competent and knowledgeable in their professions.

Management implications

One of the most important things to note is that most of the theories so far developed are for management and businesses enterprises and they would not necessarily be applied in the clinical and nursing leadership management. Models that tend to explain the leadership in clinical and nursing sphere should be distinct from the contemporary business models. Moreover, emphasis should be put on the ways through which leadership education that targets specifically clinical leaders at every level of the organization (Allan, Smith & Lorentzon, 2009).

The education content should be more explicit to the target practitioners. Essentially bedside leaders in the clinical practice are respected and followed not only for their visionary and creativity in leadership but also for their translation of values and beliefs about the services they provide as well as the respect they offer for their actions. These bedside practitioners are the heart of the organization and therefore need their leaders support in addition to the greater understanding so as to remain focused on their jobs.

Leadership is essential not just to uphold greater healthcare standard within the sphere of influence but also to transform services that will end up achieving greater levels of excellence (Prosser, 2009, p121). Developing and implementing a world-class leadership and talent management strategies is essential if one need to empower staff both clinical and non clinical allowing them to lead and drive improvements in quality for patient benefit (Bishop & Scott, 2001).

Leadership within the organization is not the domain of few selected people but is prevalent throughout the organization within the untapped talent of other employees. The role of the formally appointed leaders and the organization is to create a culture in which such untapped talents are nourished, recognized and released in daily interactions as ways through which things are collectively done (Stanley, 2008, p.524). Engagement is one of the ways to exploit the untapped resources.

Theories on the other hand, are essential foundation for the prevailing aspect of leadership. Theories act as a base on which clinical leaders explain understand and implement their leadership roles (Paton & McCalman, 2000, p.390). Contemporary leadership models particularly transformational leadership framework have fell sort of offering the best foundation that provides support in addition to building the nurses understanding of their leadership roles and responsibilities.

The proposal is that to be successful in developing clinical leadership, congruent leadership model should be adopted. As indicated, congruent leadership requires that leaders have the responsibility of responding to various challenges as well as critical problems with actions that in accordance the leadership principles (Senior, 2006, p.342). In addition the leaders actions and activities must be in accordance with the leadership values and beliefs.

Conclusion

Therefore clinical leaders are envisaged as expatriate professionals in their field since they are approachable, empowered to serve as role models to their followers, effective communicators, provide motivation to the followers by matching principles, values and beliefs about the nursing practices of care to the patients. These qualities are found in the congruent leadership a new leadership theory that is proposed to be the most suitable leadership theory that provides greater knowledge of clinical leadership. Congruent leaders are recognized since they match their values and beliefs with their actions.

References

Akerjordet, K & Severinsson, E 2008, Emotionally intelligent nurse leadership: a literature review study, Journal of Nursing Management, vol.165, pp.565-577.

Alban-Metcalfe, RJ & Alimo-Metcalfe, B 2000, An analysis of the convergent and discriminant validity of the transformational leadership questionnaire, International Journal of Selection & assessment, vol.8 no.3, pp.158-175.

Alimo-Metcalfe, B, Alban-Metcalfe, J, Bradley, M, Mariathasan, J & Samele, C 2008, The impact of engaging leadership on performance, attitudes to work and wellbeing at work: a longitudinal study, Journal of Health Organisation and Management, vol.22, no.6, pp.586 598.

Allan, HT, Smith, PA & Lorentzon, M, 2008, Leadership for learning: a literature study of leadership for learning in clinical practice, Journal of Nursing Management, vol.165, pp.545-55.

Allan, HT, Smith, PA & Lorentzon, M, 2009, Leadership for learning: a literature study of leadership for learning in clinical practice, Journal of Nursing Management, vol.16, pp.545-555.

Barr, J & Dowding, L 2008, Leadership in health care, Sage Publications, California.

Bishop, V & Scott, I 2001, Challenges in clinical practice, Palgrave Publishers Ltd, London.

Bishop, V 2009, Leadership for nursing and allied health care professions, Open University Press, United Kingdom.

Bowles, A & Bowles, NB 2000, A comparative study of transformational leadership in nursing development units and conventional clinical settings, Journal of Nursing Management, vol.8 no. 2, pp.6976.

Carroll, P 2006, Nursing leadership and management: a practical guide, Thomson Delmar Learning, New York.

Caruana, E 2008, Review summaries: Evidence for nursing practice, comprehensive systematic review of evidence on developing and sustaining nursing leadership that fosters a healthy work environment in health care, Journal of Advanced Nursing, vol.62 no.6, pp.653654.

Collins, D 1999, Organizational change: sociological perspectives, Routledge, London.

Collinson, G 2006, What makes an effective healthcare leader? Results of the best leadership practices research in healthcare in the UK, Practice Development in Health Care, vol.5 no.2, pp.81-91.

Daly, JA, Speedy, S & Jackson, D 2004, Nursing leadership, Churchill Livingstone, Philadelphia.

Davies, C, Findlay, L & Bullman, A 2000, Changing Practice in Health and Social Care, Sage Publications, California.

Edward, A 2001, Integrating leadership styles and ethical perspectives, Canadian Journal of Administrative Science, vol.18 no.4, pp.244-255.

Grojean, M 2006, Leadership, the science and art of leadership, Blackwell, Hoboken.

Livsey, KR 2009, Structural empowerment and professional nursing practice, International Journal of Nursing, vol.6 no.1, pp.1-16.

Marquis, BL & Huston, CJ 2000, Leadership roles and management functions in nursing: theory and application, Lippincott Williams and Wilkins, Philadelphia.

McGuire, E & Kennerly, S 2006, Nurse Managers as transformational and transactional leaders, Nursing Economic, vol.24 no.4, pp.179-186.

McNichol, E & Hamer, S 2006, Leadership and management: a3-dimensional approach, Nelson Thornes Ltd, Great Britain.

Murphy, L 2005, Transformational leadership: a cascading chain of reaction, Journal of Nursing management, vol.13, pp.128-136.

Paton, R & McCalman, J 2000, Change management, Sage Publications, California.

Prosser, S 2009, Leadership development: does it make a difference? British Journal of Healthcare Management, vol.15 no.3, pp.121-125.

Rohar-Murray, G & DiCroce, L 2003, Leadership and management in nursing, Prentice Hall, New Jersey.

Roussell, L 2006, Management and leadership for nursing administrators, Jones and Bartlett, Massachusetts.

Senior, B 2006, Organizational change, Prentice Hall London, New Jersey.

Stanley, D 2008, Congruent leadership: values in action, Journal of nursing management, vol.16, pp.519-524.

Stone, AG, Russel, RF & Patterson, K 2004, Transformational versus servant leadership: A difference in leader focus, Leadership & Organization Development Journal, vol.25 no.¾, pp.349-361.

Storey, J 2004, Changing theories of leadership and leadership development, Routledge, London.

Sullivan, EJ 2005, Effective leadership and management in nursing, Prentice Hall, New Jersey.

Swansburg, RC & Swansburg, RJ 2002, Introduction to management and leadership for nurse managers, Jones and Bartlett, Massachusetts.

Taylor, V 2007, Leadership for service improvement, Journal of Nursing Management, vol.13 no.9, pp.30-34.

Thyer, GL 2003, Dare to be different: transformational leadership may hold the key to reducing the nursing shortage, Journal of Nursing Management, vol.11, pp.73-79.

Traynor, M, Boland, M & Buus, N 2010, Autonomy, evidence and intuition: Nurses and decision making, Journal of Advanced Nursing, pp.1584-1590.

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