Category: Leadership and Management

The footprints of effectual, efficacious leaders have always marked history. The Royal Air Force itself was founded on the vision of two notable 20th century leaders, Jan Smuts and David Henderson; both of whom imagined a force capable of exploiting the full range of possibilities of an aerial realm to ensure the fulfilment of objectives. Yet with the growing prominence of industry and services within our modern world, a new style of command rose to the forefront: management. Since managers have been responsible for the growth of international businesses, the success of sprawling government departments, and the daily running of our information-driven world. Nevertheless, what differentiates a manager from a leader? What are the assets of both and how do these beneficially affect an organisation? How could one decide which is better? I will explicate and elaborate on these questions to illustrate why I believe the Royal Air Force’s newest officers should be trained to be the leaders, not the managers, of tomorrow.

To quantify leadership, parameters must first be established in order to distinguish it from management. Fundamentally, a leader’s role is to generate a “process of social influence, which maximises the efforts of others towards the achievement of a goal”1; motivating a team to accomplish that which an individual could not. To achieve this, a leader must “establish a vision and emphasise its [sic] importance”2 so that their team can buy into the vision and encapsulate it into their paradigm. It has been shown countless times that when a team believes in their goals and motives of their own free will, it produces significantly better results whilst in a healthier state of wellbeing3. The component of free will is essential as without it the team will either resist the leader’s efforts or else actively counteract them; no one enjoys feeling as if their opinions are inconsequential or that they have been forced to accept an idea. However, these responses are trademarks of authoritarian leadership styles4. Furthermore, a leader should provide cohesion, motivate the team, and build commitment to tasks through rewards and communication. A good leader may not actively do all of these things; however, they all evident in effective teams.

In contrast to a leader’s goal of social influencing, management is about attaining operational results. For example, a manager’s remit can have great scope and include budgeting, staffing, contingency planning and daily operations; all essential components and cornerstones of any organisation. To accomplish these tasks concurrently, a good manager must employ their key skill: resource allocation. Through this, they can realise operational efficacy and provide holistic structure to organisations5. Structure and organisations are two consequences of good management. Humans by nature are logical beings that seek to categorise and structure their world to make sense of it6, and the structured systems that are typical of a good manager generally provide security to their workforce. Furthermore, such structure inherently provides obvious protocols, hierarchies and leads to systems and practises where problems can be continually solved without detailed oversight. From this view, it can be seen that good managers create predictability and order by treating everything as a cog within a machine.

Within an organisation of diverse individuals, good leaders are essential to generate unity and genuine mutual respect. When a team is first created, whether through delegation or necessity (for example, a crisis or extenuating circumstance has occurred), there is always an element of initial confusion. There are no group roles, typically there are no S.M.A.R.T (Specific, Measurable, Achievable, Relevant, Time-Orientated) goals7 and communication is often based upon a personal bias or experience8. It is necessary for a leader to rise above the ranks and not assert themselves, but rather to stimulate the formation of relationships. This scenario led to the development of “Tuckman’s Stages of Group Development”9. The original postulated scenario is known as the “Forming Stage”9; however, before a group can gain momentum and complete tasks in the final “Performing Stage”, there are two key intermediate steps that are reliant upon the leader. During the second “Storming”9 stage, peoples’ positions and beliefs are voiced and humans – being competitive by nature – begin to conflict. It is at this stage that a leader projects their vision and communicates purpose to the group, while finding common ground for others to bond over. Following stronger relationships and a sense of unifying purpose, the group enters the third “Norming”9 stage. It is here that boundaries, conditions, and expectations are agreed upon or set while team interpersonal relationships mature. Additionally, the leader should empower their aides and the team more widely, in order to reinforce the vision. Finally, the team enters the aforementioned highly productive fourth “Performing”9 stage. Despite the forming of relationships, different opinions will materialise and so conflict is always a possibility. Unresolved disagreements can compromise harmony. Cynicism regarding the root of someone’s role or capabilities will arise. Nevertheless, a good leader can temper these angsts and build a stronger team, while a manager would simply allocate tasks and then perform damage mitigation or worse, exert unnecessary authoritarian dominance.

In large organisations such as the Royal Air Force, leaders can facilitate an inclusive environment to give a meaningful voice to all members of it. In leadership theory, it is widely accepted that overly restricting personnel’s’ abilities to contribute to problems through taking an authoritarian approach (a common style of managers in businesses) leads to a lack of motivation and reduced creativity10 11. This is especially damaging in complex, multifaceted tasks as the group is completely reliant on the command team for all of their ideas and drive – the very scenarios good managers ‘should’ thrive in. Yet, behavioural studies have shown that participative leadership breeds independence, unison and confidence within a team. Participative leadership12 is when a cycle is created, where the leader facilitates and controls the discussion regarding solutions and methods to solve problems. By considering others’ expertise and ideas, they simultaneously expand their knowledge pool13 whilst also allowing the team to proactively and meaningfully contribute, furthering their commitment to the vision. This benefits the leader as they can take the best decision while retaining control and it benefits the team. They feel included, that they have a sense of control and that they are needed for the task to succeed14. This desire to be needed is a fundamental emotional requirement for us all15 16. A manager will push on through what they consider to be the most effective path to achieve results, often to the detriment of the team, whereas a leader provides, when appropriate, a way for the team to help choose the focuses and directions of progression.

Strategic planning is challenging and full of uncertainty, and only good leaders can sell and maintain such long-term ideas. Every organisation that seeks to move beyond short-term actualisation must formulate a strategic overview that will lead to continual progression and development. In the Royal Air Force, this could be anything from recruitment or procurement of new systems and platforms to strategies in combat environments on deployments. Despite this, most long-term strategies fail17. If they did not, no company or country would ever suffer failure or consternation due to planning; the financial crisis of 200818 19 20 or the cost overshoots of the Lightning II21 22 would not have occurred. There are innumerable reasons why these plans fail22 but here the focus will be on: inadaptability, a lack of commitment, delusion, and having unrealistic goals – all of which are variables that can be controlled by the leader. If the leadership of a project is regularly changing, if management is allowed to run long-term visions, if additional resources cannot be allocated to a project, if the needs and problems confronting reality cannot be addressed – a strategy will fail. A strategy requires full commitment to implement over its lifetime alongside the adaptability to overcome inevitable obstacles when they arise23. A strategy needs an influential orator to convince others it is a good idea and it requires the strength to make difficult but logical decisions 24. Above all, a strategy requires succinct and clear objectives to be disseminated and accepted by the whole organisation25. A manager, as it has been shown, is result-driven and will pursue goals by making short-term corrections: cash injections; rapid reallocation of resources; they will be replaced when they fail26. A leader recognises reality and works with it by retaining a competent team that are committed to seeing the success of the strategy, even if its original plan is rendered invalid. A leader can influence others to back a cause and is able to rescue a situation even when others simply say it is “too big to fail”. Whether it is a fireteam encountering resistance in a section attack or an entire air force fighting a war, a truly good leader will be able to find a path to success.

Despite the overwhelmingly powerful reasons aforementioned in this essay, it must be recognised that having managers is inevitable. It is paradoxical that we desire everyone to be good leaders, but this would lead to no one idea being followed, as everyone would be influenced to follow one another. Without managers, goals could not be achieved and the Royal Air Force would overspend every budget without fail27; aircraft would be stretched thin. However, it must be accepted that the proficiency with which one performs their job does not correlate with leadership potential, called the Peter Principle28. Leaders are the products of their environments and experiences; the “Great Man” theory has proven29 false and it is now believed that leadership skills are taught. This means that during Initial Officer Training and as a Junior Officer, more so than at any other time, a strong leadership foundation must be established. Junior Officers should be trained on how to motivate and unite teams so that they can help enact the strategies of their superiors so as to further the organisation. They should learn how to influence others through clear communication and appropriate actions in order to stimulate success, following Tuckman’s model. However, they should learn to have an awareness of how to balance teams’ needs and wants. The reason is simple and I invite you to consider this example: a highly skilled team of medics is tasked to run a field hospital, to save every life within their means. Their leader has them motivated to work day and night in order to save the lives of the injured, everyone trusts one another and roles, boundaries are clearly marked and people are rewarded for doing well. Yet no system or process to treat patients was implemented. Do you think they will succeed? Everyone can learn to be a leader but ultimately managers will always be needed to enact the details of a strategy, else the leader will lose oversight and become overwhelmed by particulars.

When one looks at command from afar, it is be easy to consider leaders and managers to be one and the same. However, I hope I have convinced you that they are starkly different roles, which aim to achieve very separate aims. Managers surrounds themselves with process and detail in order to complete a task, and can result in high cost overruns and negative emotions permeating throughout a team. A leader has an overview of the task and a vision for the long-term development of the task, and aims to inspire and empower others to achieve the task. I firmly believe that the skill remits are similar but junior officers who have been trained as leaders will be more versatile; they do not need to be able to personally complete a task to encourage their team to do it with them. They can recognise the individual value of every person and engage them in the task, driving performance in an organisation limited by money and time. Who would you rather have graduate into the Royal Air Force: someone whose skills are limited by what they are given, or someone whose plans and personality could overcome adversities to reach the stars?

Scope of practice describes the services that a qualified health professional is considered competent to perform and is permitted to undertake in keeping with the terms of their professional license. The practice is also based on specific education, demonstrated competence, and experiences. A nurse’s scope of practice is composed of only the skills that are taught in an accredited nursing program that the Board of Nursing deems safe. It also provides a legal demonstration of what nurses can do and what they can’t do. The nurse administers skills at an independent nursing level. The scope of practice is based on the nursing process, which includes: assessment, diagnosing, planning, implementation, and evaluating. The registered nurse’s scope of practice varies from state to state and is updated yearly. The State Board of Nursing defines the registered nurse’s scope of practice in the Nurse Practice Act. The MSBON issues licensure to the individual who has completed the proper education and also has proven themselves competent in the art of nursing. If a skill is performed out of that scope, it will be handled consequently by the board of nurses. The MSBON’s primary function is to protect the public from harm and danger in any case in which the registered nurse is providing the appropriate care for an individual. The RN shall be accountable and responsible for making decisions based on knowledge, competency, experience, and the use of the nursing process. The registered nurse is also responsible for regulations and knowledge of the law, and for practicing within the scope of practice established by the MSBON. The RN is held accountable for quality nursing care provided to a patient on an individualized basis. They should also respect the rights of patients, a patient’s property, privacy, and family, and provide care without ever judging. Skills that registered nurses are required to perform include administering medications, obtaining vital signs, admitting and discharging patients, ensuring patient safety, etc. The RN may assign specific nursing duties and patient treatments to other qualified personnel based on their credentials and ability to perform the duties. The RN may also assign medication administration duties to other licensed nurses like a licensed practical nurse. The RN is responsible for the evaluation of care as assigned by them. For proper delegation, the following criteria must be used: the right person, the right circumstance, the right supervision, and the right task. If the RN is delegating a task to an LPN, that patient must be stable. As for UAPs, they can complete tasks such as vital signs of a stable patient and assisting with ADLs. Registered nurses are not limited to the areas of medicine in which nursing skills can be carried out. They can work in areas such as clinics, hospitals, home health, schools, correctional facilities, rehabilitation centers, and behavioral centers.

Professionalism is the word to describe what is expected out of registered nurses because they are held to a very high standard. The sole purpose of professional standards is to describe responsibilities for nurses and provide direction for nursing practice. If unprofessional conduct is carried out by a registered nurse, their nursing license may be suspended. In other instances, they may be reprimanded and revoked. Unprofessional conduct consists of falsifying documents, conviction of a felony, negligence, practicing without a state-issued nursing license, violating patient confidentiality, and violating professional boundaries of the nurse-patient relationship.

Mississippi State Board of Nursing’s primary function is to ensure that the rules and regulations are revised, to regulate the safe practice of nursing provided by the state licensure exam, and to also conduct hearings that determine whether or not a nurse will be prosecuted for violating the nurse practice acts. The MSBON has the right to deny, revoke, suspend, or refuse to renew any license to practice based on the violation. In some cases, criminal charges may be brought upon the nurse, which would depend upon the nature of the violation. MSBON performs an investigation if a nurse is reported to them. The investigator presents the evidence collected at a case review and may close the case due to insufficient evidence after the investigation is concluded (MSBN link). MSBON will decide what disciplinary action should be brought against the nurse.

ANA Code of Ethics’s sole purpose is to define the principles used to provide care to patients. It has been an important piece in molding the nursing profession. It was written in 1926 and describes the primary goals, values, and obligations of the nursing profession (ANA, 2001). It serves the following purposes: a statement of ethical obligations and duties of every nurse in the profession, the profession’s nonnegotiable ethical standard, and an expression of nursing’s understanding of its commitment to society (ANA, 2001). The Code of Ethics is regularly updated to imitate the changes in health care structure.

There are multiple and many agencies that have an impact on nursing practice. The Institute of Medicine (IOM) is a division of the National Academies of Sciences, Engineering, and Medicine that ensures that the delivery system is effective, safe, patient-centered, timely efficient, and equitable. Institute of Medicine states that “Nurses need to be transformed by practicing to the full extent of their education and training, achieving higher levels of education and training through an improved education system that provides seamless progression, becoming full partners with physicians and other health care providers in redesigning the health care system, and improving data collection and information infrastructure for effective workforce planning and policy-making” (Fundamentals). Joint Commission is another agency that relates to healthcare. It’s a non-profit organization founded in 1951, and its purpose is to improve health care for the public by evaluating healthcare organizations. It also deems whether or not a facility meets the standards of a clean and safe facility (Joint Commission link).

In 1970, the Occupational Safety Health Administration (OSHA) was implemented to assure and create safe working conditions for those in healthcare settings by enforcing job safety standards. Their main goal is to prevent work-related injuries, illnesses, and deaths (OSHA link). Center for Disease Control and Prevention (CDC) is considered the nation’s health protection agency. It supports and conducts health promotion, and prevention, and discovers ways to prevent the spread and outbreak of diseases. They do this by providing relevant health information that protects our nation against dangerous health threats (CDC link). The Agency for Healthcare Research and Quality (AHRQ) is also a government agency of the United States. Its sole mission is to produce evidence to make healthcare safer, to make it more accessible and affordable, and to support research to help improve the quality of healthcare. It also investigates the quality of healthcare delivery and establishes standards for healthcare treatment. The research is to determine ways to better patient care. (Mission and Budget).

The ultimate and common goal of the agencies discussed above is to protect the public from harm. They were initiated based solely on the safety of patients. The agencies contribute to the nursing profession by evaluating the practice of nursing and ethics within the setting of the healthcare field. They were organized to guarantee patient safety and to conduct the nurse practice safely. Each healthcare agency impacts every aspect of nursing care, with the main focus being on nurse practice acts and patient care.

Work Cited

1. American Nurses Association (ANA), (2001), Code of Ethics for Nurses, American Nurses Association, Washington, DC. from www.health.mo.gov
2. Fundamentals of Nursing, ninth edition. Potter, Perry, Stockert, and Hall. Copyright 2017 by Elsevier.
3. National Council State Boards of Nursing, “Model Nursing Practice Act”, revised 2010. Retrieved January 30, 2018 from www.ncsbn.org.
4. https://www.cdc.gov/about/organization/mission.htm
5. https://www.jointcommission.org/about_us/about_the_joint_commission_main.aspx
6. https://www.osha.gov/about.html
7. www.Msbn.ms.gov
8. www.Nursingworld.org
9. www.Registerednursing.org