Nursing Approaches in Leadership and Management

Introduction

Nowadays, a nursing leader and a manager have different approaches to quality improvement and the patients’ satisfaction. However, it appears that both approaches to leadership styles, which differ as much as the definitions of a leader and a manager themselves, are not as efficient as the situational leadership approach.

The differences between a nursing manager and a leader

Undoubtedly, the notions of a “leader” and a “manager” are closely connected. In every hospital, it is possible to separate a leader and a manager that does not always define them in such away. The reason for this is an infinite number of contradictions between management theories and their practical application – for instance, an actual nursing manager does not necessarily hold the position of a present hospital manager or possess leadership skills. As for a leader, it does not mean that the nurses seen by all the staff as active leaders will mandatorily perform as successful managers. However, though it is not always easy to define a nursing leader and a manager in practice, it is still possible to separate them accurately in theory.

Regarding a nursing manager, he/she concentrates the most on organizing the working process in the most efficient manner. The range of the manager’s responsibilities includes the implementation of supervision over the staff’s work, the allocation of tasks, resolving conflicts at work. As it was mentioned above, an employee doesn’t need to hold the position of a nurse supervisor or nurse case manager to carry out the manager’s duties. For example, both a staff nurse and a nurse temporary or permanently working at the registration desk can be considered as managers. Nevertheless, a nursing manager (no matter an official or non-official one) should possess some leadership skills to perform better.

The ways a nursing manager and a leader can reach quality improvement and the patients’ satisfaction

Concerning a nursing leader, his/her primary goal is to reach the quality improvement, and the patients’ satisfaction by inspiring and motivating other workers. Also, a leader is expected to determine an organization’s path forward and represent it when needed. A nurse cannot be considered as a truly authoritative position – on the contrary, a lot of people, for example, the patients, often consider him/her to be not more than a doctor’s assistant. That is the reason why he/she rarely gets an opportunity to approve himself/herself as a productive official leader, like ahead of a department or a hospital. However, it is possible to suggest that a nurse can demonstrate his/her leadership skills at any position at work or stage of the working experience. If he/she is punctual in the performance of the duties and works with pleasure and enthusiasm, he/she has an obvious impact on other employees and, as a result, motivates them to make more efforts. Furthermore, a nurse can be called a leader in the case of being a mentor who shares knowledge and useful skills with other workers. At last, any nurse that does not hesitate to express his/her opinion of the situation being driven by a concern about the patients’ satisfactory or organizational performance can be seen as a leader. Many hospitals and health centers that use a system of shared governance have an acute need for such employees (American Sentinel University, 2014).

Nursing managers have a lot of possibilities to reach the quality improvement and the patients’ satisfaction. Responsibilities of a nursing manager consist of managing human resources, managing finances, ensuring standards of care (Agency for Healthcare Research and Quality, 2012). The vast range of such duties includes a high level of commitment, good organization, and high requirements both to a manager and to other employees. As a result, often the colleagues can have a negative attitude to the nursing manager’s work. For instance, if there is a nursing shortage at work, a nursing manager can require the employees that were supposed to have rest for this day to come back to a hospital. Naturally, such cases decrease the efficiency of a work team and, consequently, the quality of its work.

As it was already mentioned, the nursing managers have important financial responsibilities. They supervise a lot of the economic aspects of an organization and ensure that expenses stay within the budget (Agency for Healthcare Research and Quality, 2012). Undoubtedly, if a nursing manager is a professional in this field, his/her work can bring a lot to the quality improvement and the patients’ satisfaction. However, when it comes to practice, it often occurs that the managers devote too little time to their direct duties and spend more time on nursing, like taking care of patients or communicating with their relatives (Parand, Dopson, Renz, & Vincent, 2014).

Regarding a nursing leader, he/she should aim to approach quality improvement and the patients’ satisfaction by organizing the managers’ work and inspiring the medical staff. An official leader (like a hospital’s director) runs less risk to come into conflict with the workers as he/she does not contact them personally. Nevertheless, there is a reverse of the coin – staying far from the employees on a corporate ladder an official leader does not have an opportunity to influence them directly. In the case of a non-official leader, the situation is different – being a good example for the colleagues, he/she stays in permanent close contact with them. More than that, a non-official leader supports the ideas and shares the views of the team members – that is the reason why there is a high probability that the workers will follow a non-official leader rather than an official one or a manager.

The leadership styles of a nursing manager and a leader

If to analyze the use of the leadership styles, it is possible to suppose that a typical nursing manager gives preference to the authoritarian or autocratic leadership style. A manager requires strict discipline and uses a punishment system, he/she does not always have a chance to take the workers’ opinion into account. In emergencies or chaotic situations, this style is extremely useful, but during the regular working process, it harms a lot. As for a nursing leader, he/she regards the democratic leadership style the most as it involves open communication and staff participation in taking decisions. The relationships with colleagues are utterly important for a leader and he/she tends to concentrate more on quality improvement rather than on the staff’s mistakes (Frandsen, 2014).

However, it appears that both authoritarian and democratic leadership styles are far from being perfect. The autocratic style has some significant drawbacks such as the impossibility of independent decision-making and distrust of the employees that are expressed in total control over their actions. As for a democratic style, it also cannot be considered ideal – it is simply dangerous to leave broad discretion to the workers. In a hospital, even the experienced workers sometimes make mistakes, to say nothing of the novices. It would have been best to use the situational approach to the leadership: directing would fit the novices perfectly while supporting and delegating would bring a lot of good to the experienced workers. It is important to remember that each team member is unique and requires a personal approach.

Conclusion

Finally, it might be concluded that the situational leadership approach appears to be the most efficient managing tool for both a manager and a leader.

References

Agency for Healthcare Research and Quality. (2012). The role of the nurse manager [PowerPoint slides].

American Sentinel University. (2014). What’s the difference between a nurse manager & nurse leader? The Sentinel Watch.

Frandsen, B. (2014). Nursing leadership: Management & leadership styles

Parand, A., Dopson, S., Renz, A., & Vincent, C. (2014). The role of hospital managers in quality and patient safety: A systematic review. BMJ Open, 4(9). Web.

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