Efficient leadership in healthcare is a subject that, seemingly, attracts a lot of scholarly interest. It could be linked to several positive outcomes, such as elevated patients’ satisfaction with their visits or hospital stays and improved workplace relations between personnel. Nursing leadership and management is a complex domain that lately strives to incorporate in its methodology forms of spirituality to varying degrees. Since the beginning of the twentieth century, there seems to be a rise in research dedicated to religious and Christian, specifically, leadership and management in healthcare. This change shows a tendency towards more compassionate and just leadership styles, which in such field as nursing, seem to be indispensable. Christian leadership and management in nursing create relationships between a nurse and a patient built on the notions of empathy and care.
Christian Worldview
Christian worldview could be described as a comprehensive understanding of the world formed under the influence of the Holy Scriptures and its religious community. The framework of concepts that could be found in the Bible outlines the most fundamental aspects of human existence. This type of worldview explains, among others, the conception and creation of the world, purpose, and meaning of life; it provides a system of values and a code of behavior that corresponds to the Bible. One of the imperative notions in Christianity is God’s sovereign power that excludes any possibility for polytheism. The trust in God’s justice and benevolence that builds the foundation for ultimate obedience is the basis of this worldview.
The notion of evil propels the Christian worldview as it presupposes a struggle with an overarching interest for the domination of good. Moreland and Craig (2017) claim that “members of the Christian family have a responsibility to promote worldview evangelization, the nurture of the saints, and the penetration of culture with Christian worldview” (p. 541). Such a position demonstrates that proactivity is another crucial element in a worldview formed according to the Holy Scriptures. In this way, in the Christian worldview, a call for ultimate altruism and kindness is combined with the belief that evil should be overcome on the personal and global levels. Inherent viciousness of earthly existence, its sinfulness as the result of the expulsion from the garden of Eden creates in Christians craving for continual self-improvement.
The Influence of Christian Faith on Nursing Leadership and Management
Christian faith in nursing has different manifestations; for instance, servant leadership exemplifies its virtues and principles. It could be argued that nursing is one of the career paths that embodies Christian values most completely; the dual nature of the nursing profession necessitates a person to assume roles both of a leader and a servant. Caring for those who need it is a Biblical notion that accompanies the everyday life of medical workers. It is stated that servant leadership is the approach that is endorsed by the Holy Scripture since it balances the need for assertive qualities with morality and humility (Roberts, 2015). The need to achieve a specific mission in accordance with Biblical prescriptions, that is to improve and sustain the health of a patient, is the primary concern of a Christian nurse leader. According to Roberts (2015), the positive effects of servant leadership on medical personnel’s behavior and performance are described in numerous scholarly works. This philosophy encompasses the wisdom of the Holy Scriptures and opposes more egocentric views of traditional leadership.
Humanitarianism and the Christian faith are two concepts that seem to be strongly linked. According to Best (2020), “servant leadership is unique in that servant leaders demonstrate humanitarian attributes. They affirm their intent to be effective leaders and have a set of core multi‑dimensional leadership competencies that enable them to be so” (p. 130). These competencies are authenticity, humility, integrity, listening, compassion, accountability, courage, and altruism (Best, 2020). The stories within the New Testament describe merits that concur with the ones that Best (2020) ascribes to servant leadership. Moreover, this type of management can be viewed as a philosophy in itself, as its global aim is to build a more caring kind of society (Best, 2020). In this way, servant medical leaders require Christian qualities and cannot be considered as such without them. This religious value system is deeply ingrained in a number of occidental countries, and thus influences institutional structures within them.
The character of the work that nurses accomplish in medical institutions augments the significance of spirituality for the quality of its results. Nevertheless, the spiritual element is not regarded as a priority in general patient care, and only a small percentage of nurses declare that religious training formed a part of their professional education (Best, 2020). Even though medical workers do not undergo spiritual training, Christian faith had an immense impact on the formation of nursing in general and its management and leadership specifically. Servant leadership became one of the most popular approaches and emerged under the influence of values found in the New Testament and the altruistic doctrine of self-sacrifice that stems from the life of Jesus of Nazareth. Ensuring that the professional needs of staff are met, conflicts are solved successfully, and the promotion of professional growth is the task that a servant nurse leader strives to accomplish (Best, 2020). Embracing the values promoted by the Holy Scripture and adapting them to personal nursing and leadership styles could be regarded as a way to evolve as a professional and provide high-quality care for patients.
Nursing Care Delivery Systems
Nursing care systems, seemingly, can be divided into two broad groups: traditional and contemporary. Relationship-based care system views the rapport between a nurse and a patient as the cornerstone of the domain – this system can be considered as rather a traditional one. Nursing researcher, Hildegard Peplau, suggests that relationship-based care system despite revolving primarily around patient-nurse relationships also requires a focus on the relationships within nursing personnel, and reflexive relationships with oneself (Kristoffersen & Friberg, 2016). The system necessitates an active involvement from different parties of the rapport, as well as participation from team members to design an interdisciplinary treatment plan. Communication is an essential notion to this care system, and nurse-leaders, in this case, assume the role of an intermediary. Relationship‑based care system presumes that a well-established rapport impacts patients and their care-givers therapeutically, thus augmenting further the quality of the care provided (Kristoffersen & Friberg, 2016). Another positive aspect of the system is its collaborative nature, as the decisions concerning any interventions are made together with a patient, considering their cultural background and value system. Hence, the relationship-based care system emphasizes the role that patients occupy in nurses’ professional lives.
Team nursing is a care delivery system that can be traced back, approximately, to the middle of the last century and still perseveres due to its numerous advantages. The system was designed in the 1950s due to the differentiation of skills that nurses obtained (Dickerson & Latina, 2017, p. 1). Its positive effects arise out of the system’s incorporation of the variety of skills, experiences, competencies, and qualification levels that differentiate staff members (Dickerson & Latina, 2017). The collaborative nature of team nursing also results in a sense of shared responsibility for a patient’s well-being. Dickerson and Latina (2017) state that “nurse satisfaction is increased when team nursing is used because nurses feel supported, the environment is collaborative, and staff communication improves. Research shows that team nursing can improve quality and patient safety” (p. 1). The utilization of all personnel’s strengths, potentially, leads to enhanced levels of patient care and has a beneficial impact overall. In this way, this care delivery system ensures that patients have access to individualized treatment and allows nurses to perform tasks in which they can excel.
Primary nursing is a care delivery system that emerged from the dissatisfaction that a group of nurses had with team nursing. They viewed team nursing as such that aims to satisfy first of all nurses but not patients and their families; in this new system, one registered nurse provides care for an inpatient with the help of an assisting nurse (Manthey, 2015). A primary nurse directly cares for assigned inpatients; they also supervise and direct the work of supporting medical workers. The implementation of primary nursing did not significantly affect hospital budgets and did not disrupt the balance in the nursing skills mix and staffing (Manthey, 2015). Researchers ascribe the quality of flexibility to this system, as claimed to be able to deliver nursing care in any setting (Manthey, 2015). Primary nursing centers around the nurse-patient relationship and heightens responsibility for the care provided. Moreover, the family and relatives’ engagement in a patient’s care seems to be perceived as another of the system’s strengths. Primary nursing’s impact on patient care stems from the shift from group accountability, as in team nursing, to a more personal one.
Efficacy is one of the primal criteria on which a nurse’s work is build given a hospital’s limited functioning capacity and illness seasonality – both factors affect workloads and work distribution. Functional nursing is a system that aims to maximize the number of assignments executed in a given interval of time, shifting the focus from patient-nurse rapport to performance (Treas et al., 2017). This model presupposes that each team member is given a specific task; for instance, one nurse is responsible for medication delivery, another one for transcribing physicians’ orders, et cetera. Functional nursing was developed at the beginning of the twentieth century when highly-qualified and versatile nurses were scarce, so each one was trained to perform a specific function (Treas et al., 2017). This nursing care system was advantageous for its time; nevertheless, the outlined above systems seem to be more accommodated to contemporary tendencies in the field. The system, supposedly, is disfavored in the current health care system, since it forces nurses to terminate specific tasks, but not to care for an individual patient. Functional nursing seems to have adverse effects on patients’ care due to its inherent characteristics, such as performativity, impersonality, and a quantity-over-quality approach.
The Roles and Influences of Leaders and Followers in Health Care Organizations
Even though the people management theory was amalgamated, mainly, for business and administrative spheres, a particular part of it applies to the field of healthcare. Leadership is a skill that demands a specific body of knowledge and dexterity in the resolution of conflicts, people management, and even basic psychology. In a healthcare organization, a leader is required to obtain even more specified skills tool-box. This role presupposes that a person is able to impact the quality and direction of group activities, helping to adapt to a change or produce a change (Gordon et al., 2015). Effective leadership in the context of a hospital alludes to its influence on patient care. A healthcare professional leader is supposed to control that the relationships and potential problems within a nursing unit do not cause concern or decrease patient care quality. The person who assumes or earned the role is also responsible for intellectual stimulation and enrichment of the subordinate staff. Ensuring that a nursing team works to the best of their abilities, but also that their work conditions are adequate and motivating is another vital function of a healthcare leader.
Followership in a healthcare organization has two opposing sides – the experience of a follower healthcare worker yields the role of both a passive observer and an active participant. A nurse in this position is supposed to meditate the given instructions but also be responsible for their completion. It can be argued that the complexity of this role lies in the acute need to reflect on the competence of the superiors, but also exhibit a certain degree of sensible and reasonable loyalty. The influence of a subordinate or assisting nurse on patient care is manifested more directly and instrumentally than that of a medical leader. The role of a follower is demonstrated in its community-building quality. Gordon et al. (2015) describe in their research that “when followership experiences were evaluated more positively, and the leadership process was seen to go well, pronouns “we” and “us” would be used to describe the whole team, including both leaders and followers together” (p. 6). Hence, only in synchrony, mutual support, and respect followership and leadership in a healthcare institution can attain the paramount objective, which is high-quality patient care.
Effective Units’ Budget Management
The budget design in one of the principal responsibilities of a nurse manager. Managing a unit’s budget necessitates taking corrective measures based on its performance – types and levels of the proffered services may also undergo modification as a result of this process. Budget projection and prediction is an instrument that may also increase the efficiency of the financial management of a unit. Consequently, the unit’s budget should be continually monitored through consistent and precise financial reporting and account-keeping; this would help eliminate gaps in cash and debts to suppliers. These reports help identify discrepancies by contrasting the income from a specific period and expenditures to the actual budget. This type of budget analysis could assist in determining cost‑efficiency, profitability, and revenue growth or decrease. Inventory management is another indispensable part of effective budget management.
Christian Conflict Resolution
When resolving a conflict, motivation to do so should stem from Christian moral values. Generally, the process begins with conflict identification – discovering the root of a problem could prevent energy dissipation and shorten the time needed to achieve a solution. One of the essential things for Christian medical professionals at this stage is to investigate their own feelings and wrongdoings before accusing the other person. Giving every side of a conflict an opportunity to express themselves fully and ensure that their thoughts and opinions are heard helps prevent further complications and misunderstandings.
Forgiveness appears to be an indispensable act in the process of Christian conflict resolution, as this value is at the core of the faith. This step could lead to the validation of the relationships between the parties of the conflict. Depending on their history, the significance of mutual professional respect and corresponding behavior should be underlined for the quality of patient care. Discussion about feelings could help to bring empathy into a conflict, as it allows the persons in question to comprehend the impact of their actions. A healthy discussion based on Christian morals should conclude in the proposals of how to resolve the issue. If every party involved adheres to this approach, it could result in an open discussion that would occur according to Biblical standards of compassion and kindness.
Conclusion
Effective healthcare is partially built on the notion of leadership and management in nursing as it is one of its most extensive domains. The relationships between medical staff can indirectly affect patients, increasing or decreasing the quality of the care provided. In this case, the Christian approach has the potential to bring several benefits, since nursing is one of the activities that crystallize qualities presented in this religion most fully. Caring for those in need is one of the principal dogmas of both nursing and the Bible. Servant leadership is the embodiment of Christian faith and virtues that it promotes; it emphasizes the characteristics that consolidate a call for altruism and the necessity to govern people. In this way, expressions of Christianity in nursing leadership and management are numerous and beneficial for nurse leaders, followership, and patients.
References
Best, C. (2020). Is there a place for servant leadership in nursing? Practice Nursing, 31(3), 128–132.
Dickerson, J., & Latina, A. (2017). Team nursing. Nursing, 47(10), 16–17.
Gordon, L. J., Rees, C. E., Ker, J. S., & Cleland, J. (2015). Leadership and followership in the healthcare workplace: Exploring medical trainees’ experiences through narrative inquiry. BMJ Open, 5(12) 1–12.
Kristoffersen, M., & Friberg, F. (2016). Relationship-based nursing care and destructive demands. Nursing Ethics, 24(6), 663–674.
Manthey, M. (2015). Primary nursing: Person-centered care delivery system design. Springer.
Moreland, J. P., & Craig, W. L. (2017). Philosophical foundations for a Christian worldview. InterVarsity Press.
Treas, L. S., Wilkinson, J. M., Barnett, K. L., & Smith, M. H. (2017). Basic nursing: Concepts, skills and nursing. F. A. Davis Company.