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The Highest Calling of Leadership in Nursing

In terms of the increasing complexity of healthcare issues and technology, leadership becomes one of the pivotal instruments nurses may utilize to keep their employees organized. In this connection, nurse leaders should clearly understand their managing styles and be aware of the available options to guide change at the workplace. The purpose of this paper is to examine my leadership style development from the chronological perspective, specify day-to-day operations, and formulate the strategies that are beneficial to encourage stakeholders to initiate practical change.

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Personal Leadership Style Description

Looking back to my early experience as a nurse leader, I comprehend that various events and employee behaviors shaped my current leadership approach. While getting acquainted with my team members several years ago, I was equipped with a set of theories and methods to lead nurses, yet it turned out to be quite challenging to apply my knowledge to real-life situations. For example, I encountered high-stress levels and burnout among nurses, which were caused by a lack of qualified specialists. In this connection, I tried to help them by using servant-style leadership that implies close communication with the staff and focusing on their needs. Namely, I did my best to build close relationships to create a healthy working environment and foster professional qualities of my employees to assist them in coping with stress. Consistent with Hanse, Harlin, Jarebrant, Ulin, and Winkel (2016), such an approach allowed me to achieve leader-member exchange (LMX), including mutual trust, respect, and emotional connection. As a result, the servant leadership style was helpful in overcome high burnout rates at the very beginning of my leadership career.

Another situation that is worth turning one’s attention to since it affected my leadership philosophy was a more recent experience when I acted as a mentor is the situational leadership style. According to this approach, a formal leader is quite flexible in using one or another strategy (Belrhiti, Giralt, & Marchal, 2018). He or she needs to analyze the existing environment and problems, thus identifying some actions to be implemented. I was sure that my personnel had the necessary skills and competencies in making relatively independent decisions in caring for patients. However, I learned that our team diverted from the long-term goals stated by the organization, which made me change my methods. In order to return to the course of action, as well as accomplish the goals that were defined initially, it required to adopt the transformational leadership style.

While working on the change of my leadership style and the operation of the team, it became clear that I gave too much responsibility to my employees, which caused following the wrong direction. This can be regarded as my weakness, including such points as the failure to determine early that the set goals are not considered and that short-term objectives do not contribute to the overall progress. With the application of transformational leadership, I understood that encouragement is the best way to stimulate appropriate employee performance since it eliminated any negative relationships. For example, I discovered my strengths: the ability to inspire others and remain positive even when a critical situation occurs, which allows me to resolve them effectively. For me, to lead a team means to serve people in making their lives better, and I feel that my work is beneficial to both patients and nurses, which motivates me to continuously develop as a leader.

Leadership and Day-to-Day Operations

On a day-to-day basis, nurse leaders have to perform a range of activities, managing the work done by staff, coordinating training, and monitoring their progress. At the microsystem level, the leaders should evaluate how individual nurses comply with their daily responsibilities and provide relevant feedback. For example, one of my nurses may be marked as an employee who faced the deterioration in the states of three patients within one week. The thorough investigation of these cases revealed that she reported about the vital signs of patients in an untimely manner that lead to complications. In this case, I applied democratic leadership to provide feedback on her performance and explain the importance of reporting, which was done in terms of the Organizational and Systems Leadership for Quality Improvement (Essential II). Even though I also considered the implementation of the autocratic style, I rejected it due to its negative impact on employee encouragement and communication.

The mesosystem level implies a focus on a team or hospital when a leader is expected to guide working processes and ensure that interprofessional collaboration is present. The integration of patient care, the collection and assessment of health results, and the subsequent adjustment of the approaches used by teams are day-to-day operations at this level. From my point of view, the laissez-faire and transactional styles are the most widely applied leadership that allows nurse leaders to organize group performance. Tyczkowski et al. (2015) emphasized that the laissez-faire method is often employed by those leaders who chose reactive rather than proactive approaches to change. They are comfortable with the current processes and believe that it is not critical to alter one or another issue at the hospital. This style seems to be appropriate when the change was introduced and successfully adopted by all staff; however, the rapidly developing technology and valuable evidence-based practices point to the necessity to become more open to new opportunities, which corresponds to Scientific Underpinnings for Practice (Essentials I and IV).

In this regard, I prefer using the combination of transactional and transformational leadership at mesosystem and macrosystem levels. The latter is associated with the healthcare system in general, and such areas as advocacy or research may be listed as day-to-day operations of nurse leaders. According to Belrhiti et al. (2018), “effective leaders stimulate their personnel’s awareness of the value of their work and thus trigger the individual’s internal motivation,” which helps to direct their attention to accomplishing organizational goals (p. 1073). This statement refers to transformational leaders and one more daily operation of ensuring the compliance of the staff with national and federal standards. The combination of the mentioned styles is beneficial to integrate inspiration and proper supervision, especially during change and emergencies.

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Leadership Change

Change is an inherent process that should be implemented to achieve quality improvement in various healthcare settings. The combination of transactional and transformational leadership styles composes one of the best options to conduct change. Smith (2015) claimed that transformational leadership “inspires and motivates others toward a common vision” (p. 49). Accordingly, its conjunction with the transactional style principles, including the emphasis on supervision, error identification, and group performance, is essential to prevent unnecessary mistakes. Bradley and Mott (2014) stated that the process of change planning should always start with a thorough analysis of the existing environment and problems. The following stages may be associated with interviews with stakeholders to understand their opinion and selection of several change theories. It seems that Lewin’s three-phase theory can be used to unfreeze, move, and refreeze the required change (Bradley & Mott, 2014). For example, if a new fall prevention protocol should be implemented, it is essential to identify and make the need to change clear to employees, alter the protocol, and strengthen its adoption by means of rewards and communication.

Another change theory by Spradley proposes the constant evaluation of change implementation to ensure its success. For more specialized or complicated change projects, one may recommend considering Lippitt’s or Havelock’s theories that were elaborated based on Lewin’s prospects. Even though each of the mentioned theories is specific, some similar strengths during their utilization may be noted. Among the most important ones there are a leader’s charisma and authority, group relationships, and the ability to support communication. As a leader, I try to be aware of team consciousness and attitudes towards change to adjust them through open dialogue and group discussions. Group cohesion and change resistance are the two most widespread barriers, which may be caused by different views, principles, and experiences of nurses. In order to handle the group conflict, Souza, Peduzzi, Silva, and Carvalho (2016) recommended building teamwork as an interprofessional practice so that every care provider may recognize the significance of others. Personally, I agree with these authors since my practice also shows that people are more likely to understand each other when they are integrated with a shared vision and goals.

Reawaking Strategies

Any change may evoke misunderstanding, the unwillingness to follow, mistrust, reluctance to leave the existing practices, et cetera. The role of a nursing leader is to encourage employees to eliminate destructive attitudes and behaviors (Xu, 2017). The participative leadership theory can be applied to engage nurses, reward their contribution, and create their commitment to the decision-making process. In its turn, transactional leadership should be used to clearly explain the roles of nurses and what exactly they are expected to perform to accomplish the goals identified in advance.

As for the strategies that can be beneficial to evoke the stakeholders’ passion, the provision of appropriate incentives and communication should be used. The former may include both payment bonuses and attractive social assistance. The role of communication may be ensured via individual conversations with resistant nurses and/or team discussions about the potential advantages change would bring to every member (Xu, 2017). In addition, the leader should provide the opportunity to ask any questions and respond to them in detail to foster feelings of acceptance and transparency.

Conclusion

In conclusion, this paper revealed that my leadership style is composed of a combination of transactional, transformational, and democratic types. Depending on the situation, especially emergency or change, it is possible to adopt some principles of other styles; however, the modern technology and EBP requirements are best met by transformational leadership perspective. Spradley’s or Lewin’s change theories were regarded as those that are pertinent to nursing projects and the continuous quality improvement objective. Proper communication and incentives, as well as are the two strategies along with participative leadership theory, are helpful in reawake nurses’ passion for new practices.

References

Belrhiti, Z., Giralt, A. N., & Marchal, B. (2018). Complex leadership in healthcare: A scoping review. International Journal of Health Policy and Management, 7(12), 1073-1084.

Bradley, S., & Mott, S. (2014). Adopting a patient-centered approach: An investigation into the introduction of bedside handover to three rural hospitals. Journal of Clinical Nursing, 23(13-14), 1927-1936.

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Hanse, J. J., Harlin, U., Jarebrant, C., Ulin, K., & Winkel, J. (2016). The impact of servant leadership dimensions on leader-member exchange among health care professionals. Journal of Nursing Management, 24(2), 228-234.

Smith, C. (2015). Exemplary leadership: How style and culture predict organizational outcomes. Nursing Management, 46(3), 47-51.

Souza, G. C. D., Peduzzi, M., Silva, J. A. M. D., & Carvalho, B. G. (2016). Teamwork in nursing: Restricted to nursing professionals or an interprofessional collaboration? Journal of School Nursing, 50(4), 642-649.

Tyczkowski, B., Vandenhouten, C., Reilly, J., Bansal, G., Kubsch, S. M., & Jakkola, R. (2015). Emotional intelligence (EI) and nursing leadership styles among nurse managers. Nursing Administration Quarterly, 39(2), 172-180.

Xu, J. H. (2017). Leadership theory in clinical practice. Chinese Nursing Research, 4(4), 155-157.

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