The nursing profession necessitates the development of strong leadership and management skills inasmuch as they are of paramount importance for ensuring that care is delivered in a safe and efficient manner. The aim of this paper is to discuss the application of management and leadership theories in practice.
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Assessment of Leadership and Management
Leadership refers to the use of skills, knowledge, and character traits of an individual with a goal of achieving mutually negotiated outcomes (Giltinane, 2013; Yoder-Wise, 2014). The transformational theory of leadership postulates that by manifesting certain behaviors and attitudes, a nursing leader can inspire their followers. There is a plethora of research pointing to the fact that all transformational leaders share characteristics such as inspirational motivation, consideration, and intellectual stimulation (Fischer, 2016). When it comes to the practical application of the theory, a transformational leader has to use persuasiveness and charisma to “experiment with systems redesign, empower staff, create enthusiasm for practice and promote scholarship of practice at the patient-side” (Yoder-Wise, 2014, p. 9).
Management is the process of employing planning, organizing, and controlling for the achievement of certain organizational objectives (Cox, 2016). Douglas McGregor’s theory Y embodies positive mentality of managers who exercise “a participative style of management” (Hasan & Alam, 2015, p. 91). According to the theory, workers can be more productive if they are empowered. It means that in order to engender higher productivity and commitment, a nursing manager has to involve their staff in the decision-making process, thereby delegating to them responsibility for key organizational projects. Also, employees have to receive positive reinforcement and rewards on a regular basis.
Priority Setting for Managers
There is no denying that the establishment of nursing priorities should revolve around patient outcomes. The case under discussion is associated with two complexity concepts: stacking complexity and multiple patient-simultaneity complexity (MP/SC). Stacking refers to the dimension of the nursing practice that involves ordering and re-ordering of work-related priorities. Complexity science scholars recognize that stacking ability evolves throughout the experience of a nurse practitioner (Ebright, 2010).
MP/SC complexity, on the other hand, stems from the sequential nature of care provision and refers to the difficulty of attending to the needs of several patients simultaneously. Nurses who cannot properly manage this type of complexity tend to underestimate their professional competence, which is associated with increased job turnover (Kramer et al., 2013).
Followers usually expect three key qualities from an individual holding a leadership position: direction, hope, and trust (Yoder-Wise, 2014). Therefore, in order to diffuse and resolve the issue, a transformational leader has to show that both nurses are trusted to make the right decision. By doing so, the leader will assist the nurses to reach higher levels of achievement. Instead of exhibiting an authoritarian style of leadership embodied in McGregor’s theory X, a participation-oriented nursing manager should act in an advisory capacity and help the team members to deal with complexity.
Given that the issue involves stacking complexity, the day charge nurse is correct in stating that a detailed checklist alone is not sufficient for facilitating the prioritization process. However, in order to establish a healthy work environment, a compromise has to be reached. To this end, the manager should encourage the nurses to identify system barriers that increase the level of complexity and reduce situational awareness (Ebright, 2010). By removing those barriers from the clinical area, the night charge nurse and the day charge nurse will be able to better concentrate on the direct care function, thereby improving their resistance to stacking and MP/SC complexities.
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The paper has discussed the application of the transformational theory of leadership and McGregor’s theory Y in nursing practice. It has provided a recommendation for using these theories in order to strengthen staff’s complexity tolerance.
Cox, J. (2016). Leadership and management roles: Challenges and success strategies. Association of Perioperative Registered Nurses Journal, 104(2), 1-4.
Ebright, P. (2010). The complex work of RNs: Implications for health work environments. Online Journal of Issues in Nursing, 15(1), 11-19.
Fischer, S. (2016). Transformational leadership in nursing: A concept analysis. Journal of Advanced Nursing, 72(11), 2644-2653.
Giltinane, C. (2013). Leadership styles and theories. Nursing Standard, 27(41), 35-39.
Hasan, M., & Alam, J. (2015). Douglas McGregor theory X and Y mentalities of managers and its impact on subordinate’s organizational commitment: Bangladesh perspective. Management Development, 29(3-4), 91-114.
Kramer, M., Brewer, B. B., Halfer, D., Maguire, P., Beausoleil, S., Claman, K.,… Duchscher, J. B. (2013). Changing our lens: Seeing the chaos of professional practice as complexity. Journal of Nursing Management, 21(4), 690–704.
Yoder-Wise, P. (2014). Leading and managing in nursing (6th ed.). Maryland Heights, MS: Mosby.