Leadership is an essential part of being a competent and professional nurse. The definition of ‘lead’ is “to guide in direction, course, action, opinion, etc.” (Dictionary.com, 2017). As a nurse leader, it is extremely important to have a good sense of leadership and to able to use it properly and professionally. Nurse leaders use their experience, training and personal characteristics to build their leadership style and apply it to their everyday formal and informal leadership roles. Combining all of these things allows nurse leaders to properly train new graduate nurses and build them up to be able to confidently succeed as a future nurse leader. A leader must be able to lead efficiently but also be able to work productively in a team or under another leader. In order to better understand more about leadership in the nursing profession, I interviewed PR, who has been a registered nurse for 24 years and has had many experiences in both formal and informal leadership roles.
Leadership Position
The registered nurse interviewed is PR who has gone from being a novice nurse fresh out of nursing school to being a Critical Care Nurse Manager to now precepting new novice nurses. PR also serves on the hospital’s leadership committee and serves as the representative for her department. Although PR is now a preceptor, she previously worked as the Critical Care Nurse Manager and stated that it was one of the most demanding yet rewarding jobs she has ever had (PR, personal communication, October 20, 2017). During her time as Nurse Manager, PR learned the importance of teamwork and communication. If ever there was a miscommunication or if staff members were unable to cooperate efficiently, life-threatening errors could occur. PR stated that this year the staff recently implemented the SBAR style handoff report in order to increase communication and decrease medical errors within and across the departments (PR, personal communication, October 20, 2017). As the senior nurse on her floor, PR has nurses including the novice nurses that she is precepting, seeking help from her for advice, techniques or more information on unclear issues.
Formal and Informal Leadership Roles
Leadership can be split into many categories but 2 of the main categories are formal and informal leadership. Formal leadership is defined as an assigned position of authority in an organization while informal leadership is defined as an unassigned position of authority in which the individual in question demonstrates leader-like qualities outside of a formal position of authority (Kelly, 2012, ch.1, p. 3). As mentioned before, PR previously worked as Nurse Manager in the critical care unit and a unit like this, with gravely ill patients, would have benefited from the implementation of the SBAR handoff report. PR stated that her facility did not implement this until recently but she had been educated on it prior to while working in other facilities (PR, personal communication, October 20, 2017). The need for the SBAR handoff report became apparent when the staff on the floor realized the majority of the medical errors on the floor were due to inadequate handoff report. As stated in an article, “Professionals’ use of different styles can result in miscommunication or omission of key patient care information that may jeopardize patient safety” (Stewart, 2017, p. 302). Since PR had been educated on SBAR handoff previously, she was better able to explain this process to the other staff members and they frequently came to her for assistance when any confusion had been raised. Not only has PR’s experience from her formal leadership role as Nurse Manager benefitted her professionally, it also allowed her to flourish in her informal leadership role as she was better able to assist her peers when unfamiliar concepts emerged.
Experience Builds Confidence
PR began her career as a baccalaureate registered nurse in 1993 where she worked on a medical-surgical floor for seven years. She then transferred to the Intensive Care Unit (ICU) where she worked for seven more years. After her time in the ICU, she decided she wanted a bit more of a challenge and got transferred to the Neonatal Intensive Care Unit (NICU) where she worked for four years. PR stated that although it was very heartwarming to work in the NICU, it was also one of the most heart-wrenching times of her life; there were times when she would come home crying every day because she lost patients so often (PR, personal communication, October 20, 2017). Eventually, PR moved on to the Critical Care Unit (CCU), where she became Nurse Manager. She worked in the CCU for five years until she decided to become a preceptor and, for personal reasons, transferred back to a medical-surgical floor to train new nurses. Although the transition back to having up to 5-6 patients per day has been tough for her she states that it is worth it to be able to train new nurses to become confident enough to be able to work their way up the ladder in the same manner that she did.
Training Builds Competence
Before beginning her successful career, PR studied in South Florida and graduated with her Bachelor’s of Science in Nursing. After receiving her bachelors, she went on to work as Novice nurse in South Florida and go on to pursue her masters in nursing. PR has worked in many different environments throughout her career but states that the most rewarding was working as the Critical Care Nurse Manager (PR, personal communication, October 20, 2017). In order to be able to do this job properly, PR received the proper training and became a certified critical care registered nurse (CCRN). Upon working as the Critical Care Nurse Manager for 5 years, PR decided she wanted to use her education and leadership skills to guide new novice nurses to be able to fill her shoes in the future. As part of her training for this position, her facility put her in a preceptor and mentoring course. PR also states the senior management of the leadership committee she is a part of in her facility offers ongoing exposure to leadership problems, and decision-making situations, which assist them in their role and growth as leaders (PR, personal communication, October 20, 2017). All of these experiences have shaped and built PR to be the most competent and qualified nurse that she can be.
Leadership Style
As a leader, PR best resembles two different leadership styles: Democratic and Transformational. Democratic because PR agreed that as Nurse Manager it was important to involve her staff members in the decision-making process for the patients care in order to help them become more confident. Transformational because PR also believes that setting a good example and inspiring others to be as driven and motivated to become more competent nurses will prove to be beneficial when it is time for the novice nurse to go off on their own. A study conducted by Giuliana Morsiani, Annamaria Bagnasco, and Loredana Sasso stated “nurses…want greater decision-making autonomy and better working environments” (2017, p. 127). With this information in mind, it is clear that PR’s leadership styles will prove to be especially effective when training new novice nurses. Another study discovered that new nurses showed increased competence following a 1-3 month period of preceptorship (Ke, Kuo, & Hung, 2017, p. 2302). Not only does PR include her nurses in the patient’s plan of care, but she also provides them with the proper amount of assistance needed to build their confidence and allow them the independence they need to be ready to be on their own. These styles are extremely beneficial as a Nurse Manager but are especially useful when training new nurses in hopes that some of the guidance that they are receiving may give them some insight on their own developing leadership style.
Characteristics of a Competent Leader
PR does not believe that there is one specific characteristic of a leader that is more important than another but rather that there are several key characteristics that make a great competent nurse (PR, personal communication, October 20, 2017). These include flexibility, adaptability, emotional intelligence, knowledgeable, and personal integrity. The profession of nursing does not simply demand that in order to be a competent nurse you must be proficient in all of these skills, but rather it is important to be a well-rounded individual. In an article written by Mick McKeown and Lydia Carey, it states that “Essential leadership skills and attributes of necessity include listening, patience and humility. There must also be the resilience and flexibility to recognize that the sort of dialogue that will arise in an authentic, inclusive democracy of this kind will inevitably be unsettling” (2015, p. 316). This emphasizes on the fact that not all conversations in this profession will be easy or comfortable, which is how each of the key characteristics PR mentioned play into this career. Making use of each of these will allow you to steer uncomfortable or unsettling conversations and situations toward a better direction.
Empowerment and Advice to Novice Nurses
As a preceptor, PR empowers her new nurses by encouraging them to critically think and problem solve. She provides guidance and support but also tries to maintain a certain amount of independence so that they will be able to create their own way of thinking and also promote their professional growth (PR, personal communication, October 20, 2017). Empowering employees is a vital part of any career involving leadership as providing this confidence boost to new employees can help shape the way they perceive new or current situations. As for PR’s advice to novice nurses she states, “it is so important to surround yourself with positive role models and mentors as these will be the people you go to for inspiration if you find yourself stuck or motivation when you are feeling ready to give up” (PR, personal communication, October 20, 2017). She also emphasizes pursuing every learning opportunity possible. “Even if you have performed a procedure 5 times in your career and feel fairly confident, there is always room for improvement and there is always a new and enhanced way to do things that you would not have discovered otherwise” (PR, personal communication, October 20, 2017). All of the advice PR has provided has been not only passed down from her mentors but has also originated from her own personal experience in her career.
Conclusion
Interviewing PR has opened my eyes even more to the many responsibilities nurses have and has helped me realize just how important having leadership qualities is whether you are a nurse leader, manager or a staff nurse. Even as nursing students, it is important for us to begin developing these leadership skills or strengthening the skills we already have in order to be confident in our abilities and help our team members realize their confidence as well. Being a senior nurse, a nurse manager, and a part of the leadership committee throughout her career has allowed PR to have an extensive amount of opportunities to learn, expand her leadership skills and pass on her education to the next generation of nurses. As a Democratic leader, PR is able to work well as a team leader but is also capable and willing to work as part of a team in which she allows other members of the team to have an equal amount of input as she does on decisions. This interview has taught me the importance of education among peers, and it just goes to show that there is always an opportunity to learn more about anything that you do.
References
Dictionary.com. 2017. Definition of ‘lead’. Retrieved from: http://www.dictionary.com/browse/lead.
Ke, Y., Kuo, C., & Hung, C. (2017). The effects of nursing preceptorship on new nurses’ competence, professional socialization, job satisfaction and retention: A systematic review. Journal of Advanced Nursing, 73(10), 2296-2305. doi:10.1111/jan.13317
Kelly, P. (2012). Nursing leadership & management (3rd ed.). Clifton Park, NY: Delmar Cengage Learning.
Morsiani, G., Bagnasco, A., & Sasso, L. (2017). How staff nurses perceive the impact of nurse managers’ leadership style in terms of job satisfaction: a mixed method study. Journal of Nursing Management, 25(2), 119-128. doi:10.1111/jonm.12448
McKeown, M., & Carey, L. (2015). Editorial: Democratic leadership: a charming solution for nursing’s legitimacy crisis. Journal of Clinical Nursing, 24(3/4), 315-317. doi:10.1111/jocn.12752
Stewart, K. R. (2017). SBAR, Communication, and Patient Safety: An Integrated Literature Review. MEDSURG Nursing, 26(5), 297-305.