Nursing Leadership and Management. How to Grasp its Importance

Essay, 2019

32 Pages



Table of Contents

Chapter 1: Introduction

Background of the problem

Problem Statement

Scope of the Project
Practice Change
The rationale for practice change

Chapter 2: Literature Review

Trait Theories

Behavioral Theories

Evidence Summary

Practice Change

Qualities of an Effective Leader



Appendix A

Chapter 1: Introduction

Nursing leadership and management are the practice of nursing professionals who are tasked with directing and managing nursing staff. Their roles equally entail playing an oversight role over the organization's policies and processes that help in providing patient care. Nurse leaders need to influence and motivate a group of people to direct their actions towards achieving a similar goal. The nurse leader will be able to position and advise other healthcare workers on how to utilize the available resources efficiently. A majority of nurses in leadership or managerial positions possess several years and, in some cases, decades of experience in the medical field. Their experience positions them to play an oversight and educative role to other healthcare workers, ensuring that they can deliver quality care to patients based on the available resources.

This paper helps to understand the role of nurse leaders and the various interactions they engage in to ensure they achieve the desired goal. Leadership and management are based on an organizational context in which multiple variables such as psychology, sociology, gender, and interprofessional interactions impact the carrying out of numerous duties and how individual nurses perceive themselves. It equally highlights how nurses view patients and their interactions with colleagues when working towards achieving the organization's goals.

Leadership requires implementing a long-term process that will influence people towards accomplishing the mission or goals of an organization. A nursing leader needs to set strategies and goals that will help reach set objectives and goals; equally, it will be able to position staff members to promote a culture of teamwork. Through the process, a nurse leader will be able to streamline member's perceptions and expectations on their roles and tasks that are to be completed (Cutcliffe & Cleary, 2015; Barlow, 2017). Also, the process will require establishing clear communication channels that will ensure staff members can clearly understand what is needed and how they can ask or request support to promote a positive working environment.

Poor leadership can adversely impact the delivery of care since it increases the cost, reduces efficiency and effectiveness, and results in dissatisfaction among staff members. Effective leadership will help build an organizational culture that will ensure the quality is improved, and there will be reduced conflict among staff that can stem from miscommunication. Good practices will help to improve efficiency and effectiveness through meeting individuals and the healthcare facility's goals (Boamah et al., 2018). Several leadership studies have been conducted in developed countries, highlighting the importance of healthcare professionals. This highlights how external factors such as laws and internal factors such as hospital policies impact the delivery of care.

Nursing is primarily offering services to patients to better their care by adhering to policies and guidelines that establish vital structures that are geared at ensuring healthcare workers wok towards a similar goal (Cutcliffe & Cleary, 2015). Nurse leadership and management are central to achieving the goals since there is a need for one or more individuals who are not necessarily in management positions but play an oversight role over other staff members (Manning, 2017). The person who is charged with becoming a nurse leader needs to be aware of multiple variables that impact the delivery of care, such as available resources, working hours, human error, and severity of patient's ailments.

Background of the problem

Effective leadership plays an integral role in the delivery of quality healthcare since it requires managing resources, staff, patients, and coordinating the various activities that occur daily in a healthcare facility. Effective leadership is an integral part of healthcare systems. It oversees a wide range of functions that are put in place to ensure the effectiveness and efficiency of running operations and the delivery of care. Various challenges arise in providing critical care; therefore, there is a need for someone who can manage activities and amicably resolve situations when they arise ((Tyczkowski et al., 2015; Boamah et al., 2018). Nursing leadership will require evaluating the available options and selecting the solution that provides the best impact. In some cases, the decisions might negatively impact staff, such as when healthcare workers are required to work longer shifts since there is an influx of patients but an insufficient number of healthcare workers to provide the necessary standard of care.

A majority of the people positioned in nursing leadership and management have decades of experience, meaning they are about to reach their retirement age. The resulting impact is they need to impart their years of experience and knowledge to ensure that the new generation of healthcare workers can understand their responsibilities and deliver according to the medical standards and requirements (Sfantou et al., 2017; (Al-Dossary, 2017)). There are various challenges that medical professionals face, such as understaffing in a majority of healthcare facilities.

A nursing leader will be able to utilize available staff members to ensure the health facility can efficiently deliver on its primary responsibility of taking care of patients. Unfortunately, when trying to meet the patient's needs, the challenge that can arise is overworking, resulting in fatigue and medical errors. Based on the assessment of ongoing activities that can hinder the delivery of quality care, nursing leaders act as a relay between medical staff and hospital administration to present staff needs and concerns. Healthcare workers' needs must be addressed to motivate them to increase their level of productivity (Bahadori et al., 2016). Equally, staffing concerns will help to ensure patients are not neglected but rather receive proper medical attention that works towards bettering their health.

According to the U.S. Bureau of labor statistics, gathered data reflect the increasing need of over one million registered nurses to help meet the rising demand and replacements to those who are about to hit the retirement age. Through nursing leadership and management gaps, which are identified, such as staff shortages need to be addressed to ensure medical operations run seamlessly without putting too much strain on the available resources and staff. The challenge that faces a majority of nurse leaders face is dealing with the administration and corporates who own or run the hospitals. Hospital administrators' primary purpose is to minimize cost and increase profit, but they overlook the need for additional staff to ensure the efficient delivery of services (Bahadori et al., 2016). Based on the medical industry's capitalist nature, it places significant strain and challenges on nurse leaders since they cannot offer the desired quality of care.

Hospitals should be patient-centric to ensure they can provide the resources and staff required to ensure healthcare services meet the required standard of care. A nursing leader needs to gain a deep understanding of the intricate nature of running a healthcare facility so that they employ effective strategies that will improve the quality of care offered to patients. Furthermore, nursing leadership and management require healthcare workers' needs to be prioritized to ensure they are motivated and protected when carrying out their daily tasks. The nurse leaders require to create a safe, healthy environment that works to support the work carried out by the healthcare workers, ensuring it contributes to the overall delivery of patient care (Branson et al., 2016). Nursing leaders require significant support from the hospital's administration to implement effective practices geared toward improving the quality of care accessed by patients.

Problem Statement

Nurse leaders are faced with the growing challenge of operating with limited resources and a contracted workforce, limiting the service delivery. It is of significant importance that the issue is addressed to ensure the quality delivery of medical services. Equally, solving the problem will ensure staff operates in a conducive and healthy environment that allows them to perform optimally. To achieve efficiency across a healthcare facility in running daily operations, there is a primary need for hospital administrators to work in unison with nursing leaders to work towards achieving the same goals. The importance of hospital administrators working together with nurse leaders will ensure key challenges such as limited resources, and a contracted workforce will be adequately addressed to offer a lasting solition.

Scope of the Project

Practice Change

Nurse leaders have to deal with the challenge of a capitalist-driven healthcare system, which minimizes cost to meet their bottom line resulting in negatively impacting the running of daily operations (Cherry & Jacob, 2016). As a result, the hospital operates at the bare minimum with a limited workforce and a limited supply of essential items that assist healthcare workers in delivering quality healthcare services. Hospital administrators need to shift their focus from the bottom line to better the quality of care offered in their medical facilities. Nurse leaders need to be supported in their work to ensure a pleasant working environment is promoted to reach the desired goals (Kantanen et al., 2015). In this case, the practice change requires a willingness on the part of hospital administrators or board members to prioritize care and a conducive working environment.

Nurse leaders are faced with the challenge of collaboration because of dealing with a multigenerational workforce, resulting in diverse work habits, attitudes, and communication styles to improve the quality of care offered to patients (Powell et al., 2015). There is a need to have a cultural change that centers on collaboration so that the younger generation of nurse’s work in unison with the older generation workforce. The partnership will help drive efficient delivery of services since the older generation of healthcare workers will be able to share their vast knowledge and experience equipping the younger generation with essential tools that they will require to deliver care efficiently (Mensik & Kennedy, 2016). Equally, the younger generation is well versed in current practices and technology that is implemented across the healthcare system. Collaboration between the younger and older generations will ensure the use of modern technology is embraced and understood to improve efficiency and delivery of care.

Nurse leaders have to contend with hospital policies that require less time is spent catering to one patient this has negative ramifications in the delivery of quality care since the delivery of quality service should be rushed since every case is unique and requires adequate time and attention to ensure patient's needs are adequately addressed (Kantanen et al., 2015). The need to reduce the time spent on each patient is based on the low staff numbers and increased revenue by catering to more patients. Even if the hospital wants to achieve higher revenue streams, they should be conscious not to compromise on the quality of service offered by healthcare workers.

Communication is vital to ensure staff members and staff needs are addressed adequately. Disagreements and medical errors can be avoided by improving the quality of communication among staff members. Better communication will ensure patients receive quality healthcare since staff members will be knowledgeable of the patient's requirements. Excellent communication is essential since it provides there is no miscommunication between staff and patients or among staff members (Mensik & Kennedy, 2016). Theirs is a need to establish a primary mode of communication and a communication structure that should be applied to improve efficiency and promote a positive working environment.

Bureaucracy in hospitals negatively impacts the delivery of quality care. Nursing leaders are faced with the challenge of dealing with red-tape when dealing with hospital administration, especially when it comes to changing policies that reduce healthcare delivery effectiveness. Bureaucracy slows down to change negatively impacting operations. Nurse leaders need to be empowered by the hospital administration to effect change on aspects that they view to need small changes to improve efficiency. Hospital administration should have an open-door policy for nurse leaders so that any significant issues or differences are quickly addressed, ensuring a patient can receive the required level of care (Bernardes, 2018). Hospital management should exercise change in addressing concerns or suggestions from nurse leaders since they play a fundamental role in delivering critical care and ensuring other healthcare providers are operating in a positive working environment.

The rationale for practice change

Practice change is of significant importance since it helps streamline activities in the hospital to ensure that patients receive quality care and that medical professionals operate in a conducive environment. All interested parties, such as healthcare workers and hospital administrators, need to be open to change. It provides a platform to fix and avoid problems that can negatively impact the effectiveness and efficiency of the healthcare facility (West et al., 2016). Nurse leaders have the critical role of managing other medical staff by ensuring they can maximize the available resources, institute effective communication, and ensure patients can receive excellent care through promoting a supportive working environment.

Bureaucracy in healthcare facilities is equally an issue that needs to practice change since there is a need for hospital administration to work together with nursing leaders to ensure problems are quickly resolved, or modification is effectively implemented (Ellis, 2018). The challenge that faces a majority of healthcare facilities is a red tape that hinders the implementation of effective strategies that will promote a positive working environment, provide essential working equipment, and ensure patients receive quality healthcare (Powell et al., 2015; West et al., 2016). Bureaucracy limits the effectiveness and delivery of medical services that can result in poor care and high staff turnover due to working in a sterile environment.

Practice change concerning communication should be changed since it plays an integral role in ensuring staff members can effectively support each other and ensure they follow laid out protocols that prevent miscommunication. An effective communication system will ensure that patients receive quality care since the medical professional will be able to receive information that can help develop an effective treatment plan (Ellis, 2018; Shirey, 2017). Nurse leaders need to device a communication plan that will increase efficiency, work satisfaction, and ensure the overall goal is achieved.

Chapter 2: Literature Review

Trait Theories

There are several occasions when leaders are born not made to highlight an essential requirement of leaders. The term is used to indicate that their people are born with leadership qualities, while some do not have leadership traits. Trait theories highlight that leadership can come quickly for some people, and some other people, it is not as easy. Still, one critical mention is that everyone can become leaders if they obtain the necessary skills, knowledge, and experience.

Warren Bennis conducted a five-year study to establish leadership traits shared among the 90 leaders he was basing the study. Results from the study helped to establish four prominent leadership traits that were visible from the focus group. The first is the management of attention, which highlights that the leaders were able to communicate goals or direction to other people effectively (Croft & Seemiller, 2017). The second is the management of meaning, whereby the leaders were able to communicate meaning effectively with clarity and purpose. The third is the management of the trust, demonstrating how the leaders were able to exercise reliability and consistency. The fourth trait is the management of self (Cohen, 2019; Gobbi, 2017). The leaders were able to identify their strengths and weaknesses, and they were able to utilize what they knew about themselves to be effective in offering creative direction and solutions.

Behavioral Theories

Behavioral theories educate on actions or decisions a leader makes when making decisions or effecting change. There are three prominent leadership styles that a leader can embrace and utilize when implementing change. The leadership styles include Autocratic leadership, Democratic leadership, and Laissez-faire leadership. Autocratic leadership is also referred to as controlling, directive, or authoritarian. A nurse leader can use an autocratic leadership style, which will position them to issue orders and make decisions for other healthcare workers. For instance, when an Autocratic leader has a problem to resolve, they will go to the rest of the group and direct them on the changes they need to effect to ensure the transition is implemented. An autocratic leadership style can be useful since one person's decisions can be quickly made and communicated to the rest of the group (Cherry & Jacob, 2016; Tyczkowski et al. 2015). The negative implications of autocratic leadership are there is limited creativity that may limit the level of motivation.

Laissez-faire leadership is also referred to as permissive or non-directive. This style of leadership is not as useful since it follows the principle of letting someone do. A nurse leader who follows this leadership style is not very useful since they allow people to do anything, they want without being offered any form of direction or input. For instance, a nurse leader who is required to decide an issue may choose to postpone addressing the problem, or they might never offer any feedback that will help find a lasting solution (Tyczkowski et al. 2015). A nurse leader who utilizes Laissez-faire leadership negatively impacts their team since they can leave them confused and frustrated since there is no goal, guidance, and direction.

Democratic leadership is also referred to as participative leadership, and it involves promoting a team environment through effectively making decisions by including input from other team members. This leadership style can take up a lot of time since acquiring feedback from every staff member can take a considerable amount of time. A nurse who applies this leadership style will gain from individuals' creativity and suggestions that can offer effective and lasting solutions to various challenges faced in managing affairs in the health facility. A nurse leader who utilizes a democratic style of leadership requires a nurse leader to offer guidance in the decision-making process rather than control every aspect of the issue to be addressed. There is no perfect leadership style. Therefore, a nurse leader will need to establish a form of leadership that best works for them; the best option is to use a mix of all three styles of leadership autocratic, democratic, and laissez-faire (Tyczkowski et al. 2015). They can interchange on the style they want to use depending on the kind of issue that needs to be addressed, or staff can be left to find an amicable solution on their own.

Evidence Summary

A nurse leader will need to have emotional intelligence, which will position them to connect and establish a relationship with staff, the administration, and patients. According to Goleman, Boyatzes, & McKee, the primary distinction between ordinary leaders from leadership stars is to effectively offer feedback and solutions while being conscious of other staff members' emotions. First, a nurse leader needs to recognize and understand their own emotions and learn how to manage them effectively (Boyatzis et al., 2015). By being conscious of their emotions, a nurse leader will be able to be patient until they have all of the facts that will help them make effective decisions (Kristiansen et al., 2016). Through emotional intelligence, leaders are open to constructive criticism that will help them refine their approach so that they can turn challenges facing the organization into opportunities that can create a thriving working environment.

Secondly, emotional intelligence will involve the nursing leader being a good listener so that they can listen, acknowledge, and address other concerns from staff members that can offer an interesting perspective to resolve a problem. A nursing leader will be able to use emotional intelligence to address critical issues by noting the concerns of other staff members and listening to the various ideas on amicably resolving the situation (Kristiansen et al., 2016). According to Porter-O'Grady, an emotionally intelligent leader will be able to use the team's feelings and energy to purposely establish a practical solution that will ensure critical problems are amicably resolved.


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Nursing Leadership and Management. How to Grasp its Importance
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