[MedicDanRN]

The hospital I work in is very good at promoting staff within its framework into unit manager positions. What I observe is these "new" managers are good at managerial skills. However, I do not see any leadership skills being demonstrated. This same behavior is also seen in the clinical coordinator (assistant unit manager) positions as well. The hospital has over 400 beds, is a teaching hospital (nursing and medicine) and has recently obtained magnet status.
One frustration is the lack of communication from administration. It seems we find out changes either by accident or after the fact when there is a problem. I feel that we are not treated as equals but as a seperate group of "employees" that are segregated from the hospital administration. The hospital appears to have allowed each division manager to run their own division without any apparent regard for the big overall picture - the care and treatment of the patient! As a Registered Nurse, I feel frustrated and hurt that we do not work as a team. I also feel hurt that we do not have more leadership coming from "above". I also feel that the hospital is addressing only the mandated issues (JACHO, etc) and the changes that we see are a result of those issues. It is like the hospital is being run by mandates from outside the facility.
I have spoken to the clinical director about these concerns, but I do not feel that administration wants to change from their manager type roles into a leadership type role. I think with a leadership type philosophy that employees would be happier and patient care would improve. Does anyone have any thoughts on what I can do to promote leadership at my hospital?

[Joycean]

You have great insight into what needs to be done to make a good team. Anyone in a supervisor role should have both managerial and leadership skills. I believe the leadership is more important, esp. in a Magnet envirenment. Having the frontline caregivers active in what happens in the processes and protocols involved in pateint care makes a happier, more productive team. People skills are the most difficult to learn and not everyone can do it. Along with communication is collaboration. This combination will make any team tops. I have been an Assistant Director for almost a year and the unit I took over never had involvement in what went on in the unit, much less the hospital. As a staff nurse on a sister unit in the same service I saw thought this was because there was no incentive. The fact is the opportunity was not there. I have seen a tremendous change over the past year with Shared Leadership that is hospital wide. What you need to do is research shared governance and shared leasership. This is part of being a Magnet hospital. If you voice your concerns in a factual manner, with supportive data, administration will be more apt to listen. Something else to look for is a program called First Touch which has to do with patient satisfaction. The initaition of this program was developed and initiated by bedside nurses. It is a way to get involvement and get the ears and eyes of administration. Good luck!

[fhare]

I am currently in a new and exciting Masters program at the University of Rochester School of Nursing: Masters in Leadership. This has lead also to the development of a Masters program (currently in development) for Clinical Leadership. Like many qualities of a good leader, you can't learn them. It's more a personality trait. I believe that good leaders can be honed and moulded by programs like these and are designed to bring out the best in potential leaders for nursing. Someone who has the clinical knowledge to be a leader and the managerial qualities to be a manager can be the same person. Why sacrifice one for the other.

As nursing becomes more and more acute in the hospital setting, we need clinical leaders at the masters level who are still at the bedside, but intimately involved in the management and leadership of the unit.

The future of nursing is brighter and brighter as we grow.