Leadership and YOU: The Direct Care Provider RN

Ways in which direct care providers implement leadership at the bedside:

Leadership defined as an overall framework:

A process of influencing the activities of either an individual or a group in an effort to achieve goals in a given situation (Hersey, Blanchard & Johnson, 1996)

Types of leadership to choose from:

• Transactional Leadership - The transactional leader approaches followers in an exchange position, with the purpose of exchanging one thing for another. Occurs like a bargain or contract for mutual benefits.
• Transformational Leadership -Transformational leadership is a preferred approach in settings requiring change, development, initiative, and creativity in a turbulent, unstable and uncertain environment
• Servant Leadership - The central definition of servant-leadership, as defined by Robert K. Greenleaf in The Servant as Leader, is, as follows:

It begins with the natural feeling that one wants to serve, to serve first. Then conscious choice brings one to aspire to lead. The difference manifests itself in the care taken by the servant-first to make sure that other people's highest priority needs are being served. The best test, and difficult to administer, is: do those served to grow as persons; do they while being served, become healthier, wiser, freer, more autonomous, more likely themselves to become servants? And, what is the effect on the least privileged in society; will they benefit, or at least, not be further deprived?

Leadership Values in Practice by YOU, the direct care provider

• Listen and use patient and families preferences as part of using the evidence in shared decision making
• Do the right thing for the patient, not necessarily the easy thing
• Collaborate, build relationships, work in teams
• Be accountable to patients, families and each other
• Celebrate the successes of patients, families, and colleagues

Leadership at Different Levels

Individually by providing meaningful recognition to our colleagues by acting as a mentor, coach, and motivator. It is the responsibility of each nurse to "sustain" the profession in order to keep the profession viable.

Group level leadership results in collaborating with other disciplines by building teams and resolving conflicts through skilled communication

Organizational level leaders are the builders of culture. You are a formal leader or an informal leader,

No matter what level you are functioning as a leader, your followers need to know the end result you are looking for. Begin with the end in mind. Read or reread Steven Covey's original book, The seven habits of highly effective people.

Characteristics of Leaders

• Passionate
• Trusted
• Courage
• Risk-taker
• Role Model
• Visible
• Active

Choose a colleague you admire and study their habits. What are their work styles and communication methods?

What Leadership Qualities do nurses want in each other?

• Caring
• Respectful
• Trustworthy
• Flexible
• Visible
• Provides Guidance
• Authoritative
• Ability to provide Constructive Feedback
• Yet there is no one set of traits as all leaders are different. How do you help each other? Do you inspire and instill confidence in each other?

How do direct care providers ACT as Leaders?

• We convey unwavering respect and personal concern for the patient and family
• We strive to understand what is important to them
• We safeguard their dignity and well-being
• We actively engage the patient/family in all aspects of care

Why should we understand leadership?

The successful leader....will work through clearly defined purposes and objectives, be a role model both publicly and for the organization, and be a juggler-balancer who likes people and their diversity, displays inner confidence and poise and does not shrink from making necessary tough decisions (Drucker, 1996)

Leadership in a Healthy Work Environment

American Association of Critical Care Association (2005) suggests adopting six standards to create a Healthy Work Environment:

• Skilled Communication
• Effective Decision Making
• True Collaboration
• Appropriate Staffing
• Meaningful Recognition
• Authentic Leadership

The autonomy in your decision-making is the foundation of leadership. When you decide to call a physician or create a care plan or implement an intervention, you are forming the building blocks of leadership

Leadership and Values

There is another very important part of any personal or organizational leadership process: values. What are your deep, non-negotiable core values? Do you value your patient first? All decisions are easy when you ask yourself internally, "How will this affect my patient?"

Leaders are developed by the values that drive them.

What leadership theory will you choose as a framework for your daily practice?

• Should reflect your ideas and values
• Should fit your personality best
• Should fit the patient/family/staff you are working
• Should result in a healthy work environment for all.