NURSING LEADERSHIP PHILOSOPHY 1

Nursing Leadership Philosophy

Introduction

Effective leadership in both nursing and healthcare is crucial to achieving optimal patient

care. Healthcare can be described as chaotic and continuously changing its never consistent.

Patient care standards are changed through means of innovation and evidence-based practice, the

field changes with these developments. This creates the urgency for an effective leader or

leadership team to guide nursing for a facility in the direction to provide the most up to date

optimal care for the patient, and really stay in tune with patient care needs, and provide an

instrumental role in nursing care with patient advocacy. Although there are many leadership

theories to choose from to formally adapt to the nursing care process, I found myself stuck

between two leadership style theories for my own personal nursing philosophy. The first is this

collaborative leadership style theory which focuses on working together and prioritizes

interprofessional teamwork to achieve care goals. In this theory the nurse leader places less

emphasis on hierarchy of the position but still maintains the role of giving active direction. The

second leadership style theory is Transformational leadership which is commonly found in

healthcare today which prioritizes change and improving the organization through means of staff

self-awareness and staff rewarding to achieve nursing care goals. After narrowing down to both

theories I found that I didn’t personally agree with transformational leadership as my own

personal nursing philosophy, due to the high precedence for change and the lack of

leadership/management staff relationship. In the past I’ve had to be in positions of leadership

with the goals for change and I have found that the collaborative leadership style best suits my

personal nursing philosophy and my own personal leadership goals for nursing care.

Role of the Nurse Leader

Nurse leaders and nurse managers are often in similar roles and mistaken to be the same

roles but are not the same thing. Managers are not always great leaders that is the distinct

difference. What exactly is the difference between a leader and a manager in nursing care? One

distinct difference in the role of a nurse manager is usually the nurse manager is in the trenches

with the staff nurses handling patient care problems that arise, very surface level issues such as

supply issues, staffing issues, and nurse assignments. They oversee the overall day to day

operation. Nurse leaders usually hold a grander position dealing with the logistical side of

nursing care and hold very little patient contact or involvement, but are instrumental for

composing, promoting, and implementing changes in care. The main role of the nurse leader is to

be able to speak to and empower their staff to drive change. A nurse leader must be able to be an

effective communicator, have a great working relationship with staff members under their

supervision, and be able to effectively plan/formulate ways to persuade staffing members to

achieve change and pursue optimal patient care goals set by the organization. One major core

value I have found firsthand that is crucial for effective leadership is respect by staff members

under the leaders’ supervision. The major corresponding characteristic with earning respect by

team members is knowledge and being an expert with the goals you are trying to establish in

your team members.

Collaborative Leadership

Collaborative leadership places a high priority for the nurse leader to have a strong

relationship with staff members under their supervision. This leadership style really promotes the

meaning of “Team” and promotes that strong working relationship that I feel other leadership

styles lack. One of the key lessons I learned in past leadership roles volunteering as a fire fighter

with my local fire department is that without a strong relationship with the members of your
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team that you are trying to lead communication will struggle, there will be backlash from team

members that don’t agree or respect you, and anchoring change will prove to be the largest issue.

Simply because it’s extremely hard to change the workflow of others when you yourself have

little or no involvement. Collaborative leadership places a major role on communication with

staff members and building that working relationship with staff, to form a team. Additionally,

this style of leadership promotes the use of peer resources by using partnership and team

building learning allowing the individual staff nurse to feel comfortable with having flaws and

encourages them to use team members, even the nurse leader as a resource to help with

knowledge deficits. This allows for those individual gaps to be filled and promotes nursing

knowledge (two heads are better than one), empowers nurses to be a part in facilitating change,

and improve communication via feedback.

Leadership Model

Using the theory of collaborative leadership, I developed a leadership model to use

theoretically to promote my personal leadership goals when implementing change as a nurse

leader. The first goal is to “establish an urgency for change” which is the first step to the Kotter

change theory (Accipio, 2019). The second goal would be to open lines of communication with

staff and build a leader/staff relationship through shadowing sessions, group education

sessions/seminars, and emailing individual staff members for feedback. The third goal would

provide team building educational sessions to build peer relationships and promote nurse

empowerment. The fourth goal would be to improve collaboration by using staff feedback in

policy making and set a precedent for peer accountability by providing unit wide short-term

rewarded goals. The fifth and final goal would be to use future shadowing sessions to not only
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assess results of the policy but to gain feedback for improvement, brainstorm future change

ideas, and build on that leadership-staff relationship.

Leadership Model Implementation

These five goals are very broad and nonspecific but with using the example of Central

Line Associated Bloodstream Infections a more detailed picture of each goal can be seen. To

establish this goal, I would dedicate a portion of the staff meetings already in place and use

statistics to create the urgency for change such as the CLABSI example. Next, I would open my

lines of communication to staff members to assist each one for an allotted amount of time with

patient care and discuss areas they see for improvement. This will establish a relationship with

the staff member and allow for verbal person to person communication, which is one of the four

communication methods (Sandler, 2019), and follow up each visit with a staff email regarding

my plan and their input involvement with formulating the plan. My third step which would be to

establish the vision which would be pre-determined by hospital administrators, for example

decrease Central Line Associated Blood Stream Infection (CLABSI) on the nursing floor by 20%

in 6 months. I would implement this vision through staff wide email with optional education

readings leading up to a set staff required education seminar where I would furthermore establish

the vision and the goal. During this education seminar I would provide the education for

(CLABSI) reduction and using the feedback gathered through the person to person shadowing

sessions and use a predeveloped multi learning style education plan targeting the problems

currently faced on the unit. Much like nursing school I would implement this targeted education

plan by using team building projects, case studies, and patient experience simulations to educate

staff, followed by a test with a feedback survey regarding any topics not fully grasped and

anything missed. According to a study based in Ireland regarding the education of healthcare
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professionals facilitating group work, providing case studies, and simulating patient experience

scenarios provide adequate educational methods that address all styles of learning (Sinnerton,

2014). This education seminar would promote team building and empower nurses to use peers as

resources for topics they didn’t fully grasp. As the nurse leader a new policy or procedure would

have to be developed. Through the use of feedback already collected, I could then formulate a

innovated policy/procedure particular to the care needs of the patients and problems brought up

by the nurses. By this point, staff will have a running knowledge of the issue (CLABSI) provided

from the large educational seminar. To implement the new policy, I would meet with nurses in

groups across shifts and show first-hand the implemented new policy using demonstration, visual

aids and comparing and contrasting the previous policy to the new (what has changed). In

attempt to anchor the change as a nurse leader I would create 3-month incentives programs such

as gift cards for goal attainment which would promote peer accountability in the unit.

Furthermore, I would maintain shadowing follow up session to allow for feedback,

implementation of new goals, and need assessment.

Promoting Life-long Learning

The current health care workforce statistic reveals an estimated 21.8 million people hold

jobs in healthcare (Salsberg, 2018). 70% of those healthcare workers are involved in direct

patient care 15.2 million people (EBSCO, 2018). Now think about if half of those people saved a

single life in the span of their careers from taking an education course, that would be estimated

7.6 million lives saved. Nurse leaders should both promote and implement lifelong learning in

leadership. Using my collaborative leadership philosophy as a leader I could use my working

staff relationship to open up conversations about continuing education and be able to target select

individuals that respond to these conversations with eagerness and drive. As a nurse leader I
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could groom these select individuals and teach them leadership skills, supply them with

opportunities for further educational resources such as different accreditation classes or clinical

advancement programs that could aid them in fulfilling their future goals. The nurse leader could

serve as proxy for communication between the staff nurse and even recommend them for

positions of leadership to administration. By implementing this on a staff to staff basis the nurses

that do not want to take on higher roles are not bothered with undesired education, and

time/resources from the nurse leader are more efficiently allocated.

Incorporating Patient Advocacy

Patient centered care is an instrumental part of nursing, patient advocacy is a core value

for nursing standards and drive a lot of innovation of hospital practices. The nurse leader’s role is

to not only guide change for optimal patient care but also drive for change based on the

satisfaction and recommendations by patients. To do this nurse leaders must have a close ear to

the patient and have open lines of communication to formulate change to better accommodate the

patients’ needs and overall stay. “Research suggests that patient-centered care increases

treatment adherence and leads to better outcomes” (Siminoff, 2012). Nurse leaders must address

patient advocacy in a similar way to nursing leadership. Using the collaboration leadership

method as a nurse leader communication with the patients is key. Obviously the nurse leader

can’t be at the facility 365 days a year and meet face to face every patient but one intervention

with the patient could be implementing patient feedback surveys for care which are in place at a

majority of hospitals already and during nurse shadowing sessions talking to patients and

establishing a direct line of communication. Using this communication technique to bring light

of any issues the patients encountered with their care. Using the collaborative leadership method,

the nurse leader can implement patient care centered goals along with the nurse improvement
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goals and form a dual edged spear to set goals for the unit and drive change for both patient side

and nursing side.

Conclusion

Nursing care is only as good as a quality leader, the leader drives for innovation and

improving care. The nurse leader needs to be a proxy for patient’s feedback to nursing staff and

nursing staff feedback to administration and plays a crucial role in the lines of communication.

Incorporating my collaborative leadership style into nursing care communication is improved,

staff-leadership relationships are established, peer relationships and accountability is built, and

change results and feedback can be directly assessed by the nurse leader from both staff and

patients to create a facility driven for optimal patient centered care and nursing care. Currently as

a staff nurse, I drive to give the most optimal care I can, and I see that as a lifetime goal for me.

In the future I could see myself taking on positions of leadership expanding my knowledge and

teaching others, right now my goals are set on school and continuing my own lifelong learning

so one day maybe I could be in those positions of leadership.

Resources:

Change Management. (Accipio). Retrieved February 22, 2020, from

https://www.accipio.com/eleadership/mod/wiki/view.php?id=1874

4 Different Types of Workplace Communication and How to Improve in Each Area. (2019,

September 26). Retrieved February 22, 2020, from https://www.sandler.com/blog/4-

different-types-workplace-communication-and-how-improve-each-area/

Sinnerton, T. (2014, June). The Internet Journal of Allied Health Sciences and Practice.

Retrieved February 22, 2020, from

https://nsuworks.nova.edu/cgi/viewcontent.cgi?article=1472&context=ijahsp

Salsberg, E. (2018, May 9). Health Care Jobs Projected To Continue To Grow Far Faster Than

Jobs In The General Economy. Retrieved February 22, 2020, from

https://www.healthaffairs.org/do/10.1377/hblog20180502.984593/full/

EBSCO Information Services, Inc. (2017, June). The Increasing Importance of Lifelong

Learning in Healthcare, and Especially Nursing. Retrieved February 22, 2020, from

https://health.ebsco.com/blog/article/the-increasing-importance-of-lifelong-learning-in-

healthcare-and-especially

Siminoff, L. (2012, January). Incorporating Patient and Family Preferences into Evidence Based

Medicine. Retrieved February 22, 2020, from

https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/1472-6947-13-S3-S6