Personal Leadership Analysis

Leadership and the Nine Competencies

Shardaa Khadar

New York City College of Technology

 

Nurses at all leadership levels have the capacity to make long-standing impacts on the lives they encounter daily. Becoming a good leader does not happen over-night.  It requires certain competencies such as the ability to self-reflect, commit to continued education that benefits the organization and promotes individual growth, be comfortable with change, appreciate and accept others differences, seek potential in both others and oneself, and master the art of communication (“AONE,” 2015). Some argue that people may be naturally predisposed to being leaders because of certain personality traits; however, anyone can benefit from learning new concepts that promote personal growth and character.

Throughout out the semester I have examined many concepts and theories that helped me understand the qualities of a nurse leader and how I could use them to better myself as well as help others find their potential.  I believe that the nine competencies, as seen in the “Dimensions of Leadership,” developed by the Center for Nursing Leadership, builds as strong foundation to one’s individual growth as a leader.

The first of the nine competencies describe “the presence of integrity as a key value of leadership” (“AONE,” 2015). A leader with integrity is a beacon of light that guides and sets the standard for others to follow.  Integrity is doing the right thing even when no one is looking and there is no extrinsic reward involved.  It is staying true to one’s beliefs even in difficult situations. It is standing up for what is right regardless of how others may perceive you.

An article from TheAmericanNurse.org, an official publication of The American Nurses Association, entitled, “Ethics: Integrity, courage, and leadership,” argues that nursing leadership be responsible for establishing, maintaining, and improving ethical practice environments to support safe, quality care (Cipriano, 2015).  The author stresses this point after encountering many new nurses who admitted to feeling intimidated to speak up about their work environments (Cipriano, 2015).  It is imperative for nursing leadership to generate an atmosphere of openness and trust.  Fear of unknown repercussions could make employees hesitate to report unsafe conditions or errors made; however, a leader that shows a genuine concern for the wellbeing of workers and who leads by example can make a significant difference in the level of integrity upheld by others.

The second of the Nurse Manager Competencies is the ability to learn and function comfortably despite the ambiguity of an environment (“AONE,” 2015).  Dr. Rozzano Locsin and Dr. Marguerite Prunell, authors of the book, “A Contemporary Nursing Process: The Unbearable Weight of Knowing in Nursing” discuss the ideal approach to dealing with ambiguity in work environments.  They believe that nurses should embrace ambiguity and uncertainty because it allows observation of authentic interactions and experiences (Locsin & Prunell, 2009).

The authors state:

Doing without evidence involves being open and

present, showing reverence for mystery, and

listening and enabling the novel and interrelationships.

Doing involves learning and living wisdom in

participative relationships guided by nursing theories that

invite truth, creativity, and the unfamiliar

(Locsin & Prunell, 2009). 

I believe having this outlook on situations that are not clearly defined allows creativity and the use of the senses to get an understanding of the dimensions of an environment, situation, or relationship.  Approaching ambiguity this way allows an authentic interpretation of information being received and allows for true self-reflection. Nurses can gather more reliable information when they are open to situations that are not always clearly defined. This ultimately leads to building more quality relationships with patients as well as members of the interdisciplinary team.

The third of the Nurse Manager Competencies is the “appreciation of diversity in all its forms: race, gender, religion, sexual orientation…and differences of all kinds” (Locsin & Prunell, 2009).  Studies show a positive correlation between racial/ethnic diversity in the health-care workforce and the delivery of quality care to minority populations (Jackson & Gracia, 2014). When an organizations’ staff mirrors its patient population it increases the chances of having bilingual staff as well as staff that are familiar with the cultural and religious practices of various groups. This can improve outcomes for health disparities among racial/ethnic groups and increases cultural competency.

Dr. Ronald Wyatt, Patient Safety Officer, and Medical Director of the Division of Healthcare Improvement at The Joint Commission (JCAHO) proposed via podcast interview that an organization’s workforce show at least 10% diversity in order to deliver care that is reflective of the community being served (JCAHO, n.d.).  Appreciating diversity means actively hiring a more racially, ethnically, and religiously diverse workforce that reflects a given population.  Another way nursing leadership appreciates diversity is through collaboration with the interdisciplinary team.  Seeing each member as a unique individual bringing valuable information to the table allows them to use their knowledge to the fullest extent, increasing the quality of care given to patients.

This attitude of appreciation and openness is important in establishing the fourth of the Nurse Manager Competencies, “holding multiple perspectives without judgment” (“AONE,” 2015) as well as a system of shared governance.  According to Mosby’s Medical Dictionary, “the purpose of shared governance is the establishment of a system in which staff participate fully in all activities that have an impact on their work and their ultimate goal of meaningful patient care” (“Shared Governance,”2009). In this system, members of the multidisciplinary team work together to improve patient outcomes.  Nursing is often at the center–coordinating and facilitating the plans to reach those goals.  Being open to hearing the ideas and opinions of a team member is key in being able to analyze all the angles of a situation and its pros and cons.

A leader with these qualities is considered a transformational leader. Transformational leaders are empathetic, open-minded, and inspirational. They believe in the idea of shared governance—delegating power to employees and involving them in decision making (Avolio & Yammarino, 2013).  A cross-sectional quantitative study including the use of questionnaires on Taiwanese nurses examined the relationship between transformational leaders and job satisfaction, performance, and organizational commitment.  The results concluded that there was a strong positive correlation between the two factors (Lin, et al, 2015). Thus, a leader who is open to hearing and understanding others ideas, respecting and valuing each member as important contributors of care, directly influences job satisfaction, performance, and commitment, which in turn leads to patients that are satisfied with the care given.

The fifth of the Nurse Manager Competencies is “the ability to search for and find the potential in ourselves and others” (“AONE,” 2015). Discovering one’s potential gives a boost of confidence that fuels our performance, decision making, and interactions with others. This is especially important for a person with imposter syndrome.  This syndrome causes people (usually high performers) to believe they are incompetent despite high academic and professional achievement (Sherman, 2013). Their lives are plagued with feelings of anxiety, self-doubt, and fear of being less than what others may perceive them to be (Sherman, 2013).  The transformational leader would be able to encourage, uplift, and inspire a person with imposter syndrome—actively seeking their potential while helping them see it for themselves.  Regardless of the situation, I believe everyone could benefit from discovering new potential in themselves.  Being able to see potential in others is a quality that is vital for collaboration with the interdisciplinary team.

The sixth of The Nurse Manager Competencies encourages a “quest for adventure towards knowing” (“AONE,” 2015).  Creating a constant state of learning feeds the mind, allowing new information and ideas to shape our thoughts and actions.  Continued education and fine-tuning nursing skills are essential to providing the best care possible to patients.  Staying up-to-date with evidence based practices ensures safe nursing care and prevents the legal ramifications that could potentially occur as a result of errors.

A cross-sectional study performed on over 21 health systems examined the relationship between better patient outcomes in hospitals with higher numbers of nurses with bachelor degrees and hospitals with smaller numbers of nurses with bachelor degrees.  Results showed a decrease of incidence in “congestive heart failure mortality, decubitus ulcers, failure to rescue, and postoperative deep vein thrombosis or pulmonary embolism and shorter length of stay” (Blegen, et al, 2013). As a result of such data, The Institutes of Medicine (IOM) Future of Nursing report recommended the percent of nurses with bachelor degrees be increased from 50% to 80% by 2020 (Blegen, et al, 2013).  It is important for the leader to be aware and knowledgeable of the current issues that may affect staff and the way they deliver care for patients.  It is just as important that an organization provide the opportunity for its staff to learn information and skills that improve their practice.

Awareness and self-reflection is often the first step in making change. The seventh of The Nurse Manager Competencies, is “the use of reflective learning and translation of that learning to the work at hand” (“AONE,” 2015).  Reflective learning enables us to understand how our actions affect others and our environments—allowing us to become high self-monitors.  With this knowledge, we can discover our strengths as well as potential areas for improvement. This is especially important for nursing leadership. Constantly reevaluating the way one communicates and participates with others helps develop a niche for what works for the unique members of the interdisciplinary team.

Part of being a high self-monitoring leader is the ability to nurture the intellectual and emotional self (“AONE,” 2015).  The eighth of The Nurse Manager Competencies describes leaders’ willingness to constantly increase their knowledge of the world and the development of the emotional self (“AONE,” 2015).  Emotional health impacts all areas of life and work; peeling the layers of oneself helps to understand the behaviors and choices one makes.

The term, emotional intelligence, “refers to the ability to identify, assess, manage and control self and reactions to others’ emotions (Karimi, et al, 2013).  A cross-sectional quantitative research study examining the relationship between emotional intelligence and job-stress was performed in a community nursing setting in Australia in 2010.  The results of the study showed a decrease in perceived job-stress in nurses who had higher levels of emotional intelligence (Karimi, et al, 2013).  These research findings solidify the need for emotional intelligence and regulation for both staff nurses and those in leadership positions.

Emotional intelligence is fostered by a commitment to renewing the mind, body, and spirit.  The tenth and last of The Nurse Manager Competencies is the obligation to keep commitments to oneself (“AONE,” 2015).  Jean Watson’s Theory of Human Caring (Caritas) teaches the principles of caring for both oneself and others.  This theory has been often considered the essence of nursing practice.  Watson calls for the cultivation of one’s own spiritual practice toward wholeness of mind, body, and spirit (Watson, 2008). As nurses pledge themselves to their patients, they pour out their physical, emotional and spiritual energy. If they cannot commit to rejuvenating themselves, they will have nothing left to give and the principals of the Caritas will never be upheld.

The role of the nurse leader is far-reaching and comes with much responsibility. The nine Nurse Manager Competencies from The American Organization of Nurse Executives embraces the principals of Watson’s Caritas while acting as a guide for nursing leaders to follow. By remembering these competencies while working with the interdisciplinary team, one will earn the respect and cooperation of the team members, as they would be confident in the capabilities of their leader.

Bibliography

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