Management and Leadership in Nursing

Introduction

The current nursing environment is faced with many challenges, from nursing shortage and nurse turnover to issues related to the adoption of technological changes in nursing care practice. The challenges pose a great need for strong leadership and management skills and competencies in order to maintain and improve on the standards of nursing care delivery. As such, nurse leaders and managers are likely to adopt different leadership and management theories and principles in an attempt to be effective in their discharge of duties. Additionally, one’s personal and professional philosophy is likely to affect their approach toward leadership and management. While some approaches are better in some situations, they perform poorly in other scenarios. This essay discusses the different approaches that a nurse manager is likely to adopt, as compared to a nurse leader, in addressing the challenge of nursing staff shortage and turnover in a nursing hospital case scenario.

The Nursing Shortage Issue

The nursing shortage is a thorny issue in many nursing settings. The American Association of Colleges of Nursing (AACN) (2014) projects that because of the aging baby boomers and the continuously rising need for health care, the nursing shortage will remain for some time. According to AACN, there are efforts through nursing schools, nursing organizations, the media, and the government to pay extra attention to this issue. However, it is likely that the problem will last for long. As such, nursing settings must deal with the issue skillfully since quality healthcare delivery cannot be compromised.

Differences Between Nurse Leaders and Nurse Managers

Although nurse managers and nurse leaders are often times confused to be similar, a difference exists between a nurse leader and a nurse manager. Jain and Sharma (2013) define a leader as a person who influences others in the accomplishment of an objective and also gives direction to an organization in a way that brings coherence and cohesion. According to these authors, leaders do not enjoy delegated authority as managers do. Instead of asserting personal power, a leader asserts the power that comes from his/her colleagues in their group. In their discharge of duties, leaders have been found to focus on empowering, motivating, influencing, and inspiring others. In the nursing context, a nurse leader will have good interpersonal communication skills and positive inter-professional collaboration skills. The leaders that are naturally true are also energetic and sincere in their deeds (Jain and Sharma, 2013). Even though leaders are risk-takers, true leaders do so in a careful manner that does not make others appear reckless.

On the other hand, a nurse manager exercises a power that has been given to them by someone else in a formal arrangement. Unlike leaders, who can assert power informally, managers exercise formal power, which is given to them through an established system. As such, managers have specifically defined duties and responsibilities. Their roles include controlling the process, controlling the work of others, and day-to-day decision-making. While leaders may lead with their natural-born knowledge, managers are prepared to coordinate both financial and human resources. In their duties, managers are encouraged to follow the rules strictly and centrally to leaders, who can compromise some set rules to provide direction in a situation. In order to perform their control role effectively, managers reward and punish workers as they discharge their duties.

Nurse Managers’ Approach to Nursing Staff Shortage

In a hospital scenario faced with a shortage of nursing staff, a nurse manager is likely to approach the issue differently compared with a nurse leader. It is agreeable that the management and leadership will maintain the standards of care with the available scarce human resources before employing more nurses. In the short-run, as the organization seeks to employ, nurse managers would handle the situation differently from nurse leaders. Considering McGregor’s theories X and Y, a nurse manager is highly likely to adopt theory X, while a nurse manager is likely to adopt theory Y. McGregor’s theory X assumes that the staff or employees naturally dislike work and that they are naturally unmotivated (Mind Tools, 2014). This theory also assumes that workers are looking for opportunities to avoid responsibility, and they need to be directed. In that case, the workers may need to be directed at every step, and, if need be, they are threatened in order to meet organizational objectives. Since workers are viewed as having no ambition to work, the management assumes that they need to be enticed to work. Considering this, the management is likely to assume an authoritarian style of leadership in order to meet the care needs in a hospital setting faced with a shortage of nurses (Jain and Sharma, 2013). As seen earlier, a manager has the role of controlling. Thus, the nurse manager can apply controls that will not be limited to rewarding and punishing scarce human resources in order to meet the care needs of the available staff. From a nurse manager’s point of view, for work to be accomplished by the few staff available, they have to be forced and followed step by step (Sullivan, 2012). The nurse manager will assume that applying an authoritarian style of leadership is unable to meet the required standards of care.

On the contrary, a nurse leader is likely to adopt theory Y in the case scenario of a shortage of nurses in a hospital. As seen from the definitions, a leader focuses on influencing and inspiring people rather than applying rules to make them work. Contrary to a manager, a nurse leader leads by forming strong working relationships with the workers. The leader assumes that the leaders are willing and motivated to work and/she ready to inspire more willingness in the workers (Sullivan, 2012). In light of this, the nurse leader will offer a participative style of leadership and try to reason with the few staff available about the challenge of the nursing shortage and that nursing care has to be delivered to the standards. The nurse leader is, thus, highly likely to apply the servant leadership style to the situation at hand. The nurse leader will be concerned with the individual needs of the staff members and try to meet them in order to motivate them to be more dedicated to meeting the required work standards. The nurse leader is, in the same way, likely to offer transformative and democratic leadership, contrary to the nurse manager, who will offer aristocratic and authoritarian leadership.

The approach taken by the nurse leader best fits my personal and professional nursing philosophy. I believe a person should not be coerced to work; they should be motivated to work. Through the application of servant and transformative leadership, the leader identifies with the workers, and the workers are likely to be more comfortable as they offer their services. In addition, making sure that the workers understand that their services are highly crucial, valued, and appreciated is an element of motivation.

Conclusion

In sum, management and leadership in nursing are distinct concepts. A nurse leader is likely to adopt different approaches to managing a crisis compared to a nurse manager. In the clinical nursing scenario of a shortage of nurses, a nurse manager is likely to apply McGregor’s theory X, while a nurse leader is likely to apply theory Y. I presume that theory Y is the best in this case, and it fits very well in identifying with my personal and professional philosophy.

References

American Association of Colleges of Nursing (AACN). (2014). Nursing shortage. Retrieved from http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage

Jain, S., & Sharma, K. M. (2013). Leadership management: Principles, models, and theories. Global Journal of Management and Business Studies, 3(3), 309-318.

Mind Tools. (2014). Theory X and Theory Y: Understanding team member motivation. Retrieved from http://www.mindtools.com/pages/article/newLDR_74.htm

Sullivan, J. E. (2012). Effective leadership and management in nursing. Bloomington, MN: Pearson.

Frequently Asked Questions