CLINICAL AND PROFESSIONAL LEADERSHIP


 


INTRODUCTION


 


            Health care professionals are more and more becoming involved in leadership endeavors. Such leadership is not only confined to those who hold high positions in an organization but rather to everyone within the organization. Emphasis on leadership should be taught to all health care professionals within an organization. The same thought is what is supported by  (2001).  (2005) also placed emphasis on the importance of health care professionals becoming more involved in leadership.


 


            As health care professionals, it is important to acquire the necessary knowledge and competencies that ultimately allow them to practice their profession. Regardless of the type of setting that these health care professionals work within the health care organization, each individual health care professional is responsible for using organizational resources, participating in organizational routine while providing care to a patient, using time productively, collaborating with all members the health care team, and using certain leadership characteristics to manage others.


 


            The delivery of health care services is definitely a challenge. As health care professionals develop the knowledge and skills, they will gradually learn what it takes to effectively manage patients as well as fellow health care professionals within a team and to take the initiative in becoming a leader among colleagues. This paper will further study on what can be done to influence effective leadership practice and how this could be applied within your own clinical setting.


 


BACKGROUND INFORMATION


 


            Effective leadership style is an integral part of creating an environment that nurtures the development of an empowered health care professionals.  (1997) defines leadership as “a process of social influence in which one person is able to enlist the aid and support of others in the accomplishment of a common task.”      


 


The major points of this definition are that leadership is a group activity, is based on social influence, and revolves around a common task. Although this specification seems relatively simple, the reality of leadership is very complex. Intrapersonal factors (i.e., thoughts and emotions) interact with interpersonal processes (i.e., attraction, communication, influence) to have effects on a dynamic external environment ( 1997).


 


The demands of the health care environment have brought about changes and health care professionals have been concerned about the impact this has had on patient care. Managers have had to develop ways to achieve expected outcomes and meet targets required by their organizations. To address all these issues, health care professionals need to focus on developing relationships that facilitate working with each other from strengths and not just criticizing weaknesses ( 2001).


 


Increasingly, a phenomenon called decentralized management is starting to become common within health care organizations (  2004). In decentralized management, decision making is moved down to the level of staff. This type of management structure has the advantage of creating an environment where managers and staff become more actively involved in shaping a health care organization’s identity and determining success.


 


Developing an empowering culture in which positive relationships are nurtured, leadership capabilities are developed, and professional practice is supported can improve the work environment and satisfaction of health care professionals (2001). Simply put, collaborative work relationships where leadership is part of should be actively enhanced and promoted in order to create a positive work environment.


 


 


 


 


BODY


 


            Leadership processes are directed at defining, establishing, identifying, or translating this direction for their followers and facilitating or enabling the organizational processes that should result in the achievement of the organization’s purpose. Organizational purpose and direction becomes defined in many ways, including through mission, vision, strategy, goals, plans, and tasks. The operation of leadership is inextricably tied to the continual development and attainment of these organizational goal states ( 2001).


 


The lack of leadership skills is one major factor when there are problems within a health care organization, or any other organization for that matter. In order to solve this problem, focus should be given to the managers down to the staff. Leadership training programs should be offered and leaders as well as the health care staff should be required to attend. These leaders and staff in turn should perform their responsibilities of teaching and guiding the rest of the members of the health care organization in promoting a healthy work environment.


 


In the hospital setting, this would most commonly be at the point of direct client care or staff nurse level; however, this kind of empowerment requires an environment of autonomy where mutual trust and respect are encouraged. The empowerment process requires that staff be prepared to accept and effectively use expanded decision-making responsibilities (1998).


 


To start changing the work environment into a healthy one where leadership is emphasized for all members within the organization, there should first be mutual trust and encouragement in all the parties involved. Each and every opinion should be respected and given consideration in the decision-making process. There should also be an all-out support for this desire for change.


 


The professional accountabilities of the health care professional includes having a sense of value about their work and willingness to provide the full scope of practice as well as ability to work as equal members of a comprehensive interdisciplinary team. In order to move into a fully empowered position, professional nurses need mentoring, education, awareness of political activism opportunities, and networking skills (1998).


 


In order to achieve all these, shared leadership should be employed. Shared leadership is a health care management model that supports health care professionals in extending their influence about decisions that affect their practice, work environment, professional development, and self-fulfillment (2001).


 


As previously mentioned, leadership is a group activity. In shared leadership, every voice is heard and given consideration. This could relate to Crisp’s idea that leadership must be exercised at all levels in all setting in the clinical team and in support services, in the ward and in the community and in the board room.


 


Shared leadership is a collaborative team process in which team members share key leadership roles (2004). Shared leadership is empowering employees to act autonomously, be decisive at the point-of-service, and create a shared vision aligned with organizational goals. Shared leadership development and autonomously practicing nurses appear to be the equation for success in delivering quality patient outcomes in today’s organized health care delivery systems. Employees must develop or refine new behaviors and skills in empowerment, facilitation, negotiation, systems thinking, and accountability on behalf of patients ( 2002).


 


Shared leadership is a way to strengthen continuous learning and enhance relationships between leaders/managers, staff and clients, which are the foundation upon which the nurses can develop a new type of relationship with management and with each other. This in turn could significantly improve the work environment. There is an emphasis on ‘relationships’ since these relationships can be tenuous at times as both managers and staff members adopt attitudes of contention and competition with each other.


 


Shared leadership provides an organizational framework that offers the health care staff maximal participation in decisions about work and the work environment. Every staff has to be given a chance what he or she thinks about a current situation and what they think can help such issues.


 


Aside from shared leadership, the transformational leadership theory can be employed within health care organizations. The transformational health care leader typically inspires followers to do more than originally expected. Transformational leadership theories predict followers’ emotional attachment to the leader and emotional and motivational arousal of followers as a consequence of the leader’s behavior. Transformational leaders broaden and elevate the interests of followers, generate awareness and acceptance among the followers of the purposes and mission of the group and motivate followers to go beyond their self-interests for the good of the group (1997).


 


Many health care staff are said to have the natural characteristics of transformational leaders, but these characteristics must first be nurtured and allowed to blossom. The health care managers/leaders have a responsibility to encourage and support this growth, as this is very important in the transformation of the work environment (1998). A practice/work environment in which transformational leaders strive to create new visions for enhancing patient care and nursing practice is a better environment to work.


 


Various authors have discussed the use of transformational leadership. Many researches also suggest that all health care professionals could use this leadership style to enhance their practice environment ( 1998). The workplace can be transformed by creating a work environment that ensures quality patient care. This transformation can be achieved by health care professionals becoming transformational leaders in the workplace.


 


When implementing new policies or rules, or even with simple matters, the staff should be allowed to contribute to the decisions to be made. Goals have to be set also. To support the health care professional’s use of shared leadership behaviors in the clinical setting, health care staff like nurse will be mentored by the manager or clinical nurse specialist to apply the shared leadership skills during their daily work to achieve the goals that are set.


 


The creating and sharing of this setting and achieving of goals is a key implementation challenge, and also calls for transformational leadership. Through effective communication and persuasion, and confidence building, the transformational leader encourages the adoption of new values and beliefs, endorses the goal of organizational effectiveness, and sustains the effort to realize the improvement of work environment.


 


To be included with the overall plan for achieving a positive and healthy work environment with leadership capabilities is the training of the health care professionals for empowerment. Training health care professionals for empowerment must include leadership techniques to prepare the health care professional for the integrative and collaborative role.


 


The environment in which the health care professional works is influential in developing empowered behavior (1998) since professionals do not function in a vacuum. They need an environment that encourages empowerment. The health care professional cannot reach empowerment if there are unsatisfied needs within the working environment.


 


Incorporated within the concept of empowerment is the individual’s willingness to see the vision and make the personal changes necessary to connect with that vision. It is how the concept of shared leadership works (2002). All management staff plays an important role in leading the emergence of legitimacy of this “new professional authority.” The encouragement of individual health care staff to establish individual goals that achieve more self-direction, more knowledge and self-confidence, and more networking ability by the process of shared leadership leads to a more committed employee. A more committed employee in turn contributes to a positive and healthy work environment.


           


In this proposed approach, negative consequences may also present. Shared leadership may present a conflict and ambiguity of roles. Some of the staff might revel in the shared power to the point that they will forget what the essence of shared leadership is all about. Some staff might also take advantage of such opportunity and this creates competition and jealousy within the staff. All of these wouldn’t be in line with the goal of creating a positive and healthy environment.


           


To minimize such problems, there should be an ongoing monitoring of the staff. Although they are given the rights to take part in decision-making, they should also not forget where they really belong. The staff should also be constantly reminded by the managers that this effort needs teamwork and this is done for the improvement of the work environment. Perhaps motivation would also work in minimizing this problem.


           


Aside from all these discussed, effective clinical leadership also requires something else. Good clinical leadership can help identify inadequate governance structures and practices and provide a pathway for their understanding and resolution, but for this to happen, there must be adequate funding of individuals and teams, working with and learning from each other, in order to recognize ineffective practices, promote human rights, identify mistakes and prevent them ( 2005).


 


            This perspective of leadership is therefore a functional one, meaning that leadership is at the service of collective effectiveness. It takes not one but a collective effort in order to be an effective leader. It is very much the same sense as everyone in the group becoming a leader too.


 


Describing a similar approach to team leadership, it has been argued that the leader’s main job is to do, or get done, whatever is not being adequately handled for group needs ( 2001). If a leader manages, by whatever means, to ensure that all functions critical to both task accomplishment and group maintenance are adequately taken care of, then the leader has done his or her job well.


 


These assertions can be made whether leaders are leading groups, multiple groups combined into a department or a division, the organization as a whole, or conglomerates of multiple organizations. This defining element of organizational leadership also means that the success of the collective as a whole is a (if not the) major criterion for leader effectiveness.


 


CONCLUSION


 


            In accordance with today’s practice environment, in which patient care is delivered by a multidisciplinary health care team, health care professionals must focus on the wider scope of professional and clinical leadership, addressing the roles of team members including nurses, physical therapists, radiology and laboratory managers, and occupational therapists. Integrating therapy, research, and practice, there are various leadership models that incorporate leadership development through mentorship and professional development planning, which could be beneficial for all health care professionals. This clearly relates to  emphasis on the importance of health care professionals becoming more involved in leadership. From physicians, managers, nurses, down to low-level employees, everyone should be trained to become effective leaders.


 


 


 


 


 


 


 


 


 


 


 


 


 


 



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