Term Paper: Nursing Leadership Philosophy Organizational, Economic, Social

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Nursing Leadership Philosophy

Organizational, Economic, Social and Demographic Factors in Nursing Settings

In contemporary healthcare and nursing practice, the delivery of healthcare is affected by a wide range of organizational, economic, social and demographic factors (Kennedy, 2006; Reid, 2009). Globally, countries with highly developed economies and technologies tend to provide the best healthcare while those with less developed economies suffer disproportionately from lack of adequate access to healthcare. At the national level, substantial disparities exist as a function of various variables including political, socio-economic, demographic, and geographic elements (Kennedy, 2006; Reid, 2009).

Locally, the quality and sufficiency of access to and availability of quality healthcare varies in relation to local government focus, the nature of public transportation, and the location of healthcare providers and institutions (Reid, 2009). At the institutional level, the variables that determine the quality and availability of healthcare also include organizational policies and politics, management and leadership culture, and the qualifications and commitment of the individuals making up healthcare units and medical teams (Reid, 2009).

The Difference between Management and Leadership

Management and leadership functions are frequently discussed together, but they are substantially different elements of modern organizational structure and operation (Dalton, 2003; Russell-Whaling, 2008). Management comprises organizational structure, hierarchical chains, supervisory responsibilities, operational efficiency and economy, and tactical decision-making. Leadership encompasses the specific roles of supervisors, foresight, strategic vision, commitment, and character (Maxwell, 2003 in Russell-Whaling, 2008).

Typical examples of good management would include the development of assembly-line production processes, working groups, and to creatively astute appreciation of potentially obscure factors capable of dramatically affecting production, such as the identification of the optimally efficient hand shovel-load of coal in late 19th century and early 20th century industry (Russell-Whaling, 2008). Examples of good leadership would include the purposeful internal cultivation of organization-wide commitment; the development of leadership potential in employees with leadership potential; management that is, in principle, receptive to critical perspectives and intellectual independence; and a corporate culture that is maximally conducive to identifying, recruiting, retaining, and developing the future leaders of the organization (Maxwell, 2003 in Russell-Whaling, 2008).

Strategies for Self-Management and Career Advancement

One of the most important elements of modern nursing that is responsible for its tremendous value and contribution to human health is the modern role of empirical research in evidence-based clinical practice (Hamric, Spross, & Hanson, 2009). On the other hand, the importance of empirical research in evidence-based practice also imposes some of the greatest challenges to contemporary nurses. Specifically, medicine has always been a fundamentally dynamic field in modern times; however, the current rate and complexity of its evolution requires that nurses be prepared to continue their education essentially indefinitely throughout their practice. This, combined with the daily realities and volume of clinical nursing responsibilities can be especially challenging for newly-graduated nurses who must balance adapting to an intense vocational environment with continual preparation for certifications, licensing exams, and advanced practice education (Hamric, Spross, & Hanson, 2009; Taylor, Lillis, & LeMone, 2005).

With regard to career advancement, one of the goals of self-management would seem to be considering (realistically and based on full awareness of the nature and extent of one's responsibilities and the expectations of others) how and when to pursue continual advanced education. Failure to consider those factors accurately could undermine either the quality of performance in the clinical environment or the success of advanced academic pursuits. In the worst case scenario, premature commitment to both simultaneously could undermine the chances of success in either area. Ideally, therefore, part of effective self-management must be the realistic establishment of short-term goals.

The actual practice of professional nursing also requires the ability to identify, understand, and compare several different sources of the fundamental obligations owed to patients and clients (Reid, 2009). As often as cases present relatively obvious analyses, they present tactical, practical, legal, formal ethical, and objective moral dilemmas that cannot necessarily be readily reconciled without significant sacrifices depending on which perspectives is weighed most heavily (Reid, 2009).

Finally, self-management in modern clinical nursing often requires the ability to maintain a clinical focus even under potentially challenging interpersonal circumstances in the vocational environment (Hamric, Spross, & Hanson, 2009; Taylor, Lillis, & LeMone, 2005). Many contemporary nursing administrators acknowledge that there are fairly significant problems affecting the industry (and more so in some institutions than in others) in relation to interpersonal issues between and among co-workers within nursing units. In nursing, issues routinely involve perceptions and expectations about seniority, national or ethnic origin, race, as well as ordinary interpersonal conflicts, power struggles, and social circles or "cliques" (Hamric, Spross, & Hanson, 2009; Taylor, Lillis, & LeMone, 2005). To a large degree, it is within the professional responsibilities of professional healthcare providers to self-manage their behavior in the workplace so that they contribute only positively to the quality of care and operational efficiency. In principle, this is no different from the characteristics of successful professional working groups in general, (Blair, 2003).

Establishing a Leadership Culture in Organizations

In the 21 Irrefutable Laws of Leadership by John C. Maxwell (2003), the author writes extensively about the specific attributes of effective organizational leaders and the qualities that tend to be common to or shared by organizations that establish a consistent record (and ultimately a legacy) of success (Russell-Whaling, 2008). According to Maxwell (2003, in Russell-Whaling, 2008), successful organizational leaders are, most fundamentally, those who possess the ability to influence others to follow their lead.

However, that is not at all to suggest that personal charm or "charisma" is sufficient to lead effectively, especially in highly technical fields that require life-and-death decisions on a continual basis. Rather, the ability to inspire followers is a necessary but insufficient requirement of interpersonal effectiveness. Maxwell (2003, in Russell-Whaling, 2008) argues that establishing an effective and genuine leadership culture in organizations presupposes that leaders possess high levels of personal character, relationships cultivated with others, specific knowledge, intuition, experience, previous successes, and ability. More particularly, that concept of leadership within organizations also requires that leaders know how to inspire trust through those qualities, such as by communicating their competence, establishing personal connections, and exhibiting character (Maxwell, 2003, in Russell-Whaling, 2008).

Most importantly, establishing a leadership culture throughout an organization requires the purposeful direction of effort to hiring and retaining employees with leadership potential and an equal emphasis on promoting the personal and professional development of individuals within the organization (Maxwell, 2003, in Russell-Whaling, 2008). In that regard, establishing such a culture throughout many healthcare institutions may be more complicated than doing so within general business organizations, owing to some of the differences in those respective vocational environments and responsibilities.

Leadership Issues Unique to Modern Nursing

Unfortunately, the current state of the nursing profession in the United States is being significantly weakened by the retirement of experienced nurses as well as by the high attrition rate, particularly among new graduates within their first five years of professional practice (Reid, 2009). Given the fundamental requirements of Maxwell in connection with the importance of cultivating leaders from within (Russell-Whaling, 2008), those factors currently present a challenge to nursing and institutional administrators alike.

To a large extent, the high attrition rate is directly related to the way that untenable cost considerations and decisions of insurance administrators (rather than medical personnel) determine patient loads (Kennedy, 2006; Reid, 2009). Throughout the nation, cost concerns have necessitated staff cutbacks that directly impact the experience of professional healthcare providers. Unfortunately, within the already stressful environment of clinical nursing, the additional stress and increase in responsibilities and patient load contribute directly to burnout (Reid, 2009).

The other consideration that is somewhat unique to the nursing profession in the U.S. is the large influx of foreign-trained professionals who are technically competent in their professional field but comparatively ill-prepared for social, occupational, and cultural assimilation into the community and of… [END OF PREVIEW]

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