Making the case for succession planning: who's on deck in your organization?

In Canada, the nursing shortage is all encompassing, and nurse leaders are needed from the bedside to the boardroom. Healthcare organizations and the nursing profession lag behind the corporate sector in development of strategic leadership succession planning. Contemporary nurse leaders will require all the knowledge, skills, attitudes and competencies their predecessors can provide. Effective leadership development and succession planning will provide a climate that is conducive to the transfer of that knowledge. Providing leadership development opportunities within the context of succession planning will assist nurses to develop and nurture the leader within. A definitive strategic succession plan may mean the difference between success and failure for nurses and their organizations.     

Growing our future nursing leaders

The need for strong nursing leadership to meet the future challenges of the healthcare delivery system is widely acknowledged, yet many of today's nursing leaders express concern about a lack of interest in leadership among their younger nurses. This article reports on a qualitative research study that involved focus groups with 48 younger nurses under the age of 40 who were not currently in formal leadership positions. Using a ConCensus process, participants were asked questions to identify and prioritize the factors that influence their decisions to accept or reject nursing leadership positions. In this study, participants did see a potential in the nursing leadership role to make a difference for both patients and staff. Adequate compensation for the role and true decision-making power were factors of concern for younger nurses. Feedback from current leaders about nursing leadership positions is not positive. Strategies that current nursing leaders will need to consider to encourage interest in nursing leadership will be discussed.     

The hidden treasure in nursing leadership: informal leaders

downey m., parslow s. & smart m. (2011) Journal of Nursing Management 19 , 517–521
The hidden treasure in nursing leadership: informal leaders Aim The goal of the present article was to generate awareness of characteristics of informal leaders in healthcare with the emphasis on nurses in acute care settings. There is limited research or literature regarding informal leaders in nursing and how they positively impact nursing management, the organization and, ultimately, patient care. Identification of nurses with leadership characteristics is important so that leadership development and mentoring can occur within the nursing profession. Background More than ever, nursing needs energetic, committed and dedicated leaders to meet the challenges of the healthcare climate and the nursing shortage. This requires nurse leaders to consider all avenues to ensure the ongoing profitability and viability of their healthcare facility. Key issues This paper discusses clinical nurses as informal leaders; characteristics of the informal nurse leader, the role they play, how they impact their unit and how they shape the organization. Implication for nursing management Informal nurse leaders are an underutilized asset in health care. If identified early, these nurses can be developed and empowered to impact unit performance, efficiency and environmental culture in a positive manner.     

Leadership skills for the 21st century

In today's ever-changing health care environment, nurses, especially administrators and managers, require leadership skills that provide direction for a new generation of nurses. Currently, there is a shortage of nurses globally. Along with this shortage of nurses, there is a shortage of nurse leaders. The importance of cultivating new nursing leaders is imperative for a healthful society. Gaining knowledge to become an effective nurse leader is one way to ensure quality health care for the future.     

Leadership challenges to move nurses toward collaborative individualism within a neo-corporate bureaucratic environment

AIM: The purpose of this article was to highlight the increasing corporate style pressures being exerted upon the NHS in England and Wales and how the nursing profession needs to fundamentally change in response to this emerging environment. Through examining a range of nursing leadership responses this paper offers a way forward to meet these challenges. BACKGROUND: Given the accelerating pace of fundamental change within health service delivery the nursing profession is particularly challenged to enact not just new structures but a new, eclectic model of nursing leadership that engages nurses at the clinical interface. Without this, both individual nurses and the wider professions risks being inert within an era of profound change. CONCLUSION: The palpable incongruence between health organizations and leadership models create ineffectiveness and a paucity of self-determinism within nursing. Apparent is the wide range of leadership styles required to respond to these challenges that overtly exceed a single leadership model alone.     

Elevating Nursing Leadership at the Bedside

If we are to achieve healthy work environments that produce competent nurse leaders at the unit level, care must be taken now to ensure a talent pool of nurse leaders for the future. When nurses at the bedside share in the decision-making authority in their work environments, front-line leadership emerges. Growing talent from within at organizational, microsystem, and corporate strategy levels is important for succession. By investing in our front-line nurses, we can enhance leadership at all levels within the healthcare system and enable nurses to be well-positioned in effecting transformational change.     

Leading nurses in dire straits: head nurses' navigation between nursing and leadership roles

sørensen e.e., delmar c. & pedersen b.d. (2011) Journal of Nursing Management 19 , 421–430
Leading nurses in dire straits: head nurses’ navigation between nursing and leadership roles Aim The present study reports selected findings from a doctoral study exploring the negotiation between nursing and leadership in hospital head nurses’ leadership practice. Background The importance of bringing a nursing background into leadership is currently under debate. In spite of several studies of nursing and clinical leadership, it is still unclear how nurses’ navigate between nursing and leadership roles. Method An 11-month-long ethnographic study of 12 head nurses’ work: five worked at a first line level and seven at a department level. Results At the first line level, leadership practices were characterized by an inherent conflict between closeness and distance to clinical practice; at the department level practises were characterized by ‘recognition games’. On both levels, three interactive roles were identified, that of clinician, manager and a hybrid role. Conclusions Where clinician or manager roles were assumed, negotiation between roles was absent, leading to reactive, adaptive and isolated practices. The hybrid role was associated with dialectical negotiation of roles leading to stable and proactive practices. Implications for nursing management Nursing leadership practises depend on leaders’ negotiation of the conflicting identities of nurse and leader. Successful nursing leaders navigate between nursing and leadership roles while nourishing a double identity.     

The need for leadership

This paper examined a number of leadership theories and established that Transformational Leadership is often cited as an appropriate leadership model for nursing. Evidence was put forward to suggest that Australian nurses possess many of the attributes considered as consistent with transformational leaders. However, in the future nurses may require leadership skills, such as technical and collaborative skills, beyond what they have at present since it is not know if the future leadership needs of nursing will be met with the transformational model. Suggestions are provided for the development and encouragement of future leaders. Those discussed are the learning organisation and professional practice models.     

The influence of nursing leadership on nurse performance: a systematic literature review

brady germain p. & cummings g.g. (2010) Journal of Nursing Management 18, 425–439
The influence of nursing leadership on nurse performance: a systematic literature review Aim The aim was to explore leadership factors that influence nurse performance and particularly, the role that nursing leadership behaviors play in nurses’ perceptions of performance motivation. Background Nurse performance is vital to quality patient care outcomes and nursing leadership behaviors have been linked to nurse performance. Evaluations A review of research articles that examined the factors that nurses perceived as influencing their motivation and performance was conducted. Eight studies were included in the final analysis. Key issues Nurses’ perceptions of factors that affect their motivation and ability to perform were grouped into five categories using content analysis: autonomy, work relationships, resource accessibility, nurse factors, and leadership practices. Nursing leadership behaviors were found to influence both nurses’ motivations directly and indirectly via other factors. Conclusion The review suggests that nurse performance may be improved by addressing nurse autonomy, relationships among nurses, their colleagues and leaders, and resource accessibility. Implications for nursing management Nursing managers and leaders may enhance their nurses’ performance by understanding and addressing the factors that affect their ability and motivation to perform.     

Intentional Modelling: A Process for Clinical Leadership Development in Mental Health Nursing

Clinical leadership is becoming more relevant for nurses, as the positive impact that it can have on the quality of care and outcomes for consumers is better understood and more clearly articulated in the literature. As clinical leadership continues to become more relevant, the need to gain an understanding of how clinical leaders in nursing develop will become increasingly important. While the attributes associated with effective clinical leadership are recognized in current literature there remains a paucity of research on how clinical leaders develop these attributes. This study utilized a grounded theory methodology to generate new insights into the experiences of peer identified clinical leaders in mental health nursing and the process of developing clinical leadership skills. Participants in this study were nurses working in a mental health setting who were identified as clinical leaders by their peers as opposed to identifying them by their role or organizational position. A process of intentional modeling emerged as the substantive theory identified in this study. Intentional modeling was described by participants in this study as a process that enabled them to purposefully identify models that assisted them in developing the characteristics of effective clinical leaders as well as allowing them to model these characteristics to others. Reflection on practice is an important contributor to intentional modelling. Intentional modelling could be developed as a framework for promoting knowledge and skill development in the area of clinical leadership.     

Paths to nursing leadership

AIM: The aim was to explore why nurses enter nursing leadership and apply for a management position in health care. The study is part of a research programme in nursing leadership and evidence-based care. BACKGROUND: Nursing has not invested enough in the development of nursing leadership for the development of patient care. There is scarce research on nurses' motives and reasons for committing themselves to a career in nursing leadership. METHOD: A strategic sample of 68 Finnish nurse leaders completed a semistructured questionnaire. Analytic induction was applied in an attempt to generate a theory. FINDINGS: A theory, Paths to Nursing Leadership, is proposed for further research. Four different paths were found according to variations between the nurse leaders' education, primary commitment and situational factors. They are called the Path of Ideals, the Path of Chance, the Career Path and the Temporary Path. CONCLUSION: Situational factors and role models of good but also bad nursing leadership besides motivational and educational factors have played a significant role when Finnish nurses have entered nursing leadership. The educational requirements for nurse leaders and recruitment to nursing management positions need serious attention in order to develop a competent nursing leadership.     

Preliminary clinical nursing leadership competency model: a qualitative study from Thailand

This qualitative study explored the clinical nursing leadership competency perspectives of Thai nurses working in a university hospital. To collect data, in-depth interviews were undertaken with 23 nurse administrators, and focus groups were used with 31 registered nurses. Data were analyzed using content analysis, and theory development was guided by the Iceberg model. Nurses' clinical leadership competencies emerged, comprising hidden characteristics and surface characteristics. The hidden characteristics composed three elements: motive (respect from the nursing and healthcare team and being secure in life), self-concept (representing positive attitudes and values), and traits (personal qualities necessary for leadership). The surface characteristics comprised specific knowledge of nurse leaders about clinical leadership, management and nursing informatics, and clinical skills, such as coordination, effective communication, problem solving, and clinical decision-making. The study findings help nursing to gain greater knowledge of the essence of clinical nursing leadership competencies, a matter critical for theory development in leadership. This study's results later led to the instigation of a training program for registered nurse leaders at the study site, and the formation of a preliminary clinical nursing leadership competency model.     

Learning from history: Frances Gillam Holden,a leadership perspective then and now

BackgroundCritical evaluation of leadership styles through a historical lens is uncommon. There could be missed opportunity for current and emerging nurse leaders to critically evaluate the leadership styles of the past in order to discerningly reflect on their own current leadership.AimTo critically examine the work of Australian nurse Frances Gillam Holden as she developed her vision for servant leadership for nursing in Australia in the late 19th century.MethodsExploration of, and critical reflection on, literature outlining Frances Gillam Holden's work.FindingsHolden's work and experience demonstrate the challenges faced by the profession's leaders at the turn of the century as they attempted to negotiate new ‘scientific’ knowledge and integrate this into nursing leadership. An examination of Holden's experience also demonstrates the difficulties faced by Australian nurse leaders during this time and consideration is given to what leadership in nursing looks like in the present day.DiscussionWithin the wealth of historical narratives, along with their complexities, the impact of this knowledge can have a demonstrated effect that can be far reaching and long lasting. This is particularly evident in regard to the role of nurses, nursing, and the development of modern approaches to nursing leadership, particularly with regard to the rise of nurse leaders in the form of ‘e-nurses’ and the use of social media to inform and lead the profession.ConclusionUnderstanding the influence and impact of nursing history, and historical nursing leaders such as Holden, on current leadership practices is being recognised more as contributing to contemporary nursing identity.     

Why can't a woman be less like a man? Women's leadership dilemma

Despite the emergence of new theories, our notions of organizational and political leadership are still culturally masculine. Therefore, women who lead (e.g., nurse executives and nurse managers) must deal with tensions between expectations about leaders and expectations about women. This situation suggests that nursing administration education programs can help nurses become effective leaders by including examination of what difference it makes--historically, politically, institutionally--that nursing is largely a female profession.     

The Relationship Between Nursing Leadership Practices and Hospital Nursing Retention

With the current nursing shortage and the shrinkage of the American workforce, the challenges of recruiting and retaining nurses for hospital nursing are becoming increasingly difficult. Nursing leadership is responsible for the retention of nurses once they are recruited. Leadership styles exhibited by leaders are a major contributing factor to a nurse's decision to stay in a current position, transfer, or seek employment elsewhere or outside the profession. Researchers have found a link between the effectiveness of a transformational leadership style and that of a transactional leadership style in retaining nurses in hospitals.     

Becoming a nurse faculty leader: practices of leading illuminated through advancing reform in nursing education

PURPOSE. The purpose of this study was to explore the lived experience of becoming a nurse faculty leader. BACKGROUND. In a recent study of 24 nurse faculty leaders across the United States about their experience of becoming a leader, many of the participants hesitated to call themselves leaders. METHODS. This interpretive phenomenological study explored the meaning and significance of nurse faculty leadership. Exemplars of participant leadership development experiences are provided to assist readers in determining how the findings relate to their own practice. FINDINGS. The data revealed that leadership emerges as an embodied practice when nurse educators become involved in advancing reform. Practical leadership strategies for advancing reform in nursing education are presented. CONCLUSION. Leadership is learned through three everyday practices of advancing reform in nursing education: being involved with others; struggling to serve as a symbol and preserve authenticity; and creating an environment for change. This study offers new insight on leadership development, with practical implications for how leadership is taught in nursing curriculum and how nurses can more effectively own leadership roles.     

Pearls and pitfalls of a new graduate academic residency program

Orienting new graduates to the complexities of contemporary healthcare is a challenge for organizational leaders and graduate nurses. While new graduates face one of the most difficult psychological and intellectual periods of adaptation in their careers, organizational leaders struggle not only with the clinical competency of the new nurse but also with the management of multiple transitions that effect their professional performance and patient care. The authors describe the design and implementation of a collaborative academic-service residency program for graduate nurses. The hybrid program includes a master's level course in nursing leadership, facility specific components, and socialization events. Lessons learned are presented so that other nurse leaders may continue to raise the bar in developing future residency programs.     

Assessing nurse graduate leadership outcomes: the "typical day" format

Readiness for professional nursing practice in the current diverse and complex healthcare environment requires leadership capabilities. Faculty are challenged to identify specific leadership capabilities needed by graduate nurses upon entry into professional practice and to develop models from which they can accurately and authentically assess their demonstration. This article presents the development and implementation of an innovative leadership outcome assessment model. The model was developed in collaboration with nurse practice leaders and uses nurse practice leaders as external assessors and a "typical day" in nursing practice format.     

A collaborative effort between nurse leaders to address the hospital nursing shortage

The current nursing shortage is not a routine swinging of the supply pendulum. Indeed, this shortage is determined to be quantitatively and qualitatively different from those of the past (Kimball & O'Neil, 2002). In Cincinnati, Ohio, nurse leaders decided that the uniqueness of this shortage necessitated new strategies. Hospital nurse executives proposed the creation of a community leadership group, and other Cincinnati nurse leaders enthusiastically embraced the idea. A collaborative effort was initiated in the spring of 2000 between a representative group of hospital chief nursing officers, school of nursing deans and faculty, staff nurses, hospital nurse recruiters, and professional nursing organizations to address concerns related to the nursing shortage. This article describes the process and outcomes of this collaborative effort with a focus on the retention of hospital nurses.