The Cockcroft difference: an analysis of the impact of a nursing leadership development programme

Aim Identifying impact areas of nursing leadership development programmes is needed to determine if there are measureable effects on participants. Background These impact areas help to identify measures to substantiate the benefits of nursing leadership programmes for organization leaders making decisions about support and implementation of such opportunities for their emerging leaders. Method Using mixed qualitative/quantitative methods, the impact of a nursing leadership development programme, the Amy V. Cockcroft Fellowship, is examined to determine if there are measureable influences. Results Themes of four areas of impact: improved conflict resolution/negotiation skills, communication skills, personal development and career action or change were identified through content analysis. Conclusions These themes provide the basis for creating measureable indicators for nursing organizations to use in determining the value of nursing leadership development programmes such as the Amy V. Cockcroft Fellowship. Implications for nursing management Based on the findings established in this research article, nurse managers can focus on developing themselves and their peer groups through nursing leadership development programmes to prepare for leading in the present and future healthcare environment.     

Education leadership in the clinical health care setting: A framework for nursing education development

This paper describes how a new framework for clinical nursing education was introduced at Counties Manukau District Health Board (CMDHB), New Zealand. The project was initiated in response to the significant legislative and post registration nursing education changes within New Zealand. The journey of change has been a significant undertaking, and has required clear management, strong leadership, perseverance and understanding of the organisation’s culture.The approach taken to managing the change had four stages, and reflects various change management models. The first stage, the identification process, identified the impetus for change. Creating the vision is the second stage and identified what the change would look like within the organisation. To ensure success and to guide the process of change a realistic and sustainable vision was developed. Implementing the vision was the third stage, and discusses the communication and pilot phase of implementing the nursing education framework. Stage four, embedding the vision, explores the process and experiences of changing an education culture and embedding the vision into an organisation. The paper concludes by discussing the importance of implementing robust, consistent, strategic and collaborative processes – that reflect and evaluate best educational nursing practice.     

Education leadership in the clinical health care setting: a framework for nursing education development

This paper describes how a new framework for clinical nursing education was introduced at Counties Manukau District Health Board (CMDHB), New Zealand. The project was initiated in response to the significant legislative and post registration nursing education changes within New Zealand. The journey of change has been a significant undertaking, and has required clear management, strong leadership, perseverance and understanding of the organisation's culture. The approach taken to managing the change had four stages, and reflects various change management models. The first stage, the identification process, identified the impetus for change. Creating the vision is the second stage and identified what the change would look like within the organisation. To ensure success and to guide the process of change a realistic and sustainable vision was developed. Implementing the vision was the third stage, and discusses the communication and pilot phase of implementing the nursing education framework. Stage four, embedding the vision, explores the process and experiences of changing an education culture and embedding the vision into an organisation. The paper concludes by discussing the importance of implementing robust, consistent, strategic and collaborative processes--that reflect and evaluate best educational nursing practice.     

Statistical testing of the full-range leadership theory in nursing

The aim of this study is to test statistically the structure of the full-range leadership theory in nursing. The data were gathered by postal questionnaires from nurses and nurse leaders working in healthcare organizations in Finland. A follow-up study was performed 1 year later. The sample consisted of 601 nurses and nurse leaders, and the follow-up study had 78 respondents. Theory was tested through structural equation modelling, standard regression analysis and two-way anova . Rewarding transformational leadership seems to promote and passive laissez-faire leadership to reduce willingness to exert extra effort, perceptions of leader effectiveness and satisfaction with the leader. Active management-by-exception seems to reduce willingness to exert extra effort and perception of leader effectiveness. Rewarding transformational leadership remained as a strong explanatory factor of all outcome variables measured 1 year later. The data supported the main structure of the full-range leadership theory, lending support to the universal nature of the theory.     

Leading the development of nursing within a Nursing Development Unit: the perspectives of leadership by the team leader and a professor of nursing

Leadership within nursing is receiving unprecedented focus and development. This reflective narrative explores the nature of leadership, termed scholarly leadership, by an academic and a clinical leader of a Nursing Development Unit. The narrative explores the characteristics of such leadership and highlights how it empowered a nursing team to further reach its potential. Two areas, patient-centered care and the characteristics of practice, are focused upon to highlight the leadership style that the clinical leader adopted. The paper concludes by suggesting what structural and systems changes need to be put in place in order to bring about change.     

Director of nursing and midwifery leadership: informed through the lens of critical social science

solman a . (2010) Journal of Nursing Management 18, 472–476
Director of nursing and midwifery leadership: informed through the lens of critical social science Aims Highlight the use of critical social science theories, practice development principles and a situational leadership framework within transformational leadership to inform Directors of Nursing and Midwifery (DoNM) practices as leaders. Background Healthcare is constantly changing, unpredictable, strives for quality service and cost containment, which can result in stress and crisis for healthcare workers. DoNM leadership is critical to supporting and leading staff through these complex times within healthcare. Key issues Understanding theories, frameworks and their application to real-world practice can assist in supporting individuals and teams to navigate through the changing healthcare environment. Conclusion Blending critical social science theories with practice development principles and the situational leadership framework can assist the DoNM to enact transformational leadership to support the development of individuals and teams to meet the complex healthcare needs of patients within the clinical setting. Implications for nurse management This article contributes through the practical application of critical social science theories, practice development principles and situational leadership framework within transformational leadership as an approach for enacting DoNM leadership. To further understand and develop in the role of the contemporary DoNM in leadership, these directors are encouraged to publish their work.     

领导力理论与测评工具研究现状及其在护理领域中的应用

在对领导力、护理领导力进行概念分析的基础上,阐述了国内外领导力理论的研究进展及其在护理领域的理论研究现状,从而引申出国内外护理领导力测评工具的研究现状,并指出目前研究中存在的不足,以期为护理领导力测评工具的研发提供参考。     

Political leadership and the politics of nursing

This article provides a critical examination of the concept of political leadership as it has recently developed in the field of nursing, arguing that despite its undoubted usefulness, there are important issues that it obscures. Using five guiding questions, it is proposed that a focus on political leadership is inward-looking and individualizing. It encourages a view of the profession as immature and it emphasizes separation instead of alliance formation. An alternative perspective starting from an assumption that nursing operates in a position of cultural and structural disadvantage is proposed. A close analysis of the government's strategy for nursing in England confirms the continuing cultural ambiguity that surrounds nursing. This enables a number of questions to be posed concerning where nursing fits in relation to current health policy on workforce change and raises doubts about just how far the historical neglect of nursing in policy arenas has been overcome.     

The lived experience of clinical development unit (nursing) leadership in Western Sydney, Australia

BACKGROUND: A network of nine Clinical Development Units (Nursing) (CDU(N)) were recently created in the Western Sydney Area Health Service. These units are designed to develop patient-focused nursing practice through group process and action research, based on principles of transformational leadership. AIMS OF THE STUDY: Although there is documented evidence from Australia and the United Kingdom (UK) that CDUs and Nursing Development Units (NDUs) are very successful in improving both patient and staff satisfaction, there is also growing evidence that the stressors experienced by nurse leaders are threatening the survival of some of these units. This study set out to develop an understanding of the phenomena of Clinical Development Unit (Nursing) leadership when these stressors were likely to impinge. STUDY DESIGN: Hermeneutic phenomenology was employed in order to identify how these experiences changed over time. Two rounds of interviews were conducted: approximately 4--6 months after the launch and, again, 12 months later. FINDINGS: The Clinical Development Unit (Nursing) philosophy provided a framework on which these very motivated leaders began to enhance nursing accountability in their units through reflective practice and participatory governance. While reinforcing many previously published positive and negative aspects of Clinical Development Units and Nursing Development Units, this paper also highlights how the expectations and experiences of these leaders changed over time with unanticipated pressures of work, a high turnover of clinical leaders, a perceived diminution of management support and unrealistic self-expectations. A significant theme that emerged as these stressors began to impinge was the leaders' own need for leadership in order to sustain their confidence and motivation. IMPLICATIONS FOR NURSING: Insights harvested from this study have since been incorporated into a revised leadership preparation programme and support mechanisms for the leaders of eight new Clinical Development Units (Nursing) in the Western Sydney Area Health Service.     

Promoting leadership: the development of a nurse executive team in an acute hospital trust

Aim The purpose of this study was to evaluate how an executive nursing team, within an acute hospital trust in the south of England, developed their leadership characteristics through the use of a professional development programme. Background This paper offers an insight into how this team worked together to clarify their views of their new role and how the role would be enacted. Method A questionnaire using quantitative and qualitative measures was used to explore the group’s leadership style and evaluate the professional development programme. Findings The findings show how the development programme worked and what clarity it afforded the group in terms of their leadership style. Group work, building on the findings, helped them define their particular characteristics, skills and leadership ability and what further work was needed to demonstrate this. Conclusions The issues raised, such as team‐working, mutual purpose and personal development, are discussed in terms of their function within an integrated executive team with vision and goals. Implications for nursing management In ensuring that the nursing service has positive purpose, direction and goals, there needs to be a strategic approach to corporate development; otherwise, nursing will struggle to lead itself within a fast changing health care system.     

Leadership and leadership development within the profession of physiotherapy in Ireland

Background: Health service reform, physiotherapy graduate unemployment, and the impending introduction of state regulation mean that physiotherapists in Ireland today are facing many challenges. Leadership is needed to ensure that the profession will be able to adapt to the demands and inevitable changes ahead. Objective: To investigate the perceptions of physiotherapists in Ireland of leadership and leadership characteristics, and to explore their participation in leadership development training. Methods: In this cross-sectional nationwide study, an Internet-based survey was administered via e-mail to members of the Irish Society of Chartered Physiotherapists (n = 2,787). Results: There were 615 responses to the survey. A high proportion of respondents (74.0%) perceived themselves to be a leader. Factors associated with self-declaration as a leader were time since graduation, highest qualification attained, and leadership training. Leadership training was also associated with placing greater importance on achieving a leadership position. Some form of leadership training had been completed by 41.5% of respondents. Communication and professionalism were the most highly rated leadership characteristics in all three settings. Conclusion: Physiotherapists who have had leadership training were more likely to perceive themselves to be leaders. Leadership training may support physiotherapists to assume leadership roles both clinically and nonclinically.     

Impact of clinical leadership development on the clinical leader, nursing team and care-giving process: a case study

Aim This study explored the dynamics related to a leadership development programme and their impact on the clinical leader, the nursing team and the care‐giving process. Background While there is a growing conviction about the need to invest in transformational leadership in nursing, further insight into the true complexity of leadership development and, more specifically, how leadership can make a difference in nursing and patient outcomes is essential. Method A single instrumental case study was conducted in a unit of a large academic hospital where a Clinical Leadership development Project (CLP) was implemented successfully. We used mixed methods with multiple sources of data to capture the complexity of leadership development. Data were collected through individual interviews, focus groups and observation of participants. A purposive sample of 17 participants representing a wide variety of team members has permitted data saturation. The data were categorized and conceptualized and finally organized into a framework describing leadership development on the unit and its impact on the leader, the nursing team and the care‐giving process. Results Leadership development is an ongoing, interactive process between the clinical leader and the co‐workers. The head nurse became more effective in areas of self‐awareness, communication skills, performance and vision. The nursing team benefited because more effective leadership promoted effective communication, greater responsibility, empowerment and job clarity. Improved clinical leadership seemed also to influence patient‐centred communication, continuity of care and interdisciplinary collaboration. Conclusions The results of the study give more insight into the processes underlying the leader’s progress towards attaining a transformational leadership style and its impact on the team members. The impact of leadership on the care‐giving process, however, remains difficult to describe. Implications for nursing management The interactive nature of leadership development makes CLP a challenge for the leader as well for the team members. Through its impact on the leader and the nursing team, CLP is a valuable instrument for improving work environments of nurses, contributing positively to patient‐centred care.     

The ‘F.E.E.L.’ good factors in nursing leadership at the board level through to work‐based learning

Aim The aim of this commentary is to raise awareness about the apparent lack of formal activities and the paucity of published papers in nursing leadership development at the board level in the United Kingdom (UK). The paper suggests a way forward. Background The author has been serving at a board level, within and outside of nursing, locally, nationally and internationally since 1988. His current experience as an active board member and honorary treasurer of a leading charity organization in the Southeast of England and participation on a Board Leadership Development programme in the United States of America (USA) led to the need to write this commentary. Evaluation Leadership at the board level is different because the board is the governing body of an organization. The board has overall responsibility for running the organization. The overall duty is to manage less and LEAD more. The need for this type of leadership is on the increase because these are turbulent days in the healthcare industry. This growing trend witnesses increasing and greater demand from key stakeholders for nursing and healthcare services: rising exposure to liability and litigation; a demand for stronger accountability and questioning of the nature and delivery of nursing and healthcare services. Effective and successful leadership judgment is made based on both numbers [efficient resources utilization (RU)] and stories [effective client/patient satisfaction (CS)]. Conclusions Nurses and others in the healthcare industry need to guide against the leadership myths that: ‘everyone can be a leader’; ‘leaders deliver business (service) results’; ‘people who get to the top are leaders’; and ‘that leaders are great coaches’. This commentary demonstrates these myths could be converted to become realities through developing and possessing most if not all the knowledge, skills and attitudes implicated in the Effective Board Leadership Capabilities Development Profile presented in this paper. Implications for nursing management and leadership Possessing board level leadership capabilities is significant to nursing management and leadership from three key perspectives: the need for nurses to become ‘recognized’ leaders of the healthcare industry; possessing the knowledge, skills and attitudes relevant for effective board leadership; and the need to use the technology of the 21st century to aspire to an essentially intentionally global nursing community.     

The state of the science of emotional intelligence related to nursing leadership: an integrative review

akerjordet k. & severinsson e. (2010) Journal of Nursing Management 18, 363–382
The state of the science of emotional intelligence related to nursing leadership: an integrative review Aim To explore the state of the science of emotional intelligence (EI) related to nursing leadership and its critiques. Background The phenomenon of EI has emerged as a potential new construct of importance for nursing leadership that enhances educational, organizational, staff and patient outcomes. Nevertheless, important questions and critical reflections related to exaggerated claims, conceptualizations and measurements exist. Method A literature search was conducted using international databases covering the period January 1999 to December 2009. A manual search of relevant journals and significant references increased the data. Results Critical reflection seems to be associated with the unsubstantiated predictive validity of EI in the area of nursing leadership. In addition, important moral issues are called into question. Conclusions It is important to possess in-depth knowledge of EI and its scientific critique when integrating the concept into nursing research, education and practical settings. More attention to the nature of emotion in EI is necessary. Implications for nursing leadership The dynamics of EI should be explored in the context of both the surrounding environment and individual differences, as the latter can be adaptive in some settings but harmful in others.     

A partnership approach to leadership development for Directors of Nursing in Older People's services in Ireland – articulating the impact

This paper outlines the approach undertaken by the Royal College of Nursing to design, deliver and evaluate a programme of leadership development for Directors of Nursing in Older People's services commissioned by the Nursing and Midwifery Planning Development Unit Dublin, Kildare and Wicklow. The programme was developed to support Nurse Directors of these services to enhance their leadership capabilities at a time of significant health service reform and investment. The programme was underpinned by the Office of Health Management's Nursing Competency Framework ( Rush et al. 2000 ). The key influences for the programme were the significant contemporary policy and organizational developments directly experienced by Directors of Nursing. This paper will focus on the benefits for participants, commissioners and service users alike in adopting this kind of partnership approach to the design, delivery and evaluation of a bespoke RCN leadership development programme which combined the experience of RCN Gerontology alongside Leadership. Specifically, the paper focuses on the context of the commissioned work and the ways of working between the members of the delivery team and the commissioners, their roles and responsibilities and the importance of these interrelationships in the delivery of a development programme which would meet the specific needs of this key group of nurse leaders. The key learning and experiences of the Directors of Nursing are highlighted.     

Vision, leadership and partnership: how to enhance the nursing and midwifery contribution to research and development

AIM: This paper reports an evaluation of nursing and midwifery research and development activity in Northern Ireland. BACKGROUND: Research and development is integral to the quality of patient care. Nurses and midwives have an important contribution to make and, whilst the professional landscape has changed significantly, with improved funding and productivity, there remains much room for improvement. To advance this agenda it is necessary to evaluate progress across the spectrum of research and development activity. The policy literature gives examples of the methods by which this can be achieved, but there is less evidence about evaluation criteria, or the methods by which research and development progress is assessed at organizational, national and international levels. METHOD: A comprehensive analysis of the literature was undertaken to develop a 'Research and Development Best Practice Framework'. This was then used as the basis for structured interviews with 32 organizational leads for three main stakeholder groups: health and care providers (n = 20), education providers (n = 7) and funders of research and development (n = 5). Data collection was from March to November 2004. FINDINGS: Despite general recognition of its value, only a minority of organizations had an up-to-date corporate strategy that included nursing and midwifery research and development. There was considerable variability in the systems, support structures, capacity and productivity of nurses and midwives throughout these organizations. In most, no-one had sole responsibility for leading the professional research and development agenda but, where such leadership was in place, improved outcomes were apparent. Building effective partnerships for research and development and forward planning through developing an organizational strategy were also key indicators of success. CONCLUSION: Our findings confirm progress, but also reinforce the need to develop a clear vision, enhance leadership potential and forge effective partnerships to advance the research and development agenda in nursing and midwifery.