Why talk about nursing leadership?
In this article, originally published in French in Harvard Business Review France, Sylvie Deffayet Davrout, Professor at EDHEC and Director of the Leadership Development Chair, and her co-authors look at the key skills developed by (or needed by) nurses.
They were applauded like others during the Covid-19 crisis, but today, nurses may still be suffering from a lack of legitimacy. How can this be explained, and how can we meet the expectations of a profession that is so vital to the smooth running of healthcare organisations?
Apart from clinical leadership, which is very specific to the profession, what legitimises the nurse in 2024 is increasingly borrowing from the wider managerial world (’Le leadership infirmier : un atout indispensable pour le développement de la discipline et de la profession’, by Valérie Berger and Francine Ducharme, Recherche en soins infirmiers, 2019).
Leadership refers not only to a number of personal skills for directing action, but also to the process by which an individual influences a group of people to achieve a common goal (’Leadership: theory and practice’, by Peter G. Northouse, Sage, 2010).
As well as collective performance, leadership can also be about driving change and developing individuals. Contemporary nursing leadership is in fact based on 4 key skills.
1/ Agile situation management
Noticing an influx of patients in an emergency department, the nurses draws up a project to optimise care by proposing, for example, to create within this department a clinical consultation on parenthood to respond quickly to certain families who have difficulty managing the day-to-day care of certain benign pathologies such as conjunctivitis, problems with fever, skin rashes, quantities of breast milk, etc. Thinking quickly about what could lighten the load on the department and offer a more appropriate response is a permanent reflex for the nurses.
At weekends in nursing homes, nurses may find themselves managing situations where there are no staff. They analyse the situation by studying the urgent needs of beneficiaries and implement corrective coordination actions by looking internally or externally for additional resources to ensure continuity of work.
Finally, we have all seen the central role played by nurses in intensive care units, who have to orchestrate patient care, communication with relatives and coordination with members of the department, sometimes with a deteriorating nurse/patient ratio. Patience, empathy, listening skills, stress management and confidence in one's technical skills; beyond clinical leadership, the list of qualities needed to assume this position and hold it borrows from emotional and relational intelligence. In short, the full panoply of the leader in the business world.
2/ Transactional leadership in team supervision
Nurses are responsible for assigning tasks and checking the quality of care or services provided by orderlies or service agents. They supervise actions such as the disinfection of equipment, written reports on the care file, the taking of medication, the patient's clinical condition and the state of stock.
The nurse is often in a managerial position alongside his or her mission to provide care : while working mainly under the responsibility of the health executive, he or she accompanies professionals such as care assistants, who carry out, on the one hand, day-to-day care under his or her responsibility, and on the other hand, acute care as part of a collaboration and shared responsibility. In the absence of the local manager, the nurse is also involved in managing conflicts between team members and becomes the line manager for the rest of the paramedical team. On a day-to-day basis, the nurse is called upon to demonstrate genuine transactional leadership (’From transactional to transformational leadership: Learning to share the vision’, by Bernard Bass, Organizational Dynamics, 1990).
3/ Change management and innovation
In the current training reference framework, the skill that comes immediately after that of assessing a clinical situation and acting accordingly is that of designing and managing projects. It is therefore not optional for nurses to make a permanent contribution to transforming the way in which care is delivered and provided. By keeping a constant watch, nurses are able to invent short- and medium-term solutions, as these two examples illustrate...
To read this article in full (in French), visit hbrfrance.fr
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