Leadership is an essential element of nursing practice. The quality of leadership in a particular nursing setting affects patient outcomes, employee retention rates, profitability, among other performance indicators (Rankin, Matthews, Russell, Pollard, 2016). When discussing nursing leadership, it is imperative to distinguish between executive leadership and clinical leadership. Executive nursing leaders are involved in building relationships with external stakeholders while clinical leaders provide leadership at the unit level. This literature review focuses on clinical leadership. According to Rankin, Matthews, Russell, and Pollard (2016), clinical leadership entails monitoring evidence-based practice, identifying and managing the risks that face individual patients, evaluating outcomes to improve performance, advocating for patients, and enhancing efficiency and coordination at the point of care. According to Rokstad, Vatne, Engedal, and Selbaek (2015) , the roles of clinical leaders include participating in executive decision making within the healthcare organization, acting as a bridge between the nurses and the executive leadership, ensuring nurses are involved in decision making, ensuring nurses have enough resources and knowledge, and creating effective communication between nurses and other stakeholders.
Ailey, Lamb, Friese, and Christopher (2015) note that most new nurses are not ready to assume leadership positions; this can be remedied through improving nursing education and providing on-the-job training. The process of developing nursing leaders should start from schools; leadership can be taught (Ailey et al., 2015). For nursing students to be effective nursing leaders, education institutions should teach them to apply critical thinking and reflection skills in solving their day-to-day problems, make bold decisions without fearing reprisals, disagree and support their positions, and build self- confidence (Ailey et al., 2015). Schools should also provide platforms for nursing students to exercise their leadership skills (Ailey et al., 2015). Attributes of effective nursing leaders include communication skills, flexibility, self-confidence, resilience and hardiness, and self-reflection (Rankin et al., 2016). Further, effective nursing leaders are approachable, comfortable with ambiguity, ready to take risks, and have high moral integrity (Rankin et al., 2016).
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Transformational and strategic leadership approaches are recommended for nursing units. Transformational leadership effects change in individuals; the leader motivates their followers by appealing to higher ideals and moral values (Fischer, 2016). Fischer (2016) identifies four essential elements of effective leadership: management of self, attention, trust, and meaning. Management of attention entails having visions and goals on where a healthcare organization is headed (Fischer, 2016). Such goals should outline the unit’s priorities. Management to meaning is articulating an organization’s goals and visions to the nurses and creating an organizational culture that is aligned to the goals. Management of trust entails making sound and consistent decisions; such decisions should be based on honesty and fairness (Fischer, 2016). Management of self means that leaders should be aware of their strengths and weaknesses, and uses them effectively. Fischer (2016) identify several strategic leadership skills for nursing leaders: focusing on the root causes of problems, considering the view of other stakeholders, maintaining timely and regular communication with the followers, and making inquiry part of the organization's culture.
It is necessary for nursing leaders to have conflict-resolution and communication skills; in a typical clinical setting, the leaders are required to apply these skills regularly. Nursing leaders approach interpersonal conflicts in different ways: problem-solving, avoiding, and forcing (Johansen, 2014). Problem-solving entails allowing the parties to explain their concerns and finding a solution that suits all of them. This method of resolving conflicts enhances participatory leaderships and shows that the leaders are concerned about the welfare of their followers (Johnasen, 2014). Examples of effective communication skills for nursing leaders are listening to the needs of the employees, improving relationships, opening discussions with the management and peers, and giving other staff timely feedback (Johansen, 2014). Healthcare organizations need strong and effective leadership style to survive. Strategies for creating an effective leadership style include creating a vision, implementing the changes needed to achieve the vision, and minimizing conflicts (Shah, 2017).
References
Ailey, S., Lamb, K., Friese, T., & Christopher, B. A. (2015). Educating nursing students in clinical leadership. Nursing Management , 21 (9).
Fischer, S. A. (2016). Transformational leadership in nursing: a concept analysis. Journal of Advanced Nursing , 72 (11), 2644-2653.
Johansen, M. L. (2014). Keeping the peace: conflict management strategies for nurse managers. Nursing Management , 43 (2), 50-54.
Rankin, J., Matthews, A., Russell, M., & Pollard, M. (2016). Clinical leadership and effective nursing teams. GSTF Journal of Nursing and Health Care , 4 (1), 76-81.
Rokstad, A. M. M., Vatne, S., Engedal, K., & Selbaek, G. (2015). The role of leadership in the implementation of person‐centred care using Dementia Care Mapping: a study in three nursing homes. Journal of nursing management , 23 (1), 15-26.
Shah, M. (2017). Impact of interpersonal conflict in health care setting on patient care; the role of nursing leadership style on resolving the conflict. Nurse Care Open Access J , 2 (2), 00031.
