4 unit 1 | Professional Considerations
Nurses work with an extraordinary variety of people:
physicians, respiratory therapists, physical therapists,
social workers, psychologists, technicians, aides, unit
managers, housekeepers, clients, and clients’ families.
The reason why nurses study leadership is to
learn how to work well, or effectively,with other
people. In this chapter,leadershipand followership
and the relationships between them are defined.
The characteristics and behaviors that can make
you, a new nurse, an effective leader and follower
are discussed.
Leadership
Are You Ready to Be a Leader?
You may be thinking, “I’m just beginning my career
in nursing. How can I be expected to be a leader
now?” This is an important question. You will need
time to refine your clinical skills and learn how to
function in a new environment. But you can begin
to assume some leadership right away within your
new nursing roles. Consider the following example:
Billie Blair Thomas was a new staff nurse at Green
Valley Nursing Care Center. After orientation, she
was assigned to a rehabilitation unit with high
admission and discharge rates. Billie noticed that
admissions and discharges were assigned rather hap-
hazardly. Anyone who was “free” at the moment was
directed to handle them. Sometimes, unlicensed assis-
tant personnel were directed to admit or discharge
residents. Billie believed that using them was inap-
propriate because their assessment skills were limited
and they had no training in discharge planning.
Billie thought there was a better way to do this
but was not sure that she should say so because she
was so new. “Maybe they’ve already thought of
this,” she said to a former classmate. “It’s such an
obvious solution.” They began to talk about what
they had learned in their leadership course before
graduation. “I just keep hearing our instructor say-
ing, ‘There’s only one manager, but anyone can be a
leader of our group.”
“If you want to be a leader, you have to act on
your idea,” her friend said.
“Maybe I will,” Billie replied.
Billie decided to speak with her nurse manager,
an experienced rehabilitation nurse who seemed
not only approachable but also open to new ideas.
“I have been so busy getting our new record system
on line before the surveyors come that I wasn’tpaying attention to that,” the nurse manager told
her. “I’m so glad you brought it to my attention.”
Billie’s nurse manager raised the issue at the next
executive meeting, giving credit to Billie for having
brought it to her attention. The other nurse man-
agers had the same response. “We were so focused on
the new record system that we overlooked that. We
need to take care of this situation as soon as possible.
Billie Blair Thomas has leadership potential.”Leadership Defined
Leadership is a much broader concept than is man-
agement. Although managers should also be lead-
ers, management is focused on the achievement of
organizational goals. Leadership, on the other hand:
...occurs whenever one person attempts to influence
the behavior of an individual or group—up, down,
or sideways in the organization—regardless of the
reason. It may be for personal goals or for the goals
of others, and these goals may or may not be congru-
ent with organizational goals. Leadership is influ-
ence (Hersey & Campbell, 2004, p. 12)
In order to lead, one must develop three important
competencies: (1) ability to diagnose or understand
the situation you want to influence, (2) adaptation
in order to allow your behaviors and other resources
to close the gap between the current situation and
what you are hoping to achieve, and (3) communi-
cation. No matter how much you diagnose or
adapt, if you cannot communicate effectively, you
will probably not meet your goal (Hersey &
Campbell, 2004).
Effective nurse leaders are those who engage
others to work together effectively in pursuit of a
shared goal. Examples of shared goals are pro-
viding excellent client care, designing a cost-
saving procedure, and challenging the ethics of a
new policy.Followership
Followership and leadership are separate but recip-
rocal roles. Without followers, one cannot be a
leader; conversely, one cannot be a follower without
a leader (Lyons, 2002).
Being an effective follower is as important to the
new nurse as is being an effective leader. In fact,
most of the time most of us are followers: members
of a team, attendees at a meeting, staff of a nursing
care unit, and so forth.