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April 15, 2017 BY PATRICK ALBINA

Nurses – A New Leadership Role Model

You only have to go into any bookstore (whether online or traditional) to see an abundance of literature on leadership. Much of the established literature has been largely focused on leadership styles that belong to an industrial era where large corporations, hierarchy and bureaucracy have typically been the rule. As the world changes and as we come to embrace an era as a highly interconnected global community, there is a shift away from command & control leadership style.

Leadership styles can be seen on a continuum from hierarchical to transformational. At the hierarchical end, leadership is viewed as one of “power over,” the ability to exercise authoritative dominance over others through tiered levels of relationship. At the other end of the spectrum is transformational leadership, which is characterised by “power with” due to the richness of the interrelationship between leaders and followers.

We are in an era of globalisation, information sharing, cultural diversity, freedom of choice and, as a result, we seek to connect relationally and not just cognitively. More and more interpersonal skills, not positional power, are necessary for effective leadership.  Structure, authority and rank are of secondary importance nowadays as we seek the virtues of trust and respect through sound relationships. Leaders who fail to recognise this may find that they lead an empty team.  Renowned leadership expert, John Maxwell said,

…if you’re leading and no one is following, then you’re just out for a walk.

We know that observing people as role models is an effective way of learning new skills and behaviours. In so doing, we look to identify with leaders as those who possess the virtues that we desire in ourselves. The shift of focus away from the hierarchical “power over” styles of leadership has made us come to realise that we need to seek new types of role models, specifically those who exemplify the “power with” qualities. We may be unable to find these role models in the traditional places, and need to open our minds up to relatively unchartered territory.

Nurses inherently practice leadership qualities that are subtly powerful, so subtle in fact, that they are the hidden gems in context of “power with” role models. Putting aside the efficacy of the clinical tasks that nurses perform, their conduct in their role as humanitarians have a long-term impact on patients, their family and their friends, purely with their words, actions, attitudes and demeanour. Anyone who has ever experienced any type of trauma requiring medical attention will very likely understand the feelings of uncertainty and anxiety as you come to terms with your vulnerability and mortality. As a result, everything nurses say and do, no matter how big or small, may be analysed, amplified and scrutinized. Their facial expressions, tone of voice, body language and choice of words all convey richness in their holistic exchange with people. Presence of mind is an inherently critical part of the nursing profession, the importance of which is becoming evermore integral to leadership in this fast paced world.

The notion of mindfulness has been around for some time now, but it wasn’t until my wife helped me to fully appreciate its significance through her eyes as a nurse that it really sunk in. It is a form of purposeful attentiveness through conscious engagement in the present, sensitivity to the context, being without judgment and a giving of compassion. For nurses, the context may sometimes be a matter of life and death – literally. Fortunately for most of us, we will not have to deal with life and death situations as we go about our normal lives. However I’d like to share some of these strategies around mindful presence with you. At the same time I invite you to ponder upon how we might leverage these simple yet profound practices that nurses perform for their patients, family and friends, as ways in which we can become better “power with” leaders.

  1. Slow down and think. It takes energy to look calm and composed in the face of difficulty, and it can take years of experience to know how to do this effectively. Do we consciously take a moment to consider how we can best engage with people? Are we aware of our body language and what message is our demeanour conveying beyond the spoken word?
  2. Engage eye-to-eye. What are we conveying when we are looking down upon the person we are conversing with…we are showing them who’s really in charge. Is this really what we want to do? Meet eye-to-eye. It sends the message that they are just as important. Sit down together. Sitting shows that you have time, that you are really with them and unlikely to dash out of the room to a higher priority.
  3. Focus. How much time do you have? However long or short, eliminate distractions and be fully present for that time. Give of yourself fully and put that phone away!
  4. Learn. What can you learn about the person/people you are engaging with? Are you doing more telling or more asking? Challenge yourself to find out something new. What is important to them, what might be worrying them or simply what is happening in their world at this very moment?
  5. Empathise. Quite simply, put yourself in their shoes – it is not as easy as it seems. Ask yourself, if you were in their place, what might you be thinking and how might you be feeling?

Mindful presence is intangible. It cannot be measured in the way that KPIs, performance targets, safety metrics and quality outcomes can. Yet our ability to connect in a “power with” style is profound and powerful, and can leave an indelible impression on those who engage with us.  Nursing presence has been defined as,

“…A holistic and reciprocal exchange between nurse and patient that involves a sincere connection and sharing of human experience…”

It is a standard that we would do well to consider if we seek to identify new role models to meet the challenges of tomorrow and to support the future generations of leaders to come.

The author wishes to acknowledge:

Fahlberg. B., & Roush. T., (2016), Mindful presence: Being “with” in our nursing care, Nursing 2016, 46(3).