Nursing Leadership
Abstract
In this issue of Nursing Leadership, we asked Joan Shaver, a well-known and respected nurse leader, based in Chicago, to share her thoughts on what distinguishes real leaders and how these attributes can be nurtured in emerging leaders.
"Nursing requires strong, consistent and knowledgeable leaders who are visible, inspire others and support professional nursing practice. Leadership plays a pivotal role in the lives of nurses." Canadian Nurses Association, Position Statement on Leadership www.cnanurses.ca/CNA/documents/pdf/publications/
PS59_Nursing_Leadership_June_2002_e.pdf
Joan Shaver, PhD, RN, FAAN, is Professor and Dean of the College of Nursing at the University of Illinois at Chicago (UIC), a top-10 nationally ranked college of nursing. She is currently President of the American Academy of Nursing, a 1,600-member, peer-elected group of top nursing leaders that exists as an entity of the American Nurses Association, and she has just completed four years as a member of the National Advisory Council for the National Institute of Nursing Research at the National Institutes of Health. Dr. Shaver also is Board Director for Advocate HealthCare, a large, fully integrated, not-for-profit healthcare delivery system in metropolitan Chicago, and a Sleep Advisory Board member of the Select Comfort Corporation. She holds a doctorate in physiology and biophysics and a master's degree in nursing from the University ofWashington, Seattle, with a baccalaureate in nursing from the University of Alberta in Canada.
As a biobehaviourist, Dr. Shaver has participated in funded research in women's health and sleep science for nearly two decades. She works with a team of researchers that was among the first to study sleep problems as part of menopause transition.Her interests are currently focused on stress and sleeprelated issues within a set of "mystery" conditions that disproportionately affect women, including fibromyalgia and chronic fatigue syndrome. Dr. Shaver has published her scientific work in sleep, medical and nursing journals, including Sleep, Journal of Rheumatology, Psychosomatic Medicine and Research in Nursing and Health. In 2004, she was awarded the Research Lifetime Achievement from the Midwest Nursing Research Society.
What are the attributes of a "leadership mind"?
I will comment on the mindset for transformational leadership. Leadership is not about power or position, but the power of influence that comes from behaviours enacted regardless of position. Those behaviours emanate from a mindset with attributes that include "seeing the bigger picture," scanning environments, gathering data from talking to people, recognizing emerging trends, "connecting the dots" and strategizing to shape and enable innovations or change (a core leadership function) and test novel ideas (sometimes referred to as taking risks). Actually, I like to say that an activity is not a risk if there is no fear of failure; it is only a trial.
It's one thing for a leader to embrace the contradictions often found in healthcare. But how do successful leaders persuade colleagues to go along with their thinking?
Administrative leaders must reveal their thinking and be open to changing their thinking, so one must both listen and reveal. The word "colleague" means mutual respect and equity of ideas, no matter from whom.When planning long-range change, I try to "prime the system": I introduce ideas well in advance of expecting others to embrace them. I often profile an external trend and ask that we think about what it might mean for our organization. Eventually, we cycle back to consider it more definitively in our context. I work from an ecological perspective such that change is shaped to fit the particular "cast of characters" and the evolving environments. It is persuasive to help people see that an initiative builds on what has gone before and will take us to a new advantage, not just a vantage point. I avoid addressing barriers, weaknesses or threats, and address "what if" and "how could we." I do not do SWOT analyses [Strengths,Weaknesses, Opportunities, Threats] but SO analyses.
Does developing the "will" to transform mean that you can actually "will" others to change?
A leader does not "will" others to change but must inspire them to change. One has to create the culture whereby those living within it embrace change. Among colleagues, we define leadership as the art of engaging with people to envision and enable the creation of a preferred future. The key words are engage, envision, enable. Transformational change means engaging people to envision beyond conserving what exists and also enabling movement towards the preferred ends.Many of our change initiatives end up being efforts to reform and not transform because we do not "think big" enough. Even if we do expansive envisioning, great strength of leadership is essential to enable - that is, to secure resources, support individuals or groups in testing change (taking risks), communicate progress to those immersed or not so immersed and prevent regression back to what existed.
The "leadership gap" is an issue that many Canadian healthcare organizations and universities are facing. What advice can you give for turning a follower into the next leader?
One key in my mind is encouraging active rather than passive engagement within organizations or institutions. The people who are at the point of productivity in organizations - that is, direct care nurses in hospitals, home or hospice care, or community health centres, or faculty in universities or colleges - should be actively engaged in governance. This is not necessarily the governance of how the budget is spent or who moves into other positions, but the governance of what the organization stands for, how that is profiled to constituencies that matter, what new models of improvement should look like or how they should be tested. The core function of leadership is shaping and enabling change so that as many people as possible are put into scenarios that require such [change]. Actualizing so-called shared governance or faculty/staff governance initiatives - by creating the infrastructure for engagement, coaching and guiding relevant behaviours and providing resources for developing leadership competencies - is paramount.
What is your key piece of advice for emerging leaders?
Remember that leadership is about service to others. Ben Franklin is reputed to have said that the three hardest things in the world are diamonds, steel and knowing yourself. This last element is crucial to being a good-togreat leader because you need to connect with those people who can complement your stronger talents as well as those who can fill in for any of your lesser talents. Blend being humble and proud, and be open to learning. Consider yourself a mentee and a mentor. As a mentee, you can have multiple mentors, depending on the desired focus; and as a mentor, "do unto others" as you see effectively done unto you, or better. Link with leaders that you most admire for their abilities to grow capacity within their sphere of influence, and study their techniques for shaping change, or the reasons for their reputation. Step up to every chance to be a facilitator of change - and practice, practice, practice to perfect your skills or competencies.
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