Nursing Leadership Theory Paper 1

Wayne Trader

Nur 400-601

12/3/2022

Professor Victoria Pini

Nursing Leadership Theory Paper 2

A genuine leader is not a searcher for consensus but a molder of consensus.

(Inam,2018). Martin Luther King Jr. (MLK) is considered one of the top leaders of the past

century because of his ability to lead people. This quote means that to become a great leader

you must be able to share your dream and convince others to agree with that vision and follow

you. If you wait around waiting for consensus that you are not leading anyone and being a

follower rather than a leader. Many people try to emulate great leaders like MLK, Gandhi, or

Lincoln but forget to be a great leader you must be your person and earn the respect of the

people you are trying to lead. I think for to be an effective leader they must find a style that is

similar to the value they agree with that allows them to operate most naturally and efficiently

as possible. Utilizing all these traits a nurse can become an effective leader and be an

advocate for their patients.

The leadership style that I would like to model after would be Peter Drucker who

believed an organization would flourish if everyone participated, it would help a company

grow. He believed that the autonomy of an individual was crucial in theory management as

management asking staff about their ideas could lead to significant contributions to the

growth of the company (Finkelman, 2022). The role of a nurse leader can consist of many

factors but any combination of them can result in the unification of its staff to promote patient

safety and needs. According to Garrity (as cited in Ahmadi et. all, 2021), trustworthiness,

independence, reliability, humility, resilience, initiative skills, trust, ethics, innovation, and

patience all allow a person to fulfill the needs of the role of a leader. A nurse can be a leader

in management or be a combination of both. Management is responsible for the day-to-day

operations to accomplish a mission or goal where a leader is concerned with how to inspire

and help them grow as a person as well as the company (Duggal, 2022). Peter Drucker's
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theory of management is based on people who help in the process of planning and executing

goal setting. Managers should have the ability to implement a vision, delegate, manage and

focus on people. Traits for a leader include vision, integrity, inspiration, communication, and

then be able to challenge people (Duggal, 2022). This is important because these skills can all

be implemented by a nurse leader to help promote patient safety. A nurse leader has to be able

to communicate with their coworkers to delegate tasks and take charge of the situation as time

is of the essence when a patient’s condition is deteriorating. The way I would develop this

leadership into my own would be to implement my coworkers into my decisions but also

combine it with the autocratic leadership style. Autocratic is one person assumes control of a

group and makes decisions for all of them to follow (Finkleman, 2022). When you are dealing

with situations that involve life and death you cannot have a laissez-faire approach which is a

hands-off approach. For example, when there is a code one must be able to take leadership of

the group issuing orders to effectively manage the emergency. Unless you are working

stepdown or ICU where deteriorating patients are common due to their fragile state this is

where this type of leadership would flourish. I believe that bureaucracy is the style I would

use daily as the hospital is built on the foundation of rules and policies that are fundamental to

patient safety and stability for the organization. I plan on building a relationship with my staff

based on trust and respect as that is the foundation for establishing a healthy relationship. I

think that as a leader you must be able to earn the respect of your peers for them to want to

follow you. According to Darwall (as cited in Almost, 2022), there are types of respect where

recognition respect refers to basic respect that all humans should be given whereas, in

contrast, appraisal respect is a positive appraisal of others to recognition of their value. This is

significant because there is a moral mutual respect that all human beings should get but then
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appraisal respect you must earn among your peers. I believe that for my individualized plan to

work I have to be flexible and adjust to the needs of coworkers while being steadfast in my

beliefs as well. For example, if someone makes a serious error that causes harm to a patient I

will report it whereas if they are like 5 minutes late I won’t lecture them unless it’s a chronic

problem. To be an effective leader you have to be able to balance being a leader and a

manager and I hope to use what I learn in school can be implemented in the workplace.

I will incorporate lifelong learning to be an advocate for my patient when they are

unable to do so for themselves. I plan on doing this by using my personal life experience as

motivation to attain my graduate goals and execute my plan. My father recently passed away

from marginal zone lymphoma and heart failure with an ejection fraction of less than 15%. He

was educated at every point of his hospitalization and understood what would happen if

continued to refuse medications and treatment. Eventually, dementia became a daily issue and

he was deemed incompetent resulting in my brother and stepmom making decisions for him.

It was with a heavy heart that we decided to switch him to DNR even though he said he

wanted to be a full code because his health was deteriorating with his continued refusals of

treatment which we did not want him to suffer during resuscitation. Some family members

were understandably upset by this decision but I knew from all my talks with him that he

wouldn’t want to suffer, so as much as it pained me, I tried my best to be an advocate for him.

If I wasn’t educated in the nursing field or had family support my father may be one of

thousands of patients across the country who do not have someone being a patient advocate

for them. I plan on finishing my bachelor’s degree in nursing and then pursuing my master’s

degree and possibly my doctorate in nursing after that. I believe the more knowledge you have

will help you do your job better but you must be able to adapt to the most current knowledge
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available. This is important because lifelong learning maintains your current knowledge and

applies new information which will affect patient care resulting in better patient outcomes

(Krespani, p. 1687, 2021). I will use the information I gain from school to learn how to be a

better patient advocate and pass on that information to my coworkers to help them. I can

accomplish this goal by being a nurse leader keeping up with my continuing education credits

and prompting patient health through education of my coworkers to help them deliver quality

care (Breaking down, 2020).

I think the best way to incorporate my lifelong learning with my leadership model

would be to use a combination of Peter Drucker management style and the bureaucratic

leadership styles. I would use both of these policies to implement education regarding patient

advocacy but also ask them to participate in how I could change my approach to make it

better. Nursing burnout is an ongoing issue that results in poor patient outcomes due to an

increase patient to nurse ratios. One study regarding patient ratios noted:

Nationwide, we estimate that 77,500 nurses are directly caring for COVID-19 patients

each day, compared with only 22,500 nurses in mid-September, an increase of 245%.

Metro and rural hospitals increased at a rate nearly double that of suburban hospitals

(249%, 282%, and 131% respectively). Non-COVID staffing needs are down, but taken

together, COVID-19 and non-COVID-19 nurse staff demands have increased by an

additional 26,000 nurses (11%) per day doing direct patient care that can be attributed to

increased COVID-19 hospitalizations. (Teriakidis et all, para. 2, 2021).

This quantitative study puts into perspective how much nurses are needed and why there are

shortages around the country. This is relevant because in order to be a patient advocate you

need adequate staffing to represent patients to speak on their behalf. Nursing is a team sport
Nursing Leadership Theory Paper 6

so to speak as you cannot take care of a patient by yourself 24/7 and requires reliance on the

interdisciplinary team to work together. I think bedside nursing can improve though nursing

leadership which can be improved through leadership and education. COVID-19 caused

nurse-to-patient ratios to increase, decreased direct patient care and nurse burnout in

unprecedented numbers (Acute care, 2020). Many nurses started to not give report at bedside

either because it wasn’t safe to risk exposure, lack of time, or burnout from going in and out

of the room. SBAR is a useful tool that is used for nursing shift report that conveys critical

information about a patient regarding the Situation, Background, Assessment, and

Recommendation (SBAR, 2022). I believe that the utilization of telehealth would a valuable

tool to present bedside report to the patient on isolation and maintain safety precautions to

prevent exposure from minimizing entries to and from the room. Many people feel detached

from people when they are isolated in a room and the hospital business model is driven by

patient satisfaction. With med express and other hospitals being competition healthcare

facilities must do their best to serve their patients’ needs the best way they can. I believe that

structure, process, and outcomes related to the assessment of care can be achieved with

evidence based practice and patient reviews. Use the constructive criticism of the patient you

are serving now to be the foundation of change for the patients you serve tomorrow. We must

continue to search for ways to advocate for our patient by listening to their needs so it can be

passed on to administrator’s, managers, and chief nursing officer and the CEO. Drucker’s

theory of management works well in regards to communication and collaboration with the

healthcare team. Physicians, Physical therapy, Occupational therapy, Nurses, Social work and

any specialty needs all work together in the interest of the patient. The best way to facilitate

information is to be concise and efficient while also thinking outside the box. When you are
Nursing Leadership Theory Paper 7

working with others you should welcome any input as information from staff nurses who are

experiencing these issues everyday on the floor should be heard as you never know how it can

affect you or your patient. If you are management or a leader and are not a bedside nurse who

can see the everyday issues or politics on the floor then you should rely on them to be the

voice to guide any changes you are trying to make. Every nurse is an advocate and it’s their

responsibility to convey the needs of the patient to maintain the best quality of care and

protect their rights when they are unable to speak for themselves.
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References

Acute care nursing burnout related to the COVID-19 pandemic. Exigent. (2020, August 21).

Retrieved from https://www.exigent-group.com/blog/acute-care-nursing-burnout-related-

to-the-covid-19-pandemic/

Ahmadi , M., Akhoondi, M., Baigi, S. A. S., El-Farr, H., Hosseingholizadeh , R., Lotfi, H., &

Kerman, N. T. (2021). A Systematic Review and Synthesis of Empirical Research on

“Knowledge Leadership”: A New Insight in the Field of Knowledge Management , 20(4),

169–192. https://doi.org/https://dorl.net/dor/20.1001.1.20088302.2022.20.4.11.0

Almost , J., & Mildon , B. (2022, June). R-E-S-P-E-C-T: A key to nurse retention. Nursing

leadership (Toronto, Ont.). Retrieved from https://pubmed.ncbi.nlm.nih.gov/35976780/

Breaking down nursing management roles: USAHS. University of St. Augustine for Health

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management/#:~:text=A%20nurse%20leader%20oversees%20a,on%20the%20latest

%20healthcare%20research

Duggal, N. (2022, September 28). Leadership vs management: Understanding the key

difference: Simplilearn. Simplilearn.com. Retrieved from

https://www.simplilearn.com/leadership-vs-management-difference-article 

Finkelman, A. (2020). Leadership and management for Nurses: Core Competencies for Quality

Care (4th ed.). Pearson.

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Inam, H. (2018, April 5). Martin Luther King on leadership: 10 quotes for a Changing World.

Forbes. Retrieved from https://www.forbes.com/sites/hennainam/2018/04/04/martin-

luther-king-on-leadership-ten-quotes-for-a-changing-world/?sh=6b461155c88a

Krespani, M., Tsaloglidou, A., Koukourikos , K., Ouzounakis, P., Iliadis , C., Krepia , V.,

Kaptanoglu, A. Y., & Kourkouta, L. (2021). Educational Needs and Motivations for

Lifelong Learning of Nurses , 14(3), 1686–1696. Retrieved from

http://internationaljournalofcaringsciences.org/docs/16_kourkouta_original_14_3.pdf.

Sbar tool: Situation-background-assessment-recommendation: IHI. Institute for Healthcare

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https://www.ihi.org/resources/Pages/Tools/SBARToolkit.aspx

Teriakidis, A., McNitt, J., McAllister, M., Sizemore, O., & Lindemann, P. (2021, January 5).

Covid-19 impact on nurse staffing and ICU Beds. Epic Research. Retrieved from

https://epicresearch.org/articles/covid-19-impact-on-nurse-staffing-and-icu-beds