Leadership Style Of A Band Six Nurse

The essay aims at giving the reader a clear definition of leadership and the relative merits and demerits of a variety of approaches to leadership from different perspectives. In the first instance it may be prudent to provide a definition of the concept of leadership and to distinguish leadership from the concept of management. Although management and leadership are often considered in the same turn of phrase and may both be requisites of a management level role, the two are quite different. On one hand, management may be seen as the activity of organisational processes, policies and physical resources to achieve a given outcome (Mullins 2009, Landy and Conte 2010), on the other, leadership considers how an individual chooses to inspire and motivate others to achieve goals and objectives (Robbins and Judge, 2007).

It is important to consider the effects of leadership; the literature (Hardy 1999; Huczynski and Buchanan, 2007) does not seem to indicate that any single form of leadership or management style produces superior results in all situations and circumstances. Rather, different styles of leadership have the ability to generate differing levels of performance depending on a number of variables including: the manager, those being managed and the general environment (Northouse 2004).

The NHS Leadership Council is responsible for overseeing leadership matters across healthcare (NICE 2010). To create the necessary leadership environment, Leadership Council needs to display set behaviours that break down thinking and adopt new ideas (NICE 2010). Due to organisational changes within the healthcare system, every nurse will require leadership skills as well as an understanding of the roles that these skills play in delivering good quality care to the patients.

In this essay I will discuss the leadership style of a band six nurse within the ward of a local hospital trust. I will then analyse the impact the nurse’s style has upon the team working and multi-professional collaboration related to client care. Finally, I will discuss how my observation may influence my future management style. Throughout my essay I will refer to the nurse as Ms A to maintain confidentiality, in accordance with the Nursing and Midwifery Council Code of Conduct (NMC 2008).

Ms A’s role was to act as a team leader/ sister within the oncology ward. She has worked within her current post for one year. She had decided that oncology was her field of choice when she first started her nurse training. Her role modelling attribute was her inner passion within the oncology profession; she believed in providing her patients with the best possible care, to achieve the best possible outcome. Ms A would engage her nurses in the decision making processes and let them carry out their work in an independent manner. However, she would delegate the work according to the experience of her staff. New members of staff were given support and supervision.

On arrival for handover, Ms A would be relaxed, yet professional. She would appear to focus on the abilities and commitment of her staff and this seemed to help in developing patient-nurse relationships. Although Ms A would appear to be relaxed, her knowledge, judgement, energy and motivation within the hand over of the patients would be outstanding. She discussed each patient’s total holistic needs, whilst empowering her staff by encouraging staff contributions within the decisions of care. Marquis and Huston (2009) suggested that by giving staff a sense of belonging and making them feel valued increases their self esteem, which are all characteristics of a democratic leader.

———————————————————————————————————————-
SECTION ONE

One of the important factors in deciding the leadership style to be employed in a given circumstance may depend on the personal attitude of the manager. Macgregor’s X and Y theory (Hardy 1999) states that managers generally fall into two categories with regard to their beliefs about the attitudes of those who work for them: Theory X managers, who have a tendency to believe that employees would exhibit the behaviour of minimising the level of input and effort required in the workplace, and Theory Y managers, who believe that workers generally exhibit higher levels of motivation, which are only held back by poor organisational processes and practices.

Ms A can be categorised as a Theory Y manager. Her predominant leadership style was democratic; as a characteristic of her style was that she focused on the growth and development of her staff, which appeared to exhibit higher levels of staff motivation (Grohar-Murray and Langan 2010). She ran her shift allowing her team members to come forth with their ideas, which appeared to give them equal say in the process of decision making (Marquis and Huston 2009). Ms A assessed the requirements of her team and developed a form of leadership that best suited them as a whole helping her to gauge the personality in every member of the staff and their level of intelligence, whilst taking into consideration the task to be completed within the group (Grohar-Murray and Langan 2010).

The basic premise behind the concept of the democratic and consultative style of leadership is that individuals within the organisation all have distinct and specialist levels of knowledge (Northouse 2004). By Ms A’s consulting a broader range of individuals with different levels of knowledge in chemotherapy, she was well informed, was able to make better decisions and indeed empowered her workforce to make better decisions (Adair 1989).

The democratic leadership style sees leaders frequently engaging their workforce both to consult for information and opinions in decision making processes (Northouse 2004). For the leader to be able to consult her employee’s for information she needs to have good communication skills, this is a key characteristic to maintain the democratic style of leadership. Grohar-Murray and DiCroce (2003) suggest that a democratic style is not punitive and therefore, treats staff with dignity, openness and fairness. Ms A was very considerate to the choices of her team member and adapted her communication skills to each individual member creating a sense of job satisfaction and greater levels of motivation.

The democratic approaches to leadership are not without disadvantages. One of the major issues in the democratic style is that decision making can often become more time consuming (Bratton and Gold 2007). Another problem is that by the time a decision is made through the consultative process, a key opportunity within the environment may have been missed. An example of this issue in practice was one of the afternoon updates with Ms A. At 5pm, every afternoon, she would ask all her nursing staff to gather their patient’s files and do a ward round with her. It was a consultative process where Ms A would want to know what had happened throughout the day with the respective patients of the staff members, and then decisions would be made as to what needed to be done before the end of the shift. The key problem was that all qualified nurses would be on this round and there was only one health care assistant to meet the needs of all the patients during this hour long process. In such circumstances, an autocratic manager would be more suited; simply by making a decision without resorting to a democratic process (Omolayo 2007).

As, Schmidt and Tannenbaum continuum (Dean 1976) allows the leader to adapt their style of leadership to meet the needs of a given set of specific circumstances, Ms A assumed autocratic characteristics when it came to hygiene of the nurses entering patient’s rooms.

======================================================================

A consideration in the democratic approach to leadership was the classical concept that Ms A’s team was simply motivated by extrinsic rewards (Hardy 1999). The democratic or consultative approach to leadership is also based upon the premise that employees actually derive a benefit or reward simply from being a wider part of an organisation. Nurses within the oncology profession seem to very dedicated and motivated within their speciality and appear personally rewarded within their work. Such increasing levels of motivation are often linked to well known intrinsic theories of motivation such as Maslow (1970), who indicated that increasing levels of motivation came not from money but from fulfilling employee’s higher needs, such as a sense of belonging that is achieved through teamwork.

From a negative viewpoint, an issue with the democratic style leadership is that it can often be difficult to build a consensus on a given issue. Where such circumstances arise, the leader will be forced to make a decision based upon a split team consensus, thus risking the belief in the minds of some that their personal opinions have been ignored. Such actions can lead to poorer levels of motivation and a general detraction from the benefits of the democratic leadership style in the first instance. An autocratic stance in such circumstances might prove to be beneficial. As Adair (1989) indicates, consultation is only beneficial from a motivation perspective, where those who are engaged in the consultation process have genuine belief that their views and opinions are being taken into account. Where, such consultations are considered to be merely a “check box” exercise, there is a risk that this can harm motivation and morale, rather than aiding such considerations.

“POWER” – Positive and Negative effects

The democratic approach promotes autonomy within the team, which has an implication on the team, making the staff feel powerful within their positions (Daft 2007). By valuing her team’s opinions, Ms A would take on board their individual viewpoints and delegate the staff’s workload in a fair manner. As Ms A delegated her staff’s patients according to their skill mix, there appeared to be equal job satisfaction at the end of the shift. Ward (2002) suggests that delegation is a necessary skill and argues that staff not given any responsibility through delegation, may become discouraged. However, within the practice environment some staff would work more effectively individually but others will postpone completing their tasks, which sometimes lead to negative outcomes. On the other hand, from a positive viewpoint, if your team achieves participation from the whole group, it will lead to more productive work when utilising democratic practice (Rigolosi 2005).

Within practice, you can identify the members of the staff that excel from been given this increased responsibility, as they present, by wanting to give the best possible care to their patients whilst appearing satisfied, empowered and confident within their role. When the team is highly motivated and committed to the goals of the organisation, the team will deliver more effective care to their patients (Kuokkanen and Leiono-Kilpi 2000). On analysis, this highlighted how essential the implication of the leader’s style has on good patient care.

“JOB SATISFACTION” – positive and negative effects

At the beginning of each shift Ms A would ask all staff to come to the wipe board, where the action plan of what needed to be done for each patient was updated each morning. All the members of ward were involved including the ward clerk, who appeared to have a quite an active role within this specific task. Ms A crafted her message and was clear about her goal for each patient; however she still appeared to want other staff’s constructive criticism. The characteristic of the democratic approach that Ms A was exhibiting was the involvement of the whole team within the decision making of each patient’s needs. The communication flowed up and down discussing each member of staff’s views, whilst Ms A’s emphasis was on “we” rather than “I”. Each member of staff’s cooperation was positive, however, another effect this process had on each individual nurse was the time it took, as every member was consulted. This, in turn, delayed the medication round and morning washes. It is the responsibility of every leader, irrespective of the leadership style, to delegate work effectively to the subordinates, and at the same time take good care of them and motivate them by involving them (Omolayo 2007).

Democratic type leadership is concerned with human relationships and teamwork (Omolayo 2007). Ms A valued her team member’s opinions that impacted within the team in a spirit of collaboration. The effect of this collective collaboration impacted on each team member resulting in increased motivation and job satisfaction.

SECTION TWO
Multi professional collaboration

In multi-professional collaboration, the healthcare professionals look at the original goals for each patient, and with open and honest communication, work together toward fulfilling that common goal (Marquis and Huston, 2009). All members of the team will then accept mutual responsibility for achieving this goal. True collaboration requires honest communication and all decision making should be shared at all stages of the patient’s journey of care.

It is important for the individuals in organisations to work in cohesive teams. Daft (2007) has defined team cohesiveness as the extent to which the teams members stick to each other in pursuit of a common objective. Members belonging to cohesive groups report feeling more involved in the activities; are highly committed to the goal and objectives; are happy working in a group and take joy in success of the team.

The important aspect of a successful team is a potent leader. Leadership styles can govern the satisfaction of the workers and their productivity as individuals. Omolayo (2007) has enthused that teams under democratic leadership experience a better sense of community than autocratic. However, Daft (2007) has pointed out that managing teams may become difficult and the leaders may need to get out of their comfort zone and adapt to the given circumstances.

Positive impact of Democratic Leadership

Within the collaboration of the multi-disciplinary team the democratic approach provides a spirit of joint effort and good team work, as long as the team accept your opinion you have as an active part of the discussion (Marquis and Huston, 2009). This gives staff member’s autonomy to make actual decisions in the best interests of their patients.

In general terms, the effect of such a democratic style of leadership on the multi disciplinary team has brought great benefits to the staff and wider organisation (Daft 2007). Principally, the benefits have been those of better decision making, based upon a wider level of knowledge obtained in the first instance. Secondly, general levels of motivation have been seen to have improved when compared to the motivation and morale of those working for managers with a more autocratic style within the organisation. Again, this has a real benefit to the organisation as a whole, such as reduced levels of absenteeism, higher rates of staff retention and generally a better performing team.

What is bad about this style?

Whilst the research acknowledges the superior performance of the democratic leadership style, it is worth pointing out that the style is not without its limitations and can require considerable efforts on behalf of the leader to maintain such a style effectively.

A negative view of the democratic leadership style is that it appears less productive, as decisions take time. The authoritarian leaders appear more productive (Omolayo 2007), which is effective in a critical life threatening situation. Due to the fact that democratic leader always consult their teams for their views on each given situation, it can appear that these leaders are not sure about themselves and lack confidence. Mahoney (2001) suggests that leaders should give clear direction to their teams to maintain their group effectiveness. On analysis, in an ideal world these characteristics could be demonstrated, however, by asking their follower’s opinions, the leaders have motivational influence on their staff. We need to be aware that motivational influence is a powerful tool, as it inspires creative thinking and individual growth (Ward 2002).

Indik (1965) suggests that the democratic style of leadership impacts the team members as the group sizes increase, the groups become less cohesive and the members are less satisfied (Indik 1965). Mullen (1989) discusses further that as the size of the group increases, the team members may also become less satisfied with the actual leader. This evidence suggests that leadership styles have conflicting evidence and the effect of team satisfaction within democratic style leadership may be a product of the size of the group.

Within practice, I noticed that not every member of the nursing team could perform their tasks at the same level and did not respond to stress in the same way. Some staff could nurse four sick patients with ease; however, some staff was showing evidence of stress at nursing two sick patients. Ms A would notice these different levels of performance and adapted different leadership strategies appropriate to each member of staff. The effect of her democratic style helped reduce their stress and helped them achieve their goals. This exhibited Ms A’s democratic leadership style as she was concerned about the feelings of her staff, so shared the responsibility.

————————————————————————————————————————-
FUTURE MANAGEMENT STYLE

It is important that the style of leadership taken up in healthcare should respond to the needs of the organisation’s consistency (Rigolosi 2005). Eagly and Johannesen-Schmidt (2001) have stated that women should use transformational style and supplement it with contingent reward to enhance organisational effectiveness. I observed that no single form or type of leadership can be deemed to be perfect or the most effective. In the field of nursing, democratic leadership style seems to be very appropriate keeping in mind the small number of nurses on every team.

Ms. A’s use of democratic leadership was very effective in creating a feeling of work culture in the team and motivating them to work the best. But, sometimes, consulting everyone in the group becomes time consuming and may disrupt the normal flow of things and eats away from the time, which can effectively be utilised for other important things. Therefore, I personally would like to follow a more situational and environmental approach to leadership to obtain the best from my team and to achieve the best I can for the patients.

This will mean that different situations will require different style of leadership. Both democratic and autocratic leadership styles will be maintained to keep a balance between humanitarian and organisational needs. The situational approach assumes that in order to achieve organisational goals, all the people can be helped and educated, and the styles of leadership should be directed towards achieving the best for the organisational needs (Rigolosi 2005).

This approach will allow me to interact with the team that I am working with, and will help me to delegate the work efficiently. I can gauge the personality characteristics of all the people and occasionally indulge in team discussions and consensus over issues. This will help me create a reputation with the team and motivate them to work better without making it a routine. I would like to inculcate the sensitivity of the democratic leadership style with the effectiveness of autocratic leadership to delegate and regulate work efficiently. It is important for the leaders to provide vigilant guidance to the subordinates or the team members to keep the focus on the organisational goals and efficacy of work (Omolayo 2007).

Conclusion

For a leader, it is the most important to delegate responsibilities efficiently to get the work done properly and in time. Any single type of leadership styles may not be successful in achieving so in the variable situation. Therefore, it is a viable move to adopt a situational/environmental approach that lets the leader choose a leadership style according to a given situation.

The case of Ms. A clearly shows the importance of democratic indulgence and at the same time, the drawbacks in the form of wastage of time. Therefore, the human element of the democratic leadership needs to be concocted with the strictness of autocratic leadership to govern a team effectively towards organisational success.