Today, dramatic changes in the provision of medical services and issues specific to health care are creating the demand for a new kind of medical professionals. A wide range of leadership-related issues arise due to rapid technological development, progress in medicine, scientific findings, new drugs, and innovative methods of treatment. In accordance with contemporary requirements, nursing leaders should be able to deal with complexity, change, and uncertainty, as well as work independently and interdependently, and consider quality care to be of the highest value. Therefore, an immediate and urgent need for the development of nursing leadership has become increasingly obvious nowadays.
It is necessary to carry out significant changes in leadership roles and practices to develop leadership skills and abilities of medical personnel at all levels of health care institutions. This development of professionalism can be crucial in order to eliminate issues specific to health care, such as the nursing shortage, insufficient availability of medical services, inadequate health insurance, high rates of chronic and incurable illnesses, etc.
The Concepts of Leadership
Leadership is a process that encompasses multiple influences occurring in a group setting. Leadership can be identified as the practice of leading people or entities in order to increase the effectiveness of the healthcare workforce. Leadership involves experimentation, failure, risk, and reward, as well as the movement toward a specific vision and a set of goals. According to Astin and Astin (2007), leadership is a method that targets the promotion of change. Leadership implies a procedure where movement is evident as this kind of headship is viewed in the light of association with leaders who are agents of change. Power, ascendancy, domination, and supremacy are frequently perceived as equivalents of the word “leadership”. Although the word “leader” has been always associated with renowned personalities, today, leadership skills are defined as obligatory managerial abilities in health care.
Furthermore, despite widely accepted viewpoints, leadership does not mean the power or ability to control what people do. According to Greenleaf (1996),
the simplest definition of a leader is one who goes ahead to guide the way… The essential abilities required to lead – values, goals, competence, and spirit – are expressed in two sets of requirements: the ability to set and articulate goals and reach them through the efforts of other people, and the ability to satisfy the people whose judgment must be respected even under stress (p. 294-295).
A plethora of psychology-oriented investigations and behavioral research studies have not entirely elicited the nature of leadership so far. Scholars, theorists, practitioners, and ordinary people endeavor to specify why some individuals are capable of inspiring and motivating others and whether they have inherited or developed abilities to influence others. In order to reveal contemporary requirements for leadership specific to health care, servant leadership theory, transformational leadership theory, situational leadership theory, and role theory should be explored. These theories are all interconnected and determine requirements for effective leadership. The diversity of these theories has erected a complex web of concepts related to issues concerning nursing leadership.
Servant Leadership: Theoretical and Practical Implications
Contemporary leadership-related studies indicate that alternative leadership styles are gradually replacing historically formed definitions of leadership. Leadership is now recognized as a phenomenon that can emerge from various places within an institution and is no longer focused only on formal leadership roles. Being developed by Greenleaf, servant leadership turns into a concept that starts to gain acceptance.
Geedey (2004) claimed that irrespective of their position, nurses should perceive themselves as public servants, keeping “in mind that nurses have internal and external customers”. External customers are “patients, families, physicians and hospital administrators,” while internal customers are “nursing staff and ancillary personnel within the organization”. Striving to achieve the primary objectives of their organization, servant leaders perform their duties and activities to meet the needs specific to their patients, subordinates, and associates. Nursing servant leaders empower their subordinates, recognize their achievements, stimulate their natural desire for learning, growth, and creativity, increase self-esteem, and encourage involvement in problem-solving. Servant leadership greatly contributes to an increase in nurses’ motivation. Being motivated at work, nurses improve their job satisfaction, gain confidence, increase efforts, contribute to positive working environments, and promote better outcomes. In accordance with the principles of servant leadership, nursing professionals should be oriented toward the services they provide.
Situational Leadership in Nursing
Being developed by Hersey and Blanchard, a model for situational leadership involves leaders’ skills and abilities to recognize and assess the needs of their subordinates and respond to diverse situations that arise after the appropriate response. “Situational theories emphasize the importance of understanding all the factors that affect a particular group of people in a particular environment”. The effectiveness of leadership in health care depends on nursing leaders’ abilities to analyze and assess their subordinates’ skills, competencies, and commitments in order to respond accordingly. The implementation of situational leadership is stipulated by the fact that the best approach to leadership problems cannot be restricted by specific limitations. Situational circumstances will necessarily influence the way a problem and medical professionals involved should be addressed.