How relational leadership can enhance nurses' well-being and productivity

Leadership is an essential skill in nursing and has a fundamental role in ensuring high-quality patient care and the effective functioning of healthcare systems. Effective nursing leadership is vital to support nursing teams as they negotiate the challenges confronting the profession, such as ageing populations and the increased use of healthcare technology. This article discusses various relational leadership styles that can be used to promote nurses' health and well-being and enhance productivity. The author also explores the benefits and challenges of implementing relational leadership in nursing.

Factors influencing early career nurses to adopt leadership roles: a literature review

Effective nursing leadership has been shown to improve patient outcomes, but there has been little exploration of the factors that influence early career nurses to develop their leadership skills and adopt leadership roles. This article presents a rapid review of the literature on these factors, integrating data from 25 articles. Findings suggest that improving leadership confidence and self-efficacy, particularly in relation to system leadership, can increase nurses' motivation for adopting leadership roles. Supportive organisations that value leadership and give nurses opportunities to exercise it are equally important. Training and education, preceptorship, peer-to-peer shadowing, modelling and mentoring can all be useful in improving leadership skills and inspiring the next generation of nurse leaders.

Exploring the role of communication in effective nurse leadership and patient care

Nurses have to be aware of their personal responsibility to demonstrate effective leadership and thereby contribute to safe and effective patient care. One of the primary skills that nurses can use to become effective leaders is communication. This article explores how communication is a vital tool in enabling nurse leaders to motivate their team members and advocate for patients. The author details some of the essential communication skills that nurses require if they are to promote person-centred care and explores the often-neglected areas of non-verbal and written communication. By possessing a full range of communication skills, nurses can empower themselves to lead clinical teams and advocate for patients.

Program for advancing supervisor skills among pharmacy technicians

PURPOSE

This publication outlines the development and implementation of a leadership enhancement program for pharmacy technician supervisors at University of Michigan Health (UMH). The program aims to equip these supervisors with the skills and knowledge necessary to excel as leaders in the pharmacy field, addressing the pressing need for strong leaders in healthcare.

SUMMARY

UMH recognized the need to cultivate effective leaders within its pharmacy department due to the impending shortage of pharmacy leaders and the rising demand for technicians and future pharmacists. To meet this need, a leadership enhancement program was introduced, offering flexibility and a comprehensive framework for enhancing the skills of pharmacy technician supervisors. The program covers annual, biennial, and flexible rotating topics and offers a structured monthly format for active participation. Additionally, the program utilizes a rigorous selection process for training resources and continuous quality improvement efforts to ensure effectiveness. Through developing leadership skills among technician supervisors, the organization aims to achieve tangible benefits, including decreased turnover rates and increased employee satisfaction.

CONCLUSION

The program for enhancing supervisor skills at UMH is a flexible and adaptable framework for leadership development in pharmacy. Its success in enhancing leadership skills for future pharmacy leaders is crucial in the evolving healthcare landscape and supports the growth of leaders in this domain. By acknowledging the value and expertise that pharmacy technicians bring, organizations can harness their potential and, in turn, benefit the entire healthcare system. This program's principles are transferable to other organizations seeking to empower their employees with tools to thrive in new leadership roles, thus contributing to their growth and success.

Mapping ward managers' core competencies using the Balanced Scorecard model

BACKGROUND

Nurse ward managers have a crucial role in the effective functioning of hospital wards and in organising the work of the nursing team. The Balanced Scorecard model is a management framework that enables strategy to be translated into action by setting goals that lead to measurable outcomes. Few studies have used the Balanced Scorecard model to map the competencies of healthcare professionals.

AIM

To use the Balanced Scorecard model to map the core competencies of nurse ward managers and determine relevant key performance areas (KPAs) and key performance indicators (KPIs).

METHOD

This mixed-methods study was conducted in the surgical department of an Italian hospital using a qualitative and quantitative exploratory sequential approach. For the quantitative part, the authors asked a convenience sample of various clinical staff to rate a list of nine competencies in terms of their importance for the work of nurse ward managers. For the qualitative part, two focus group discussions were held with nurse ward managers.

FINDINGS

Responses to the questionnaires showed that all nine competencies were important to respondents, with no statistically significant differences between roles. Findings from the focus group discussions broadly confirmed the relevance and importance of the nine competencies. Based on these findings, the authors formulated a strategic map of the nurse ward manager role, with core competencies and associated objectives mapped against the four dimensions of the Balanced Scorecard model.

CONCLUSION

A strategic map of the nurse ward manager role informed by the Balanced Scorecard model can help measure nurse ward managers' performance and provide a benchmark for them to improve their competencies.

Leadership skills for the multi-tiered nursing team

In a challenging global healthcare climate, new workforce models are required to address the ongoing shortfall in the number of nurses. One way of addressing the workforce crisis in the NHS has been to introduce the roles of nursing associate and assistant practitioner, which are designed to support registered healthcare professionals in their work and 'bridge the gap' between registered professionals and support workers. This article examines the leadership skills required of nurses when seeking to embed these roles in practice, and the leadership skills assistant practitioners and nursing associates themselves need to take their place in the team. The author also discusses the need for nurses to adopt a relational leadership style, hone their delegation skills and foster a climate of psychological safety for their assistant practitioner and nursing associate colleagues.

Leisure education to leadership: Youth with physical disabilities' experiences in South Africa

Introduction

Young people with physical disabilities frequently lack opportunities to develop their leadership potential. These include their ability to make decisions and be able to take charge of their leisure programmes. An argument is made that developing leadership skills for youth with physical disabilities can be facilitated by participating in leisure education programmes.

Objectives

The objective of this study was to explore youth with physical disabilities' perceptions of how leisure education can be used as a tool to develop their leadership.

Method

This study used a descriptive qualitative research design to collect data using the purposive sampling method from 10 youths with physical disabilities aged 18 to 34 years in the Western Cape, South Africa. One-on-one interviews with semi-structured and open-ended questions were used to collect data for this study.

Results

The findings of this study include 4 main themes and 11 sub-themes. This study's findings showed that participants' perceptions and experiences were evidence of leisure education being used to build their capacity as leaders within their society. Furthermore, their understanding of how they apply leadership opportunities is an encouraging moment for their development.

Conclusion

Leisure education should be considered as a means to promote leadership in youth with physical disabilities in South Africa.

Contribution

Knowledge and experience about youth with physical disabilities, their leisure education experiences and skills development during activities.

Important Leadership Skills and Benefits of Shared Leadership Training for Chief Residents: A Delphi Analysis

Background

Chief residents (CRs) have pivotal educational and leadership roles in residency programs. The necessary CR leadership skills that transcend specialties have not been defined and most training on these skills occurs in silo.

Objective

The primary goal was to define leadership skills important for the general CR role. The secondary aim was to determine which skills should be included in cross-specialty CR training and identify benefits of such training.

Methods

Sixty-three CRs and 25 program directors (PDs) from 25 residency programs at a single institution were surveyed via a modified Delphi approach in 2022 as part of a needs assessment on CR leadership training. First, respondents answered three open-ended questions about skills needed for the CR role and the potential benefits of cross-specialty CR training. Respondents then rated categorized responses on the importance of the skill, agreement that skills should be included in cross-specialty training, and agreement on benefit of cross-specialty training using a 5-point Likert scale. Positive consensus was defined as 80% agreement.

Results

Fifty respondents (53%) participated in round one and 28 (32%) in round two. Positive consensus was reached on 38 skills (63%). Nine skills reached consensus on inclusion in cross-specialty training including communication skills and certain management skills. Consensus on benefits of training include learning from and collaborating with other residency programs.

Conclusion

The authors defined important skills for the CR role that reached consensus across a broad range of specialties and identified the perceived benefits of shared leadership training. Residency programs should consider cross-specialty leadership training for CRs with a focus on communication and management skills.

Digital transformation and middle managers' leadership skills and behavior: a group concept mapping approach

This study, with the aim to test theory in practice, used group concept mapping to develop a comprehensive conceptualization of middle managers' leadership behaviors concerning digital transformation as a form of radical change. Participants were professionals in the largest public organization in the Netherlands (a police organization) who were dealing with digital transformation in their own practice and who enrolled in an education program on leadership and intelligence. Based on 94 unique statements, the participant-driven results revealed six thematically coherent clusters representing leadership skills and behaviors regarding improvement and results, digital technologies, cooperation, the self, change and ambivalence, and others. The stress value of 0.2234 indicated a good fit. Further analysis showed that clusters containing soft skills and people-oriented behaviors were considered the most important. These results can serve as input to support leadership development programs for middle managers to develop themselves into people-oriented, empowering leaders who can adapt their leadership approaches to fit and support change in general and technology-driven change in particular. Ultimately this will benefit their and their employees' overall well-being at work. This study is the first to investigate middle managers' leadership skills and behaviors in a large public organization that is entirely participant-driven.

Quantum leadership: a new approach for nurse leaders

Healthcare is continually evolving in response to new global challenges, changes in society, limitations on resources and the growing use of technology. In light of these changes and challenges, this article discusses the benefits for nurse leaders to explore a new approach known as quantum leadership. This is a relationship-focused and value-based leadership style in which leaders understand that healthcare organisations have been in a state of flux and recognise how to respond constructively to change in the future. Quantum leadership enables nurse leaders to create and maintain synergistic team working, whereby the team works together towards the common goal of delivering optimal person-centred care. The author suggests that quantum leadership is an engaging and realistic approach to adopt, with benefits of all staff delivering healthcare services and ultimately for patients.

Using collective leadership to support nurses and enhance patient outcomes

Healthcare services and nursing environments are becoming increasingly highly pressured and stressful areas in which to work. However, effective leadership can have a significant effect on the workplace experience of nurses. This article explores the changing landscape of nurse leadership, from a traditional hierarchal approach focused on a small number of leaders to a leadership style that aims to support staff through a relational approach such as collective leadership. Collective leadership has been shown to lead to improvements in nurses' workplace experience, the care environment generally, productivity and patient outcomes. Collective leadership values nurses' leadership skills and seeks to involve them in achieving organisational goals.

Developing ward leadership skills

Nurses who are responsible for a clinical area do not only have a management role but also, crucially, a leadership role. The role of ward leader is complex and demanding. Ward leaders are accountable for patient safety and the quality of patient care, act as role models, motivate staff and cascade organisational goals to them. They also ensure the correct skill mix on the ward, alleviate pressures on staff and provide opportunities for staff development. This article describes several leadership models which all have something to offer to nurses looking to develop their ward leadership skills. It discusses core elements of effective ward leadership, notably providing support and direction to the team through coaching and mentoring, developing the ward as a learning environment, understanding the wider care context and taking time for self-care.

Understanding the importance of kindness in nursing practice

The word 'kindness' stems from the concept of kinship and how people relate to and work with others in society. This article outlines how kindness is a vital element of nursing practice, including how kindness is linked to the related concepts of compassion and civility. It explores kindness from the patient's or service user's perspective as one of the qualities they value most in nurses, as well as considering why kindness within a healthcare team is important to the delivery of safe and effective care. The author also discusses the concept of 'self-kindness' and the importance of leadership in developing an organisational culture that supports the provision of high-quality person-centred care.

Supporting newly qualified nurses to develop their leadership skills

Leadership is not expected solely of managers. At any stage of their career, nurses are expected to be able to demonstrate leadership in their day-to-day role. However, newly qualified nurses, who often experience a challenging transition from nursing student to registered nurse, may lack the confidence to demonstrate leadership. Nurse managers can support junior nurses to develop their leadership skills, notably through training, mentoring, reflection and action learning. By guiding newly qualified nurses in the use of different leadership approaches, experienced nurses can contribute to enhancing the quality of patient care. This article discusses how nurse managers can support newly qualified nurses to develop their leadership skills.

Exploring the role of authentic leadership in nursing

Authentic leadership is a relatively new concept in nursing, with limited studies undertaken into its application in healthcare. Authentic leadership emphasises the importance of the leader being true to their personal core values and developing honest relationships with team members, valuing their contributions, and behaving ethically and transparently. Trust is a central tenet of authentic leadership that aims to lead to increased staff engagement, and enhanced individual and team performance. This article explores the principles, benefits and challenges of authentic leadership, as well as examining its potential role in nursing.

"Not everybody approaches it that way": Nurse-trained health department directors' leadership strategies and skills in public health

Evidence points to nurses as possessing particular skills which are important for public health leadership; in particular, investigators have found that a nurse public health director is strongly associated with positive health department performance. To better understand this association and to guide the effective deployment of nurse leaders, researchers sought to explore the specific leadership strategies used by nurse public health directors, using a critical thematic analysis approach to examine these leadership strategies in the context of certain ideologies, power differentials, and social hierarchies. Data were collected via semistructured interviews conducted from July to September 2020 with 13 nurse public health directors from across the United States. Major themes illustrate a distinct picture of the nursing approach to public health leadership: (a) approaching their work with an other-focused lens, (b) applying theoretical knowledge, (c) navigating the political side of their role, and (d) leveraging their nursing identity. Findings articulate the nurse public health director's distinctive combination of skills which reflect the interprofessional nature of public health nursing practice. Such skills demonstrate a specialized approach that may set nurse leaders apart from other types of leaders in carrying out significant public health work.

Exploring the relationship between leadership and conflict management styles among nursing students

BACKGROUND

Leadership and conflict management are essential skills that nursing students need to acquire and practise. There is a gap in the existing literature on conflict management strategies, the role of leadership styles in conflict management and the relationship between leadership and conflict management styles among nursing students.

AIM

To investigate nursing students' leadership and conflict management styles and determine the relationship between their leadership and conflict management styles.

METHOD

A descriptive correlational study was conducted with 250 third-year and fourth-year students at a nursing college in Saudi Arabia. Participants completed the Leadership Styles Questionnaire and Rahim Organizational Conflict Inventory-II. Descriptive statistics were used, and correlation and regression analyses were conducted.

RESULTS

Overall, the democratic style of leadership and the integrating style of conflict management were the most favoured by participants, while the laissez-faire leadership style and the dominating style of conflict management were the least favoured. Significant positive correlations were established between the leadership styles of participants and their conflict management styles. The regression analysis showed a significant predictive power of leadership styles, specifically the democratic and autocratic styles, on 30% of the variance in conflict management styles.

CONCLUSION

Leadership skills are essential for clinical decision-making, while leadership style can affect the choice of conflict management style. Nurse educators have a crucial role in teaching and modelling effective leadership and conflict management for students.

Exploring how nurse managers' knowledge of succession planning affects their leadership and organisational resilience

BACKGROUND

The effectiveness and stability of a healthcare organisation's workforce, including nurse managers, can be negatively affected by many factors, including illness, retirement and low levels of retention. One way of mitigating these effects is through succession planning, which can be defined as a strategy to employ the appropriate number and quality of people in key positions such as management to account for factors such as turnover, which can cause instability in a workforce. Many healthcare organisations understand the importance of having trained individuals who are ready to be promoted into leadership and managerial roles vacated by those who leave or are promoted into other positions. However, few formal education programmes specifically target the leadership development of nurses and their potential to progress into more complex leadership positions.

AIM

To assess the effect of nurse managers' knowledge of succession planning on leadership practices and organisational resilience.

METHODS

A quasi-experimental research design was applied using a test conducted before and after sessions on knowledge of succession planning, with a group of 60 nurse managers working at a Saudi university hospital. Each nurse manager attended the sessions. Study variables were measured using structured questionnaires before and after attendance.

RESULTS

The results showed significant improvement after the sessions. Improvements were noted in knowledge of succession planning, leadership and succession planning practices, and organisational resilience.

CONCLUSION

This study demonstrated that providing sessions on succession planning resulted in improvements in nurse managers' knowledge of succession planning, demonstration of succession planning practices, and demonstration of leadership practices.

Igniting the leadership spark in nursing students: leading the way

New graduate nurses are not always prepared for the challenges of the chaotic clinical environment, and often struggle to demonstrate sufficient clinical leadership skills. Facilitating the acquisition of leadership abilities in students will support the pursuit to generate competent nursing graduates fully prepared to effectively function in today's challenging healthcare environment. Nursing faculty need to implement more creative ways of introducing leadership qualities to nursing students. Nurse educators can be proactive in implementing leadership strategies for students, based on The Five Practices of Exemplary Leadership: Model the Way, Inspire a Shared Vision, Challenge the Process, Enable Others to Act, and Encourage the Heart, as described by Kouzes and Posner. By continuing to "lead the way" for professional leadership skills in nursing students, nursing faculty can possibly expect leadership activities to emerge in settings in which the students practice.

Exploring how nurse managers' knowledge of succession planning affects their leadership and organisational resilience

BACKGROUND

The effectiveness and stability of a healthcare organisation's workforce, including nurse managers, can be negatively affected by many factors, including illness, retirement and low levels of retention. One way of mitigating these effects is through succession planning, which can be defined as a strategy to employ the appropriate number and quality of people in key positions such as management to account for factors such as turnover, which can cause instability in a workforce. Many healthcare organisations understand the importance of having trained individuals who are ready to be promoted into leadership and managerial roles vacated by those who leave or are promoted into other positions. However, few formal education programmes specifically target the leadership development of nurses and their potential to progress into more complex leadership positions.

AIM

To assess the effect of nurse managers' knowledge of succession planning on leadership practices and organisational resilience.

METHODS

A quasi-experimental research design was applied using a test conducted before and after sessions on knowledge of succession planning, with a group of 60 nurse managers working at a Saudi university hospital. Each nurse manager attended the sessions. Study variables were measured using structured questionnaires before and after attendance.

RESULTS

The results showed significant improvement after the sessions. Improvements were noted in knowledge of succession planning, leadership and succession planning practices, and organisational resilience.

CONCLUSION

This study demonstrated that providing sessions on succession planning resulted in improvements in nurse managers' knowledge of succession planning, demonstration of succession planning practices, and demonstration of leadership practices.

Acute Care Nurse Practitioner Students' Perceptions of a Debriefing Experience After a Cardiac Emergency High-Fidelity Simulation: A Qualitative Study

Acute care nurse practitioners need specialized training to prepare for their advanced role. Limited research investigates acute care nurse practitioners' leadership skills related to team dynamics and evidence-based practices. This study explored students' perceptions of a simulation and debriefing experience and the effects of debriefing on their ability to transfer their leadership-related learning. A qualitative exploratory approach was used. Students (N = 28) were divided between a video-assisted debriefing group (n = 16) and a verbal debriefing group (n = 12). Focus group interviews were conducted in order to explore students' experience of acting as team leader when managing emergency dysrhythmias during high-fidelity simulation code scenarios. Three themes emerged: leadership training, video-assisted debriefing and verbal debriefing, and transferability. This study adds valuable information about how simulation technology could be used in leadership skills learning by and training for nurse practitioners.

Role of emotional intelligence in effective nurse leadership

Emotionally intelligent leaders demonstrate a sensitivity to their own and other people's psychological health and well-being, directing others towards common goals while developing effective personal relationships with their colleagues and team members. Emotional intelligence is particularly relevant in the context of the coronavirus disease 2019 pandemic, where nurse leaders need to demonstrate this skill when supporting their teams to manage high levels of stress, exhaustion and the risk of moral injury. This article explores emotional intelligence, discusses its importance as a characteristic of effective nurse leaders and managers, and suggests practical activities that leaders can undertake to develop their emotional intelligence skills.

Understanding effective nurse leadership styles during the COVID-19 pandemic

Leadership is central to effective nursing practice and is considered to be particularly important during crises such as the coronavirus disease 2019 (COVID-19) pandemic. This article examines several leadership styles that are commonly used in healthcare - namely the transactional, transformational and laissez-faire leadership styles - and considers their advantages and disadvantages in the context of the COVID-19 pandemic. It also explains the potential benefits of compassionate leadership in supporting the nursing workforce during this highly challenging and stressful period.

Leadership

Description Though they become responsible for leading teams and supervising more junior learners early in their career, physicians receive little formal leadership training. The "see one, do one, teach one" approach to behavioral modeling and mentorship does not serve the modern young physician well. The complex nature of modern healthcare demands that physicians learn to work within the teams they will often come to lead. Within these teams, members often look to physicians to fill leadership roles. This review will examine effective leadership as defined by the business community, review attempts to incorporate leadership training into graduate medical education programs and discuss the benefits of leadership training in medical residency programs.

Learning and leadership in advanced dementia care

This article, part of a series in Nursing Older People exploring the nursing care of people living with advanced dementia, considers learning and leadership. It outlines learning opportunities about advanced dementia and what developments are needed. The need for strong leadership at all levels and settings is explored along with the challenges of educating those who care for the person with advanced dementia. It also outlines educational opportunities and programmes before illustrating how one nurse leads advanced dementia care in practice.

Understanding leadership for newly qualified nurses

Becoming a newly qualified nurse can be a daunting prospect and leadership may appear to be a quality that only experienced nurses and managers should be concerned with. However, leadership is a requirement for all registered nurses and inquiries into cases of suboptimal care have often identified inadequate leadership as a major contributor. In the past, leadership was defined as an innate characteristic or trait, but over time concepts of leadership have evolved and it is now recognised as a set of skills and behaviours. There are many different leadership styles, qualities and behaviours, but these should not be confused with the role of management. It is important for newly qualified nurses to develop their leadership skills using tools such as preceptorship, reflection and continuous professional development.

Exploring the benefits and limitations of transactional leadership in healthcare

Leadership theory is a crucial aspect of nursing and the focus of a large body of literature. However, it remains a challenging concept to define and has been subject to various interpretations. Much of the literature on leadership is contradictory, with some studies claiming particular leadership styles are more effective than others. This article discusses the benefits and limitations of one approach to leadership - transactional leadership - and considers its use in nursing practice. The author suggests that transactional leadership remains useful as an approach to meeting short-term goals and completing tasks, but that it should be combined with other leadership styles to maximise its effectiveness in healthcare settings.

Identifying the challenges and opportunities of the executive nurse director role in the UK: a scoping review

The executive nurse director role is complex and there is significant variation in the expectations and responsibilities placed on it. The main function of the role is to deliver the nursing agenda and ensure that safety and quality remain the focus of the executive board. However, it is unclear what evidence exists regarding the challenges and opportunities experienced by executive nurse directors. This scoping review, undertaken as part of the Stronger Study, explores the literature published from 2009 onwards on the challenges and opportunities affecting executive nurse directors' ability to deliver the nursing agenda in the UK. Findings from the review suggest that the importance attached to the executive nurse director role is not matched by the amount of research available. Strengthening the executive nurse director role requires a stronger evidence base and an awareness of the benefits of the role.

Developing effective nurse leadership skills

Leadership is a role that nurses are expected to fulfil, regardless of their job title and experience. Nurses are required to lead and manage care as soon as they have completed their training. However, the development of leadership skills and the associated learning can be challenging, especially for less experienced nurses and those at the beginning of their careers. This article examines the importance of effective leadership for nurses, patients and healthcare organisations, and outlines some of the theories of leadership such as transformational leadership. It also details how nurses can develop their leadership skills, for example through self-awareness, critical reflection and role modelling.

Effective nurse leadership in times of crisis

The emergence of coronavirus disease 2019 (COVID-19) has meant that nurse leaders need to respond rapidly and decisively to the demands and challenges of a pandemic in a context of increased staff shortages and limited resources. This article suggests essential leadership skills and characteristics that nurses can use to underpin effective leadership in a crisis, emphasising the importance of decision-making and emotional intelligence. It also addresses two important questions: 'what do leaders in a crisis need to do that differs from any other time?' and 'what does effective leadership look like in a crisis?'

Leadership in Surgical Residency

Surgical training can be compared with a functioning military unit with chain of command, responsibility/accountability relationship, and graduated leadership assignments. Proficiency, commitment, communication, consistency, ownership, relationships, confidence, humility, feedback and evaluation, exemplary behavior, empathy, and humanity are all aspects of leadership. Leadership skills developed in the protected environment of residency are the basis for a successful career.

Effect of authentic leadership on newly qualified nurses: a scoping review

Authentic leadership is a relatively new concept in nursing in which authentic leaders are anchored by their deep sense of self, and know where they stand on important issues, values and beliefs. While there is considerable literature available on authentic nurse leadership, little has been written regarding its effect on newly qualified nurses. Therefore, the author undertook a scoping review of the literature on authentic leadership and newly qualified nurses. A total of 12 articles were found through database searches and included in the review. Thematic analysis of the articles identified two primary themes of 'well-being at work' and 'work environment', and two lesser themes of 'transition from student to nurse' and 'retention'. The scoping review found that authentic leadership has a positive effect on newly qualified nurses and that authentic leaders can develop genuine and trusted relationships, thereby promoting a supportive work environment for newly qualified nurses.

What the COVID-19 pandemic tells us about the need to develop resilience in the nursing workforce

Most research on resilience in healthcare systems such as the NHS is based on organisational crises, such as nurse shortages, an ageing workforce and financial restrictions. However, nursing can learn lessons from the past to consider how to become more resilient, particularly considering the 2020 COVID-19 pandemic. This article briefly looks at previous pandemics and disasters that have affected healthcare systems, as well as the 2020 COVID-19 pandemic, and considers how nurse leaders can support staff and show organisational resilience during such emergencies. The article also discusses how nurse leaders can develop their own resilience.

Implementing collective leadership in healthcare organisations

Effective leadership is essential in healthcare organisations, with several high-profile reports on suboptimal care in the NHS demonstrating a link between ineffective leadership and compromised patient safety. Therefore, it is important that nurses understand how leadership is defined and what effective leadership entails in practice. Various types of leadership are described in the literature, such as transactional, transformational and contingency leadership. One approach that could be beneficial in NHS organisations is collective leadership, which involves developing a leadership culture where formal and informal leaders work together to generate actions. This article explores the implementation of collective leadership in healthcare organisations, the potential benefits of this approach, and the behaviours and qualities that nurses require to be collective leaders.

Using Benner's model of clinical competency to promote nursing leadership

This article explores the concept of leadership in health and social care. All nurses have an important leadership role, which is reflected in the principles of the NHS Leadership Academy and in the new curriculum for nursing students. By critically applying the 'novice to expert' model of clinical competence to leadership, nurses are encouraged to consider the skills involved in moving from novice to expert alongside identifying the strengths and skills they wish to develop. Nurses are encouraged to reflect on leadership approaches operating in health and social care and to consider the type of leader they want to be. This article examines what expert or exemplary leadership might involve and some of the characteristics that are required. An expert leader can recognise their own values and beliefs, and the values and beliefs of those they lead and serve.

Exploring the influence of the nursing and medical professions on policy and politics

BACKGROUND

The Nursing Now global campaign is aimed at raising the profile of nursing and its influence on policy and politics. Calls for the profession to have an increased role in policymaking are not new, but recent developments offer significant opportunities to advance this message.

AIM

To compare and contrast the published scholarly evidence, indexed in Web of Science (WoS), relating to how medicine and nursing influence policy and politics.

METHOD

A bibliometric analysis of scholarship was undertaken to determine how medicine and nursing influence policy and politics. Indexed articles in Web of Science were compared to examine the evolution of scholarly contributions by both professions.

RESULTS

Since 1990, nursing and medicine have been consistent contributors to scholarship on policy and politics. At the same time, there has been an exponential growth in scholarly output, but nursing is now starting to fall behind. Nursing has focused on the necessary knowledge and skills, whereas medicine has focused on acting on specific issues.

CONCLUSION

There are multiple opportunities for nursing scholars to accelerate their indexed output to inform evidence-based advocacy, and influence policy and politics. These endeavours will increase their potential to inform future healthcare.

Applying transformational leadership in nursing practice

The updated Nursing and Midwifery Council (NMC) standards of proficiency for nurses emphasise the importance of nurse leadership, while the NHS has also developed models to support leadership development. There are several approaches to leadership that are applicable in nursing practice. Transformational leadership is an approach that focuses on the attributes and behaviours of the leader required to empower and motivate team members. This article outlines the four elements of transformational leadership - idealised influence, inspirational motivation, intellectual stimulation and individualised consideration - and discusses these in relation to the NMC standards. It also describes the advantages and disadvantages of transformational leadership, and suggests ways that this approach can be applied in nursing practice.

Developing the personal qualities required for effective nurse leadership

Leadership within the healthcare system should be visible at all levels, rather than being dependent solely on the characteristics of those who exert control from the top of the organisation. All nurses can act as leaders, and providing effective leadership requires them to develop specific personal qualities and behaviours. This article explores four 'leadership intelligences' - spiritual, emotional, business or practice, and political - and discusses how understanding these can assist nurses to enhance their leadership skills. It also considers the evidence base for the use of these intelligences and how they can be adopted by individual nurses and healthcare organisations.

[Training and construction of leadership skills]

To fulfil the objectives set out for nursing teams, synergy needs to be created between managerial leadership and clinical leadership. The desire must be present, but specific skills also need to be developed both in nursing training and management training.

Chairing and managing formal workplace meetings: skills for nurse leaders

Few nursing staff from band 6 and above receive formal training on how to chair and manage formal business meetings, which can be a challenging experience for novices and when participants fail to engage with the discussion. This article gives an overview of how to lead and manage effective meetings, focusing on process, content, managing conflict and how to engage participants fully. This will give meetings more purpose and ensure participants feel their time is being used efficiently. Learning how to conduct effective meetings will enhance the quality of team working and team effectiveness.

Role of front-line nurse leadership in improving care

Healthcare professionals continue to debate how to address the issues of suboptimal care, neglect and abuse in healthcare settings. One solution that is likely to achieve improvements in care is the widespread development of leadership skills in front-line nurses. The behaviour of front-line nurses is a major determinant of patients' healthcare experience and their perception of the quality of care they receive. Front-line leaders in healthcare settings such as wards, care homes and clinics are the people with the strongest and most immediate influence on staff behaviour. Therefore, nurses, ward managers and matrons are well-placed to improve organisational cultures and implement appropriate changes in their practice settings, if provided with appropriate support and training.

Student-led simulation: preparing students for leadership

It is vital to prepare nurses to become informed leaders with the required knowledge and skills to support effective patient care and outcomes. This article describes an innovative teaching method that enables students to create simulation scenarios based on their clinical experiences, to lead simulations and to take part in self-reflection and peer review activities. The article shows how the method can help prepare nursing students to become future leaders by allowing them to practise 'real-life', real-time leadership skills, and apply theory to practice in the safety of a simulated scenario.

How To Be a Leader: A Course for Residents

Background: Physicians are required to assume a leadership role as part of their career. For most, this is not an innate characteristic and must be developed throughout their medical training. There are few residency courses designed to assist in the enhancement of these leadership skills. We created and implemented a novel course on leadership, utilizing weekly presentations designed to stimulate discussions and improve the leadership qualities of trainees.

Methods: Senior residents provided leadership lectures stimulated by assigned readings from the book "The Founding Fathers on Leadership." The traits and characteristics demonstrated throughout course readings and discussions were subsequently incorporated into everyday resident activities. Baseline and post-course survey responses were evaluated to assess changes in leadership qualities.

Results: Seven senior (postgraduate year (PGY) 3-5) participated as course leaders. All seven filled out pre- and post-course surveys. Seventeen junior residents (PGY 1-2) were involved as audience members. Significant pre- and post-course differences were noted in the following areas: feelings of increased encouragement of personal development (4.86 vs. 5.43, p=0.03); increased team participation in decision-making (4.00 vs. 4.57, p=0.03); increased ease of obtaining answers to difficult questions (4.57 vs. 5.23, p=0.047); increased team member work (4.86 vs. 5.71, p=0.047), and a sense of leading a more balanced life (3.86 vs. 4.43, p=0.03).

Conclusion: The initiation of a novel leadership course for senior surgical residents led to an enjoyable experience, resulting in enhanced leadership skills for all participants. We believe this process resulted in a more cohesive, efficient, communicative, and supportive residency program.

Exploring the role of advanced nurse practitioners in leadership

There have been several changes to healthcare services in the UK over recent years, with rising NHS costs and increasing demands on healthcare professionals to deliver high-quality care. Simultaneously, public inquiries have identified suboptimal leadership throughout the NHS, which has been linked to a lack of clear leadership across the healthcare professions. In nursing, the role of the advanced nurse practitioner is regarded as a solution to this leadership challenge. This article examines the background to the development of the advanced nurse practitioner role. It also explores the various factors that may affect nurse leadership and the role of the advanced nurse practitioner, including professional identity, gender, nursing's strategic influence, clinical outcomes, and recruitment and retention. The article concludes that while advanced nurse practitioners can positively influence clinical outcomes and cost efficiency, they must also be adequately prepared to undertake a leadership role.

Exploring entrepreneurial intentions in Latin American university students

The aim of this study was to determine if entrepreneurial intention, based on Ajzen's model of planned behavior (1991), can be predicted by risk propensity, internal locus of control and leadership skills. Six standardized and reliable instruments were applied to 1493 undergraduate university business students in Latin American countries, selected through non-random quota sampling in accordance with their formation level in each of the five participating universities. Using structural equation techniques, the research model was validated and intention estimated and analyzed in relation to a set of socio-demographic variables. According to the results, entrepreneurial intention can be significantly predicted by the psychological variables under consideration and, contrary to what has been reported in other research, no gender differences were found in the intention of entrepreneurship. These findings are discussed.

Medical leadership in the 21st century

OBJECTIVE

Psychiatry as a discipline and as a profession stands at the cusp of major challenges in many areas including social, biological and psychological spheres. The practice of psychiatry is affected by ideologically driven policies by politicians, and the continuing long-lasting impact of the global economic downturn along with new developments in health care delivery. Changing biological factors include better understanding of brain structures and functioning and potential developments in psychopharmacogenomics. Social changes facing psychiatry include globalisation and rapid urbanisation. Psychological changes include therapies without therapists and the impact of social media and the information age. The current paper explores these challenges and the opportunities for psychiatrists to provide leadership in a number of settings.

CONCLUSION

Leadership skills are essential skills for psychiatrists, and enable an individual to plan and deliver services, and also help them to lead not only clinical teams but organisations and institutions. Psychiatrists are best placed because of the breadth of the training they undergo and their communication skills. Leadership is markedly different from managerial skills, although there may be a small degree of overlap.

Health care leadership development and training: progress and pitfalls

Formal training in the multifaceted components of leadership is now accepted as highly desirable for health care leaders. Despite natural leadership instincts, some core leadership competencies ("differentiating competencies") must be formally taught or refined. Leadership development may begin at an early career stage. Despite the recognized need, the number of comprehensive leadership development opportunities is still limited. Leadership training programs in health care were started primarily as internal institutional curricula, with a limited scope, for the development of faculty or practitioners. More comprehensive national leadership programs were developed in response to the needs of specific cohorts of individuals, such as programs for women, which are designed to increase the ranks of senior women leaders in the health sciences. As some programs reach their 20th year of existence, outcomes research has shown that health care leadership training is most effective when it takes place over time, is comprehensive and interdisciplinary, and incorporates individual/institutional projects allowing participants immediate practical application of their newly acquired skills. The training should envelop all the traditional health care domains of clinical practice, education, and research, so the leader may understand all the activities taking place under his/her leadership. Early career leadership training helps to develop a pipeline of leaders for the future, setting the foundation for further development of those who may chose to pursue significant leadership opportunities later in their career. A combination of early and mid-to-late career development may represent the optimal training for effective leaders. More training programs are needed to make comprehensive leadership development widely accessible to a greater number of potential health care leaders. This paper addresses the skills that health care leaders should develop, the optimal leadership development concepts that must be acquired to succeed as a health care leader today, some resources for where such training may be obtained, and what gaps are still present in today's system.

Leadership skills are associated with health behaviours among Canadian children

Life skills development is a core area for action in the Ottawa Charter for Health Promotion. The role of life skills in influencing health behaviours among children has received little attention in research. The purpose of this cross-sectional study was to investigate the relationship between self-leadership, as a model of life skills, and diet quality, physical activity, sleep duration and body weight. A provincially representative sample of 2328 grade 5 students (aged 10-11 years) was surveyed in Alberta, Canada. Self-leadership skills were assessed based on student responses indicating frequency of performing various leadership traits. Diet quality was based on responses to the Harvard Youth/Adolescent Food Frequency Questionnaire and physical activity on responses to the Physical Activity Questionnaire for Children. Sleep duration was assessed based on parent survey responses, and body mass index determined based on measured height and weight. Random effects regression models with children nested within schools were used to determine the associations. Higher self-leadership was associated with better diet quality (P < 0.01) and more physical activity (P < 0.01). Although not statistically significant, higher self-leadership was suggestive of healthier body weight status (OR = 0.91, 95% CI = 0.66, 1.27). No association of self-leadership with sleep duration was found. The incorporation of leadership skill development may enhance the effectiveness of school-based health promotion programs. This study reinforces the importance of leadership skill promotion in the promotion of healthy eating and active living, which may help curb the obesity epidemic in the short term, and prevention of chronic diseases and mounting healthcare costs in the long term.