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Where are the leaders?

Raso, Rosanne, MS, RN, NEA-BC, FAAN

doi: 10.1097/01.NUMA.0000558488.23062.f6
Department: Editorial
Free

Editor-in-Chief, Vice President and CNO, NewYork-Presbyterian/Weill Cornell, New York, N.Y.

The less dogmatic we are, and the more we let ideas grow and be executed by our staff, the more we'll develop leadership at the bedside.

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Two separate colleagues recently challenged me on leadership development, and it wasn't about nurses with titles or even emerging nurse leaders. Yes, we need formal leaders, and many articles in this journal and others have addressed successful development programs. However, everyone needs leadership skills—from the bedside to the boardroom.

An academic colleague teaching in an RN-to-BSN program shared this with me: “Leadership seems to be understood only with a ‘capital L,’ not a ‘small l.’ I think that the first sentence a nursing student should hear in nursing school is, ‘You need to be a leader every day of your professional career. If you can't lead, you can't be a good nurse.’” Hmmm. I sense a call to action for all of us.

Attributes of positive leadership are universal and apply to all; for example, honesty, relationship-building, moral courage, advocacy, listening, integrity, and sound decision-making. Aren't these the same skills you need as a clinical nurse to be successful? Plus, organizational skills, tech savvy, delegation, collaboration, and a few others of course.

These skills should be clearly called out as leadership and I'm thinking we must be better at helping nurses at every level develop them. Our efforts toward true professional governance and structural empowerment help a great deal. We've all seen nurses flourish as they become engaged in unit activities. The less dogmatic we are, and the more we let ideas grow and be executed by our staff, the more we'll develop leadership at the bedside.

My nephew is a senior in a BSN program and recently took a leadership clinical. The practicum entailed helping junior students by making assignments and being a resource. This is clearly leadership, although I suspect he perceived it as a “small l,” not a “capital L.”

Nurse advancement programs such as clinical ladders do lead to improved outcomes, personal growth, and preparing nurses to consider being emerging leaders with a “capital L.” A concept analysis by Chavez et al. on clinical leadership supports this approach, finding that it takes a combination of competence, communication, empowerment, and a collaborative environment to attain clinical leader status. I've seen this happen repeatedly with clinical nurses and it's powerful. We just don't have the option to ignore this pressing need in our workforce.

The other colleague who had me thinking on this subject was notable nursing workforce guru Peter Buerhaus. He brought up the concept of “personal leadership” at a regional presentation on the current state of Nursing (“capital N”). What does personal leadership mean? It means taking personal responsibility for yourself and your own growth—“leading from within.” In the context of his talk, he referred to finding these driven “personal” leaders among our staff, using them as role models, and pairing them with others to help them grow. Sage advice.

So, where are the leaders? Everywhere. It's part of our practice from the bedside to the boardroom. And it's our responsibility as leaders with a “capital L” to develop clinical leadership at every level.

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