The adage that “every nurse is a leader” has been prevalent lately in opinion pieces and network conversations, revisiting a decades-old belief. Most say yes, some say maybe, and others assert all nurses should or even must be leaders. A dear colleague puts forward another possibility: every nurse can be a leader. Could all of these be true?
Probably. We do know leaders aren't only those in formal positions as we see leadership in many forms at every level, but we could also argue that a title doesn't make anyone a leader either. Can you be a leader without followers or without influence? I don't think so, do you? Personally, I love leading, and I like following just as much depending on the circumstances.
Scope of leadership influence could be at the point of care advocating for a patient or family and/or in the community, at micro- to macroorganizational levels, or even in government. It could be locally, nationally, or globally. Nurse influencers are all over social media whether you agree with their messages or not. It's all leadership, and the resulting followership determines the influence.
It's not about “style,” although task-oriented leadership practice is just as undesirable as task-oriented clinical practice. Tim Porter O'Grady has been preaching about complexity leadership for years, making the strong case that leadership (whether positional, professional, or as an expert) must face constantly changing dynamics to be effective. Maybe that makes the concept of every nurse being a leader even more complex, but in our healthcare reality, all agree that nurses face constantly changing headwinds from the beside to the boardroom. Every patient, family, team, service line, department, healthcare system, nursing school, and on and on, have different forces involved in every situation. Leadership in a complex world is, well, complex. And possible at every conceivable level.
So how do we help nurses lead, and help each other as well? It starts in the preparation of new nurses at the academic level, which is supported by the American Association of Colleges of Nursing's core competencies. That's obviously not enough. We must be role models and expect leadership in the form of escalation, advocacy, critical thinking, teaching, professional contributions, and more starting at onboarding, which isn't possible without a psychologically safe environment. Perhaps we should do more to recognize, facilitate, and publicize leadership and innovation exemplars big and small; that can be inspirational, begetting more of the same.
Even more critical, nurses must be willing and able. It's hard to believe a licensed professional RN would be unwilling or unable, but we've all seen it in practice—it's possible. And not acceptable from a role expectations perspective at the point of care and onward. In a Nurse Leader article this year, Godsey and Hayes gave multiple reasons for rebranding nurses as leaders, different from the public perception of nurses solely as caring healthcare workers following physicians' orders. This is our place in society considering our value and impact on healthcare in this country. And we haven't even touched on “nurses on boards,” taking this to yet another level.
That brings us full circle. It seems that all nurses can be leaders, are expected and need to be leaders, and our public persona should be that we are leaders. We must use our influence to encourage and uphold nurse leadership in all its forms. It's who we are.