Changing leadership style and hospital culture could help keep some 20 percent of licensed nurses from walking away from the profession.
"Outside of better pay, retaining nurses comes down to how they are treated," Cheryl Peterson, senior policy fellow at the American Nursing Association, told UPI's Caregiving.
"They want visible nursing leadership -- all the way to the top. They want nurses to be part of the whole decision-making team, and they want to be treated with respect by everyone, especially by doctors," Peterson said. "They also want opportunities to continue education and go up the career ladder, and they want recognition for their role."
Peterson says nurses are asserting themselves more, and while some older physicians might not welcome their input, younger doctors see nurses in a different role.
"It's been long in coming -- our roles are very interrelated, but some doctors may fear that we are encroaching on the physician's turf," Peterson said.
"During a patient's recovery time a team approach is needed. It takes a team to care for a patient, a collaborative approach. We know patients do better with a team approach, and we also know that when there is a satisfying nurse environment, we have better patient outcomes."
Healthcare has its own culture as does each hospital, but what nurses seem to be saying is that they would prefer a less autocratic leadership model and a more "servant leadership approach." While there are several management styles, autocratic and servant leaders define the two ends of the continuum.
Autocrats are task oriented but hard on their workers and have no allowance for cooperation or collaboration. They expect people to do what they are told without question or debate; when something goes wrong they tend to focus on who is to blame and they are intolerant of what they see as dissent, according to Robert Blake's and Jane Mouton's "The Managerial Grid III: The Key to Leadership Excellence," a book published in 1985.
"You can see why some would prefer to be an autocrat in the military or a hospital using control and command because there is no time to hold a meeting before making a decision -- a decision has to be made quickly," Fred Dansereau, professor of organizational behavior and human resources at the University at Buffalo School of Management, told Caregiving.
"With the tremendous pressure on time, doctors don't have time to consult with people -- they move on, and hope the head nurse manages the floor."
Any person questioning an autocrat can be seen as interfering with the autocrat's plans, according to Dansereau.
"Some people become autocratic when they become in charge of something because it's the only role model they've ever seen and they think it's expected. Some may think that once they've reached a position of leadership it is their turn to be autocratic," Dansereau said.
At the other end of the leadership spectrum is the servant leader. The paradoxical term was coined in 1970 by Robert K. Greenleaf, a retired AT&T executive who said a servant leader is servant first.
Corporations such as Southwest Airlines and non-profit organizations such as hospitals have embraced the servant-leader model. It seeks to involve others in decision-making, is strongly based in ethical and caring behavior and enhances the personal growth of workers while improving the caring and quality of organizational life.
"In the last 20 years there has been a growing shift from autocrat to servant leadership -- leaders who take a long view and don't just focus on short-term profits," Larry Spears, chief executive officer of the Greenleaf Center for Servant-Leadership, told Caregiving.
"A servant leader cares about employees and customers. They seek feedback -- an airline mechanic is encouraged to raise concerns and provide information to prevent a plane crash."
It's interesting that the military has been emphasizing communications and team building -- core values of the servant leader -- for quite a while.
The U.S. Army handbook "Military Leadership," published in 1973, emphasizes communication, setting an example, knowing subordinates, looking out for their welfare and keeping workers informed.
"Train as a team," it urges. "Although many so called leaders call their organization, department, section, etc. a team, they are not really teams ... they are just a group of people doing their jobs. Use the full capabilities of your organization -- by developing a team spirit, you will be able to employ your organization, department, section, etc. to its fullest capabilities."
--
Alex Cukan is an award-winning journalist, but she always has considered caregiving her primary job. UPI welcomes comments and questions about this column. E-mail: [email protected]
