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Leading When You're Not the Formal Leader

There are ample opportunities for nurses to find themselves in leadership roles - officially or not.

Nurses are often called upon to step up to leadership roles-both formal and informal.

The formal roles, while often challenging, have the benefit of coming with overt authority. The nurse manager or CNO is the person in charge. It's legitimate authority which is well recognized by others.

That isn't always the case, though.

Often nurses find themselves in leadership positions where they lack formal, recognized authority. In these situations different methods must be used to ensure that others will follow.

 "As an experienced nurse you are often called upon to lead though you may not be the formal leader," says Mary Sue Kavalam, EdD, RN, Who worked for 17 years as a critical care nurse in New Jersey, and also has experience in diabetes research in the pharmaceutical industry.  Charge nurse or preceptor roles are good examples.

Healthcare is becoming increasingly complex, notes Allison Rimm, author of The Joy of Strategy: A Business Plan for Life (Bibliomotion, 2013) and former senior VP of strategic planning at Mass General Hospital.

That complexity opens up a range of opportunities for nurses to get involved in everything from patient quality and safety initiatives, to preparing for Joint Commission accreditation visits or Magnet Hospital designation. There are ample opportunities for nurses to find themselves in leadership roles, regardless of whether they hold official leadership authority.

Different Types of Leadership

There are two types of leadership power, says Barry Maher: position power and personal power. Maher, an author and speaker who has worked with companies ranging from Hewlett-Packard to the U.S. Government, is also the author of Filling the Glass: The Skeptic's Guide to Positive Thinking in Business (Barry Maher & Associates, 2007).

Position power is the power that you may have because of your job, he notes. "Personal power is the power you have because of who you are and how you act." In situations where you are not the formal leader, personal power comes strongly into play.

 "The best leaders understand the people they work with can achieve more than they themselves believe they can achieve," says Maher. "They build those people up. They show them the vision they have for what each and every one of them can become and what they can accomplish."

Effective leadership isn't so much about leading others, than it is about helping them lead themselves. This is an area where informal leaders with strong personal authority can excel.

What It Takes to Lead Effectively

Regardless of whether the role is formal, or informal, there are some best practices that nurses can follow to boost the odds of leading effectively.

"A healthy dose of respect for everyone you deal with," is chief among these, says Kavalam. "Respecting others' differing backgrounds and experiences and expecting these differences to make the situation richer," is a valued skill. Soft skills, in fact, are important skills for nurses to cultivate. These might include, says Kavalam: "Being able to read someone's body language if their defensive, staying calm in times of stress, slipping into an authoritative tone of voice in an emergency situation."

Jenè Kapela is the owner of Leadership Solutions, LLC, a consulting firm based in the Miami/Fort Lauderdale area. "Relationships are a key component of effective leadership," notes Kapela. Nurses must develop and maintain positive working relationships with those around them. Importantly, she says, it's important to begin building those relationships early so that, when leadership opportunities emerge, the relationships are already firmly established.

People follow those they like and trust, says Kapela. "That doesn't mean you need to be everyone's best friend or that people have to love you," she says. "But they should respect you and your work." To gain this level of respect, she says, it is important to be authentic and trustworthy in all of your dealings with others.

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Critical Thinking

The ability to bring critical thinking skills into play also can be especially important for nurses in the challenging environment they often find themselves in, notes Kavalam.

For example, when calling a doctor in the middle of the night to relay a patient's complaints of chest pain, nurses must anticipate how the conversation might go and what information might be required. And, she adds, they must do so quickly.

Of course, stresses Rimm, communication skills are essential. Nurses in leadership roles must be able to communicate effectively with multi-disciplinary colleagues. They must be able to understand the task at hand, achieve consensus and make forward progress through others. Importantly, they must recognize the contributions of others, says Rimm.

 "A real leader celebrates the contributions of others rather than taking credit for the team's success," she says. "That way you make your own accomplishments apparent while calling attention to the team's success."

Best Practice Tips

What leadership is not about, stresses Kapela, is asserting power over others. "Do not think that, because you are placed in a leadership role, you have a newfound power over those around you. This isn't how it works." Leadership, Kapela points out, is more about others than about you.

 "The fastest way to lose credibility and trust is to act like you think you are elevated over others."

Laurie-Ann Murabito is based in the Boston area and is the author of Rethink Leadership, 4 Lessons to Make You Remarkable (CreateSpace Independent Publishing Platform, 2011).  She has more than 20 years of experience in the trenches of healthcare, from direct patient care to the corporate side of medical devices. She is the founder of LA & Associates, a consulting firm that focused on developing strong leaders. She offers some additional tips for nurses who find themselves taking on an informal leadership role, whether planned or spontaneous:

Be ready. "Nurses should get ready to be ready," says Murabito. "You never know when an emergency will arise and you will be called upon to lead others. A higher up may ask you to step in or it may be your peers who are in need of guidance."

Build relationships. Outstanding leadership begins long before someone actually steps into a formal leadership role, notes Murabito. Learning how your body language, listening skills, tone along with the actual words you use affects communication is key. "Get to know people and maintain those relationships," she recommends.

Manage yourself. Your emotions impact those around you, Murabito points out. "When leading, followers need to trust you are confident and not scared. Healthcare is an extremely stressful industry where things can change quickly and not always for the better. People's lives are at stake."

Effective leaders aren't born, they are made. We all have the potential to become effective leaders but it takes time, commitment and self-awareness.

"Identify role models who have been successful informal leaders in your organization and study what they do," suggests Rimm. "Go and talk to leaders you admire and ask them for advice. Read books, articles and take advantage of leadership development courses your organization offers."

Most importantly, actively seek and take on informal leadership roles within your organization or other groups where you can learn the best way possible-by doing.

Lin Grensing-Pophal is a freelance writer.

At Work Archives
  Last Post: May 11, 2014 | View Comments(23)

I couldn't agree more. I have worked in the same hospital for 8 1/2 years and find while I am not a charge nurse, I do take on trouble shooting some of the "mechanical" problems on the unit (like are the room lights working?, are the computer accessories up and running? are the dynamaps operational? are supply levels being met?). I still am doing nursing tasks--assessing,data gathering, etc. and while I may have to ultimately turn the data over to management to complete the task, management has been more than happy to thank and recognize me for my efforts.

Evelyn Sheridan,  RN,  AHS/Highland HospitalMay 11, 2014
Oakland, CA

I think this article is really great for us as we near graduation. It discusses how important it is as nurses to prepare for leadership because you never know when an opportunity will present itself. In clinicals with the first year students, I made sure to be aware of myself and how I came off. If I felt like I'm too good to help them, then I wasn't doing my job right. I brought as much respect to them as I expected from them and I think that really helped through the two days. Also, from the first thing in the morning I let them know I was there if they had questions or needed any kind of help, which they also respected I think. For me, the biggest takeaway was at the end when they talk about identifying a role model and study what they do. I think that's important because it's a very genuine way of learning and there are so many role models I would like to be and I can try to mold each idea into my leadership style.

Jennifer PerryApril 25, 2014

This article was helpful for me because it helped explain what it takes to be a good, successful leader. With recent clinicals last week with the first year students I used some of these skills. I always tried to help them and encourage them. The biggest take away I got from this article was how to be a good leader and skills to use in my future nursing practice

Christena  Zachgo April 24, 2014

Read all comments (23) >>


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