Catherine Best (@CBest_23) is a public health nurse and an Honorary Visiting Lecturer in Nursing at the University of Bradford, whose research focuses on health inequality. She is a member of the Phi Mu chapter of Sigma Theta Tau, and organisation that works to develop nurse leaders to improve healthcare everywhere. Catherine has written for us before, take a look at her blog co-authored with Parveen Ali (parveenazamali) about safe staffing.
Within the last decade concerns have been highlighted regarding the unethical behaviours of senior staff employed within a number of high-profile organisations (Gifford et al, 2019). This is supported by Crawford et al, (2020, p.115) who argue that poor and unethical decision making by some of the foremost ‘political, societal and organisational leaders’ has created a global challenge for many modern-day thinkers.
Healthcare has not escaped this criticism, with the behaviour of nurses and nurse leaders having been implicated in such scandals as Winterbourne (DoH, 2012), Mid Staffordshire NHS Foundation Trust (Francis, 2013) and Morecombe Bay (Kirkup, 2015). These scandals ultimately leading to a demand for increased corporate responsibility and a need for significant change in how healthcare services are delivered.
Such behaviours have amplified the call for a new type of genuine and values-based leadership; that of authentic leadership (Gardner et al, 2011). Characteristics of which argue Gill and Caza, (2018) include:
• Self-awareness
• Internalised moral perspective
• Relational transparency
• Balanced decision making
Within the literature, leadership theories endorse the importance of the leader ‘serving, motivating, and empowering others’ (Browning, 2018, p.14). Leadership is a process argues Ng, (2017) that begins with the concept of self-leadership. A strong advocate for self-leadership is Daskal (2017), who, through her research, has created a set of guided principles of leadership development. These principles it could be argued, formulating the skillset of authentic leaders.
A core premise of the work of Hirst et al, (2016) is that authentic leaders play a crucial role
in encouraging supportive behaviours in others, whilst demonstrating the value of openly sharing information. Such qualities assert Raso, (2019) being conducive to building trusting and productive relationships. Crucial elements of effective teams.
Having the ability to develop healthy workplace environments, however is reliant upon contextual factors, such as organisational culture, politics, and structure (Shirey, 2017), which can either promote or disrupt its development.
Until recently healthcare organisations have been dragged down by unrelenting bureaucracy, (Segel, 2017), a quintessentially command and control leadership regime and toxic cultures (West, 2019).
It could be argued however, that the impact of Covid-19 has witnessed a sea change in the way in which services are delivered, for we have witnessed first-hand how quickly systems, processes and laws can be put into place to protect the NHS, as evidenced with the establishing of the Nightingale Hospitals (NHS, 2020) and new legislation for example, – The Health Protection, (Coronavirus, Restrictions (England) Regulations 2020 (SI 2020/350). Although, has all this been managed simply by using a command and control approach to leadership?
It is likely that in time a plethora of research will emerge that will testify how healthcare leaders, including nurse leaders effectively managed this situation. Whether this research will identify new styles of leadership not yet considered, or simply regurgitate what we already have, remains to be seen. What is important however, is how we move forward.
Perhaps what will emerge is the need for individuals to find their way in the world. Is it possible for example that self-leadership will become ingrained within the fabric of the nursing workforce, or that the command and control style of healthcare leadership will soon be consigned to the annals of NHS leadership history? We can only wait and see.
Resilience, the current buzzword, will take on a new meaning as we emerge from the crisis, perhaps to a very different world than before. A nursing workforce that should above all else value its worth, will no longer be satisfied with excuses that limits the professions ability to grow. Nurses know the sacrifices they have made at a time of greatest need and will in time begin to demand opportunities that enable aspirational growth, which in turn has the potential to see new leaders emerge; ones with very different skillsets.
How we manage this as a collective remains to be seen. For ultimately, only time will tell.
References
Browning, M. (2018) Self-Leadership: Why it Matters? International Journal of Business and Social Science, 9 (2) February, pp. 14-18
Crawford, J.A. Dawkins, S. Martin, A. and Lewis, G. (2020) Putting the leader back into authentic leadership: Reconceptualising and rethinking leaders Australian Journal of Management, 45 (1) April, pp.114-133
Daskal, L. (2017). The Leadership Gap: What Gets Between You and Greatness. New York: Penguin Random House.
Department of Health (2012) Transforming Care A national response to Winterbourne View Hospital. Department of Health Review: Final Report. London: DoH
Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: Executive Summary. TSO: London.
Gardner, W. Cogliser, C Davis, K. and Dickens, M.P. (2011) Authentic leadership: A review of the literature and research agenda. Leadership Quarterly, 22 August, pp. 1120–1145.
Gifford, J. Green, M. Barends, E. Janssen, B. Capezio, A. and Nguyen, P. (2019) Rotten apples, bad barrels and sticky situations. An evidence review of unethical workplace behaviour. London: CIPD.
Gill, C. and Caza, A. (2018) An investigation of authentic leadership’s individual and group influences on follower responses. Journal of Management, 44 (2) February, pp. 530-554.
Hirst, G. Walumbwa, F. Aryee, S. Butarbutar, I. and Chen, C.J.H. (2016). A multi-level investigation of authentic leadership as an antecedent of helping behavior. Journal of
Business Ethics, 139 (3) December, pp. 485-499
Kirkup, B. (2015) The Report of the Morecambe Bay Investigation. London: TSO.
NHS (2020) News: NHS to build more Nightingale Hospitals, as London set for opening. https://www.england.nhs.uk/2020/04/nhs-to-build-more-nightingale-hospitals-as-london-set-for-opening/
Ng, J. (2017). Unleashing the Greatness in You: The Power of Self-Leadership. London: WS Professional
Raso, R. (2019) Be you! Authentic leadership. Nursing Management, 50 (5) May, pp. 18-25
Segel K (2017) Bureaucracy Is Keeping Health Care from Getting Better. [Online]. Available from: https://hbr.org/2017/10/bureaucracy-is-keeping-health-care-from-getting-better Accessed 01 May 2020
Shirey, M.R. (2017) Leadership practices for healthy work environments. Nurse Management, 48 (5) May, pp. 42-50
The Health Protection, (Coronavirus, Restrictions (England) Regulations (2020) SI 2020/350. London: TSO.
West, (2019) The NHS crisis of caring for staff: what do we need to do? [Online]. Available from: https://www.kingsfund.org.uk/blog/2019/03/nhs-crisis-caring Accessed 01 May 2020.