Clinical Leadership in Nursing and Healthcare offers a range of tools and topics that support and foster clinically focused nurses and other healthcare professionals to develop their leadership skills and strategies. The textbook is helpfully divided into three parts: information on the attributes of clinical leaders, the tools healthcare students and staff can use to develop their leadership potential, and clinical leadership issues. It also outlines a number of principles, frameworks, and topics that support nurses and healthcare professionals to develop and deliver effective clinical care as clinical leaders. Lastly, each chapter has a range of reflective questions and self-assessments to help consolidate learning.
The newly revised third edition has been updated in light of recent key changes in health service approaches to care and values. While it covers a wide spectrum of practical topics, Clinical Leadership in Nursing and Healthcare also includes information on: - Theories of leadership and management, organisational culture, gender, generational issues and leaders, project management, quality initiatives, and working in teams - Managing change, effective clinical decision making, how to network and delegate, how to deal with conflict, and implementing evidence-based practice - Congruent leadership, the link between values and actions, authentic leadership, leaving behind control as an objective, and managing power - Why decisions go wrong, techniques for developing creativity, barriers to creativity, conflict resolution and management, negotiation, self-talk, and leading in a crisis
With expert input from a diverse collection of experienced contributors, Clinical Leadership in Nursing and Healthcare is an invaluable resource for new leaders trying to establish themselves and existing leaders looking to perform at a higher level when it comes to quality and effective patient care.
Table of Contents
Notes on Contributors xvii
Preface xxi
Acknowledgements xxv
Part I Clinical Leaders: Role Models for Values Based Leadership 1
1 Clinical Leadership Explored 5
David Stanley
Introduction 5
Clinical Leadership: What Do We Know? 6
Attributes Less Likely to Be Seen in Clinical Leaders 8
Clinical Leaders Are Not Seen as Controlling 8
Clinical Leaders Are Not Seen as Visionary 8
Clinical Leaders Are Not Seen as ‘Shapers’ 10
Attributes More Likely to Be Seen in Clinical Leaders 11
Clinical Competence/Clinical Knowledge 11
Approachability 13
Empowered/Motivator or Motivated 13
Supportive 13
Inspires Confidence 14
Integrity/Honesty 14
Role Model 14
Effective Communicator 15
Visible in Practice 15
Copes Well with Change 16
Other Attributes 16
Values: The Glue that Binds 17
Who Are the Clinical Leaders? 18
Clinical Leadership Defined 21
Why Clinical Leadership Now? 21
A New Agenda 22
Changing Care Contexts 22
Change Equates to More Leadership 22
More Emphasis on Quality 23
Summary 25
Mind Press Ups 25
References 26
2 Leadership Theories and Styles 31
David Stanley
Introduction: Leadership - What Does It All Mean? 31
Leadership Defined: The Blind Man’s Elephant 33
No One Way 36
Leadership Theories and Styles 36
The Great Man Theory: Born to Lead? 36
The Heroic Leader: Great People Lead 37
The Big Bang Theory: From Great Events, Great People Come 37
Trait Theory: The Man, Not the Game 38
Style Theory: It’s How You Play the Game 40
Situational or Contingency Theory: It’s about Relationships 42
Transformational Theory: Making Change Happen 44
Transactional Theory: Running a Tight Ship 46
Authentic/Breakthrough Leadership: True to Your Values 47
Servant Leadership: A Follower at the Front 48
Other Perspectives 50
Shared Leadership/Collaborative Leadership 50
Compassionate Leadership 50
The Right Leader at the Right Time 51
Summary 54
Mind Press Ups 54
References 55
3 Values Based Leadership: Congruent Leadership 61
David Stanley
Introduction: A New Theory 61
Values Based Leadership 62
Values Based Leadership Theories Applied in Healthcare 62
Congruent Leadership: Another View 66
It All Started with Clinical Leadership 66
Congruent Leadership Theory Explored 79
A Solid Foundation 80
The Strengths of Congruent Leadership 82
Grassroots Leaders 83
Foundation for Other Theories 83
Strong Link between Values and Actions 84
Supports Further Understanding of Clinical Leadership 85
Anyone Can Be a Congruent Leader 85
The Limitations of Congruent Leadership 85
New Theory 85
Similar to Other Values Based Leadership Theories 86
Not Driven by a Focus on Change 86
Not Suitable for Leaders with ‘Control’ as an Objective 86
Congruent Leadership, Change and Innovation 87
Congruent Leadership and Power 88
Congruent Leadership and Quality 91
Summary 96
Mind Press Ups 97
References 97
4 Followership 105
David Stanley
Introduction: From behind They Lead 105
Defining Followership 106
Followers’ Responsibilities 106
The Good Follower 110
The Not So Good Follower 113
Summary 116
Mind Press Ups 117
References 117
5 Leadership and Management 119
Clare L. Bennett and Alison H. James
Introduction: Why Delineate? 119
Who Should Take Centre Stage? 120
Skills 123
The Need for Education 125
Toxic or Misunderstood? 127
The Future 128
A Culture Shift 129
Summary 131
Mind Press Ups 132
References 133
Part II Clinical Leadership Tools: How to Influence Quality, Innovation and Change 137
6 Organisational Culture and Clinical Leadership 139
Sally Carvalho and David Stanley
Introduction: Values First 139
What Is Organisational Culture? 139
A Culture of Care and Compassion 142
Culture and Leadership 144
How Congruent Leaders Shape Culture 146
Clinical Leadership, Education and Training 150
Summary 152
Mind Press Ups 153
References 153
7 Leading Change 157
Clare L. Bennett and Alison H. James
Introduction: Tools for Change 157
All Change 158
Transformational Change 159
Approaches to Change 160
SWOT Analysis 161
Stakeholder Analysis 162
Pettigrew’s Model 163
The Change Management Iceberg 164
PEST or STEP 165
Kotter’s Eight Stage Change Process 166
Nominal Group Technique 166
Process Re Engineering 167
Force Field Analysis 168
Restraining Forces 169
Driving or Facilitating Forces 169
How Do You Find Either Restraining or Facilitating Forces? 170
Initiating, Envisioning, Playing, Sustaining: A Theoretical Synthesis for Change 171
Beckhard and Harris’s Change Equation 172
People Mover Change Model: Effectively Transforming an Organisation 172
Instituting Organisational Change: An Examination of Environmental Influences 172
Change Is Never Simple, Even with a Model 172
Resistance to Change 173
Self Interest and Conflicting Agendas 173
Increased Stress 173
Uncertainty 174
Diverging Points of View 174
Ownership 174
Recognising the Drivers 175
Some People Just Do Not Like Change 175
Recognising Denial and Allowing Time for Reflection 175
Successfully Dealing with Change 176
Summary 179
Mind Press Ups 180
References 180
8 Patient Safety and Clinical Decision Making 183
Clare L. Bennett and Alison H. James
Introduction: A Choice 183
Patient Harm 183
What Is Patient Safety? 184
Leadership and Patient Safety 185
Clinical Decision Making and Patient Safety 186
Terminology 188
Decision Making Approaches 188
Theories of Clinical Decision Making 190
Knowledge and Information 191
Intuitive Humanistic Model 191
Systematic Positivist, Hypothetico Deductive and Technical Rational Models 192
Integrated Patient Centred Model 192
IDEALS Model 193
Managerial Decision Making Process 193
Clinical Leadership and Decisions 194
Why Decisions Go Wrong 195
Not Using the Decision Making Framework 195
Flawed Data 195
Bias 195
Seeking to Avoid Conflict or Change 196
Ignorance 196
Hindsight Bias 196
Availability Heuristics 196
Over Confidence in Knowledge 196
Haste 196
How about Emotion? 197
Group Decision Making 197
Advantages of Group Decisions 198
Disadvantages of Group Decisions 198
Challenges 198
Summary 200
Mind Press Ups 201
References 201
9 Creativity 205
David Stanley
Introduction: A New Way Forward 205
What Is Creativity? 206
Building Creative Capacity 209
Techniques for Developing Creativity 210
Relax 211
Keep a Notebook or Journal 211
Journaling 211
Record Your Ideas 211
Do or Learn Something New Each Day 211
Learn to Draw 211
Become a Cartoonist 212
Learn to Map Your Mind 212
Try Associational Thinking 212
Go for a Walk 212
Adopt a Genius 212
Open a Dictionary 213
Study Books about Creative Thinking 213
Flood Yourself with Information 213
Attend Courses 213
Listen to Baroque Music 213
Face a New Fear Every Day 213
Develop Your Imagination 213
Leave Things Alone for a While 214
Find a Creative Space 214
Develop Your Sense of Humour 214
Define Your Problem 215
Know Yourself Well 215
Use Guided Reflection 215
Be Mindful 215
Focus 215
Do Not Be Afraid to Fail 215
Develop Some Techniques for Creative Thinking 215
Barriers to Creativity 216
Organisational Barriers 217
Competition 217
Organisational Structure 217
Being Too Busy to Address a Problem 217
Too Hectic an Environment 217
A Sterile Environment 217
Poor or Harsh Feedback 218
Rules 218
Unrealistic Production Demands 218
The Boss Is Always Right 218
Poor Communication 218
Personal Barriers 219
Fear of Criticism/Fear of Failure 219
Our Belief that We Are Not Creative 219
Fear of Change 219
Ego 219
Beliefs and Values 219
Lack of Confidence 219
Stress 220
Previous Negative Experiences with Risk 220
Negative Self Talk 220
Routines 220
Other Barriers 220
Daily Distractions 220
Not Having a Place to Go or Time to Get There 220
Drugs 220
Leadership and Creativity 221
Summary 224
Mind Press Ups 224
References 225
10 Leading Teams 227
Alison H. James and Clare L. Bennett
Introduction: Identifying Dynamics and Self Role within Teams 227
Do We Really Need Teams? 228
Are We a Team or a Group? 229
Established Teams 230
High Performance Teams 230
OK or Functional Teams 232
Struggling Teams 232
‘Teaming’ for Healthcare 233
Creating Powerful and Positive Teams 234
Psychological Safety 236
Team Building 236
Team Roles 237
Leadership and Teams 239
Summary 241
Mind Press Ups 241
References 242
11 Networking and Delegation 245
Tracey Coventry
Introduction: Strength in Numbers 245
Networking 245
The Skills of Networking 246
Get Yourself Known 247
Volunteer 247
Join a Professional Organisation 247
Look Beyond Your Own Organisation 247
Be Professionally Committed and Have Clear Messages 247
Join Professional Discussion Groups 248
Use Social Networks 248
Engage with Professional Development 248
Go to Conferences 248
Mentor Others or Be Mentored 249
Travel (for Professional Reasons) 249
Develop a Clinical Supervision Process 249
Expand Your Informal ‘Coffee’ Network 249
Publish 250
Other Ideas 250
Networking Through Social Media 250
Networking Tips 251
Delegation 252
Effective Delegation 253
Common Mistakes in Delegation 255
Under Delegation 255
Over Delegation 255
Inappropriate Delegation 255
Failing to Provide Sufficient Supervision 256
Resistance to Delegation 256
Delegation and Clinical Leadership 256
Summary 258
Mind Press Ups 259
References 260
12 Dealing with Conflict 261
Kylie Russell
Introduction: Collaboration or Clash 261
Past Conflict 262
Influencing Factors 262
Conflict Styles 263
Conflict at Work 266
Conflict Resolution 267
Responding to Conflict 268
Conflict Management and Clinical Leaders 270
Building Bridges: Negotiation and Mediation 271
Pre Negotiation Phase 271
Negotiation Phase 271
Post Negotiation Phase 272
Non Productive Behaviour 273
Negativity 273
Being Talkative 273
Attention Seeking 273
Arrogance 273
Arguing 274
Withdrawing 274
Aggression 274
Complaining 274
Active Listening 275
Self Talk 276
I Messages 277
Communication Styles 278
Mindful Communication 279
Assertive Communication 279
Communication Tools 279
CUS/S 280
CUS 280
PACE 280
Benefits of Conflict Management 280
Summary 282
Mind Press Ups 283
References 284
13 Motivation and Inspiration 287
David Stanley
Introduction: Inspiring Others 287
What Is Motivation? 288
Models and Theories of Motivation 288
Maslow’s Hierarchy of Needs 288
Expectancy Theory 290
Job Characteristics Model 290
How to Motivate Others 290
Signs that People Are Demotivated 293
The Motivational Power of Failure 294
Inspiration 296
Summary 298
Mind Press Ups 299
References 300
14 Creating a Spirit of Enquiry (Enhancing Research) 303
Judith Anderson, Sarah Dineen Griffin and David Stanley
Introduction: Is the Spirit with You? 303
Two Keys 303
Evidence Based Practice 304
How to Create a Spirit of Enquiry 306
Being Involved in Research 306
Role Modelling Use of EBP 306
Mentorship 307
Understanding the Value of a Nexus 307
Encouraging Quality Improvement Initiatives 307
Fostering Innovation 307
Rewards 308
Professional Development Opportunities 308
Collaboration 308
Journal Clubs 309
Making It Relevant to Practice 309
Benefits of Evidence Based Practice and a Spirit of Enquiry for Health Professionals 309
Barriers to the Development of a Spirit of Enquiry and the Use of Evidence Based Practice 310
Applying Evidence Based Practice 311
Strategies for Breaching the Evidence/Practice Nexus 312
Diffusion: A Simple Form of Nexus Development 314
Dissemination: More Involved with Wider Nexus Results 314
Implementation: Key Nexus Activity Integration 314
What Can Clinical Leaders Do to Promote Evidence Based Practice and a Spirit of Enquiry? 315
Summary 318
Mind Press Ups 318
References 319
15 Reflection and Emotional Intelligence 323
David Stanley
Introduction: The Noblest Way to Wisdom 323
What Is Reflection? 323
Reflection and Learning 324
Benefits of Reflection for Clinical Leaders 324
Better Self Knowledge/Increased Self Awareness 325
Identification of Your Values 325
Connection to Caring 325
More Effective Working Relationships/Stronger Teams 325
Empowerment 325
Learning from Mistakes 326
Models to Support Reflection 326
Using Reflective Models 327
Approaches to Reflection 327
What Is Emotional Intelligence? 329
The Five Building Blocks of Emotional Intelligence 329
Reflection on Reflection and Emotional Intelligence 331
Summary 333
Mind Press Ups 333
References 334
16 Quality Improvement 337
Clare L. Bennett and Alison H. James
Introduction: What Does Good Quality Healthcare Look Like? 337
Systems Thinking 338
The Quality Cycle - A Quality Management System 340
Quality Initiative Stories 343
Project Management 344
Project Management Explored 345
What Is a Project? 345
What Is Project Management? 345
What Is the Role of a Project Manager? 346
How Is Project Management Structured? 346
Phase 1: The Initial Phase 347
Project Management Team 347
Time, Money and Scope 347
Charter 347
Scope Statement 347
Phase 2: The Intermediate Phase 348
Planning the Project 348
Baseline 348
Progress or Executing the Project 349
Acceptance or Controlling the Project 349
Phase 3: The Final Phase 349
Closure of the Project 349
Key Issues 349
The Components of Project Management 350
Final Project Management Issues 350
Implications for Clinical Leaders 350
Summary 352
Mind Press Ups 352
References 353
Part III Clinical Leadership Issues: The Context of Values Based Leadership 355
17 Gender, Generational Groups and Leadership 357
Julie Reis and Denise Blanchard
Introduction: The Impact of Gender and Generations 357
Is There a Difference? 357
The Case for a Difference 358
The Case for No Difference 359
Challenges for Women in Leadership 360
The Causes of Gender Differences in Leadership 362
Personal Differences 362
Professional Differences 363
Potential Barriers that Female Leaders Face 364
Recommendations and Strategies to Address Gender Differences Manage Gender Bias 367
Gender and Congruent Leadership 369
Generational Differences and Leadership 369
Builders 370
Baby Boomers 370
Generation X 370
Generation Y 370
Generation Z 371
Generation Alpha 371
Summary 376
Mind Press Ups 376
References 377
18 Power, Politics and Leadership 385
Alison H. James and Clare L. Bennett
Introduction: Power and Politics 385
A Beginning 386
Professional Power 386
Power Base 387
Powerlessness and Abuse 388
Influencing Styles 389
Critical Social Theory 392
Healthcare and Politics 394
Practical Politics 396
Dealing with the Media 396
Becoming Politically Active 397
It’s How You Use It! 398
Summary 399
Mind Press Ups 400
References 400
19 From Empowerment to Emancipation - Developing Self Leadership 403
Alison H. James and Clare L. Bennett
Introduction: Elevating Your Voice 403
Defining Empowerment 404
The First Perspective: Empowerment as a Tool 405
The Second Perspective: Empower Walking 406
Oppression: Bridging the Power Divide 410
Liberated Leaders or Co Oppressors? 412
How Can Oppressed Groups Liberate Themselves? 414
Summary 416
Mind Press Ups 417
References 418
20 Leading Through a Crisis 421
Alison H. James and Clare L. Bennett
Introduction 421
Defining Crisis 422
Flexibility, Innovation and Resilience 424
Lessons Learnt for the Long Term 425
Maintaining Compassion and Empathy in Leadership 426
Considering the Emotions of the Experience 428
Leading for Self Care and Well being 428
Stories of the Crisis 429
Summary 433
Mind Press Ups 433
References 434
21 Clinical (Values Based/Congruent) Leaders 439
David Stanley
Introduction: Clinical Heroes 439
Many Marys 440
Values Based or Congruent Leaders beyond the Ward 442
The First Step: Finding Your True Voice 443
Innovation, Change and Quality 444
Two Final Examples of Values Based/Congruent Leaders 445
Mother Teresa 445
Tank Man 446
Conclusion 447
Summary 447
References 448
Index 451
