Nurse Leadership in Non-Traditional Settings

Leadership is a complex concept with many different theories to be found in the literature. A total of 66 leadership theory domains and a wide variety of methodological approaches have been identified (Dinh et al. 2014). It has also been concluded that several established leadership theories, such as neo-charismatic, information processing, trait, and leader-follower exchange theories, continue to capture the interest of the field; with other theories such as behavioral approaches, contingency theory, and path-goal theory witnessing significant growth (Dinh et al. 2014). Most of these theories recognize that leaders are ‘architects’ who can influence the way inputs are combined to produce outputs, often by influencing the actions of others (Dinh et al. 2014, p21). Leaders are embedded within organizational systems that are continually evolving. Therefore, leaders must be able to read a situation and adapt accordingly. This means adapting to the task at hand, the needs of the team, and in a manner that maintains and builds productive relationships (Maxwell 2017).

In terms of leadership in nursing, there are many barriers to be wary of. Denker et al. (2015) conducted a survey to examine barriers to nursing leadership and succession planning needs for nurse leaders in Florida (n=1354). The top two contributors to leadership success were reported as ‘experience’ (75%) and ‘educational preparation’ (54%). Results also showed that ‘a lack of a unified voice amongst nurses when speaking on issues’ (68%) and ‘public perception of nursing roles’ (66%) were regarded amongst the top major barriers to nurses attaining leadership roles. The contributors to leadership success identified in this research could be considered as easy to achieve for each individual nurse leader; however, the barriers are overarching, rooted, and complex issues that are difficult to overcome at an individual level. A similar study investigated nurses’ (n=72) experiences of leadership within health care in Ireland (de Vries and Curtis, 2018). Participants provided narrative descriptors of good nursing leadership and identified obstacles to such leadership. Obstacles observed included high workload, lack of support from management and peers, limited opportunities to gain experience, lack of education and poor work environments. Interestingly, there are common themes across both studies; for example, a lack of support from peers and a lack of a unified voice amongst nurses. It appears that nurses may be reluctant to support and promote one another in terms of leadership development.

Yet, nurses have unique leadership skills and competencies that are transferable across many diverse settings. In the US, the Institute of Medicine Future of Nursing Campaign (2011) recommended that nurses should be prepared to assume leadership positions across all levels; and public, private, and governmental healthcare decision makers should ensure that leadership positions are filled by nurses. In the UK and Ireland, the increased autonomy of the Chief Nursing Officer role, within the respective government departments, is testament to the increasing recognition of nurses’ contribution to policy development and high-level decision-making. Nurses are increasingly regarded as well-educated individuals with excellent communication skills, who work well under pressure, make good decisions in stressful situations, and can work as part of a team. More and more nurses are migrating into settings such as the pharmaceutical and medical device industry; with many other nurses identifying entrepreneurial opportunities and establishing their own companies. Aside from some anecdotal commentary papers (e.g. Fitzpatrick, 2014; Abney, 2018), there is very little literature published on this topic. The contribution that nurses can make to an organization or company is becoming more and more visible to those outside of nursing; but it seems nurses are not as quick to recognize this potential in themselves. Future research is warranted to document and map this evolution in the nursing profession.

This session will blend findings from the literature with real-life personal leadership experiences in clinical practice, academia, and industry. The aim is to create an enlightened perspective of the non-traditional opportunities available to nurse leaders and to boost the self-belief of the nursing profession. The specific objectives are to:

• Highlight the transferable leadership skills of nurses;
• To understand the potential nursing leadership opportunities outside of traditional settings;
• To describe the challenges that can occur in a position of leadership, especially in non-traditional settings;
• To provide recommendations for future research on the topic of nurse leadership in non-traditional settings.

This session will highlight this evolution in nursing leadership and make recommendations for future research on the topic.