About nursing management & leadership

Written by johnroskoski
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About nursing management & leadership
Nursing leadership is essential to patient care. (nursing duties image by Pix by Marti from Fotolia.com)

Nursing management and leadership are both key elements in the delivery of proper patient care. The nurse leader and nurse manager complement each other in their actions, responsibilities and roles. However, even though the two positions are complementary, the leader and the manager serve different functions in the health care organisation and command different types of authority.

Definition of Nursing Leadership

A nurse leader, according to Eleanor Sullivan and Phillip Decker in "Effective Leadership and Management in Nursing," can be anyone who uses interpersonal skills to influence others to accomplish specific goals. The leader has the capacity to earn and hold trust and can inspire others to commit to the goals of the health care organisation. The leader facilitates group cohesion and performance. The authority of the leader is informal, meaning that the leader has no specific managerial role; however, the leader's ideas and actions influence the "efficiency of work flow."

Definition of Nursing Management

The nurse manager, according to Sullivan and Decker, is employed by the health care organisation and is responsible and accountable for the efficiency in accomplishing the goals of the organisation. The organisation defines the manager's power and authority. The manager coordinates and integrates resources, clarifies the organizational structure, delegates tasks, evaluates outcomes and provides feedback. Unlike the nurse leader, the manager's "personal skills" are reinforced by organizational mandates.

Leadership Qualities and Behaviors

The nursing leader exhibits a set of distinctive qualities and behaviours, according to Ruth Tappen, Sally Weiss and Diane Whitehead in "Essentials of Nursing Leadership and Management." Qualities include intelligence, integrity, courage, initiative, energy, optimism, perseverance, balanced life, ability to handle stress and self-awareness. These qualities are complemented by behaviours that include thinking critically, problem solving, respecting individuals, skilful communication, setting goals, sharing a vision and developing self and others.

Management Qualities and Behaviors

According to Tappen, Weiss and Whitehead, a nurse manager has the quality of leadership--which entails all of the qualities and behaviours of the nurse leader--as well as clinical expertise for effective patient care and business sense for administrative duties. In addition, the manager exhibits strength in three major areas of behaviour. These are: interpersonal behaviour, which includes networking, conflict negotiation and resolution, and employee development; informational behaviour, which includes being a spokesperson, monitoring of an area, and dissemination of data; and decisional behaviour, which includes employee evaluation, resource allocation, hiring and firing, planning for the future, and job analysis and redesign.


A key difference between leaders and managers is in their organizational function, as suggested by Patricia Yoder-Wise in "Leading and Managing in Nursing." The nurse leader employs personal power and persuasion to "constructively and ethically" move patients, families and staff toward an end point or goal. The exact steps needed to accomplish the goal may not be known, but the leader evokes a sense of security to those around, enabling them to handle unanticipated details. On the other hand, the nurse manager follows set behaviours and activities that provide structure and direction in patient care. In accomplishing the goal, the manager ensures that the organizational process is carried out. Leadership is a key factor in effective nurse management. But, management skills are not needed for effective leadership.

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