While I was doing some research on a favorite subject of mine, nursing leadership, I took time to reflect on the many definitions of a leader. A leader, depending on the source of your definition, is one who guides, leads or influences others in a particular direction. Indeed, modern leadership has been defined by many current authorities as the art of influencing one or more people in a positive manner.
Yet, when I talk with some nurses about leading their patients and the concept of a nurse leader, they fail to see nursing as a leadership activity. When pressed about their thoughts about the role of the nurse, they tend to see their role as temporarily being in charge of the care of an individual. They are there for a short period of time to take care of the patient. Those words struck home with me.
So I looked up the definition of the word ‘caretaker.’ This is generally defined as one who is in temporary charge of something (a building or a government), usually in the absence of its owner. The differences between the two views were immediately apparent to me.
Leader
First, the leader definition indicates that there is an interaction between at least two people. People! You may refer to individuals or groups, but the bottom line still goes back to people. This also indicates why leadership is such a fluid activity. There are many components to the interaction between individuals that must be accounted for. Education, maturity, goals, and motivation differ with each person involved in a leadership scenario.
We must also factor in the particular situation that leadership is being used. It is very appropriate to change your style of leadership depending on the situation at hand. The use of an authoritarian leadership style is very appropriate during an emergency situation. The leader will direct all followers since there is no time to get input and discuss possible routes of action. On the other hand, with educated and motivated individuals, many projects can be accomplished through the use of a participative style of leadership.
Good leadership also shares a vision of the future, where do you want to lead this person. How often do we paint a picture of where we want our patient to eventually arrive? We must have this goal in mind if we are to be a positive influence to our patients. Indeed, we should strive to involve the patient and their family members together in setting goals and planning the route to take.
Caretaker
On the other hand, the caretaker definition specifically relates to objects such as a building. References to a caretaker government are as close as the definitions come to any reference of people. In this situation, the goal is only to maintain the status quo until someone else comes along to assume control. The caretaker is not interested in improvement, only the prevention of any deterioration in condition.
The caretaker definition also specifies that the relationship is a temporary matter. There is no goal setting for the future or plans for improvement. The caretaker knows that their time is limited. Any changes or improvements await the arrival of the person who will relieve the caretaker. The personal goal of the caretaker is to make it to the end of their time period without upsetting any apple carts along the way.
Now that I think about it, I have known several caretaker nurses in the course of my nursing career. These are the ones who say, usually in all seriousness, “I just need to keep them alive until the next shift gets here.”
So What Are We?
I like to think that nurses of today are truly leaders, that they have the long term interest of an individual at heart. This long term outlook can be contagious (the best type of contagious) to patients and their families.
It is in our best interest as healthcare providers to instill this long term plan for improvement with those we take care of. Though we are only with the patient for the time period of our work, we can still inoculate our patients with a vision of increased health and wellness for the future.
The problem that I see is that most nurses see leadership skills as something reserved for those who have access to the administrative suite, sometimes referred to as ‘the suits’. Yes, some of those positions are leadership positions, but the person who occupies that position must possess the skills of a leader. Leaders are people, not offices. Each and every one of us can be a leader to someone through the knowledge and use of some basic leadership skills.
Leaders come in a variety of positions. If you look at your job description, I am willing to bet that, while it may not mention being a nurse leader, there is no prohibition against being a leader either.
It is time for all of us to increase our knowledge of nursing leadership and practice these valuable skills.