By Michael G. Pringle, MPA
After working in healthcare for 35 years, nursing leadership continues to disappoint. Poor support for frontline nursing staff from unit managers and failure by executive leadership to resolve persistent workplace problems like horizontal violence, favoritism, verbal abuse and theft continues to tarnish the field of nursing's image. For example, a colleague had requested a day off six months in advance to attend their son's wedding. Upon reviewing the staffing schedule, the nurse noted that the day off for the wedding had not been granted. Despite the nurse's request, the manager ignored the nurse's concerns. Consequently, the nurse had to work and miss their son's wedding. Shortly after this event, the nurse terminated their employment and has not returned to nursing. In another instance, a medical staff member verbally abused a colleague at the bedside in front of a patient. When the staff nurse reported the abusive interaction to the nurse manager and the hospital's chief operating officer, the medical staff member was never disciplined. "Intraprofessional" disharmony has plagued nursing for more than 40 years due to ineffective nursing leadership, causing nurses to leave the profession (Hartin et al., 2020). Sometimes, nurses attempted to interrupt abusive behavior from others on their own but had been largely unsuccessful due to poor organizational support (Zullo et al., 2022). In other healthcare facilities, a perception of operational inequity existed along with favoritism and fear of being misrepresented by nursing leadership invoked a code of silence from nurses regarding workplace issues (De los Santos et al., 2020).
With such a legacy of professional cannibalism, the question arises: “How qualified are today’s nurses in leadership positions?.” In the book, Innovative Decision Making in health care: A Case-Based Approach to Nursing Leadership in Academic and Clinical Settings, the predominant method employed to select nurses for leadership positions was based on employment longevity and having obtained a graduate degree rather than leadership ability (Neal-Boylan & Rotkoff, 2021). Leadership positions hold some level of authority that is usually recognized by others. Ineffective leaders employ their positional authority to influence others’ actions through the decisions they make. Using authority as a method of influence is not leading. Leading is the ability to influence others to act in such a way out of desire, not obligation or coercion (Khan et al., 2022).
The healthcare landscape is dynamic. Leaders are expected to function in multiple roles to meet the needs of various stakeholders, including employees, community members, executive leadership and shareholders (Voegtlin et al., 2020). Effective leaders work collaboratively with their staff employing a shared decision-making process where communication between staff and leaders is a parallel dialogue with some decisions being made by staff members at the grassroots level. Effective leaders use emotional intelligence skills with staff member interactions being aware of how their behavior and communication is being perceived. Successful leaders routinely interact with staff members and serve as a source of inspiration, which improves team members' job performance and fosters a more positive work environment from enhanced team cohesiveness (Lai et al., 2020). Competent leaders empower their staff. Empowerment positively impacts attitudes and behavior, thus enhancing career satisfaction, which ultimately impacts the success of an organization (Türe & Akkoç, 2020).
If you are a nursing leader, I challenge you to take some time and reflect on your effectiveness as a leader and consider the following: “How often are you interacting with your staff?” “Have you ever worked after normal business hours with your evening and night shift teams?” “What have you done to enhance the relationships you have with your staff?” "Do you know what your team members’ concerns are?” Your job as a leader is to support your staff; your team should be your priority; patients come second. If your team is well supported, trained and supplied, patients will be happy with their care (Spiegelman & Berrett, 2013).
Bio: Mike Pringle is a registered nurse with over 35 years of experience in emergency, intensive care, occupational health and chronic pain management nursing. Mike is also a board-certified case manager. Presently, Mike is a full-time doctoral student at Regis College pursuing his nurse practitioner degree specializing in adult critical care. His clinical experience spans small community hospitals to large regional trauma centers. Mike spent several years in the United States Navy assigned to U.S. Marine forces in the Pacific as the Executive Office of 3d Medical Battalion in Okinawa, Japan, where he coordinated medical support services for small and large-scale military operations across Southeast Asia, Guam and Australia.
After completing his primary nursing education, Mike received his bachelor’s degree in Nursing from Barat College and Finch University along with The Chicago Medical School, graduating with honors. Mike went on to complete his Master’s Degree in Public Administration with an emphasis in Health Care Systems from the University of Oklahoma. While in the military, Mike successfully graduated from the U.S. Marine Corps Amphibious Warfare School and became an expert on crafting medical support plans for combat operations.
Mike holds an active membership with the Case Management Society of America; he has given lectures on chronic pain management with the Massachusetts Department of Industrial Accidents and the Massachusetts Bar Association.
What are your thoughts on leadership?
If you're passionate about case management, it might be time to advance through involvement. There are (5) open positions on the CMSA National Board and applications will be accepted through October 31st. Share your voice, build your leadership skills and grow your network. Learn more and apply: https://cmsa.org/board-directors-nominations/