Leadership can often be mistaken with management and the two do overlap. But while leadership and management in nursing and midwifery share some similarities, they are two distinct roles.
“The biggest difference is that while we have leadership skills inherent in all of us, management is more of a learnt process”, says RN and Academic Kate Hurley who oversees the Leadership and Management Major of James Cook University’s (JCU) online Master of Nursing.
“Good leaders do not have to be managers but managers have to be good leaders,” says Ms Hurley.
“Everyone is leading in their own way even if they don’t realise it”, says Ms Hurley who has diverse clinical experience and has been in managerial and education roles for the best part of her nursing career.
“Leadership is a constantly evolving process. You have certain skills as a novice health practitioner built into your day-to-day practice through engagement with patients, families, and colleagues.
“As we mature, the way we utilise our skills and the context in which we lead changes. The development of these skills and our confidence in applying them to our role evolves.”
Anyone can be a good leader if they display certain attributes and set a positive example for others. Some common traits of good leaders include being approachable, open, optimistic, and compassionate. Effective clinical leaders contribute to creating a healthy, functional, and supportive work environment.
“Effective leadership is critical to trust and respect, collegiality, and workplace engagement. Good leadership leads to positive health outcomes and a healthy workplace culture,” says Ms Hurley.
On the flip side, ineffective leadership can lead to poor workplace culture and workplace inefficiencies, which can impact staff satisfaction and retention.
Ms Hurley suggests three key attributes that provide balance as an effective leader.
- Compassion: leaders create an emotional connection, taking people with them. Evidence shows people are more willing to follow the lead if they feel connected.
- Resilience: having emotional and mental strength, a positive mindset. When things go wrong, people turn to a leader to pave the way. Good leaders have an ability to adapt quickly and strive under pressure.
- Honesty: Showing honesty and being vulnerable to share past failings and inadequacies demonstrate that you’re not perfect, you make mistakes and you learn from them.
There is a need to step away from the pervading culture in nursing and midwifery of perfectionism which doesn’t exist, argues Ms Hurley and leaders demonstrate the way to do this. “People are already reluctant to own mistakes. If leaders can cultivate trust so people feel comfortable to share openly, they will feel safe to disclose errors and learn from their mistakes. This approach creates openness and transparency.”
“People inevitably make mistakes – we’re human. No one goes to work wanting to make a mistake. Nursing has a skewered idea about justice and equality. There’s this culture of wanting to punish”, concurs Melbourne public sector ICU nurse manager Nel.
Nel argues that people can only work well if they’re being cared for themselves.
“It’s really important to take the time to encourage the people you work with. As a manager, it’s about recognising those differences in your staff. You come to work every week day so you get to see a fair proportion of your staff.”
While leadership is something inherent, management is based on qualifications and experience of years in the role, says Ms Hurley.
“To manage effectively, you need to have had exposure in that context first. You cannot lead a team effectively if you are unable to relate to their experiences – you’re setting yourself up for failure. You need to be able to understand the crux of what that team is, likes or needs.”
Management also requires the skills and experience to deal with challenges such as workplace conflict. Effective nurse managers address conflicts or problems as they arise and support collaboration and open communication.
“Management requires putting out fires and having developed an approach that is going to work best in your context. You’ve got to have walked in the shoes of those you’re managing.”
World-renowned author and speaker Simon Sinek concurs, presenting at the International Council of Nurses Congress in 2023, he said: “I think we have to know what the job is as a manager before we start acting in it.”
Three skills that managers need in the healthcare environment, says Ms Hurley are: communication, innovation and engagement.
- Communication: Collaborate and share information with your team, encourage open discussion and be prepared to hear feedback. Staff need to be heard and appreciated. How people feel about change is constantly evolving. Listen to what is happening on the floor and how any changes that are being implemented are being received.
- Innovation: Healthcare managers drive change in the workplace. Managers need to keep up with evidence-based practice to deliver high quality care. Empower your staff and encourage and support your team by role modelling innovative behaviour. Build up the capabilities of people in your team who want to make change and improve practice – the evolution of our profession should be a shared responsibility.
- Engagement: Don’t switch off – it’s easy to become trapped at your desk and busy with meetings. Empower your team by engaging them regularly. If you’re managing people build positive team culture with connection and engagement.
Reflection is a really good tool for both leaders and managers to monitor how they’re going in the role, says Ms Hurley. “It encourages you to identify weaknesses and learn from your mistakes. People often say they don’t have the time to reflect, but it’s important to set aside time to look at your growth and appreciate where you’ve come from and see where you’re going.”
The Leadership and Management Major in JCU’s Master of Nursing covers four topics: Leading and Managing in Health, Ethics and Health Management, Business and Finance for the Health Manager and Conflict and Dispute Resolution in Healthcare. For more information, visit www.jcu.edu.au/online-courses/master-nursing
