This chapter discusses the challenge of reducing health disparities by training peer educators, and thereby effectively cultivating Black leadership and potential partners for participation in ethnographic community-based participatory research. Such community insiders may, also, ideally, be members of hard to reach subpopulations, such as Black men who have sex with men (MSM) and face intense cultural-based and societal-wide stigma and homophobia. The chapter explains the rationale for peer education to address HIV/AIDS. It highlights how the use of evidence-based and theory-based models can be useful in the design and implementation of effective peer education training programs that not only prepare peer educators to educate others, but also prepare peer educators to overcome any personal stigmatizing attitudes and behaviors, and empower them to address stigma when encountered in the community.

Crisis situations are common in the care of acutely and critically ill patients. A psychiatric crisis calls for de-escalation strategies, security personnel, sedation, and restraints. During a crisis, in addition to providing direct care in response to the patient’s urgent physiological needs for intervention, the nurse must also prepare, orchestrate, and coordinate multiple aspects of the environment. Acute and critical care environments are generally set up at all times for a possible emergency. Experiential leadership is seeing what needs to or must be done before or during a crisis and doing it, even though a physician is present. Recognizing clinical talent and marshaling skilled clinicians requires astute clinical judgment and skill and is a pervasive aspect of caring for critically ill patients in crisis. An aspect of skilled know-how required for smooth management of a crisis is modulating one’s emotional responses to assist others in their ability to function well.

The term genius is peculiar. It can be applied to a diversity of phenomena or confined to just one or two. The tremendous range in usage reflects the fact that genius is both a humanistic concept with a long history and a scientific concept with a much shorter history. The word genius goes way, way back to the time of the ancient Romans. Roman mythology included the idea of a guardian spirit or tutelary deity. This spiritual entity was assigned to a particular person or place. Expressed differently, geniuses exert influence over others. They have an impact on both contemporaries and posterity. The exemplars of intelligence have a feature in common: They are called as exceptional creators. The favored definition is that creativity satisfies few separate requirements. First, to be creative is to be original. In main, genius in the leadership domain of achievement appears to fall into several groups.

This chapter highlights how relational and clinical leadership skills are embodied by expert clinical leaders. Building and preserving collaborative relationships with others is the fundamental way of providing clinical leadership. An aspect of clinical leadership focuses on transforming and/or teaching others how to transform care delivery systems so that they become more responsive, effective, efficient, safe, and flexible in meeting patient’s needs. Many clinical leaders evolve by design. They are formally appointed into leadership roles, such as clinical nurse specialists, acute care nurse practitioners, and charge nurses. Multiple and nuanced patient transitions are a major source of the complexity in caring for acutely and critically ill patients. Gaps in patient care have always been problematic, but the recent and rapid changes in healthcare have escalated this already difficult problem. Hospitals spend a great deal of time educating nurses about new procedures, technology and regulation.

This chapter discusses the historical background of the mentor connection and mentoring relationships in nursing, different types of support relationships and mentors. It also discusses why and when nurse need mentors and early career challenges and mentoring. The mentor connection is a developmental, empowering, nurturing relationship extending over time, in which mutual sharing, learning, and growth occur in an atmosphere of respect, collegiality, and affirmation. Clearly, mentor connections and networks were integral to the developmental experience of successful career-oriented men. Mentoring is a vital component of professional nursing and that mentors are essential for nurses’ ongoing development and leadership achievement. In organizations, mentoring relationships serve as an antidote to disrespectful attitudes and behaviors among nurses and physicians and other health care providers. Mentors mentoring activities can be broken down into two categories: career functions and psychosocial functions.

This chapter talks about becoming a mentor-leader: Beliefs and behaviors, mentoring across cultures and generations, and mentor as Pygmalion: Believing in potential and expecting success. Nurses can learn leadership by observing good leaders, mentors, and role models; studying leadership theories and research; testing leadership behaviors through work and professional association activities; and using reflective learning to develop and fine-tune nurse’s behaviors. Mentor-leaders are present in every cultural and ethnic group and in every generation. Global, cross-cultural, and cross-generational mentoring occur when nurses are open and receptive to learning from each other and are willing to share their unique perspectives and skills. The nursing profession has an impressive track record of global collaboration and mentorship. Through mentor bonds that break down global and cultural boundaries, nurses have unprecedented opportunities for driving change in health and nursing around the world.

This chapter discusses the effects of personality with respect to the other, that of getting ahead. The literature examining the impact of personality on career-related outcomes is vast and stretches back to the beginnings of psychology. The chapter reviews the most important research and paradigms concerning the areas of: academic achievement, work performance, leadership and entrepreneurship. Early reviews of the relationship between personality and job performance seemed to suggest that personality was a trivial or insignificant predictor of job performance. Psychological theories focusing on leaders’ personality or traits were influenced by Carlyle’s ‘Great Man‘ theory of leadership, which posited that ‘the history of the world was the biography of great men’. Over the past 20 years, an increasing amount of attention has been given to the area of bad leadership. The literature on personality and leadership suggests that a leader’s personality has a substantial influence on how the group performs.

This chapter explores some of the skills that might help people be more comfortable in taking the role of a facilitative leader. The ability to listen is one of the first skills people develop as human beings. Listening with intent is a practiced skill that every social worker those in clinical settings and not should have as part of his or her skill set. The facilitative leader helps the group move through its process by providing the leadership needed to accomplish the outcome. It is about breaking impasses, modeling behavior, using the right tools at the right time to keep focus and progress. The role of facilitative leader transcends those of chairing the group process, providing training or teaching a class, or being the facilitator of a meeting. Once one’s group has the racial, ethnic, and cultural diversity desired, facilitative leaders ensure and affirm voice of all members.

The facilitative leader has to possess the skills to intervene while still being very much a part of the group process. The facilitative leader social worker help to create a positive group environment that enables good communication like talking face to face or changing the space. In a traditional facilitation approach, group intervention can be described as an action, or series of actions that the facilitator takes to change the group’s current behavior. From a facilitative leader’s point of view, an intervention includes three steps: observing and diagnosing what is happening in the group, hypothesizing what one would like to have happen in light of the group’s task or developmental phase and doing something that encourages change. This chapter depicts a diagnosis-intervention cycle that incorporates these steps. At each stage of the intervention process, it is important to keep the facilitative leader’s values of respect and empowerment.

One secret to the art of facilitative leadership is preparation. Social workers prepare prior to seeing an individual client and work with a group a team, community gathering, or multiagency task force requires prior preparation. All groups create norms and group culture whether spoken or not and it is generally harder to undo or alter the established norms of a less-than-productive established group. This chapter helps one to be personally and professionally ready to be a participant, a facilitative leader no matter what their position is in the group. It covers the infrastructure and support of the group’s operation from minutes and communication to the seating arrangement and meeting site. The facilitative leader will be sensitive to cultural rules about voicing opinions and to gender and status mores that may play out in the dialogue. In addition to preparatory empathy, the facilitative leader engages in self-reflection and reviews previous interactions with other group members.

The facilitative leadership role calls for a great deal of flexibility and creativity in helping make groups work, whether one is the formal leader or a participant in the group process. Tuckman, in his 1965 seminal work on the stages of group development, ‘Developmental Sequence in Small Groups’, described a group as going through steps of maturation he called forming, storming, norming, performing and adjourning. Social workers are often called upon to provide valuable content to groups while also being the person who formally facilitates the group process. Facilitative leadership, like most things in life, is about balancing process. This chapter discusses groupthink, how to assess its presence, and how to minimize its influence. However, the facilitative leader will be wary when the group is functioning so well that it just seems to be too good to be true.

Louise Woerner, the author has often been called a friend of nursing. From her perspective, she is an admirer of nursing and nurses. In fact, she is virtually in awe of nurses. She became part of the health care system through a turn in her business concept based on the regulatory environment in New York, and through that, an admirer of nurses. Over the course of her career, she has come to know there are many different types of nurse leaders. Leadership has to incorporate some exibility based on the situation and the goal. Home Care Rochester (HCR) began a successful “Roadway to Independence” program that took the home health aide employees from “bussers” to car owners, which enabled more care to be delivered in the hard- to-reach suburbs, and offered a new opportunity for both the patients and employees. Home care is a nursing-driven business with quiet leaders.

David C. Pate learned about nurses as leaders from an early experience as a volunteer in a busy surgical intensive care unit. The professional status imbalance between medicine and nursing is often learned in medical and nursing education, and certainly often is dominant in the clinical arenas. One of Pate’s most important messages is the potential for nursing leadership in health care delivery in the future. The chief nursing officer (CNO) was an integral part of the team expected to be able to explain the vision, inspire the employees to achieve their goals, demonstrate accountability, participate in setting the strategies, and engage in their team meetings whether the subject involved patient care or not. The CNO/nurse executive will be critical in redesigning the health care delivery system of the future. Nurses and nurse leaders can and must lead this change in the care model together with physicians and other providers.

Jerry Cromwell has a rich history of both preparing nurse leaders in research and collaborating with nurse researchers. On the basis of his extensive experience, he offers cogent advice on leadership roles that nurses can fill in research on health care policy formulation and implementation that will change the course of health care payment, delivery, and quality throughout the United States. Cromwell believes that nurse researchers can provide leadership through the development of skills in management, program development, research, and teaching. To illustrate the characteristics of nurse research leaders, Cromwell describes one such leader with whom he has worked for more than two decades. He details her skills in project leadership, her technical research skills, and her management skills. Cromwell also identifies other nurse researchers who are leading policy development at the government levels, including those at some of the top federal agencies.

This chapter provides an overview of leadership and discusses several historical and current leadership theories. One’s path to becoming a facilitative leader involves learning about some of the theories and research about leadership. Equally important as the concepts of leadership are the views those theories articulate about followership. The trait theories come from historical roots that the leader is a great man and a hero. Leadership is often presumed in people with high positions, including corporate CEOs and directors of agencies. Administrator is a neutral position, and persons in that position may be perceived as positive or negative according to the leadership values they bring to the job. Social workers must engage in leadership and also that their efforts should address issues of social justice and injustice. Like Theory X-Theory Y, situational leadership is a theory designed around how those in leadership positions perceive followers.

Over the years, many of the participants in the authors’ facilitative leadership training programs have worked to implement facilitative leadership in their agencies and community organizations. The authors have asked them for recommendations on how to increase facilitative leadership skills. While the authors had attempted to demonstrate that facilitative leadership is greater than the sum of leadership and facilitation skills, having some materials that build both of those skills can greatly benefit individual social workers and their agencies. Whenever possible, persons with good facilitative leadership skills within the agency or community organization and outside facilitators are paired with other individuals so they can observe the skills being put into practice. Asking group members with limited experience in serving as the formal facilitative leader to take various parts of the group process is an excellent way for them to build skills. Facilitative leadership and social justice are two strong, stand-alone concepts.

The author, Arthur G. Cosby speaks about his mother, Lillie Mae Mclntire Cosby; a nurse who led him to understand what constitutes leadership, his responsibilities to others, and the role of women in the modern world. In his mother’s mind, discipline was a critical aspect of good health care. As head nurse, she supervised large number of junior nurses, aids and orderlies, many of whom had limited formal health care training. It was very important to him that he had a mother who could do so many things and do them well. Not only was she a mother and nurturer, she was also a woman who was the breadwinner, who could successfully carry out most any job even the most difficult. Over the course of her career, she actively carried out the health care responsibilities of head nurse, hospital administrator, emergency room nurse, obstetrics nurse, public health nurse and nurse practitioner.

In times past, leadership of schools of medicine and nursing would have directed their efforts to the education of autonomous professionals. Our educational systems have matured to the point that they focus, in a collaborative professional practice model, on the tenets of our professions and the needs of those we serve. In the health care setting, be it subacute or acute; inpatient or outpatient; low or high intensity; or community or academic in its orientation, each patient needs advocacy. Interprofessional clerkships allow nursing students to form teams with their future health care delivery partners, as they pursue learning opportunities in clinical, community, and policy pursuits. Nurses can play a key role in the education of patients and the improvement of the patient condition.

This chapter presents the address of Steven C. LaTourette, a former member of the U.S. Congress and co- chair of the Nursing Caucus in the U.S. House of Representatives. He addresses the role nurses can and should provide in shaping national policy. The nursing profession must engage a more signifcant percentage of its constituents to be influential. For the last several sessions of the Congress, LaTourette have had the pleasure of being the Republican co-chair of the Nursing Caucus in the House of Representatives. Congress had earlier adopted locality pay schedules for Veterans Administration (VA) nurses that were designed to increase nursing salaries: a noble goal since a large number of VA nurses were, at the time, on average 55 years of age and women. The staff can also be a resource for how the Congress works and assists you in going from great idea to great law.

Facilitation is a process in which a person or persons, acceptable to all members of the group, substantively neutral, and who has no decision-making authority intervenes to help a group improve the way it identifies and solves problems and makes decisions in order to increase the group’s effectiveness. Being acceptable to all members is significant, because facilitation has some similarities to therapeutic roles social workers use with treatment groups and individuals. Neutrality is key difference that distinguishes a facilitator from a facilitative leader. An effective facilitative leader monitors the group dynamic, offers process suggestions, and intervenes as needed to help the group stay on track to complete tasks with a high level of member satisfaction. The National Association of Social Workers (NASW) Code of Ethics is a guide to help social workers use themselves in the ethical way possible to embody the values and principles of the social work profession.

This chapter discusses how one understands the group process and put it to work in practical ways: developing ground rules, building an agenda, conducting dialogue, and helping the group to make decisions. Rules can cover a broad range of areas that affect group process. Facilitative leaders should become aware of these categories for establishing norms or ground rules. Every group process has an agenda. Spending some time on understanding how a group makes a thoughtful agenda is the best way to avoid the unproductiveness. The outcomes may be generated by the group members themselves as they assemble in response to an idea, event, or movement for which some action is desired. Dialogue process is important as the decision-making session begins to make a list of the various alternatives mentioned in the dialogue or to do an idea-generating exercise such as brainstorming to make the list.

This chapter lays the foundation for facilitative leadership from the unique social work perspective. Social work’s Code of Ethics and social work practice principles contribute to the value-based leadership that is part of the facilitative leader’s core. Among the important expectations of social work leadership are cultural sensitivity and competence. Five discussion areas have been selected as essential to facilitative leadership from a social work perspective: inclusion, strengths-based leadership, power and the difference between power over and power with, oppression and social justice, and the elusive but critically important concept of empowerment. There are different types of power and power relationships such as productive power and destructive power. Being conscious of privilege and oppression are precursors to understanding social injustice and working toward social justice. The social work program identifies social justice as a professional obligation of social workers to attempt to improve the quality of all people’s lives.

This chapter shows some of the participants’ observations when there was little or no facilitative leadership present. Group members had a general expectation that achieving a consensus was the preferred result in all but the most formal meetings. Communication among group members was often directed to or within small subgroups. Once facilitative leadership trainees were introduced to the dialogue process, they noticed that many meetings were absent a listening process that informed decision making. Evaluating outcomes of facilitative leadership in social work practice requires examining its fit with the National Association of Social Workers (NASW) Code of Ethics. The facilitative leader reminds members that no group is perfect and if, over time, progress is made, it warrants a group celebration to acknowledge the group’s continuing development. Facilitative leaders guide the group to develop evaluation questions for its own outcomes and impacts, questions that relate to the group’s purpose for being.

Karen Gross shares eight lessons learned about leadership that occurred not from leading per se but from the process of hiring an academic nursing leader. The search now successfully concluded gave her an opportunity to reflect on what type of health care leader they were seeking at Southern Vermont College (SVC). Although not a health care professional, she spent more than 15 months thinking about leadership in the context of nursing. The whole search process from creating the job description to identifying a quality candidates’ pool to interviewing and ultimately selecting a divisional chair to helping the successful candidate see the fit with the institution allowed her to consider what qualities are critical to nursing leadership within the academy. In an interesting way, the search for a leader in nursing enabled her to think more effectively about leadership, and in the world of unintended consequences, made her a better leader.

Kate Judge’s first glimpse of nursing leadership in action came the day she arrived at the University of Pennsylvania School of Nursing for an in-person interview to lead Penn Nursing’s development and alumni relations program. During her 8 years at Penn Nursing, she collaborated with a number of faculty members who were gifted in attracting philanthropy. Leadership in philanthropy combines a deep personal moral purpose and the perfect balance between impatience for immediate impact and a desire to achieve long-term outcomes. To be a nurse leader in philanthropy, one must expose oneself to other values, interests, and priorities. Nursing can assume a larger role in tomorrow’s health care delivery if it commands a larger portion of U.S. and global philanthropy. Finally, to be leaders in philanthropy, nurses need to educate themselves about the larger world and the values and issues that resonate with donors.

Scott Reistad is a storyteller, and throughout his entry he entertains readers with his unconventional ideas about nursing and about leadership. In today’s health care, there is a tendency to consider “nursing” as the work of a person who is a registered nurse (RN). It has been said that all employees in hospitals are caring for patients, either directly or indirectly. There are the individuals who deliver direct patient care and those who support those who give the direct patient care. Betsy Sanders, a former Nordstrom executive, states that often the lowest paid, shortest-tenured, entry-level employees have more interaction with the patients than the leaders. “Nursing” leaders have a tendency to have read thousands of pages of textbooks about the technical aspects of their job. Yet they get promoted into leadership and believe that they should just magically know what to do to lead effectively.

The increasingly more complex, diverse, and interdisciplinary facets of the health care system prompted the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF) to join together and assess the current state of health care, thus issuing a “call to action” by the nursing profession. This monumental report challenges nurses to practice to the full extent of their training, transform health care and improve research and information systems. The heightened roles of the professional nurse allow nurses of all practices to more fully develop their leadership skills. The author’s, Greer Glazer, personal and professional life changed when she was notified by the RWJENF Program that she was a finalist for their leadership program. Doctor of Nursing Practice (DNP) programs are designed to prepare nurses for the highest level of leadership in practice that is innovative, evidence based, and reflects application of research.

Every group is a collection of unique individuals who bring a variety of relationships, skills, emotional issues, and desires into the group process. If people make it a point to observe those attributes of the persons in the group, it will make their facilitative leadership effective. The acts of communication are the construct of the group process. Dominant group members tend to be the talkative, volunteer quickly, are assertive with their opinions, and perceived as engaging by other group members. The facilitative leader observes the task sequence for several purposes. The facilitative leader, formally leading the process or not, would be wise to understand the emotions present in the process and find ways to respond appropriately to benefit the whole group. Groups are constantly making decisions, sometimes on purpose, sometimes not. The facilitative leader observes a group’s dysfunctional behaviors to determine if there is cause to intervene in the process.

The author, Carol A. Cartwright, had the privilege of leading Kent State University and Bowling Green State University public research universities for nearly two decades. In these roles, and in the other leadership posts within academe that preceded them, she have witnessed and experienced the inextricable link between personal development and professional progress. Her leadership path challenges the common perception that successful leaders are born, complete with the requisite temperament and talents. She accepted a faculty position at The Pennsylvania State University. A colleague who observed her in various meetings noted that she had leadership potential and encouraged an intentional exploration of leadership opportunities. Self-knowledge is a psychological prerequisite for effective leadership in general and for leading change in particular. It is nothing less than essential for current and aspiring nurse leaders who want to help transform health care in ways that benefit society and the nursing profession.

Basic management and leadership skills are necessary for nurses in all levels of the organization. Leadership is a key standard of correctional nursing practice as defined by the American Nurses Association. As a licensed health care professional, nurses have a legal and ethical responsibility to appropriately delegate tasks within the health care team. The American Correctional Association (ACA) accreditation program is a voluntary accreditation process evaluating the service delivery of a correctional facility. National Commission on Correctional Health Care (NCCHC) standards are widely recognized as a basis for effective health service delivery in the correctional setting. The health care programs operated by Federal Bureau of Prisons (FBOP) have been accredited under the ambulatory health care standards of The Joint Commission (TJC). Effecting organizational and clinical change through a structured process and attention to the human factors of change can move a clinical program forward, even in the challenging correctional environment.

In Johnnie Maier’s description, the true leader is the symphony conductor, who creates the vision and the direction that merges the many sounds into harmony. For Maier, the most important lesson for a nurse leader is to learn the skills of the symphony conductor achieving harmony, balance, and an extraordinary performance without making a sound. Nurse leaders would do well to study the orchestra conductor’s understanding of his/her work and leadership role. Because of the foresight, the vision, and the direction of a few legislative leaders, the health care professions involved, nurses and others, were able to play their instruments together. Observing the orchestra conductor is key to understanding how good leadership should work. A leader must combine vision and direction with an understanding of those he seeks to lead. An effective leader must strike the right balance between task orientation and people sensitivity.

This chapter addresses an influential aspect of leadership in nursing how it is perceived by others. The term “nurse” represents a wide range of roles, work experiences, and educational levels. Duke University Hospital (DUH), the flagship hospital of the Duke University Health System (DUHS), is a 924-bed tertiary care facility, and Kevin Sowers, serves as its president. The chapter highlights two recommendations salient to the issue of nursing leadership: expansion of opportunities for nurses to lead and diffuse collaborative improvements; and preparing and enabling nurses to lead change to advance health. The future is bright for nursing, with increasing roles and responsibility, particularly in leading and providing direct primary and advanced care. Health care cost is growing at unsustainable rates with challenges of providing access and achieving consistent quality of care. Modernizing nursing education and training to meet the emerging and complex needs also requires strong leadership as well as partnerships.

Nurse leaders should be poised for change. One of the common themes across entries was that nurses are central to the changes occurring in health care and that they should seize the opportunities to be in charge of the redesign of the U.S. health care system. There was another strong theme that permeated the entries: that of the knowledge necessary for nurse leaders in health care delivery. To assume leadership roles in a new delivery system, nurse leaders are advised to understand policy and finance and the roles of all team members. Furthermore, leadership must be about the organizational goals, not one’s individual goals. Self-knowledge is essential, including the understanding of how you are reflected in the eyes of others. A high level of self-confidence is essential for leadership. Other important developmental needs for nurse leaders include quantitative skills and technological expertise, including electronic and digital forms of communication.

The care management nurse faces a different task than the nurse in the inpatient or outpatient setting. The focus for the latter is typically narrow: care for the patient during the acute treatment, then releases the patient to home, a nursing facility, a step-down unit, and so on. This chapter discusses the Triple Aim of care, health, and cost, which serves as a framework to discuss other key dimensions of leadership in managed care. A nurse leader’s basic skill set is similar to that of a nurse leader in any role. Innovative organizations are realizing that successful clinical management can be a huge competitive advantage for both employers and health plans. This sector of the medical industry is poised for explosive growth as population health management takes center stage in the era of health reform.

According to Shawn D. Mathis, leadership is always defined by the leader’s character. He identifies the true leaders in health care as the nurses on the front lines, the nurses who “share our pain”. Nurse leaders today would agree with Mathis; indeed, much of the current emphasis within health care organizations from the nurse leaders’ perspective is the empowerment of nurses at all levels. Talent and skills are important, but any good manager can display both talent and skill, and not rise to the level of a leader. The true leaders of the health care industry are on the front lines of health care delivery, wearing stained scrubs, and hearing their names called 24 hours a day, 365 days a year. It is a monumental failure of nurse industry “leadership” because organizational strength is often measured by how an organization treats its people.

As a clinical pharmacist, Al Patterson has shared-many experiences with nurses; he reflects on the key dimensions of nursing leadership and describes the similarities between the professions of pharmacy and nursing. He believes that nursing leaders recognize the societal responsibility inherent in their role, and the professional responsibility to provide the most meaningful care to each patient and to structure the environment to ensure safety and quality. There are several things that stand out to me as examples of the transformational nature of nursing leadership: patient advocacy, professional development, and most important, the focus on quality and safety. Initially many department leaders volunteered staff for quality advisor (QA) training, and over 160 teams were formed to address a wide array of problems. Central to the concepts of shared leadership/shared governance is the recognition that the profession must continually improve itself.

Anne Rosewarne has a wealth of experience working with nurses at all levels in many different roles. Through the Council a leadership development program was established, focused primarily on preparing nurse managers as leaders within their health care facilities. The purpose of the Leading Toward Tomorrow project was to design, implement, and evaluate a comprehensive Leadership Development Program (LDP) that would assist in a nurse’s leadership growth. The national and state changes in the delivery and reimbursement systems will continue, with nurses poised as well-trained, cost-effective leaders in the shortage-ridden primary care workforce. New opportunities in an evolving health care system will also include nurses engaging as team members in interprofessional (IPE) settings. Nurse policy leaders could develop in-depth understanding of other members of the health care team, their practice parameters, and relevant health policy issues. Diverse involvement is also low among nurse leaders both in practice and academia.

The second decade of the young publishing company brought several changes that pointed to the future characteristic of Springer Publishing Company. While the 1950s were strong in medical titles, combined with some nursing and important psychology titles, during the second decade of the young company, a clear shift is noticeable: only 5 books on medical topics, 4 on veterinary topics, and 13 in psychology came out, but 20 new nursing books were published. Very little expenses for promotion were required as most of the customers were subscribers and agricultural machinery and equipment dealers who sold the books to their farmer customers. Books on leadership techniques, on clinical teaching, were joined by such titles as The Nurse and Her Problem Patient by Gertrude Ujhely, Perspectives on Clinical Teaching by Dorothy Smith, New Directions for Nurses and Issues in Nursing by Bonnie Bullough, and more on similar levels.

This chapter explores how three successful nursing leaders, using different leadership approaches, demonstrate traditional leadership attributes such as strategic vision; risk-taking and creativity; interpersonal and communication effectiveness; and inspiring and leading change. It discusses the opportunities and implications for nursing leaders and those external to the profession to develop collaborative and transformative partnerships to advance quality health care. Pragmatic leaders demonstrate leadership excellence by effectively translating their nursing care assessment skills into the ability to approach organizational problem solving and decision making in a systematic, logical manner. In contrast to the present-needs focus of pragmatic leaders, charismatic leaders are vision-based leaders who predicate their leadership agenda on attaining future goals. Each of the three nursing leaders profiled understands the importance of being politically astute and effectively leveraging power and influence to make value-added contributions. To varying degrees, the various constituents of the nursing leaders profiled view them as socialized leaders.

Fatherhood is a socially constructed notion that arises within the gender, economic, and political structures that underlie families. Historically the meaning of fatherhood in the United States has shifted from “moral leader” during the Colonial period to “breadwinner” as industrialization took fathers out of the home. Recent decades have given rise to a new ideal, the nurturing father. This chapter focuses on the partner-relational processes that support the development of this new model of fathering. Workplace norms and governmental policy have also been slow to recognize that fathers’ responsibilities for children extend beyond bread-winning and exist independently of their relationships with mothers. The chapter presents the results that distinguish father responsivity as the key relational process through which changing societal notions of gender, work, and family play out within the emotional world of families and help to clarify the conditions that support its development.

To celebrate the 25^th Anniversary the author invited various authors, business partners, and friends in publishing from the New York region, and asked two authors to express some thoughts about Springer Publishing under the new leadership. Later the ladies, gentlemen, colleagues and friends who came to attend the anniversary party. The author recollected some of the memories and shared with them. The first book published was Rudolf Seiden’s Livestock Health Encyclopedia, and it was Fred Praeger, the publisher then working as an agent, who provided the manuscript. The second publication was a book in nursing, Cardiology for Nurses, by Dr. Walter Modell. Medical books were a natural for the son of the Springer-Verlag family, thus in his own company a number of books in neurology, on brain tumors, also lung diseases were published in the 1950s.

This chapter provides an alternative view of traditional leadership, describing assumptions of leadership in global health and how these assumptions, along with leadership skills, can be adapted fluidly among members of global health projects in order to maintain partnerships. Global health nursing leadership occurs within organizations and the highest levels of government, but the concept of leadership in global health nursing extends to nurses working within nongovernmental organizations or serving as volunteers on health care teams. Critical team leadership roles include the following: convener, visionary, strategist, and team builder. Leadership roles will continue to emerge throughout the partnership as the need arises, and partners will assume leadership roles according to their personal and professional skills as well as experience. The chapter then provides two case studies that demonstrate the challenges involved in maintaining partnerships between academic institutions in different countries.

This chapter examines concepts in nursing, and explains delegation, including a student survey research project, prioritization, leadership styles, team management, and supporting research. It describes personal protective equipment (PPE) and palliative care. Nursing students must learn how to delegate. Delegation involves giving another person the authority to be responsible for completion of a task. The licensed practical nurse or licensed vocational nurse (LPN/LVN) can perform wound care, suctioning, urinary catheter care, and blood glucose readings. The nursing student can perform simple concepts such as patient coughing and deep-breathing exercises, simple assessments, and administer oral medications under the instructor’s supervision. The nursing student must review certain terminology in order to engage in a decision-making process that provides optimal nursing care. Leadership, or the ability to lead, must be developed at every level of nursing. Palliative care is the umbrella concept that includes both comfort care and hospice care.

This chapter talks about the use of self as a valuable teaching tool and describes available tools and insights to facilitate understanding self. It discusses the importance of leadership behaviors in the classroom. The chapter explores the development of characteristics of successful educators and talks about the value of reflective practice. The primary tool the educator has when teaching in a classroom is self. Perhaps the easiest way to conceptualize the importance of self is within the Emotional Intelligence framework. Self-awareness can lead to understanding how one handles or manages one’s self in a variety of situations. The relationship management aspects of emotional intelligence address the ability to work well with others and to utilize the understanding of self and others in subtle ways that induce desirable responses in others. Leader behaviors can be observed in the classroom, as leaders create a vision through imagination and dreaming.

This chapter helps reader to develop a professional curriculum vita for entry-level career positions. Preparing applications for the first career position is the culminating event of years of professional training and competency building. The American Psychological Association (APA) defines the postdoctoral fellowship as a temporary period in which postdoctoral graduates receive highly individualized mentoring and supervised training to obtain essential skills for one’s chosen career path. A postdoctoral teaching appointment can expand the competency as a faculty member by broadening experiences in presenting varied course topics, participating on college committees, attending leadership meetings, and involvement in program development. Postdoctoral supervision for seeking a license to practice psychology also may permit individuals to obtain specialty credentialing. Additional listings of postdoctoral openings may be found in several journal and professional organization publications such as the Chronicle of Higher Education and the APA Monitor.

Interprofessional simulation (IPS) can aid in the development of knowledge and skill required for collaborative practice. IPS can also have a positive influence on students’ attitudes and perceptions of their own and others’ unique contribution to the health care team. Thus, IPS scenarios are an excellent way to support the development of interprofessional collaboration, role clarification, and leadership skills of health care students. A needs assessment should be completed before the development of a simulation scenario. When creating this scenario, the authors reviewed current trends in nursing education, feedback from clinical partners, and our health studies programs’ curricula. The scenario was designed to help students recognize scopes of practice and develop interprofessional skills. These skills include communication, collaboration, and shared leadership. Through interprofessional collaboration and communication, the team bachelor of science in nursing, practical nursing, and health care assistant students should determine that their patient has experienced elder abuse.

This chapter explores how to role model professionalism and how to role model a passion for teaching, for the profession, for patient care, and for learners. It examines the power of your attitude and positive reinforcement with importance of preparation and practice. The chapter focuses on the importance of developing relationships with learners and role model of being a functioning nurse. The leadership research frequently addresses attitude for both the leader and the follower. Most of us began a nursing career with excitement, commitment, and a love for nursing and caring for human beings who are sick and in crisis. Liesveld and Miller identified that relationships are what drives the learning experience. By role modeling the positive attributes of professional behavior, a positive attitude, a passion for nursing and teaching, and by building relationships with learners, the educator can enhance the learners’ experience and knowledge acquisition.

This chapter examines the case of an interprofessional education (IPE) initiative in order to highlight the significant role that nursing can play in building a new program for interprofessional learning. Though it recognizes that many forces and stakeholders are necessary to the success of transforming health professions education and health care delivery locally and globally, it uses this case to illustrate nursing’s role in supporting and leading these efforts at one institution. Through this case study and discussion, the chapter considers how nursing leadership can influence the development of a new IPE program, subsequently enhancing the profile of nursing and strengthening the current and future leadership capacity of the participating nursing students and faculty. The opportunity for the profession to demonstrate leadership in interprofessional education and practice will create systems of care that monitor health needs of individuals, families and populations in relation to complex evolving health care systems.

Faith-based organizations (FBOs) are of particular interest in realizing this goal, especially in many parts of the developing world, since they often provide the only infrastructure reaching rural areas. Religion has long been recognized as wielding a significant impact on the health and well-being of individuals, families, and communities across the globe. This chapter discusses the lessons learned by the authors based on their experiences of working with FBOs in Malawi, an impoverished country in southern Africa, to address the HIV/AIDS crisis that has claimed nearly 1 million lives in the past 30 years and produced 770,000 orphans. FBOs provide critical infrastructure, particularly in rural African communities from both a leadership perspective and social support. The role of FBOs in health matters is of critical importance in encouraging health-promoting behavior as well as care-seeking and caregiving behavior when members fall ill.

Leadership is defined as the “process of influencing people to accomplish goals”. Management involves not only leadership but also “coordination and integration of resources through planning, organizing, coordinating, directing, and controlling to accomplish specific institutional goals and objectives”. The nurse must demonstrate leadership and management skills in interacting with clients and their families and with nursing colleagues. The contemporary view is that the manager focuses on planning, monitoring results, decision making, decision analysis, resource control, and development. Critical thinking, active listening, and coping skills are essential at all levels in today’s nursing workforce. Creating a healthy work environment requires strong nursing leadership at all levels of the organization. Shared governance impacts client care by including nurses at all levels in organizational decision making regarding client care. Nursing role in shared governance may be included in their job description.

This chapter explores the need for nonprofits to have leadership, particularly board membership that will help them to weather the current economic times and come out on firm footing for the future. It considers how government, business, and foundations can play an important role in building nonprofit capacity. A 2010 study of the nonprofit sector by the Philadelphia Foundation (TPF) concluded that the financial fragility of nonprofits is often rooted in the business models under which they operate. The nonprofit sector comprises a large part of the economy in many U.S. cities, and it has grown tremendously. Communities across the United States need to recommit to effective nonprofit governance leadership. The chapter provides case study that illustrates leadership Philadelphia, mobilizing the private sector to serve the community; TPF’S capacity-building strategy two success stories; and the ins and outs: innovating through outsourcing.

This chapter helps the reader to develop a professional internship curriculum vita (CV). Given the role of internship in graduate preparation and finding employment after graduation, internship is among the most important decisions in graduate school. Regardless of the anticipated internship setting, all school psychology graduate students should prepare an effective and updated CV. Both are designed to outline the education and professional experiences. The professional experiences include practica or internship experiences, volunteer experiences, graduate assistantships, leadership experiences, editorial work, or other related work experiences. Selecting an internship site presents an exciting yet potentially stressful opportunity. Some districts allow interns the opportunity to participate in brief “rotations” in specialized centers or settings within the district to help create a broad and diverse learning experience. Some doctoral school psychology students may plan to pursue internship settings that either blend school and clinical settings, or are almost exclusively clinical in nature.

Since ancient times, self-knowledge has been regarded as the key to effective leadership. No nurse is good at all aspects of nursing; therefore, each nurse needs to figure out what will be her or his area of special contributions. Instead of focusing largely on weaknesses, organizations should identify their employees’ strengths for the purpose of using them strategically and then managing to those strengths. It is better to admit one’s limitations early on, and deal with them, rather than spend years trying to hide them. No one really likes criticism, but criticism is the lifeblood of professional development and improvement; therefore, leaders need to know how to give and accept criticism in an ego-enhancing way. Self-knowledge is never complete; it is achieved through ongoing introspection, candor, figuring ourselves out in different situations, and looking at ourselves through the eyes of others.

Influential leaders from each of the sectors public, private, and nonprofit in every region of the world have issued a call for leadership within and across sector boundaries, boundaries that have inhibited economic and social wealth creation in times of great need. The United Nations has worked to identify critical areas of focus and investment: extreme poverty and hunger; primary education; gender equality and female empowerment; child mortality; maternal health; eradication of HIV/AIDs, malaria, and other diseases; environmental sustainability; and global partnerships for development. Like many large organizations public, private, and not-for-profit Wharton has developed a set of seven leadership competencies to which it devotes significant resources and programs. The seven competencies that constitute the Wharton dimensions of leadership are influence, emotional intelligence, teamwork, communication, decision making, diplomacy, and organizational awareness. This chapter provides case studies that illustrate successful succession planning through leadership development; Ashoka: innovators for the public; Eisenhower Fellowships (EF).

This chapter focuses on leadership as transformational. Transformational leadership means moving a profession, an institution, or some aspect of healthcare down a new path with different expectations, structures, and ways of conceptualizing how the mission can be achieved in light of changing conditions. Looking back on all that nursing has achieved in the last half century can be energizing; it makes trying to do something different yourself not seem quite as daunting. Nursing is much stronger now as a profession than it has been in the past—larger, better educated, somewhat more diverse with a solid infrastructure, demonstrated outcomes, specialty expertise, a growing research base, more opportunities, and no longer time and place bound. Nursing’s commitment to the optimization of health and ability, alleviation of suffering, and advocacy hasn’t changed over time; values endure, but how they get expressed will vary as new sensibilities and knowledge become available.

Career opportunities are projected to grow faster for nursing than all other occupations through 2026. The advantage of a career framework with multiple stages is that one doesn’t start out expecting to be fully developed at the beginning. Mentoring is needed throughout a career, not just at the start. This chapter provides an overview of the career model that the author has fleshed out over time, greatly influenced by Dalton, Thompson, and Price’s classic article (1977) on stages of a professional career and subsequent work. There are five career stages whereby the individual moves from: (a) becoming prepared, to (b) demonstrating the ability to work independently and interdependently in achieving professional goals, then (c) developing others and the home institution, then (d) advancing the profession and healthcare, and eventually (e) daring to be a truth teller. Exerting leadership presupposes complete career development, going through all five career stages.

Neediness cannot be banished, but it’s possible to learn from each shortcoming, determined not to be derailed by either hubris or core anxieties. Taking on new leadership roles, we have to get in touch with warring expectations on the way to a more textured view of leadership and our sense of ourselves as leaders. There are a number of normal-crazy thoughts that get in the way of leadership; for example, wanting to be liked by everyone; believing that if you’re not perfect then you’re no good; thinking things should not go wrong. To succeed, nurses must realize that failure is commonplace. Expect failure, recognize root causes, and then proceed to learn from the experience—this process builds personal resilience. Learning environments that foster a culture of potentiality enable fledgling practitioners to persist in the face of failure because the emphasis is on improving over time.

This chapter describes the differences between management and leadership. The complexities of the nursing department demand both leaders and managers. Leaders also can possess management responsibilities and skills; likewise, managers, as well as people who do not carry management titles, can demonstrate leadership. Critical thinking is an important skill for both leaders and managers. Leaders and managers need to display the behaviors they desire and expect in staff, such as a positive attitude, team spirit, openness to learn, and adherence to high standards. Various styles can be used to lead a department or team to accomplish goals. Some of the common leadership styles include: Autocratic/authoritarian, Laissez faire, Democratic/participative, and Inconsistent. The chapter describes strategies to enhance communication and explains the steps in effective delegation. It discusses the methods that can be used in performance appraisal and explores measures for managing complaints. The chapter also reviews methods to improve time management.

In more recent times, the leadership literature has seriously questioned the longstanding exclusive emphasis on whether the person in charge has the right stuff on the grounds that leaders are substantially influenced by the situations they encounter, including their ability to harness their followers. In this view, a person might be an effective leader in one situation but not in another one. The longing to figure out who has “the right stuff” and how it can be taught to others is strong. Leaders develop over time rather than being born with “the right stuff”. Nurses as a group possess many of the abilities that leaders are expected to have; for example, integrity, practical intelligence, and systems thinking. Leadership is less a matter of brilliance and more a matter of persistence and being able to access and use the collective wisdom of others.

Strategic planning involves examining how your professional and/or organizational mission is being affected by changing circumstances, setting goals with concrete actions and a timeline, and then figuring out needed resources and expected outcomes. “The vision thing” at its best involves periodically embarking on a process of strategic planning whereby you examine how your professional or organizational mission is being affected by changing circumstances, and then set short-term and long-term goals with concrete actions and a timeline that moves you in desired new directions. Transformational leaders are deeply committed to the organization and its mission/values, make use of consultants so that they are not limited by the boundaries of their expertise, are willing to try something new knowing that not all good ideas work out, combine vision with practicality in figuring out how to operationalize the change process, and know how to use a range of individuals to the organization’s advantage.

This chapter stresses that one has to be involved in resource development if one wishes to play a larger role in shaping an organization. Nurses have to be resourceful to accomplish their goals and realize their values. Nurses in hospitals, universities, and other settings should play an active role in any fund-raising campaigns mounted by their institutions to ensure that their priorities are front and center as the public is engaged. Resource development is essential to organizational effectiveness, so it must be an expectation of professional leadership and not just a responsibility of those with administrative titles. Resource development can take many forms, from helping others take advantage of opportunities already in place and developing strategic partnerships to lobbying for new programs and fund-raising. Fund-raising requires one to explain the nature of nursing to stakeholders, lining up the values of our profession with what others value.

There is no aspect of leadership as gratifying as helping others reach their potential. It is rewarding in a way that other things aren’t because any investment in people pays dividends forevermore. Appreciating others includes giving feedback that is customized to the person. There is growing evidence that indiscriminate praise doesn’t change behavior positively, particularly if the commendation is for something relatively immutable like being smart. Appreciating others includes a broad range of behaviors—valuing the contributions of different kinds of people; respecting what each generation contributes to the mix; developing a community of learning so all continue to grow and develop throughout their careers; understanding that investments in people have a ripple effect because those who have been helped tend to “pay it forward” and providing timely and effective feedback that encourages improvement or advancement. Appreciating others also means valuing what others have done to help your advancement.

This chapter provides an overview of concepts that will explain both organizational and systems leadership. This knowledge helps the reader to enhance their current leadership and communication skills to more effectively provide high-quality nursing care. Describing the organizational culture and design in an organization will enable the reader to be an active, engaged member of the healthcare team. This engagement will encourage them to participate in patient safety and quality care initiatives aligned with organizational goals. The chapter discusses key concepts of an organization's professional practice model, shared governance model, and participation in strategic agenda planning that supports nursing clinical practice. These concepts support the registered nurse in gaining knowledge to promote and participate in a shared governance model. The shared governance model is often used as a strategy for healthcare organizations to ensure higher retention reorganizational test of registered nurses, increased job satisfaction, and empowerment of frontline nurses.

The importance of mentoring to nurses gathered steam in the 1980s with the growth of graduate education and specialty practice, the development of nursing research, and awareness of the paucity of role models as more nurses took on leadership positions. Building a mentoring network is the means by which one keeps up-to-date, surmounts limitations, discovers opportunities, and continue to evolve as a leader. The feminist critique of mentoring pointed out that not only had gender been ignored in who got mentored, but race and social class were also disregarded. The best way to grow our mentoring network is through professional organizations. Understanding the reciprocal nature of collegiality can be especially useful to top performers because their triumphs can engender envy and retaliatory behaviors; to counteract such competition, they should make sure that anyone who works with them profits from the relationship.

This chapter switches gears, away from what leadership means from the view-point of personal qualities to the perspective of what one need to do to achieve the goals of our workplace. Leadership is increasingly defined as the ability to work successfully with others to achieve the organization’s mission and goals. Stereotyped views of nursing stress virtue and busyness but not strength and innovation, thus reinforcing the notion that nurses are helpers, not leaders. The point of naming what one do is for others to see what one does and how one contributes to the organization as a whole. The more others see the contributions of nurses to the organization, the more nurses will be included in key decision-making forums. The more all nurses are expected to be leaders, the more nurse leaders cannot operate from a command-and-control framework but must lead by developing the leadership of others.

Nurses practice in environments that are filled with potential conflicts. This chapter helps the reader to further build upon nursing leadership skills by helping them to identify the sources of interpersonal, intrapersonal, and organizational conflicts that can lead to poor patient outcomes, poor working relationships, and poor personnel well-being. Identifying these sources will allow nurses to foster a work environment that facilitates the mitigation or resolution of conflicts. The chapter encourages nurses to think outside of the box, and that conflict is not always negative, because it can be the catalyst to elicit changes. The way that leadership manages conflict will in turn determine how other employees manage their conflict with each other. Nurses are held accountable and need to be able to decrease, if not eliminate, conflict in their organization by using blameless communication skills and assisting in facilitating conflict resolution between individuals.

This chapter helps the reader to learn the leadership skills needed for team problem solving and decision-making. Problem solving and decision-making are basic components of leadership. Decision-making is a component of problem solving. Problem solving begins with the process of defining the problem: Is there a problem? What makes you think there is a problem? How is this happening? Decision-making involves the process of choosing among the generated solutions. That choice should solve the problem and move the organization forward. Many strategies can be used to make decisions. The chapter reviews voting and the consensus process. The purpose of voting is to make a choice from the generated alternatives. The purpose of the consensus process is to arrive at a conclusion that all members can live with. There are different ways to reach a consensus. One easy way to build consensus is to suggest a decision to the group.

Leadership is a fundamental component and core competency of nursing practice. This chapter describes four key leadership theories that are particularly applicable to nursing, meaningful in today's organizational environments, and can remain relevant throughout the constantly evolving landscape of healthcare. Transformational leadership focuses on producing revolutionary change through a commitment to the organization's vision. Servant leadership are servants above all else. They put serving others, including employees, customers, and community, as the number one priority. Situational leadership theory examines the interplay of three specific dimensions: task behavior, relationship behavior, and the readiness of the follower. Authentic leadership refers to developing a personal leadership style that is consistent with one's own personality and character. The chapter discusses a leadership self-assessment tool that can be used to identify leadership strengths in addition to areas with room for growth. Finally, it differentiates leadership and management.

This chapter describes work-related values and their ties to organizational goals and offers the process of values clarification as a means to prioritize the important beliefs. Consistency between nursing values and a health system’s mission was examined in light of professional practice model (PPM) design. The chapter explores a theoretical framework to guide nursing practice is best accomplished by a diverse group of nurses who examine the literature and other organizations and make careful decisions that are consistent with organizational and nursing values. This process facilitates the proper identification and application of a patient care delivery system (PCDS) that fits with the idealized nursing values. The chapter explains shared leadership and governance system for decision making to monitor and improve professional practice. It identifies component parts and formalizing the PPM through a visual representation and enhances how the model will be used in a specific health system.

Health care leadership in the 21st century has evolved in countless ways. Leaders were believed to have unique personality qualities and characteristics that separated them from others and were the reason for their leadership roles. Leadership communication theories help the health care providers to understand and potentially apply in their various roles, situations, and/or teams. Contingency theory requires leaders to be chosen or appointed based on the task, problem to be solved, and/or goal. Path–goal theory focuses on a leader helping subordinates understand the organization’s/team’s goal, helping followers determine the best path to attaining it. Based on team leadership theory, a leader needs to be very communication–centric and analyze both the goal and his or her teammates to provide understanding, motivation, and feedback, but also to offer support, conflict management, ethical behaviors and a collaborative, participative environment for the maximum sharing of information, ideas, and solutions.

This chapter showcases the preparation phases necessary to apply for and accept different nursing leadership positions. It explores the components of lifelong learning that are needed to foster new career endeavors. The chapter helps the reader to distinguish between a resume and a curriculum vitae. It provides more in-depth skills to enhance this application process as the nurses continue to move forward in their nursing career. Nurses have so many opportunities within healthcare, but it is up to each individual to best position himself or herself for those opportunities. Nurses who take ownership of their professional development will be able to revaluate their careers at different points to determine where there may be gaps in professional development. Nurses who address an identified gap in their professional development will position themselves in the best possible light for future potential promotional opportunities.

This chapter is titled somewhat provocatively, equating leadership with telling others what to do. One cannot expect others to be mindreaders, so one cannot expect others to do what one wants done without telling them. Being able to be clear with others about expectations, next steps, processes, and direction is integral to leadership, no matter the position held. Leaders have interests, responsibilities, and a purview that span boundaries, making them knowledgeable about how the pieces fit within the organization; therefore, they have a responsibility for making sense of why a course of action is necessary. Providing a context so the work ahead makes sense also means explaining what one do in our leadership position to support the efforts of others and further institutional goals. Successfully functioning teams and committee work are the lifeblood of complex organizations, so all nurses need high-level meeting- management skills.

This chapter focuses on diversity and inclusion not as an administrative problem but as a leadership concern. Diversity and inclusion aren’t so much regarded as important in avoiding conflict and difficulties, but as crucial in fostering innovation and creativity. When people come together to solve problems or improve processes, they bring different sentiments, information, and view points. This makes sense when we talk about diversity of disciplinary backgrounds—think about the growing importance of interdisciplinary teams to healthcare education, practice, and research. Embracing diversity can be a competitive advantage for an organization because it is associated with creativity and innovation, but highlighting diversity can lead to suspicion and conflict, and leadership requires balancing these tensions. Developing an inclusive environment implies a respectful appreciation of individual attributes as you forge a sense of belonging and trust, with equitable access to opportunity and reward/recognition.

Aiming for impact means that one not only thinks that one can transform clinical service, but wants to develop and provide patients and their families with the kind of positive moments that are remembered 20 years later. Leadership presupposes aiming for impact; that is, a determination to address the challenges inherent in the current healthcare system. Impact means always giving some thought to how something good can be parlayed into something better. If one is aiming for impact, developmental learning will inevitably move from focusing on mastery of what today is considered to be best practice to imagining and developing a new and improved version of future practice. Nurses have historically been socialized in the direction of convergent thinking, but leadership requires divergent thinking, experiences that promote creativity and innovation.

Organizations are goal-directed entities that can be created in society, business, health care, and family units. Organizational commitment (OC) consists of three behaviors: identification, loyalty, and involvement. The defining attributes of OC in nursing practice are multidimensional, continuous, collective goal seeking, and involvement. The three broad categories of antecedents for OC are personal characteristic, work experience, and organizational environment. Work experience antecedents include opportunities and job security. Organizational environment antecedents to OC are trust of the organization and leadership style. One of the important consequences of OC is that once it exists, it empowers individuals and stabilizes behavior as circumstances change. Two widely known quantitative instruments have been utilized to measure OC. These instruments are the Organizational Commitment Questionnaire (OCQ) and the Affective, Continuance, and Normative Commitment Scale. The hospital should then provide work opportunities that foster the OC behaviors.

This chapter talks about the real work of being a behavioral intervention researcher. It discusses a range of common challenges and professional considerations in the conduct of behavioral intervention research, and offers guidance where possible. The chapter examines hot button issues related to staffing, collaborating with others, team leadership, and career development and intellectual property considerations. As each institution has different hiring practices and processes, prior to staffing a project it is important to know institutional requirements. The chapter shows some common staff positions and their associated key roles and skill sets. Given the complexity, multisteps, and nuanced considerations as well as the interdependency of staff in the conduct of an intervention study, staff training is critical to all intervention studies irrespective of the phase along the pipeline. Yet an important consideration in the conduct of behavioral intervention research is career-related.

This chapter helps the reader to differentiate between the terms professional and being professional, to apply the principles of interprofessionalism to the professional practice of nursing, to evaluate how the professional practice of leadership is tied to nursing professional practice models (PPMs) and to examine individual and leadership commitment to professional nursing practice. Being professional encompasses specialized knowledge and skills, collaborative interpersonal approaches, responsiveness and revision of how one is perceived by others, ongoing improvement, and informed decision making. Interprofessional collaboration is crucial for meeting society’s expectations for enhancing health. The Institute of Medicine’s (IOM) report. The Future of Nursing advocated for nurses to take on greater roles in leading change to advance health care in America. This report called for leadership at all levels of nursing, and personal accountability for ongoing professional development, including interprofessional collaboration and coordination.

This chapter focuses on what it takes to disseminate a proven behavioral intervention. It discusses the key reasons why dissemination and subsequent adoption or uptake of an intervention may be challenging. The chapter shows the ways to determine if a proven intervention is ready to be disseminated. It describes the core elements of a robust plan for dissemination. Developing and carrying out a dissemination plan can be costly. Existing but limited literature suggests that a proven intervention is evaluated for its dissemination and ultimately its implementation potential based upon five considerations: the characteristics of the intervention, environmental context in which it would be delivered, fit between the intervention and the context or practice setting, leadership capacity, and access to communication channels. Typically, environmental and key stakeholder scans are conducted following the publication of the trial outcomes for an intervention. A value proposition statement varies according to the targeted stakeholder.

This conclusion presents some closing thoughts on the concepts covered in the preceding chapters of the book. The book includes Patient/Client-Focused Concepts, Caregiver-Focused Concepts, and Organization-Focused Concepts. The concept analyses follow a specific method, with defining attributes, antecedents, and consequences given. It talks about the personal characteristics of patients/clients experiencing health/illness. These concepts include hardiness, hope, motivation and self-motivation. The book then explains the caregiver-focused concepts such as anxiety, caregiver burden, clinical autonomy, compassion fatigue, cultural competence, decision making, emotional intelligence, empathy and so on. It also presents analysis of concepts pertinent to nurse workaround, commitment, teamwork, transformational leadership, work engagement, and nurse manager accountability. Nurse workarounds are described as nurses devising an alternative work procedure to address a block in the workforce, even though these alternatives are deviations from policies, procedures, and work processes.

This chapter helps the reader to find in-depth information that will be useful in creating innovations and implementing change. It presents a framework for the development of skills to foster innovation and lead change. In addition, the chapter provides information on change. Change is inevitable but it is not always welcome. It is often necessary for growth. However, whether change is planned or not, it often causes anxiety and fear for those affected by it. Nurse leaders who use a structured change theory framework improve their chances for success. The chapter presents three of these: Lewin's change theory, Kotter's eight steps to leading change, and Rogers's diffusion of innovation. These change theories provide a framework for understanding change and improving learner's chances of success. Nurse leaders need to use effective change strategies and help colleagues deal with constant change.

This chapter presents a review of the foundations of effective leadership—ethical, spiritual, legal, and professional advocacy. Knowledge and behaviors related to ethical practice, spiritual awareness, legal requirements, and professional advocacy are core dimensions of an effective nurse leader. Ethical nurse leaders are responsible with regard to their practice to be aware of the organizational work environment, to establish systems to enhance nurse's knowledge of ethics within their practice, and to facilitate discussion of ethics in the day-to-day practice environment. The chapter provides case studies and reflective questions to provoke self-assessment and awareness of one's professional practice with regards to ethical dilemmas that one may have encountered or experienced in the work environment. The goal of these reflective exercises is to stimulate a greater understanding of one's role as a nurse leader and as an advocate for both patients and nurses.

Interpersonal communication and health communication are intimately linked. But, often, interpersonal communication is as important in peer-to-peer and provider-to-provider interactions as it is to provider-patient discourse. Providers in health care settings communicate continuously in small groups, with organizations, and in dyads. These multifocal and multitask behaviors require a wide variety of verbal and nonverbal communication skills. Recognizing the value of interpersonal and leadership communication as well as the importance of negotiation skills is critical to the provider’s effectiveness and achieving his or her desired outcomes. The context for a communication often has a direct effect on the interaction, the interactants, and the outcome. The alternative scenario required interpersonal communication that did not deteriorate to a status/power debate, but instead relied on sharing information and concerns and negotiating a settlement to the conflict that was best suited for the patient, staff, and institution.

Motivation is a complex, multifaceted term with many meanings that is used frequently in different contexts and environments. Motivation is a theoretical construct used to explain the reasons underlying behavior relating to initiation, direction, and intensity of goal-directed behavior. It is a central phenomenon in nursing and is critical to effective nursing leadership and management in health care organizations. More specifically, motivation has been proposed as a key predictor in the practice of health promotion. Health behavior change can be difficult to predict or control, but motivation has been shown to be a powerful and consistent predictor of outcome. It is widely recognized as a key element influencing behavior change. Motivation is the driving force within individuals which causes a specific action or certain behavior that is underpinned by self-determination, self-efficacy, and readiness to change.

Nurses do not feel comfortable with the concepts of power and politics. Most likely, they feel this way because they equate the terms with dominance, coercion, and corruption. Nurses may fear that power and politics are not compatible with caring. This chapter talks about how the reader can use power and politics to improve their role as a nurse leader. " Power" refers to your influence and authority over others to mobilize them to accomplish a goal. It can be an effective tool that can lead to positive outcomes in organizations. The chapter describes types and sources of power used in nursing leadership. The chapter then examines how one can effectively use power to accomplish patient safety goals. It helps the reader to formulate strategies to enhance the development of one's personal power and political skills. The chapter describes how politics can be used to improve nursing leadership skills.

This chapter helps readers define the nurse leader’s role in the long-term sustainment of a professional practice model (PPM) and evaluate various sustainability frameworks and assessment tools. Sustainability refers to the continual presence of all or most of an innovation’s components so that delivery of its intended benefits over an extended period of time can be realized after implementation support has been terminated. The chapter presents several sustainability frameworks that analyze influencing factors, capacity-building approaches, institutionalization, and continued improvement as ways of conceptualizing the process. It reviews organizational memory as a set of shared traditions that systems develop over time and linked to sustainability. The chapter explores leaders’ roles in preserving organizational memory related to PPMs and its many benefits. It also evaluates measuring sustainability in terms of psychometric properties and limitations for use. Finally, the chapter offers leadership strategies related to enhancing sustainability and continued research was recommended.

This chapter reviews personal attributes of effective leaders and discusses ways to promote their level of self-awareness. It explores the topic of emotional intelligence (EI) as an ability that can enhance one's leadership effectiveness. The chapter focuses on the ability-based model by Mayer, Salovey, and Caruso who define EI as the ability to reason with emotions to enhance thinking. In this model, EI encompasses four abilities: to accurately perceive emotions, to use emotion to facilitate thoughts, to understand emotions, and to manage emotions. This model is measured by Mayer–Salovey–Caruso emotional intelligence test. The chapter presents a box that will help us to put this into practice with questions to consider and a case scenario. An essential personal attribute that is critical to effective leadership is self-awareness. The chapter discusses sources of information to promote self-awareness as well as obstacles to gaining self-awareness.

Communication styles and behaviors are dynamic and responsive to situations, environments, and personal experience. Even with good communication skills, challenges will continue to arise when working with diverse cultures and generations, as well as when using different modes, such as face to face, audio, email, and texting to communicate. This chapter discusses how effective communication is critical to the development of leadership and management roles in nursing. It discusses and illustrates the principles of effective communication and how to overcome negative styles in case studies. The chapter helps the reader to reflect on their current communication style and integrate new communication techniques to improve their leadership skills to promote a healthy work environment. Considering how to practice assertive communication style, using technology to enhance conveying messages, and appreciating different perspectives begin to strengthen effective communication for the individual and the organization.

This chapter contains practical examples of how a Chief Nurse Executive and Chief Executive Officer from different health care facilities use tenets from complexity and caring sciences as a framework to guide leadership styles and practices in nursing and health care. It highlights how concepts from complexity and caring frame health care economics and financial decision making within complex organizations. The nurse leader, functioning within a dynamic CAS, can strengthen relationships and promote self-organization using the unifying framework of caring science. From the perspective of the nurse leader, the delivery of competent and compassionate care to patients in a caring, healing environment should be enough to define program excellence. Chaos theory, one of the theories in complexity science, has investigated the sensitivity of systems to variations in initial conditions as one cause of complex behavior.

Historically, community-based nonprofit organizations have drawn board members from their local communities. Board members are being asked to deepen their understanding of the mission of the agency and develop an understanding of social change and social justice. As the agency matures, the roles of the board shift and they become more responsible for governance and fundraising. A well-balanced board is composed of people of various professional backgrounds and social skills, with cultural and ethnic diversity that reflects the composition of the people being served by the agency, and with the financial means, or access to it, to provide support for the agency. Irrespective of any professional credentials that board members may hold, it is critical that all board members have strong leadership skills. Board members are frequently concerned about how agencies handle their ‘legal issues’.

This chapter helps the reader to identify characteristics of formal and informal leaders, describe ways nursing leaders encourage an organizational spirit of patient-centered inquiry and to outline a plan for implementing an evidence-based practice (EBP) healthcare culture. It addresses the roles of formal and informal leaders in developing and sustaining an organizational culture of EBP. Healthcare settings with an embedded EBP culture demonstrate the EBP process as normative and expected behavior of nurses' everyday work life. Effective nurse leaders understand the organization's overall purpose and goals for establishing an EBP culture. Nurse leaders are clear about the needs of the organization's participants to help EBP grow and thrive as a means of delivering high-quality patient care. The chapter highlights ongoing strategies that effective nurse leaders use to attain and uphold an EBP culture. It explores the underreported, yet vitally important, role that informal leaders have in fostering an EBP culture.

This chapter describes the components of a professional practice model (PPM) implementation plan. Planning, selecting strategies, and ensuring accountability for PPM implementation requires a working group of diverse nursing professionals from multiple levels of a health system to fully capture their expertise and insights. The chapter reviews the steps of the implementation process and provides examples of a strengths, weaknesses, and opportunities/threats (SWOT) analysis, broad goal statements, and measurable objectives. It demonstrates the distinction between goals and objectives and suggests criteria for selecting among many implementation strategies. The chapter explores several implementation strategies: such as education, modification of work roles, workflow redesign, effective communication, and ongoing support and enrichment. It explains accountability for the plan’s implementation in terms of assigning responsibility, prioritizing goals, and setting realistic time frames for completion. Finally, the chapter presents the key success factors, including an optimistic leadership tone.

This chapter explains the nurse manager’s accountability and responsibilities for leading professional practice environments in a rapidly changing health care system. Today’s nurse managers, in addition to managing the operations of a particular service, are now required to have an organizational and community presence, effectively pulling them away from their geographical area of responsibility. Despite the fact that individual nurses and other health care professionals are accountable and responsible for their individual practice, and the availability of clinical support from clinical nurse educators, mentors, and nurse specialists, no one but the nurse manager has the authority or professional accountability to manage nursing practice to ensure that standards of practice are met. With the increasing demand for evidence-based practice, this becomes a significant additional challenge. The chapter also describes the specific strategies for demonstrating leadership and “walking the talk” about professional practice in the workplace.

This chapter focuses on aspects that are critical for effective nursing leadership. The key concepts of complexity science relate to leadership by using the framework of the seven core realities of leadership, which clearly exemplify the human-environment mutual process. The emphasis on action related to environments promoting rich relationships, so important to the practice of nursing in any arena, further explicates the connection between complexity science and nursing. Leaders who develop and practice their own personal self-reflective activities are more likely to be able to sustain the style and actions of complexity leadership. An appreciation for organizations as complex adaptive systems derives from a developmental progression of scientific work that spans from early systems theories, the scientific breakthroughs of new physics, to current concepts of complexity. The chapter addresses leadership styles that resonate with a complexity approach. It describes the self-reflective practice of personal being and awareness.

At every stage of the job search, the successful candidate will need to ensure positioning as a strong fit for the right opportunity. First, job seekers who have clear insight on what they have to offer will gather information to identify target organizations that are good prospects for a fit with their career goals. Having identified a list of their target organizations, the next step is to gather as much intelligence on them as possible to help these individuals customize their resumes and cover letters for specific opportunities. Most nonprofit organizations are dedicated to a mission of advancing social justice or making the world better in some way. In filling leadership level positions, they look for the candidate who will embrace the mission and has leadership skills that will spark the organization to generate an even greater impact.

This chapter presents a summary of authors’ perspectives as Fordham Graduate School of Business lecturers who had the opportunity to teach in an entirely different environment with students seeking to develop their skills in the field of nonprofit leadership for social justice. There are many similarities between the for-profit and nonprofit sectors in terms of the need to focus on leadership, management, strategy execution, organizational design, measuring performance, and developing talented individuals. The chapter reviews the principles and methodologies of strategic planning and the planning process used in for-profit organizations. It focuses on the assignment and discussion of an actual case study of the Madison Community House (MCH) as an example of a nonprofit strategic planning process and also on developing a course that would foster a robust learning environment. A theme of the course is to create a culture of integrity and ethical behavior.

This chapter discusses why it is important for nurses to learn about leadership. It reviews the strengths of the associate's degree nurse and how one can build upon that as one evolve in one's professional development. The chapter discusses also leadership expectations and differentiates leadership skills from management skills. Nurses study leadership to prepare themselves for the essential expectations of the professional nurse. Leadership competencies are viewed as a fundamental human activity and a critical component of nursing. Leadership competencies help nurses make that difference because leadership skills are needed to facilitate and implement beneficial change. Leadership is not just about the position a nurse hold but also about self-awareness, knowledge of processes, and relationships with others. In addition to improving patient care, nurse leadership abilities can potentially benefit one with personal as well as professional satisfaction.

Although there is a scarcity of specific research on leadership principles and practices and the community/mental health/clinical counseling profession at the agency level, a number of leadership theories can be related and applied to the counseling practice. Leadership is defined as a process that is established and implemented by a group of individuals working together to achieve a common goal. One prominent theory of followership as it relates to leadership is the leader-member exchange (LMX) theory. Although the focus of servant leadership appears to be on the leader and leader behavior, the perceived outcomes of servant leadership include follower performance and growth, organizational performance, and societal impact. The nature of the mental health field is one of multiple constituencies working together to promote the well-being and mental health of individuals and communities, and the process of leadership is a natural fit for implementation in professional practice.

Dorothea Lynde Dix was born into an upper-class, highly educated, intelligent, and politically connected Bostonian family. These opportunities provided the foundation necessary to propel her into a leadership role as national and international advocate for the most vulnerable groups in the mid-1800s. Dorothea utilized her Methodist father’s background to augment the teachings of her adopted religious calling, Unitarianism, which promises salvation through leading a directed life. This chapter explores her leadership role in this period of American history. It also shows how her family background, pursuit of education, personality, and religious commitment to humanitarianism enabled her to confront seemingly insurmountable obstacles to implement national and international reform of care for psychiatrically disabled and imprisoned populations. In the final phase of her career, Dorothea was chosen for a national role to lead nursing during the American Civil War, a role that she considered as within her scope of knowledge and skills.

This chapter discusses future trends and challenges associated with the care coordination clinical reasoning (CCCR) model. The care coordination trends and models require that educational measures be in place to prepare the advanced practice nurse for leadership roles in care coordination with an interprofessional team and the recipients of care: the patient and the family. The Advanced Practice Registered Nurse (APRN) Consensus model was designed to provide a framework to prepare clinicians to meet the demands of patient populations. The CCCR model was developed based on the success of the Outcome-Present State-Test (OPT) model of clinical reasoning. The CCCR model facilitates the APRN student transition into the role of professional clinician. The strategies and worksheets presented in the CCCR model moves the process forward and provides support to reinforce the professional standards and curricula that are being implemented in current professional health care educational programs.

This chapter defines the concept of leadership and describes the most common leadership theories. Most scholars agree that leadership is a key component of organizational effectiveness. The very range of definitions of leadership and the absence of consensual agreement between the definitions make the concept of leadership an issue in itself. The chapter examines leadership from various perspectives with an emphasis on the influence of particular leadership styles on the financial sustainability of a nonprofit organization. It integrates theory-based and practice-based approaches, and thus provides tools to better understand and influence the leader-follower dynamic in the nonprofit setting. Early leadership theories include: Great man theory, traits theories, behavioral theories, contingency theories, and attribution and charismatic theories. The chapter explains the relationship between leadership and community relations and discusses the role of leadership in strategic planning. It also explains the relationship between leadership and financial sustainability of nonprofit organizations.