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Nursing leadership for patient-centered care: Authenticity, presence, intuition, expertise
Nurse Education in Practice 11 (2011) e34
Contents lists available at ScienceDirect
Nurse Education in Practice journal homepage: www.elsevier.com/nepr
Book Review
Nursing leadership for patient-centered care: Authenticity, presence, intuition, expertise, Harriet Forman. Nursing leadership addresses practicing nurses who seek advanced education in the art of leadership/management skills. It is also a book of nursing stories through which the author reveals the humanity and lessons to be learned from chapter topics. The subjective nursing experiences in these enticing vignettes would instruct students at any level of nursing education, but their pivotal message to advance practice students is to build empathetic relationships with their nursing staff to lead to a common goal: patient-centered care. Patient-centered care, this book’s central premise, permits a fresh approach to familiar leadership topics: in chapter one, it is the unifying point of consensus around which team members develop skills of collaboration, communication, and cooperation. In chapter two, it places the patient at the center of an organizational structure of concentric circles, instead of at the bottom of a hierarchy, or sidelined by egocentric power struggles. In chapters 3 and 5, it both clarifies and dissolves distinctions between leaders and managers as they apply various theories to build relationships which motivate professional development of staff members. Discussion in chapter 4 through 9 narrates these relationship building skills in vignettes which extend from emergent to longterm care settings, and lead logically to each chapter’s bulleted summary points. Chapter 4 reframes collective bargaining into building non-adversarial relationships between nursing staff and management in a context of patient centered rather than staff centered solutions. Vignettes in chapters 6–9 illustrate circumvented, yet frequently encountered dilemmas in the reality of relationship building: prejudice in chapter 6, spirituality in chapter 7,
doi:10.1016/j.nepr.2011.05.010
grieving in chapter 8, and abuse of power in chapter 9. Forman skillfully builds the leadership skills needed to confront these topics in a forthright manner, which assumes no easy answers; instead, it challenges nursing managers to create diverse approaches to respond to the ambiguity inherent in nursing situations. Until managers educate themselves on oppressed group perspectives, they cannot recognize or address disruptions to team building such as horizontal violence and bullying among team members (chapter 9). Until managers expand their conceptual appreciation of spirituality as meaning making, they cannot develop their team members’ presence to patients’ search for meaning (chapter 7). Lessons from the vignettes while focused on United States’ nursing situations could translate to diverse cultures in other countries. For instance, human and material resources fall under a manager’s domain of responsibility. However, diverse cultural settings impose variations on distribution of resources – from developed countries’ technological focus in critical care units to developing countries lack of basic resources like water and sanitation. Each end of the resource spectrum poses situational challenges for patient-centered care, awaiting cultural-specific direction from prescient nursing leaders or educators. More difficult to translate would be Forman’s call for baccalaureate education as a uniform entry level to professional nursing. This simplistic conclusion supports the author’s final chapter on what nursing can be, but contrasts with its overall message: listen to the voices of diversity; they express multiple paths to patientcentered care. Mary Tod Gray East Stroudsburg University, Department of Nursing, East Stroudsburg, PA 18301, USA E-mail address: [email protected]
Contents lists available at ScienceDirect
Nurse Education in Practice journal homepage: www.elsevier.com/nepr
Book Review
Nursing leadership for patient-centered care: Authenticity, presence, intuition, expertise, Harriet Forman. Nursing leadership addresses practicing nurses who seek advanced education in the art of leadership/management skills. It is also a book of nursing stories through which the author reveals the humanity and lessons to be learned from chapter topics. The subjective nursing experiences in these enticing vignettes would instruct students at any level of nursing education, but their pivotal message to advance practice students is to build empathetic relationships with their nursing staff to lead to a common goal: patient-centered care. Patient-centered care, this book’s central premise, permits a fresh approach to familiar leadership topics: in chapter one, it is the unifying point of consensus around which team members develop skills of collaboration, communication, and cooperation. In chapter two, it places the patient at the center of an organizational structure of concentric circles, instead of at the bottom of a hierarchy, or sidelined by egocentric power struggles. In chapters 3 and 5, it both clarifies and dissolves distinctions between leaders and managers as they apply various theories to build relationships which motivate professional development of staff members. Discussion in chapter 4 through 9 narrates these relationship building skills in vignettes which extend from emergent to longterm care settings, and lead logically to each chapter’s bulleted summary points. Chapter 4 reframes collective bargaining into building non-adversarial relationships between nursing staff and management in a context of patient centered rather than staff centered solutions. Vignettes in chapters 6–9 illustrate circumvented, yet frequently encountered dilemmas in the reality of relationship building: prejudice in chapter 6, spirituality in chapter 7,
doi:10.1016/j.nepr.2011.05.010
grieving in chapter 8, and abuse of power in chapter 9. Forman skillfully builds the leadership skills needed to confront these topics in a forthright manner, which assumes no easy answers; instead, it challenges nursing managers to create diverse approaches to respond to the ambiguity inherent in nursing situations. Until managers educate themselves on oppressed group perspectives, they cannot recognize or address disruptions to team building such as horizontal violence and bullying among team members (chapter 9). Until managers expand their conceptual appreciation of spirituality as meaning making, they cannot develop their team members’ presence to patients’ search for meaning (chapter 7). Lessons from the vignettes while focused on United States’ nursing situations could translate to diverse cultures in other countries. For instance, human and material resources fall under a manager’s domain of responsibility. However, diverse cultural settings impose variations on distribution of resources – from developed countries’ technological focus in critical care units to developing countries lack of basic resources like water and sanitation. Each end of the resource spectrum poses situational challenges for patient-centered care, awaiting cultural-specific direction from prescient nursing leaders or educators. More difficult to translate would be Forman’s call for baccalaureate education as a uniform entry level to professional nursing. This simplistic conclusion supports the author’s final chapter on what nursing can be, but contrasts with its overall message: listen to the voices of diversity; they express multiple paths to patientcentered care. Mary Tod Gray East Stroudsburg University, Department of Nursing, East Stroudsburg, PA 18301, USA E-mail address: [email protected]