- Email: [email protected]
Transformational leaders in the perioperative setting
Transformational leaders in the perioperative setting Michelle Tinkham, MS, BSN, RN, CNOR
W
ithin the American Nurses Credentialing Center’s Magnet® Recognition Program’s Forces of Magnetism—14 characteristics that provide the conceptual framework for the Magnet appraisal process—transformational leadership is a model component that represents Quality of Nursing Leadership (Force #1) and Management Style (Force #3).1 Transformational leadership is meant to encourage positive change in those being led and transform followers into leaders.2 This leadership style was first coined by James MacGregor Burns in 1978 who felt its purpose was to create a symbiotic relationship between leaders and followers to help each advance to a higher level in leadership.2 In simplified terms, transformational leadership is defined as a leadership style through which leaders identify needed changes for performance improvement and create a vision to achieve them, using inspiration of group members to gain commitment.³
meaningful suggestions in staff meetings) and sharing knowledge (e.g., how to set up a difficult surgical procedure) with peers, staff members demonstrate themselves as leaders to their team.
Transformational leadership is achieved through four elements:
Managers and staff members can work together to become transformational leaders through shared governance in the form of leadership or unit-based councils.5 These structured meetings allow managers and staff members to identify solutions to improve their work environment and patient safety. This is an excellent time for staff members to demonstrate leadership qualities to their fellow coworkers by providing feasible performance improvement ideas, thus embodying intellectual stimulation, another element of transformational leadership.
1) Individualized consideration—leaders serving as mentors for followers, 2) Intellectual stimulation—leaders encourage creativity and independent thinking of followers, 3) Inspirational motivation—leaders create a vision followers want to follow, and 4) Idealized influence—leaders provide a positive example for followers.2 Transformational leaders are a necessity in the perioperative setting. Operating room managers need to be role models for their staff members by providing support and creating an environment of open communication and shared governance. Perioperative staff nurses and ancillary staff members also can demonstrate transformational leadership among their peers. By becoming actively involved in department decisions (e.g., making
One method managers can use to be transformational leaders is to make leadership rounds, which consist of planned, structured conversations with team members and patients to assess the satisfaction with current services and identify opportunities for improvement.4 This helps the manager be more visible while advocating for staff members and patients and contributes to a culture of change and accountability.4 This process also gives staff members the opportunity to be engaged as leaders and provide alternatives or solutions for areas needing improvement. This type of comradery helps create an environment for inspirational motivation and idealized influence, two elements of transformational leadership.
Individualized consideration, the first element of transformational leadership, is one of the most important and often most difficult to achieve. Every manager should be assessing talent within his or her department, so he or she may mentor and cultivate the organization’s next leaders. For an organization to succeed, everyone must possess transformational leadership skills. Nurses on the frontlines encounter daily challenges, such as staff-to-patient ratios, mandatory overtime, and budget constraints. As a
http://dx.doi.org/10.1016/S0001-2092(15)00069-1
© AORN, Inc, 2015
March 2015 Vol 101 No 3 • Periop Briefing | P13
PERIOP BRIEFING
IN FOCUS
PERIOP BRIEFING
TRANSFORMATIONAL LEADERSHIP
result, nurses possess unique insights for offering viable solutions.6 Identifying and supporting talented nurses within an organization to become new leaders will help the organization grow and remain stable. Managers need to know how to lead and encourage the trust of others to achieve the organization’s goal.6 TeamSTEPPS is one method that leaders can employ to increase communication.6 Created by the Agency for Healthcare Research and Quality, this system is made up of three tools: the Two-Challenge Rule, Call-Outs, and Check-Backs.6 The two-challenge rule can help cultivate assertiveness by encouraging new leaders to speak up because they must challenge a situation or voice a concern twice in a meeting before receiving acknowledgement from the leader.6 Call-outs are a communication strategy used to inform large groups of staff members of important information during emergencies. Checkbacks are used by the sender to verify the listener received and understood the given message.6 In addition to quality communication techniques and problem-solving abilities, a transformational leader also needs to be able to deal with difficult people and conflict. Setting ground rules, displaying respect for all members, and finding common goals are tactics to effectively defuse a tense situation.6 Self-development is also a necessary component of transformational leaders. Nurses need to cultivate self-respect and confidence before leading others. Many facilities will send potential and new leaders to leadership development training to help them identify their strengths and weaknesses.6 It is also the responsibility of all nurses to stay up-to-date on current evidence-based practices and continue to advance their education. In addition, being resilient amid change is an essential skill of any health care leader today. A transformational leader not only finds positive methods to deal with necessary change but also helps fellow co-workers embrace change in a positive way.7
Conclusion It is essential for nurses to acknowledge their strengths and improve areas of weakness, so they may provide an example that others would want
P14 | Periop Briefing
to follow. A nurse who does not have respect for others or confidence in himself or herself will find it difficult to gain trust from fellow co-workers and patients. Many resources exist to help new and seasoned nurses build a solid foundation to become effective leaders. This ongoing positive change will help each nurse and the organization achieve a healthy work environment. Editor’s note: ANCC Magnet Recognition is a registered trademark of the American Nurses Credentialing Center, Silver Spring, MD.
References 1. Magnet Recognition Program Model. American Nurses Credentialing Center. http://www.nursecredentialing.org/ Magnet/ProgramOverview/New-MagnetModel#TransformationalLeadership. Accessed December 23, 2014. 2. Transformational leadership. Langston University. http://www.langston.edu/sites/default/files/ basic-content-files/TransformationalLeadership. pdf. Accessed December 23, 2014. 3. Transformational leadership. Business Dictionary. com. http://www.businessdictionary.com/ definition/transformational-leadership.html. Accessed February 6, 2015. 4. Managing the change process. AORN Center for Nursing Leadership. http://www.aorn.org/ Nurse_Executive/Supporting_Documents/ Nurse_Executive_Webinar_Series/Managing_ the_Change_Process_-_Presentation/. Accessed December 23, 2014. 5. Tinkham M. The road to magnet: encouraging transformational leadership. AORN J. 2013;98(2):186-188. 6. Sherman R, Pross E. Growing future nurse leaders to build and sustain healthy work environments at the unit level. Online J Issues Nurs. 2010;15(1). http://www.nursingworld. org/MainMenuCategories/ANAMarketplace/ ANAPeriodicals/OJIN/TableofContents/ Vol152010/No1Jan2010/Growing-NurseLeaders.html. Accessed December 29, 2014. 7. Leadership skills for nurses. Nurs Times. http:// www.nursingtimes.net/Journals/2011/08/24/j/ n/i/Leadership-Skills-for-Nurses.pdf. Accessed December 29, 2014.
W
ithin the American Nurses Credentialing Center’s Magnet® Recognition Program’s Forces of Magnetism—14 characteristics that provide the conceptual framework for the Magnet appraisal process—transformational leadership is a model component that represents Quality of Nursing Leadership (Force #1) and Management Style (Force #3).1 Transformational leadership is meant to encourage positive change in those being led and transform followers into leaders.2 This leadership style was first coined by James MacGregor Burns in 1978 who felt its purpose was to create a symbiotic relationship between leaders and followers to help each advance to a higher level in leadership.2 In simplified terms, transformational leadership is defined as a leadership style through which leaders identify needed changes for performance improvement and create a vision to achieve them, using inspiration of group members to gain commitment.³
meaningful suggestions in staff meetings) and sharing knowledge (e.g., how to set up a difficult surgical procedure) with peers, staff members demonstrate themselves as leaders to their team.
Transformational leadership is achieved through four elements:
Managers and staff members can work together to become transformational leaders through shared governance in the form of leadership or unit-based councils.5 These structured meetings allow managers and staff members to identify solutions to improve their work environment and patient safety. This is an excellent time for staff members to demonstrate leadership qualities to their fellow coworkers by providing feasible performance improvement ideas, thus embodying intellectual stimulation, another element of transformational leadership.
1) Individualized consideration—leaders serving as mentors for followers, 2) Intellectual stimulation—leaders encourage creativity and independent thinking of followers, 3) Inspirational motivation—leaders create a vision followers want to follow, and 4) Idealized influence—leaders provide a positive example for followers.2 Transformational leaders are a necessity in the perioperative setting. Operating room managers need to be role models for their staff members by providing support and creating an environment of open communication and shared governance. Perioperative staff nurses and ancillary staff members also can demonstrate transformational leadership among their peers. By becoming actively involved in department decisions (e.g., making
One method managers can use to be transformational leaders is to make leadership rounds, which consist of planned, structured conversations with team members and patients to assess the satisfaction with current services and identify opportunities for improvement.4 This helps the manager be more visible while advocating for staff members and patients and contributes to a culture of change and accountability.4 This process also gives staff members the opportunity to be engaged as leaders and provide alternatives or solutions for areas needing improvement. This type of comradery helps create an environment for inspirational motivation and idealized influence, two elements of transformational leadership.
Individualized consideration, the first element of transformational leadership, is one of the most important and often most difficult to achieve. Every manager should be assessing talent within his or her department, so he or she may mentor and cultivate the organization’s next leaders. For an organization to succeed, everyone must possess transformational leadership skills. Nurses on the frontlines encounter daily challenges, such as staff-to-patient ratios, mandatory overtime, and budget constraints. As a
http://dx.doi.org/10.1016/S0001-2092(15)00069-1
© AORN, Inc, 2015
March 2015 Vol 101 No 3 • Periop Briefing | P13
PERIOP BRIEFING
IN FOCUS
PERIOP BRIEFING
TRANSFORMATIONAL LEADERSHIP
result, nurses possess unique insights for offering viable solutions.6 Identifying and supporting talented nurses within an organization to become new leaders will help the organization grow and remain stable. Managers need to know how to lead and encourage the trust of others to achieve the organization’s goal.6 TeamSTEPPS is one method that leaders can employ to increase communication.6 Created by the Agency for Healthcare Research and Quality, this system is made up of three tools: the Two-Challenge Rule, Call-Outs, and Check-Backs.6 The two-challenge rule can help cultivate assertiveness by encouraging new leaders to speak up because they must challenge a situation or voice a concern twice in a meeting before receiving acknowledgement from the leader.6 Call-outs are a communication strategy used to inform large groups of staff members of important information during emergencies. Checkbacks are used by the sender to verify the listener received and understood the given message.6 In addition to quality communication techniques and problem-solving abilities, a transformational leader also needs to be able to deal with difficult people and conflict. Setting ground rules, displaying respect for all members, and finding common goals are tactics to effectively defuse a tense situation.6 Self-development is also a necessary component of transformational leaders. Nurses need to cultivate self-respect and confidence before leading others. Many facilities will send potential and new leaders to leadership development training to help them identify their strengths and weaknesses.6 It is also the responsibility of all nurses to stay up-to-date on current evidence-based practices and continue to advance their education. In addition, being resilient amid change is an essential skill of any health care leader today. A transformational leader not only finds positive methods to deal with necessary change but also helps fellow co-workers embrace change in a positive way.7
Conclusion It is essential for nurses to acknowledge their strengths and improve areas of weakness, so they may provide an example that others would want
P14 | Periop Briefing
to follow. A nurse who does not have respect for others or confidence in himself or herself will find it difficult to gain trust from fellow co-workers and patients. Many resources exist to help new and seasoned nurses build a solid foundation to become effective leaders. This ongoing positive change will help each nurse and the organization achieve a healthy work environment. Editor’s note: ANCC Magnet Recognition is a registered trademark of the American Nurses Credentialing Center, Silver Spring, MD.
References 1. Magnet Recognition Program Model. American Nurses Credentialing Center. http://www.nursecredentialing.org/ Magnet/ProgramOverview/New-MagnetModel#TransformationalLeadership. Accessed December 23, 2014. 2. Transformational leadership. Langston University. http://www.langston.edu/sites/default/files/ basic-content-files/TransformationalLeadership. pdf. Accessed December 23, 2014. 3. Transformational leadership. Business Dictionary. com. http://www.businessdictionary.com/ definition/transformational-leadership.html. Accessed February 6, 2015. 4. Managing the change process. AORN Center for Nursing Leadership. http://www.aorn.org/ Nurse_Executive/Supporting_Documents/ Nurse_Executive_Webinar_Series/Managing_ the_Change_Process_-_Presentation/. Accessed December 23, 2014. 5. Tinkham M. The road to magnet: encouraging transformational leadership. AORN J. 2013;98(2):186-188. 6. Sherman R, Pross E. Growing future nurse leaders to build and sustain healthy work environments at the unit level. Online J Issues Nurs. 2010;15(1). http://www.nursingworld. org/MainMenuCategories/ANAMarketplace/ ANAPeriodicals/OJIN/TableofContents/ Vol152010/No1Jan2010/Growing-NurseLeaders.html. Accessed December 29, 2014. 7. Leadership skills for nurses. Nurs Times. http:// www.nursingtimes.net/Journals/2011/08/24/j/ n/i/Leadership-Skills-for-Nurses.pdf. Accessed December 29, 2014.