“All you have to tell me is that you are a nurse, and I already know you have leadership skills. Every nurse has leadership skills. You manage other members of the healthcare team, you cause others to act, and you facilitate positive outcomes.”However, despite of the established leadership styles, there is still a great need to discover new approaches to meet the demands of the ever changing needs of our profession. Stress-related illness contributes to rising healthcare costs and disability, and creating a healthy work environment is a priority for maintaining an adequate nurse workforce. Nurse Managers play an integral role in creating the healthcare work environment. But what is a healthy environment and how can we achieve it?
"Healthy" as defined in the AACN Standards for Establishing and Sustaining Healthy Work Environments (American Association of Critical-Care Nurses, 2005) and in the original construction of the Nursing Work Index (Kramer M, Hafner, LP. , 1989) means productive, able to give quality care, satisfying, and able to meet personal needs.Thus a healthy working environment is a work setting in which policies, procedures, and systems are designed so that employees are able to meet organizational objectives and achieve personal satisfaction in their work.”18(p3),34(p741) The term healthy work environment with its humane elements appears to be used interchangeably to incorporate healing work environments.23 Philosophical approaches associated with healthy and effective work environments include learning organizations, healthy work environments supportive of the whole human being, joyful workplaces, and patient-focused environments.
In 2001, the American Association of Critical- Care Nurses (AACN) made a commitment to promote the creation of healthy work environments that are safe, healing, humane, and respectful for patients, patients’ families, and nurses.5 To this end, the AACN recently released a landmark publication specifying the standards necessary to establish and sustain healthy work environments in healthcare.5 Authentic leader- ship was identified as one of the 6 standards (skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership) crucial to creating and sus- taining healthy work environments in nursing practice.5The role of leaders is so pivotal that authentic leader- ship, not just any leadership, has been identif ied as “the glue that holds together a healthy work environ- ment.”6(p2) In fact, so important is leadership in estab- lishing the principles and elements of a healthy work environment for practice7 that a coalition of 60 nurs- ing organizations known as the Nursing Organizations Alliance8 has supported a set of principles that each member organization has been asked to discuss and endorse. Among the 60 members of the alliance9 are AACN; the American Association of Colleges of Nursing; the American Organization of Nurse Execu- tives; Sigma Theta Tau International, The Honor Soci- ety of Nursing; and the American Academy of Nursing. These organizations to some extent have incorporated the principles of healthy environments as part of their organizational strategic plans. For example, AACN has contributed with its document5 on standards for a healthy work environment, the American Association of Colleges of Nursing has issued a document10 describing the hallmarks of the professional nursing practice environment, the American Organization of Nurse Executives has produced a 2-volume series11 of exemplars of the healthy work environment, Sigma Theta Tau International has actively engaged in a call to shape the future through renewal,12 and the Ameri- can Academy of Nursing has through its members broadly contributed in the health policy arena. From a broader perspective, a call for transforming the work environment with leaders as key partners has also been echoed by other influential organizations.2,13,14
But what is an authentic leadership? What are the qualities of this leader that makes him more effective leader than the other types of leader? AACN definition of the term authentic, which proposes that leaders who are authentic “conform to fact” or speak the truth and therefore are worthy of trust, reliance, or belief.5 Congruently, George45 describes an authentic leader as an individual in a position of responsibility who is genuine, trustworthy, reliable, and believable. Furthermore, One conceptual definition of authentic leadership is proposed by Avolio et al41 as part of the beginning development of a theoretical framework to guide future research. These researchers define authentic leaders as “those individuals who are deeply aware of how they think and behave and are perceived by others as being aware of their own and others’ values/ moral perspective, knowledge, and strengths, aware of the context in which they operate, and who are confident, hopeful, optimistic, resilient, and high on moral character.”41(p804)
However, a question lingers my mind, how can one be an authentic leader? Does it possess a distinct feature from the other types of leader? The process of becoming an authentic leader appears to be a journey rather than a destination. Some of the identified essentials of becoming an authentic leader are the following:5. pursue a personal journey of self-discovery, self-improvement, reflection, and renewal6. develop an individual leadership style that is con- sistent with his or her personality and character.7. requires courage to commit to a process of personal transformation “from the inside out.”438. understanding one’s strengths and weaknesses while simultaneously accepting one’s “shadow side” is an essential compo- nent of becoming an authentic leader.45The key distinction of authen- tic leaders is that they are anchored by their own deep sense of self and know where they stand on important issues, values, and beliefs.54 Authentic leaders “stay their course and convey to others, often times through their actions, not just words, what they represent in terms of principles, values, and ethics.”54(p329) The combined work of multiple contributors41,43,45,49-51 supports the assumption that authentic leaders create lasting organizational value that extends well beyond bottom-line success.
Although it may be reasonable to conclude that authentic leadership may be increasingly needed in today’s complex healthcare systems, additional empirical work is necessary. Authentic leadership may not only be crucial to creating and sustaining healthy work environments for practice but also may hold promise in creating lasting organizational and professional value. The ripple effects of authentic leadership may be so marked that not only will organizations need to be cultivating authentic leaders in formal leadership positions but authentic leaders also may be needed at the front lines or the point of care. To produce leaderful organizations, however, requires a better scientific understanding of what authentic leadership is how it may be developed, and how it contributes to the creation of healthy work environments. Additionally, developing leaderful organizations implies a commitment to longitudinal research and to an emphasis on fostering leader- ship development at all levels in the profession. In light of the need for leaderful organizations for the 21st century and for further development of authentic leadership science, AACN is positioned to advance the current understanding of authentic leadership to document the empirical link with a healthy work environment. This important work potentially may affect not only the nursing workforce but also the profession, the healthcare delivery system as a whole, and society at large.
"Good leaders are not born; they are developed through experience, studying, mentoring, and a basic desire to be the best they can be." Guide questions
- With much being said, in what situations can you apply the principles of authentic leadership?
- As you think of the scenarios where we can apply the principles, do you think authentic leadership is the ultimate solution in every problem we encounter with our profession?
- Are you an authentic leader?
References:
Maria R. Shirey, MS, MBA, RN, CNAA, BC. Authentic Leaders Creating Healthy Work Environments for Nursing Practice. American Journal of Critical Care. 2006;15: 256-267www.aacn.org/DM/Media/MediaView.aspx?mid=2864&itemid=56
American Association of Critical-Care Nurses. AACN standards for establishing and sustaining healthy work environments: a journey to excellence. 2005. Am J Crit Care. 2005;14(3):187–197.
Kramer M, Hafner, LP. Shared values: impact on staff nurse job satisfaction and perceived productivity. Nurs Res. 1989; 38(3):172–177