the future of the cnl. distinguish the context for leading and managing describe the potential of...
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The Future of the CNL
Distinguish the context for leading and managing
Describe the potential of the CNL in multiple settings
Specify the kinds of outcomes that might be generated if the CNL receives the best possible education and experience to support the role
A platform of beliefs that includes rules, rationality, analysis, logic, reason, and cause-effect predictability
Some kinds of decisions benefit from ‘linear’ approaches
Alternative thought patterns of intuitive & emotional assessments, creativity & lateral thinking, holistic & total systems appraisal, integrative & synergistic thinking, perceptual flexibility, imagination & visualization, & insight.
The nature of the decision (predictability) The complexity of the decision (risk factor) The nature of the environment (stability factors) The maturity of relationships (intensity &
temporal)
“CASs possess distinctive properties that set them apart from linear systems . . . First, they are defined in terms of connections & patterns of relationships among agents . . . Second, they exhibit the property of synergy; the whole is greater than the sum of the parts & the system is self-producing . . . Order emerges without the need for a hierarchical system of control (emergent & self control) . . . Third, the system trajectory over time is fundamentally unknowable.” Anderson & McDaniel (2000).
Leadership is defined as the use of personal traits and personal power to constructively and ethically influence patients, families, and others toward an end-point vision or goal, yet exact or predictable steps to achieve the goal is not known, or must be decided along the way, or requires adaptation from what is known.
The leader builds and forges relationships so those being led are empowered to accomplish the clinical or organizational goal.
Effective leaders communicate a sense of direction, use principles to guide the process, and possess an air of self-assuredness that, in turn, evokes a sense of security in those associated with the task at hand, and encourages reasonable risk taking.
Leadership does not involve coercion or manipulation of others, in that the leader makes known to followers the goal/target being tackled, whereas in coercive or manipulative relationships, this information is withheld from followers.
Think of leadership in terms of delving into uncharted territory, dealing with and composing strategies as-you-go to handle details that could not be predicted in advance, while inspiring others to get the job done!
Management is a set of behaviors and activities that provides structure and direction in conducting patient care and organizational functions where the norms and outcomes to be achieved are known, and where a desired sequence to accomplish these outcomes is prescribed, either in writing or through historical practices embedded in the organization’s culture.
Management tasks are afforded to any staff member who bears responsibility for the work of others or who has the responsibility to assure that an organizational process is carried out.
In another usage, management refers to engaging individual skills and abilities to organize self-directed actions to accomplish goals within a pre-determined time frame (as in completing all essential patient care activities for an assignment of patients by shift end).
Management may or may not refer to positions of authority (such as a Nursing Director or CEO).
Think of management as using power constructively as a professional to expediently guide the accomplishment a task known to be necessary for clinical and organizational success (such as in assignment making, or coordinating discharge planning with other disciplines).
When managing something, a best way, or a set of norms are introduced and used to accomplish goals.
Followership refers to the behaviors demonstrated by individuals with whom the leader/manager interacts.
Followership is the healthy and assertive use of personal behaviors that contributes to patient, family, and healthcare team achievement leading toward clinical and organizational outcomes while practicing acquiescence in some tasks, such as direction setting, politicking, pacesetting, or planning, to the individual(s) leading or managing the team.
As defined, followership is not a passive process, but rather a set of behaviors that demonstrate collaboration, influence, and action with the leader.
When taken together, the behaviors that reflect leading, managing, and following are complementary to each other.
By virtue of being a professional, all organizational staff will be in leading, managing, and following situations.
Discern evidence as the foundation for developing standards of care & practice to guide care delivery.
Develop, collect, & act on critical metrics to assure safe and effective care. l
Demonstrate individual & aggregate decision-making taking the ‘big view’ of organizational systems & processes.
Distinguish evaluation of individuals & processes & act accordingly.
Serve as a change agent by giving direction to groups & teams: defined actions versus innovation
Bring to the inter-disciplinary table skills: standards development , statistical process control, individual & population focus, systems & process design (macro & micro-level, linear & non-linear).
Perform root cause analyses & other risk-aversion or risk-correction procedures.
Link performance measurement to data bases (NDNQI, EMR, CMS and others).
Restore the nursing role to sustain consumer confidence in the discipline & the healthcare team.
