All Nurses Are Leaders

By Rose O. Sherman, EdD, NEA-BC, FAAN

A professional colleague called me with a dilemma. She is in a philosophical argument with some well-known nurse leaders on whether – All Nurses Are Leaders. She thought there was general agreement on this but was learning others saw it differently and didn’t believe all nurses are leaders. She wanted my opinion.

I told her that I think (especially now) that we must promote the idea that all nurses are leaders. How will we ever be able to move to a team or collaborative care model if our nurses don’t see themselves as leaders?  From my experience teaching undergraduate nursing classes, I found that many students don’t identify themselves as leaders when asked. This is problematic as we look at redesigning care delivery with nurses serving as team leaders. It also promotes the victim mentality we see so often today.

I think part of the challenge is confusion between leadership as an “officially designated” role on an organizational chart with direct reports and leadership as a mindset.  John Maxwell wisely observed that a leadership position buys you time. Ultimately, leadership is, above all, about influence and not position. If we expect nurses to lead teams effectively, they must develop leadership capacity. If you look at the new AACN Essentials, Domain 10 clearly outlines competency expectations of graduates, and leadership capacity is an expected program outcome.

Domain 10: Personal, Professional, and Leadership Development

Descriptor: Participation in activities and self-reflection that foster personal health, resilience, and well-being, contribute to lifelong learning, and support the acquisition of nursing expertise and the assertion of leadership.

• Demonstrate a commitment to personal health and well-being.
• Demonstrate a spirit of inquiry that fosters flexibility and professional maturity.
• Develop leadership and professional capacity.

Changing the narrative nurses have about themselves as leaders involves changing mindsets (and even the mindsets of some leaders).  Mindsets are powerful in every aspect of our life. They determine how we see our work, relationships, and world. Nurses who have served in the military will confirm that leadership is an expectation of every soldier, regardless of rank.

So how do we infuse this leadership mindset so all nurses feel empowered to lead?  The first and most challenging step is to move nurses from the “fixed” mindset of seeing leadership as a role to a “growth” mindset of seeing leadership as the power to influence others. Dr. Carol Dweck, a researcher and professor at Stanford University has been a pioneer in studying how transformative a growth mindset can be for individuals applying to this leadership mindset discussion.  A mindset, according to Dweck, is a self-perception or “self-theory” that people hold about themselves. Mindsets can either be growth-oriented or fixed. In a growth mindset, people believe their most basic abilities, such as self-empowerment to influence others, can be developed. This view creates a love of learning and resilience essential for great accomplishment.

A growth mindset results in a powerful belief that anyone can be a leader if he or she decides to learn, work, and develop influencing skills and characteristics. Even when you fail — and you’re human, so you’ll fail from time to time — you won’t be defeated.  Instead of giving up and going home, you’ll begin to look at every situation as a learning experience. When you fail, you’ll figure out what went wrong and work on making sure it doesn’t happen next time.   You don’t write yourself off and are willing to step outside your comfort zone.  This is congruent with how we would like nurses to view their roles.  It fits nicely with shared governance and ideas about empowerment.

To cultivate a leadership mindset, you must recognize that you are a work in progress. What you can influence as a new graduate might be different than what you can wield with years of experience, BUT you still have influence.  A leadership mindset starts with small steps and thoughtful coaching.  We need to discuss leadership as a mindset during professional education and then continue the discussion with the transition into practice.  When nurses say, “I can’t influence this situation because I am not in a leadership role,” – we need to challenge that fixed mindset with the idea that you may not have the influence YET, but with the right approach and some new influencing tools – you could develop it.

The concept of leadership is nebulous even to those who have spent years studying it.  Yet to move forward in nursing, we need to promote leadership as a key competency for all nurses. We need to shift our language to the idea of a leadership mindset focused on developing powerful influencing behaviors. This is what it will take to lead teams successfully. It is a focus that nurses would understand and could lead to better organizational outcomes.

References

Dweck, C.S. (2006). Mindset:  The New Psychology of Success.  New York: Penguin Publishers.