12
Lisa Little; Joan Wagner; and Anne Sutherland Boal
Let whoever is in charge keep this simple question in her head (not, how can I always do this right thing myself, but) how can I provide for this right thing to be always done?
—Florence Nightingale (1860, p. 37)
Introduction
According to the Canadian Nurses Association, “Nursing leadership is about critical thinking, action and advocacy—and it happens in all roles and domains of nursing practice.” It exists across all domains of nursing (clinical, academic, administration, research, and policy) in every setting and at various levels. Leadership can occur in formal, appointed positions or in informal roles that nurses assume. In administration, it is
about innovative and visionary administrators from the first level to the most senior nurse executives—leaders who understand and hold themselves accountable for creating vibrant, exciting practice settings in which nurses can deliver safe, accessible, timely and high-quality care for the Canadians they serve. (CNA, 2009a, p.1)
This chapter will focus on the tools and resources required to support the first-level manager (nurse manager) and builds on the ethical nursing practices and professional nursing values discussed in Chapter 10.
Learning Objectives
- Recognize the role of nurse leaders, and nurse managers in particular.
- Integrate the role of the professional nurse into the role of the nurse leader or manager.
- Illustrate the importance of examining personal, professional, and organizational values in nursing practice.
- Describe how the CNA’s Code of Ethics can be used in your nursing practice to deal with environmental threats.
12.1 Nursing Leadership
“Nursing leadership plays a pivotal role in the immediate lives of nurses and it has an impact on the entire health system and the Canadians it serves” (CNA, 2009a, p.1). Perhaps nowhere does nursing leadership play a more pivotal role in the immediate lives of nurses than in the case of the nurse manager. A nurse manager is responsible and accountable for the day-to-day operations of the workplace. This includes employee selection, hiring, orientation, staff development and evaluation, resource allocation and management, risk management, patient safety, and financial accountability, among others. Nurse managers are also expected to provide inspiration, guidance, and direction to nurses and other health care providers. They supervise and influence the professional practice of the largest number of frontline nurses, and by that, the largest groups of health care providers in the health system. In 2015, more than 80 per cent of Canada’s nurses worked as staff nurses (CIHI, 2016). On average nurse managers have 56.9 direct reports, with many managers overseeing over 100 staff members (OHA, 2011). Those with a self-reported wide span of control are more likely to have:
- more than 80 staff members reporting to them;
- responsibility for three or more units (physical spaces, which can exist acr