Leadership vs. Management…

Leadership vs. Management…

Recently I had an interaction with a person that lead me to think about the leadership styles and management that I have encountered throughout my nursing career.

As a nurse, we are expected to grow and learn throughout our careers. As a novice nurse we focus on building our practice experiences and work on our theory to practice integration. Once we are more experienced, we are expected to start taking on a leadership role and are often given the assignment of charge nurse (often way before we are ready). And as we continue our growth, we often take on preceptor students, apply for more permanent leadership positions such as Patient Care Coordinators (PCC) or in the USA this role was often call Assistant Nurse Manager (ANM), or we may even seek a higher stature like manager.

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Although as nurses we have the above expectations, not everyone is made of the same cloth and some struggle more with leadership than others. In order for me to demonstrate my point it’s important to review the definitions of leadership and management. Leadership according to Webster’s dictionary “ molds individuals into a team” whereas management is defined as “those who manage or direct”. The definitions are significantly different with each eliciting different outcomes and although both may have a place or time they are used or effective, there are some nurses who only possess a “management” style; and whether this is inherent or a learned trait is to be determined at another time.

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A prime example of when management may be necessary is when you have a busy department and things are going a little sideways, sometimes you may have to breakout the management style to get things done and facilitate flow or movement throughout the department. When management is required, the person in charge is actually only managing movement of patients, they are not managing staff, they are “telling” them what/when/how to do their job in order to empty and fill beds. This is very different than leadership but does at times serve a purpose.

Leadership can in fact have the same goals as management, however; through leading people to critically think and facilitate movement throughout the department it not only aids in development of staff, builds critical thinking, leads to accountability to the department, it also reduces the workload and stress of the leader. Trust is formed between leaders and nurses and an overall boost in moral is evident when a leader is present! I’m sure you see which direction I lean.

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While on some travel assignments, I experienced varying levels of “managers”. I’ve even been “micro-managed”! When a ANM/PCC asks you “why haven’t you hung those IV fluids on patient A?”, many thoughts run through my mind. Mostly, why are you scouring through my patients charts and double checking what I have or have not done (yes, defensive). In this instance, although the fluids were ordered, there were many factors as to why it wasn’t done, and none of those reason were due to incompetence or laziness. In fact, after assessing the patient, discussing the issue with the MD, and critically thinking about the repercussions of the fluids, the MD and I collaboratively decided to wait before giving the fluids. This example demonstrates a manager, task focused, without enquiry, and punitive in their approach. This style of management is overly evident in nursing and directly contributes to attrition rates and job satisfaction. I could tell many stories with similar approaches; the stories are from both sides of the border and amongst many different departments. More recently I was told “if you had just moved your patients you would have reduced your workload”. Although I cannot convey tone, I can assure you this statement came with a tone that implied ignorance. Additionally, the reason the PCC/ANM wished for me to move my patients was in no way to reduce my workload, if fact she wanted to readily fill those beds with patients, some of which may have been actually more work than the 2 I had just finished completing all tasks for!

Now a leader is a different story. The best statement I’ve heard from a leader in a busy department is “what can I do to help facilitate those moves?”. This person recognizes many facets of the department, including that there are somethings that may need to be done (or not) to get the patient going where they need. There will be no “push back” or resistance from a nurse when the AMN/PCC asks enquiry questions, the nurse is empowered to ask for assistance or decline, critical thinking is developed, and the department moves along…

Obviously, we can’t make leaders out of all managers as some just don’t have the insight into their leadership style; however, when people in positions of leadership recognize these “managers” it is important to have those tough conversations and perhaps even review their position within the department. Task focused micro-managers can be toxic to a department…

What style of leadership does your department have? I’d love to hear your perspective in the comments!

fullsizeoutput_1e3c Trudi~A hopeful leader

Life with Indy~bath time

Life with Indy~bath time

The peace and tranquility of living in the country is certainly a great reason to live outside of the hustle and bustle of the suburbs. Part of the tranquility is watching nature. Out here we have all kinds of animals that we enjoy spying and some that we have grown to resent (try finding a mouse in your sock drawer).

This past weekend, our grandson was staying with us. He has been good with Indy and is enjoying getting to know her, getting to know commands, and taking her for walks. He decided to take Indy to explore some of the back property, which is a win win for a boy and a dog! As they returned home, a very pungent odor was present near the dog…what is that? Cow? Well, we don’t have cows on our property, so after some thought we decided she must have rolled in deer poop! OMG, this is not part of the plan for the day, nor had I though that I would have to figure out how to bath this large dog! What now?!?

My choices to clean the dog up and get rid of that smell, included putting her in my car and finding a groomer, find a doggie bath, or getting her into my shower stall…the shower it is!

I’m sure I’ve mentioned it before, but remember we live in a small space. Our 33′ trailer is equipped with a shower large enough for a man but is it big enough for a large dog and her hooman? I decided that at this point in time, the only thing is to try and get her showered. Cue comedy music…

After lot of struggles of even getting her into the small bathroom (took 2 of us), then shutting the door to prevent escaping, I was able to literally drag her into the shower stall. Once there she stood pretty good to get a nice shampoo and rinse. Although there were a couple of escape attempts, she was fairly well contained. I can attest tho that my back, after struggling with her and leaning to wash her, was certainly strained. And then, what do dogs want to do once they are wet, shake of course. I’m not sure my tiny bathroom has ever seen so much water!

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After completing the beauty treatment, I then needed to scrub the bathroom top to bottom, every surface for water and dog hair. This was a project I had not planned for on my day off! I was looking forward to the rest of the day full of rest, relaxation!

Once Indy was dry, I took her for a lovely walk and on our return we received a wonderful brushing and some more TLC, what a good doggie momma I am! Until…

Not 2 seconds after I stropped brushing the doggo, she went directly to the grass and begun to roll around. At first I didn’t think too much about it but I quickly realized that of all the 20 acres she could have rolled, she of course chose the spot a deer had left a special treat, just for my nose!! I’m not sure I could be any angrier! I definitely was not going to do the whole rinse and repeat that the shampoo bottle said to do but this dog can not remain this stinky in our tiny home!

With some quick thinking, I recalled that our trailer is equipped with an outside hose connection, so that’s where her second bath would take place, too bad it was cold water! I put on her harness and attempted to wash this dog one more time. I am certain if my neighbors could hear me, they would have thought I was crazy, they would have been mostly right because crazed was part of the event. Holding with one hand and washing with the other was a true test of my strength.

I am most certain it will take days for my body to recover but my trust in this doggie may be gone for a while longer…

fullsizeoutput_1e3c Doggie Washer (Trudi)