Management is about arranging and telling. Leadership is about nurturing and enhancing.
– Tom Peters
As I prepare to take office in June as the CMSA National president, I find myself reflecting on how I came to this moment. Being the “leader” of a national professional organization was not something I had on my “bucket list” for my career when I graduated from nursing school in 1999. Somewhat of a late bloomer, I returned to school at age 28 with two small children after a decade-long career in the business world. It is truly interesting how life takes you on a twisting path, with each turn contributing to the journey in its own way until, finally, here you are.
Leadership is defined as “the action of leading a group of people or organization” (Merriam-Webster, 2021). It is also described as “the ability of an individual or group of individuals to influence and guide followers or other members of an organization” (Pratt, 2021). Leadership involves making decisions – good, sound decisions and sometimes difficult and unpopular decisions – creating and articulating a clear vision, establishing achievable (key word) goals and providing team members with the knowledge and tools necessary to achieve those goals. Please note that “management” and “leadership” are not the same thing.
Leaders create a vision and can successfully inspire others to work toward achieving the goals that contribute to that vision. They do this by plotting the course, charting the direction and inspiring others to want to succeed in achieving the end result. How do they do this? By getting people excited and motivated to work toward the vision.
Think of a cause or project that is/was important to you. Can you do it alone? Most probably not. You’ll need help. So, you recruit your team of helpers and explain to them what your vision is and what is needed to get there. This is the time to get your team’s “buy in”: “acceptance or willingness to actively support or participate in something” (Merriam-Webster, 2021). If your team doesn’t buy in, you have a group of people. Get them excited and motivated to achieve the goal and you now have a team.
As an illustration of this, I think of Eric Bergman and his efforts in Illinois to get the Nurse Licensure Compact (NLC) passed. He brings groups together, thoughtfully explains the issue, identifies what the NLC means to his audience and gets them motivated for the action steps he is asking of them.
CASE MANAGERS AS LEADERS
Case managers are leaders on the healthcare team. As I sit in our morning interdisciplinary team meetings, it is the case manager (nurse or social worker) who takes the lead, presenting the patient cases with the rest of the healthcare team contributing from the points of view. The case manager is the hub of the patient discussion because we have information from every team member/discipline, patient and family perspectives, community resources and other care providers. The case manager gets that buy in from the team and advocates for the patient while motivating the rest of the team toward that patient’s goal(s). Leadership in action!
NATURE VERSUS NURTURE
Is a leader born or made? That is an age-old question, and I will postulate that it is both. An effective leader should possess characteristics that include self-confidence, strong communication and management skills, creative and innovative thinking, perseverance in the face of failure, willingness to take risks, openness to change and levelheadedness and reactiveness in times of crisis. That doesn’t mean that you are born with all these tools. I have always been a strong communicator (just ask my father), and I have a strong stubborn streak that could be interpreted as perseverance. I am not afraid of change, and, in fact, I tend to enjoy the change process. The rest of that list? Definitely acquired over time and still acquiring.
Studies show that first-born children tend to be leaders. As the eldest of five children, my role was to be the one “in charge,” whether it was babysitting my younger siblings or helping out around the house, especially in the care of my younger brother who had many medical problems. At times, I would be the only person he would participate with in his therapy exercises. Interestingly though, I was painfully shy in public and terrified of “breaking rules.” While I had the “first-born” leadership edge, I certainly was not born with the skills I use day by day. These skills were acquired through education, mentoring and sheer perseverance.
My journey to healthcare leadership was a bit convoluted. I worked in the business arena for 11 years before returning to school to start my healthcare education. I started my healthcare career through an associate’s degree in nursing program, then to a BSN, MSN and finally, a doctorate in nursing practice. Real leadership-focused, educational content began to make an impact for me in my MSN program.
By the time I began my MSN, I had been in management positions for several years. I had been able to successfully translate my decade-long business career experience into management in healthcare. But that still did not equate into “leadership” skills.
MY LEADERSHIP APPROACH
I discovered the concept of “servant leadership” while in the middle of my MSN program.
A servant-leader focuses primarily on the growth and well-being of people and the communities to which they belong. The servant-leader shares power with the team, puts the needs of others first and helps people develop and perform as highly as possible.
I believe that a leader should be able to “walk the walk and talk the talk.” Just last week, I was discussing cases with my fabulous social work partner, Ellen. She had two complex cases that were pulling at her simultaneously. We split the workload and managed to resolve both expeditiously. Leaders should be able to step in and help team members when the workload is overwhelming, setting expectations through example and role-modeling excellent teamwork. My experience has been that team members have more buy in if they know the leader has their back, is supportive of them and has firsthand knowledge of the issues they face on a day-to-day basis.
Developing people is probably my favorite thing to do as a leader. The satisfaction I receive from helping someone achieve new goals is incredible. As a supervisor, I worked with a team of 10 nurses. Two members of my team were interested in transferring to a new, more challenging position within the company. I worked with them during lunch breaks to prepare for their interviews; we found articles to review and talked with people, who were currently in the role, for their perspectives. How wonderful it was when both team members were offered the new positions!
VALUE OF EDUCATION IN LEADERSHIP DEVELOPMENT
I mentioned earlier that I certainly was not a born leader. My journey to leadership started by default. I have excellent organizational skills and was named “charge nurse” by default as no one else was interested in the position at the time. The nurse manager on the unit felt I could do the reports, triage the problems and handle the issues that would arise, trusting that I would escalate what I couldn’t handle. It was that faith in me that inspired my leadership journey. I had never felt that before from a “boss.” He made me want to achieve the goals, simply by empowering me to do so. (Thank you, Rey!) Think of the impact we have on our patients by empowering them. Again, it’s leadership in action.
You can obtain leadership education from a variety of sources. Ongoing classwork/experiences offered through employers, more formal education programs, self-directed education and professional organizations keep building the skill set. My involvement with CMSA National, CMSA Chicago and ANA Illinois has contributed in building skills across the years as I have been involved with them. As I write this, we are two days out from the CMSA Chicago 29th Annual Conference and I am the Conference Committee chair. If you had told me 10 years ago that I would be doing something like this, my answer would have been a serious “no way.”
As case managers, we know that being leaders in healthcare is not all sunshine, bunny rabbits and flowers. Remember those “difficult and unpopular decisions”? Like anything else in life, leadership has its good and not-so-good moments. But as case managers, let’s remember that we are leaders on the healthcare team, charged with advocating for our patients’ best outcomes and that we are the ones with the “big picture view.” Think back on your journey to where you are now and where you want to be. What impact could further developing your leadership skills have?
Merriam-Webster (2021). Buy In. Merriam-Webster (2021). Leadership. Pratt, M (2021). Leadership. https://www.techtarget.com/searchcio/definition/leadership.