Leadership and Dynamic Adaptation

       In a recent School Wide Nursing Forum a speaker brought to our attention the fact that in Great Britain, Nurses frequently have complete control over patient diet and activity levels. This made me curious as to why Nurses aren't able to take control of certain aspects of care when it is warranted. The fundamental change would likely have to come at first in the curriculum and research into the practice of nurse run nutrition programs etc. But what prevents this change in healthcare or really any change in healthcare that may be for the better.

In the British Journal of Healthcare Management, Joanna DaCosta writes, "The traditional hierarchal model of postgraduate medical training is not conducive to developing practical leadership skills among
doctors and does not support change and innovation. Medical professionals should actively
promote the development of leadership skills amongst their more junior colleagues with a
particular emphasis on collaborative working across professional boundaries" (Dacosta, pg 575, 2012)

Now this may seem like an attack on traditional medicine, provider models of care or doctors in general but in reality it is none of the above. The author goes on to emphasize the need for Dynamic Adaptation and how to foster a Dynamic Environment. (Dacosta, 2012).  If there is one thing I have learned about leadership this quarter it is that the preconceived notions I had about leadership were false. In my mind a leader gave orders and in turn had responsibility for the overall success of any undertaking. A leaders job is actually to do everything in their power to ensure that all have a responsibility for the outcome and a desire to see that outcome to be a positive one. In patient care the outcome is often a life that hangs in the balance right? Ultimately a more effective model of care saves more lives doesn't it? I may be misunderstanding things or thinking too black and white but ultimately leadership contributes to this balance somewhat of that I am sure.

The author goes on to outline transactional and transformational leadership, one focused on negotiation and the other focused on promoting "followers [that] are both emotionally and rationally inclined to contribute more to a task than originally planned" (DaCosta, pg 576, 2012).

For innovation and growth to occur "an environment of 'psychological safety' that fosters risk taking and opportunism, and supports others to learn and adapt" (Dacosta, pg 579). If we want to solve the system wide issues in healthcare we must create this environment. We need to draw on the experience and ideas of all. As nurses we can lead the way in fostering leadership within our profession that is Progressive, Dynamic and Adaptive.

I would like to thank Marie Manthey the amazing nurse and amazing woman who came and spoke to our school at the forum. I was lucky enough to attend a Nursing Salon Marie held and it is people like her who continue to contribute and care in an immeasurable and immense fashion that are able to truly make a difference.










DaCosta, J. (2012). Leadership models for healthcare improvement. British Journal Of Healthcare Management, 18(11), 575-580.