Nursing Management & Clinical Governance: Leadership vs Management

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This essay provides a comprehensive analysis of the differences between nurse leaders and nurse managers, emphasizing the unique attributes of leaders, particularly congruent and transformational leaders, in driving change and fostering long-term organizational goals within the nursing profession. Drawing upon Stanley's work and other peer-reviewed sources, the essay highlights that leaders nurture and empower followers, prioritize long-term vision, and demonstrate interpersonal skills, while managers focus on day-to-day operations and maintaining the status quo. The discussion also touches on the importance of leadership styles, such as transformational leadership, in addressing challenges like nurse shortages and improving service delivery in the healthcare sector, ultimately arguing that nurse leaders are better equipped to handle complex situations and create a positive work environment compared to nurse managers. Desklib offers a wealth of resources, including similar essays and study tools, to support students in their academic endeavors.
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Running head: NURSING MANAGEMENT AND CLINICAL GOVERNANCE
Nursing Management and Clinical Governance
Student’s Name
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NURSING MANAGEMENT AND CLINICAL GOVERNANCE 1
Nursing Management and Clinical Governance
Introduction
Nursing is increasingly becoming a challenging and dynamic profession that self-
motivated individuals to deliver cope with emerging changes. These people can be managers or
leaders, but leaders are preferred over managers. Out of the concern to address effective
leadership and management, scholars have reported that there are key attributes that set leaders
apart from been managers. Stanley (2017) has explored the unique attributes of nurse leaders and
why they are suitable for to address different challenges affecting the nursing profession. It is in
respect to this point that this paper presents an exploration of differences between leaders and
managers basing on Stanley. The paper uses other external peer reviewed resources to support
Stanley’s (2017) view of nurse leaders and importance of having leaders within the nursing
profession. It is expected that the analysis presented in this paper will contributed to the current
theoretical understanding of the differences existing between nurses and managers and motivate
current nurses to take a leadership approach in their profession.
Differences between Nurse Leaders and Nurse Managers
Yang (2016) and Algahtani (2014) explain that the primary distinction between leaders
and managers is that leaders are system changers. The primary difference between the two when
it comes to effecting change is in the nature of the manner in which the two execute their
responsibilities. Stanley (2017) gives an example of congruent leaders. He writes “congruent
leaders may have ideas and vision about where they want to go…they are driven by values.”
Congruent leaders articulate the roadmap for future change and motivate and channel the efforts
of their colleagues towards achieving the goals of the organization. On the other hand, managers
do not have long-term goals for the organization as explained in the Harvard Business Review
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NURSING MANAGEMENT AND CLINICAL GOVERNANCE 2
handbook (2017). Managers are motivated by day-to-day operations within the firm, making
them less effective when it comes to effecting long-term goals of the organization. This implies
that in order to tackle and solve the dynamic issues that emerge in clinical practice, there is a
need to focus on empowering leaders instead of managers.
In most cases, leaders tend to nurture and create other leaders with the goal of continuity
for future. This is another strength that distinguishes them from managers who focus on
following the day-to-day rules within the organization (Spurgeon & Cragg, 2007). While both
nurse leaders and nurse managers are important for the healthcare sector, it is evident that the
long-term interests of nurse leaders are different from those of managers. As a matter of fact,
nurse managers hardly seem to be concerned with the future of the organization because they
tend to do things right (Azad, Anderson, Brooks, Garza, O'Neil, Stutz, & Sobotka, 2017).
Leaders forge the way forward, invite others to follow the way, and teach the followers how to
walk the way so that the followers can walk the way even when the leader is not available
(Swanson & McKim, 2017). On the other hand, managers identify do not teach or motivate
others to walk the way. They are, instead interested in commanding others to do what even
themselves cannot do (Milton, 2009). A manager commands followers, but a leader will be with
the employees at the ground, working with them, understanding the challenges they face, and
developing strategies to overcome those challenges. It is evident from this explanation that a
leader is preferable for long-term vision of the organization because the organization will keep
moving even when the leader is not available.
Mortier, Vlerick, and Clays (2016) explain the difference between nurse leaders and
nurse managers in terms of roles and responsibilities within the organization. Nurse managers
occupy a rank within the organization and they use their rank to command and instruct others to
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NURSING MANAGEMENT AND CLINICAL GOVERNANCE 3
follow instructions. This is specifically different from nurse leaders. Nurse leaders may hold the
same rank within the organization, but when it comes to executing their roles, the leader will
play an influencing role. Nurses can sow the seeds of leadership when they channel their efforts
towards helping others and working the best within their profession. Connolly, Jacobs, and Scott
(2018) explain that a nurse leader is different from a nurse manager in the sense that the leader
does not necessarily need a rank or powerful position for one to work. For instance, nurse leaders
will develop their competencies when they work productively and influence others even when
they are not occupying a top position within the organization. On the other hand, nurse managers
will wait to be assigned a top position before they start executing their powers and
responsibilities. Nurse leaders will work maximum under minimum supervision.
Korniewicz (2017) explains that due to the nature of leadership, the roles of leaders are
often many when compared to those of managers. This is due to the fact that managers are
change influencers For instance, while the manager only requires to focus on the status quo
within the organization and impact change on a daily basis, the leader is expected to use
interpersonal skills to direct, motivate, instruct, and delegate duties. Leadership styles and skills
have a significant role to play when it comes to clinical practice. In today’s age where nurses are
forced to deal with high number of patients and strike to balance personal goals with the
professional goals, transformative skills in nursing help the professionals in navigating
challenges while at the same time developing their careers. When a leader looks at the core
workers, he sees an opportunity for expansion and growth. Compared to a manager who will
blame the followers for failing to effect change and produce results, a nurse leader will take
responsibility and use the opportunity for learning.
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NURSING MANAGEMENT AND CLINICAL GOVERNANCE 4
In Nelsey and Brownie (2012), the two authors argue that nurse leaders are are different
from nurse managers, in spite of numerous confusions surrounding their definitions. For
instance, people think that managers can complement leaders, only to find that a manager lacks
leadership skills. Spurgeon and Cragg (2007) explain that leaders can demonstrate managerial
skills, but it is difficult for managers to demonstrate leadership skills. For instance, a nurse leader
has intrinsic skills that propel him to always work towards self-improvement and the people
around. Thus, while a nurse manager is dedicated to overseeing their subordinates perform the
assigned duties and tasks, the nurse leader will often be found among the nurses working with
them and motivating them. The leader manager will also share with others what he has learned
and ask consult them and involve them in making decisions that affect them within the
organization. The manager hardly creates or develops the system. The primary concern of a
manager is to maintain the status quo within the organization and apply skills that have proven
working. The leader has entrepreneurial skills and is willing to test systems and find one that
applies on the situation. It is for this reason that Caragher and Gormley (2016) emphasize that
leaders create fans, but managers create employees.
According to Stanley (2017), goals and visions distinguish leaders from managers.
Managers will look at the issue and create goals, but leaders will create vision. Goals are short-
term and can end when the final result has been achieved, but visions are long-term and require
strategic planning and preparation. While it is true that both leaders and managers need goals and
objectives to execute their functions, a leader has a wider and defined scope when it comes to
goals and objectives (Nesley & Brownie, 2012). Visions entail knowing where one is currently
positioned, what he wants, and how he can achieve that goal. Additionally, a manager is often
self-centered and will hardly listen to issues affecting the subordinates in their work
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NURSING MANAGEMENT AND CLINICAL GOVERNANCE 5
environment. Nurse leaders are people-focused and focus on forging relationships with workers
with the goal of exploiting the unique strengths in each of the employees.
One of the leading differences between management and leadership is that while
leadership has different styles that determine how a leader interacts with followers. Some of the
leadership styles said to be effective in managing change and developing followers are the
transformational and transactional leadership styles as discussed in Korniewicz (2015).
Transformational leaders have distinct characteristics of raising followers to higher levels of
morality and motivation. They will create an opportunity for followers to develop and grow in a
given area. Stanley (2017) explains that transformational leaders are characterized by
inspiration and charisma. They prepare their followers for change by creating social bonds and
psychological motivation to the extent that followers will not resist change. This is practically
important in today’s competitive world where health institutions are struggling with competition
and internal challenges that affect productivity.
The health sector is currently facing significant challenges and issues that make affect
service delivery. Health institutions are facing the problem of nurse shortage, while the few still
loyal to the profession are overworked and stressed due to high patient to nurse ratio. Addressing
such issues does not require a nurse manager, but a nurse leader. It requires a person that can
forge the relationship with the followers and empower them to work and make moral decisions
when they are facing challenges (Spurgeon & Cragg, 2007). It also requires a person that will
allow the followers to express their views about the current problem they are facing and what
they think can be done to improve the situation. Managers are void of such qualities because the
nature of their task is constricted to what Spurgeon and Cragg (2007) call “doing things right.”
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NURSING MANAGEMENT AND CLINICAL GOVERNANCE 6
Only nurse leaders can be an answer for current issues because the solutions required are not
short-term.
The attitude of the manager or leader plays a crucial role in effecting change and
managing complex situations. In the Harvard Business Review (2017), the authors claim that the
attitude of the manager or leader has a significant impact on the success of any business
company. When people are overworked and stressed in their current position, the best thing they
will ever need is support and motivation from their seniors. According to Connolly, Jacobs, and
Scott (2018), many nurses working under managers are likely to quit employment because of
lack of moral support and victimization from top managers. Saravo, Netzel, and Kiezewetter,
(2017) further explain that managers face challenges in dispensation of their roles because they
appear authoritative in nature. This limits successful implementation of change strategies,
considering that motivation is a key factor for change management.
In spite of the above differences, there are some common areas of agreement where
leadership plays a role for successful change and transformation within organizations. Carsten,
Uhl-Bien, West, JPatera, and McGregor (2010) explain that successful leaders blend
management skills with leadership skills for proper functioning of their organizations. However,
Stanley (2016) explains that managers hardly find it possible to apply leadership skills. The
primary reason is that nurse leaders tend to have an innate calling in their profession that will
drive them towards the call of serving others. Nurse leaders will rise to leadership ranks after
years of serving, and some of them may die in service. On the other hand, managers are
compelled by power or authority. They do not have time to serve because that is not their
interest. They want to use their learned skills to execute change today, with little consideration
for tomorrow.
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NURSING MANAGEMENT AND CLINICAL GOVERNANCE 7
It is evident from this analysis that even though there are some similarities between
managers and leaders, leaders stand out with unique capabilities. Leaders create and nurture
followers with long-term goals for their profession, while managers prioritize the goals of the
firm. There are high chances of the manager creating conflict between the organization and its
people due to ignoring the needs and interests of employees. A manager cannot effectively forge
a relationship between the firm and its employees because he lacks necessary skills for
motivating workers. Nurse leader prepares the followers for successful transition into future by
making them part of the change process. This explains the theoretical and practical importance of
having empowered leader in healthcare and clinical practice.
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NURSING MANAGEMENT AND CLINICAL GOVERNANCE 8
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