The impact of a leadership development programme on nurses' self-perceived leadership capability.

AIM: This paper reports on the outcomes of a locally designed educational programme to support leadership capability of junior registered nurses. BACKGROUND: The Developing Leader Programme is an in-house programme delivered in three face-to-face workshops, comprising self-directed reflective and application activities. METHOD: Surveys were used to evaluate self-perceived leadership capability over a 9-month period. The survey comprised a Leadership Capability Instrument adapted from two existing tools. Participants completed surveys at the commencement of the programme, after the third and final workshop and approximately 6 months afterwards. In addition, examples of descriptive accounts of programme activities submitted by individual participants were included to enrich data. RESULTS: Of 124 participants, 79 completed surveys at the first workshop, 28 at the final workshop and 31 were returned 6 months after completion of the programme. Mean scores for each area of leadership capability significantly improved throughout the duration of the programme (P < 0.001). Participants also indicated a willingness to enact leadership behaviours through reported activities. CONCLUSIONS: Survey responses indicated that participants perceived improved leadership capability after completing the Developing Leader Programme. IMPLICATIONS FOR NURSING MANAGEMENT: Early educational intervention to facilitate the development of leadership skills as well as clinical skills in junior registered nurses can assist with how they interact with the team. Participation of junior registered nurses in a locally designed leadership programme can assist them to develop leadership behaviours for everyday practice.

Staff perceptions of leadership during implementation of task-shifting in three surgical units.

BACKGROUND: Registered nurses are difficult to recruit and retain. Task shifting, which involves reallocation of delegation, can reduce demand for registered nurses. Effective leadership is needed for successful task shifting. OBJECTIVE: This study explored leadership styles of three surgical nurse unit managers. Staff completed surveys before and after the implementation of task shifting. Task shifting involved the introduction of endorsed enrolled nurses (licensed nurses who must practise under registered nurse supervision) to better utilize registered nurses. METHODS: Implementation of task shifting occurred over 4 months in a 700-bed tertiary hospital, in southeast Queensland, Australia. A facilitator assisted nurse unit managers during implementation. The impact was assessed by comparison of data before (n = 49) and after (n = 72) task shifting from registered nurses and endorsed enrolled nurses (n = 121) who completed the Ward Organization Features Survey. RESULTS: Significant differences in leadership and staff organization subscales across the settings suggest that how change involving task shifting is implemented influences nurses' opinions of leadership. CONCLUSION: Leadership behaviours of nurse unit managers is a key consideration in managing change such as task shifting. IMPLICATIONS FOR NURSING MANAGEMENT: Consistent and clear messages from leaders about practice change are viewed positively by nursing staff. In the short term, incremental change possibly results in staff maintaining confidence in leadership.

Educating for leadership: a programme designed to build a responsive health care culture.

AIM: To describe a leadership programme that progressively builds nurses capacity from the commencement of their employment to assist with the development of 'others'. Such an approach ultimately contributes to the creation of a team responsive to changing health care needs. BACKGROUND: The literature supports the relationship between positive leadership attributes, good nursing care and patient outcomes. Despite this, nurses are not routinely encultured into effective leadership practices early in their career, but rather they are 'added on' at a later stage according to organizational need. KEY ISSUES: The effective education of leadership practices in this programme is largely dependent on an inclusive and embedded approach to learning. This is achieved through targeting staff early, enhancing their responses to clinical interactions in a structured and supported approach, and challenging their beliefs about capacity to influence through leadership. CONCLUSIONS: Clinical leadership education needs to directly link with clinical areas to engage staff at the commencement of employment, and support them through their career trajectory, so that a systematic pathway of professional development is fostered. IMPLICATIONS FOR NURSING MANAGEMENT: Clearly delineated progressive pathways for leadership development are essential to encourage lifelong reflection and learning that directly impacts on health care quality.