General Role of NursesUnlike the medical doctor, whose primary role is one of diagnosis and treatment, the role of the nurse can be thought of in terms of caring, healing and actually dealing with the patient on an intimate basis as he or she goes through the process of improving their health. This necessarily makes the nurse responsible for the physical, mental, emotional and sometimes spiritual well-being of the patient. In order to effectively accomplish their mission, however, the nurse must not only act as an administrator of care, but also as a leader in general well-being. This is the philosophy espoused by one of the major theorists in nursing, Sister Calista Roy. According to Roy, the role of the nurse is to function as a facilitator of the patient's own natural ability to adapt to injury and illness. This dynamic model sees nurses in what is essentially a leadership capacity, bringing their knowledge, expertise, techniques and compassion to guide the patient toward good health.
Leadership SpecificsSusan O. Valentine of the University of North Carolina writes that nursing can best take advantage of current medical knowledge and recent technological advancements by adopting a "transformational leadership approach." Through this approach, the nurse becomes instrumental in leading the charge toward more effective care in the clinical setting. She mentions, for example, how simply being beside a patient's bed for up to 24 hours makes the nurse the first line of leadership in ensuring well-being. They are often called upon to make instant life-saving decisions before a doctor can be called on scene. Furthermore, they are also often in charge of deciding how best to approach a patient when it comes to sensitive issues revolving around care. Combined with functioning as a sort of liaison between patient and doctor, the nurse must be a master of interpersonal relationships and show leadership in order to get the job done.
Other Forms of LeadershipIn addition to the transformational approach, there is also the idea of "quantum leadership," for which nurses seem especially suited. This theory sees leadership within any organization or group as emerging from various places and at different levels within hierarchies. For example, a nurse administrator might set a hospital's overall policy when it comes to nursing, while the nurse in the emergency room can show effective leadership when patients suffering from life-threatening wounds are brought in. While some nurses may have more prestige and recognition within this understanding, all of them form an integral part of overall function and act as leaders in their own right.
Theory and PracticeBeyond the idea of nurses as transformational leaders, affecting all aspects of care and inspiring each other, other staff and the patients themselves, they can also lead in terms of an advancement of the theory and practice of nursing. Many notable theorists of the 20th century have led the way in redefining what it means to be both a nurse and a leader. Such leadership requires both careful scholarship and insightful imagination, requiring the grandest of efforts in order to be the sort of paradigm shift needed to advance the discipline.
FutureAn example of this leadership can be found in the work of Hildegard Peplau, who wrote "Interpersonal Relations in Nursing," first published in 1952. Her work centered on the various roles taken by nurses, including what she called the "active leadership role." In that role, the nurse becomes primarily responsible for ensuring that the patient reaches the treatment goals which have been prescribed. Aside from helping to define the leadership roles of nurses, she also helped push the envelope when it came to adapting many of the insights obtained in psychology to the field of nursing.
It is precisely that incorporation of new knowledge that makes it possible for nurses to lead in the intellectual capacity as well as the others described previously. From that starting point of theory, as Peplau shows, the nurse leader is able to apply what is effective and what is not when it comes to practice, thus helping to shape both the future of the profession and the well-being of all patients. Nurses and nursing in general tends to evoke images of humble service and caring for the sick and infirm through compassion and love. Such things, while noble, usually do not seem to imply leadership, yet the reality is that nursing as both an art and a science is built upon the idea of leadership, not through force but through example.