Senior Nurse Advisor Clinical Leadership Development Programme Leadership

Senior Nurse Advisor Clinical Leadership Development Programme Leadership - practices and principles Ian Govier (Facilitator)

Welcome from Sara Jones Director of Unscheduled Care / Nurse Director Welsh Ambulance Trust

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Aim of the Programme To assist the clinical leadership development of Senior Nurse Advisors at NHS Direct Wales

Programme Objectives The Programme will assist participants to develop their clinical leadership potential through: • Active participation in clinical leadership workshops and related activities; • Identifying and critically examining the key characteristics, attitudes and behaviours associated with effective clinical leadership; • Taking action to successfully lead the Nurse Advisor team and thereby enhance the performance and quality of health care provision provided by NHS Direct Wales.

Senior Nurse Advisor Clinical Leadership Development Programme Introductory Days x 2 Clinical Leadership an introduction to practices and principles July 25 th & 26 th Module 1 Clinical Leadership September 5 th developing & sustaining effective teams Clinical Leadership September 6 th exploring organisational influences Module 2 Clinical Leadership October 24 th leading and implementing complex change Clinical Leadership October 25 th managing performance & improving patient care

Participant Aims & Expectations

Name & Role What do I want to achieve as a result of this programme? What am I bringing to this programme? What is one thing you don’t know about me? How might I sabotage my learning / development?

What are some of your current challenges?

Leadership - practices and principles

Let’s look at Leadership

Let’s consider some leaders!

Leadership: The Myths It’s rare It’s found mainly at the top It’s about being superhuman

Message Board Nov 22 nd Hey, where is everybody? Don't we need nursing leaders? Someone to round the troops and lead us in a certain direction! Oh, yeah, nursing doesn't have a direction. . . why doesn't anyone care about that? Let's just keep nursing the same way it is now because I don't see leaders or anyone talking about nursing leaders anywhere! Lets just complain about this profession until the cows come home I guess. 2005

Who are the leaders? “Lots of ordinary nurses are leaders – it is in the very nature of the job. Good care involves winning your patient’s confidence, convincing them to keep to their treatment regimes and inspiring them to battle their way back to health” (Crouch, 2002)

Leadership & Management Principles

The Leadership / Management Dilemma!

Leadership & Management …essential yet different!

• Managers maintain paths • Administrators tidy paths LEADERS MAKE PATHS!

Management is efficiency in climbing the ladder… …leadership determines whether the ladder is leaning against the right wall.

Management (transactional leadership) is essential!

Managers and Leaders Management (Order & Consistency) Leadership (Change & Movement) (Kotter, 1990)

Management (Order & Consistency) Planning / Budgeting Organising / Staffing Establish agendas Set time tables Allocate resources Provide structure Make job placements Establish rules & procedures Controlling / Problem Solving Develop incentives Generate creative solutions Take corrective action (Kotter, 1990)

Leadership (Change & Movement) Establishing Direction Aligning People Create a vision Clarify big picture Set strategies Communicate goals Seek commitment Build teams & coalitions Motivating & Inspiring Inspire & energise Empower subordinates Satisfy unmet needs (Kotter, 1990)

Managers and Leaders • Are transactional • Seek to operate & maintain current systems • Accept given objectives & meanings • Control & monitor • Trade on exchange relationships • Have a short term focus • Focus on detail & procedure • Are transformative • Seek to challenge & change systems • Create new visions & meanings • Seek to inspire & transcend • Have a long term focus • Focus on the strategic bigger picture (Storey, 2004)

A Leadership Story A group of workers and their managers are set a task of clearing a road through a dense jungle on a remote island to get to the coast where an estuary provides a perfect site for a port. The managers organise the labour into efficient units and monitor the distribution and use of capital assets – progress is excellent. The managers continue to monitor and evaluate progress, making adjustments along the way to ensure the progress is maintained and efficiency increased wherever possible. Then, one day amidst all the hustle and bustle and activity, one person climbs up a nearby tree. The person surveys the scene from the top of the tree and shouts down to the assembled crowd:

“Wrong Way!” “Management is doing things right, leadership is doing the right things” (Warren Bennis & Peter Drucker)

Seeing the bigger picture

Seeing the bigger picture Z

An elephant is like a fan An elephant is like a wall An elephant is like a spear An elephant is like a rope An elephant is like a snake An elephant is like a tree

Theories & Concepts of Leadership

Concepts of Leadership • Leadership is the ability to direct a group of people in realising a common goal • This is done by people applying their leadership attributes • Leaders create commitment and enthusiasm amongst followers to achieve goals • Leadership is achieved through interaction between leader, follower and environment

Leadership Research • 1930 s – 1950 s focus on Personality • 1960 s: focus on Behaviour • 1970 s: focus on Situational variables • 1980 s: emergence of the ‘New Paradigm’

Common Leadership Theories ‘Great Man’

Wanted! A born leader. Must have superior intellect, be outgoing and under 40. Ability to walk on water a distinct advantage!

Common Leadership Theories Trait

Let’s identify traits associated with effective leaders Group Work

Common Leadership Theories Situational / Contingency

Hersey's and Blanchard's Situational Leadership® Model

Telling & Selling (Boss-centred Leadership) Participating & Delegating (Staff-centred Leadership) (Tannenbaum & Schmidt, 1958)

Boss-centred Leadership Staff-centred Leadership Tells Sells Decides Consults & Delegates & sells & decides delegates (Tannenbaum & Schmidt, 1958)

Let’s Nail It!

The ‘New Paradigm’ Models of Leadership Visionary Charismatic Transformational

Common Leadership Theories Interactional: Transactional Transformational

Transformational Leadership An approach to leadership which seeks to bring about success and sustainable growth within groups through a change within the consciousness of participants

Leadership and Performance Outcomes Transformational Leadership has a significantly greater impact than Transactional Leadership on: Staff Teams Organisations Source: Bass, B. M. (1998) Transformational Leadership: Military, Industrial & Educational Impact. London: Lawrence Erlbaum

Transformational Leaders have: Staff who: • have higher levels of satisfaction, motivation, and performance • have lower levels of stress & burnout Teams that…. • are more innovative, collaborative and effective Organisations which… • • • respond more quickly and productively to change are more effective have healthier, more humane cultures (Bass, 1998)

Qualities of Leaders desired by NHS Staff • • • Genuine concern for others Inspirational communicator, networker and achiever Empowering others to lead Transparency Accessibility, approachability and flexibility Decisiveness, determination, readiness to take risks Ability to draw people together with shared vision Charisma Encouraging challenges to the status quo Supporting a development culture Ability to analyse and think creatively Manage change sensitively and skilfully (Alimo-Metcalfe, 2000)

Transformational Leadership Leading Self Leading Others Leading the Organisation (Alimo-Metcalfe & Alimo-Metcalfe, 2006)

Leading Self (Personal Qualities) Being Transparent Acting with Integrity Being Decisive Inspiring Others Resolving Complex Problems

Leading Others Showing Genuine Concern Enabling Being Accessible Encouraging Change

Leading the Organisation Networking & Achieving Focusing Team Effort Building Shared Vision Supporting a Developmental Culture Facilitating Change Sensitively

Transformational Leaders (Kouzes and Posner, 2002)

What am I doing to become a transformational leader?

Final Thoughts

The Constants ü Change ü Principles ü Choice (Covey, 2006)

What am I going to do differently after today?

If we always do what we’ve always done… …we’ll always get what we’ve always got

The ‘Trim Tab’ effect

HMS ‘Trim Tab’

Be a TRIM TABBER!

and finally…

The world is moved along, not only by the mighty shoves of its heroes, but also by the aggregate of tiny pushes of each honest worker. Helen Keller

We do not lead by being corporate, professional or institutional… …we lead by being human

Great leaders … are people with enormous self-knowledge. They have self-insight and self-respect balanced by scepticism … sceptics who understand their own masks as well as the masks of life, and this understanding makes them humble. They see the humanity in others and deal with them in compassionate yet realistic ways. This duality makes for a wonderful leader. (Mc. Kee, 2003)

And finally… If we do nothing about it in 24 hours… we’ll probably do nothing about it!

Diolch Website: www. ctrtraining. co. uk http: //www. ctrtraining. co. uk/resources. php Thank You

The Manager’s / Leader’s Prayer Please grant me the serenity to prioritise things I cannot delegate, the courage to say no when I need to & the wisdom to know when to go home!