Leadership and management in nursing

• Being the largest group of workers in the health system, nurses increasingly occupy management and leader positions in medical teams.

Health systems have undergone significant changes in recent years, and along with this, the role of nurses is changing as well. We must consider that nurses are the largest group of licensed health workers and hence their presence and participation are much more significant than that of doctors. Medical teams are increasingly coming to include personnel from different specialties, and they all must collaborate to achieve quality medical care for the patients. Nurses are present in almost all areas of medical practice, and many of them have assumed management positions. That is why current education programs for nurses include the development of leadership and management skills in students.

Leadership is considered a process that occurs in interpersonal relationships and tends to influence other people so that they reach their goals or those of the group to which they belong. Management, on the other hand, is based solely on the fulfillment of the tasks or goals assigned to an individual or group. Several theories help define leadership and management according to how the leader/manager accomplishes his functions. Among them we can distinguish the Charismatic based on the personal qualities of the leader, Quantum based on maintaining an adequate balance between tension and order, Relational founded on collaboration and teamwork, Servant based on the ability to serve others, Shared established on sharing responsibility among all group members, Transactional based on the principles of social exchange, and finally Transformational based on individual commitment to the group promoting changes that help reach the common goal.

Once defined the concepts of leadership and management and their bases of work, it is important to know that these people can assume different styles or ways to exert the leadership and management. These are the most significant:

• Autocratic: The leader or manager dominates the group and issues orders without listening to the suggestions of the group members. He is entirely focused and able to attend to all problems, make decisions, and maintain total control of the group.
• Democratic: The leader or manager allows the participation of all members and listens to their ideas. Decisions are made in consensus with the opinion of all members. It is also known as a participatory method and is closer to collective management as it is much less authoritarian.
• Laissez-faire: This type of leader is one who delegates all responsibility to the group, assuming an entirely passive attitude to problems. There is no guide or support to members, and it is the group who should make its own decisions.
• Situational: This style is a combination of all the above and is based on analyzing the specific circumstances surrounding the task and group to apply one or other of the methods described above.
• Bureaucratic: As the word implies, in this style decisions are made based on the procedures and policies defined by the organization. It comes from the belief that group members are motivated by external forces and that everything is already decided in advance by the agency.

Good leadership depends in no small extent on the leader's character and behavior. He must be an excellent communicator and a credible person by his subordinates, among whom he will promote a spirit of collaboration at all times. Must have critical thinking and be capable of detecting all the risks present in a particular situation, but at the same time must be a person who assumes those risks naturally and in correspondence initiate the actions needed at any time. All these qualities will allow him to persuade and influence the people he leads.

It is useless for a leader or manager to have an appropriate character and exert considerable influence in his group if his behavior is not capable of supporting those qualities. A good leader should always be visible and accessible to his subordinates, and he will treat them as individuals with their particular characteristics. His thinking should be critical regarding old problems for which he will try to look for new solutions. The leader should motivate his group to reach their goals by stimulating them and communicating the vision of the organization or company to which they belong. He should never fear to delegate responsibilities to other members, and this means promoting the participation of his employees in decision making, empowering them to fulfill their duties.

Perhaps the most crucial challenge a leader can face is to get his subordinates feel the group's mistakes as their own, but also the triumphs that they can achieve working as a team. It is not an easy task, but all of us who ever had the opportunity to work with a great leader, know that work will no longer be a burden when we are motivated and that proper management benefits both employees and the organization.