Unlike some entrepreneurs in the general marketplace who creatively feed self-interest, effective entrepreneurial leaders in health care foster some aspect of altruism. At the root of healthcare leadership is caring for and about others. No industry is more appropriate for servant leadership.
“Leadership is giving. Leadership is an ethic, a gift of oneself to a common cause, a higher calling” (Bolman & Deal, 2001, p. 106). The unique power and prerogative of a leader is the freedom to share yourself, your style, your values, and your influence for a better future. Bolman and Deal (2001, p. 106) reminded:
The essence of leadership is not giving things or even providing visions. It is offer- ing oneself and one’s spirit. Material gifts are not unimportant. We need both bread and roses. Soul and spirit are no substitute for wages and working conditions. But . . . the most important thing about a gift is the spirit behind it . . . . The gifts of authorship, love, power, and significance work only when they are freely given and freely received. Leaders cannot give what they do not have . . . . When they try, they breed disappointment and cyni- cism. When their gifts are genuine and the spirit is right, their giving transforms an organiza- tion from a mere place of work to a shared way of life.
The concept of servant leadership was introduced by Robert Greenleaf in the 1970s (1977, 1998) and has been further developed by Spears (1995). Servant leadership re- leases powerful energy and proposes skills that are particularly effective in health- care disciplines where some degree of altruism is at the heart. It resonates in special ways within the discipline of nursing (Howatson-Jones, 2004; Swearingen & Liberman, 2004). It encourages the professional growth of the leader and clinician and promotes positive health outcomes. It facilitates collaboration, teamwork, shared decision making, values, and ethical behavior (Barbuto & Wheeler, 2007; Neill & Saunders, 2008).
Eleven characteristics of servant leadership include having a sense of calling, listen- ing, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, growth, and building community.
Peter Senge (1990, 2006) suggested the following five elements of the servant-leader:
(1) personal mastery, or “continually clarifying and deepening personal vision . . . focus- ing energies, developing patience, and seeing reality objectively” (1990, p. 7); (2) mental models, or deep assumptions, generalizations, or images “that influence how we un- derstand the world and how we take action” (1990, p. 8); (3) building shared vision, or sharing the image we create of the future; (4) team learning, or fundamental learning as a team unit rather than as individuals; and (5) systems thinking.
Some people are natural servant-leaders. You know who they are in your own life.
But more important, one can learn to become a servant-leader. It begins with commit- ment and practice to lifelong personal and professional learning. Personal mastery is the first step. It means to commit to continual engagement in redefining and clarifying your own personal mission. It means that you cultivate exquisite self-knowledge and personal growth, that you set personal goals related more to the advancement of others than to self-aggrandizement, and that you take time for reflection and feeding your inner self.
You come to see your work with a sense of calling.
To be aware of mental models means that you are sensitive to your own personal bi- ases, viewpoints, history, and style and that you strive to use your best self to promote the effective work of others to achieve organizational goals. You examine your own thinking and strive to create a clear vision that you can valiantly communicate and defend. You cultivate exquisite sensitivity in listening, awareness, and empathy. You approach your work and relationships from a perspective of healing.
The shared vision is the common and persuasive image of the future. As the leader, you conceptualize and facilitate that picture with foresight and empower others to share the dream and focus energies to make the changes and do the work to achieve shared goals.
Team learning reflects your ability to suspend your personal assumptions and pace in order to bring the team together to listen to each other and to work in synchrony or harmony. It means that your focus is on the needs and strengths of the team and that you create ways to develop the team to foster collaboration and effectiveness. You lead the team with a sense of stewardship and interest in the growth of its members and help them to build a community together. Systems thinking allows you to see the whole as a synergistic concept rather than simply as parts put together. It allows you to see the influence of your own actions and the work of the team on the entire system.
Secretan (2009a) identified the following five “shifts” in servant leadership: from self to other, from things to people, from breakthrough to “kaizen” (celebration of doing things differently rather than simply doing things better), from weakness to strength, and from competition and fear to love. He reminded leaders to ask how we use our gifts to serve.
He further outlined six values or principles for “higher ground” leadership:
1. Courage: Being brave enough to reach beyond the boundaries created by our existing, often deeply held, limitations, fears, and belief. Initiating change in our lives—of any kind—hap- pens only when we are courageous enough to take the necessary action . . .
2. Authenticity: Committing oneself to show up and be fully present in all aspects of life, removing the mask and becoming a real, vulnerable, and intimate human being, a per- son without self-absorption who is genuine and emotionally and spiritually connected to others . . .
3. Service: Focusing on the needs of others by listening to them, identifying their needs, and meeting them. Being inspiring, rather than following a self-focused, competitive, fear-based approach . . .
4. Truthfulness: Listening openly to the truth of others and refusing to compromise integrity or to deny universal truths—even when avoiding the truth might, on the face of it, especially in testing times, seem easier . . .
5. Love: Embracing the underlying oneness with others and life. Relating to, and inspiring, oth- ers and touching their hearts in ways that add to who you both are as persons . . .
6. Effectiveness: Being capable of, and successful in, achieving the physical, material, intellectual, emotional, and spiritual goals we set in life . . . (Secretan, 2009b).
When a leader adopts the transformational stance, along with transforming the orga- nization is a tacit promise to transform others. This is an unspoken covenant to guard the integrity, respect, and good works of others. This is done in a myriad of ways. Create tra- ditions replete with ceremonies and rituals that provide a sense of community, belong- ing, and the image that significant things are happening and that the people involved are important. Celebrate successes and rejoice in the achievements of others. Find ways to distinguish good work and reward it. Create an environment with high standards to which people are drawn with assurance that their work is appreciated. Servant leader- ship is based on the assumption that the people are more important than the task and that authentic service to people gets the task done.