The transformational leader in health care has an eye on and a heart for the next generation of leaders. Leadership development, coaching, and mentoring are integrated into the very life of the transformational leader. That is the only hope of society for a better future. That is how you leave a living legacy. As the number of experienced managers and leaders in health care continues to diminish at the same time the demand for competent and vi- sionary leaders increases, entire organizations are now beginning to integrate leadership development into the everyday life of clinical practice (Spallina, 2002). Unfortunately too many disciplines in professional health care have histories of a kind of professional hazing (as in “if I did it, so should you”), including long hours with assigned shift work; sink-or- swim approaches to practice; see-one, teach-one, do-one; or “probie” approaches to learn- ing. Such traditions simply will not work in the new competitive environment that must focus on quality improvement, patient outcomes, cost containment, and professional re- cruitment and retention. A study in Belgium attempted to identify the impact of a specific clinical leadership development program on the clinical nursing leader, the nursing team, and the caregiving process. Although the study uncovered insights related to the leader’s progress toward a transformational style and its effects on nursing staff, effects on care processes were more challenging (Dierckx de Casterlé, Willemse, Verschueren, & Milisen, 2008). Another exploration in England demonstrated the value of structured planning
and programs in professional development and coaching for future leaders (Alleyne &
Jumaa, 2007). There is certainly room for more study in this area.
Drucker (2000) proposed four ways to motivate and develop future leaders: (1) know people’s strengths, (2) place them where they can make the greatest contributions, (3) treat them as associates, and (4) expose them to challenges. Wells and Hijna (2009) proposed five key elements to develop new talent for leadership in health care: (1) identification of leader competencies, (2) effective job design, (3) a strong focus on leadership recruit- ment, development, and retention, (4) leadership training and development throughout all levels of the organization, and (5) ongoing leadership assessment and performance management. Of course, this is common-sense jargon, but how do we do it in a way that inspires the dreams and hopes of new leadership?
One way to inspire the next generation for leadership is to tell your own story. Some re- search has demonstrated that storytelling, especially directly related to the aspiring leader, is effective in developing managers with high potential for success (Ready, 2002). Stories need to be related to the context of current situations and at the level understood by the potential leader. Effective stories are told by respected role models. Share the passion and drama of your experiences, how you failed and learned from the failure, what your suc- cesses were, and how you learned to survive. And listen to the stories of aspiring leaders.
What is their context and where are they going? How can you help them get there?
Stichler (2006, p. 256) advised that the leader “must consider a logical succession plan in developing tomorrow’s nurse leaders and demonstrate competencies and skills as a mentor, coach, role model, and preceptor. The [leader] teaches by example and fosters continual growth” and extends increasing responsibilities to those to assume future leader- ship. One nurse leader suggested specific steps to approach succession management as a professional obligation, calling it a “migration risk assessment” (Ponti, 2009). First, assess potential attrition and emerging leaders within the organization, establish core competen- cies for leadership positions, and develop individual plans while identifying critical suc- cess factors for upcoming leaders. Then prioritize, coach, and mentor aspiring leaders.
Many healthcare organizations recognize the need to develop future leadership and provide formal programs. The National Center for Healthcare Leadership offers a com- prehensive lifelong, competency-based, and assessment-oriented leadership develop- ment program. Its focus is on leadership competencies, team effectiveness, organization climate, strategic human resource systems, governance alignment, cultural diversity prac- tices, and organizational performance (Davidson, Griffith, Sinioris, & Carreon, 2005).
The transformational leader with a constant eye on developing others for leadership is investing in the future. Generativity is a characteristic of leaders with passion for what they do, a vision for a better future, and a genuine interest in helping others to grow. By enabling the next generation, you extend a living legacy of your own efforts, you enliven our own experiences, and you contribute to a positive human investment in making the world a better place.
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4
Understanding Contexts for Transformational Leadership
The significant problems we face cannot be solved at the same level of thinking we were at when we created them.
— Albert Einstein
T
here are few more important qualities to acquire as a transformational leader than the ability to understand and function effectively within the realities of the context and environment in which you work. Stichler (2006, p. 255, emphasis added) reminded:Today’s [leader] is more challenged than ever to manage multiple, competing priorities in organizations with ever-diminishing financial and human resources. Accountability for ensuring positive patient outcomes, productivity goals, financial targets, retention quotas, customer and provider satisfaction goals, and other performance metrics demand that the contemporary [leader] possess and demonstrate well-developed leadership skills and organi- zational management competencies . . . [and] excel in developing a culture and work environment that fosters professional models of care, evidence-based practice, interdisciplinary and collabora- tive practice, professional autonomy and, quality nursing leadership.
National and international calls continue to go forward for healthcare system reform.
Such calls are grounded in current ongoing uncertainty, mandates for change, and cries for transformation (Hamrick, Spross, & Hanson, 2009). The new jargon is all too familiar:
chaos, quantum leadership, complexity, change, aggregates, and populations. What do these mean for the next generation of leaders?
They all refer to context. In the past, context of care was simple. It referred to set- tings, like hospital, clinic, or home—all with fairly simple linear and hierarchical models for care of the sick. Context as mere setting did not matter so much then to the role of leader. Now, and for the foreseeable future, context is everything. Not only is any single setting more complicated than in the past, but also, the very nature of context itself is more complex. Context is the circumstance of your work. It refers to the multifaceted climate, background, domain, and terrain of service. It is more than setting or environ- ment, although it includes those. It comprises all systemic, physical, social, emotional,