The article "Leader Visibility: What's Your View?" by Bryan Kennedy, MS, RN, NEA-BC, and Tina Jury, MSN, RN, NEA-BC (July 2016) couldn't come at a better time. This has been a hot topic in my organization over the last several months, with all leaders brainstorming on how to make leader visibility more effective. One of the ways to become more visible on the units and hospital-wide is the implementation of Thank You Thursdays. During the month of July, hospital leaders-from nurse managers to the CEO-are taking treats to the units/staff on both day and night shifts. Treats range from brownies and fruit cups to hot dogs and nachos, with the treats lined up in connection with a theme (such as tie dye/1970s attire with the brownies and wear your favorite sports team shirt with the nachos). This has been well received throughout the facility and, as such, we've decided to keep up with Thank You Thursdays for a while longer.

We also participate in daily Gemba rounds, which allow administrative leaders to round on different units to discuss hospital or unit processes that need a drill down and staff members to share issues or concerns with the executive staff. This is a great opportunity to meet staff members and give them a voice to make changes where needed. Although this provides visibility for our day-shift staff, we're lacking in visibility for night and weekend employees. Ways to eliminate this deficiency are much needed and desired.

Upon reading one of this article's references, I found it odd that a CNO videotaped her annual nursing report in favor of face-to-face forums, with unit leaders providing discussion and feedback. Although a timesaver for the CNO, it makes me wonder how the staff members feel about the lack of face time.

-Kelly Lomack, BSN, RN

I enjoyed reading the article "Leader Visibility: What's Your View?" by Bryan Kennedy, MS, RN, NEA-BC, and Tina Jury, MSN, RN, NEA-BC (July 2016). Leadership visibility is extremely important to elevate the level of transparency and trust in healthcare organizations. However, I do question whether nurses are truly interested in the visibility of all leaders or more specifically just nursing leaders. I had a similar experience at the organization where I work: An employee engagement survey revealed a lack of leadership visibility. As we explored this question in our unit practice councils, it was brought to our attention that many nurses weren't familiar with nursing leadership, more specifically the CNO.

In this article, the study conducted by the authors revealed that nursing staff reported high familiarity with clinical leaders but lacked familiarity with nonclinical leaders, including executives. Unfortunately, familiarity and visibility aren't always the same thing. Nurses may be familiar with nursing leadership, but are nursing leaders visible and accessible? There's great benefit in developing and fostering relationships between frontline nursing staff and the CNO. Effective communication from the CNO influences nursing performance, organizational culture, and clinical patient outcomes. Because evidence shows that transformational leadership styles and increased leader visibility improve job satisfaction and patient outcomes, determining which leaders need to increase their visibility is imperative. Further research should be conducted to determine whether nurses value visibility of the CNO or other hospital executives.

-Dawn Dickens, BSN, RN, CMSRN

As a nurse with just over 30 years' experience, 15 of those being at the bedside in a Level 1 Trauma ED and/or ICU/CVICU, the next 7 in management, and the last 8 as a CNO, I most certainly understand the need for visibility of the leadership team from all angles and couldn't agree more with authors Kennedy and Jury that "engaged leaders create a supportive environment that promotes innovation, trust, and teamwork" ("Leader Visibility: What's Your View?" July 2016). The study in this article, as I understand it, was completed to determine the relationship of employee engagement to leadership visibility. However, I wonder why only those who associate with transformational leadership were included in the group of "engaged leaders who motivate and empower staff to accept and take ownership of the organization's goals."

Although the evidence clearly supports transformational leadership as being a style in which the leader uses vision, passion, and personal integrity to inspire staff to follow, it's only one of many leadership styles, such as authentic leadership, that can inspire change. It should be noted that authentic and transformational leadership theories are, in many ways, redundant; in one leadership theory, they're even combined as the authentic transformational leader.

Based on this study, employee engagement as it relates to leadership visibility succeeds only with transformational leadership; however, to limit the success to just one leadership theory seems to be an injustice. Perhaps instead of limiting their study to transformational leaders, the authors could expand it to include evidence-based leadership. Those who practice evidence-based leadership can clearly see that the evidence supports visibility of the leadership team to bring about positive results.

-Jaci Mester, BSN, RN

Thank you for your enlightening article "Leader Visibility: What's Your View?" by Bryan Kennedy, MS, RN, NEA-BC, and Tina Jury, MSN, RN, NEA-BC (July 2016). As an assistant nurse manager in a large healthcare organization, I enjoyed reading this study on the need for executive leadership visibility and how this affects the climate of the organization. I appreciated that the study was based on transformational leadership and recognizes the important role that the executive leadership team has when empowering staff, developing leaders, and clearly communicating the vision of the organization. As the authors noted, clinical nurses often aren't familiar with the executive leadership team and feel a sense of disconnect. The authors also noted that clinical nurses often used the word "care" in their survey responses, referring to a need for the executive leadership team to care about them.

I've personally seen this lack of connection between the frontline nursing staff and the executive leadership team at my own organization as we prepared for Magnet^(R) recognition. The Magnet model recognizes the need to not only empower staff, but also transform the organization for the future. In order to accomplish this transformation, the executive leadership team has a responsibility to clearly communicate the strategic plan and vision of the organization, as well as be available for discussion and questions. The authors of this article recommend periodic leadership rounds, opportunities for town hall meetings away from the work environment, e-mail updates from the executives, and personal biographies of the executive leadership team to be shared with staff. Beyond those measures, it's been suggested that incorporating an informal opportunity for discussion, such as sharing a meal together or even a coffee/tea break, presents another opportunity for the executive leadership team to be visible in a casual atmosphere, which may promote a more open discussion.

-Kerri Covert, BSN, RNC-NIC