Political Competency: Part of the Nurse Leader Role
An attorney friend of mine once asked me which of my various career roles I think of as my specialty. Having known me as I moved from medical-surgical to orthopedics to pediatrics to critical care, and having heard my enthusiasm and enjoyment of each segment of this professional journey, I think she assumed I would name one of those areas. Instead, I mentioned my current area of expertise, Nursing Administration. The initial silence that greeted this declaration did not surprise me. Often people who hear my title (both nurses and nonnurses) are left puzzled because they are not quite sure what nurses in management positions do. However, my friend was not speechless for long. "Oh," she said. "You are a specialist in diplomacy."
My astute friend's observation was so accurate that I thought about it for several days, recalling a conversation with a different colleague more than 30 years before. I had been asked to take a leadership position and had confided in another staff nurse that I did not want to do it because I just wanted to "take care of patients, and stay out of all the useless political junk." Yet, here I am with decades of formal leadership experience, described as a specialist in diplomacy, a euphemism for politics.
Nurse leaders are diplomats, and much of their success (or survival in this specialty) has to do with their political competencies. We are called on to address the desires of diverse stakeholders with divergent and conflicting demands. Our communities, organizations, bosses, administrative peers, medical staff members, nurses, ancillary staff, and patients look to us not only to meet their individual needs but also to serve as mediators when they are not in agreement. Our days are filled with managing conflicts fueled by professional disagreements; intergenerational, cultural, and gender differences; personality issues; communication problems; and the constant mismatch between healthcare financial realities and the resources needed for quality patient care. We negotiate, smooth, soothe, and balance today's crises with the proactivity needed to avoid tomorrow's crises. In other words, we are experts in organizational politics.
However, political savvy for nurse executives must go beyond our own practices and our own organizations. Our commitment to leaving healthier worlds requires political sophistication as a tool to influence a variety of individuals and government entities.
The nurse leaders who served as peer reviewers for this issue chose an array of political subjects, from the macro world of professional politics to the micro view of realities within individual organizations. Nurse leaders have an interest and need to be competent in both arenas. The International Council of Nurses, in recognition of the power inherent to elected office, has recently established an International Nurse Political Network. In the United States, the Nursing Organizations Alliance sponsors a nurse in Washington Internship to provide nurses the opportunity to learn how to influence healthcare through the legislative and regulatory process. Both organizations understand the power in being politically involved.
A nurse executive does not need to be an elected official, nor an intern in Washington, DC, to understand the need for patient care advocates gaining and exercising official power. An interview with Colleen Scanlon, RN, JD, senior vice president for Advocacy at Catholic Health Initiatives, describes how one system exercises its responsibility for an interface with the political arena. This is followed by an article from leaders of the American Organization of Nurse Executives on the importance of lobbying and being heard through political action committees.
Our second group of articles covers negotiation skills needed in the daily life of nurse leaders. From Harper and McCully's exploration of acuity to Baker's description of research methods to Collins' advice on negotiating for information technology resources, they provide information on how executives must seek and utilize data in order to make a compelling case for quality patient care. In the real world of limited resources, knowledge of where to get and how to present information is an essential competency.
Finally, our reviewers selected a series of articles on the relationship between organizational culture and politics. As the various authors demonstrate, politics influence culture, while the culture can dictate the success or failure of various political maneuvering. Nurse executives who wish to affect cultural change must understand the politics involved, and even those with exquisite political savvy must also be competent in assessing which skills will be most successful in a given culture.
My attorney friend was correct: Successful nurse executives are diplomats. As a young staff nurse, I was wrong: Political skills and an understanding of political power are not useless, they are essential.
Political savvy is a competency needed by all of us. Whether we choose to seek elected positions like the several nurses who currently serve in the US House of Representatives and others who are elected to state legislatures, select a job specifically based on advocacy, like Colleen Scanlon or JoAnn Web, director of Federal Relations for American Organization of Nurse Executives, or remain in traditional nurse leadership positions, we must know how to obtain and use power. Then we can continue our work as advocates for our patients, colleagues, organizations, and communities.
Kathleen D. Sanford, DBA, RN, FACHE
Senior Vice President and Chief Nursing Officer, Catholic Health Initiatives, Denver, Colorado