Elements of Leadership Excellence

"Leadership in Nursing Administration" was the very first issue of the Nursing Administration Quarterly (Vol 1, No. 1, Fall 1976), and featured in that issue was NAQ Forum: What Is Needed in Leadership for Nursing Administration? Several of our nation's leaders in the field of nursing administration, in that era, offered their views of "leadership excellence." As we look to the future, a look at the past thoughts from these leaders challenges us to reflect on how we are doing today.

* Edna A. Fagan, Nebraska Methodist Hospital, Omaha, Nebraska: "Two of the most important characteristics for the leader in nursing administration may in reality be curiosity and discontent. These characteristics provide the incentive for evaluation, experimentation, and innovation-the primary functions of any leader."

* Julian Cicatiello, Mercy Hospital, Miami, Florida: The nursing administrator must have a broad understanding of the current internal and external social forces that affect the health care delivery system, and must be capable of dealing with these issues. The ability to bring about change and improve the quality of nursing care with full support of the nursing staff is an essential qualification of a nursing administrator. There is no magic formula for becoming a dynamic administrator, it takes stamina, long hours, hard work, and it all depends on you.

* Eunice Blair, University of Colorado Medical Center: "I see leadership as interpersonal influences, which utilizes the process of human communication and assessment of the environment for the purpose of achieving a goal or a set of goals. Leadership calls into play a conceptual process, which integrates knowledge and insight, personality traits, cultural and personal values, and situational variables into a framework for goal directed behavior."

* Joan F. Moore, Tucson Medical Center, Tucson, Arizona: "Many titles are used, but the essential ingredient is that we, as nursing administrators, be an active, articulate member of the decision making level of health care administration and have an irreplaceable role in care planning and implementation. The leadership role of nursing administrators is a demanding one that offers us unlimited challenges: challenges to keep reaching for the best."

* Ruth Barney Fine, University Hospital, University of Washington, Seattle: "Leadership in nursing administration requires bionic women with replaceable parts. [horizontal ellipsis] a computer brain, programmed to understand the social and political work environment. [horizontal ellipsis] radar, a monitor to pick up new ideas in order to adapt the nursing services to changing conditions and to improve the delivery of patient care. [horizontal ellipsis] a weather sensor for high pressure disturbances in the work climate-bionic temperature control valve as a resource allocator-a strain gauge to sense the give and take needed to negotiate-contracts, budget, nursing decision making and work loads."

* June Werner, Evanston Hospital, Evanston, Illinois:" Leadership in nursing must accept the reality that though we may work for an institution or agency with one name, it is ultimately a conglomerate of separate cultures, each with its own values and standards."

* Frances Tompkins, Union Memorial Hospital, Baltimore, Maryland: "Strength, a sense of purpose and-over riding it all-a deep respect and love for all people. [horizontal ellipsis] My personal definition of a wise person in nursing leadership is one who has the capacity to gather facts carefully, evaluate them thoughtfully, and on the basis of their worth, make sound judgments."

* Loucine Huckaby, University of California, Los Angeles: "Leadership is viewed as the interpersonal process influencing the activities of an organization group, through the communication process, aimed at achieving the specified goals. Leadership exists when an individual meets organizational and individual needs and creates an environment in which these needs are met. These are the leaders of the seventies and eighties, many of whom were presidents and board members of the American Society of Nursing Service Administrators, the now American Organization of Nurse Executives. I was privileged to serve with them and learn from them, as I was elected president of ASNSA in 1977."

* What is different about excellence in nursing leadership today? Is there a significant difference? I will leave that up to Tim Porter-O'Grady, EdD, APRN, FAAN, senior partner, Tim Porter-O'Grady Associates, Inc, Atlanta, Georgia; Associate Professor and Leadership Scholar at Arizona State University Program in Healthcare Innovation; and guest issue editor for Elements of Leadership Excellence.

Dr Tim Porter-O'Grady has been involved in healthcare for 38 years and has held roles from staff nurse to senior executive in a variety of healthcare settings. Tim is currently senior partner of an international healthcare consulting firm, specializing in health futures, organizational innovation, conflict and change, as well as health service delivery models.

Tim is certified by the Georgia Supreme Court's Office of Dispute Resolution as a registered mediator and arbitrator. He has published extensively in healthcare, with more than 165 journal articles and 17 books, and he is a 6-time winner of the AJN Book of the Year Award. He believes that we are called to embrace the challenges of transformation and that as we work to develop systems for the future, we cannot help but transform ourselves.

Transformational leadership requires the tearing down of walls and moving toward the future, a global challenge that confronted me during my four years in Saudi Arabia as Associate Executive Director at the King Faisal Specialist Hospital and Research Center in Riyadh. Transformational leadership is dependent on a management process that develops staff to be as clinically proficient as possible and can only be accomplished with clinically proficient leaders, with transformational values and competencies, which include serving your community, redefining health care with a focus on healing, changing life styles, and holistic interplay between mind, body, and spirit; shared vision; continuous quality improvement, systems thinking, and mastering change.1

Leadership for the future is a combination of lessons learned from our leaders of the past, our present leaders, and leadership that is yet to come. Be passionate about nursing and remember that love embraces all. We are here to give of ourselves, to love to be of service to others. Love life and embrace it to the fullest, surrounding yourselves with those who experience your own zest for living life to the fullest each day. Emanate positive energy and enthusiasm for the daily events as well as the accomplishments of others. Negativity produces negative results and wastes too much energy. To the nurse leaders of tomorrow, look to the past and present for the wisdom, balancing and centering on life's values with flexibility and adaptability to provide the leadership needed for our future throughout the world.

-Barbara J. Brown, EdD, RN, CNAA, FAAN, FNAP

Editor-in-Chief Nursing Administration Quarterly

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