From nurse education, clinical, or workforce issues through to healthy living, Nursing Review has it covered.

OPINION: JO ANN WALTON says it is time to stop hoping some ‘mythical matrons’ – a la Florence – will emerge to lead the nursing profession to new heights. Instead, she argues, it is time to recognise the everyday leaders working amongst us.

I have just spent two weeks in a classroom with some wonderful nurses, midwives and others talking about health care, research and a range of other topics.

The opportunity to explore experiences and ideas is one of the things I most love about my job as an academic. Mostly I am excited about what I hear, especially the creative solutions generated in the room.

On the other hand, sometimes I leave the classroom troubled. One of these troubles resurfaced for me last week.

We were discussing health care leadership. Somehow the familiar refrain “where are our nursing leaders?” was raised yet again. I think I have heard this question, or variations of it, repeated numerous times in every one of my 30-plus years as a nurse.

It keeps being raised in the media too. In fact, on my desk last week was a short article from the Nursing Times in the UK (17 September 2014) in which one of the peers (the only member of the House of Lords with a nursing background) was commenting on the problem of leadership at all levels in nursing in her country. But leadership doesn’t depend on position or level. It is about action and vision.

That troublesome question – “where are our nursing leaders?” – has been playing on my mind for days, like an annoying tune (an earworm, I’ve heard it called) that won’t leave you alone. 

A leader by any other name

So there I was in the classroom, and we were talking about the challenges and rewards of working in health care. We heard about the challenges of keeping the team together, of managing in the face of budgetary constraints and policy limitations, and of working to lift spirits, meet individual needs, and help solve personal crises. We learned about ways to help resolve team conflicts, to manage across disciplinary boundaries, and to design and launch new projects that enable safer, better and more efficient care for patients, families and communities.

We talked about creative problem-solving, ways to help our managers manage better, and the importance of really listening when someone needs to be heard. People described the challenges they face and how, at times, they struggle to achieve the work-life balance they need while counselling others on just this topic.

We discussed the challenges of dealing with ‘difficult’ colleagues, of guiding others gently, of deciding when to pull rank, how to develop others, when to blow the whistle and when to whisper rather than shout. We examined the difficult task of leading through influence when you don’t have authority, and how to harness our personal power. We considered the importance of maintaining our own values, of working from our individual strengths and ways to clarify what exactly these are for each of us.

And still the question arose: “where are our nursing leaders?”

As I see it, the question is all wrong. It is as if we are expressing a nostalgic longing for a past that never really existed, in which a strong and charismatic figure (a mythical matron: maybe Florence herself) would take charge and lead us into a rosy future. Somehow, perhaps, a return to ‘how it used to be’ would shelter us from uncertainty and all our troubles would be over. In this wistful dream the hierarchical pecking order, subordination of juniors, sluice room horrors, sputum mugs, and misaligned bed wheels that made up the ‘good old days’ are all forgotten.

We also forget that we have won other victories over time. And with time what we now know about good and effective leadership has changed.

Look for leaders all around you

Much (if not almost all) of the current writing about leadership suggests that good leadership requires highly developed communication skills, good insight, the ability to empower and develop others, to listen carefully and well, to build teams, to work from a strong values base and to articulate a clear vision that others want to work towards. That and more. Leadership isn’t easy.

I have my own answer to the question “where are our nursing leaders?” They are all around us.

I have just been talking with classrooms full of leaders. I sit with them in committees and meet with them in the wards and in clinics and the community. Highly motivated, generous, well-qualified women and men whose passion is to see that our health care system does what it promises in delivering competent, safe and compassionate care.

People who are ready to push themselves to achieve yet another step in their career; who accept and even look for challenge; who are willing to stand up and to step forward are there in all sorts of guises: young and not so young, new graduates and old hands, born here or born elsewhere. When their lives are already full of responsibility they enlist for more. They are the nurses we all aspire to be. Some are strong and commanding, others are quiet and thoughtful.

Next time you hear the question “where are our nursing leaders?”, don’t hesitate. It is a question that deserves a confident and genuine answer. Start naming some of the very many you already know. I know I will. :

*About the author: Jo Ann Walton is Professor of Nursing at Victoria University’s Graduate School of Nursing and an elected member of the Nursing Council of New Zealand.