Purpose This study aims to enhance understanding of the collaboration between chairs of nurse councils (CNCs) and members of executive hospital boards (BM) from a relational leadership perspective. Design/methodology/approach The authors used a qualitative and interpretive methodology. The authors study the daily interactions of BM and CNCs of seven Dutch hospitals through a relational leadership lens. The authors used a combination of observations, interviews and document analysis. The author’s qualitative analysis was used to grasp the process of collaborating between BM and CNCs. Findings Knowing each other, relating with and relating to are distinct but intertwined processes that influence the collaboration between BM and CNC. The absence of conflict is also regarded as a finding in this paper. Combined together, they show the importance of a relational process perspective to understand the complexity of collaboration in hospitals. Originality/value Collaboration between professional groups in hospitals is becoming more important due to increasing interdependence. This is a consequence of the complexity in organizing qualitative care. Nevertheless, research on the process of collaborating between nurse councils (NCs) and executive hospital boards is scarce. Furthermore, the understanding of the workings of boards, in general, is limited. The relational process perspective and the combination of observations, interviewing and document analysis proved valuable in this study and is underrepresented in leadership research. This process perspective is a valuable addition to skills- and competencies-focused leadership literature.
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Most nurse leadership studies have concentrated on a classical, heroic, and hierarchical view of leadership. However, critical leadership studies have argued the need for more insight into leadership in daily nursing practices. Nurses must align their professional standards and opinions on quality of care with those of other professionals, management, and patients. They want to achieve better outcomes for their patients but also feel disciplined and controlled. To deal with this, nurses challenge the status quo by showing rebel nurse leadership. In this paper, we describe 47 nurses’ experiences with rebel nurse leadership from a leadership-as-practice perspective. In eight focus groups, nurses from two hospitals and one long-term care organization shared their experiences of rebel nurse leadership practices. They illustrated the differences between “bad” and “good” rebels. Knowledge, work experience, and patient-driven motivation were considered necessary for “good” rebel leadership. The participants also explained that continuous social influencing is important while exploring and challenging the boundaries set by colleagues and management. Credibility, trust, autonomy, freedom, and preserving relationships determined whether rebel nurses acted visibly or invisibly. Ultimately, this study refines the concept of rebel nurse leadership, gives a better understanding of how this occurs in nursing practice, and give insights into the challenges faced when studying nursing leadership practices.
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Aim(s): To understand how nurses experience their positioning amidst hospital crises. Background: Nursing leadership literature is predominantly focused on the skills and competencies of nurses and less on the relations in practice with nurses. Nurses are often valued for bedside care but are overlooked in strategic decision-making during crises. Foundational research emphasizes the need for nurses’ equal participation in interprofessional healthcare practices and governance. Methods: We conducted a qualitative interpretive interview and focus group study, amidst the COVID-19 crisis. We interviewed 64 chairs of nurse councils and deepened our understanding of our initial findings in four focus groups with 34 participants. Results: Nurses differ widely on (a) what is important to them in crisis management, (b) how they can contribute to crisis management, and (c) how they value their involvement or lack of it. Furthermore, we uncovered three relational leadership struggles for nurses concerning (1) navigating, (2) positioning, and (3) collaborating, in crisis management structures. Conclusion: The ailing positioning and representation of nurses in crisis management result from their limited participation in strategic decision-making, and the lack of intervention on this by board members, physicians, and managers. Implications for Nursing Management: This study highlights the need for agents such as board members, managers, physicians, and nurses themselves to create clear frameworks and policies that define nurses’ roles in crisis situations, emphasizing the importance of addressing power dynamics and enhancing communication and collaboration in hospital settings. Effective crisis management requires involving nurses from the start, providing regular training, and promoting a more equal approach to teamwork. Understanding relational leadership and its impact during crises can empower nurses and improve overall hospital crisis response.
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Nurse clinician-scientists are increasingly expected to show leadership aimed at transforming healthcare. However, research on nurse clinician-scientists' leadership (integrating researcher and practitioner roles) is scarce and hardly embedded in sociohistorical contexts. This study introduces leadership moments, that is, concrete events in practices that are perceived as acts of empowerment, in order to understand leadership in the daily work of newly appointed nurse clinician-scientists. Following the learning history method we gathered data using multiple (qualitative) methods to get close to their daily practices. A document analysis provided us with insight into the history of nursing science to illustrate how leadership moments in the everyday work of nurse clinician-scientists in the “here and now” can be related to the particular histories from which they emerged. A qualitative analysis led to three acts of empowerment: (1) becoming visible, (2) building networks, and (3) getting wired in. These acts are illustrated with three series of events in which nurse clinician-scientists' leadership becomes visible. This study contributes to a more socially embedded understanding of nursing leadership, enables us to get a grip on crucial leadership moments, and provides academic and practical starting points for strengthening nurse clinician-scientists' leadership practices. Transformations in healthcare call for transformed notions of leadership.
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Some nurses are responding rebelliously to the changing healthcare landscape by challenging the status quo and deviating from suboptimal practices, professional norms, and organizational rules. While some view rebel nurse leadership as challenging traditional structures to improve patient care, others see it as disruptive and harmful. These diverging opinions create dilemmas for nurses and nurse managers in daily practice. To understand the context, dilemmas, and interactions in rebel nurse leadership, we conducted a multiple case study in two Dutch hospitals. We delved into the mundane practices to expand the concept of leadership-as-practice. By shadowing rebel nurse practices, we identified three typical leadership practices which present the most common “lived” experiences and dilemmas of nurses and nurse managers. Overall, we noticed that deviating acts were more often quick fixes rather than sustainable changes. Our research points to what is needed to change the status quo in a sustainable manner. To change unworkable practices, nurses need to share their experienced dilemmas with their managers. In addition, nurse managers must build relationships with other nurses, value different perspectives, and support experimenting to promote collective learning.
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When organizations start to digitize, this often means that processes will be changed. The management paradigm that is centered on the continues review and improvement of organizational processes is Business Process Management (BPM). To digitize processes, an organization should have the right competences to deal with both technological and process changes. However, currently, it is not known which competences are needed by leaders to guide an organization with digital process transformation initiatives. Hence, this paper consists of an explorative study based on interviews with five experts to find out if and how the competences related to digital leadership can guide such initiatives. The experts are employees within five different organizations. The interviews showed some interesting results. First of all, several competences of digital leadership were mentioned by various experts. Many of these competences corresponded with each other. In the interviews, the following competences of digital leadership were mentioned most often: Collaboration, Self-direction, Lifelong learning, and Flexibility. Secondly, there are many approaches to gain insight into processes within organizations. The use of models is necessary to create added value, to help coordinate information provision between the processes and the people who work for the organization. One such approach is the use of Business Process Management Maturity models, which provide insight into the process maturity level of an organization. According to the respondents, there is a relationship between BPM maturity and digital leadership.
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In my view, organisations are playing an ever-larger role with and in these changes. This is why we need organisations that are not afraid to express and give concrete meaning to their innovative views on economic and social themes. These are organisations that dare to break out of the old thought and behavioural patterns in order to create room for change and renewal. They are guided by an innovative philosophy and mode of thinking, and show this leadership by translating this body of thought into concrete actions and results. This is why, in the professorship, we call these organisations ‘thought leaders in a society of change’.
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A Magnet-related program has been recently adopted in the Netherlands. Support for staff nurses from nurse middle managers (NMMs) is a key component of such a program. A Bourdieusian ethnographic organizational case study in four hospitals in the Netherlands and the United States (Magnet, Magnet-related and non-Magnet) was conducted to explore NMMs’ supporting role behavior. Bourdieus concepts of habitus, dispositions, field and capital guided the analysis. Eight dispositions constitute NMMs habitus. A caring, clinical and scientific disposition enhance NMMs’ capital in particular organizations-as-fields. Further research is necessary to link Magnet (related) program characteristics to various configurations of dispositions of NMMs habitus.
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The importance of leadership is increasingly recognized in relation to digital transformation. Therefore, middle management and top management must have the competencies required to lead such a transformation. The purpose of this paper is to investigate the relationship between the digital leader competencies as set out by the European e-competence framework (e-CF) and the digital transformation of organizations. Also, the relationship between digital leadership competency (DLC) and IT capability is examined. An empirical investigation is presented based on a sample of 433 respondents, analyzed using PLS-SEM. The results strongly support our hypotheses. DLC has a strong impact on organizational digital transformation. A post-hoc analysis showed this is predominantly the case for the e-CF competencies of business plan development, architecture design, and innovating while business change management and governance do not seem to affect organizational digital transformation. This is the first empirical study to conceptualize, operationalize and validate the concept of DLC, based on the e-competence framework, and its impact on digital transformation. These findings have significant implications for researchers and practitioners working on the transformation toward a digital organization.
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Educational innovations often tend to fail, mainly because teachers and school principals do not feel involved or are not allowed to have a say. Angela de Jong's dissertation shows the importance of school principals and teachers leading 'collaborative innovation' together. Collaborative innovation requires a collaborative, distributed approach involving both horizontal and vertical working relationships in a school. Her research shows that teams with more distributed leadership have a more collaborative 'spirit' to improve education. Team members move beyond formal (leadership) roles, and work more collectively on school-wide educational improvement from intrinsic motivation. De Jong further shows that school principals seek a balance in steering and providing space. She distinguished three leadership patterns: Team Player, Key Player, Facilitator. Team players in particular are important for more collaborative innovation in a school. They balance between providing professional space to teachers (who look beyond their own classroom) and steering for strategy, frameworks, boundaries, and vision. This research took place in schools working with the program of Foundation leerKRACHT, a program implemented by more than a thousand schools (primary, secondary, and vocational education). The study recommends, towards school principals and teachers, and also towards trainers, policymakers, and school board members, to reflect more explicitly on their roles in collaborative innovation and talk about those roles.
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