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Leadership is embedded in professional practice behaviors of frontline medical-surgical nurses (FMSNs), but leadership competencies remain under-developed in the workforce. An exploratory descriptive online survey design was used to examine prevalence and patterns of leadership behaviors among FMSNs.
In landmark work, the Institute of Medicine (IOM, 2010) declared the following: Nurses should be full partners in redesigning health care; they must understand and accept their responsibility to lead, and they must be educated and socialized accordingly in education and practice environments. Arguably, the leadership capacity of nurses is insufficient to support significant influence on the much-needed transformation of healthcare systems. Nurses are recognized as having critical knowledge and awareness of patients, families, and communities, and are the most trusted professionals (Altman et al., 2016; Reinhart, 2020). However, they are not perceived as important decision-makers by the public and often do not self-identify as leaders (Girven et al., 2016; Miles & Scott, 2019). The deficit of leadership competencies is particularly evident at the point of care, and calls for developing clinical nurses as leaders are increasing (Beck et al., 2015). In 2016, the IOM affirmed the ongoing relevance of their initial recommendations and added new recommendations for increased attention to leadership development among nurses (Altman et al., 2016).
Historical Perspectives on Leadership in Nursing
The topic of leadership has been the subject of multiple scientific reviews in the 21st century (Chavez & Yoder, 2015; Cook, 2001; Cutcliffe & Cleary, 2015; Stanley & Stanley, 2018). Each review revealed a frequent conflation of leadership and management. Roussel and Ratcliffe (2013) differentiated leadership from headship (management) as follows: "Authority embodied in a title or position of leadership is legitimized power, it is not leadership" (p. 741, emphasis added). In contrast, leadership reflects the capacity to influence others with or without legitimized power. From this perspective, leadership is about behavior rather than title; therefore, the potential for leadership exists in all nurses. This sentiment is supported by multiple authors (Chavez & Yoder, 2015; Patrick et al., 2011; Stewart et al., 2004) who suggest nurses wield significant influence with patients and other members of the healthcare team through enactment of professional behaviors such as communication, collaboration, and coordination.
Notably, the literature contained numerous discussions about leadership and very little empirical...