Development of a programme to enhance nurse managers' relational leadership skills in a designated hospital in the Mpumalanga province

Abstract

ABSTRACT Introduction There is uncertainty and differences in how the concept of leadership is defined, interpreted and its characteristics described. Leadership is defined as the art of moving others to want to struggle for shared aspirations. Relational leadership is now considered a far more effective way to organize and implement leadership to respond to the challenges facing 21st-century organisations. Relational leadership positions leadership as an intrapersonal phenomenon associated with collaboration, empathy, trust, and empowerment, as non-hierarchical and distributed as embedded within everyday interaction, conversation, and relational processes. The researcher has observed in the specific public hospital that nurse managers are those that hold the power and decision-making authority. Suggestions and initiatives from followers are not entertained. These nurse managers decide what goals should be achieved, and direct and control all activities without meaningful participation by the followers. During informal discussions with nurses working at the hospital, it was indicated that the nurse manager-nurse relationship is impersonal. They indicated that they must obey instructions and that they do not receive any explanation about the instructions. Furthermore, nurses indicated that the poor relationship between them and the nurse managers contribute to low morale, trust issues and job dissatisfaction. Aims The study aimed to firstly explore the knowledge base of relational leadership. Secondly, it was to explore what leadership skills nurse managers in the designated hospital use and how these skills are related to relational leadership, and lastly to develop a programme to enhance relational leadership skills of nurse managers in the designated hospital. Methodology A qualitative single, holistic case study design was used to explore the phenomenon within its context. The ‘case’ for this study was ‘the development of a programme to enhance relational leadership skills of nurse managers in the designated hospital in Mpumalanga province’. The Relational Leadership Theory, scoping review findings, and findings about the leadership skills of nurse managers were used to develop the interventions, rationale and actions for the relational leadership programme.

Findings Nurses working at the specific public hospital do use some skills related to relational leadership unaware. Findings revealed that nurse managers in the hospital mostly used leadership skills based on the situation in which they find themselves. Some of these leadership skills could be construed as relational in nature but it was not done with relational mindfulness that allows the leader to make informed and shrewd judgements about the interpersonal situation at hand. The relational foundation needed in building open, inclusive and mutually beneficial relationships with those being led was found to be inadequate. The nurse managers are aware of the different types of leadership, but most of them indicated that they switch to autocratic leadership when they are under challenging situations. Some nurse managers indicated that their interpersonal, emotional, and relational skills should be developed. The study findings revealed that most nurse managers of the designated hospital lack relational skills. Conclusion The study concludes that relational leadership is a way of being in the world that embraces an intersubjective and relationally responsive way of thinking and acting. Leadership as a position acknowledges that the practice and outcome of leadership emerge with those they are leading. Becoming a leader calls a person to negotiate with those they are leading to build a mutually understood and accepted view of what the inherent responsibilities of the leadership position are, and how it is best to be performed. Key words & phrases Development of a programme, leadership skills, leadership skills development, nurse, nurse manager and relational leadership.