The complexity of the health care provision, current rates of nursing shortage, scientific progress, novel treatment methods, and inadequate affordability of medical services evoke a wide scope of leadership-related issues in health care. Irrespective of their positions, specialties, or ranks, effective leaders are able to enhance the manageability of health care institutions. Well-developed leadership skills of medical professionals allow increasing the effectiveness of medical aid delivery through the cohesion, nonstandard ways of personnel management, maintenance of motivating environments, and so forth. Thus, the necessity of the development of leadership abilities in health care providers has become increasingly apparent today. This paper will explore a phenomenon of leadership through the review of relevant concepts and the evaluation of leadership importance in the emergency services. It will also examine the personal interactions with the best and worst leaders I have ever worked with.
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A multidimensional phenomenon of leadership is examined in a number of sciences, including philosophy, sociology, psychology, and so forth. However, so far the researchers have not elaborated a generally accepted definition of this term due to its complexity and sophistication (Northouse, 2013, p. 4). The phenomenon of leadership becomes apparent when individuals solve problems that affect their interests. This notion always involves a leader’s attempts to influence and direct the behavior of the followers in a particular situation. Social interactions and psychological collaboration between leaders and followers ground on voluntariness. Their basic characteristics include the presence of perspectives, innovations, reasonable risks, creativity, motivation, and followers’ active involvement in the achievement of organizational objectives. Thus, it is possible to identify leadership as mutual interpersonal influences, occurring in certain conditions and guided by the communication process aimed at achieving specific purposes. Transformational, situational, and servant leadership theories appear to be the most pertaining to the importance and outcomes of leadership in the emergency services. The further research will explore these concepts in order to determine the requirements for leadership in this particular area.
Being initially developed by Burns, the concept of transformational leadership has been expanded by Bass (Hutchinson & Jackson, 2013; Northouse, 2013). According to Noethouse’s definition (2013), idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration are constituents of transformational leadership which strengthens motivation, morale, and performance of followers through a variety of mechanisms (p. 191). A transformational leader identifies strengths and weaknesses in his or her followers and sets goals that can optimize their performance. Seeking to promote and encourage the creativity of the adherents, they generate “a vision that provides meaning and motivation” (Hutchinson & Jackson, 2013, p. 12).
Such leaders exert their best efforts to make their team more potent in goal attainment. Followers perceive leaders as role models; respect and trust them, imitate their behavioral patterns, and adopt their way of thinking, ideals, and values. It is possible to achieve these attitudes via the detection of followers’ needs and concerns, assistance in finding methods to solve existing problems, encouragement in making decisions, and enhancement of critical thinking in the subordinates. The approaches of a transformational leader should motivate and satisfy the employees’ personal and professional self-actualization in exchange for achieving organizational goals. This paradigm of leadership corresponds to the complexity and frequent challenges in the emergency service.
The concept of situational leadership is based on the necessity of reconciling personal qualities and behaviors in accordance with a particular situation. A leader should act flexibly and differently, depending on the followers’ competence, a problem or situation to be addressed, and external environments (Skog et al., 2012). Different situation-focused leadership styles depend on a leader’s behavioral patterns, including supportive and directive behaviors (Northouse, 2013, p. 101). Furthermore, a leadership style should correspond to the followers’ maturity levels. According to Whitehead, Weiss & Tappen (2010), “Situational theories emphasize the importance of understanding all the factors that affect a particular group of people in a particular environment” (p. 8). Skog et al. (2012) proved the effectiveness of this approach to leading subordinates in emergency services from the quantitative perspective.
A theory of servant leadership was initially conceptualized by Greenleaf (Northouse, 2013, p. 220). A servant leader is able to influence others, evoking in them desire to work toward a common goal. This theory primarily refers to credibility and trustworthiness. There are two levels of carrying out the activities. On the one hand, servant leaders prioritize the fulfillment of the subordinates’ objectives and needs; on the other hand, they are focused on the implementation of general prospects and organizational mission (Hanse et al., 2015). Such leaders appreciate the professionalism of the subordinates, stimulate their natural pursuit of learning, growth, self-esteem, creativity, and admission of responsibility, sharing power and encouraging collaborative participation in solving problems. They increase employees’ motivation, linking it to organizational goals and mission. According to Northouse (2013), “The outcomes of servant leadership are follower performance and growth, organizational performance, and societal impact” (p. 230).
In addition to innate qualities and abilities, the formation and development of individuals are significantly influenced by their social environments and interactions with others. While volunteering at the Saudi Red Crescent Authorities, I took part in the daily operations performed by Dr. H. and his interactions with patients. Besides his advanced knowledge and level of expertise, Dr. H. served as a role model for our team due to his abilities to organize mutual support, resolve conflicts, inspire others, and empower them to make decisions. He contributed to the formation of a favorable psychological environment and respect-based relationships between staffers. I gained a considerable practical experience by shadowing him in emergency medical services. Saving lives of high-risk patients, Dr. H. managed to support me in my professional endeavors and give valuable advice. I learned that the healing power of health care providers did not solely depend on the state-of-the-art equipment and efficacious medications. I acquired a habit of helping others and a vision of myself dedicating my life to treating and curing patients. Following Dr. H., I realized that the provision of emergency services is an extremely demanding job that requires professional competence, precision, resilience, self-discipline, responsiveness, communication skills, attention to details, and leadership abilities.
Working at the Emergency Department of King Khalid Hospital, I gained the experience of consequences of abusive leadership. Mr. F. supervised other health care providers and had some patient responsibilities. Although he was on good terms with me, Mr. F. excessively focused his energies on two other novices. He strictly controlled every minute of their job performance, diminishing their experiences of competence, autonomy, and relatedness. He based his behavior and tactics on his philosophy of leadership and understanding of professional responsibilities; however, the novices’ motivation decreased dramatically. Moreover, when the new interns suggested some appropriate improvements, Mr. F. did not appreciate their proposals at all and perceived them as an unjustified criticism of his management style. His refusal to evaluate the staffers’ propositions resulted in his subordinates’ reduced motivation and job satisfaction. Thus, his leadership style appeared to be abusive. According to Lian et al. (2012), abusive supervision can induce “negative ramifications for a wide range of relevant organizational outcomes” (p. 43). The subordinates’ responses to abusive management can lead to their deviant behaviors.
Leadership is especially needed when a social group or an organization solves problems that affect interests of its majority. A leader inspires the followers and instills enthusiasm, transfers his or her vision of the future and helps adapt to challenging tasks and innovations. Taking into consideration the complexity of duties and responsibilities in the emergency services, leadership is instrumental in providing appropriate patient care and efficient teamwork (Sarcevic et al., 2011). The performance of the emergency departments is based on an interdisciplinary team approach; that is associated with different leadership styles and possible emergence of contradictions between leaders. In order to ensure high-quality care and effective performance of a medical setting, leaders in the emergency service should maintain morality and cohesion in staffers, helping them to cope with conflicts and tensions. Leaders should be able to allocate tasks with the highest priority and motivate followers to solve them; therefore, leaders in the emergency service should possess a high level of expertise and competence.
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Efficient performance of health care settings is directly linked with effective leadership. Various concepts of leadership provide different interpretations of this phenomenon and its determinants. The theories of servant, transformational, and situational kinds of leadership are the most pertinent approaches to skills required for leaders in the emergency service due to their congruence with the scope of duties and responsibilities. Operations of the emergency service departments pose especial requirements for leadership. A person who strives to become a leader in such an organization should purposefully develop and deepen relevant qualities and abilities via ongoing training, self-assessment, self-learning, motivating, self-actualization, and practical experience.
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