Leadership: behind the mask

Abstract

The aim of this study was to discuss the significance of a leadership theory to support the development of clinical leadership in the specialist area of operating theatres. Leadership theories, particularly transformational leadership, have developed primarily from management paradigms. However, these theories may be ineffective in helping nurses to gain insights into clinical leadership or to develop and implement clinical leadership skills, particularly in specialist areas such as in operating rooms. Congruent leadership theory, based on a match between the clinical leaders' actions and their values and beliefs about care and nursing, may offer a more suitable theoretical foundation on which operating room nurses can build an understanding and capacity to implement clinical leadership or become clinical leaders in this specific environment. The paper draws information from a contemporary literature review and is based on an extensive research study conducted by the author. It is concluded that clinical leadership can be better understood when an appropriate theoretical foundation is employed. Congruent leadership is proposed as the most appropriate theory for nurses in specialist clinical fields. It is important to recognise that leadership theories based on the management paradigm may not be appropriate for all clinical applications. Education should be aimed specifically at clinical leaders, recognising that clinical leaders are followed not for their vision or creativity (even if they demonstrate these), but because they translate their values and beliefs into action, are approachable and open, visible, effective communicators, are positive clinical role models and empowered decision makers, and are clinically competent and knowledgeable.