Oleh Reini Astuti, S.Kp., M.Kep.*
Nurses comprise about half of the global healthcare workforce and provide nearly 80% of direct care. They help the sick, injured, and dying families and communities by providing care, support, and treatment. They diagnose infections, give medications, help in surgeries, treat patients beyond the initial diagnosis, provide psychological support, and perform other essential tasks. They are frequently the first healthcare personnel to interact with patients and, in some cases, the only health professional they will ever encounter. As a result, nurses are inextricably related to a country’s ability to handle public health issues. Nurses are at the forefront of the world’s current health concerns, from combating noncommunicable and infectious diseases to combating antibiotic resistance and responding to health emergencies and pandemics.
To achieve this, we need effective health leadership and workforce management because it is essential to address the human resource needs of the health system and strengthen capacities at regional and global levels for universal coverage. Nurses also must learn about management and leadership to support change and achieve goals by ensuring the efficient mobilization and use of health personnel and other resources. Health leadership and workforce management are intertwined and significantly affect health care improvement. Because modern healthcare systems are organized as networks with varying levels of responsibility, they require collaboration and coordination from effective healthcare leadership and workforce management to provide high-quality, cost-effective, accessible, patient-centered, equitable, and safe care.
Leadership is an ability possessed by a person to unite various kinds of differences to achieve the same goal. The staff we encountered could not have been perfect to our liking. They have different characters, values, beliefs, educational backgrounds, families, cultures, perspectives, philosophies and different ages. Of course, I think it can affect how they think and act. Someone who has leadership will be able to unite these differences harmoniously to achieve the same goal. In my analogy, in the game of soccer, eleven players have different roles and characters. Some act as defenders to defend the opponent’s attack, some are midfielders, attackers, ball feeders, and goal scorers, and some are kept goals. They have different roles, talents, and characters, but the leader can manage them according to their respective roles to achieve a common goal of scoring goals in the opponent’s goal. Look, everything is beautiful.
Leadership is an ability possessed by a person to unite various kinds of differences to achieve the same goal. The staff we encountered could not have been perfect to our liking. They have different characters, values, beliefs, educational backgrounds, families, cultures, perspectives, philosophies and different ages. Of course, I think it can affect how they think and act. Someone who has leadership will be able to unite these differences harmoniously to achieve the same goal. In my analogy, eleven players have different roles and characters in the game of soccer. Some act as defenders to defend the opponent’s attack, some are midfielders, attackers, ball feeders, and goal scorers, and some are kept goals. They have different roles, talents, and characters, but the leader can manage them according to their respective roles to achieve a common goal of scoring goals in the opponent’s goal. Look, everything is beautiful.
Likewise, in an organization, we cannot generalize staff who have different abilities, strengths, weaknesses, and talents from one another. We cannot expect them to have the same uniform abilities. Leaders must be able to place their subordinates according to each staff’s character, personality, abilities, and strengths. Some staff can work well in terms of concepts but are not good at communicating with people. Staff with this character are well placed in the back office. There are also staff who are not good at making concepts but have good communication skills that can be placed in marketing or public relations. All will work optimally according to their passion, personality, and abilities. In my opinion, leadership is someone who can see his staff’s ability, directing, and placing in the right place (the right men in the right place). Unite differences to achieve a common goal, and staff can work safely and comfortably.
Leadership in the practice environment and patient outcome
Leadership can influence practice, practice environment, and patient outcomes because leadership possessed by a leader can make and determine policies in the patient’s work environment and outcomes. Leaders have the power to make policy in the practice environment. Leaders with authority can develop skill and tool standards (such as standard operating procedures that meet international standards), provide positive support and maintain respect for staff so that their lead staff can make professionals feel safe. Furthermore, the staff will be focused on the task, and the team will be energized and engaged. This situation makes staff more likely to speak up so that professionals can change their behaviour. If the strength of the staff has been formed in the practice environment, the outcome is safety, and patients are more likely to be free from harm.
My Leadership vision for healthcare
My vision for healthcare in 2022 is that I want to realize that a sound healthcare system, especially in post-pandemic situations, must have good governance skills and be supported by abilities in administration and management. My future vision is to realize a sound health care system utilizing collaboration (integrating programs). Why do I underline collaboration? Each department can work together for the same goal. For example, in Indonesia, in my opinion, the implementation of the Healthcare System in Indonesia is still fragmentary. For example, I take the example of handling the problem of the elderly. The Ministry of Health has a program to deal with the elderly. The Ministry of Social Affairs also has the same program. The Ministry of Public Works and Public Housing and several other departments have almost the same program even though they have the same goal of improving the health and welfare of the elderly. It would be better if these departments could synergize and collaborate to create and implement the same program, perhaps only the governance that distinguishes functions and roles to be more effective in terms of human resources and resources efficient in terms of financing.
Approaches to Leadership
We can use all leadership approaches at different times and conditions. No one leadership style is best applied because it depends on the situation, conditions, and employees we face. As I have said above, leaders will face various individual characters, ranging from different ages, educational backgrounds, cultures, personalities, beliefs, and values, so the leadership style that we will use may not be the same from situation to situation. It depends on the environment, circumstances, and abilities of the employees we are dealing with.
Diversity leadership style we can use when we find employees who come from age, race, marital status, physical ability, income level, and lifestyle. Different cultures or countries. We must recognize that everyone can bring values and strengths to the workplace based on their various combinations of characteristics. Organizations establish workforce diversity programs to promote the recruitment, inclusion, and career advancement of diverse employees and to ensure that differences are accepted and respected in the workplace. People who differ in many ways, be it race, cultural background, gender, physical ability, education level, lifestyle, age, marital status, or other dimensions, are more likely to have diverse opinions and perspectives. Opinions and broader and more profound experiences for problem-solving, creativity, and innovation.
If, under certain conditions, we get new employees, who are inexperienced and do not understand governance at work, then what is suitable to be used is Transformational and transactional leadership theory because, in this model, the leader guides or motivates his employees in the direction of goals that are enforced by clarifying roles and demands. So for new employees who have no experience, this theoretical approach is very suitable.
Sometimes we can also use servant theory, which happens when employees are bored with work or anxious about work problems. Because of this theory, this theory believes that a good leader is a leader who can serve, maintain and maintain the physical and mental well-being of members or followers. This leadership style tends to be focused on meeting the needs of employees who require guidance. Leaders help employees become more independent and broad-minded. In this theory, a good leader is required to have sympathy. In addition, it can relieve the anxiety that is felt to be excessive by employees. Therefore, the function of leadership is given to someone who has a servant or servant spirit. This theory suggests that a leader has to contribute to the welfare of others. It is a form of social responsibility.
A great leader is a leader who can unite a difference to achieve one goal. To achieve quality improvement in health care, we need a great leader that can be produced through an educational process. Education is one way to get quality improvement for a leader, and later the leader will make quality improvement in his workplace because the leader has the power to change things for the better with his policies. To be able to change anything, leaders must be able to work together in teams that may have many differences. Thus there is no one theory of the best type of leadership, and all good leadership theories depend on the situation and conditions of the work environment and the people faced at that time.