What leadership means to me as a nurse

By Jaana Seitovirta | 10/06/2017

Leadership is more about coaching people than ordering them around.

Girl holding applesWhen she was made responsible at age 5 for keeping a supermarket’s coffee grinder clean and preparing fruit for display, she didn’t know she was preparing for nursing leadership.

For me, leadership means believing in and respecting human dignity. It means listening, inspiring and encouraging, being attentive, and upholding a rewarding culture. It means comprehensive management that constantly focuses on quality. Great nurse leaders, be they upper-level executives, administrative directors, or managers—I consider these roles complementary—instill within their staffs a common vision in which high-quality patient care is key. Nursing leadership should be customer-oriented. Genuine customer orientation means considering patients holistically rather than solely in terms of their illnesses.

Nurse leaders—including staff nurses—should be admired as role models. It’s a matter of believing in and respecting human dignity. Courage is also a particularly important leadership skill. Nurse leaders must earn their status as role models; it doesn’t simply come with the job title. On the other hand, there is no place in modern nursing for leadership styles based on fear.

Jaana SeitovirtaThe perfect need not apply
While my list of desirable leadership characteristics is long, it does not include perfection. Effective nurse leaders recognize they are imperfect and need to develop and grow in their profession, just as the nurses who report to them do. Also, it’s important to remember that the human-dignity values and attitudes I’ve listed apply in both directions—from staff nurses toward those who oversee them and from nurse managers toward those they supervise. Leadership belongs to all of us.

My career in nursing has been somewhat unusual. My personal journey in nursing leadership started in 1967, when I was 5 years old. In fact, it didn’t begin in healthcare at all, but in retail.

My mom applied for a job in a supermarket. The job required her to start immediately, but she told the shopkeeper she couldn’t because it would be a week before a place at a child nursery would become available. Since he wanted to hire her, the retailer sought to resolve his dilemma by suggesting I come to work with my mom and promising to take care of me. She accepted his offer.

The shopkeeper and the rest of the staff lived up to that promise. He bought me a small, colorful dustpan and brush and gave me the job of using those tools to keep the coffee grinders clean. He also made me responsible for the store’s apples and oranges. They were delivered in wooden boxes wrapped in silk paper, and my task was to remove the paper. The rewards I received included recognition, appreciation, and a sense of being needed as a staff member on equal footing with the others. This was my first experience with successful teamwork and a servant leadership culture in which rewards were used.

The solution my mom’s supervisor came up with was very thoughtful. As a shopkeeper, he wanted my mom to perform well at work, and he identified a solution to her problem that allowed everyone to be a winner. This is the essence of leadership. In part because of this experience, I have come to believe that leadership should involve teamwork and cooperation with management. The shopkeeper’s solution shows how a single outstanding example can shape someone’s perception of good leadership and guide that person’s actions over many years. My experience in the supermarket gave me a perspective on leadership and customer-oriented service that I have sought to apply in my nursing career.

Customer service helped prepare her for nursing
Before starting my career as a nurse, I worked for many years in business and customer service. Modern, customer-oriented, service-business approaches have brought healthcare organizations into a new era in which productivity and competitive advantage are important.

My professional nursing career started in 2008 when, after four years as a student at the Diaconia University of Applied Sciences in Helsinki, Finland, I graduated as a registered nurse and public health nurse. I initially worked in elder care services as a “responsible public health nurse,” as the position was known, and deputy nurse manager. After a few years, I began studying for a Master of Health Science degree at the University of Eastern Finland in Kuopio. Upon completing that program, I decided I wanted to work as a researcher. I have found it rewarding to share my knowledge of leadership in nursing and healthcare and will always be a nurse committed to ethical nursing practice. As I work toward my doctoral program in nursing science, my research focus is on use of rewards in healthcare, especially registered nurses’ experiences and perceptions on the use of rewards.

You can learn a lot from a poor example
In the course of my nursing career, I have observed changing work environments that include increasing importance of the internet and social media, advances in medicine, multiprofessional teamwork, and greater emphasis on customer orientation. However, the importance of good leadership has remained constant. Both in healthcare and business, I have interacted and worked with many managers and directors. A significant number are role models I admire who have excellent leadership skills. But not all have lived up to the ideals I cited at the beginning of this article. Fortunately, even from those who have not provided good examples of leadership, I have learned a lot.

Because I started my nursing career relatively late in life, I feel, in some respects, that I belong more to Generation Y, also known as millennials, than my birth generation. Generation Y is known for having different perspectives on work and different motivational needs than previous generations. My experience suggests that we should not think in terms of different generations but rather emphasize individuality.

A commonly cited challenge for those who supervise Generation Y workers is that people of this demographic cohort constantly seek meaning in their work and value good treatment and attention. I don’t view this as negative. In my opinion, leadership is more about coaching people than ordering them around, and micromanagement often leads to poor results. Effective leaders learn new things throughout their careers, share their knowledge, and have the courage to speak up when they encounter what they don’t fully understand.

Open your eyes and listen!
Should all nurse leaders and nurse managers have strong backgrounds in nursing care? I think it is necessary for them to understand healthcare, but I don’t think they need to be experts in every aspect of nursing care. I suggest that nurse leaders who supervise others organize regular “open eyes and attentive ears” days and take more time to listen to employees.

I also see a need for more visible leadership. We need to frequently ask nurses we supervise—face to face—how things are going. This is also true for executive-level nurse leaders, who should be interested in everyday issues facing their entire staff. Recent surveys show that subordinates consider supervision they receive as inadequate, especially in terms of listening, opportunities to participate, fairness, and equity. This is consistent with my experience and confirms my personal stance that listening to staff members and acknowledging the work they do is vitally important to leadership.

Finally, as a nurse, I think there should be a caring approach to leadership. In healthcare and nursing, we often talk about lean thinking and transformational management, which involve a motivational, coaching, and inspirational style of leadership. However, in my opinion, whatever management or leadership style one favors, it is essential to take care of all issues related to the work environment, including provision of high quality, evidence-based practice; safe patient care; adequate human resources; justice; equality; and a clear vision of the future.

Symbolically, I regard leadership as a powerful locomotive, with customers, patients, and staff members as passengers on the train. Without passengers, the journey is irrelevant, and nobody goes anywhere without the locomotive. To ensure that the journey is swift and smooth, we must keep the locomotive in good working order and upgrade it when possible. I believe, therefore, that self-management is a necessary attribute for effective nurse administrators, nurse managers, and staff nurses. Through self-management, leaders can better deal with the growing importance of teamwork and remote work.

I hope that, by the end of my personal journey in nursing leadership, I will see staffs of healthcare organizations around the world feeling genuinely needed and appreciated. I also hope that maintaining that feeling will be a leadership and management priority within those organizations. RNL

Editor’s note: Jaana Seitovirta and colleagues will present “The Best Reward Types: Perceived by Registered Nurses,” on Saturday, 28 October, at the 44th Biennial Convention in Indianapolis, Indiana, USA. See the Virginia Henderson Global Nursing e-Repository for additional information.

Jaana Seitovirta, MNSc, is an early stage researcher in the Department of Nursing Science, University of Eastern Finland, Kuopio. 


  • 2017 holiday sampler
  • Vol43-4
  • stticonv17
  • rewards
  • nursing leadership
  • millennials
  • lean thinking
  • leadership
  • human dignity
  • Generation Y
  • Finland
  • customer orientation
  • Nursing Student
  • Nurse Researcher
  • Nurse Leader
  • Nurse Faculty
  • Nurse Educator
  • Clinician
  • ClinicalC
  • Educator
  • Roles
  • RNL Feature
  • RNL
  • Nursing Faculty
  • Nursing Student
  • Nurse Researchers
  • Global - Oceania
  • Nurse Clinician
  • Global - North America
  • Global - Middle East
  • Global - Latin America
  • Global - Africa
  • Global - Asia
  • Global - Europe
  • Personalization Targeting
  • Little girl holding apples