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Question: Discuss about theNursing for Journal of Clinical Leadership. Answer: In any organisation the leadership and management are important concepts that play a vital role in accomplishment of the set targets and goals. It is necessary to fulfil the organisations mission and vision. Similar, health care industry may not work without leadership and management owing to the complexity of the sector. The essay explores and discusses the ideas and theories of the leadership and management in the health care. The evolution of the various leadership and management theories are the complexities of the modern organisations. According to Mannix et al. (2015) one leadership style cannot be used within the complexities of the modern organisations, regardless of the situation. It will be critically examined to relate with the debate about the leadership and management and in reference to clinical situation. The arguments and the debate are supported with the examples from the clinical practice. To start with the basics of management, it encompasses the planning, directing, controlling, staffing, and organising in health care setting (Marquis Huston, 2015). Clinical Leadership on the other hand is being visionary while leading a group of people, motivating them, implementing plans, and direction. It means the leadership role is associated with the coaches, role models, mentors, and advocates for high quality patient care (Howieson Thiagarajah, 2011).). Unlike the manager the leader always focus on development of the interpersonal communication for result oriented workplace. According to Kieser, Nicolai Seidl (2015) leadership is one of the several functions performed by manager. On the other hand it is also argued that leadership requires strong managerial skills. The role of leadership and the management both goes hand in hand as per the literature review. It makes it difficult to analyse the concepts in isolation. For instance, nurses need leadership to manage the effec tive nurse is to patient ratio. On the other hand the nurses may lack direction and focus without effective management. Consequently it leads to the leadership vacuum. In this regards the decisions to be made in a manner that it promotes optimal care to the patients. It means there is the need of amalgam of the leadership and management in clinical practice for growth and development of the health care sector. There are several management theories but all are focused on supervising, group performance and organising. To start with the scientific management theory, it focuses on increased productivity by working through agreed standards with group members. Therefore, it may be called ahumanistic approach from the perspective of the closed system (Marquis Huston, 2015). For instance, the nurses could be taught to accomplish the risk management in one best way. The theory X and theory Y are contradictory management theories. The former focuses on supervision and direction without considering the organizational needs. On the other hand the Theory Y believes that people are self motivated and should be self-directed. The theory Y can be well used in nursing as they need great amount of self awareness and self motivation to deal with job burnout and stress due to long working hours as well as social and ethical dilemmas (Marquis Huston, 2015). Nurse leaders should be able to use their acumen an d make strong decisions to develop work environment that is dedicated to high quality care to the patients (Mannix, Wilkes Daly, 2013). This may be the underlying principle for nursing leadership and management. Therefore, the debate on leadership and management still continues. On contradictory to the above mentioned management theories that belong to the close system, the strategic management theory are based on open system perspective. It focuses on following the logical process on meeting the organizational goals while adapting to the external and internal environment (Courtney et al., 2015). The nurse manger can apply this theory to address any change required in the organisation. For instance, to address the hospital acquired infections in the hospital, a survey or audit can be conducted to deduce factors causing the problem. Formulation of hand hygiene policy is based on such logical process to address the organizational goal to reducing noscomial infections. Similarly patient assessment for diabetes and schizophrenia may not be same. It needs to follow logical structure for assessment of each illness. This calls for strategic management leadership in nursing (Marquis Huston, 2015). Thus, it again makes it difficult to prioritise the importance of le adership and management. Common nursing leadership styles in nursing in 1951 were authoritarian, democratic, and laissez-faire (Marquis Huston, 2015). The first one focuses on the strong control, punitive criticism, and does not involve others in decision making. Democratic leaders give constructive criticism, exhibit less control, and involve others in decision. Laissez-faire leader only motivates people without direction and criticism. Interactional leadership is the style for nurses to diagnose a situation such as medication error, increase in noscomial infection or fall rates among elderly. This leadership style calls for effective group interaction. It is determined by the situation and the leaders personality (Marquis Huston, 2015). Nursing leadership is dominated by the transformational leadership style and is considered the popular style for professional growth of the nurses. It is argued by Grossman Valiga (2016) that this leadership style allows the leaders to transform the followers so that can accept change for organisational mission and goals. As this leadership is focused on the individuals and relationships, it is appropriate for nurses who are into the world of the human interactions and experiences. Nurse manage can use this theory to encourage and inspire fellow nurses to share ideas thorough effective communication. They may empower the nurses to meet the patient and the organisational priority. For instance, the implementation of the patient centered care model involves great role by transformational leadership style in mental health setting (Cleary et al., 2011). Transactional leaders are also in alignment with above style of leadership as both focus on morals. Unlike the transformational leadership style, the transactional leaders identifies the common values, acts as a caretaker, has long term vision, look at affects and empower others (Grossman Valiga, 2016). Other leadership theory that is congruent with the transformational theory is the compatibility of this style with the nurses day to day function in their clinical setting. It is in alignment with the situational leadership model and congruent leadership style. However, it is argued that that the later is adapted from the former (Courtney et al., 2015). Congruent leadership style is the reflection of the leaders values and beliefs in the actions and demonstrates the interpersonal and communication skills well enacted with integrity (Scully, 2015). Like transformational leadership it considers the patient-focussed care as first priority (Courtney et al., 2015). Based on this literature, it can be interpreted that the congruent leadership is more appropriate than transformational leadership for development of nurse leaders. However, it is questionable due to lack of sufficient evidence for efficacy of congruent leadership for its newness and bulk of literature favouring transformationa l leadership. Both can be well applied for mental health and geriatric setting that requires patient focused care (Sayers et al. 2015). Health care sector is the complex sector and dynamic in nature. The nurses in clinical setting face varied challenges related to medication error, risk of fall among elderly, falls prevention, interpersonal conflict with fellow nurses. Each of the problems may demand different leadership style. Medication safety can be taught through transformational leadership style (Mannix, Wilkes Daly, 2013). However, fall prevention is multifaceted problem. Innovative fall prevention problem requires evidence based practice. Fall can be prevented through need assessment, support from stakeholders, and implementation of strategy, project outcomes and evaluation (Breimaier et al., 2015). These processes promote the complexity of the workplace, and impact the leaders relationship with the followers. It calls for implementation of different leadership theories. To establish any kind of change such as patient centered care model, hand hygiene policy or a new fall risk prevention policy, it is necessary to consider the views of the followers. Aesthethetic leadership is one such philosophy that is base on knowledge of felt meaning of leadership phenomena as well as sensory knowledge. It gives the leader a variety of emotional tools as it is underpinned by moral, sensory, somatic, and emotional awareness. It acts as a buffer between the transformational and congruent models (Mannix et al., 2015). It is best style of complex clinical situations. It overcomes the limitations of all the above mentioned leadership styles. According to Marquis, Huston (2015) contingency and situational theory of leadership, nurse mangers must adapt to the different leadership style depending on task delegated to each nurse, relationship with the nurse team, commitment and skill levels of the followers. For instance, if the nurses are less committed and skilled to prevent fall in geriatric care a strong supervision is needed on the other hand, if registered nurses are present with high commitment, nurse leader may switch to low supervision/control (democratic). Thus, it is the mixture of autocratic, authentic, transformational, transactional leadership style and democratic leadership style. Authoritarian leadership style can be used to reduce nursing frustration due to interpersonal conflicts and give feeling of security. When all the nurses are self motivated in fall prevention, the use of laissez faire leadership can result in much creativity and productivity. If the leader is congruent in beliefs, values and actions in mitigating the fall risk issue, then it is the implementation of congruent leadership (Scully, 2015). Interpersonal conflicts among nurses can also be resolved by keeping values and beliefs central to leadership. Nurses may respect each other values and beliefs and of patients to act as role model in establishing the patient centered care model. It is called as authentic and servant leadership style (Courtney et al., 2015). Health care environment is all about adapting to change contributed by the technical, social, professional, political, economic, environmental factors. Thus, the leadership and management imperatives involve creating and fostering innovation, building shared visions, and creation of positive work environment for nurses and staff. Therefore, it must involve situational leadership model to implement appropriate leadership style discussed as above. Coming back to debate about leadership and management, both are equally necessary in clinical setting. Any management and leadership style chosen by the nurse must be consistent with her ideals. The Y management style and the situational leadership model as per my opinion are more likely to greater benefits. Nurses must cultivate these leadership and management styles to deal with any situation in complex health care setting as the main focus of aesthetic leadership. Dearth of such model may become redundant expression. References Breimaier, H. E., Halfens, R. J., Lohrmann, C. (2015). Effectiveness of multifaceted and tailored strategies to implement a fall-prevention guideline into acute care nursing practice: a before-and-after, mixed-method study using a participatory action research approach.BMC nursing,14(1), 18. Cleary, M., Horsfall, J., Deacon, M., Jackson, D. (2011). Leadership and mental health nursing.Issues in Mental Health Nursing,32(10), 632-639. 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(2015).Leadership roles and management functions in nursing: Theory and application. Lippincott Williams Wilkins. (8th Ed). PILADELPHIA Wolters: Kluwer Health | Lippincott Wiliams Wilkins Sayers, J., Lopez, V., Howard, P. B., Escott, P., Cleary, M. (2015). The leadership role of nurse educators in mental health nursing.Issues in mental health nursing,36(9), 718-724. Scully, N. J. (2015). Leadership in nursing: The importance of recognising inherent values and attributes to secure a positive future for the profession.Collegian,22(4), 439-444.