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Ed Harley was admitted to the cardiac observation unit earlier in the day. He had been diagnosed previously with heart disease and had experienced episodes of ventricular arrhythmias. His cardiologist had determined the need to change his antiarrhythmic medication to reduce the side effects Mr. Harley was experiencing. That evening, while Mr. Harley was talking to his wife on the phone and as his nurse, Maria, was walking to his bedside, he suddenly stopped talking and went into ventricular fibrillation and cardiac arrest. Maria reacted instinctively and startedAdvanced Cardiac Life Support (ACLS) defibrillating him immediately. Normal sinus rhythm appeared on the monitor before anyone else could respond to the code. Mr. Harley was then transferred to theCoronary Care Unit (CCU).

Maria had been a Registered Nurse (RN) for less than one year at the time, and although she had participated in Code arrests a few times, she had never witnessed one occur right before her eyes. Her knowledgeable action saved this patient's life. In nursing, Cardiopulmonary Resuscitation (CPR) and ACLS are mandatory skills and considered part of a nurse’s ordinary work. Yet it is quite extraordinary work.

Everything had happened so quickly that evening that Maria did not have a chance to talk to the patient before he was transferred. She entered his room the next morning in CCU, as the sun was just rising. As he awoke, Maria spent that quiet time with him. While he embraced the start of a new day, his thoughts were intense. What he chose to share was this acknowledgment: “You saved my life. Thank you.” This precious moment was a celebration of both of their lives.

What leadership characteristics did Maria demonstrate in preventing a nurse‐sensitive outcome of cardiac arrest?

Why is Maria considered a leader, even though she is not in a formal leadership or management position?

For all nurses, their knowledge of nursing and ability to apply that knowledge, is the basis of their leadership. Many people think that leaders are only top corporate executives and administrators, political representatives, military generals, or those who head an organization. This is because these leaders are highly visible and hold high‐profile positions. However, leaders are needed at all levels of an organization. With the advent of the information age, many professionals, including nurses, became known as knowledge workers. Nurses' education and specialized clinical preparation develops their expertise and leadership ability. Nursing knowledge workers are leaders. This idea of nursing knowledge workers contrasts with the manufacturing age, where the manager was the most knowledgeable person and closely supervised employees to carry out routine work. Leadership however is a basic competency for all nursing professionals. Leadership development is a necessary part of the preparation of nurses.

Nurses make a critical difference every day in the lives of their patients and patients' families, yet nurses believe those accomplishments are part of their ordinary work. Nurses are leaders, and by using their expert knowledge, they coordinate patient care and lead patients and families through health care journeys. Nurses lead themselves as they develop in their career and nurses lead change to improve patient outcomes and the quality of care. Nurses are leaders and lead without being in a management position.

Leadership and management are different. Leadership influences or inspires the actions and goals of others. One does not have to be in a position of authority to demonstrate leadership. Not all leaders are managers. Leaders have been characterized as people who do the right thing whereas managers are viewed as people who do things right (Drucker, 1993). Both leadership and management are crucial but different.

This chapter lays the groundwork for the development of knowledge about nursing leadership and management. Many concepts touched on in this chapter will be developed in depth in the chapters that follow. This chapter discusses leadership and provides a framework to differentiate leadership and management and explain emotional intelligence. Leadership characteristics, styles of leadership, and leadership theories are described emphasizing transformational leadership and complexity leadership. The chapter introduces the process of management and explains management and motivation theories. The content is developed for the beginning nurse preparing to graduate from a pre‐licensure program and enter the profession in the role of registered nurse. Benner's work describing skill acquisition of nurses uses a framework called, “From Novice to Expert” and labels this new graduate nurse as an advanced beginner (Benner, Tanner, & Chesla, 2009).