Читать книгу Kelly Vana's Nursing Leadership and Management - Группа авторов - Страница 49

Margaret Wheatley, in Leadership and the New Science (1999), says, “There is a simpler way to lead organizations, one that requires less effort and produces less stress than the current practices.” She presents a new view of leadership, one encompassing connectedness and self‐organizing systems that follow a natural order of both chaos and uncertainty, which is different from a linear order in a hierarchy. The leader's function is to guide an organization using vision, to make choices based on mutual values, and to engage in the culture to provide meaning and coherence. This type of leadership fosters growth within each of us as individuals and as members of a group. A new model of leadership and understanding health care organizations and patient care units as Complex Adaptive Systems (CAS) has emerged from these ideas. CAS are complex, nonlinear, interactive and self‐organizing systems with the capacity for self‐renewal. The environment in a CAS is unpredictable and control is distributed with simple rules as the basis of operation. CAS are able to learn and adapt as a network of interacting, interdependent agents who cooperate in common goals and create new patterns of operating (Plowman & Duchon, 2008).

Complexity leadership is the new model where leadership is described as transformational, collaborative, self‐reflective, and relationship based. Complexity leaders see people in organizations as self‐organizing and self‐renewing and envision work occurring through relationships. This optimizes autonomy at all levels because the relationships among the individual and the whole are strong. For nursing, such relationships might provide the infrastructure that will foster interprofessional decision making and strengthen the connection with other health co‐workers.

In Wheatley's subsequent book, Finding Our Way: Leadership for an Uncertain Time (2005), she discusses how humans learn best when they are engaged in relationships with others and can exchange knowledge and expertise through informal, self‐organized communities. Wheatley refers to these as communities of practice and encourages us to develop new leaders using communities of practice. Her notion of a community of practice represents several elements nurses are familiar with, that is, forming informal groups, using a group process of organizing, using principles of learning, and sharing information. What is unique in her description of these communities of practice is that they form via self‐organization. They come together naturally. What makes these communities of practice different from informal groups is Wheatley's characterization of a community of practice built from relationships and participation in a way that connects nurses and allows the creation of meaning from information or the exchange of knowledge. One example of the concept of a community of practice is a group of nurses and physicians who work together to identify the best evidence to establish efficient patient flow through the emergency department to admission to the hospital. In work done for the Center of Creative Leadership, communities of practice are described as being different from the ideas or experiences we have had with groups, teams, and collective forming, because communities of practice emerge from shared activity, shared knowledge, and ways of knowing that create meaning and thus a culture of engagement, participation, and relationships (Drath & Palus, 1994). Wheatley directs nurses to name these communities of practice that bring people together, support these connections, nourish the community, and illuminate their work. These exciting notions hold great promise for health professionals as we learn how to collaborate within and across disciplines and countries to advance health care practices.