Exploring key elements of effective nursing leadership: a former nursing leader in New Zealand, who has worked for the International Council of Nurses for more than a decade, has written a book on effective leadership. It's a good read, according to a current nursing leader.

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International Council of Nurses: Nursing Leadership. Shaw, S. (2006) Oxford: Blackwell Publishing. 215pp.

Sally Shaw maintains that leadership can be learned. In 11 "easy-to-read" chapters, she lays out the elements of nursing readership, readership development programmes and the ingredients for readership success and sustainability. The book promotes the idea of balancing readership theory and knowledge with the development of readership attitudes, skills and behaviours, and explores environmental factors that hinder and promote readership effectiveness.

In the foreword, International Council of Nurses' (ICN) chief executive, Judith Oulton, says this is a book for those committed to doing better. Thus it is a book for all of us.

The book references a decade of ICN's experiences with its Leadership For Change[TM] (LFC[TM]) programme in more than 50 countries. Key principles developed in the book are illustrated with case studies and vignettes from the programme. Although the book has come out of experience with resource-limited health systems and settings, it seeks to illustrate commonalities across different cultures and socio-political and economic environments, and reinforces Shaw's observation that readership principles remain constant across multiple settings.

'Leaders on the edge'

An underlying premise is that nurse readers, like others, are leaders on the edge. That is, they work in a world that is complex, constantly changing and at times chaotic. Shaw notes that "leaders on the edge have had to ask what sort of health services they want for the people of their country. And if the answer has meant massive change, then leaders on the edge have had many challenges", including the realisation that the status qua is no ranger acceptable and that reading and managing change is inevitable.

Chapter one explores the challenge of change. Shaw notes that "effective leaders look beyond their immediate boundaries and work environments". This point is emphasised with consideration given to assessing the potential impacts of the wider environment on health and hearth systems, as well as the need for effective readers to be aware of the political environment and the importance of external networks and partnerships.

Chapter two discusses what readership is not and explores the difference between readership and management. Chapters three and four introduce the framework for leadership used in the book and describe in depth the three key components: the reader, the setting and the followers. The concept of follower is not as passive as the word suggests, and Shaw emphasises their key role in supporting and delivering positive change.

'Dispersed leadership'

This book recognises the importance of what has been referred to as "dispersed readership", where there is not a reader nor the leader, but many leaders dispersing the responsibility of leadership across the organisation. (1) Thus there is a need to develop a critical mass of readers in greater numbers than previously and make available a variety of opportunities for readership development.

Chapters five and six focus on readership development programmes, while chapters seven and eight discuss readership development in practice, and focus on the outcomes of development programmes. A key part of an effective readership development programme is "action teaming", or learning by doing, in real life settings. In LFC[TM] programmes participants team by tiring the experience. Shaw notes that participants develop as readers "by internalising the highs and lows of emotions that come with this experience, and by developing skills, attitudes and behaviours that will make them more effective". Adaptation of the programme content to the actual environment is critical for issues and challenges to be explored and for realistic strategies to be developed for dealing with them. Chapter nine focuses on the important issue of sustainability of readership development and chapter ten is titled Defining success and getting a good return on investment. Shaw makes the point that readership development is an investment and that readership success is the expected return. However,. success is more likely with commitment from the developing reader's organisation, not only to the readership development programme, but also to its sustainability. The lesson here is that readership development programmes that rely safety on educational institutions are less likely to reap the benefits that can be gained when organisations recognise the important part they play in supporting such programmes.

The book, written for consumption as a whole, is also designed so readers can focus on particular sections relevant to their needs. At the end of each chapter there are a series of exercises and discussion questions based on the chapter's contents. References and notes for each chapter are presented at the end of each chapter and a comprehensive bibliography is contained at the back of the book.

I highly recommend this book. Shaw's decade of experience in more than 50 countries, using concepts that are familiar to us, speaks of its potential for application here in New Zealand.

* Sally Shaw is an international nurse consultant (nursing leadership and health policy) with the ICN. She held a number of nursing leadership positions in New Zealand before her departure to the International Council of Nurses in the early 1990s, including chief executive of the then Eastbay Health and director of nursing in the then Deportment of Health. She was also very involved in NZNA. International Council of Nurses: Nursing Leadership is available for loan from the NZNO library.

Reference

(1) Hesselbein, F. (2004) Leadership imperatives in on age of change and discontinuity. Paper presented at the New Zealand Institute of Management Conference. October 2.

Jane O'Malley, RN, PhD, is the director of nursing and midwifery at the West Coast District Hearth Board.