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Learning intuition--less college and more kindergarten: the leader's challenge.

Executive Summary

* The great and defining moments of leadership occur when there is minimal opportunity for formal analysis.

* What we came to know in kindergarten is as valuable as the analytical knowledge we have since acquired.

* In leadership, we will do well to remember our clinical roots and to continually hone our skills in intuition and thinking with our gut.

CLINICAL EXPERTS who are promoted to leadership positions can feel the schizophrenia between the world of clinical competence, and the world of numbers, planning, and analysis. An expert clinician is valued for the ability to quickly think through a diagnostic problem, and to come to an answer intuitively that automatically triggers the correct interventions. The nurse in the emergency department who can look at the patient coming through the doors and know that this person is coding before there are any data to help with this decision is an example of this kind of intuitive clinical insight. Clinicians with this gift automatically go through an analysis subconsciously, and intuitively determine what is happening and what needs to be done. Clinicians are highly valued for their ability to recognize familiar patterns and to use their gut in times of complexity to come to conclusions and options for interventions.

But this is not always the case when a leader uses the skill of intuition. In many situations, leaders are valued for their ability to produce analytics that direct actions and the "soft side" of intuition is less valued. For example, a leader in a budget meeting who says "I just know" when asked to defend the budgeted numbers will not be valued when, in fact, if you have enough experience with budgets and acuity, you do know intuitively before you have the numbers that validate your intuition. However, in these situations, only spreadsheets will be accepted. And by contrast some people are immobilized without date, and are unable to make decisions without a clear analytic solution. The polarization between getting answers intuitively and analytically makes no sense. The leader needs both skills, and more information is pointing to the ability to utilize intuition as the defining separation between great and average leaders.

Business courses are known for their methodology of framing problems, formulating solutions, and evaluating the options. The nursing process has taught us the same structured linear approach to problems. But Stewart (2002) reports that brilliant decisions of executives and leaders come from the gut, and offers the example of the Marine Corps that now has moved away from the checklist, rational analysis format of solving problems in crisis. After consulting with a cognitive psychologist, Gary Klein, and studying successful decision making in crises, the Marine Corps now teaches the intuitive approach that encourages creativity which is more appropriate for uncertain times. The test of the greatness of a leader happens in the uncertain times of great crisis. The process of consciously analyzing every situation is not effective. Goleman (1998) makes the point that being overly analytical is the equivalent of having too much college and too little kindergarten. We, as leaders, need to go back to kindergarten to reawaken the creativity and intuition we learned then but have forgotten through many years of analytic course work.

The Physiology of Intuition

Researchers have provided us with more of the physiologic explanation of intuition. Stewart (2002) reports the work of Damasio which documented that skin conductance responses began to appear before the subjects could verbalize the "hunch." Physiologic reactions were occurring before the person could intellectually articulate what was happening. Damasio also concluded that our brains differ from computers because of the ability to weigh the emotional bottom line of previous experience in addition to just presenting the facts (Goleman, 1998). We receive a steady stream of information about feelings based on our past experiences. Therefore, to ignore, or to not value the ability to work with hunches is to negate a large content of information necessary to successful leadership. The "soft side" of leadership is as important as the hard analytic side.

The Work of Leaders

The work of leaders would be easy if all of leadership could be directed by planning and analytics. However, the great and defining moments of leadership occur when there is minimal opportunity for formal analysis. Great moments of leadership are driven by one's ability to assimilate past practices and experiences into an operating system that drives that person in times of crisis to the defining moments of great leadership. Bad things do happen in health care. We have sentinel events, computer crashes that disable clinical systems, fires, floods, the death of a beloved nurse in a patient's room, and the list goes on and on. A leader doesn't have the opportunity to study and choose interventions from an analysis of possible scenarios in situations such as these. The leader must "go with your gut" and respond and adjust on the fly. Leaders also have everyday events such as sizing up new candidates for positions, making decisions between two apparently equal products, and new strategic directions for which there are no data to help in the decision. Effective leaders can lead when there are no data to evaluate and can successfully read their trenches and go with their gut.

So how does a leader arrive at this level of sophistication? It is a matter of balancing kindergarten and college.

Principles to Guide Action

Well-grounded leaders who are clear about their values and their principles have an internal compass that guides them through any emergency. Goleman (1998) describes this at the "inner rudder" that provides the compass to guide feelings based on gut reactions to situations. For example, a person who values patient/staff safety first, will intuitively know how to make the appropriate decision based on this value without thinking. President Bush was the epitome of resolute leadership when he spoke to the nation on September 19, 2001. When asked by British Prime Minister Tony Blair if he was concerned or nervous before the speech, Bush said that "I know exactly what I need to say, and how to say it, and what to do" (Woodrow, 2002, p. 107). And when the speech was over, Bush said "I have never felt more comfortable in my life" (Woodward, 2002, p. 109). Bush's operating system gave him clear, intuitive direction that guided him into this great moment of leadership. His gut and his inner rudder told him exactly what needed to be done in this speech.

Acquiring Intuition Through Experience and Practice

Klein (2003) believes that intuition is an extension of experience and learning. He believes that acquiring intuition is much like exercising muscles: the better the quality of the workout situation, the greater the muscles will grow. Experience delivers to us a set of patterns. As we have more experiences, we assimilate more patterns and have a well-defined dictionary of data in a system that we can instantly access without really thinking about it. Klein (2003) also notes that there are many obstacles that can interfere with instinctual, intuitive thinking and suggests that a major problem for executives is listening to their gut and convincing others that their intuitions should be taken seriously. New people in the organization, he believes, should be helped as quickly as possible to build the intuitive skills they need to be as successful in the intuitive area of their leadership as they are in the analytical side.

Learning to Think With Your Gut

Goleman (1998) uses the term "managed heart" to describe the balance of emotional and rational reactions to events, and to subsequent interventions. For some leaders, it means learning more about what we should have learned in kindergaten, and also spending as much time in leadership development activities with our gut as we do dumping new content into our brain.

After surveying information about thinking with your gut, Stewart (2002) recommends that leaders "get out of their own way." He offers four guidelines for leaders.

* Practice, practice, practice. Stewart (2002) quotes Gardner in stating that thinking with your gut is primarily the ability of learning patterns and pattern recognition. Learning to think with one's gut is like building the muscles for an Olympic event. It takes practice.

* Learn to listen by crafting the fine art of focusing. Learning from attunement includes the ability to immerse oneself in the experience of others, and the process of accommodation, which is the free art of accommodating one's beliefs and language to another (Mackoff & Wenet, 2001). Focusing involves the process of attunement and accommodation to carefully listen to everything, not just the words spoken.

* Tell stories to free up your imagination and do postmortems to learn from experience. Mackoff and Wenet (2001) describe the process of learning from exemplars and experience and learning from models of behavior and guiding metaphors that guide our intuition. These authors focus on the reflective thinking process that helps our brains learn from what we experience and reorganize in new and different ways. If we don't allow ourselves the think time to put our brains in neutral, replenish ourselves, and to process all of the information that comes our way, we will not grow. When we are sleep deprived, overloaded with information, and stressed, the learning will not happen. Stories about how people have learned the fine art of intuition teach us well.

* Breed gut thinkers in your organization. Eliminate barriers to this kind of thinking and free up opportunities for people to think with their gut by acknowledging and rewarding their hunches. Sharing the thinking of others opens many portals in the brain.

Stewart (2002) notes that in situations where the problem is covered by rules, analytic thinking will work. But in situations where the situation is complicated, complex, or chaotic, instinct will be the tool of great leaders because there are no analytic answers to these situations. Very few situations that leaders encounter are covered by rules. Most of our work is in complicated, complex, and chaotic situations that demand thinking with our gut.


Learning to think instinctually and to depend on our intuition means, for many of us, going back to kindergarten and focusing more on our instinctual side to balance the linear approach that we've learned in many college and business school courses. It also means building time into our lives for reflection and allowing our brains the time to reorganize the events of our lives into patterns that we will recognize in the future. The process of the incubating experience and data in our minds over time will build the intuition and instincts that will help us all to learn how to be great leaders (Gardner, 1995).

We can learn much from the training of clinicians in pattern recognition and intuitive analysis of clinical situations. Many of us who were clinicians first understand the intuitive side of clinical practice and of administrative practice because we were educated in both worlds. We have the advantage of knowing the concepts of intuitive thinking and must remember to apply those concepts daily to our practices in leadership, Toffler said "You can use all the quantitative data you can get, but you still have to distrust it and use your own intelligence and judgment" (Boone, 1999, p. 80). As we acquire, more experience and wisdom, we learn to trust our own intelligence and judgment. What we came to know in kindergarten is as valuable as the analytical knowledge we have since acquired. In leadership, we will do well to remember our clinical roots and to continually hone our skills in intuition and thinking with our gut.


Boone, L. (1999). Quotable business. New York: Random House.

Gardner, J. (1995). Leading minds. New York: Basic Books.

Goleman, D. (1998). Working with emotional intelligence. New York: Bantum.

Mackoff, B., & Wenet, G. (2001). The inner work of leaders. New York: AMACOM.

Klein, G. (2003). Intuition at work: Why developing your gut instincts will make you better in what you do. New York: Currency/Doubleday.

Stewart, T. (2002). Think with your gut. Business 2.0, 3(11).

Woodward, B. (2002). Bush at war. New York: Simon & Schuster

KARLENE KERFOOT, PhD, RN, CNAA, FAAN, is Senior Vice President for Nursing and Patient Care Services and Chief Nurse Executive, Clarian Health, Indianapolis, IN, and Associate Dean, Nursing Practice Indiana School of Nursing.
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Title Annotation:On Leadership
Author:Kerfoot, Karleen
Publication:Pediatric Nursing
Date:Nov 1, 2003
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