Relational work: At the core of leadership
Eloise Balasco Cathcart MSN, RN, FAAN

Nursing Management
March 2014 
Volume 45  Number 3
Pages 44 - 46
  PDF Version Available!

Contemporary healthcare organizations require nurse executives who can manage complexity, uncertainty, and increased transparency while ensuring that patients and families receive the care they need in ways that address their concerns.1 To be successful as leaders of both the discipline and the organization, nurse executives need sophisticated frontline managers who have the knowledge and skill to translate this demanding agenda into everyday practice. Relational work has emerged as a key domain in nurse manager narratives of best practice, and expertise in this core leadership skill is what allows our nurse managers to venture into unknown territory and ensure positive outcomes for patients and the organization.2Relational work is the ability to create, sustain, and effectively manage relationships with staff, patients and families, peers, interdisciplinary colleagues, and organization executives.1 It's impossible to become an expert leader without successfully mastering the skills of interpersonal engagement, and only through authentic connection can nurse managers create trust and influence clinical nurses to do the arduous work that their roles require.For nurse managers, the relational skill of involvement is first and foremost a moral skill because it's directly connected to the ethical demand of nursing practice. Highly effective nurse managers' relationships with others are fueled and measured by the moral obligation to always do the right and good thing for patients, families, and staff in ways that build on strengths and respect individual concerns. The expert skill of involvement is much more than cordial conversation or making a clear distinction between self and other. To do relational work, it's necessary to be engaged in the particular situation in an open and attentive way. Only then is it possible to discern the true nature of the situation, see what's at stake, and be able to draw on relevant knowledge to respond in effective ways.The skill of involvement

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