Leading a relational caregiving organization
– Constructing the role for the leader and exploring systems intelligent
practices
Frank Martela
frank.martela@gmail.com
9.3.2011
Manuscript – Do not cite without permission
Abstract:
As has been argued, traditional leadership research is often based on a top-down,
authoritarian and bureaucratic paradigm that doesn’t take into account the complexity of the
leadership task, its contextuality or the relational process between the leader and the
followers in which the leadership and the role for leader is constructed. Accordingly, my task
in this article is to look at leadership as a relational and complex phenomenon that emerges
from the interdependencies and the socially constructed process between organizational
members. Through this perspective I look at an elder-care home as an empirical context to
find out how the role for the leader in this type of organization is constructed through
follower expectations. Through an analysis and categorization of the interviews, I identify
seven different themes, with one to four categories in each, that capture the main
expectations that the followers have towards their supervisor in such an organization.
Moreover, to look at the matters also from the leader’s perspective, I make an attempt to
build a theoretical understanding of the key tasks and leverage points for a leader of a
caregiving organization such as an elder-care home. Finally, to account for the leader’s
agency within a relational and affect-laden context such as a caregiving organization, I
introduce systems intelligence as a way to understand how the leader is able to influence the
organization towards desired directions employing both her cognitive resources as well as
her sensitivities-based attunement to the organization on an implicit level.
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Table of contents
Introduction .......................................................................................................................................... 3
Theoretical background ...................................................................................................................... 4
Method ................................................................................................................................................ 11
Site of the research ........................................................................................................................ 11
Data gathering ................................................................................................................................ 12
Analysis ........................................................................................................................................... 14
Systems intelligence and the leadership challenge of the caregiving organization ................... 17
The complex leadership challenge at the caregiving organization ..................................... 17
Systems intelligence .................................................................................................................. 20
Constructing the role for the leader within a caregiving organization ....................................... 22
The goals of a leader of a caregiving unit .................................................................................. 22
Role for the leader ......................................................................................................................... 27
Work-related expectations............................................................................................................ 30
Supervising the work ................................................................................................................ 31
Taking responsibility ................................................................................................................. 32
Trusting the employees ............................................................................................................ 33
Community-related expectations................................................................................................. 34
Being an authority ..................................................................................................................... 34
Mediating the conflicts ............................................................................................................. 35
Giving emotional support ........................................................................................................ 36
Being just .................................................................................................................................... 39
Summary ......................................................................................................................................... 40
Leading systems intelligently ............................................................................................................ 40
Leading one’s own self-system .................................................................................................... 43
Discussion ........................................................................................................................................... 47
Theoretical and practical contribution ................................................................................... 47
Limitations and future research .............................................................................................. 49
Conclusion .......................................................................................................................................... 51
References ........................................................................................................................................... 53
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Introduction
As has been argued, the “leadership models of the last century have been products of topdown, bureaucratic paradigms” formed to meet the challenges of the Industrial Age (UhlBien, Marion, & McKelvey, 2007: 298). As the world has moved beyond this era, leadership
researchers have insisted that it is necessary to find alternatives ways to think about
leadership (Uhl-Bien et al., 2007: 299). In place of one definitive model for leadership, it
becomes necessary to understand how “the world of traditional bureaucracy exists but it is
only one of many contexts” and instead look at the different and diverse contexts where
leadership is exhibited (Osborn et al. 798). While most of these efforts have concentrated on
the context of knowledge work (e.g. Osborn, Hunt, & Jauch, 2002; Uhl-Bien et al., 2007) the
present article will look at caregiving organizations (see Kahn, 1993) as one important and
distinct context for leadership.
In coming to appreciate the distinct characteristics of caregiving organizations for leadership
the recent paradigm that looks at leadership as relational seems especially promising (cf.
Kahn, 2005). Placing the emphasis on the relationships between people rather than individual
characteristics of people the relational paradigm looks at leadership as something that is
constructed in the interactions between people (e.g. Lichtenstein & Plowman, 2009; UhlBien, 2006). This leads to an appreciation of the process-like character of leadership and
how leadership emerges through patterns of human interaction. The principal aim of this
article is to take such a relational perspective on leadership and answer the questions: How is
leadership manifested in a caregiving organization and how to be a good leader for the
caregivers? In answering this question I attempt to develop understanding “that is more in
tune with the diversity, complexity and ambiguity of organizational life and corresponding
intricacies of leadership practices”, to use the words of Küpers and Weibler (2008: 455).
To achieve this task I start by discussing the nature of agency of the leader within the
relational systems-understanding of leadership. I will propose that the concept of systems
intelligence (Martela & Saarinen, 2010; Saarinen & Hämäläinen, 2004) can expand the
present way of understanding how the leader is able to exhibit her influence in desired ways
in the work community. By understanding how the leader is able to tune to the wholeness of
the work community through “human sensitivities” and “beyond-the-verbal connectivities”
only some of which “can be reduced to the traditional cognitive categories of objective
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knowledge” we get a better grip on the actual process through which the leader is able to act
fruitfully vis-à-vis the organizational system (Hämäläinen & Saarinen, 2008: 822-823).
After that I look more specifically at what expectations are loaded in the role of leadership in
a caregiving work community; what do the employees expect from their leader and what do
the leaders expect the employees to expect from them? There obviously are many things the
caregivers seek from their leaders: “Members of caregiving organizations often converge on
their leaders. They seek answers. They seek support. They seek help for nameless struggles
whose contours they cannot fully articulate. They seek witnesses to their joys and
frustrations.” (Kahn, 2005: 195). Küpers notes how some researchers are ready to view
“both leadership and its consequences as largely constructed by followers and hence
influenced by followers’ cognitive processes and interfollower social influence processes”
(Küpers, 2007: 195; Meindl, 1995). Thus getting clear on what exactly do the employees
expect from their leader becomes an important question that significantly will shape the role
of leadership that the supervisor can take within such an organization.
I will answer this question empirically through a sample of nurses and their head nurses
working in an elder care home. Instead of looking at leadership as comprised of certain
characteristics of the leader, certain processes of influencing or certain achievements (see Grint,
2005) I thus look at leadership in this article as a role that is construed through the expectations
of the work community. As argued by Avolio et al. (2009: 429, 434) “limited research” has
examined “the role of follower” in explaining leadership and thus the present article is able
to address “one of the most interesting omissions in theory and research on leadership.”
This constructive view on leadership also fits well with the relational tradition that
emphasizes the relations between people as more fundamental than the individuals in
themselves.
Theoretical background
To somewhat exaggerate, the traditional image of a leader sees him [sic] as rationally
behaving individual in control of himself and with an authority to command and control the
actions of his subordinates in an one-directional manner (cf. Lichtenstein et al., 2006;
Meindl, Ehrlich, & Dukerich, 1985; Kulich, Ryan, & Haslam, 2007; Küpers & Weibler,
2008). As put by Hosking et al. (1995: x; cited in Uhl-Bien, 2006: 656), “the ‘reality’ of
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management is understood as individual creation and control of order.” The focus is on
individuals, their personal characteristics and their agency in controlling the internal and
external environment (Uhl-Bien, 2006: 655). For example, although transformational
leadership ‘humanizes’ leadership as compared to more transactional approaches based on
“economic cost-benefit assumptions” (Bass 1985: 5), it still focuses quite exclusively on the
characteristics and actions of the managers and their ‘effects’ on the followers (see Bass,
1990). Uhl-Bien connects traditional leadership to an entity perspective because “it focuses on
individual entities, is consistent with an epistemology of an objective truth and a Cartesian
dogma of a clear separation between mind and nature” (Uhl-Bien, 2006: 655; see also
Bradbury & Lichtenstein, 2000). In this Cartesian and atomistic view of an individual the
mind is seen “in isolation, radically separated from an external reality” (Orange, Atwood, &
Stolorow, 1997: 41); the other human beings being but elements within this external reality.
Research stemming from this kind of basic assumptions easily leads to “simplistic, trivial or
superficial ideas about management” (Küpers & Weibler, 2008: 444). Even more worriedly,
“many of the worst excesses of recent management practices” have their roots in these and
similar simplistic ideas developed by business school academics (Ghoshal, 2005: 76).
In contrast, the relational paradigm offers a “view of leadership and organization as human
social constructions that emanate from the rich connections and interdependencies of
organizations and their members” (Uhl-Bien, 2006: 655; Bradbury & Lichtenstein, 2000).
The relational dimension between human beings is viewed as vitally important in
understanding and explaining the patterns of thoughts, actions and interactions of
organizational members. Focus is on the “space between” individuals which leads to a “kind
of ‘meso’ unit of analysis” reflecting the “network of interactions” between organizational
members (Lichtenstein & Plowman, 2009: 618). Thus the relational paradigm “moves
beyond unidirectional or even reciprocal leader/follower relationships” and instead focuses
into the “dynamic system” within which all leadership action is embedded (Hunt & Dodge
2000: 448). The differences in the individualistic and relational paradigm thus go deep into
epistemological and ontological levels. The individualistic paradigm understands relational
processes as “centered in individuals’ perceptions and cognitions” and happening between
two independent and atomistic individuals exchanging information and influence, but the
relational paradigm goes much deeper than this, understanding persons and organizations
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themselves “as ongoing multiple constructions made ‘in’ processes and not the makers ‘of’
processes” (Uhl-Bien, 2006: 655).
Through this relational paradigm, the systems metaphor becomes centrally important in
understanding leadership and accordingly many writers have emphasized a dynamic systems
understanding of the nature of organizations (e.g. Lichtenstein & Plowman, 2009; Marion &
Uhl-Bien, 2001; Uhl-Bien et al., 2007). According to this perspective, organizations are
complex systems in which the component parts – mainly human beings – “interact with
sufficient intricacy” so that the development of the system cannot be understood linearly but
instead “its overall behavior can only be understood as an emergent consequence of the
holistic sum of all the myriad behaviors embedded within” (Levy, 1992: 7-8; quoted from
Marion & Uhl-Bien, 2001: 397). In here, system can be understood as “a complex whole the
functioning of which depends on its parts and the interactions between those parts”
(Jackson, 2003: 3). Ultimately, it can be argued, “all human life is embedded and located in
what is going on systemically, locally and globally” (Saarinen & Hämäläinen, 2010: 11).
Additionally, as I will propose later, “humans have a fundamental connectivity to their
environment in terms of systems” (Martela & Saarinen, 2010). Relevant to our later
discussions, it must be further noted that Kahn uses general systems theory (Bertalanffy,
1968) to understand caregiving organizations as systems (Kahn, 2005, 1998: 19).
Taking such a relational systems orientation to leadership means that one “does not focus on
identifying attributes of individuals involved in leadership behaviors or exchanges, but rather
on the social construction processes by which certain understandings of leadership come
about and are given privileged ontology” (Uhl-Bien, 2006: 655). Leadership is viewed as
something that the work community constructs through a dynamic and relational process. The
“identity of the leader is essentially relational not individual: thus leadership is a function of a
community not a result derived from an individual deemed to be objectively superhuman”
(Grint, 2005: 2). As Sayles (1964: 27) acknowledged already in 1964: “The manager does not
have a neatly bounded job [- -] he is placed in the middle of a stream of relationships.”
The relational perspective also highlights the emotional dimension of leadership. As has
been widely acknowledged within leadership research, “affect and emotions are deeply
intertwined with the process of leading” (Gooty, Connelly, Griffith, & Gupta, 2010: 979). It
has been found for example that transformational leadership leads to followers experiencing
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more positive emotions during the workday (Bono, Foldes, Vinson, & Muros, 2007).
However, despite leadership research acknowledging emotions as part of the leadership
process, it can still be argued that much of the models are “wedded to a rational model of
human agents and action” (Küpers & Weibler, 2008: 446) that narrows the understanding of
leaders possibilities to operate also on implicit, affective and attunement-related dimensions.
Luckily resent work on implicit and aesthetic dimensions of leadership (e.g. Hansen, Ropo,
& Sauer, 2007; Ladkin, 2008) as well as emotional intelligence in leadership process (George,
2000; Wong & Law, 2002) have started to change this situation.
This emphasis on the complexity of dynamic interactions between organizational members
leads also to an acknowledgement of the importance of emergent outcomes as part of the
organizational life (Lichtenstein & Plowman, 2009). Thus leaders must acknowledge that
instead of organizational change taking place through top-down interventions and “specific
directives from managers” much of it is a result of complex processes that develop into
unexpected directions through “dynamic of emergence” (Lichtenstein & Plowman, 2009:
618). It is natural for us humans to attempt to generate causal attributions for organizational
events and we have a tendency to attribute much agency for the leader (Meindl et al., 1985).
Through an understanding of organizations as relational and complex systems we can get rid
of this overemphasis we tend to place on the will-power and ability of the leaders to
influence the fates of their organizations. This “focuses leadership efforts on behaviors that
enable organizational effectiveness, as opposed to determining or guiding effectiveness” (Marion
& Uhl-Bien, 2001: 389).
The emphasis of relational paradigms is thus on leadership as something that is construed
and emergent rather than something fixed and residing only within certain persons. For
example, Lichtenstein & Plowman (2009: 618) understand leadership as “capacity to
influence others” that can be “enacted within every interaction between members” while Mary
Uhl-Bien (2006: 655) studies leadership as a “social influence process through which
emergent coordination [- -] and change [- -] are constructed and produced.” The focus thus
shifts from the person in the formal leadership position to looking at the processes through
which leadership is manifested in all interactions between all organizational members.
Accordingly, leadership researchers have started to look at manifestations of leadership as
distributed and in the collective (Uhl-Bien, 2006: 667).
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Acknowledging that leadership may occur in every interaction, in this article I will still
confine myself to looking at leadership in the most traditional form – that exhibited in the
manager-subordinate relationship. Although leadership is exhibited also in other places the
manager-subordinate relationships “are still important to organizational functioning” (UhlBien, 2006: 667). Additionally, because of the specific roles people occupy in these
relationships they have their own special functioning as forms of leadership. In a living work
community the role of the formal leader goes well beyond the constraints and privileges set
officially by the larger organizational structures. As argued already by Sayle (1964), the
actions of the manager are “embedded not only in an organizational and environmental
context but within a dynamic and unfolding history of role-bounded interpersonal
relationships” (Osborn, 1999: 14). Thus it becomes interesting to understand how the role of
the leader and leadership is constructed through follower attitudes and expectations. There is
an urgent call for such research, in fact “there have been a number of calls over the years to
examine the role that followers play in the leadership process” (Avolio et al., 2009: 434; see
also Küpers & Weibler, 2008). Despite this “the absence of discussions of followership and
its impact on leadership” is “perhaps one of the most interesting omissions in theory and
research on leadership” (Avolio et al., 2009: 434). For example in the recent review of
antecedents of charismatic leadership (Walter & Bruch, 2009) there is no evidence of
research looking at follower expectations as influencing the leader. This leads Avolio et al.
(2009: 435) to recommend future research on how “followers’ needs, identities, and implicit
theories” as well as their interactions affect and influence the emergence of leadership and
leadership behavior. Thus there is significant progress in research to be made through asking
how the expectations and interactions of the members of the work community and the
assigned leader together generate the role of the leader. By combining the novel view of
leadership as relational with a more traditional view of the leader as someone occupying a
certain role the present article aims to participate in the fulfilling of this gap in research.
Additionally, in answering this question from a relational perspective on leadership we come
to appreciate the contextual nature of leadership. Many scholars have argued for the
importance of taking contexts into account in leadership and organizational research in
general (Hunt & Dodge, 2000; Johns, 2006; Osborn et al., 2002; Rousseau & Fried, 2001).
As argued by Osborn et al. (2002: 798) “leadership is embedded in context. It is socially
constructed in and from a context where patterns over time must be considered and where
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history matters.” And contexts in which leaders operate can be “both radically different and
diverse” (Osborn et al., 2002: 798). Naturally there are many similarities between leadership
in different contexts but concentrating only on these general dimensions would blind us
from seeing what the most important characteristics of leadership are in these specific
contexts. Accordingly, there have been calls for both quantitative and qualitative inquiries
that are “sensitive to the characteristics of teams” (Burke et al., 2006: 302).
The importance of contexts has thus been widely acknowledged. However, usually the
traditional bureaucratic context has been challenged by looking at leadership in more
knowledge-intensive work (e.g. Osborn et al., 2002; Uhl-Bien et al., 2007)1. I argue that
caregiving organizations differ from both traditional bureaucratic as well as modern
knowledge-intensive organizations in the demands and challenges that the leaders face: “The
leadership of caregiving organizations is both like and unlike that of other organizations”
(Kahn, 2005: 179). As emphasized by one of my interviewees “being in this kind of
caretaking community is not the same thing as being in some kind of factory” [Head nurse
3]. By caregiving organizations I mean institutions “that serve their client populations via
personal relationships between caregivers and care-seekers” (Kahn, 1993: 539) and I will use
the term caregiving leader to refer to the supervisor of such an organization and the term
caregiving leadership for her leadership responsibilities. The name is actually quite appropriate
because, as will be shown, providing care for the followers is found to be one of the most
important dimensions of such leadership. In addition to ordinary leadership tasks such as
vision setting and motivation, “in caregiving organizations, leaders must [- -] enable
resilience throughout the organizations, and maintain real systems of caregiving” (Kahn,
2005: 179). Because of their own special nature caregiving organizations offer an interesting
context to explore the nature of leadership. As caregiving industry – hospitals, elder care,
schools et cetera – is expanding in developed countries and employees for example in the
United States around one in six of the whole workforce (Bureau of Labor Statistics, 2009) it
is a context that cannot be ignored in leadership research. The aim of this article is thus to
1
There are many different forms of context that are potentially important to be taken into account (see Johns,
2006) but in this article I concentrate on context understood as the nature of the work done in the
organizations.
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develop a mid-range theory (Eisenhardt, 1989) that explores the dimensions of leadership in
one specific context. My purpose is to offer a rich description (Rousseau & Fried, 2001: 7) of
the nature of leadership in caregiving organization by studying events and processes (Johns,
2006: 401) to reveal the contextual impact on the understanding of leadership in that
context. I especially concentrate on exploring the nurses’ expectations of their leaders to
reveal the process through which the role of the leader is constructed in caregiving
organizations.
It may legitimately be asked whether we are able to capture the processes and dynamics
inherent in the leadership construction process by just studying the expectations of the
followers. If the main focus of relational paradigms is on the “communication processes”
such as dialogue “through which relational entities are ‘made’” (Uhl-Bien, 2006: 664) it
indeed is true that the expectations of the followers are just one piece in the puzzle through
which leadership is constructed. More specifically, the follower expectations are both the raw
material upon which the leader’s position is molded and also something that is reshaped
throughout this process. In any case, understanding what these expectations are is the first
step towards understanding what it involves to occupy the formal managerial position in
terms of relational leadership. As Uhl-Bien (2006: 663) argues “the organization is actively
held together not by its policies and rules and procedures, but the web of interpersonal
relationships that is built through ongoing interaction.” By studying the expectations of the
followers as perceived both by the followers themselves and by the supervisors who attempt
to meet these expectations I try to reveal one important dimension of this social negotiation
process.
One way to argue for this kind of research approach is to say that it presents a Giddensian
approach to the relational process-orientation towards leadership. In Giddens’ theory of
structuration "social structures are both constituted by human agency, and yet at the same
time are the very medium of this constitution" (Giddens, 1976: 121). To study this
structuration it is often necessary to engage in “methodological bracketing” in which one
either studies “strategic conduct” and treats “structural properties as methodologically
‘given’” or then more or less omits the agency perspective and concentrates on these very
structures (Giddens, 1986: 288). Understanding leadership through the follower expectations
thus brackets the agency of the leader, focusing instead on the landscape of follower
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expectations upon which the position of the leader is built on. Thus it aims to gain insight
into the structures in which the leader needs to operate.
Taking into account the ‘other side’ of this bracketing, I will also discuss the agency of the
leader within complex and systemic organizational context, bracketing in turn the structured
patterns of interaction that the follower expectations have produced. I will argue that an
important part of the leader’s agency can be understood as an often implicit capacity to
behave intelligently within systems one is embedded in. This capacity is conceptualized here
as systems intelligence. Through experience and her natural human endowment the leader
gains a sense of operative ways of acting within the work community that enables her
effective behavior as a leader (Hämäläinen & Saarinen, 2007; Luoma, Hämäläinen, &
Saarinen, 2011). This capacity for systems intelligence is arguably especially important in the
context of a caregiving organization in which the underlying emotional currents are strong.
It has been argued that in order to capture the intricacies and complexities inherent in
leadership a “multi-level approach investigating the complex, interrelated processes
involved” is needed (Küpers & Weibler, 2008: 443). Thus through discussing both the
agency of the leader and the relationally constructed structures in which this agency is
embedded, the present work aims to produce a deeper understanding of the relational nature
of leadership generally and especially within caregiving organizations.
Method
Site of the research
The site of the research was a large public elder-care home located in Finland that houses
nearly 600 elders. The organization was divided into twelve units. A single unit had
approximately 24 residents and employed approximately twenty regular nurses and a head
nurse in charge of the whole department. Above the head nurses were two senior nursing
officers and the director of the elder care home but the head nurses had quite much
independence in leading their own units. The senior nursing officers and the director didn’t
participate in the day-to-day work of the units and the regular nurses very rarely met them in
their work.
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In general the work of the elder care nursing is considered to be both physically and mentally
demanding (e.g. Bakker, Killmer, Siegrist, & Schaufeli, 2000) and accordingly absenteeism,
burnout, quitting the job and a shortage of qualified staff are major problems in the industry
(see e.g. Aiken, Clarke, & Sloane, 2002; Petterson, Hertting, Hagberg, & Theorell, 2005). In
fact, certain amount of emotional exhaustion is understood to be an inevitable result of
nurses’ primary task: “Stress is an inevitable byproduct of the caregiving task.” (Kahn, 2005:
21). In accordance with these general trends the nurses under study also experienced their
workload as being heavy and had a feeling that the cost-cutting and downsizing efforts in
recent decades had left them to cope with an increasingly tough work environment.
Data gathering
It has been argued that to investigate relational, multilevel processes within organizations it is
best to deploy a “qualitative, interpretive, and ethnographic research strategy with a strong
situational focus” (Küpers, 2007: 211; Alvesson, 1996). Accordingly, the data for the study
was gathered primarily through interviews and ethnographic observation that were
implemented in two waves during the year of 2009 and the autumn of 2010 between which
the first set of data was analyzed. During the process I personally interviewed 28 nurses and
nine head nurses. The interviewed nurses varied in age from twenty to sixty-two and had
been in the field from half a year to thirty years. Of the interviewed all except for one nurse
were females. This reflects the general balance between the sexes in the occupation and the
fact that in the units where I carried out the interviews he was the only male nurse that was
available during the time of the interviews. To protect his identity, I will refer to all nurses
with the feminine pronoun. Of the twelve head nurses working in the elder care home, all
were women. Representative of this, I will use the feminine pronoun in discussing leaders
throughout this document. The interviewed head nurses varied in age from twenty-eight to
fifty-nine with most of the head nurses being around fifty years of age. Most of the head
nurses had extensive work experience as nurses before their current position as supervisors
in which they had been from a couple of months to around twelve years. All interviews were
recorded with the approval of the interviewees and transcribed verbatim in the language of
the interview. The interview language was Finnish and the quotations from the interviews
have been translated by the author.
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The interviews were semi-structured (Rubin & Rubin, 2005) and lasted in average 40
minutes. In the first research period, I interviewed 22 nurses and four head nurses. The
interviews with the nurses consisted of seven general themes related to well-being that I
explored with all the interviewed. Each theme contained around three to five open-ended
main questions followed by probes and follow-up questions to pursue themes brought up in
the interviews. Some representative examples of the questions asked from the nurses are
‘What are the things you like about your job?’, ‘Can you remember a situation when you
really had a hard time with your job?’, ‘When have you really felt that you are doing a
meaningful job?’ and ‘Have you ever thought of quitting the job and why?’ The head nurses,
in turn, were asked questions such as ‘In terms of employee well-being, what is the situation
in this unit?’, ‘When some problems emerge in the work community, how do you handle
them?’ or ‘What kind of feedback do you get from your subordinates?’ Given the semistructured nature of the interviews, I attempted to explore particularly interesting themes in
more detail and didn’t feel the necessity to ask every question in the protocol with every
interviewee. As the aim of the research at this point was to keep the data collection process
open to all possibilities the interviewed were chosen through open sampling (Strauss & Corbin,
1998: 206), which in this case meant that I interviewed the nurses that were at the working
shift at the time of the interviews and the head nurses that were available for interview
During the second research period I interviewed an additional six nurses and five head
nurses. As my research focus had at this point already concentrated on the relational
dimension of work community and its leadership I was able to ask more specific questions
about this theme.
In addition, I conducted thirteen days of ethnographic observation, seven days during the
first research period and six days during the second period. During a single day I followed
one nurse during her daily shift observing the realities of her working life and listening to her
interaction with the elders and other nurses. I also had informal conversations with the nurse
during the course of the day. The level of participation was thus moderate (Spradley & K.
Baker, 1980: 60).This provided the opportunity to experience the realities of her work and
considerably deepened my understanding of the nature of the nurses’ work in general and
about relational dimension of the work in particular. These experiences were gathered in
research notes that I wrote during the day in a small note book and which were
supplemented by longer reflections written immediately after the observation days. Contrary
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to my initial fear, my presence didn’t seem to bother the nurses at all. In fact the nurses
seemed to be quite happy and satisfied that somebody took an interest in their working life
and were glad to share their experiences about their work.
The usage of two different data gathering methodologies allowed for between-method
triangulation that increases the validity of the research (Denzin, 1978; Jick, 1979). In addition
to interviews and observation, some documentary data was collected and used in the
analysis. These included some care-taking manuals, house rules, internal bulletins, and so
forth that were available at the elder care premises during the time of the research visits.
Analysis
The data that the article is based on is of qualitative nature, consisting of observations and
interviews. The method to analyze the data could be described as abductive-hermeneutical.
Abductive refers to the fact that instead of an inductive approach that idealizes the results as
emerging from the data as such, one acknowledges that the results are arrived in a process
where the data itself and the pre-understanding of the researcher are in a constant interplay
(Dubois & Gadde, 2002; Peirce, 1931: 5.181). The aim of the inference is to arrive at the best
available explanation. The hermeneutical (Gadamer, 2004), in turn, refers to the fact that the
researcher is
“deepening his understanding of the meaning of the text in circular movement where
the details of a certain text [or any data] are contrasted with emerging, more
generalized theoretical thoughts. The aim of the hermeneutical researcher is not to
arrive at an ‘original meaning’ of the text [data] but to seek to enter into a dialogue
with it, seeking to ‘merge horizons’ between the interpreter and the text [data]”
(Mantere, 2008: 299).
This means that the research questions, the theories used, and the insight gained are all
“crystallized in an iterative process” (Mantere, 2008: 299). Abductive-hermeneutical research
is thus about a continuous circular (or rather spiral) movement between one’s own world
horizon or pre-understanding, the data one has gathered and existing theories to arrive to the
best available understanding of the phenomenon at hand.
In Uhl-Bien’s juxtaposition of two approaches to relational leadership the difference lies
“primarily in the philosophical underpinnings and methodologies” (Uhl-Bien, 2006: 665): the
14
first is the modern ‘entity’ perspective that operates with a realist ontology in which
individuals perform “‘internal’ cognitive operations” and relating is “reduced to one-way
causal relations with feedback” and the second is the postmodern perspective where
processes of leadership construction are “historical and social co-ordinations” and accordingly the
research focus is on communication processes through which leadership positions are
ongoingly generated (Uhl-Bien, 2006: 665). Put as such, the present work doesn’t represent
either of these approaches. Along with the relational, process-based approach it starts with a
constructivistic ontology for leadership understanding it to be co-created through the
ongoing interactions between organizational members. However, it also assumes that these
interactions can produce semi-stable structures of expectations and patterns of behavior that
can be studied on their own right. So although leadership is ultimately present only in the
ongoing interaction patterns that are created and re-created continuously in every
interaction, we can discern some more general patterns that have a tendency to re-emerge in
different leader-follower relationships within caregiving organizations.
In the end the ontological and epistemological position of the present work can be described
as pragmatic (see Martela, 2011). The ultimate aim is not to reveal the final truth about
organizations (as in realism) nor is it to only produce a contextually rich description of some
organizational occurrences (as in constructivism) but to produce knowledge that is
pragmatically useful for people within and in interaction with organizational life. In this work
the focus is especially on people in leadership positions. How can we reveal pragmatically
useful understanding that helps these managers to better lead their subordinates and the
organization at large towards a healthy and flourishing work community?
To answer my research question about the expectations of the nurses towards the
supervisor, I relied exclusively on the interviews while my ethnographic experiences acted as
merely a control variable against which I could reflect on my findings. The interviews of the
nurses and head nurses were first analyzed separately. The initial open coding procedure
with the nurse interviews resulted in 166 different coded excerpts [including excerpts that
were categorized as representative of two different categories at the same time] that were
categorized into 28 different categories that were further arranged in seven themes and two
aggregate dimensions.
15
The open coding of the head nurse interviews, in turn, produced 209 different coded
excerpts categorized into 33 different categories and further arranged in nine themes and
three aggregate dimensions. Further analysis revealed that one of these aggregate dimensions
was related to general characteristics of supervising and not to the expectations of the
subordinates and it was dropped from the analysis resulting in 20 different categories in six
themes and two aggregate dimensions. In both cases the analysis seemed to reach a
saturation point with at least the last three interviews not producing new categories or items
that wouldn’t fit into existing categories (see Strauss & Corbin, 1998: 158).
Next, I compared the results of the two different analyses and realized that they were
significantly overlapping. Thirteen of the first-order categories were found in both analyses
and six out of seven second-order themes were found to touch upon the same theme (see
Figure 1). Given this similarity, it was reasonable to continue the data analysis by combining
the results of these two analyses. This resulted in some re-arrangement of data as well as
merging and re-labeling of some categories. The resulting data structure consisted of 17 firstorder categories arranged around seven themes and two aggregate dimensions (see Figure 1).
In addition to the role of the leader constructed through follower expectation, I will say
something more general about the main challenges, goals and leverage points of caregiving
leadership. In answering this question I attempt – in the spirit of the abductive search for
best explanation – to reach the best possible understanding by combining my experiences
within the elder-care home with what I see as the most informative accounts of current
leadership practices found in the theory. Accordingly, the discussion will be more based on
theory than empirical observations – especially discussion about caregiving organizations,
positive psychology and relational leadership. But my empirical material enters into this
discussion through three ways. Firstly, it has guided the choice of theoretical perspectives I
draw from in here. I have used those theoretical perspectives I have seen as most suitable to
respond to the leadership challenge I have observed in the elder-care home. Thus the choice
of theoretical perspectives is not arbitrary but reflects my empirical encounter with the elder
care nurses. I have chosen theoretical perspectives that I see to best fit with and explain my
observations there. Secondly, the discussion about these main targets builds upon the
understanding of leader’s role developed more empirically in this work. So although in
presenting the findings I start by discussing these general goals and only after that dig deeper
16
into the expectations of the followers, the research process itself proceeded in the other
direction: Only after I had answered the question about the expectations of the followers did
I turn to this more general question about the main goals and leverage points of the
caregiving leader. Thirdly, I try to illustrate these insights through examples drawn from my
empirical work. Through such a combination of theoretical discussion with empirical
insights I will thus offer the reader the most advanced understanding of the leader’s role
within caregiving organizations I am able to produce.
Systems intelligence and the leadership challenge of the caregiving
organization
To get a grip on what it means to lead a caregiving organization we need to start by
describing the special nature of caregiving organizations in terms of leadership. But in
addition, we need to understand with full force what the understanding of organizations as
relational and complex systems means in terms of one wanting to control, direct and lead
them. Thus along with discussing caregiving organizations, I will present the challenge that
the complexity sets on leadership and offer systems intelligence as one answer through
which we can understand how the leader is able to exhibit agency within such organizations.
The complex leadership challenge at the caregiving organization
At first sight, the complex and relational perspective on leadership seems to lead to a
situation in which it is very hard to see how the leader can influence the organization
towards any desired direction. If we view “organizations as elaborate relational networks of
changing persons, moving forward together through space and time, in a complex interplay
of effects between individual organizational members and the system into which they enter”
(Uhl-Bien, 2006: 661-662) and in which “power is not a commodity, concentrated within
certain individuals, but is distributed throughout the social field” (Uhl-Bien, 2006: 662), then,
how is it possible that a formal leader can have a desired impact on this nonlinear process
operating on multiple levels simultaneously? If we understand organizational systems as “a
dynamic web of the tensions, reciprocalities and transformations between various aspects of
organizational life, each differentiated from and connected with, depending upon and
affecting, each other” (Zhu, 2007, p 460), then where does the capability to deal with such
complexity in an intellectual and productive way originate? Or as one colleague put it, given
17
that organizations are complex wholes the parts of which behave essentially in non-linear
fashion, “how the hell could anyone lead such a mess?” This seems to be an especially hard
nut to crack for leadership researchers operating with a constructivist and relational
understanding of leadership. In essence, the question is about how to account for the agency
of the leader within complex and systemic organizational context?
In addition to the general challenge for leadership set by our relational perspective, we must
understand what is the special nature of leadership challenge within caregiving organizations.
In here I will especially draw from Kahn’s (1998, 2001, 2005) work as my experiences in the
elder-care home much resonate with the interpretations that he has generated of the currents
that are at play within a caregiving organization.
What makes the caregiving organization special is its primary task in which one group of
people directly, face-to-face, cares for another group and thus ends up in close and emotionfilled relationships with them (Kahn, 2005, 1993). The caregivers need to form “meaningful
connections” with careseekers who “may experience any combination of powerful emotions
– fear, anger, joy, excitement, nervousness, sadness, terror” and especially anxiety (Kahn,
2005: 177). The caregivers need to be able to receive and manage such strong emotional
reactions as part of their everyday work. The emotional exchanges present in these
interactions in a way set the tone for the whole organization as the “caregiving relationships
[- -] reverbate throughout the larger systems in which they are embedded” (Kahn, 2005: 1).
The nature of nurses’ work makes it emotionally exhausting and to be able to manage it the
nurses need to “feel contained and held within the context of their work relations” (Kahn,
2005: 42). They need to feel that there is a “system of supportive relationships” (Likert 1967)
in place in the work community so that they can share and discharge their emotional loads
when needed. The key question for such an organization and its leadership is how to “deal
with the emotions absorbed from careseekers” and those triggered by the work of the
caregivers with them? (Kahn, 2005: 19.) How can the larger organization make sure that the
caregivers are not exhausted by these emotions but can find ways to share and discharge
them?
The second key condition of the caregiving organization such as an elder-care home is the
fact that the work is deeply interdependent – done as a collective whole rather than as
something individuals could achieve on their own (Kahn, 1998; see also Wenger, 1999). Task
18
interdependence is understood as “the degree to which team members must depend upon
one another to perform their tasks in route to goal accomplishment” (Burke et al., 2006: 294;
Saavedra, Earley, & Van Dyne, 1993) and both theory and my empirical observations
confirmed that this degree is quite high in caregiving organizations such as an elder-care
home. This increases the coordination requirements “needed to achieve efficacious
performance outcomes” (Burke et al., 2006: 294). To provide care for the elders, the nurses
needed to cooperate and coordinate their work efforts together – to form a team with
collective capability (Orlikowski, 2002) to offer good quality care together. It has been found
that the need for person-focused leadership is greater, the more interdependent the nature of
the work is (Burke et al., 2006: 299). Thus the second key question for the leader is how to
lead the team as a whole rather than as separate individuals into achieving good results in
terms of caregiving?
Taking these two conditions together, the leadership in caregiving organizations is much
about the emotional undercurrents; being able to create a work community where the
individual nurses feel that they are psychologically safe and their emotions are contained. As
Kahn (2005: 187) put it “Effective department leaders take seriously the idea that units have
emotional lives that must be publicly excavated and tended to.”
Given the complex influencing processes and the importance of the emotional dimension,
the leadership challenge for a superior of a caregiving unit seems quite complex and difficult
to handle through any systematic and rational method. Yet both my ethnographic
observations and interviews with the nurses in the elder-care home as well as the theoretical
literature (e.g. Kahn, 2005) all confirm that leaders of such units can have a significant
impact on the atmosphere and culture of the work communities. When asked how big
impact does the head nurse have on the work unit, the typical answer was “She sure
influences it quite much”[Nurse 14] and nurses told many stories of how the atmosphere of
the work unit transformed completely following the change of its head nurse. To answer this
enigma, what needs to be acknowledged is the fact that quite often the head nurses were lead
to fruitful forms of acting by their intuition rather than by any rational analysis of the
situation. When asked how calculated their interaction with the nurses is, a typical answer
was “I think it by and large is about intuition” [Head nurse 4]. Combining this empirical
finding with the complex and relational understanding of social systems we come to see that
19
the cognitive abilities of the leader seem not to be enough to explain their ability to lead and
influence these organizations to the extent they are – after all – able to have an impact on
them. The question arises: How are we able to account for the leaders’ practical and often
intuitive ability to lead such complex and emotionally rich work communities?
Systems intelligence
Given the relational systems understanding of organizations, a promising way to approach
leadership is to look at the leader’s task as one of operating intelligently within systems she is
herself embedded in. This means acknowledging that she doesn’t stand outside of these
complex relational systems but is herself an integral part of them. Thus we can look at good
leadership as the contextual capability to operate intelligently in the context of such systems
within the role that has been assigned to one. The concept of Systems Intelligence – our
“ability, capacity or skill to identify, assess, and manage the systems of one's environment
and within one’s self” (Martela & Saarinen, 2010) – aims to capture precisely this capability.
Systems intelligence has been defined as “intelligent behaviour in the context of complex
systems involving interaction and feedback. A subject acting with Systems Intelligence
engages successfully and productively with the holistic feedback mechanisms of her
environment. She perceives herself as a part of a whole, the influence of the whole upon
herself as well as her own influence upon the whole. By observing her own interdependence
in the feedback intensive environment, she is able to act intelligently.” (Saarinen &
Hämäläinen, 2004: 3) Or more succinctly: “Systems intelligence involves the ability to use
the human sensibilities of systems and reasoning about systems in order to adaptively carry
out productive actions within and with respect to systems” (Saarinen & Hämäläinen, 2010:
16). Ultimately, the rational for systems intelligence stems from the fact that “all human life
takes place in the systemic process contexts of something-largerthan-self. That something
requires a constant and lively relating to. The success and survival of a human individual, for
any significant length of time, calls for systems intelligence.” (Saarinen & Hämäläinen, 2010:
11). Accordingly, I will take systems intelligence as the guiding framework around which I
structure the following discussion about good leadership within the caretaking organization
understood as a relational system.
Along with the relational paradigm systems intelligence emphasizes the contextual nature of
intelligent behavior. The wisdom of one’s actions are measured by their general
20
successfulness to bring forth good results in the specific context one is embedded in – not
against some abstract yardstick. In this challenge to act intelligently, systems intelligence
emphasizes that along with our more cognitive skills and consciously learned patterns of
behavior we are equipped with a strong arsenal of “non-rational, non-propositional and noncognitive capabilities, such as instinctual awareness, touch, ‘feel’, and sensibilities at large, as
capabilities that relate the subject intelligently to a system” (Hämäläinen & Saarinen, 2006:
193). As recent psychological and neuroscientific investigations have revealed, our brains and
our whole beings have been attuned to social life and through mirror neurons and other
systems we are equipped with strong precognitive capabilities to read the intentions of
others and navigate purposefully and with heed within complex social settings (e.g. Gallese,
2009; Gallese, Eagle, & Migone, 2007; Hari & Kujala, 2009; Iacoboni, 2009; Lieberman,
2007). Additionally, recent infant research has shown us how this fundamental human
capability to read social systems preverbally and preconsciously is present in infants from a
very early age (Beebe & Lachmann, 2005; Bruner, 1983; Stern, 1985). There is in infants a
“readiness to find or invent systematic ways of dealing with social requirements and
linguistic forms” (Bruner, 1983: 28). Thus our ability to act intelligently within systems “is
not dependent on us taking an external viewpoint of the systems or becoming cognitively
aware of their function” (Martela & Saarinen, 2010) but is to a large extent innate and tacit.
Looking at leaders, it can be argued that much of their ability to act intelligently within the
organizational systems is not about conscious analysis of situations but about expertise that
they have gathered through their long-term exposition to acting in the context they are
embedded in (see Ericsson, Prietula, & Cokely, 2007; Mumford, Marks, Connelly, Zaccaro,
& Reiter-Palmon, 2000). Through extensive amounts of practice experts are able to provide
“consistently superior performance on a specific set of representative tasks for a domain”
(Ericsson & Lehmann, 1996: 277). What research on expertise has revealed is that a
significant proportion of the superior performance of experts is linked “to complex
representations that are specific to the domain of expertise, and, consequently, were
developed as a result of extended exposure and practice” (Ericsson et al., 2009: 8). In other
words, “expertise resides in implicit context-bond heuristics” the expert “has acquired
through adaptation to the constraints of the environment one operates in” (Martela &
Saarinen, 2010; Ericsson & Lehmann, 1996). Expertise thus is first and foremost a systems
21
competence – the ability to act with finesse within the systems one has been exposed to and
learned to navigate within.
Taking stock of these findings, it becomes possible to argue that a large proportion of the
leaders practical acumen to lead a work unit successfully is embedded within her implicit,
procedural and affectively-attuned abilities (Luoma et al., 2011: 4). An experienced leader is
“armed with a keen sensibility of what kind of behavior might be appropriate in a given
situation” (Martela & Saarinen, 2010); in many situations she is able to sense her way
forward to the right form of action. This insight is in line with the leaders’ own experiences
in the elder-care home. They felt that interacting with the subordinates in the right way “is
quite much based on intuition” and how “some form of flavour for different people is
generated” [Head nurse 3] that enabled them to ‘act right’ with their followers.
Constructing the role for the leader within a caregiving organization
Equipped with the understanding of the leader developed in the previous section, let’s turn
to look at how a leader should lead within a caregiving organization. I will start by discussing
the general goals of the caregiving leaders before proceeding to look at the more specific
demands placed upon her by the subordinates. As was already mentioned, this discussion of
the general goals and leverage points for the caregiving leader will be quite strongly theorydriven although it also reflects and is in accordance with my experiences within the eldercare home.
The goals of a leader of a caregiving unit
On the most general level, one could say that there are two major goals that the caregiving
leader should aim towards. Firstly, she must facilitate the construction of a work community
that is relatively self-organizing and able to work together to achieve the practical goals of
the work. In other words, the leader must make sure that the community she herself is part
of is able to perform the tasks assigned to them in a well-functioning and coordinated
manner. One of the head nurses crystallized this dimension well in stating: “Good work
community is one that knows its basic mission and all employees are committed to it. And
the work community takes responsibility for their own work.”[Head nurse 5]. Instead of
being about strict overseeing and control of subordinates, leadership of a caregiving unit is
more about the “ability to create conditions under which relational outcomes such as
22
coordinated action, collective achievement, and shared accountability can be achieved”
(Fletcher, 2007: 349).
One way to conceptualize such a functionally coherent work unit is to talk about a
community of practice (Wenger, 1999) which is combined of three elements: Firstly,
members “are bound together by their collectively developed understanding of what their
community is about and they hold each other accountable to this sense of joint enterprise.”;
secondly, the community is built “through mutual engagement” and norms and relationships
of mutuality; and thirdly, through their joint action they have produced a “shared repertoire of
communal resources” such as routines, sensibilities, language, tools, styles, stories and so on
(Wenger, 2000: 229). It can be argued that doing effectively such collectively oriented and
jointly coordinated work as elder-care nursing requires that the work unit is able to raise to
the level of a community of practice.
Secondly, the leader should aim at facilitating the members of the work community to be
connected on the emotional level. Kahn calls such work units ‘resilient’ and argue that
“resilient organizations, like individuals, have the capacity to absorb stress and difficult
emotions without being so harmed that they cannot function effectively” (Kahn, 2005: xi).
Organization becomes resilient when its members “routinely and consistently inquire about
and attend to others, validate and empathize with them, support and show compassion for
them.” (Kahn, 2005: 43). Resilience – the ability to cope with difficulties and disturbing
emotions – can thus be understood as the “property of the collective” (Kahn, 2005: xi). Such
a work community amounts to a ‘holding environment’ which Kahn (2005: 42) describes as
follows: “Members feel contained and held within the context of their work relations. These
systems operate on a simple, powerful principle: caregiving that flows throughout work
relationships among organization members maintains a steady flow into careseekers and, not
incidentally, an ongoing stream by which to maintain a resilient organization.” Because of
the nature of the work in caregiving organizations, building and maintaining the resilience of
the work community becomes often the most important task of the leader. As Kahn (2005:
179) puts it: “Individuals vary in how resilient they are but it is their collective resilience that
is of concern to effective leaders.”
How then to work towards these goals – building both functionally and emotionally closelyknitted and well-working unit? I will argue that there are at least three dimensions that the
23
systems intelligent leader can influence and the aiming towards of which will enhance the
functioning of the work unit both on the emotional and functional level. First of these is
positivity. As I will show, through investing in the positivity the leader will indirectly
improve many of the most central dimensions of organizational life. Thus influencing the
climate of the unit towards more positivity and building a positive work atmosphere is one
of the most important leverage point for the leader wanting to improve the work community
understood as a system.
In their study on team performance, Losada and Heaphy (2004) analyzed the
communication of 60 management teams and found out that the most important variable
explaining the difference between high-performing and low-performing teams was the
amount of positive communication as opposed to negative communication. A speech act
was coded as ‘positive’ “if the person speaking showed support, encouragement or
appreciation” and ‘negative’ “if the person speaking showed disapproval [- -], sarcasm, or
cynicism” (Losada & Heaphy, 2004: 745). The differences in this dimension were striking:
For high-performance teams positive communication was 5.6 times more prevalent than
negative while the ratio for medium-performance teams was 1.9 and for low-performance
teams as low as 0.36 (Losada & Heaphy, 2004: 747). Similarly, other research has found how
positive atmosphere improves decision making, creativity and productivity (Cameron 2008:
19; Bolino, Turnley & Bloodgood 2002). It can thus be argued that through generating a
positive work climate the leader of a caregiving organization is able to improve ultimately the
quality of care that the nurses are able to produce. In addition, positive work climate has also
been found to enhance social integration and prosocial behavior (Cameron 2008: 19; Bolino,
Turnley & Bloodgood 2002) and thus it can be argued that it makes the work community
more resilient. Accordingly, influencing the atmosphere for the positive will have a healthy
impact for the team on both functional and emotional dimensions.
In addition to the general atmosphere, the leader should invest especially to the generation
of positive work relationships, understood as “reoccurring connection between two people
that takes place within the context of work and careers and is experienced as mutually
beneficial” (Ragins & Dutton, 2007: 9). The advantages of positive work relationships are
plentiful. For our purposes perhaps the most important ones are that positive relationships
have been found to enhance the emotional carrying capacity of individuals indicated by
24
“both the expression of more emotion by people [- -] and more variety in the emotions
expressed” (W. Baker & Dutton, 2007: 328; Dutton & Heaphy, 2003), and foster greater
resiliency and “the ability to adapt and bounce back from difficult experiences” (Cameron,
2008: 40; Dutton & Heaphy, 2003). This is because within positive work relationships the
workers feel safe to display different emotions (Dutton & Heaphy, 2003: 266). Within
positive relationships individuals in a caregiving organization are thus more able to
experience the difficult and encumbering emotions that derive from caregiving and can more
easily share them with their colleagues. On the other hand, positive relationships also foster
healthier team functioning (Ancona & Isaacs, 2007). Teams characterized by positive
relationships are more able to work together as a dynamic and balanced wholeness. Again we
see that positive relationships are advantageous on both functional and emotional
dimensions of the caregiving unit.
Some of the head nurses I interviewed seemed to be well aware of the importance of this
positivity. For example, one head nurse had noted how in the work unit “some kind of
negativity is much alive there” and made much effort to improve that through “giving
positive feedback” and reminding employees of all the good things in their work and the
potential that they have within them [Hed nurse 6]. Of course, influencing the work-life for
the positive is not an easy task. As argued by Küpers (2005: 228), “well-be(com)ing is a
complex inter-relational process and therefore cannot be simply ‘organised’ or ‘managed’.
This implies that it cannot be ‘designed itself’, rather it can only be ‘designed for’, i.e.,
facilitated and frustrated.”
In addition to positivity, another tendency that the leaders should attempt to strengthen
within the work community is a more collective and other-focused orientation instead of
everyone focusing just on themselves. “Building a community” is about “enabling a rich
fabric of connectivity among people” (Wenger, 2000: 232). In Losada and Heaphy’s (2004)
research described above two other dimensions showed also significant differences between
high- and low-performing teams and they both related to the extent that the members of the
teams were focused on themselves as opposed to the team as a whole. Firstly, there was the
amount that a person was in an inquiry mode – making questions that “aimed at exploring
and examining a position” – as opposed to being in an advocacy mode in which one is
“arguing in favor of the speaker’s viewpoint” (Losada & Heaphy, 2004: 745). For high25
performing teams these were in balance, the ratio was 1.143, in medium-performance teams
the ratio was 0.667 while in the low-performing teams there was a significant imbalance with
the ratio being only 0.052 (Losada & Heaphy, 2004: 747). Secondly, they looked at
connectivity between team members which was measured by “how strongly and at what lag
a particular behavior of one person over time is interlocked with the behavior of another
person” (Losada & Heaphy, 2004: 747-748). In other words, the higher the connectivity of a
team, the stronger the interconnectedness and mutual influence between team members. In
here, high-performance teams scored 32, medium-performance teams 22 and lowperformance teams 18 with coefficients of variation being below 6.8% for all three
categories. Taking these two results together, we see that high-performing teams were more
attuned to each other on both emotional and verbal levels. In addition, there are indications
that the focus on the collective and positivity are connected: psychological research looking
into the usage of ‘I’ versus ‘we’ pronouns has found that disproportionate usage of ‘I’ –
which is interpreted as a sign of a weakness to connect with others – is associated with
depression (see Pennebaker, Mehl, & Niederhoffer, 2003: 560).
It can be argued that success in such collectively done work of which nursing is a good
example is dependent on the workers being able to maintain the focus on the collective good
instead of thinking just about themselves. If the goal is to build a community of practice to
facilitate effective caretaking of the elders, then we must understand that “generalized
reciprocity is a hallmark of communities of practice” (W. Baker & Dutton, 2007: 329).
Wenger et al. (2002: 37) note that “members of a healthy community of practice have a
sense that making the community more valuable is to the benefit of everyone.” By orienting
themselves to what they see as best from the point of view of the wholeness, the nurses of
the elder-care home can thus enable each other to work better towards the shared mission of
taking care of the elders.
We will see in the forthcoming discussion about expectations of leadership how the
importance of this dimension was acknowledged by the head nurses. They put much effort
in clarifying the basic mission of the unit as well as clarifying the roles for the nurses. Both
the head nurses and the nurses themselves saw this as one of the most important tasks of the
supervisor. The head nurses wanted the nurses to have “a good understanding of the
wholeness and why we are here” [Head nurse 3]. These can all be interpreted as efforts to
26
bring the focus of the nurses towards the common mission and the collective dimension of
the work.
Thirdly, the employees of a caregiving organization need to feel secure. They must have a
feeling that they are contained by the larger work community; that their psychological needs
are met (Kahn, 2005). This perspective is strengthened through the literature on perceived
organizational support and social support that both “tap the extent to which individuals feel
they are valued and cared about and have others to turn to who will help them in times of
need” (George, Reed, Ballard, Colin, & Fielding, 1993: 167-168) and which are widely
believed to be connected to meeting “the needs for emotional support, affiliation, esteem,
and approval” (Rhoades & Eisenberg, 2002: 711). Perceived organizational support has been
found to lessen the effect of stressors at work (Rhoades & Eisenberg, 2002: 711), be
negatively associated with strains experienced in workplace, with turnover intentions as well
as with burnout, and positively associated with job satisfaction and organizational
commitment (Cropanzano, Howes, Grandey, & Toth, 1997; Rhoades & Eisenberg, 2002).
For example, in a study that examined nurses caring for AIDS patients it was found that
both perceived organizational support and social support lessened the adverse effect on
psychological well-being that was caused by caring for this group (George et al., 1993).
In addition, it can be argued that feeling secure even facilitates learning and creation of
shared knowledge which in turn facilitate the better coordination of the work. Miller and
Stiver (1998; see also Dutton & Heaphy, 2003: 273) argue that in relationships characterized
by mutual empathy and empowerment people are more able to elaborate on their thoughts
and feelings and build shared understanding while von Krogh, Ichijo and Nonaka (2000)
argue that demonstrating care in a relationship creates an enabling context which is vitally
important for the creation of new knowledge. So also in this dimension of secure
atmosphere we see how it can be beneficial to the work community on both functional and
emotional dimensions.
Role for the leader
Having discussed the general directions towards which the leader of the caregiving unit
should direct the organization, it is time to look at the more specific roles that the leaders
must occupy in order to lead successfully their work community. The results presented in
27
this section are based on the interviews of the nurses and head nurses within the elder care
home under study.
Interviews with the head nurses confirmed that they indeed felt that they stepped into a role
when they became leaders of their units. Many of them had been regular nurses before
becoming head nurses – sometimes in the same unit – and described how significantly the
role expectations changed on the day they took the supervisor position. For example, one of
the interviewees had taken the role of the head nurse only a few months before the
interview, having been a regular nurse in the same unit before that. She described how the
expectations from here were totally different “from the day one” and how it was initially
hard to adjust to being expected of so much just because “I had stepped into that [head
nurse’s] room” [Head nurse 3]. She felt that “it is very strong and clear what the personnel
demand or expect from you.” Other head nurses with more experience described similar
initial difficulties in adjusting to their new roles but also felt that after a time you grow
adjusted to the role and it becomes more natural for you [Head nurse 4, Head nurse 5].
Sometimes they felt their role demanded them to act in situations where they rather would
have wanted to stay passive. In these situations they felt that they just have to act their role:
“But it sure is my duty after all. That’s just the way it is.” [Head nurse 6]. Because of their
formal position “People look carefully at what kind of a person you are” [Head nurse 7]. The
need for someone to fill the role of a leader was also emphasized in the stories of units that
had lacked supervision for some time. One head nurse described how the work unit she
came to be a head nurse for had had four different supervisors in a year and thus lacked any
long-term leadership. She told that she received a warm welcome in the unit and the nurses
came to say to here “how wonderful it is that there is someone to whom one can tell
different things and who takes responsibility” [Supervisor 1]. Her story was confirmed by
one of the nurses in her unit who told “how horrible it was when we didn’t have anyone”
[Nurse 16]. Another head nurse told of a work unit she was responsible for but unable to
devote much time to. She had found how certain persons within the community had
emerged as some sorts of leaders within them [Head nurse 3]. The head nurses thus saw that
the need for leadership emerged from the work units themselves. One of them told how she
don’t believe in self-organizing teams but instead “every [team] needs someone that in the
28
end takes the responsibility and frames the work; why are we here and what are we paid for”
[Head nurse 6].
Looking at the matter through the interviews with the nurses, it was equally clear that they
had certain expectations of their supervisors and saw them as possessors of a special role in
their work community. “Of course a boss has to be a boss” as one of them exclaimed
[Nurse 23]. They didn’t want the bosses to be on the same level with them but expected
them to hold a certain distance and “not be too buddy-like” [Nurse 22]. In general they saw
that the “head nurse has a significant impact on the work atmosphere” [Nurse 1] and were
ready to list their most important expectations from their supervisors as well as examples of
both good and bad supervising they had experienced. In my analysis, the nurses expectations
of their leaders fell into seven themes – supervising the work, taking responsibility, trusting
the employees, being an authority, mediating the conflicts, giving emotional support and
being just (see Figure 1) that are presented in more detail below. As said, the nurses’
expectations and the head nurses’ perceptions of these expectations were so close to each
other that I draw from both sets of interviews in representing them.
29
First-order categories
Second-order themes
Setting the goals and rules
Clarifying job descriptions
Controlling that the rules
are obeyed
xo
xo
o
Enabling that the work
gets done
Making decisions & taking
the final responsibility
xo
Trusting the employees
Discuss important matters
with the employees
Being flexible
x
xo
Authority
Being upright
xo
xo
Being sensitive to the
atmosphere
Interfering to the conflicts
Solving the conflicts
xo
Being approachable
and empathetic
Listening and supporting
Encouraging
xo
xo
xo
Giving emotional support
Being just
xo
Being just
o
Aggregate dimensions
Supervising the work
Taking responsibility
Work-related expectations
Trusting the employees
x
Being an authority
Mediating the conflicts
xo
xo
Community-related expectations
x = Category present in the interviews with the nurses
o = Category present in the interviews with the head nurses
Figure 1 The data structure of the leadership expectations
Work-related expectations
Overall, the expectations could be divided in two broad dimensions: the expectations that
related to the work itself and the expectations that related more to the work community.
This division was present in some of the head nurses accounts of their work. For example,
one stated how the work involves “in addition to coordinating and planning the work, being
supportive in many different ways” [Head nurse 4] and another stated how the work is
“constant balancing” between having the actual activities as the starting point but not
forgetting the human needs of the employees [Head nurse 3]. Kahn (2005: 177) also makes
30
the same distinction in his account of the leadership within caretaking organizations:
“Leaders must also work at both technical and emotional levels in relation to their
organizational members.” In fact, in their meta-analysis of team leadership Burke et al (2006:
291) noted that “a common theme within nearly every identified classification system was a
trend for behaviors to be broken into one of two categories: those dealing with task
accomplishment [i.e., task-focused] and behaviors which facilitate team interaction and/or
development [i.e., person-focused].” Thus it seems very natural to break the expectations
into these two broad categories. Starting with the more technical dimension of work-related
expectations, it is comprised of three themes: supervising the work, taking responsibility and
trusting the employees.
Supervising the work
The nurses firstly expected the head nurse to act as a supervisor of their work. This involved
first of all that the head nurse was able to clarify for the nurses their job descriptions and set
the direction they were heading towards together: “Perhaps the most important thing is after
all that the head nurse has a clear vision of the basic task of the unit” [Nurse 21]. One nurse
described a situation in which she had been in a unit that lacked clear direction and job
descriptions and accordingly ”everyone was like a big question mark every time they came to
work: ‘so what should I do now?’” [Nurse 14]. This resulted in a chaos: “doors were
slammed, people yelled, and almost scuffled with each other.” The situation had calmed
down only after the head nurse together with the nurses had gone through and clarified the
job descriptions so that everyone felt that their work had some clear purpose. The head
nurses quite unanimously felt this rule-setting and clarifying the basic mission of the unit to
be one of their major tasks. They felt it to be of paramount importance that “everyone
knows their own tasks” [Head nurse 8], “why we are here” [Head nurse 3] and “what is
expected of them” [Head nurse 2]. Accordingly, many of them had devoted considerable
time to “refine our rules” [Head nurse 1] together with the nurses. I will return to this theme
later but it should be noted that Kahn (2005: 180) emphasizes how clarifying primary tasks
and delineating roles are essential leadership tasks for caregiving organization members to be
able to engage in their work. In their meta-analysis of team leadership Burke et al. (2006:
290), in turn, identified setting compelling direction and initiate structure to minimize role
ambiguity as one of the primary tasks of leadership.
31
Controlling that the rules are obeyed was also a category that was strongly present in the
interviews with the head nurses: “Of course one has to set limits and those rules of work”
[Head nurse 5]. The head nurses saw it to be their responsibility to oversee that all the
relevant rules were respected. For some reason or another, the same category did not directly
emerge in the interviews with the nurses expect for one nurse who told that “If there are
people who just loaf around then she [the head nurse] has to bee strict and say that things
ought to be done in this way” [Nurse 18]. Nevertheless, this dimension was implicity present
also in other nurses’ accounts of some of the occurrences at work. For example, one nurse
told about a worker who “was a real nuisance” [Nurse 4] and constantly broke the rules such
as coming an hour late to work. The work community solved the problem by complaining
about the matter to the new head nurse who then put the worker in line. This and similar
stories in which the head nurse acted the role of rule-overseer confirmed that this dimension
was implicitly present in the nurses expectations of their supervisor although they didn’t
state it out aloud.
Taking responsibility
Second work-related theme was that of taking responsibility of the work. In here, the nurses
felt that the head nurses were accountable for enabling that the work itself gets done. “the
role of the head nurse is really just that to make sure that things get done” as one nurse put it
[Nurse 17]. The nurses needed to trust that the head nurse “gets things done” [Nurse 3].
This involved also that they saw the head nurse as the one who advocates and fights for the
needs of the unit further up in the organization thus securing the needed resources for the
members of the unit. As one head nurse put it: ”At least they expect that I am the one who
enables the work; that there is always enough personnel and the equipment we need” [Head
nurse 5].
This theme also involved a category that the head nurses felt to be important part of what is
expected of them, but that did not emerge in the nurse interviews, namely making decisions
and taking final responsibility of matters. One head nurse for example told that the nurses
had come to her to say “how wonderful it is that there is someone to whom one can tell
different things and who takes responsibility” [Head nurse 1] while another told how the
nurses feel it important that there is someone who says how things are done and gives
reasons for her decisions [Head nurse 6]. Third told how in conflict situations with the
32
relatives of the elders she is always the one who answers to the claims made by the relatives
[Head nurse 5]. Again, although this category didn’t come out directly in the interviews with
the nurses it was present in their accounts of their work and also in the everyday work I
observed. When the work community couldn’t reach out a decision on their own, they
sought the advice of the head nurse and her verdict was taken as the final word on the
matter. In bigger decisions the nurse didn’t want to carry the responsibility on their own but
negotiated the matter with the head nurse. Through this procedure they thus transferred the
responsibility of the decision from their own hand to the head nurse. In practice, thus the
nurses also wanted the head nurse to be the one who makes the important decisions and that
takes final responsibility of the matters. Thus making decisions and taking final responsibility
of them seems to be an important part of the job of the caregiving leader.
Trusting the employees
The third theme in the work-related expectations of nurse leadership was about trusting the
employees. The nurses appreciated the ability to do the work relatively independently and
simply wanted their supervisors to trust them: “What I want from my supervisor is that she
trusts her employees and their abilities to do the work so that she doesn’t have to interfere
with everything that is done.” In some units the nurses complained how lack of trust and the
resulting “stalking” and “nit-picking” [Nurse 23, Nurse 18] from the part of the head nurse
had a major negative impact on their work-related well-being. They longed for some
previous units they had worked in where “she [the head nurse] trusted in us that we do the
work well” or “the invisible trust [on the part of the head nurse] has been somehow more
visible.”
A dimension of this trust towards employees was that the head nurse discussed important
matters with the nurses rather than just bringing in ready decisions and orders. One nurse
told how extremely frustrating it is when the orders just come from above without any
possibility for real discussion about them [Nurse 10]. Another compared the reactions of
two head nurses to the work unit having made an independent decision: supposedly the first
would say “oh my, how well you have done things [- -] Carry on in the same spirit” while the
second – that she didn’t like – would ask “why did nobody ask me?” thus getting angry if she
didn’t get to be on top of every decision [Nurse 18]. The head nurses themselves seemed to
be quite aware of this need on the practical level and accordingly told stories about how the
33
job descriptions, rules of work and similar issues were discussed together with the nurses to
come up with solutions and decisions that everyone could feel to be part of and accept.
A special need within this category was flexibility. What made it interesting was that there
seemed to be something of a gap between generations in here with the young employees
demanding flexibility from the part of the head nurse. Some of them saw that a good head
nurse is “flexible in some situations” [Nurse 18] and not too strictly guarding the rules.
Older nurses in general didn’t bring up this theme and instead sometimes felt that the
younger generation had much to learn in terms of obeying the rules of work. Some of the
head nurses also brought up this theme of younger generation not being able to obey the
rules as they should be obeyed. Thus this category represents an interesting dimension of
mixed demands placed on the head nurse. At the same time as some members of the
younger generation wanted her to be more flexible some older nurses would want her to be
more strict in controlling the work habits of the very same members of the younger
generation. Answering to both these demands simultaneously might be an impossible task
for the head nurse and accordingly she might have to decide where she wants to stand on
this dimension.
Community-related expectations
Being an authority
Turning to community-related expectations, the nurses clearly wanted the head nurse to take
a position of authority. The head nurse wasn’t simply accepted as an authority because of her
formal position but the nurses wanted her to act like an authority: “one must have that
special kind of authority” [Nurse 17]. One nurse told how the best thing about her previous
head nurse as compared to the present was that she “used her direction rights in some
situations, and her voice expressed that she is not to be walked over” [Nurse 24]. The nurses
thus complained when some head nurses were too “lax” [Nurse 4]. One nurse told that she
herself is a strong personality and this was problematic when the head nurse didn’t have
enough authority to resist her [Nurse 12]. The head nurses were aware of this expectation:
”If I start to be very uncertain in there and waver back and forth then that is not good for
the work community” [Head nurse 6]. In fact some of them admitted that this was one
dimension they struggled constantly with: “I am quite soft, so I would need to have some
34
more courage” [Head nurse 7]. They thus wanted to fulfill the expectations of authority that
were assigned to them although this sometimes didn’t fit well with their personality.
Connected to this the nurses wanted their supervisor to be upright, to stand behind her
words and be “assertive” [Nurse 19]. As one nurse stated: “you have to be precise; that
things get done” [Nurse 18]. When this dimension was lacking, the nurses felt that it was
hard to trust the supervisor. Again, the head nurses acknowledged this. For example, when
asked what nurses expect from her one of the head nurses answered: “assertiveness, you
cannot start to please anyone; that would come through quickly. One has to stand on one’s
own feet.” [Head nurse 3.] Another told how it is important that “the supervisor is in her
own way sure-handed” [Head nurse 6].
Mediating the conflicts
Next theme in the community-related expectations was related to conflicts and quarrels that
sometimes occurred between two or more employees. In here, the head nurse had a clear
role as the person responsible for mediating and solving these conflicts. First of all, this
involved that the head nurse should be sensitive to the atmosphere and the happenings in
the work community: “One has to be sensitive and in some form of dialogical connection
with the whole personnel of the unit so that one can interfere with some problematic issues
early enough” as one nurse summed it up [Nurse 21]. This was reflected in the head nurses
accounts, they felt that they “should be so sensitized to different people” [Head nurse 3] and
that they can’t just rely on employees coming to tell them about problems but “the
supervisor has to notice them oneself” [Head nurse 6]. Of course, more often than not when
the employees felt that the head nurses didn’t notice a conflict they did just that: came to tell
them about it: “they come to tell me immediately if there is for example some problems in
the work community” [Head nurse 3]. Kahn (2005: 192) also mentions maintaining “a cleareyed, insistent focus on interpreting the patterns of behavior within and between groups” as
important resource for the leader of caretaking organization wanting to keep up a healthy
work unit.
But notifying the conflicts either directly or through someone telling about them was only
the first step. It was the head nurses’ responsibility to interfere to them. “What I expect from
the supervisor is what we are dealing with right now: Interfering quickly when some
problems arise, that they are dealt with immediately.” [Nurse 17.] So being the head nurse
35
“one has to have the skills and the courage to interfere to nasty issues” [Nurse 15]. If the
supervisor lacked this dimension, the problems in the units “start to accumulate” [Nurse 17]
and get worse. Thus one nurse complained that “the supervisors role should be more
visible”, that she should “step more into situations and be more present” [Nurse 2]. Because
of their special role in the work community, the head nurses were in a better position to
interfere to the conflicts than the ordinary workers: “So it is felt quite differentlu if the head
nurse interferes because then it is more neutral; in a way it doesn’t personify to someone that
‘she said that and now it is her fault.’ So it is expected quite much.” [Head nurse 3.] The
head nurses also felt this as their responsibility: “if there are problems in human relations or
interactions and such things, then they have to be straightened out” [Head nurse 8].
Sometimes this was a duty they would rather wanted to avoid: “Sometimes you feel that now
I am not able to do this, but it just is part of this work” [Head nurse 3]. Many were also the
stories about actual conflicts I heard and almost always these stories involved the head nurse
as a mediator trying to solve these conflicts. Kahn (2005: 178) also makes it clear that good
leaders of caretaking organizations take this task to “interrupt disturbing patterns” seriously
“aware that if they did not, the emotional currents will grow stronger and more insistent.”
The third category within the mediator of conflicts theme floats quite naturally from the
previous one: the head nurse has the responsibility to solve these conflicts; to act as the final
authority that takes care that the quarreling parties get over with it and can continue with
their work. The nurses expected that when the conflict reached the hands of the head nurse,
it would be solved in one way or another. If the head nurse was unable to solve the conflict
herself she was expected to seek some outside support (cf. Kahn, 2005: 192) from her own
supervisors, some counseling workers or similar. The main thing is “to get the thing off the
agenda” because unsolved conflicts and cliques can “start go heavily in the wrong direction
if they are left unintervened” [Head nurse 6]. In other words, head nurses had the
responsibility either to solve the conflict using their own resources or make sure that
adequate outside resources were used so that the conflict was settled.
Giving emotional support
The next theme emerging from the interviews was about head nurses giving emotional
support for the employees. This theme was quite strongly present in the nurses’ accounts of
their needs from their supervisor. This is understandable given William Kahn’s (1993, 1998)
36
findings that in caregiving organizations the caregivers give much emotional support to the
customers and this creates a need to replenish this emotional energy by getting emotional
support from one’s peers and especially from one’s supervisor. In their meta-analysis of team
leadership, Burke et al. (2006: 293) also note the existence of a category they label as
‘consideration’ and which is “directed at maintaining close social relationships and group
cohesion.” It is, however, mainly discussed in relation to provision of expert coaching. It can
thus be argued that given the nature of work of nurses, this dimension is much more present
in caregiving leadership as compared to leadership in many other forms of work.
First of all, then, the nurses wanted the head nurse to be approachable and available for
them. When asked what kind of a person should a head nurse be the first thing mentioned
by one nurse was “being easily approachable” [Nurse 18] while a second nurse started by
stating “being a person that can be approached” [Nurse 22]. Another nurse felt that they had
a good head nurse and a good senior nursing officer because “I have felt that collaboration
with them is positive and easy. They are easily approachable people” [Nurse 5]. Connected
to this they also wanted the head nurse to be empathetic and friendly towards them. One
nurse praised how her former supervisor “was just kind of heartfelt and friendly and it was
easy to go and talk and discuss with her” [Nurse 18] while another wanted the head nurse to
be “empathetic and sympathic to some degree” [Nurse 22]. The nurses didn’t want just an
authority to command them but someone with a warm heart that responded also to them on
the emotional level. This kind of person should listen, support and encourage them in their
work.
The nurses thus needed a head nurse to whom they could come and confess their problems
and who would listen to their sorrows. One nurse praised her supervisor because “with her
you can discuss anything freely. Sometimes you just have to talk and that helps too.” [Nurse
16.] Second praised the supervisor because “it is easy deal with her, almost if we would have
known each other for a longer time. [- -] It is easy to discuss whatever things with her.”
[Nurse 19.] In their stories about difficult moments in work the nurses also constantly told
how they in these moments sought to discuss the matter with the head nurse and how they
got much needed support from them. Hinshelwood (2001: 140; quoted in Kahn, 2005: 186)
has summarized the important functioning of this dimension well: “The supervisor’s role is
to be a setting that can in some way take the anxiety and do some thinking about it. This is
37
the creation of a reflective space, the purpose of which is to convert something anxious into
something communicated.”
The head nurses felt strongly the subordinates need to seek support from them. “When they
have these questionnaires for personnel it seems that everyone anticipates that the supervisor
is available to them. It is quite much the main expectation from personnel.” [Head nurse 6.]
In fact the head nurses were sometimes overwhelmed with the extent to which the
employees wanted to discuss matters with them and had to learn to regulate the amount of
support they could give to them. Using the metaphor of carrying monkeys on the shoulder,
one nurse reflected how she had had to learn not to get too involved in the personal
problems of her subordinates: “Perhaps I took quite much of those monkeys on my
shoulder in the first years. So I somehow wanted to be empathic and such. And then I was
totally exhausted after the workday. So now I have perhaps learned through the years to give
the monkey back, to not start to gather them to myself.” [Head nurse 5.] Another head nurse
that had started just a few months ago in the supervising role had “startled” at how much
the subordinates opened up to her and was struggling with the same issue: “Some of them
anticipate that we would have time to talk things over and sort them out; sometimes even
quite intimate things. But there is not much time for that. And we are not any kinds of
psychologists in here; we can’t start to sort out people’s personal things.” [Head nurse 3.]
The head nurses’ experiences reflected Kahn’s (2005: 196) insight that “the knottiest issue
for leaders in caregiving organizations is that of dependency.”
Finally, the nurses also wanted emotional support in the form of encouragement. They told
how getting positive feedback from supervisors gladdened them [Nurse 7] and how a good
supervisor “also states out aloud when there are good things to be said” [Nurse 22]. One
nurse told how sometimes she lost sight of the importance of her job and in these moments
an encouraging word from the supervisor could help to see the purpose of the job again
[Nurse 2]. They thus wanted someone to acknowledge the good work they do and encourage
them to remember the positive sides of the job and to seek to do their work even better.
Some head nurses had clearly acknowledged the importance of this dimension and told how
they tried to get better on this dimension: “One makes an attempt to say that you’ve got that
something. You just have to find it and make use of it. [- -] Giving such positive feedback
indeed has a very big significance for the employees.” [Head nurse 6.] She told that she had
38
noticed how it makes a big difference whether or not the head nurse acknowledges it when
the nurses have done something remarkably well.
In discussing the emotional support that the nurses seek from their supervisors it is also
important to consider the metaphors that were used by the interviewees. Two different head
nurses equaled their job to that of being a mother and discussed how sometimes they felt
how many nurses “think of the head nurse as a kind of mother” [Head nurse 9]. One of
them felt that especially with younger employees the relationship easily came to resemble
that between a mother and a daughter: “Perhaps with these young employees sometimes
they are so much searching for direction in life that you come to guide and direct them. In
the same way as I have guided my own children and still do. [- -] In some way the young
then resort to it” [Head nurse 5]. Also a couple of quotes from the nurses are revealing here:
“She is wonderful, she has taken care of us so well” [Nurse 16] and ”it is very good
supervising work, she tends us well”. The extent to which the employees seeked emotional
support from the head nurses thus could reveal that it is deeper psychological needs –
usually found in the interaction between children and their mothers – that they sought to
fulfill in these relationships. Kahn held this to be an important part of the leadership
challenge within caregiving organizations acknowledging how “relations of authority
between caregiver and careseeker, and leader and member” are sometimes unconsciously
mapped “on the basis of parent-child relationships” (Kahn, 2005: 197). It thus is reasonable,
along with Kahn, to look towards literature around psychological attachment in attempting
to make sense of the relationships between subordinates and superordinates in the
caretaking organizations.
Being just
Finally, the employees wanted their supervisor to be just and treat everyone equally. This is
not surprising given the vast literature on the importance of justice in organizations. Good
supervisor is the one “who listens and treats everyone in a just way” [Nurse 24] and good
supervising is about “equality; that every employee is on the same line in the eyes of the head
nurse” [Nurse 21]. This was also a regular issue for complaints: some nurses felt that
everyone was not treated equally in their unit and this lead them to condemn their supervisor
in rather harsh words. Especially in one unit issues with this dimension had led to an
39
escalating conflict between some of the nurses and the supervisor. Observing them it was
clear that this was an issue that the nurses felt very serious about.
The head nurses were also aware that equal treatment was expected from them and
accordingly emphasized this dimension in the interviews when I asked what is expected of
them: “I feel that the most important thing after all is about justness and assertiveness”
[Head nurse 3] or “perhaps it is justness and such which is most expected” [Head nurse 4].
This was also seen as challenging, because “although you would act fairly, everyone looks at
it from their own perspective and has to understand why she has ended up in certain things
before feeling it to be just” [Head nurse 7]. In any case, the head nurses at least assured that
part of their task is to attempt to be as just and fair as possible.
Summary
Overall, the employees in the elder care home needed more than someone to coordinate the
work. They needed someone who they could rely on emotionally and functionally. They
needed someone who created an atmosphere in which they could feel secure that they can
do their work and that their emotional needs are answered to. As one of the head nurses
summarized: “that the work community has a secure feeling that there is someone from
whom you can ask if something arises. And that person takes responsibility so that the
employee doesn’t get confused about what she should do next. So they get that support
from the head nurse. That must surely be the main thing” [Head nurse 6]. Borrowing from
Kahn, we could state that the leader needed to establish a secure base (Kahn, 2005: 7) or a
holding environment for the nurses in which “members feel contained and held within the
context of their work relations.” (Kahn, 2005: 42)
Leading systems intelligently
Taking stock of the previous discussion, a few more general points emerge about how to
lead caregiving organizations in a systems intelligent way. Looking at the roles the leader is
expected to fulfill within a caregiving organization we come to appreciate how big amount of
her task is about attending to the emotional and non-rational dimension of organizational
life. Thus leading a caregiving work unit systems intelligently is about finding a balance of
attending to both the rational and explicit as well as the emotional and implicit dimensions
40
of the complex and organic whole that the employees together form (Hämäläinen &
Saarinen, 2007).
In facing these complexities and challenges of the caregiving unit, the leader needs to remind
her about her final responsibility as a leader: making the organizational system work. The
leader must understand that “a system that works comes first; understanding and explaining
why it works comes second” (Hämäläinen & Saarinen, 2006: 193). The leader must not
shrink from the acknowledgement that she is not able to ‘control’ the system, or from the
fact that when she is able to influence it, she is not always able to tell why what she did
accomplished what it accomplished. As Dreyfus (2006: 46) states, expertise is not about
“detached rule following” but requires “a more involved and situation-specific” way of
acting in the situation. Sticking only to the predictable and understandable parts of the
organizational life would lead to the omission of crucial dimensions of her full leadership
task. Thus she must realize how operating with uncertainty will be a permanent part of her
work and something to be celebrated and learned from.
In the end the systems intelligence of the leader is her total ability to influence the
organizational system in the desired direction and will involve “fine-grained elements that
might seem to be mundane and barely noticeable per se but may gain momentum through
the amplifying force of the [- -] system (Martela & Saarinen, 2010). Gratitude, compassion,
hugging and other ‘soft’ elements often dismissed in more rationally-oriented accounts of
leadership will form an important part of the leader’s practical assets to influence the system.
Especially in emotionally abundant caregiving organizations such elements become
indispensable for good leadership.
Understanding the organization as a system that is continuously co-constructed in the
interactions of its members means also that “every contact, every exchange of information
presents an opportunity for influence” (Lichtenstein & Plowman, 2009: 618-619). The leader
must realize that she is building and reconstructing the organizational system through all of
her interactions. This is emphasized by Fletcher’s proposition that the positive outcomes of
“dyadic interactions between leader and followers” will “spiral outward from the initial
dyadic interaction” to impact the broader community in a positive manner (Fletcher, 2007:
358). Thus the emotions and attitudes that the leader displays in her most mundane
interactions with her followers become crucially important for generating the kind of
41
atmosphere within the work community that the leader is aiming towards. Therefore the
leader should be conscious about how she displays emotions such as empathy, vulnerability,
humility and resilience (Fletcher, 2007: 348) in her interactions with the employees. Through
being behavioral role models for followers (see e.g. Ilies, Morgeson, & Nahrgang, 2005: 385)
they will encourage also them to display more of these emotions thus being able to generate
a more care-filled and positive atmosphere into the work community.
Non-linearity and unpredictability of the systems means also that leading emergence
becomes an important part of the leadership (Lichtenstein & Plowman, 2009). Often the
leader is not able to control and decide what kind of processes will emerge within the work
community. What she can do, however, is to identify, promote and strengthen those
emergent processes that she sees as beneficial. Instead of ‘deciding’ and ‘controlling’ the
organizational events directly, coordinating and facilitating these emergent processes towards
fruitful outcomes becomes a central part of the leader’s role (Marion & Uhl-Bien, 2001). The
leader must remain constantly open for the emergence of new patterns of thinking and
behaving within the organization – and learn to utilize them to her benefit.
In learning to live with this complex and relational understanding of organizational life, the
systems metaphor could turn out to be an important ally for the leader. As argued by Luoma
et al. (2011: 4) “a system can be conceived as a conceptual device that allows people to
identify and relate themselves with their environment as a whole that involves interplay,
emergence or a state of becoming. Systems might be highly meaning-intensive, humanly
tense and highly nonconceptual, such as the dyadic systems of an infant and her mother.”
Through looking at the organizational life as a system, the leader might be more ready to
perceive the non-linear and emergent processes that are at play there. In other words, the
systems metaphor might make her more sensitive to the subtleties of the system.
Additionally, although I have attempted to generate some general understanding of the
leadership roles and expectations that the caregiving leader must meet, we must never stick
too firmly to such frameworks and advices. Because of the complex nature of the leadership
challenge, the wisdom about right leadership conduct is not easily captured in law-like
generalizations. This is emphasized by the contextual nature of leadership that was generally
acknowledged by both the nurses and the head nurses. For example before responding to
the question ‘what makes a good head nurse?’ one of the nurses felt necessary to remark
42
how “the work communities have been different” [Nurse 21]. Similarly, some of the head
nurses were responsible for two or more units and reported how the expectations of the
leader can be significantly different in the units. For example, one head nurse told how in
one unit her presence is more important while the other is so self-organizing that she
sometimes feels it hard to intervene in their work [Head nurse 3]. Thus the head nurses had
to take into consideration the special needs and rooms for development in different units
[Head nurse 6]. In other words, there are no identical contexts for leadership but every
context is in the end unique. Instead of sticking to generalized advices or ways of acting that
have worked well in one context, the leader needs always to adjust her ways of behaving to
the particularities and subtleties of the specific – and evolving – context in which she
operates at that particular moment. Thus there will always be room for improvisation and
exploration. Indeed, improvisation in the face of the unexpected and unpredictable equipped
with incomplete information becomes an essential part of the leader’s role that she must be
psychologically ready to handle.
Leading one’s own self-system
Finally, we must discuss the important shift of perspective from leadership as something
fixed and final to leadership as a continuous achievement and a growth process. Taking the
perspective of systems intelligence on leadership emphasizes the leader’s natural ability and
implicit expertise in ‘doing the right thing’ as a leader. From this it follows that the leader
must attend to her own inner “dynamic self-regulatory systems” (Hannah, Woolfolk, &
Lord, 2009: 270) as one of the most important systems she must lead. In the short term, only
when she has attended enough to her most important instrument as a leader – herself – is
the leader able to be sensitive and open enough to lead the work community systems
intelligently. In order to be emotionally available, in order to be able to control her own
reactions and in order to be open to new interpretations about the work community the
leader must herself be in a good mood and not too tired, stressed or caught up in a negative
emotional state (see e.g. Fredrickson, 2000). Being able to regulate one’s workload and mood
thus is a necessary skill for the leader. Leaders in the elder-care home told how they
struggled continuously with this issue and how they had learned slowly to attend to their
own needs and well-being instead of exhausting themselves with taking too much
responsibility and worrying too much about things in their workplace. For example, one
43
head nurse told how “you have to learn that one person can’t be everywhere at the same
time. If you try to do that – and that was what I occasionally did in the beginning – that
doesn’t end well. So I had to notice that I became exhausted and I have to surrender
something.” [Head nurse 4.] As the old wisdom says, to be able to attend to others, one
must first attend to oneself.
In the long term becoming a good and systems intelligent leader is bound with the leader’s
ability to grow as a leader. The challenge of complexity and fundamental uncontrollability of
systemic environment should not be interpreted as discouraging but rather be understood as
a “call for human growth, self-renewal and emergence” (Hämäläinen & Saarinen, 2007: 24).
Nobody is born as the ‘perfect leader’; consistent with the current knowledge of leadership
we must see it as an ability that can be developed (e.g. Day, 2000; Mumford et al., 2000).
Thus the leader who wants to be good must take responsibility of her own growth as a
leader. She must constantly aim to improve her leadership abilities and not get lost into the
illusion that she would be ‘complete’ as a leader. This orientation towards growth is
especially important in contexts such as caregiving organizations in which one of the prime
tasks of the leader is to empower the employees to be able to manage their work relatively
independently. This is because “leaders who, in their self-construct, are oriented toward
growth and the fulfillment of human potential are more likely to bring about these same
outcomes in those they lead”, as Hannah et al. (2009: 285) argue. Through normative
influence and positive role modeling growth-oriented leaders are thus able to inspire also
their followers to grow in their work roles.
Perhaps the most important thing in growing as a leader, in addition to experience as such, is
the leader’s own attitude towards her growth. In here, the work of Carol Dweck (2000, 2007)
is centrally important. She distinguishes between ‘implicit entity theory’ and ‘implicit
incremental theory’ – more popularly ‘fixed mindset’ versus ‘growth mindset’ – as two
opposing attitudes towards learning and growth. People holding an entity theory to learning
believe that intellectual abilities are fixed and accordingly seek situations in which they can
succeed easily – in order to self-validate and prove their ability to others. In contrast, those
acting according to the incremental theory have a desire to increase their competence and
accordingly seek actively challenging situations as they see them as opportunities for learning
and growth. (Dweck, 2000, 2007; see also Ilies et al., 2005: 379.) Dweck has showed
44
consistently how learners with an incremental perspective outperform those holding the
entity perspective and there is no reason to doubt that the same holds true for leaders. Thus
it is possible to argue that “leaders who are more motivated to learn at the outset and who
have higher motivation to lead will more likely embrace trigger events that stimulate their
thinking about their own development as an opportunity to improve their leadership
effectiveness” (Avolio et al., 2009: 426). Therefore adopting the growth- and masteryoriented mindset as suggested by Dweck becomes a crucial element of good leadership in all
contexts.
Another central aspect of leader’s development is a strive towards authenticity that the
proponents of authentic leadership have emphasized (Avolio & Gardner, 2005; Ilies et al.,
2005). As argued by Ilies et al. (2005: 374), in addition to being deeply aware of their own
values and characteristics, the authentic leaders are able to “focus on building followers’
strengths, broadening their thinking and creating a positive and engaging organizational
context.” Building on Kernis’ (2003) work on authenticity, Ilies et al. (2005) divide authentic
leadership into four components: self-awareness, unbiased processing, authentic
behavior/acting, and authentic relational orientation2. Of these, the first two are especially
connected to growth as a leader. Firstly, a good leader needs to be “aware of one’s strengths
and weaknesses as well as understanding one’s emotions and personality” (Ilies et al., 2005:
378). Especially important is to acknowledge one’s “contradictory self-aspects and the role
of these contradictions in influencing one’s thoughts, feelings, actions and behaviors” (Ilies
et al., 2005: 377). Secondly, unbiased processing is “at the heart of personal integrity and
character” (Ilies et al., 2005: 378-379) and involves “not denying, distorting, exaggerating or
ignoring private knowledge, internal experiences, and externally based evaluative
information” (Kernis, 2003: 14). Though totally unbiased processing is an unreachable ideal
for human beings (see e.g. Pronin, 2006), getting towards more ‘balanced processing’ (Avolio
& Gardner, 2005: 317) is important because it leads to a better awareness of the systems of
one’s surroundings as well as that comprised of oneself. Through a recognition of one’s own
2
These have quite much similarities with the intrapersonal competences associated with leader development
initiatives identified by Day (2000: 584): “self-awareness (e.g. emotional awareness, self confidence), self-regulation
(e.g. self-control, trustworthiness, adaptability) and self-motivation (e.g. commitment, initiative, optimism).”
45
biases and through abandoning the view of one’s own positon as the correct one and instead
assuming a more fallible attitude towards one’s own position is the person more able to
listen to and learn from the viewpoints of others (Pronin, 2006). Transparency, understood
as “the willingness to hold oneself (and one’s actions) open to inspection in order to receive
valid feedback” contributes to learning and growth (Popper & Lipshitz, 2000: 187).
Third dimension of leader’s development is related to the complexity of the leadership
challenge. Utilizing self-complexity theory, Hannah et al. (2009: 269) argue that to meet the
diverse demands of leading a complex organization, the leader’s self-construct must be both
“highly complex” and “imbued with a panoply” of positive characteristics. This is because
complexity in one’s self-construct “allows one to view him or herself and his or her social
situations in a multidimensional way” and opens up multiple ways of reacting to the multiple
social roles that the leader must perform (Hannah et al., 2009: 270). When the complexity of
the organizations and the leader roles called for within them increases, the leader needs a
more varied and flexible repertoire of self-aspects in order to meet those demands: “To be
effective, leaders may require kindness or forgiveness in one situational role and persistence
and vitality in another – perhaps within the span of minutes, requiring behavioral flexibility”
(Hannah et al., 2009: 273). To meet these challenges, the leader must thus strive towards
developing a diverse set of self aspects that might be relevant in diverse challenges of the
leadership task. She must be able to take multiple roles within her work at the same time as
she maintains a sufficient amount of integrity between these roles, especially in terms of
“values and core aspects of identity” (Hannah et al., 2009: 276). Managing to hold a balance
between being flexible in the roles occupied while at the same time maintaining enough
integrity is an ongoing task that requires continuous effort, reflection and self-knowledge.
As I have shown in the first part of this paper, the role demands for a leader of a caregiving
organization are more diverse than those of leaders of traditional organizations because of
the diverse emotional needs that are generated by the nature of caregiving work. Therefore
the developmental challenge presented here is especially salient for leaders of caregiving
organizations that in addition to being vision setters, task masters, analyzers and motivators
(see Hart & Quinn, 1993) have to play the roles of therapists and even mothers at some
points as part of their leadership acumen. As argued by Kahn (2005) they must face the dual
challenge of leading the unit towards good results and attending to the emotional
46
undercurrents generated by the caregiving relations. To achieve this, a fair amount of
variability and flexibility in one’s self-construal is required.
All in all, good leadership – both inside and outside of caregiving organizations – should be
about “a sense of continued growth and development as a person”, to borrow from Ryff &
Keyes’s (1995: 720) wellness theory. One should continuously attempt to reflect on one’s
actions and deeds, to see what was successful and what caused unfortunate consequences.
To be satisfied with one’s current state as a leader usually involves some form of ignorance
from the part of the leader. Thus one should continuously attempt to challenge one’s current
interpretations and seek new perspectives through which to enhance one’s leadership
abilities. Systems intelligent leader acknowledges that good leadership is always in the
process of becoming, something one must continuously strive towards.
Discussion
Theoretical and practical contribution
The present work contributes to a number of discourses within leadership research. Firstly, it
answers the calls to examine the role of followers in the leadership research (e.g. Avolio et
al., 2009: 434) by giving a detailed account of the various expectations and needs that the
followers have towards their leaders within caregiving organizations. At the same time,
through this specific focus on caregiving organizations, it contributes to the discussions
about the importance of context for leadership. The importance of context has been widely
acknowledged by leadership researchers (e.g. Hunt & Dodge, 2000; Osborn et al., 2002) but
caregiving organizations as one specific form of context has up to date received very little
attention. By learning more about the similarities and peculiarities of caregiving organizations
as a context for leadership we thus are more able to appreciate the contextualities as an
essential part of leadership. More generally, the present work participates in the growing
movement of leadership research that looks at it through relational, complex and systems
perspectives (Lichtenstein & Plowman, 2009; Uhl-Bien, 2006; Uhl-Bien et al., 2007).
Additionally, by introducing the concept of systems intelligence into leadership research the
present work contributes to the discussion on leadership agency within relational and
systems-discourses on leadership. Through emphasizing the leaders attunement to the
systems she is embedded within, we get a better sense of how she is able to act
47
constructively and fruitfully within these contexts. At the same time, the perspective of
systems intelligence highlights implicit and sensibilities-based dimensions of leadership that
are often downplayed in traditional leadership research. Thus the present work joins effort
with those approaches to leadership that aim to strengthen our understanding of the central
role of these implicit dimensions within leadership (e.g. Hansen et al., 2007; Ladkin, 2008).
By concentrating on an organizational type where the emotional dimension is especially
salient and through discussing ways to influence these emotional undercurrents the present
work also contributes to discussions about leading the emotional dimension of organizations
(see Gooty et al., 2010). Similarly, this work can be seen as part of the emerging discourse
that aims to combine positive organizational scholarship and leadership (e.g. Hannah et al.,
2009) to produce a deeper understanding of how to lead the positive dimensions of
organizational life such as displays of compassion or care as well as “explore the
characteristics of positive relational interactions between leaders and followers” (Fletcher,
2007: 350-351).
Also, by emphasizing the leader’s willingness and efforts to grow as a central tenet of good
leaders, the systems intelligence perspective on leadership touches on a “very promising area
of research that has not received sufficient attention in the leadership literature”, namely the
leader’s developmental readiness (Avolio et al., 2009: 426).
On the practical level, this work aims to give the caregiving leader a sense of those issues
that are expected from her in that role. Through acknowledging these dimensions she is
more able to perceive and respond to them in her actual work. Additionally, the perspective
of systems intelligence can empower her to trust more her implicit mastery and expertise in
dealing fruitfully with the work community she is embedded within.
Furthermore, although I have concentrated in this research on the formal supervisor
position as the context for leadership, it must be acknowledged that leadership can be
manifested in every interaction between organizational members (e.g. Lichtenstein &
Plowman, 2009; Uhl-Bien, 2006). Although other actors might possess less formal power the
same basic dynamics are at play in all organizational interactions and thus influencing the
organizational system towards desired direction involves same basic points disregarding the
formal role of the influencer. Thus most of the insights about systems intelligent leadership
48
developed here are directly transformable to apply to other actors within the organizational
context.
Limitations and future research
One limitation for the study is that all the results were gathered in one elder-care home and
in one particular country. This opens up the question of how much can the results be
generalized to other elder-care homes and caregiving organizations as well as to other
countries? Here I can only appeal to the fact that the head nurses in the elder-care home
operated quite independently of the top level of organization in their everyday interaction
with the nurses. In addition, many of the nurses and head nurses had worked in other
caregiving institutions both inside and outside of elder-care industry and Finland. They
seemed to find no radical differences on this account between the institution where the
inquiry was made and other institutions. One head nurses report was descriptive of this
situation: “While I have been part of many kinds of work communities, I believe that there
are relatively similar laws of behavior within this kind of work. [- -] Of course in some places
some things might be more emphasized, at some point the financial matters are more
emphasized while at other point the availability of the nurses. [- -] But all in all, quite similar,
I have to say.” [Head nurse 4.] Additionally, when describing their expectations about their
leaders the nurses were explicitly asked to think both about their present head nurses as well
as their former supervisors in other organizations. Thus although it would be important to
replicate the findings in other types of caregiving organizations, I would not be too
concerned about this issue after all.
One could also argue that taking the relational perspective on organizations from the outset
constitutes a limitation for the study. Here, quoting the words of Osborn et al. (2002: 799802) is appropriate: ”Hence one sees what one is looking for – not automatically what is
important. Therefore, without a common theory people will not see the same dimensions as
being important. The theory selected here allows us to see the importance of some new
dimensions at the cost of ignoring some of the important details revealed by others.” In the
end the relational paradigm as well as pragmatism both imply that there are no theory-less or
‘objective’ viewpoints on organizations. More generally, philosophers of science have long
emphasized that all observation is theory-laden (Alvesson & Sköldberg, 2009: 6; Hanson,
1958; Kuhn, 1962). Being transparent and making explicit that this work outgoes from a
49
relational understanding of organizations rather than being silent about one’s chosen (or
implicit) theoretical perspective is arguably the best cure available for this theory-ladenness.
It must also be acknowledged that choosing to limit my study to the systems comprised of
the work units within a caregiving organization should be seen as a conscious choice. Taking
the systems-perspective seriously we come to understand how all system boundaries are in
the end arbitrary (e.g. Ulrich 1994). As Luoma et al. (2011: 5) state: “system boundaries are
conceptual markers that define what and who is to be included in an analysis or
intervention.” In actuality the system comprised of the work unit is in constant interaction
with the larger organizational context, the other units in the organization, the careseekers
and their families, the friends and families of the employees as well as the larger political and
cultural context – and these all influence how leadership comes to be constructed. In
practice, we always have to set the boundaries somewhere in order to be able to understand
or study anything and the most natural place for such boundaries in the context of this study
concentrated the study to singular work units within the caregiving organization.
One limitation of the present study is also the fact that all supervisors and the vast majority
of the followers were women. Thus one could argue that the results reflect only the situation
in organizations that are so dominantly occupied by women. Research on leadership have
revealed that there indeed are some gender differences in people’s perceptions and
expectations about leaders and also in the actual leadership styles – although not always
those one would expect to find (e.g. Eagly & Johnson, 1990; Kulich et al., 2007). In here, I
would tend to adopt a perspective on gender as a soft assembly (Harris, 2009). There might
on average be some differences but these amount to no categorical difference between men
and women but only to some aspects being more or less emphasized. Thus it can be argued
that the phenomena that are found in female-dominated occupations might be less prevalent
on average in more male-dominated or mixed work communities but nevertheless there is
no reason to doubt that they would also exist there – although perhaps in more hidden
forms.
One interesting dimension of leading the caregiving organization that I have not touched
upon here but which would be important to address in future studies is the role of
spirituality in caregiving organizations. For some of the nurses it clearly was an important
dimension in their work and thus something that the leaders of such organizations would
50
potentially need to take into account. It has been argued that among business life there is a
“growing interest in spirituality at work” (Ashmos & Duchon, 2000: 134) and it is easy to
believe that forms of spirituality are more prevalent in work where caregiving and attending
to others are the central nature of work than in more traditional organizations. Discussions
of nursing starting from Florence Nightingale also more often than not seem to emphasize
spirituality as part of the nurses work (e.g. Watson, 2008). Additionally, it can be argued that
emphasizing spirituality might be one very salient pathway to get the nurses to occupy a
more other-regarding attitude in their work, which in turn – as has been argued – is in most
situations better for both the work community and the careseekers. Thus exploring this
dimension as part of the leadership challenge of the caregiving leader would comprise an
interesting future study.
Conclusion
Leadership is perhaps the most mysterious and myth-bound aspect of organizations.
Different management and leadership fads and fashions abound with little knowledge about
their practical effectiveness (see Abrahamson & Fairchild, 1999; Gibson & Tesone, 2001).
One key reason for the managers’ eagerness to cling to the latest leadership fad is arguably
them wanting to base their good leadership on some solid ground. Through connecting their
practices to some ‘objective’ theory their sense of doing rational and grounded decisions is
increased; they thus have an increased feel that their otherwise sense-based judgments are
validated and objectified. If not else, management fads are bound to increase the selfconfidence of the managers in their ability to make decisions based on reason and objective
conditions of the situation. A cynical observer could thus argue that management fads serve
ultimately the purpose of fulfilling a psychological need of the managers for safety and
controllability.
In this work I have argued that a large part of effective leadership is not about cognitive and
rational decision-making of the manager but more about her systems intelligence; her ability
to sense her way forward in complex context using both rational and emotional cues. This
ability amounts to an expertise that allows the manager to see and sense patterns in the
complex dynamics of the system she is embedded within. The perspective of systems
intelligence allows us – to use the words of Giddens (1986: 285) – to be able to be “sensitive
51
to the complex skills which actors have in co-ordinating the contexts of their day-to-day
behaviour” that are easily “more or less bracketed out.”
This of course should not be interpreted as a call for leaders to stop reading books about
leadership and just trust their cumulative expertise. By shifting the perspective from rational
decision-maker into an expert attuned to the currents of the work community, we come to
emphasize the learning process that makes the leaders better. Thus a good leader is a leader
who resists the all too human tendency “to rest on our oars, to fall back on what we have
already achieved” (Dewey, 1998: 353) and instead seeks continuously to improve herself as a
leader. Becoming a good leader is about reflecting on and learning from one’s past successes
and failures and seeking out new perspectives through which to improve one’s ability to lead
the work unit successfully. For a good leader every situation is a learning opportunity. So
instead of looking at good leadership as an inborn ability that only few are blessed with we
should see it as an achievement made possible through systematic practice. Attitude of
improvement is what characterizes good leaders (see Ilies et al., 2005; Dweck, 2000).
To summarize, this work has looked at leadership as a contextual task done embedded
within the larger organizational system. Particularly, I have looked at a caregiving
organization as a context for leadership with its specific characteristics and challenges. I
identified most important leadership tasks to be the creation of a community of practice that
is able to take care of the elders in a coordinated and intertwined manner, and the creation
of an emotionally connected work community in which the nurses are able to get emotional
support from each other. The three most important leverage points for the manager I argued
to be the generation of positive, other-focused and safe atmosphere. These are achieved in
part by focusing on the work-related tasks of supervising the work, taking responsibility and
trusting the employees as well as the community-related tasks of being an authority,
mediating the conflicts, giving emotional support and being just.
Identifying these general tenets of the leader’s role within a caregiving organization does not
take away the particularity of the leadership task. These tenets merely point towards some
important leverage points that the leader should focus her attention to in attempting to lead
successfully the work unit. Ultimately good and systems intelligent leadership is about being
sensitive to the particularities of the situation, being open to growth as a leader, being
courageous to act on both one’s rational analysis of the situation as well as on one’s
52
sensibilities within the situation and being wise enough to know when to trust either of
them.
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