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Applying Servant Leadership in PracticeBy Jennifer S. Thomas

Essential Questions

· What is a servant leader?

· What are some attributes of a servant leader?

· How can nurses demonstrate servant leadership qualities?

· What motivation techniques can be used to drive increased performance outcomes in nursing?

· How does a performance-driven team affect performance?

Introduction

This chapter introduces the concept of servant leadership and how it is applied to nursing, health care organizations, and professional relationships. Servant leadership supports a culture of trust and value, which is the foundation necessary for performance-driven teams to excel. Further, it encompasses the Christian values that Grand Canyon University (GCU) builds upon to prepare "learners to become global citizens, critical thinkers, effective communicators, and responsible leaders" (Grand Canyon University, 2018).  Conscious capitalism  and the five disciplines of highly successful organizations are also introduced to provide insight into how organizations and businesses can be global industrial contributors.

Servant Leadership

Acts of  servant leadership  can be seen in biblical writings chronicling the ways Jesus exhibited the concept of servant leadership to gain trust and build relationships with followers. The servant leader has an initial and primary focus to serve, which is then followed by the desire to lead, which differs from that of leader-centered approaches. When individuals seek to serve first, their efforts are directed toward the people and community around them.  “Employees value their own performance when they know their performance is being valued.”They serve to build their followers through guidance and mentorship in order to fulfill an organization's mission, whereas the leader-centered approaches begin with establishing mission success, then focus on building followers in order to prosper (Gandolfi, Stone, & Deno, 2017).

The implementation of servant leadership has proven to contribute to the success of organizations. Employees have been found to be more satisfied with their positions and display more commitment to an organization when servant leadership is practiced (Irving & Berndt, 2017). This can be related to how employees feel valued and supported within an organization, which is particularly important in health care because of the nature of services rendered. Employees value their own performance when they know their performance is being valued. This value increases commitment and has a direct effect on the quality of services provided (Caba, 2013).

Example of Servant Leadership in Action

Seventeen organizations listed as one of Fortune’s “100 Best Companies to Work For” practice servant leadership as the guiding principal to the organization's success (Modern Servant Leader, n.d.). Of the 17 organizations, SAS, a company that provides analytic solutions, was ranked number one on the list. Jim Goodnight, the CEO of SAS, provided the following statement, outlining the company's social responsibility.

Being able to make an impact begins with our greatest resource—our employees. Our world-class workplace supports our employees by creating an environment that helps them balance career and personal life. This support eliminates many everyday worries and distractions, and ultimately inspires creativity and innovation. With better health and lower stress, employees are naturally more energized on the job. It's a virtuous circle: Healthy, satisfied employees contribute to customers' success, which in turn feeds SAS' success. This culture helps position SAS and our employees to be good corporate citizens. (SAS, n.d., para. 4)

Background of Development

Many people question how they can lead if they are also serving. This is the question that Robert Greenleaf (2008) strived to answer and make sense of in his book  The Servant as Leader. Although Greenleaf created the term "servant leader," the concept is also found in biblical scripture and further explored in literature throughout centuries, prior to Greenleaf's formulation. One story that influenced Greenleaf in the development of his theory was a short novel called  The Journey to the East by Herman Hesse, a Nobel winning German-Swiss novelist. The book describes the experiences of a mystical group's search for spiritual renewal in which one central character offers some intuitive insight regarding leadership in terms of "the law of service" by stating that "he who wishes to live long must serve, but he who wishes to rule does not live long" (Hesse, 1932/1956, p. 34).

Qualities of a Servant Leader

Servant leaders maintain certain characteristics that set them apart from other leaders around them. The characteristics build trust and acceptance amongst their followers and elicit dedication and faithfulness to the servant leader's vision. Yet, trust first begins with the servant leaders’ ability to trust and believe in themselves. Greenleaf, Senge, Covey, and Spears (2002) observed that "leaders do not elicit trust unless one has confidence in their values and competence (including judgment) and unless they have a sustaining spirit (entheos) that will support the tenacious pursuit of a goal" (para. 37). Their sustaining spirit can be characterized by different qualities and skills, including listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment, and building community (Greenleaf et al., 2002). These qualities are further explained in Table 3.1.

Table 3.1

Qualities of a Servant Leader

Quality	Description
Listening	. Communication begins with listening. . Servant leaders have an innate ability to hear what others are saying through both verbal and nonverbal communication and reflect upon what they hear to lead a group to its full potential.
Empathy	. Understanding and sharing the feelings of followers allows servant leaders to be placed in a position at the level of those followers. . Servant leaders are further able to identify the characteristics that make each individual unique and provide them with the ability to understand how best to support and lead their followers to achieve success in the mission. . While the leaders may not always accept the performance or actions of followers, the leader always accepts each follower as an individual.
Healing	. Servant leaders establish an understanding of personal healing, as well as the healing of personal relationships, to encourage healing among followers. . There is nothing more powerful than "practicing what you preach," beginning with healing.
Awareness	. Awareness, more particularly self-awareness, brings deep insight into one's ability to influence present and future situations. . Servant leaders are aware of how individual actions and reactions have a direct impact on those around them. . Awareness spans through time, allowing servant leaders to determine how the actions of today can affect the overall path to success in the future.
Persuasion	. Persuasion is a powerful tool that servant leaders use to gain the acceptance and dedication of followers. . The key to this is patience and understanding that persuasion is achieved through one person at a time. . Persuasion does not entail changing the way individuals think by forcing someone else's own perceptions upon them. Instead, it involves the ability to change what people think by allowing them to reach into their own inner perspectives and to allow them to voluntarily find a relationship between those perspectives and the mission or goal at hand.
Conceptualization	. Servant leaders have more than just short-term goals in mind. . Good perception of now and the future is a key quality of servant leaders that helps to create visions and dreams for the betterment of the organization. . The servant leader's ability to conceptualize and maintain daily operational efforts sets them apart from other leader types.
Foresight	. Servant leaders are able to distinctly predict the most probable outcomes by understanding how past trends and present actions affect future outcomes. . This is a unique and strong skill to attain because it causes leaders to make conscious ethical decisions now, rather than reacting to poor outcomes and unfortunate events in the future.
Stewardship	. Acts of stewardship entail that a servant leader commits to first serving the needs of others. . By utilizing natural talents and leadership skills, servant leaders are able to focus on creating a culture of acceptance of all and work to prepare an organization, and its people, to contribute responsibly and ethically in society.
Commitment	. Servant leaders are able to see how each individual can meaningfully contribute to the improvement of the organization and society, beyond just their duties within the organization. . Servant leaders inspire and promote personal and professional growth and strive to identify ways to support this growth among staff.
Building Community	. Servant leaders understand the importance of community and how a solid, well-established community contributes to a better society where the population values life and the lives of others. . By touching one life at a time, several servant leaders within a community can build or rebuild a productive and well-respected society.

Note: Adapted from  The Servant as Leader, by R. K. Greenleaf, 2008;  Servant Leadership: A Journey Into the Nature of Legitimate Power and Greatness, by  R. K. Greenleaf, P. M., Senge, S. R. Covey, & L. C. Spears, Paulist Press, 2002; and "Character and Servant Leadership: Ten Characteristics of Effective, Caring Leaders," by L. C. Spears, 2010,  Journal of Virtues & Leadership, 1(1), pp. 25-30.

Application of Servant Leadership Practice in Nursing

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Nurse leaders are armed with the knowledge and power to influence the team around them. Leaders maintain a performance driven culture that includes a sense of purpose, open communication, trust and mutual respect, shared leadership, effective working procedures, building on differences, flexibility and adaptability, and continuous learning (Neumann, 2014).  “The quality of services that nurses provide to the community and to clients in any institutional setting is often dependent on their own interpretation of how they feel valued.”To maintain this culture, servant nurse leaders employ several characteristics that develop and support high performance. They strive to foresee how they can best serve the community, build meaningful relationships, and optimize patient care and satisfaction (Tropello & DeFazio, 2014). This is especially important in health care, where change is constant and a necessary part of continuous improvement.

The quality of services that nurses provide to the community and to clients in any institutional setting is often dependent on their own interpretation of how they feel valued. This said, the servant nurse leader has an opportunity to directly affect services provided by engaging and building relationships with the nurses they serve. This  engagement  can be achieved through many different tactics, but one that is easy, yet effective, is the display of personal interest and investment in the staff's well-being. This can be accomplished through meetings with employees, simple daily engagements while rounding on staff, and genuine follow-ups that show personal interest in the staff's welfare. For example, a servant nurse leader could schedule times to round on staff during each shift. This presence would show a genuine investment regarding the staff's well-being and would provide opportunities for personal communication to occur.

In addition to supporting engagement, servant nurse leaders are also aware of how to motivate those around them. Motivation occurs when needs are met. This is the foundation of Maslow's hierarchy of needs, where self-actualization occurs in one's life only when physiological factors, safety, belongingness, and esteem are all achieved (Maslow, 1954). Table 3.2 details the qualities servant nurse leaders display in management roles to help staff achieve their full potential through Maslow's motivational theory.

Table 3.2

The Servant Nurse Leader's Role in Meeting Staff Needs Through Maslow's Hierarchy

Needs	Description of Staff Needs	Servant Nurse Leader's Role
Self-Actualization	Autonomy	Support growth; Empower nurses to be part of the decision-making process when change occurs; help staff feel a sense of control over their personal working environment.
	Achievement of full potential	Show an interest in personal staff goals and mentor them towards achieving them; Encourage staff to excel through learning and performance.
Esteem	Competence	Foster learning; Promote growth through encouragement; Increase working responsibilities to show trust and value of competence.
	Promotion/Recognition	Advance workers who are productive and display actions that promote the mission of the organization; Provide genuine feedback in personal and public forums that recognizes employees for their hard work.
Belongingness	Peer acceptance	Promote positive working relationships through peer encouragement (peer recognitions for good deeds, mentorship, etc.); Foster an environment of guidance where nurses feel comfortable asking questions, giving advice, and building up their peers; Show a personal investment in staff by getting to know their personal interests, hobbies, and valuable relationships (spouse, significant other, kids, pets, etc.).
	Value of work	Help followers find value in what they do through recognition; Get to know staff on a personal level and identify how their knowledge and experience (personal or professional) bring value to their work.
Safety	Safe physical working environment	Ensure a safe physical environment is established; Listen to staff and determine areas needing improvement to the current working environment that will lead to optimal safety for both staff and clients; Act on promises and follow up on suggestions.
	Safe emotional working environment	Foster an environment of teamwork; Discourage intimidating behavior and act on cases of “bullying”; Encourage feedback and display effective communication techniques that encourage motivation, even in times when constructivism is needed; Show respect.
Physiological	Salary	Ensure that employees are receiving fair compensation based on experience and knowledge; Ensure that each profile is reviewed individually to support fair compensation for services rendered.
	Job security	Look beyond immediate staffing needs; Project future needs to ensure staff can maintain promised hours of employment.

Note: Adapted from "Maslow Theory of Motivation," by M. Martinez," located on the Project Management Skills website (n.d.); "How to Motivate Your Team With Maslow’s Hierarchy of Needs ," by B. Taylor, located on the PayScale, Inc. website, 2014; and "Driving Employee Engagement Through Maslow’s Hierarchy," by F. Diaz, located on the GovLoop website, 2018.

Not only does the work of the servant nurse leader have an effect on patient outcomes and satisfaction, but it also inspires a healthy working environment where nurses want to work and are dedicated to the organization for long periods of time (Sherman, 2012). As the nursing shortage is anticipated to increase, servant leadership has become vital to engage and empower nurses to strive to provide excellent services and maintain dedication to the organizations for which they work. Moreover, this empowerment develops a culture of growth and high-performance outcomes.

While change is an inevitable part of the health care business, it can cause strife and anxiety amongst front-line staff, which can ultimately affect performance and productivity. The servant nurse leader has an important role in maintaining staff interest during periods of change. This begins with connection and allowing inclusiveness in the change process.  “One true mark of servant nurse leaders is their ability to willingly sacrifice their own self-interest for the good of others.”When change occurs, staff must feel part of the development, which can be accomplished by being allowed them to offer input and identify how to implement the change to best meet their needs. Often, when change is implemented without the inclusiveness of staff, performance and productivity are affected in a negative way. Therefore, the acts and quality of support that servant nurse leadership brings during times of change are an integral part of developing committed staff that supports a high performance-driven culture and increased productivity.

One true mark of servant nurse leaders is their ability to willingly sacrifice their own self-interest for the good of others. This is not an easy task, especially in a world that centers on praise and rewards; however, servant nurse leaders are able to make decisions and establish routines as a servant in mind (Waterman, 2011). The implications of this sacrifice allow followers to feel the dedication the leader has toward their well-being within an organization. When the followers rather than the leader's own intentions are the priority, an engaged and productive working environment is likely to emerge.

The balance between service and action is another important skill that servant nurse leaders exhibit. While the emotional support that these leaders display is what first gains the attention of their followers, it should be backed up with actions that exhibit the genuineness of their words.

Servant leadership fosters growth, development, and success in any setting. When applied to health care, more specifically in nursing, the outcomes achieved through this leadership style are extraordinary. It is one's ability to serve first that dictates the ability to reach goals and fulfill potential.

Example of Servant Leadership in Action

Four nurses who work the day shift at a busy medical-surgical unit, come to the nurse manager to discuss their unhappiness about their working conditions. They mention that in the past two days, acuity has been so high that they have not been able to take their full breaks. Because of the demanding medical needs of the patients for whom they are caring, these nurses say they are exhausted. The servant leader nurse manager understands that listening and empathy alone will not create an environment where these nurses feel supported and engaged. Therefore, the manager constructs a plan that will help to meet the nurses' immediate need for rest and breaks during the shift. This action may immediately engender the trust and support of the staff as their immediate needs are met.

Application of Servant Leadership in Institutions

While the services organizations provide are what allow outsiders to form opinions about them, organizations as a whole are often judged as a single entity. Therefore, the concept of the institution as servant was identified, and Greenleaf et al. (2002) produced the notion that whole institutions must make decisions and produce results as a servant in mind.

A Team of Equals

In health care, many organizations have one individual who sits at the top of the  vertical structure , but the concept of the institution as servant does not rest solely on that individual's shoulders. Greenleaf et al. (2002) recognized the board of trustees as the governing board of both for-profit and not-for-profit organizations. The trustees make decisions regarding the direction of an organization, keeping in mind the most moral and ethical route that serves in the best interest of the institution and the people who work for it (Greenleaf et al., 2002). It is the trust bestowed upon them that moves the organization toward servanthood by creating a more accepting society and producing more opportunities for the people they touch (Greenleaf et al., 2002).

The vertical structure within organizations is one of two traditional ways organizational structures are seen. This pyramidal flow has one person at the top who is responsible for the everyday government and daily flow of an organization. This position is most commonly referred to as the chief executive officer (CEO) or president. More levels of management fall below this individual, and responsibilities of operation and flow of smaller departments are delegated through several levels of management.

The other traditional structure is a  horizontal structure , and while it has not been widely used in the past, it has gained popularity for its effectiveness in increasing productivity and developing positive working cultures.  Primus inter pares is a Latin phrase, meaning "first among equals" (Greenleaf et al., 2002).  Primus , refers to the chief or leader, and while this is an identified role in this traditional structure, a team of individuals is seen as equal contributors to the changes and decisions made within organizations (see Figure 3.1).

Figure 3.1

Traditional Structures

Note: Adapted from  Servant Leadership: A Journey Into the Nature of Legitimate Power and Greatness, by  R. K. Greenleaf, P. M., Senge, S. R. Covey, & L. C. Spears, Paulist Press, 2002.

While  primus inter pares is what has shown to produce results, it has not been widely accepted and adopted within health care organizations. This may be partly due to the resistance of change and inability or unacceptance of a board to move toward placing responsibilities on a team of equals instead of just one chief (Greenleaf et al., 2002). This is not to say that the vertical structure is not effective or efficient, but it does produce certain limitations that would not be an issue in a leadership team with a primus. For example, indecisiveness or emotions of one individual can cause prolonged and inefficient decision making, whereas a team with a primus may be able to discuss ideas, accepting several different perspectives, in order to produce effective results in a timely manner.

Operating and Conceptual Talent

Two distinct types of talent are credited for success and growth of any large organization.  Operating talent  has the role of administering and overseeing the day-to-day operations of an institution in meeting their objectives. This differs from  conceptual talent , for which more holistic approaches are implemented to achieve mission success. This includes building relationships and serving as efficient persuaders, which entails more leadership and less administering (Greenleaf et al., 2002). For example, a nurse manager is responsible for staffing and maintaining productivity. Because these tasks oversee day-to-day operations of the unit the nurse is managing, they reflect operating talent. In addition to these tasks, the manager must maintain a positive working culture, which may be done through staff rounding, recognizing positive staff performances and learning what motivates staff to perform at full potential. These are leadership qualities that reflect conceptual talent and embody more holistic approaches to achieve mission success. While these two types of talent are different in their approaches, a balance between both styles is needed to enable an institution to serve and operate at its full potential.

For an institution to be seen as servant, it must first be guided by servant leaders themselves. Trustees play an important role in ensuring that the organizations in which they are invested are guided justly and that service to the people is the main priority and focus. Establishing a primus among the group can provide greater opportunities for success through teamwork and a culture of inclusiveness with regard to decision making.

Conscious Capitalism

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The idea of  conscious capitalism , although not yet identified as a credited term, began in the early 1980s, when John Mackey, the cofounder and CEO of Whole Foods, and his partners experienced a tremendous loss after a flood wiped out their first and only Whole Foods Market in Austin, Texas. The store, which was less than a year old, along with all the goods, products, appliances, and equipment, was damaged in the flood. Although the loss was devastating,  stakeholders , including customers, vendors, staff, and creditors, donated their time and resources to get the back in business just 28 days after the flood. It was at this point that Mackey realized that businesses hold a higher purpose in the world than to focus solely on self-sufficiency. Organizations have an ability to make a great impact within the communities they serve, and the individuals and teams that lead the organizations can work hand-in-hand in growing and excelling the " global marketplace " (Schawbel, 2013, para. 3). Further, practicing conscious capitalism increases business profitability by focusing on the stakeholders who make the business successful (e.g., employees, customers, investors, vendors), rather than focusing on business trends and systems that would increase profitability if applied.

Conscious capitalism has four guiding principles that serve as a driving force for helping businesses and the people that lead them create valuable experiences for all their stakeholders. The four guiding principles are higher purpose, stakeholder orientation, conscious leadership, and conscious culture ("The Four Principles of Conscious Capitalism," 2018). Each of these four principles are interdependent of each other in establishing conscious capitalism within a business (see Figure 3.2).

Figure 3.2

The Four Principles of Conscious Capitalism

Note: Adapted from "The Four Principles of Conscious Capitalism," 2018, located on the Conscious Capitalism website at https://www.consciouscapitalism.org/

Higher Purpose

What is the purpose of your business? When owners or leaders of an organization are asked about the purpose of their businesses, their answers may be dictated by the goods they produce, services they provide, or their overall personal or organizational desires. For example, a bookstore owner might say that the purpose is to provide reading material to book lovers. A restaurant chain owner might respond that the purpose is to provide the best food and services in the area and be ranked among the top restaurants in the state. A CEO of a large health care organization might respond that the purpose is to provide the best health care to the communities it serves. While all these responses addressed the question about purpose, these responses are superficial with respect to the responses of conscious businesses.

Conscious businesses look beyond the profitability aspect that affects their personal growth and seek a higher purpose that engages stakeholders and creates an environment where employees, customers, investors, and other businesses want to be involved ("The Four Principles of Conscious Capitalism," 2018). While conscious businesses understand making a profit is what keeps their doors open, they identify a higher purpose to their work and their business that establishes achievements toward growing and excelling the global marketplace.

Stakeholder Orientation

Building upon their higher purpose, conscious businesses understand that every single person, from employees to customers, vendors to investors, and shareholders to owners, have an integral role in the success of the organization. If even one entity is lacking, the whole organization is affected. Conscious businesses focus on creating meaningful relationships with all their stakeholders in order to serve the higher purpose of the organization and to essentially place great value in the services or products they provide. For example, an organization that focuses on employee satisfaction and quality customer service shows genuine investment in employees who make the business run and the customers who keep the business going. This investment promotes success and establishes a culture in which the primary focus is on satisfaction and quality, rather than profits. Yet, eventually, increased profitability occurs because of stakeholder investment ("The Four Principles of Conscious Capitalism," 2018).

Conscious Leadership

Conscious leadership is servant leadership. Conscious leaders work hard to inspire those around them by serving those around them ("The Four Principles of Conscious Capitalism," 2018). They nurture an engaging environment that guides and mentors followers to succeed in fulfilling the mission of the organization and finding their purpose. Furthermore, conscious leaders foster growth among followers and guide them into conscious leadership roles by helping them to find their strengths and determine how to use these gifts to continue to serve those around them.

Conscious Culture

Culture , which involves the principles, values, and attitudes of an organization, has a direct impact on employee satisfaction, customer satisfaction, and relational success with stakeholders. Conscious organizational cultures encourage growth and foster compassion, trust, and faithfulness among employees and customers. In addition, conscious businesses work hard to create a culture that identifies how each individual employee's talent contributes to the success of the organization and allows the business to operate at its full potential, while simultaneously making an impact on the global marketplace.

Why Conscious Capitalism?

In today's fluctuating economy where individuals and households may feel the sting of instability,  value-driven consumerism  has allowed businesses, large and small, to keep their doors open and customers wanting more goods and services. Consumers are naturally drawn to organizations that value customer relations and provide quality working environments where staff are genuinely engaged and a positive culture is felt. In fact, Schwartz (2013) offered that companies that have adopted the conscious approach out-performed other companies and competitors. One such company is The Container Store. The Container Store has had a long-standing commitment to supporting an employee-first culture ("Heroes of Conscious Capitalism," 2018). By continually focusing on stakeholder satisfaction as the number one priority, this conscious company has been recognized by  Fortune for 19 years in a row as one of the top 100 best companies to work for, citing "'outstanding' communication, pay that’s well above the industry’s average, and 'amazing' benefits (even for part-timers)" ("Fortune 100 Best," 2017). The contributions that The Container Store and other conscious companies make to global marketing have set higher standards for creating a world where focus is placed on meeting the needs of global citizens, rather than solely on the companies' best interests.

Servant Leadership Development and the Fifth Discipline

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The application of servant leadership and conscious capitalism has armed businesses with many opportunities to grow and serve with meaningful purpose. In addition to servant leadership and conscious capitalism, Senge (2006), a contributor to notable servant leadership publications, found that in order to become global industrial contributors, companies needed to apply a systems thinking approach to ensuring that there was a clear definitive path between the present and the end state or vision. To achieve this, organizations must adopt strategies of learning that foster an environment where diverse patterns of intellectual application and employees are inspired to contribute to achieving mission success. Personal mastery, mental models, building a shared vision, and team learning are all part of the disciplines for which Senge advocated. The fifth discipline, systems thinking, is the "system that integrates the disciplines, fusing them into a coherent body of theory and practice" (Senge, 2006, p. 12).

Figure 3.3

The Five Learning Disciplines

Note: Adapted from "Five Learning Disciplines…," by B. Cropper (n.d.),  FactFile 2, located on The Change Forum website at http://www.thechangeforum.com/Learning_Disciplines.htm

Personal Mastery

In order for an organization to grow and produce results, it must foster motivation and eagerness within its people to want to do the same. Because workers are the foundation of any organization, the learning and growth of an organization does not occur unless its people learn and grow as well. Personal mastery emphasizes the necessity of allowing people to grow through the identification of personal vision or defining what is important to them, as well as allowing them to see how their contributions make a significant impact on the organization's current and future successes (Senge, 2006). The most efficient way to promote personal mastery is to model personal mastery. Leaders within an organization are responsible for encouraging and fostering personal mastery in others through exhibiting their own sense of personal mastery in the field.

Communication and Satisfaction

The general manager of a clothing store has become very focused on effective communication as the top contributor to customer satisfaction. He has put into place many workshops for employees to learn and practice effective communication techniques; however, he realizes that it is his own personal mastery of this skill that would serve as the driving force. Therefore, he works hard to understand how to communicate with his employees in an efficient manner and practices effective communication daily, which encourages employees to model his behavior.

Mental Models

Mental models are the ideas and generalizations that humans form through experience and exposure to differences in societal acceptances. For example, many humans judge other humans based on their initial appearance or interaction. This is referred to as a "first impression." If a manager has two candidates lined up for an interview and one candidate appears in a suit with ironed slacks and polished shoes, while the other candidate attends the interview in a t-shirt, wrinkled khakis, and tennis shoes, the manager may form the initial opinion that the more presentable candidate is more prepared for the job. This same concept can be applied within organizations. When change or a challenge occurs, many individuals react to the challenges promptly, based on assumptions from past experiences. Senge (2006) declared that organizations and workers must be challenged to identify mental models. According to Senge (2006), "the discipline of working with mental models starts with turning the mirror inward; learning to unearth our internal pictures of the world, to bring them to surface and hold them to scrutiny" (p. 8). By doing this, workers can come to a common understanding on how to approach challenges and changes efficiently.

Building a Shared Vision

Shared visions are the genuine integration of ideas from all members of an organization regarding the organization's goals and vision. When utilizing a shared vision approach, staff feel a deeper connectedness and responsibility toward achieving the vision. Senge (2006) suggested that when a shared vision is introduced, "work becomes part of pursuing a larger purpose" (p. 193). The value that shared visions have on learning organizations is priceless. When staff feel empowered and that they are a part of the growing process of an organization, a higher level of commitment is noted (Senge, 2006).

Team Learning

Teamwork  is a well-known term that involves the collective integration of individuals with various talents, working toward achieving a particular goal or outcome; however, teamwork must be aligned to be efficient and productive. The team learning discipline involves individuals learning faster and with higher quality than if working independently (Senge, 2006); however, in order for team learning to be successful, members must be open to learning and accepting constructive criticism. This involves putting mental models aside and allowing the learning process to occur naturally. The benefit of this discipline is that it allows organizations to foster openness and productive dialogue among team members.

Systems Thinking

Systems thinking, also known as the fifth discipline, refers to the complete integration of personal mastery, mental models, building a shared vision, and team learning disciplines in order to work toward becoming a notable learning organization. Leaders and managers are responsible for maintaining the implementation of all the disciplines in order to achieve the best results. Each discipline is directly related to a systems-thinking approach. For example, if a company creates a shared vision, but does not identify the route necessary to fulfill the vision, then it has no meaning and does not influence engaged behavior.

Reflective Summary

Leadership within nursing and health care is imperative to the evolution and continuous improvement of engagement, performance outcomes, and patient outcomes. Identifying ways that both individuals and organizations, at any level, can introduce the skills necessary to promote engagement and create an environment of trust and dedication is essential in nursing. By utilizing the servant leadership approach and applying concepts such as conscious capitalism and systems thinking, nurses become empowered to motivate peers and colleagues utilizing creative and people-driven approaches.

Key Terms

Conceptual Talent: The leaders within an organization who achieve mission success and high performance by using holistic approaches, including building relations and persuasion. Conceptual talent differs from operating talent, which focuses on the day-to-day operations within an organization.

Conscious: Being aware of immediate physical and emotional surroundings or making a deliberate choice of action.

Conscious Capitalism: The application of four guiding principles (higher purpose, stakeholder orientation, conscious leadership, conscious culture) to increases business profitability by focusing on the stakeholders (e.g., employees, customers, investors, vendors) that make the business successful, rather than prioritizing business trends and systems that would increase profitability, if applied. The principles serve as a driving force for helping businesses and the people that lead them create valuable experiences for all stakeholders.

Culture: Traditional beliefs and values shared among a group of people.

Engagement: The feeling of investment and dedication to a particular purpose or role.

Global Marketplace: The act of buying or selling goods or services that impacts a particular industry. The manner in which goods or services are sold can impact the value of the goods or services worldwide.

Horizontal Structure: An organizational structure in which power is shared and staff are given more decision-making power.

Operating Talent: Administering and overseeing the day-to-day operations of an institution in meeting its objectives

Primus: Derived from the Latin phrase  primus inter pares, meaning "first among equals," primus refers to the chief or leader of a team of individuals who are seen as equal contributors to the changes and decisions made within an organization.

Servant Leadership: A style of leadership that places emphasis on serving followers before leading them. Individuals within a group or organization are encouraged and supported to grow and become self-motivated to maximize performance outcomes and establish mission success. Encouragement and support are the priority of servant leaders, and service to others comes before serving their own needs and self-interests.

Stakeholders: Person or persons both involved and directly affected by plans, actions, and outcomes. Person with a vested interest or personal stake in the outcome.

Teamwork: The action of two or more people working together to reach a desired outcome efficiently and effectively.

Value-Driven Consumerism: The selling or exchange of products or services that focuses on what is important to the consumer. The satisfaction of goods or services received increases consumer satisfaction and helps businesses or organizations maintain or increase business flow. In health care, this term is often used to depict the payment model of health care agencies and is highly recognizable through the Centers for Medicare and Medicaid Services' (CMS') value-based payment model.

Vertical Structure: An organizational structure that implements a top-down approach in which managers, at various levels, are tasked with directing staff and the services or goods provided. Power or decision making depicts a pyramidal flow with one person in charge at the top and several levels of managers below.

References

Caba, S. (2013).  The complete idiot's guide to leadership. New York, NY: Penguin.

Fortune 100 best: The Container Store. (2017). Retrieved from fortune.com/best-companies/the-container-store/

The four principles of conscious capitalism. (2018). Retrieved from https://www.consciouscapitalism.org/

Gandolfi, F., Stone, S., & Deno, F. (2017). Servant leadership: An ancient style with 21st century relevance.  Review of International Comparative Management, 18(4), 350-361. Retrieved from http://www.rmci.ase.ro/ro/no18vol4/01.pdf

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