Leadership in Care

Nicole Brooke - Thursday, November 10, 2016

  • Have you ever considered why leadership is such an important concept in healthcare?
  • Have you ever reflected on the number of leadership programs you have attended or how every organisation seems to have a similar iteration of a common theme?
  • Have you ever paused to consider that rarely has there been a program that changed your practices or sustained emotional drivers to improve inherently challenged cultural environments?

This piece of writing is one of reflection and inspiration of a journey to which I would encourage you to join me on. I have been attending leadership courses and writing them, as well as developing leadership cultural strategic plans for more than two decades, yet I find myself disheartened. We are seemingly still a long way from finding the secret to translating core theory and empowering critical thinking within the sector as a whole.

Arguably leadership as a capability, is one of the hardest functions a clinician and manager/ director has to undertake. It is not a set of skills, but rather a complex mesh of communication, creativity, vision, values, integrity, initiative, relationships, strategy and values within the milieu of politics, governance, behaviours and change. It is not for the light hearted nor is it cultivated to support a development pathway for the often naive and ill-prepared graduate. Despite this issue, and with consideration to the roles of our current managers and clinicians, our graduates are less than skilled in this area, and yet they frequently exposed to the demands of leadership. Further to this, we often find ourselves missing core interviewing capabilities within recruitment processes to articulate and elucidate arguably the two most critical elements to a successful candidate and longer term success in the business – assessing leadership capability and inherent personal values.

“Leadership cannot be taught. It can only be learned” (Geneen 1984)

Over the past few decades we have seen leadership courses, business coaching, and professional mentoring services have flourished. To what end one may ask? To what value may one assume is gained? Aside from the obvious networking, relationship building, knowledge acquisition, and professional development opportunity – how then can we really start changing the culture of an organisation to really develop and nourish the leadership capabilities and energies of our staff?

“To lead, one must first be led,

To change, one must first want change, and

In order to achieve one must first reflect.” (Brooke 2010)

If we continue to select people to undertake a leadership development course, by default there is often a lack of commitment and motivation. I would argue that organisational managers and leaders are ill prepared to drive the change required! But one must go further than just finding motivation within an individual, it may concurrently foster a motivation and a readiness to change within the culture of the organisation at the same time in order facilitate the learnings of the individual. This complexity would leave anyone bewildered to how then leadership can be successful.

Are you a Leader?

Two fundamental components need to be in place if someone is truly seen as a leader. Firstly, that they have to have goal to which they seek to accomplish and have been able to specify the means by which these can be acquired or translated into practice. This is typically regarded as having a clearly articulated vision and strategic means for realising the vision. Secondly, that there are people who want to join in and be part of moving towards the realisation of the vision, or at least, their perception of the vision. A leader is someone who takes people to where they otherwise would not have gone. This means that the vision is sufficiently inspirational for others to want to be part of bringing it about. Effective leadership is often defined by assessment of others and the emotions they experience in response to the communication, vision and demeanor of a leader as they seek to make their vision a reality.

To acknowledge a great adult educational theorist, Malcolm Knowles (1984), adults must have a readiness to learn and to which they should derive a motivation to learn. All of us are motivated - moved and inspired to action - by our needs, concerns and our internal interests. These shape how we observe and respond to lifes’ circumstances, and how we come to define the sort of person we wish to be, personally and professionally. When we engage with a leader, we find our journey and intent of life are synergistic, therefore we want to move with them into bringing about those possibilities.

Effective leaders are influential, yet they are not defined by a set of skills, rather it is an elucidation of a way of being. It is a resolution with ones values and vision, whilst it resonating with a way of being in action and language, as well as in ones body. Their way of being, their ways of observing and acting, also need to be influential in shifting others as learners. To be able to move others out of their traditional ways of observing and learning without alienating them, so that the collective wisdom that resides with many organisational employees becomes an invaluable resource in dealing with the change process

To propose however some key strategies for having an improved chance of success to develop a leadership rich organisation, one could consider the following;

  • Cultivate a strong leadership strategy that is developed in a consultative model. The strategy should translate acceptable practices, opportunities for leadership promotion, reward and recognition elements, and business case concepts to engage strong business acumen strategy to invest internally in innovation ideas.
  • Organisational success needs very capable leaders at the top, whereby the principles are driven throughout the entire business. Review your leadership policies and practices in relation to recruitment, retention and development initiatives. Every person can be taught skills to do a job or a series of tasks, however not everyone can be a leader.
  • Make time for leadership. Leadership will flourish where organisations enable reflective practice and growth opportunity within teams.

Definitions(Australian Government 2014):

  • A Leader is a person with responsibility for directing or influencing the work of others, and
  • Leadership refers to the behaviour of those with responsibility for directing or influencing the actions of others.

Aged Care Consultancy Australia specialises in working with organisations and professionals to optimise their leadership. If good leadership leads to good care then our job is fundamentally promote leadership in whatever capacity the organisation or the person is able to find motivation.

Call us on 1300 277 818 or email- Dr Nicole Brooke on


Australian Government (2014). Australian Aged Care Leadership Capability Framework. Department of Industry.


Brooke, N. J. (2010). Is case management rhetoric or reality? A survey on the use of case management in Australian residential aged care facilities. Faculty of Nursing, Midwifery and Health. Sydney, University of Technology, Sydney. PhD.


Geneen, H. S. (1984). Managing. New York, Doubleday & Company Inc.


Knowles, M. (1984). The Adult Learner: A Neglected Species Houston, TX: Gulf Publishing.


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