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Denver Post: Rise of the "servant-leader?"

February 1, 2004 -- Today's Denver Post carried a very good, nurse-driven story by business writer Marsha Austin about how the severe nursing shortage and construction of new suburban hospitals have given some Denver area nurses--but not others--unprecedented influence over their working conditions and how their hospitals are run. The piece also describes the accompanying pressures placed on some older urban hospitals, which may have difficulty holding onto nurses in the face of tight budgets and (apparently) a greater reluctance to listen to the nurses.

The article's main theme is that, although short-staffing, dissatisfaction and a "profound lack of support" still afflict nurses in much of Colorado, the shortage has given some increased bargaining power, especially at new suburban hospitals trying to attract staff nurses. Austin builds the piece around comments by two Denver area nurses, who are friends. Kathleen Doughty is an OR nurse who has struggled to change her urban hospital from within. She has participated in a bitter, unsuccessful union organizing drive, watched as units were closed without any input from nurses, and generally felt that nurses have been accorded little respect by hospital management. Doughty predicts that talented young people will continue to shun nursing unless nurses get more say in how care is delivered, and Austin cites statistics showing that the nurse workforce is aging even as the demand for nurses continues to grow. She might also have described how nurse short-staffing harms patients, as recent studies have shown.

By contrast, Doughty's friend Janice Swanson is a labor and delivery nurse who is starting work at a new suburban hospital where "staff nurses interviewed job candidates, tested and ordered equipment, drafted their own schedules and worked alongside physicians to develop patient care guidelines." Nurse Lesia Douglas, who supervises Swanson, has implemented what she describes as a "servant-leader" management philosophy, and according to Swanson, the result is that "[y]ou're not brushed off. They listen to everything you say." Austin reports that, on the L & D floor, the "enthusiasm is contagious." The piece ends with a quote from Douglas, boasting as the staff nurses prepare new L & D rooms for patients: "All this, my nurses did. (It's) everything that they wanted all along, but that the political structures of their (former) hospitals didn't allow them to create."

See Marsha Austin's February 1 article "Nurse shortage a critical condition: Hospital boom gives workers upper hand" in the Denver Post.

Marsha Austin may be emailed at


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