LEADERS ARE BORN, NOT MADE 1
LeadersAre Born, Not Made
Leaders are born, not made
Although behavioraltheories stipulate that people become leaders through the process oftraining, observation, and learning (Olson 2009), I believe thatpeople inherit certain qualities and traits that make them bettersuited to lead. I concur that leadership is a set of skill that canbe acquired through perception, training, practice and overtimeexperience (Olson 2009). Instead, there are pretesticular featuresthat predispose people to be and become leaders. There is asignificant distinction between mastering a skill and learning askill, in the same way that people are with amazing musical talentsor athletic talents.
The dilemma happensduring my internship at a home health in last year. The incidentwhich involved my supervisor, a physician, an elderly patient and aworker, happen at the woman house. The woman had dementia and livedwith her son who a physician with the power of attorney (POA).Although the woman was bed-ridden, her son had decided not to admitthe woman to the hospital but could receive treatment at home.Instead of her ongoing intravenous (IV) therapy, the physicianrequested a change on a do not resuscitate order (DNR) for his motherand insisted on feeding tubes. The patient had a congestive heartfailure with increased level of acuity level. If the woman was goingto stay at home, the prognosis was not going to support any qualityof life since she had lived longer than expected. While discussingthe new received order, the patient’s team reported to thephysician a four plus edema, decreased lung sound with rales in theupper lung fields, shortness of breath with use of accessory andmuscle and a death rattle. The nurse expected to receive an order fora potent diurect but rather received an order for a two-liter bolusof IV fluid. The dilemma had to be dealt with since the physician waswell thought and a large family practice with more than five hundredpatients. A nurse who went against his order could easily lose herjob. The physician confirmed the order and implied that since themother was dehydrated and had not received nutrition for days, shemay be starving to death. The nurse followed the order and gave thefluids and the following morning the mother died. I heard a nursemention that it was a mercy killing of a kind.
If had been thesupervisor, I would have encouraged this nurse to refuse to give theIV bolus since I would not support my staff in performing a treatmentthat I thought could be unethical or that I would not do myself.There are two kinds of values that could applied in such situationpersonal and professional values. Personal values stipulate ourposition about behaviors, truths, principles and standards (Marquisand Huston 2012). Besides, personal values make a foundation fordeveloping our professional nursing values that encompass humandignity, altruism, autonomy and social justice. Because of bothprofessional and personal values, I would have found a reason toavoid the administration of the IV bolus.
The ethicalprinciple that relates to this dilemma than can help carry out betterdecision making is the beneficence (Walsh, 2010). Beneficence is theobligation of other people to maintain a balance between harm andbenefits. This principle recommends that the outcome of ethicaldecisions should produce the best and east harm to the patient, andis founded on the notion of “do no harm” (Walsh, 2010). I feltproviding the patient with an IV bolus could have likely caused deathto the patient which in my opinion had violated beneficence andpossibly caused death.
This incidence gaveme the opportunity to reflect and relate this ethical dilemma toresources material we learned for the past weeks. This scenarioallowed me to explore what I might have differently if I were thenurse, leader. Using my inherent leadership traits, I would havepresented a guide to better decision making and discuss theappropriate ethical principles that are connected to this dilemma.
Marquis, B. L., & Huston, C. J. (2012). Leadership roles andmanagement functions in nursing: Theory and application.Philadelphia, PA: Lippincott, Williams & Wilkins.
Olson, D. A. (2009). Are great leaders born, or are they made?Frontiers of Health Services Management, 26(2), 27–30.
Walsh, A. (2010). Pulling the heartstrings, arguing the case: Anarrative response to the issue of moral agency in moral distress.Journal of Medical Ethics, 36(12), 746-749.