Mini Review

Effective Leadership in ICU

Evangelia Michail Michailidou1,2,3,4* and Konstantina Salpiggidou5

1Intensive Medicine Department, Hippokration General Hospital, Greece

2Senior Student in the Department of Business Administration, University of Macedonia, Greece

3Masters Degrees, International Medicine-Health Crisis Management, Greece

4Member of Health Response team to Crisis Situations of G.H.T. Hippokration, Greece

5Clinical Pediatric Nursing and Research / Certified adult educator of G.H.T. Hippokration / Responsible Trainee for pediatric nursing - Deputy Coordinator of emergency and intensive nursing specialty of G.H.T. Hippokration, Greece

Received Date: 28/09/2020; Published Date: 07/10/2020

*Corresponding author: Evangelia Michail Michailidou, Intensive Medicine Department, Hippokration General Hospital, Senior Student in the Department of Business Administration, University of Macedonia, Masters Degrees, International Medicine-Health Crisis Management, Member of Health Response team to Crisis Situations of G.H.T. Hippokration, Greece

DOI: 10.51931/OAJCS.2020.01.000006

The concept of effective leadership

It is important to clarify how its meaning leadership is not identical with its concepts power, authority and influence. That too because all three of these dimensions, although are important in its exercise leadership, often become the object confusion and disorientation, since used in a way that their interpretation obscures the essence of leadership in ICU. Specific elements such as the ability of one to impose one's desires on others (power), the legal right to exercise the power that holds (power), one's ability to influence in a way in their behavior or way of thinking other personnel in ICU (influence) are important parameters of a leadership behavior, however do not constitute the ICU leadership function at its core.

Despite the large bibliography and theories disputes over the concept of leadership will, we could condense its performance concept, in that function which affects decisively οn the way in which they deliberately and willingly a group of people adopt one way of thinking and acting in the environment of the ICU. We could indicatively identify leadership as the process through which actions of an organized group of employees in ICU are affected, resulting in high expectations regarding problem solving or the fulfillment of medical or not purposes. Also, as effective leadership could characterize the process of influencing thought, of action, attitudes and behaviors a group of people (small or large / formal or informal) by one person, resulting in, voluntarily and willingly and with the appropriate cooperation, to participate jointly in effective implementation of objectives aimed at progress and well-being, as well as the positive outcome of patients. • In other words, when we refer to its meaning effective leadership we mean a complex and dynamic operation which cannot interpreted statically and unambiguously.

This means that to be understood in its entirety is required to be seen as a process which is based on pillars, such as its components personality of the leader - director (or the collective leadership), the team profile of associates / members / subordinates, the culture that governs the team, its value system, its cultural capital, its source power, external environment, opportunities, as well as threats to the environment.

The role of leadership at work

It is clear that the concept of effective leadership is all about institutional and non-institutional, formal and informal areas of social life, as well as all the individual fields of social relations in which people take part:

  1. In politics
  2. In economy
  3. In the trade union movement
  4. In civil society
  5. In the family
  6. In social gatherings

In this case, it is particularly important to focus on how leadership can exercise effectively in the workplace, especially on our days that rapid social, economic and Cultural changes directly determine the workplace environment and the efficient operation of the ICU. Work as a social and economic phenomenon is a top process in their lives people, since through it people cover their biotic, personal and social needs. At the same time, the working life of peoples concerns almost half of their life, with the result that many times, change more than 2-3 professions during their lifetime, even health professionals. It is understandable that through work it is achieved both social and individual progress prosperity consistently invested so much "Human" as well as "artificial" capital for achieving productive results with the aim of individual progress, development and social cohesion - well-being and in the case of ICU the optimal treatment and outcome of our patients.

Nevertheless, the work done at Intensive Care facilities continues to be a collective effort which is often proven an extremely conflicting process, a social function with conflicting interests, consequently cooperation between people many times it becomes even impossible. Undoubtedly, in conditions of crisis, unemployment, job reduction, poverty and social exclusion increase the chances a workplace to become problematic consequently degrading both the project that produced as well as their daily workers within the ICU. It is understandable that, especially in times of crisis, the role of effective leadership is highly valued neuralgic since it depends on:

  1. The formulation of the ICU strategy
  2. The shaping of the inner life and its quality daily life of employees
  3. The quality of the work produced
  4. The prospects for growth and economic viability of the ICU
  5. The personal and professional development of employees
  6. The ICU's social responsibility towards the general total
  7. The relationship with the other ICUs
  8. Its contribution to the development of science and the evolution of human resources
  9. Maintaining jobs

Key features of the ICU workplace leader

The constant question that concerns those who are concerned with work issues and in general around issues of organization and management of the workplace in organizations, is related to what are characteristics that make a leader in the workplace of. • It is clear that this question can be answered accordingly the way one sees the phenomenon of leadership. • If, for example, someone adopts the "genetic theory" that emphasizes hereditary transferable abilities, is obvious he will be preoccupied with the "leading" genes that inherited from one generation to the next. If, in another case, we emphasize the features traits of leaders (theory of characteristic traits) then we will look for leaders specifically characteristics such as social status, gender, age, appearance etc. which are considered to be responsible for leadership behavior displayed by someone.

According to other studies and research (approaches behavior) attempted to be analyzed specific behaviors which characterized effective leadership in workplaces, emphasizing two dimensions which were considered particularly critical in the development of leadership behavior:

  • Whether the leader can define and direct the activities of its subordinates within one specific framework for the purpose of satisfaction of the goals of an organization, in our case in the Intensive Care Unit &
  • Trying to inspire each other, trust through respect, solidarity and the development of a human-centered orientation.


It is worth noting that despite research and studies on the profile and characteristic straits of the leader no visa could give a completely convincing answer to the question of effective leadership, much more in the ICU workplace. For example, even the anthropocentric management model with emphasis on participation and joint decision making (human movement relations) in some cases was deemed not to effectively meet the goals of one organization. Something that will be the subject of analysis in our next article.Other visas attempted to respond through the creation of a “managerial grid "in one attempt to combine types of leadership with or interest in people or interest in effectiveness. However, and these views were based on specific features which should incorporate the leader, but without being able to to answer convincingly the question of one universally accepted leadership model behavior.

In the extension of "behavioral theories" "dependency approaches" have been developed (Tannenbaum-Schmidt, 1958 ∙ Fielder, 1967 ∙ House, 1971) which more generally attempted to shape the image of the "flexible leader" in an attempt to document how the leader must adjust his behavior on given conditions and circumstances without follows an inelastic model of exercise of his leadership.

It is clear that the debate over who has it τhe "charisma" of the leader has occupied a lot the scientific community. Max Weber΄s contribution to this issue was important cause he spoke about the role of a charismatic leader in the bureaucratic organizations, recognizing one's ability to inspire enthusiasm and devotion, convincing his subordinates to voluntarily embrace his own vision. Whether this "gift" is a hereditary privilege or shaped by social circumstances, it is clear that even today is a discussion that obviously will remains open and always exceptional interesting.

However, despite the many and conflicting views he has formed a common site for mapping key points that govern the leading behavior in the field of work. In conclusion, • the conception of a vision, • its spread, • thorough "reading" and analysis of reality, • the rational prediction of future trends, • The creation of innovative and groundbreaking goals, • the mobilization of team members to achieve their objectives, • the ability to synthesize forces and manage them conflicts • are proven to be some of the key elements of each leadership behavior which is exercised beneficially and efficiently. It is clear that the ability to combine and utilize individual skills, particularities, opportunities and possibilities etc. that are inherent in an environment, constitute the basic axis on which the ability of the effective moves leadership in every workplace.

To recapitulate management means responding to complexity. In order for any task to be performed, manager- director must focus on control and predictability and organize the processes that will produce methodical results for the operation of the ICU. Planning, assignment and staffing are management activities. Instead, leadership is about responding to change. The leader often sees opportunities in instability. Now more than ever in Coronovirus Crisis building and sustaining healthy relationships to his team which construct on trust and a shared understanding of context are crucial for any leader. The leader often sees opportunities in instability. Making directions, aligning people and motivating them are leadership activities. The most successful managers in the modern, demanding ICU environment selectively utilize skills in both management and leadership for the benefit of the smooth operation of the ICU and the extension of optimal patient care. This is because leadership does not always require formal authority, but a range of spiritual and interpersonal skills.


    1. Evangelia Michail Michailidou (2020) Change-management-in-ICU.
    2. Gershengorn HB, Kocher R, Factor P (2014) Management strategies to effect change in intensive care units: lessons from the world of business. Part II. Quality-improvement strategies. Ann Am Thorac Soc 11(3): 444-453.
    3. Carole Foot, Liz Hickson (2019) Leadership skills in the ICU. Chapter: Leadership skills in the ICU.
    4. Till A, McKimm J, Swanwick T (2020) The Importance of Leadership Development in Medical Curricula: A UK Perspective (Stars are Aligning) Journal of Healthcare Leadership 12: 19-25.
    5. Evangelia Michail Michailidou (2020) Successful and Effective Administration in ICU.

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