Inclusive Leadership: Influencing and Inspiring Professional Organizational Engagement

By Nelson Tuazon, DNP, DBA, RN, NEA-BC, CENP, CPPS, CPHQ, FNAP, FACHE
Vice-President & Associate Chief Nursing Officer, University Health System, San Antonio, Texas
District 8 Director, Texas Organization for Nursing Leadership
 
The U.S. workplace continues to undergo a demographic change at a rapid pace. The composition of the workforce will be impacted by the increasing number of Asian and Hispanic workers and professionals. The growth of Black Americans is projected to be 6.4 million by 2050. Whites make up the majority of the labor force (78%), Blacks (13%), and Asians (6%). By ethnicity, 17% of the labor force were of Hispanic or Latino ethnicity, who may be of any race  (Bureau of Labor Statistics, 2018). By 2025, racial and minority groups will comprise 42% of the U.S. population, thereby increasing the diversity of the workforce (Brimhall et al., 2014). The rapid shifts in the U.S. workforce demographics have provided the impetus for organizations to forge culturally competent labor force and develop inclusive work environments (Velasco & Sansone, 2019).

What Is in a Name?

The terms diversity and inclusion have been used interchangeably; however, it is important to differentiate the two. Diversity refers to the presence of people possessing a wide range of characteristics, which may be seen and unseen, and which the members were born or acquired. Inclusion, on the other hand, refers to the practice of making all members feel welcomed and providing them with an atmosphere that provides equal opportunity to connect, belong, and grow (Fucci & Cooper, 2019). Diversity also refers to the composition of differences of individuals, which traditionally may include race, ethnicity, gender, and education (Homan & Greer, 2013). Inclusion, on the other hand, refers to the extent to which the members of the group are encouraged and urged to participate and get involved (Mor Barak, 2015). The ultimate aim of inclusion is to value the characteristics of the individual members and to foster a welcoming climate that promotes the sharing of their true selves (Nishii, 2013). Inclusive leadership is associated with the integration of diversity dimensions in leadership theory and is concerned with the knowledge of how these dimensions influence an understanding of leadership. Ultimately, inclusive leaders focus on the mechanism by which their followers view the leadership development of their leaders (Gotsis & Grimani, 2016).

Why are Diversity and Inclusion Important?

Fucci and Cooper (2019) emphasized the importance of diversity and inclusion in corporate and nonprofit boards. Diversity and inclusion have been proposed as the possible key to overcoming the next recessions because they serve as a potent source of strength during tough times (Gencler, 2019). The 2020 McKinsey report indicates, however, that diversity does not always mean inclusion. Despite the increasing diversity, many companies are still unable to cultivate work environments that promote inclusive leadership and accountability. Equality and fairness to opportunities and freedom from bias and discrimination remain as issues (Gassam, 2020).

The business case for diversity and inclusion has been successfully demonstrated. Organizations with a clear purpose and intention of promoting diversity and inclusion should understand the current state of its workforce to have sustainable outcomes (Prieto et al., 2016). Diversity in the workforce has been linked to the achievement of better health care outcomes and more culturally appropriate and relevant care, for both the organizations and the communities they serve (Persaud, 2020). The formal assignment of responsibility for diversity to a diversity manager, taskforce, or committee has proved to be successful (Dobbin & Kaley, 2016). 

There is evidence to show the benefits of an inclusive climate, especially in organizations that comprise diverse groups.  The positive outcomes that have been associated with inclusive settings and organizations include member satisfaction, retention, engagement, creativity, and innovation (Bradley, 2020; Brimhall et al., 2014; Nishii, 2013). The McKinsey 2020 report indicates that gender diversity and ethnic and cultural diversity are associated with above-average profitability. Companies that subscribe to gender diversity are 25% more likely to be profitable and those that espouse ethnic and cultural diversity are 36% more likely to be profitable (Gassam, 2020). Increased profitability and innovation have been shown in companies that have greater diversity in their workforce and promote inclusion (Hunt et al., 2015).  

Frameworks and Considerations for Diversity and Inclusion

One of the first important steps in developing strategies to integrate diversity and inclusion into the organization is the identification of a framework. Several theories and models exist in the literature. Some of the more fitting theories and models are presented here for consideration.

Social Identity Theory and Optimal Distinctiveness Theory

In examining the impact of inclusion on the leader-member exchange, Brimhall et al. (2017) analyzed theoretical frameworks that may be used. They explored the social identity theory (Tajfel, 1982) and the optimal distinctiveness theory (Brewer, 1991). Brimhall et al. (2017) posited that being part of a group, trust, and feelings of acceptance promote the feelings of inclusion. An important aspect of inclusion, beyond the feeling of belonging to a group, is the sense of being valued and accepted for the unique characteristics an individual brings to the group (Mor Barak, 2015; Nishii, 2013).

Humanitarianism

Harpell and Andrews (2010) offered humanitarianism as a framework, which regards all humans as equal. Broadly, humanitarianism aligns with diversity and inclusion because of its focus on fair treatment and respect for all individuals. Although Harpell and Andrews focused on the application of inclusion in the academic arena, their exposition on the individual needs of the learners and the need to adjust the instructional methods to meet the needs of the students, apply to the inclusion roles of leaders of professional organizations towards their members.

Social Change Model

The social change model (SCM) promotes equity, social justice, self-knowledge, service, and collaboration. This model is particularly relevant to individuals who may not perceive themselves as leaders and is especially meaningful in a diverse society (Read et al., 2015, p.164). The seven values of SCM encompass the individual (consciousness of self and others, congruence, commitment), group (collaboration, common purpose, controversy with civility), and society (citizenship). SCM aligns with inclusive leadership because the model promotes equity, social justice, self-knowledge, service, and collaboration (Read et al., 2015, p. 166).

Organizational Culture

Sanders (2017) has explored the concepts of organizational culture as a framework for integrating diversity and inclusion. The Organizational Culture Assessment Instrument (OCAI) (Cameron & Quins, 2011), based on the competing values framework, is a fitting model in examining diversity and inclusion because of its flexibility and adaptability. The application of OCAI is suitable for diversity and inclusion mainly due to the assumption that there is no one best culture; rather, the model is premised on the notion that cultures vary based on circumstances (Sanders, 2017).

Faultlines

Organizations, institutions, and professional associations are continuing to attract employees, clients, patients, and members from diverse backgrounds. In response, organizations form interprofessional health care teams to address the multifaceted issues resulting from the increasingly complex interplay of factors affecting these entities. Adding to the complexity of group interaction and the success of teams is the concept of faultlines (Mitchell & Boyle, 2020). Faultlines are the hypothetical separations and distinctions that segregate teams into subgroups based on their attributes and characteristics (Lau & Murnighan, 1998). The composition of teams is a major factor that is linked to team dynamics and performance (Mitchell & Boyle, 2015). In the case of professional associations such as the Texas Organization for Nursing Leadership (TONL), there may be perceived faultlines amongst the members from various settings such as the acute care, academic setting, and post-acute care. There may also be a division in the professional roles of the members such as those who are nurse executives, directors, and managers and those who are at the beginning of their leadership roles as supervisors.

Although faultlines are viewed as negative due to the effect of conflicts to group performance (Lau & Murnighan, 1998), there is an alternative view to argue that faultlines could be beneficial especially when the diverse team is working to solve complex problems and propose innovative solutions (Mitchell & Boyle, 2015). Academic-practice partnership is an example of an approach where diverse teams solve complex problems. Inclusive leadership can promote and foster the sharing of diverse input from the different team members with unique capabilities. The synergy, collaboration, and combined effort from the interprofessional team could enhance innovation. The presence of strong faultlines will lead to a greater likelihood of the emergence of interprofessional comparative dynamics (Carton & Cummings, 2013).

Who is an Inclusive Leader?

Six Signature Traits of Inclusive Leaders

Inclusive leaders have the following characteristics: a) visible commitment – a commitment to and making diversity and inclusion a priority; b) humility and courage – modesty, admission of culpability, and valuing others’ contributions; c) awareness of bias or cognizance – awareness of personal blind spots; d) curiosity about others – open-mindedness and non-judgmental attitude; e) cultural intelligence – cultural awareness and adaptability, and f) effective collaboration – empowering others and promoting psychological safety (Bourke & Dillon, 2016; Bourke & Espedido, 2019; Bourke & Espedido, 2020). Tapia and Polonskaia (n.d., p. 9) describe inclusive leaders with the following traits: a) authenticity – humility, setting aside ego, and establishing trust; b) emotional resilience – composure amidst adversity and differences; c) self-assurance – confidence and optimism; d) inquisitiveness – openness, curiosity, and empathy; and e) flexibility – tolerance to ambiguity and adaptability.

Commitment, Connection, and Collaboration

Inclusive leaders commit to making diversity and inclusion as an organizational priority by engaging all levels of management and staff in the organization, developing formal processes and structures to create a positive work environment, and engaging employees from various backgrounds. Inclusive leaders make connections with individuals early and engage them in a continuous process of leadership development. Specific criteria and clear pathways are developed and communicated to diverse groups at the entry- mid- and senior levels within the organization. Finally, inclusive leaders collaborate with external stakeholders towards the achievement of shared goals to promote equity and create the momentum for diversity among the leadership team (Persaud, 2020).

What are the Competencies of an Inclusive Leader?

Inclusive leadership requires specific skills and competencies in effective communication. When communicating with others, particularly in a cross-cultural and diverse group, inclusive leaders convey the message of being included, valued, and heard. The ability to bring individuals from different backgrounds to a common platform characterizes an inclusive leader (Jain, 2018). The role of servant leadership has been examined as an approach to fostering inclusion. Gotsis and Grimani (2016) have identified organizations that promote the perceptions of employees of inclusion.  Through empowerment, diverse groups perceive equitable and more humane work climates. Servant leaders are believed to be more sensitive to different societal expectations.

Inclusive leaders should develop and master the following competencies: a) build interpersonal trust, b) integrate diverse perspectives; c) optimize talent; d) apply an adaptive mindset; and e) achieve transformation (Tapia & Polonskaia, n.d., p. 10). Additionally, inclusive leaders can adopt the following strategies in promoting organizational change that fosters diversity and inclusion: a) lean into discomfort – this opens the door to trust; b) listen as an ally – this opens the door to collaboration; c) state your intent and your intensity – this opens the door to understanding; and d) share your street corner – this opens the door to breakthroughs (Sanders, 2017, pp.77-78). It is important to remember that organizational commitment to diversity and inclusion does not mandate leaders to hire or promote unqualified individuals for leadership roles or positions (Persaud, 2020).

How Do the Leading Professional Organizations Embody Diversity and Inclusion?

A review of the websites of six major leadership and executive organizations revealed three primary approaches to diversity and inclusion. These include structures (e.g. committees, councils, expert panels, and institutes), representation (e.g. policy statement, forums, recruitment, and retention), recognition (e.g. awards, research, publications, and celebration). These organizations include the American Academy of Nursing (AAN), American Association of Colleges of Nursing (AACN), American Nurses Association (ANA), American Organization for Nursing Leadership (AONL), National League for Nursing (NLN), and the American College of Healthcare Executives (ACHE).

American Academy of Nursing

The American Academy of Nursing (AAN) has a Diversity and Inclusivity as the top values in its 2017-2020 Strategic Plan. The AAN has a Diversity and Inclusivity Statement that is aligned with its mission statement. The AAN a) requires its members to reflect the increasingly diverse society and their contributions across nursing; b) offers opportunities to engage the members in its work; and c) develops and aligns policies and policies to achieve goals. The AAN has expert panels that address diversity and inclusion. These include the expert panels on aging, cultural competence and health equity, lesbian, gay, bisexual, transgender, queer (LGBTQ) health, and women’s health (AAN, 2015).

American Association of Colleges of Nursing

The American Association of Colleges of Nursing (AACN) website features a Diversity and Inclusion page that highlights the organization’s rich resources including its comprehensive position statement, Diversity, Inclusion, & Equity in Academic Nursing (AACN, 2017). The page includes information on the Diversity in Nursing Education Award; data, publications, and educational programs on diversity; pod casts including topics on diversity in nursing education; and funding opportunities that provide resources to students, including many minority focused programs. The Diversity Digest newsletter, produced quarterly, highlights AACN’s diversity and inclusion initiatives. The Diversity in the News showcases current noteworthy announcements on diversity, inclusion, and equity (AACN, 2020). AACN is holding a Diversity Symposium entitled Diversity: Essential for Inclusive Excellence in December 2020.

American Nurses Association

The American Nurses Association (ANA) website features a Practice and Advocacy page that includes Diversity Awareness, an expansion from ANA’s Nursing’s Social Policy Statement. The page also highlights information and resources regarding LGBT Individuals and Communities, Racial and Ethnic Minority Communities, and Culturally-Specific Tools. The tools include resources about Black and African Americans, American Indian/Native Americans/Alaskan Natives, Asian and Pacific Islander Americans, and Hispanic and Latino Americans (ANA, n.d.a). ANA offers a Minority Fellowship Program that focuses on mental health and substance abuse (ANA, n.d.b).

American Organization for Nursing Leadership

The American Organization for Nursing Leadership (AONL) has a Diversity and Inclusion page, part of the Institute for Diversity and Health Equity of the American Hospital Association. The site has resources that include a Workforce Library and highlights Reports on the Guiding Principles for Diversity in Healthcare Organizations and Guiding Principles for Nurse Leaders. AONL features a Nurses’ Diversity, Equity and Inclusivity Pledge that it developed in partnership with the New England Regional Black Nurses Association (NERBNA). There is an Equity of Care Award that recognizes member hospitals and health systems for their efforts to advance diversity, inclusion, and equity (AONL, 2020).

American College of Healthcare Executives

The American College of Healthcare Executives (ACHE) webpage highlights its Diversity and Inclusion activities and initiatives that include a statement, “we are promoters of diversity and inclusion.” The page also showcases the LGBTQ Forum and the Asian Healthcare Leaders Forum, the ACHE Statement on Diversity, Research on Diversity, and the Policy Statements on Diversity (ACHE, 2020a). The Diversity and Inclusion Career Center features the Executive Diversity Career Navigator, the Thomas C. Dolan Executive Diversity Program, and Gender and Race/Ethnicity Studies (ACHE, 2020b). ACHE’s policy statement on Increasing and Sustaining Racial/Ethnic Diversity in Healthcare Management emphasizes its advocacy efforts to providing equal opportunity for all citizens regardless of race and ethnicity. The policy encompasses recruitment, promotion, and support for improving the representation and equitable treatment of racial and ethnic diversity in healthcare management (ACHE, 2020c).

National League for Nursing

The National League for Nursing (NLN) Advocacy and Public Policy page highlights its commitment to promote a population of nurses and nurse educators who reflect the diversity in the nation, advocate for policies that enrich culturally relevant nursing education, and support the incorporation of the national standards for Culturally and Linguistically Appropriate Services (CLAS) (NLN, 2020a). The NLN website also features a Diversity page that focuses on health disparities (NLN, 2020b). NLN’s Center for Diversity and Global Initiative has developed a comprehensive Diversity and Inclusion Toolkit that covers diversity and inclusivity in the academic mission, administrative leadership, faculty, and students (NLN, 2020c).

Strategies for Inclusive Leaders

Leaders could enhance their potential as an inclusive leader in their style and approach by adopting the following strategies (Dow, 2017). These include a) exemplify self-awareness; b) develop a strategy for leading; c) model courage; d) inspire trust and respect; e) exhibit self-control, and f) stop assigning blame. As leaders of professional organizations, we have to reflect upon these strategies that could affect our decision-making, ability to achieve organizational goals and objectives, inspire others to act with courage, build trust, and demonstrate emotional intelligence. As change agents, transformational leaders elevate individual and group performance by empowering others, holding individuals accountable, and adhering to diversity and inclusion (Davalos, 2014). Leaders that subscribe to transformative leadership theory focus on inclusion, equity, and social justice (Shields & Hesbol, 2020). It has been suggested that leadership theories should encompass social equity and inclusion issues that evolve as consequences of the rapid changes within the organization and the society (Chin, 2010).

To prepare early careerists and activists in the labor union movement, Alvarez and Alvarez (2018) shared the principles they developed to guide the young leaders to tackle the issues of racial and gender equity.  Some of these include strategic recruitment of targeted diverse demographics, promoting the value of a learning community, developing leadership program focused on strategic thinking and broader issues rather than skills, and utilizing interactive pedagogy with peer learning and focused on self-assessments. Two principles that may sound like a shift from the inclusive leadership paradigm suggest that there should be a recruitment of internal candidates rather than self-selection and acceptance to the leadership training program should be selective. The implications of these principles to professional organizations are profound, particularly for students and young members who have the desire to be engaged in professional organizations. The following are some ideas to ponder upon.

a.       To ensure that the demographic make-up of the organization is represented equally and equitably, appointed positions to the board, committees, and taskforces provides the leaders to offer opportunities to qualified candidates and nominees.

b.      To create a pool of diverse candidates and nominees for elected and appointed positions, a succession planning committee should be established in addition to the nomination and election committee.

c.       To create robust local and regional activities, strengthen the role and participation of the board members-at-large and the district directors.

d.      To develop strategic agility and strategic thinking  among the members, program development and educational offerings should be strategic in scope and scale.

e.       To promote member engagement, deploy pedagogical approaches that cater to the various learning styles of individuals and that are based on identified learning needs.

Parting Words

The mission of nursing is profoundly aligned with social justice and health equity (Read et al., 2015). As advocates for social change, leaders of professional organizations are duty-bound to cultivate, foster, and advance diversity and inclusion among its members, constituents, and stakeholders. The creation of a culture of inclusion requires a new set of leadership qualities and competencies that include flexibility, fluidity, self-awareness and mindfulness, courage, and vulnerability (Wasserman et al., 2008, p. 180). Inclusion forges an environment that recognizes, espouses, and adopts various ways and experiences that allow individuals to reach their full potential and ultimately result in positive outcomes (Winters, 2014). Tapia and Poloskaia (n.d., p. 5) sum it best: "being an inclusive leader does not make you a good leader of inclusion and diversity – it makes you a good leader overall."

 

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