Towards the Transition to an Empowered and Resilient Leadership of Nursing Professionals

This editorial is oriented to reflect on the need for a transition to an empowered and resilient leadership of nursing professionals as a fundamental axis of strong, competent, and empowered health systems to face epidemiologic, social, economic, political, and cultural challenges from a globalized, complex, and demanding world.


Introduction
One of the priority goals of health systems internationally is to guarantee services that are safe, sustainable, fair, equitable, and accepted by the community, which demands health professionals leading those organizations to be agents of change and to have adequate abilities.
A competent workforce is essential to accomplish quality health attention.The World Health Organization recognizes sanitary workers are fundamental for establishing solid and resilient health systems that contribute to reaching their objectives.However, it is also evident the need to strengthen the institutions' capacities to promote efficient health human resource leadership with professional abilities that respond to the population's health needs (1).
Nursing professionals represent the majority group within health systems and play an essential role in all attention levels, with a central axis around care, result evaluation, and efficiency.They are firsthand witnesses of the challenges sanitary organizations face.Nevertheless, internationally there are areas of opportunity that limit their transition to effective transformational leadership due to the organization demands' complexity and the dominant leadership style that influences decision-making processes (2).These complicated organizational environments challenge the institutions while they also create opportunities to develop strategies looking to strengthen nursing leadership (3).

Empowered and Resilient Leadership
Nursing professionals face complex and even more demanding situations in their working environments, which is why it is fundamental to promote their leadership regionally, nationally, and internationally, as well as to have as a principal objective the development of abilities that support their health decision-making.It is relevant to consolidate a transformational, empowered, and resilient leadership that contributes to establishing quality, stable, and efficient health systems, which are the product of a transformative, flexible, and proactive vision.
There is a need for leaders that can recognize the dangers of adversities and search for the best alternatives and face them.It is also determinant they have capacities, abilities, and initiatives to act before prospective scenarios and to support and strengthen those around them (2,4).
It is considered relevant to inspire the development of leadership abilities in nursing professionals that allow them to influence decision-making at all levels and implement innovative and evolutionary management, occupying a central position to reach the organizational and collective objectives in the work-life with responsibility, autonomy, trust, and transparency to improve health attention quality (5).
According to literature revision, empowerment favors resilient leadership and autonomy.Empowerment is the capacity to promote development, improve performance and attitudes, and create autonomy and added commitment and satisfaction (6).Resilience is people's ability to face adversity, overcome obstacles, and generate even more growth, professional and personal.Resilient leaders allow the building of positive interpersonal relationships, the development of emotional intelligence, the creation of balance-at work and personal, and the reflection on successes as effective strategies for overcoming challenges (7).
The most empowered nursing professionals are capable of driving and consolidating resilient leadership (2,4).Other variables associated with empowerment and resilience are self-leadership ( 6) and self-efficacy (8).Self-leadership refers to a person's ability to reach their objectives and obtain good results, which generates a feeling of satisfaction for the accomplished goals and the overcame difficulties, favors autonomous leadership, and contributes to being resilient (9).Self-efficacy is people's believes in their ability to perform a task or an activity regarding the knowledge and the course of action needed to control life's different activities and events.
Nursing professionals that perceive themselves as self-efficient have empowered and resilient leadership; additionally, they keep a balance between their thoughts and emotions to overcome adversities, negative reactions, and exhaustion, which increments resilient leadership and work satisfaction.A resilient leader is always considered to be efficient (8).
Education level is another relevant aspect associated with empowerment and resilience.Nursing professionals with doctorates and master's degrees are more empowered and resilient.A higher professional level is associated with more autonomy and being more competent and resilient even if there are difficulties at work or personal environment (10).
Before the evidence that empowered and resilient leadership of health professionals contributes to the transformation of organizations into strong and committed institutions and inspires accomplishing innovative goals that leave uncertainty and instability behind to develop competent, stable, positive, and improved work environments, there is a requirement to develop actions that, from early training stages, promote effective leadership to guarantee, in the future-short, medium, and long term-health systems with empowered and resilient nursing leaders that face adversities and strengthen the population's health attention quality (4).

Conclusion
Health systems' transformation requires guaranteeing that nursing professionals have effective, empowered, and resilient leadership.This process has already started, we are on our way towards the transition, and there is evidence of the successful positioning of nursing in the different fields of action; however, more effort and investment are required.Empowered leadership is necessary for sanitary systems.Even though the emphasis must be on impulsing empowered sanitary systems, not resilient, it is a fact that health institutions face multiple demands and requirements that force them to face obstacles, which is why the need nursing professionals able to face challenges and make the best decisions that contribute to the population's health.
It is essential that educational institutions training nursing human resources include in their academic programs and continuing education, content, and learning strategies in real and simulated scenarios that contribute to the develop of resilience, self-efficacy, and self-leadership because of their association with empowerment.Moreover, it is advisable to motivate clinical professionals to have master's and doctorate training that expands their disciplinary knowledge and advanced practice to favor the transition toward the consolidation of nursing leadership.