NURSING3009 Leadership And Transition To Practice

Introduction

The healthcare industry has seen a lot of transformation in the last couple of decades and has indeed rendered it complex and multifaceted. One requirement needed to keep up with this transformation and dynamism is the institution of effective and productive leadership in the manner in which health care issues are planned, formulated and implemented (Nielsen, et al., 2008, pp.465-475). Being the first health practitioners to receive and journey with patients in their recovery process, nurses are amongst key healthcare practitioners that ought to be at the helm of leadership at the health facility where they work. Nurses are critical in influencing the manner in which treatment procedures are conducted as well as planning, formulation and implementation of different healthcare policies, and strategies.    

To this end, nurses ought to be impacted with leadership skills and knowledge to be in a position to deliver the promise of healthcare to patients. One critical leadership style that is at the heart of the healthcare industry is the transformational leadership. Moreover, in their leadership role, nurses are supposed to acquaint themselves with coping mechanisms such as being resilience amidst the adversities of the nursing profession. In this paper, the focus will be on analysing how transformational leadership can be employed to impact the provision of quality health care as well as drawing a personal reflection on how resilience can be critical in transitioning a fresh nursing graduate to registered nurse practice.

Transformational Leadership

Transformational leadership has been lauded by healthcare practitioners across the globe as a critical leadership style in the healthcare industry. This is because this type of leadership posits a socialistic and humanistic approach to healthcare leadership that also proactively but empathetically nurtures the change process at the healthcare facility (Ross, et al., 2014. pp.201-206). Like was stated, the healthcare industry is undergoing a great transformation with new technologies, human resource approaches, policies, programs, strategies and action plans coming into play. To cater for this complex and multifaceted complexities, a formidable leadership style like transformational leadership is very critical. The need to develop high-quality nursing   workforces with extemporal performance has become the need of the current and future times. As such, nurse leaders should strive to remain proactive at inspiring and motivating their followers with the purpose of coming up with committed yet enthusiastic teams to their promise of advancing the best care to patients (Wong, Cummings, and Ducharme, 2013,pp.709-724) 

In 1973, James Victor Downton coined the term transformational leadership and James McGregor Burns further developed it to transformational leadership theory. Burns’ definition of transformational leadership read “a process by which leaders raises the aspirations and motivations of others to higher levels by appealing to higher ideals and values” (Burns, 1978).  From this definition, Bass further idealized that transformational leadership is premised on moral foundations and constitutes of four moral yardsticks that are supposed to guide any transformative moral leader. These are; individual consideration, inspirational motivation, intellectual stimulation and idealised influence.

These tenets of transformational leadership motivate the ideology that both leaders and their followers are equal partners in the transformational agenda of the healthcare organization   through the achievement of higher levels of moral and motivation. The four components are schematized by the transformational leadership model to suggest that though they may be interdependent, they also need to be integrated and harmonized to produce extemporal organizational outcomes. To this end, transformational leadership comes out as a leadership style with an “additive effect” paramount for catering for any massive or sudden change at the workplace.

Bass (1985): Transformational Leadership Model

Transformational leadership has had far-reaching nursing implication since its invention and has come out as a critical management approach for nurse leaders. Not only is it instrumental at inspiring, influencing, and motivating fellow nurses but also significant at empathetically considering the needs of nurses (Doody &Doody, 2012. pp.1212-1218). Under transformational leadership, nurse leaders are expected to be trustworthy both to the profession and to fellow healthcare practitioners, stable minded, able to advance motivation to fellow nurses, remain organized, assertive, respectful, optimistic, adaptable, approachable, appreciative, reliable and legitimate. These virtues are critical at influencing other employees and making them follow their leader.  Moreover, a transformational leader is expected to effectively communicate to command the leadership role besides being able to be part of interdisciplinary or multidisciplinary teams. Being emotionally intelligent, remaining resilient, facilitative, and empathetic as well as being a source of constant inspiration and motivation to followers are critical virtues transformational leaders need to embrace.

Impact of Transformational Leadership to Healthcare Organisational Management

From the transformational leadership model, inspirational motivation denotes that transformational leadership is committed to the nurturing of formidable communication and relationship within the nursing profession. This is especially the case when nurse leaders are in a position to effectively communicate the goals and objectives of the different activities and tasks at their disposal (Schwartz, et al., 2011, pp.737-748). Transformational nurse leaders inspire and motivate other healthcare practitioners towards not only at accomplishing organizational goals and objectives but also achieving their personal aims. To this end, such leaders promote teamwork and commitment spirit among healthcare practitioners by spelling out clearly the vision, and mission statements of the healthcare organization. This by extension creates a grounded sense of purpose throughout the organization.      

With regard to delegation of work and definition of the scope of nursing practice, intellectual stimulation of the transformational leadership model advance nurse leaders an opportunity to encourage and appreciate nurses’ creativity and innovation in healthcare. Nurse leaders are obliged to assign, delegate duties or even promote junior nurses showcasing exceptional nursing prowess to senior levels (Salanova, et al., 2011, pp.2256-2266). Transformational leadership discourages nurse leaders from publicly blaming or criticising nurses for mistake done during patient care. With intellectual stimulation, however, transformational nurse leaders ought to elicit and promote problem-solving capacities, creative and critical thinking as well as empowering nurses for the purpose of leaving them more engaged and inspired. This opens more working opportunities for fellow nurses through expansion of the scope of practice as nurses are motivated at trying out new treatment and patient management approaches.

It has been evidenced by empirical research that the healthcare environment is a very stressful environment for healthcare practitioners and especially nurses (Thomas, & Revell, 2016, pp.457-462). Workplace challenges, difficulties, adversities, trauma, and excess workload have been labelled as the principal causes of nurse burnout, turnover, depression, frequent leave, and absenteeism. To this end, there is need of coming up with formidable strategies and approaches of dealing with workplace burnout. Under transformational leadership model, individualized consideration advance nurses opportunities of being empathetic, compassionate, considerate, and understanding of fellow nurses’ needs.       

This goes a long way in curtailing workplace conflicts by finding amicable solutions to troubling challenges. Transformational leaders ought to act as mentors to their juniors and should have the audacity of entering into their shoes and by extension acting earnestly in finding amicable solutions to their problems and conflicts. Transformational leadership calls upon nurse leaders to showcase sincerity and compassion towards their followers besides supporting them based on their needs and nurturing with regard to their talents (Nielsen, et al., 2009, pp.1236-1244). To this end, the continuous advancement and growth of nurses ought to be the primary concern of transformational leaders.

Professional relationships, effective communication, and documentation of health records, and productive team working are all amicably catered for by the idealized influence tenet of transformational leadership. Leaders’ followers will always act within the spirit that their leader showcases. To influence people to do the right things   and remain on focus on them, the leaders ought to act rightfully and morally. The transformational leadership zeal is premised on the ideology that followers will always act on the example that their leader is advancing (Pieterse, et al., 2010, pp.609-623).    

As such transformational leaders are mentors as well as role models to their subordinates. When nurses’ leaders endeavour to forge formidable and lasting professional workplace relationships with all employees at the health facility, then their example automatically trickles down to the juniors. This is the case with communication and documentation of health records which are critical at extending a patient cantered kind of care to patients. By engaging in teamwork activities with fellow employees, nurse leaders stimulate trust and respect within and without professional borders as followers try to emulate their leaders. This by extension naturally eliminates workplace conflicts and resistance to change or adopting new patient management approaches. 

Transformational Leadership Contribution to Quality healthcare

Transformational leadership has had great clinical implications since its earliest days of development and appreciation in the healthcare industry (Fischer, 2016, pp.2644-2653). It has been an exceptional strategy of mentoring new entrants into the nursing profession as well as inspiring and motivating those already in practice. Like has been stated earlier, the healthcare industry posits a great deal of challenges as well as opportunities for nurses. If unchecked, challenges, workplace trauma, stress, and adversities can lead to burnout and other more serious healthcare complications to nurses. Being resilience to adversities such as work overload   and health and safety requirements is very critical in the nursing career. Transformational leadership extends nurses an ample platform over which to empty workplace baggage and receive solace.

Novice nurses are extensively able to develop trust and commitment to a healthcare organization that practices transformational leadership. Novice nurses are instilled professional values and nursing standards of practice enabling them to settle calmly to their nursing profession from the very beginning. This helps to build their autonomy in decision making with regard to what is supposed to be the best care to patients under their care. Virtues such as teamwork, responsibility, and accountability are impacted in them which by extension assist them to be effective team players of different interdisciplinary or multidisciplinary teams.  This is a sure strategy for novice nurses to build their nursing leadership skills and knowledge besides leading high nurse retention (Weberg, 2010, pp.246-258)

Transformational leadership is committed to nurturing innovation, inventions and new ways of taking care of patients. This position gives nurses an opportunity to develop their nursing skills and knowledge as well as giving their autonomy of being creative and critical in healthcare service delivery a chance to thrive (Erkutlu, 2008, pp.708-726). By being motivational, inspirational, appreciative and facilitative, transformational leaders extend healthcare practitioners a backing upon which they can further their creativity, inventiveness, skills, and knowledge of advancing comprehensive healthcare to their patients.

With the advent of person-centred care in the Australian healthcare system, transformational leadership has been critical at achieving the goals of this approach to patients’ care. Person-centred care demands that health care providers ought to advance health care to their patient through amicable consultation with the patient and their families. This proposition is informed by the premise that patients are in a better position than healthcare providers in knowing how exactly treatment and nursing management need to be impacted on them. Since person-centred care approach is aimed at making patient s feel respected, understood and valued, transformational leadership happens to be its comparable counterpart to this end.

Hutchinson and Jackson (2013, pp.11-22) posit that with transformational leadership, patients are able to build trust and faith with the healthcare institution and therefore are able to remain at peace while undergoing care. Moreover, both patient-centred and transformational leadership emphasize on the need to be empathetic, respectful, optimistic, flexible, compassionate, and considerate while care is being undertaken. To this end, transformational leadership not only reinforces the tenets of patient-centred care approach but also compliment the same which by extension elevates healthcare levels.      

Transformational leadership calls upon all health care providers to be collaborative, cooperative, and communicative while advancing care to patients. This nurtures teamwork and togetherness throughout the whole institution. For hospitals to be declared as having a “Magnet Identification” in the U.S. transformational leadership is very key. Transformative nurse leaders under this recognition are required to carefully listen and respond to their colleagues’ work and personal needs in order to forge better healthcare services to patients (Clavelle et al., 2012, pp.195-201). This eliminates most healthcare risks, workplace conflicts, and hazards. 

Conclusion

By and large, it can be deduced that as the healthcare industry advances in complexity of healthcare delivery, better health care leadership approaches need to be advanced to keep up with the transformation. Since its advent, transformational leadership has been instrumental in the healthcare industry in providing leadership and has indeed led to numerous achievements in different healthcare facilities across the globe. Its virtues of individual consideration, inspirational motivation, intellectual stimulation and idealised influence has been instrumental at  advancing patient-centred king of care besides impacting nursing practice positively in numerous ways. 

Transitioning Strategies into Nursing Practice: Resilience

Foureur, et al., (2013, pp.114-125) observe that the nursing environment is full of adversities, challenges, and traumatic situations. These nursing environment circumstances have the capacity of burning out nurses and can lead to even more serious healthcare complications. To this end, I will be laying formidable transitioning strategies that will facilitate my transformation from being a nursing student to being a registered nurse. First, I will endeavour to build my resilience capacity to be in a position to adapt and cope effectively to the nursing profession adversities, challenges, trauma, and stress. Auburn, Gott, and   Hoare (2016, pp.980-1000) defines resilience at the ability of simply “bouncing back” from challenging situations.

Since resilient nurses posit the capacity of going through adversities with their emotional and social well-being remaining unshaken, I will make efforts of building my resilient capability within the shortest timespan after registering as a nurse. I will exploit strategies such as effective communication, forging effective relationships with fellow employees, friends, and family members, team working, proper work planning, practicing patient-centred kind of care to this end. Like (Hart, et al., 2014, pp.720-734) contends, resilience has elicited my thinking that as a registered nurse, I am obliged to exploit my nursing capacity and internal confidence in capitalizing different workplace changes, professional skills and knowledge as well as attitudes with the view of creating a workplace environment that is not only productive, satisfying but also meaningful. 

Upon recruitment as a registered nurse, I will immediately start to employ well-thought decisions in tackling different nursing activities and tasks. Rather than being an escapist to nursing challenges, I will endeavour to turn these nursing challenges to opportunities for both learning and gaining nursing experience. Kim and Windsor (2015, pp.21-27) posit that nurses who exploit their capacities to the brim in the presence of workplace adversities are at a greater advantage of overcoming most of the workplace adversities. Rushton et al., (2015, pp.412-420) reiterate this proposition by stating that nurses who undergo workplace adversities yet take their time to exploit opportunities in those adversities portray effective resilient capacities such as heightened self-worth, life appreciation, and better relationships.

In the first few months of my nursing career engagement, I will spend most of my time mastering these resilient capabilities. It will be obvious that my resilience as a registered nurse at this period will be under testing from all spheres. I will be expected to showcase prowess in the manner in which I transit coursework into professional practice while advancing holistic patient care. However, with continuous resilience development, support systems, proper orientation and tackling patients’ requirements whose needs are not critical will further orient me deeper into the nursing profession. Burnout, attrition, trauma, workload, and challenges are by and large the unfortunate consequence of the nursing profession (Hunter, & Warren, 2014, pp.926-934). As such packaging myself with amicable transitioning strategies such as resilience will go a long way in settling me into the profession.

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