NUR3120 : Nurses As Leaders In Healthcare Settings

1. Explain why you have chosen the topic, using the lens of one developed value, one developing value, and your primary saboteur.

2. Discuss the topic using at least five course reference sources other than the textbook, and two reference sources from outside the course materials. You should demonstrate an ability to integrate sources into your discussion to demonstrate critical thinking. You should demonstrate evidence of wide reading.

3. In the context of your reflections, how does this topic contribute to what you are trying to change, or to your learning?How is this topic viewed in the literature? Is there evidence of widespread use or has uptake been poor?

1. Explain why you have chosen the model of care using the lens of one developed value (different from Part 1), one developing value (different from Part 1), and your primary saboteur.

 

2. Discuss the topic using at least five course reference sources other than the textbook, and two reference sources from outside the course materials. You should integrate sources into your discussion to demonstrate critical thinking and wide reading.

 

3. In the context of your reflections, how does this topic contribute to what you are trying to change, or to your learning?

2. Discuss the topic using at least five course reference sources other than the textbook, and two reference sources from outside the course materials. You should integrate sources into your discussion to demonstrate critical thinking and evidence of wide reading.

 

3. In the context of your reflections, how does this topic contribute to what are you trying to change or your learning?

Introduction:

Proper leadership and management skills, adoption of the appropriate care models and communication skills are the three important aspects of the nursing profession. Enhancing these three skills not only helps in the professional development of the nurse but also helps to provide a patient centred care. It is the performance of the nurse and the other health care professional that finally decides the reputation of a clinical organisation (Barr & Dowding 2015).

The written assignment aims to reflect on the leadership and the management skills in the nursing, where  have referred to the appropriate leadership style required to provide a comprehensive care to the patient and which is also appropriate to the identified values. The identified values mainly indicates towards the transformational type of leadership.

The second part of the assignment will throw light upon the appropriate care models in lens of the identified values from the second part. The identified values are “empathy “and “patient safety”, with reference to Watson’s human caring theory. In both the parts I have provided rationale about the choice of my topics. The third part of the assignment mainly focuses on the development of the communication skills among the nurses to reduce medical errors and to provide an equal care to the patients belonging to diverse cultural background. Finally I have also discussed about how the choice of topic would be helpful in developing my future professional practice.

Part 1

With the increasing amount of complexities in the health care field nurses are not confined to their conventional roles and have pushed their competency levels while working in frontline with the physicians. In clinical setting nurses often have to be in situation where they have taken the lead of situations. In order to understand one’s own capability it is necessary to determine the type of leadership based upon the core beliefs and the values of the individuals.

Based upon my knowledge and values I have decided to work on transformational leadership for this part of my assignment. More precisely, I will be discussing about clinical leadership which is a part of the transformational leadership. Transformational leadership style in nursing is mainly based on motivating the employees to give their best at work and encouraging them to feel positive and feel motivated while performing the clinical tasks (Barr & Dowding, 2015). This is normally done through a common mission and a vision which results in the formation of productive multidisciplinary team of nurses.

The transformational leadership theory is also consistent with the Saboteurs assignment that has been done in the starting of the assignment. I will be focussing on the values of “shared decision making” that I have identified in the beginning. My identified value is in compliance with elements of a transformational leadership, which has provided the rationale for choosing this leadership skills for the discussion. In order to provide information about the useful clinical leadership strategies I have conducted an extensive literature search using the databases like CINAHL, PubMed. Some of the essential keywords that has helped me to retrieve the evidences are – “Clinical leadership”, “transformational leaders” , “ nurse leadership”,” health care leadership”.

However, as discussed earlier, one of my identified values had been “shared decision making”, and shared governance is an important process that is designed for achieving organisational goals by shared decision making and accountability (Bleich & Kist, 2015). It is both transformational leadership that shared governance go in hand for enhancing the profession of nursing. Registered nurses often face challenges when it comes to motivating the junior nurses to work beyond the self-interest. A transformational leadership is the leadership for an in action (Stanley, 2011). Making of teams is one of the positive impact of a transformational leadership. Active listening, welcoming other’s opinion in practice, allowing others to involve in the decision making process is necessary for a collaborative practice (Lamb, 2015). It has to be remembered that health care management is not a one step process and generally involves several levels. The working of an entire health care organisation totally depends upon the functioning of all the levels and a shared decision making is necessary for all the levels to perform in an integrated manner and to provide a collaborative care to the patient (Mannix,  Wilkes & Daly, 2013).

According to Doody & Doody (2012), some of the competencies associated to transformational leadership includes personal integrity, adopting an open and approachable style , confidence and optimism, clear and effective communication  excellent listening skills, capacity to engage the individuals at all the levels, having the ability to manage up by engaging actively with the peers and the supervisors, being accountable to the scope of practices ad having the ability to articulate her/ his own visions and values and their implementation to day to day operations and individual goals. Hence, I believe that a nurse should follow a transformational leadership in order to promote patient safety care and proper functioning of the health care organisation.

Part 2

One of the important personal values that I have developed “patient safety” and another values that is still developing is the sense of empathy. I should mention that nurses are often faced with stress of burnout due to the excessive workload and are sometimes found to commit clinical errors or lose their temperament. Hence I personally feel that development of “empathy “for the patients in all situations is an important skill that has to be worked upon and preserved.

In my academic career I have learned to keep patients as the first priority and provide them with a care that is safe (Shekelle, 2014). According to the nursing codes of ethics- nurses action should promote good to the patient and nurse are expected to refrain from causing any harm to the patients (Dubois et al., 2013). In light of these values I intend to discuss about a model of nursing care.

Nursing models are made up of theories and concepts that assists the nurse to assist plan and implement the patient care by providing a nursing care model. It is the nursing care models that enables the nurses to achieve uniformity and a seamless care (Kitson et al. 2013).

The human care theory is introduced by Dr. Jean Watson, who initially identified 10 curative factors that are referred to as “core of nursing”. The choice of this nursing model is due to the fact that my chosen “value” goes in compliance with this concept of nursing theory and care is the main element of delivering care to patients (Sitzman & Watson, 2018). Some of the core principled of “human caring’ model is practicing of the love and kindness, providing a caring and a healing environment, a relational caring for the self and the others, establishment of  a transpersonal caring relationship, provision of some caring moments , reflective and a meditative approach (Lachman, 2012). According to Watson, the 10 curative factors to provide care to the patients are- practicing of loving kindness and equanimity within the context of the caring, cultivation of the spiritual practices and the transpersonal self and one going beyond the ego self, engaging in a genuine learning, teaching experience that attends to the wholeness and meaning, to see the world with others eye (Derksen, Bensing & Lagro-Janssen, 2013). All these comes under the broader element “empathy”.

This reflection would help me to continuously thrive for the betterment of the patient, keeping their interest in the first place and to relate to their thoughts. I specifically believe that engaging patients with empathy would empower the patients to engage in a therapeutic relationship and would also help them to participate in their own health and wellbeing (Raab, 2014).

Part 3

I have chosen the topic “Professional communication” for discussing the second part of the assignment. In today’s world the health care delivery process consists of patient handoffs and numerous interface among the health care professionals with varying levels of the occupational trainings and competencies (Kourkouta & Papathanasiou, 2014). Throughout the day a patient might have to interact many health care professionals such as nurses, dieticians, physicians and more and thus effective information’s has to be communicated effectively among the nurses and the health care professionals. Development of a multidisciplinary team within the health care setting require effective communication skills to facilitate a shared decision making (O’hagan et al., 2014).

The chief values that I have developed in my nursing practice is “developing communication skills” in nursing. I have understood that the development of communication skills in nursing is essential for the development of the therapeutic relationship between the nurse and the patient. An important value that is still to be developed is “development cultural awareness”. Although effective communication is a primary step to ensure a culturally safe care, yet there are certain critical elements that has to be considered to provide a culturally safe care (O’hagan et al., 2014).  These two values can be explained by the development of interpersonal and communication skills among the nurses. While in practice I have learnt that lack of communications creates several situations where medical errors can occur and these medical errors can lead to unexpected patient morbidity. According to Kourkouta & Papathanasiou, (2014), medical errors caused due to failure in communications is one of the pervasive problem in today’s health care organisation. Furthermore, there had been several researches that have proved that lack of communication has led to inappropriate behaviour, conflict, confrontation that not only affects the staff relationships, but also affects patient care.

Effective professional communication has been found to be the vital component of cultural safety. Without knowing the appropriate techniques of communication, the health care providers misinterpreted overlook the health related concerns of the person. It is the professional communication skills in the nurses that the enables them to provide an equal care to patient belonging to diverse cultural background. All these supportive information have provided the rationale to choose this topic for discussion.

This topic would enhance my learning as I have already mentioned that although I have developed the interpersonal skills required for communicating within our genre of profession, however, I still lacked the confidence required to communicate with the patients and their families. Things become more difficult when, it comes to communication with patients belonging to different cultures and beliefs. I have learned about several types of communication techniques associated with the nurse patient curative relationships- such as the verbal communication techniques, non –verbal communication techniques, use of silence, use of the perfect body language, maintenance of the eye contact and active listening, using proper portal for dissemination of information among the staffs, that would help me in my professional practice.

Summary:

Clinical leadership and management skills, effective communication and interpersonal skills and proper nursing care concepts enhances the competency skills among the nurses. It has to be understood that nurses being an active part of a multidisciplinary team often have to take on management roles without any formal support and training (Swanwick & McKimm, 2017). Hence it is important to incorporate the leadership strategies within ones self which can be done by evidence based learning or taking lessons from the seniors. All the values that I have chosen are mainly dependant on these skills and needs to be developed to become a successful registered nurse.

In conclusion it can be said that nurse has always been over managed and led inadequately, due to which they are faced with unprecedented challenges in health care. An organisation is constantly faced with the changes and hence require a flexible and adaptive relationship, a transformational leadership. In relation to this nurses also require effective communication skills to address the grievances of the patients and avoid medical errors. Effective communication is also the essential element to lead a health care team. Finally the paper had also discussed about the values of empathy, in light of the Watson’s human caring model.  

References:

Barr, J., & Dowding, L. (2015). Leadership in health care. Sage.

Bleich, M., & Kist, S. (2015). Leading, managing, and following. in P Yoder-Wise (Ed.) Leading, and managing in nursing (6^th ed). St, Louis, PA: Mosby.

Derksen, F., Bensing, J., & Lagro-Janssen, A. (2013). Effectiveness of empathy in general practice: a systematic review. Br J Gen Pract, 63(606), e76-e84.

Doody, O., & Doody, C. M. (2012). Transformational leadership in nursing practice. British Journal of Nursing, 21(20), 1212-1218.

Dubois, C. A., D’amour, D., Tchouaket, E., Clarke, S., Rivard, M., & Blais, R. (2013). Associations of patient safety outcomes with models of nursing care organization at unit level in hospitals. International Journal for Quality in Health Care, 25(2), 110-117.

Kitson, A., Marshall, A., Bassett, K., & Zeitz, K. (2013). What are the core elements of patient?centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. Journal of advanced nursing, 69(1), 4-15.

Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia socio-medica, 26(1), 65.

Lachman, V. D. (2012). Applying the ethics of care to your nursing practice. Medsurg Nursing, 21(2), 112.

Lamb, M. (2015). Nursing leadership and management. Toronto, ON: Pearson.

Mannix, J., Wilkes, L., & Daly, J. (2013). Attributes of clinical leadership in contemporary nursing: an integrative review. Contemporary Nurse, 45(1), 10-21.

O’hagan, S., Manias, E., Elder, C., Pill, J., Woodward?Kron, R., McNamara, T., … & McColl, G. (2014). What counts as effective communication in nursing? Evidence from nurse educators’ and clinicians’ feedback on nurse interactions with simulated patients. Journal of advanced nursing, 70(6), 1344-1355.

Raab, K. (2014). Mindfulness, self-compassion, and empathy among health care professionals: a review of the literature. Journal of health care chaplaincy, 20(3), 95-108.

Shekelle, P. G., Wachter, R. M., Pronovost, P. J., Schoelles, K., McDonald, K. M., Dy, S. M., … & Larkin, J. W. (2013). Making health care safer II: an updated critical analysis of the evidence for patient safety practices. Evidence report/technology assessment, (211), 1.

Sitzman, K., & Watson, J. (2018). Caring science, mindful practice: Implementing Watson’s human caring theory. Springer Publishing Company.

Stanley, D. (2011). Clinical leadership: Innovation in action. South Yarra, AU: Palgrave MacMillan.

Swanwick, T., & McKimm, J. (2017). ABC of clinical leadership. John Wiley & Sons.