Nursing Leadership Guide - Essay Example

Nursing Leadership Guide TABLE OF CONTENTS Page...................................................................................................................... Table of contents......................................................................................................... 1 Assessment of a Nursing Leadership Problem............................................................. 2 Annotated Bibliography.............................................................................................. 5 Leadership Theories, Styles, and Application..............................................................7 Strategic Analysis and Leadership Interventions......................................................... 8 Summary..................................................................................................................... 12 References.................................................................................................................... 13 Nursing Leadership Guide Introduction Success in the medical area and particular nursing goes beyond the practice of profession. Leadership and management skills are vital in practice of any profession. A nurse needs to be equipped with all necessary tools in relation to leadership and management. These skills ensure that there is high level of competence in health care industry. A well equipped nurse is able to practice team leadership and coordination regardless of the settings from which they are operating. This leadership guide outlines strategies and theories that can be used in the nursing arena. Past experiences in the nursing arena has helped individuals learn and develop theories that are applicable to day to day practices in the health care. Nursing is a very dynamic field and new challenges emerge. These challenges require high level of preparedness. According to (Daly & Speed, 2004) a recurring theme of leadership in nursing that it is something that can be learned and applied to leadership challenges as they appear. Thus leaders in nursing should have passion, commitment and flexibility. Nursing Leadership Problem Incompetence in leadership affects all professions. Nursing is not excluded. There are so many reported cases that can be related to leadership from nurses. The fact that the profession deals with society directly is a clear indication that there is need for high level of leadership. (Williams & Media, 2015) A case is reported in a medical journal concerning a supervising nurse from a local medical centre who found herself in trouble after giving her juniors freedom to plan their own working schedule. (Nurses) The writer of the articles explains how the nurse did not posses any authority in controlling the rest of the workmates. As a supervisor, he was expected to create weekly work schedules, compile daily reports on performance of the nurses among other responsibilities. The article’s main concern was one particular event in the hospital that shocked everyone. One morning, as everyone was reporting to work, the supervising staff was shocked to realize that she was the only nurse present at work. She got concerned and decided to call the rest of the nurses. On calling the nurses, they all claimed that they thought it was their day off. An urgent meeting was called that afternoon to discuss the issue. At the meeting, the management questioned the supervising nurse concerning what really happened that night. According to her, the previous day, she asked her juniors how they would wish to take their day off starting from the following day. Each staff had their own preferred system. Eventually, the supervisor asked the nurses to discuss among them and decide how they would wish to work. The supervising nurse did not make an effort to find out what the staff concluded. The nurses were also questions concerning the same issue. According to the junior nurses, they did not come to an agreement as everyone wanted to start their off day the following day. The nurses also reported that the supervising nurse had asked them to feel free and work with freedom as far as the principles of their work are not compromised. It is evident that the supervising nurse here was using Laissez Faire style of leadership. In as much as the style gives the juniors a chance to freely do their work and brings innovativeness, this style has its major challenges. In the case of the supervising nurse, the junior nurses found an excuse of not to attend to work in the name of not agreeing. The supervising nurse seemingly was too lazy to seat down and develop the program/schedule other than leave it with her junior staff. The activities in the medical care were altered the whole day because of this leadership crisis. All these happened because a senior nurse failed to perform their duty. Leadership problems in nursing exist and the effects are extreme. A better style of leadership would be autocratic. According to (Academic Conferences, 2013),this style of leadership exclusively gives the management power to make all decisions. In the above case, if the clinical supervisor was using autocratic style, all he would do is submit the already developed schedule to the juniors who would follow without questioning. Somebody else might argue that democratic would be more effective. Considering the fact that the juniors were consciously aware that no other nurse had reported that morning, it is clear that even in a democratic situation, they would easily jeopardize activities at the medical centre. According to (Benoist, 2011) the problem with democracy is that even a wrong thing will become right as far as there is a quorum Annotated Bibliography T Porter-OGrady (2015). Leadership in Nursing Practice. London: Jones & Bartlett Publishers. According to T Porter-OGrady, (2015) leadership in health care sector is very important. Any clinical leader has a responsibility to ensure that their department is working according to plan. The failure of this from the leadership creates crisis that may lead to serious dangers considering the profession involves human lives. Leadership in the health care sector needs proper structural development the same way cooperates do. This will ensure high level of professionalism. The author is a Clinical Professor and Leadership Scholar at The Ohio State University. He has done research in clinical leadership and trains medical practitioners on leadership skills. His argument, clinical supervisors are equally important to the health institution as any other member of the managerial team. Their performance affects the whole system. The author also says that institutions have been making mistakes of enrolling individuals with no medical background into supervisory roles. This is a dangerous move as such individuals will not be able to practice styles of leadership like situational. All Nurses (2012). Nursing Leadership Styles (Part III): Laissez-Faire Leaders Retrieved on March 13, 2015, from All Nurses: http://allnurses.com/nurse-management/nursing-leadership-styles-753195.html The nursing website (All Nurses, 2012) explains on an online article, that Laissez-Faire is a form of leadership that sees management keep off major decisions and let people decide. This method is effective in institutions with people who are passionate about their job and who are highly motivated. Working with people who are less liberal with this style would proof very difficult. There are people who would take advantage of Laissez-Faire and go against the policies of the institution. The website was established in 1997 by Brian Short RN and the site has help connect nurses globally. The website creates a platform for nurses to communicate and network with each other. The site gives nurses chance to share their experience from work. Jasper, M., Rosser, M., & Mooney, G. (2013). Professional Development, Reflection and Decision-Making in Nursing and Healthcare. New York City, NY: John Wiley & Sons. According to (Jasper, Rosser, & Mooney, 2013) clinical supervision has been promoted as a strategy for professional development and as a way of facilitation reflective practices and clinical decision making. It involves majorly a relationship between two people; the supervisor and the supervisee. The clinical roles played by both, needs sense of direction and it is the clinical supervisor who gives this direction. Kibourn, B. (1982). LINDA: Case study of Clinical Supervision. Canadian Journal of Education , 1-3. In his case study from the Canadian Journal of Education, (Kibourn, 1982)explains how a clinical supervisor faced leadership challenge after promotion from a junior position. The supervisor’s main challenge was handling one of the staff who had been demoted for to take the position. The use of democracy helped her in regaining grip at work. The Canadian Journal is the top bilingual publication from Canada. The journal focuses on educational issues and research. Campbe, D. F., Barth, T. D., Pölzlbauer, P., & Pölzlbauer, G. (2014). Democracy Ranking (Edition 2014): The Quality of Democracy in the World. New York city;NY: BoD –Books on Demand According to (Campbe, Barth, Pölzlbauer, & Pölzlbauer, 2014) democracy is one of the most accepted leadership styles that are globally accepted because of its “fairness”. The style is accepted all over because it gives subjects the sense of control in the running of the institutions. The author is a Clinical Professor who has specialized in leadership training. His focus into clinical leadership has seen him develop principles of leadership that have been put into practices in hospitals and other health related institutions. Leadership Theories, Styles, and Application For effective performance in the profession, nursing needs high level of leadership. Times change really fast and new trends arise on leadership. Theories have been developed to try explaining leadership in nursing. According to Singh, (2009) some of these theories work depending on individual behavioural principals, exposure among other factors. Leadership theories can are important when put in practise. Policies of an institution tend to concur with the leadership theories used in the institution. This therefore calls for a proper understanding of theories used in managing different institutions. There are five major leadership theories; 1. Great man theories- According to this theory, leaders are born and not made. Great leaders arise when there is a great need. They are determined by factors such as social class, age and physical fitness. 2. Trait theories- This theory claims that leaders are born. They inherit traits from their parents and become great leaders. 3. Situational-contingency theories- The theory explains leadership based on particular incidents that leads to one portraying signs of leadership. 4. Transactional theories- These leaders use reward and punishment. 5. Transformational theories – The theories says that leaders in this category base their work on relationship with people they lead. Leadership styles Leadership styles to be used by clinical supervisors vary depending on personal behavioural orientation, environment and leadership theory in place. Above all that is the personal traits or principals. There are four main leadership styles. 1. Autocratic. The leadership has full control and exclusivity in decision making. 2. Democratic. Leaders make decisions based on majority vote. 3. Laissez Faire. The leader lets the juniors make their own decisions. 4. Situational. Leaders stand up in particular situations and current needs. Situational leaders are very flexible. Application of leadership styles Situational style of leadership Take a case of a health centre where doctors have gone into an industrial action demanding a raise in their pay. Nurses are still reporting to work and doing their job. The patients are still reporting looking for treatment. Nurses need to be innovative in a way that will help them attend to the patients even if this may not be their area of specialization. Some patients might be suffering from minor cases that may need mere psychological play (Coombs, 2004) Clinical supervisor will have to step up and take the responsibility and play the part. Communication is one the most important factors used in leadership. As a leader, the supervisor has to motivate the juniors and show them way forward. An instance is where junior nurses find it hard to deal with the fact that they are not working with any doctor. Experience at work is vital and will have to be put in play here. A supervisor may decide to do referral to the nearby health centre. This is a perfect example of where situational style of leadership has can be used. The crisis calls for quick adjustment that will see the operations run smoothly. In this scenario, the supervisor also has stepped up from their normal position to show leadership in a different department or position. Critical thinking comes in play here too. Human life and wellness is more important than anything else. Nurses should prioritise their actions on this. Autocratic style of leadership Cases have been report of shortage of staff in health centre. Financial constraints in medical centers affect all departments. Lack of funds affects all departments in an institution. Issues that rise include understaffing, poor medical facilities, shortage supply of medicines, delays in payments of salaries and wages among other challenges. For a clinical supervisor working under such circumstances, delivery becomes a challenge. Limitations is implementing the policies of the institution affects the morale of the whole team. As a way of trying to make things work, clinical supervisors find it easily to go out of the way and use their own funds. They do this in hope of reimbursement from the accounts department. Such decisions are vital in situations where there are urgent needs. As a clinical supervisor, there are financial responsibilities that are given out. One such responsibility is making purchases in their department. These might be minor purchases but they affect the smooth running of the department. In as situation where there is no cash from the accounting department and there is a shortage in the nursing department, the supervising nurse will need to discuss with his juniors on how to raise the money to meet the current needs. At this level, the decision will have to involve all the nurses. This is an example of democratic leadership. Autocratic leadership There are people who do not have medical insurance cover. When such a patient comes to the health facility, they need to show that they are covered. Failure to do this, the person may not get the proper treatment. Take a case of a patient who comes with a critical condition and does not have a medical cover. The supervising nurse might decide to help the patient get treatment out of their own decision without consulting with the rest of the departments. Strategic Analysis and Leadership Interventions Leadership skills are dynamic. They change with change in times, challenges and level of performance. For one to be effective in their work as leader, they need commitment and passion in their work. Competency model put in practice by the leader in a work analysis will determine the success of the organization. There are several nursing leadership analysis model; they include Trauma Medical Director Leadership model, Moses Cone Health System (MCHS) among others. Trauma Medical Director Leadership model This leadership model states clearly the roles and responsibilities of the entire member. The model states clear objectives for the job requirements. Specific responsibilities for each of the members are clearly stated. In addition, the model has created a division of role into 3 individual roles. This division of roles allows completion of responsibilities and requirements at the right time. Moses Cone Health System (MCHS) This model focuses on supporting nurses that seek to grow and become leaders in near future. The model has the following goals; Ensure that the firm has a pipeline of current and future leaders Nurture and develop new leaders from the organization other than bringing new individuals. Set guideless and policies for selection and recruitment. Improve leadership performance and competency in the firm. The use of Trauma Medical Director Leadership model would be appropriate in solving the leadership problem stated earlier. This is because the conflict is caused by a leadership style that does not involve shared responsibilities and duties. The model allows division of responsibilities and this aspect would help ensure that all the nurses have specific responsibilities. This will also ensure that nobody assumes that a certain duty is being performed by other staff members. This is because every staff member will have a clearly stated responsibility. Interventions It is important to note that, long before we deploy any intervention, we need to know what performance will be needed in order patients can complement our services to them as nurses. a) Nurture a positive attitude towards work among junior nurse: Nursing involves taking care of human life. For that reason kind of attitude we possess towards our work determines their performance. Having a positive attitude will increase efficiency and effectiveness in our work and have patients appreciating our services as our fruitful outcome. (Right Management, 2012 ) b) Set departmental goals and objectives: having set goals to achieve gives a room for performance evaluation at the end of set period of the goal set. c) Division of labor. With each nurse focusing in their department, it is easier to evaluate departmental progress and implement new changes. Conclusion Leadership in nursing is not only focused on the profession aspect of nursing but rather needs a whole managerial perspective. Clinical supervisors need more than qualification in nursing. This necessitates the need for proper equipping and training of individuals planning to venture into this position. For better performance and service delivery, Clinic supervisors need to be evaluated regularly as way making sure that emerging issues in the department have been taken care of. Evaluation of performance is important also in ensuring that managerial policies are implemented. The nursing department is an implementing department that sees policies and operational functions implemented. Leadership in nursing should ensure that new and fresh talent within the department is also nurtured to ensure that there are no vacuums incase of drastic changes in leadership. Mentorship should also be a way of raising new leaders. References Academic Conferences. (2013). Proceedings of the International Conference on Management, Leadership and Governance. 33 Wood Lane, Sonning Common, RG4 9SJ: Academic Conferences Limited. All Nurses. (2012). Nursing Leadership Styles (Part III): Laissez-Faire Leaders . Retrieved March 13, 2015, from All Nurses: http://allnurses.com/nurse-management/nursing-leadership-styles-753195.html Benoist, A. D. (2011). The Problem of Democracy. London: Arktos. Campbe, D. F., Barth, T. D., Pölzlbauer, P., & Pölzlbauer, G. (2014). Democracy Ranking (Edition 2014): The Quality of Democracy in the World. New York city;NY: BoD – Books on Demand. Coombs, M. A. (2004). Power and Conflict Between Doctors and Nurses: Breaking Through the Inner Circle in Clinical Care. London: Psychology Press. Daly, J., & Speed, S. (2004). Nursing Leadership. Amsterdam: Elsevier Health Sciences. Jasper, M., Rosser, M., & Mooney, G. (2013). Professional Development, Reflection and Decision-Making in Nursing and Healthcare. New York City, NY: John Wiley & Sons. Kibourn, B. (1982). LINDA: Case study of Clinical Supervision. Canadian Journal of Education , 1-3. Nursing Times. (2008, May 1 ). Improving the performance appraisal system for nurses. Retrieved March 13, 2015, from Nursing Times: http://www.nursingtimes.net/improving-the-performance-appraisal-system-for nurses/1314790. Right Management. (2012). The Importance of a Positive Work Attitude. Retrieved March 13, 2015, from Right Management: http://www.right.com/blog/careerpluswork/2012/the-importance-of-a-positive-work-attitude/ Singh, K. (2009). Organizational Behaviour: Text and Cases. Mumbai: Pearson Education India. T Porter-OGrady. (2015). Leadership in Nursing Practice . London: Jones & Bartlett Publishers. Williams, E., & Media, D. (2015, February 23). Importance of Strong Nursing Leadership. Retrieved March 13, 2015, from Globa Postl : http://everydaylife.globalpost.com/importance-strong-nursing-leadership-30151.html Read More