Effective nurse leadership is fundamental to patient outcomes more so for vulnerable patients. Every patient in the delivery room, both mother and child, can be considered as vulnerable but the vulnerability is augmented when the mother also happens to be a teenager (Cavazos-Rehg et al., 2015). The instant essay will canvass the SON competencies of professionalism and professional values, communication and critical reasoning. The outcomes will be evaluated based on the scenario regarding a teenage mother delivery. During a teenage mother delivery, a variety of professionals need to work together as professionals and also as human beings so that their various inputs work together, without any conflict, for the benefit of the patients .
Part I: Leading Through Collaboration
The Scenario
The situation on focus takes place in the delivery room where after several hours of labor, an African American teenage mother was delivering in a community hospital. Several layers of vulnerabilities were involved in this scenario. First, the patient is African American, a segment of the community that research has shown have relatively poor health outcomes than the general population. The patient also happens to be an expectant teenage mother-to-be which create vulnerabilities (Cavazos-Rehg et al., 2015). Finally, there is the child who, by virtue of the teenage birth stands a higher risk of negative outcomes including a higher rate of mortality. The team involved include the APRN who also acts as a certified nurse midwife (CNM), two midwives, a pediatrician and an RN who specialize in infant care. The intended patient outcome was to ensure a safe delivery resulting in a healthy mother and child.
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Evaluation of the Leadership Role
With the instant scenario taking place in the delivery room, the medical officer in charge of the entire exercise was the CNM who was also in charge of the other midwives. However, there was also the pediatrician who was primarily there specifically for the sake of the infant. With there being two teams with one focusing specifically on the baby, there was a lot of potential for conflict more so when major decisions were being made. Further, with the patient being African American, there is always the underlying presupposition on the part of the patient that the attention being given is insufficient (Cherry & Jacob, 2016). It is important to note that when it comes to patient satisfaction with a focus on principles of health equity and social justice, even what the patient believes matters.
The CNM applied inter alia the concepts of competencies of professionalism and professional values, communication, and critical reasoning to ensure the eventual success of the procedure. For a start, the CNM ensured that no matter how heated the situation became, all communication remained civil and professional. The need for proper and formal communication was crucial because team members were not from the same department hence there was potential for conflict (Yoder-Wise, 2019). Professionalism and professional values also came to the fore more so in the situation as it was easy to focus more on the welfare of the baby and ignore the immediate health needs of the mother. The CNM kept reminding the team that there were two patients in the room, not one. Finally, critical reasoning was applied more so when there was a contrast between what the pediatrician thought was best for the child, and what the CNM thought was best for the mother. Through critical reasoning, the two of them found a middle ground resulting in a successful procedure.
Management of Staff and Resources
It is evident from the example above that two teams, the midwifery team and the other being the pediatrician’s team has been deployed to ensure the smooth delivery of the baby. The CNM in charge had to make special arrangements specifically of the instant delivery. Normally, in the community hospital where the delivery happened, human talent is a very limited resource. In most cases, the ratio of patients to a single nurse is relatively high and personal evaluation is commonly adjudged based on the number of patients attended (Yoder-Wise, 2019). It would thus have been normal for a single midwife, not even a CNM to attend to minority-race mother delivering in the community hospital. It was a sign of good nurse leadership for the CNM to organize for the teenager to have the delivery team described above.
Further to the overview above, it is important to note that all forms of care are relational in nature hence it is not just about the professional qualification of the nurse but the personal situation of the nurses themselves. For example, when there is a very high patient to nurse ratio, then the nurses will be under pressure and will need to prioritize issues (Cherry & Jacob, 2016). It is during such prioritization that minorities and vulnerable groups fail to get the level of care that they need. Further, caregiving also involves impersonal relationships and a strained nurse may not be able to relate properly with patients. It is inter alia for this reason that minority patients such as African Americans experience health outcomes that are seemingly lower than the rest of the population (Cherry & Jacob, 2016). A nurse leader can bring about change in the instant scenario through advocacy for the improvement of available resources more so when it comes to human talent. There are only so many patients that a nurse can handle competently hence when resources are stretched, having the available teams work harder does not solve the problem per se.
Reflection and Conclusion
During nurse leadership, situations will arise where standard procedure is not good enough and exigent measures are necessary. Such a scenario comes about when a vulnerable patient with several layers of vulnerabilities is being assisted. In such situations, the nurse leader’s competence, both as a nurse and as a leader becomes a matter of life and death for the patient. In the instant scenario, a minority patient of minority age was undergoing delivery hence creating a lot of potential for negative outcomes. The CNM in charge was able to assemble a team to alleviate the crisis. It would, however, be much better if, through advocacy, more resources were availed in managing vulnerable segments of the community so that vulnerable patients do not have to be exceedingly worried about negative outcomes.
References
Cavazos-Rehg, P. A., Krauss, M. J., Spitznagel, E. L., Bommarito, K., Madden, T., Olsen, M. A., ... & Bierut, L. J. (2015). Maternal age and risk of labor and delivery complications. Maternal and Child Health Journal , 19 (6), 1202-1211.
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management . New York: Elsevier Health Sciences.
Yoder-Wise, P. S. (2019). Leading and managing in nursing . St. Louis, Missouri: Elsevier.
