In numerous regions of the industrialized universe, contemporary hospital care is confronted by numerous challenges. They range from workforce problems, varying consumer demands and expectations, monetary constraints, upsurge in demand for access to care, and matters regarding quality and health care safety. Effective governance is vital in maximizing the efficient management of care in a hospital facility. In clinical settings, effective clinical leadership has constantly been established as an important element to guarantee quality care and healthy workstations. The significance of good leadership is becoming progressively evident in health care. This paper aims to utilize diverse leadership theories to understand a common scenario within a clinical setting to advance leadership efficiency. Moreover, it explores diverse leadership forms and theories and clarifies how they are related to nursing practice.
Characteristics of an Effective Leader/Managers from Nurse Leader Interview.
The present scenario setting is in a medical unit of a dependable health institution in a public area. With minimal bed capacity at this local health facility, hospital superintendents have developed a series of work policies. The interview was conducted on a nurse leader and nurse manager working at a small rural hospital on the medical and surgical unit. A good nurse leader is somebody that can motivate others to work together in search of a mutual objective, for instance, improved patient care. From the interview, an efficient nurse leader and nurse manager have a distinguishing set of individual abilities. This nurse leader and nurse manager are frequently well-regarded in their attempts to think analytically, and communicate effectively,
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Characteristic of the Nurse Leader
Although having a strong inclination to learn is an important ability in a good nurse, putting that understanding into effective practice needs the capability to think—particularly in high—stress circumstances critically. The nurse leader portrays a highly effective critical thinking skill as a qualified nurse's most significant features. After a long period of education and training, the capacity to integrate clinical strategies and best practices is dependent on a nurse’s capability to think critically. This can be rapidly observed either positively or negatively by management, other health practitioners, and, eventually, patients. While this proficiency can be enhanced over time, it’s frequently something that comes more logically to some health practitioners than others.
Characteristic of the Nurse Manager
One of the major characteristics of the interviewed nurse manager is strong communication skills. A nurse manager’s role depends on the capability to efficiently relate with other health practitioners, doctors, specialties across other units, invalids, and their relatives. Without the capability to understand and communicate effectively, medical faults are more probable to happen, patients frequently feel deserted or misrepresented, and the whole organization may feel the impacts ( Sullivan & Garland, 2010) . By highlighting and practicing communication abilities, the nurse manager will offer reliable caution and profit to their patients, their division, and the whole hospital and their long-standing job.
Contrast of Both Characteristics
Communication and critical thinking portray numerous contrasts in different ways. On a fundamental level, the nurse leader ability to think critically, reasoning through challenges and generate cogent arguments is vital for the hospital setting. The nurse manager’s ability to think about issues and view them from a different perspectives is considered to be better. On the other hand, the nurse leader’s effective communication skills presents increased knowledge that is beneficial to the hospital setting. Communication is as much regarding paying attention as it is about conveying. Listening entails careful understanding what is articulated and not articulated. The nurse leader considers others’ arguments, stimulate other viewpoints and distil facts.
Leadership theory
A leader is a person with commanding power or influence over persons or groups of individuals, whereas leadership labels the capability to lead a group or organization toward a goal. In the present healthcare scenario, proficient clinical leadership assures a superior healthcare structure that reliably provides safe and effective care. It is then beneficial for health to recognize the leadership styles and models relevant to the nursing profession. Applying leadership forms is significantly based on each staffs’ diverse roles.
The initial concept that can be used in this scenario is the transformational leadership concept. The transformational leadership model was initially acknowledged by leadership specialist James MacGregor Burns. According to Ghasabeh Soosay and Reaiche (2015) , transformational leadership is a connection between leaders and personnel. They inspire each other to advanced heights, resultant in value system congruence between the leaders and the nurses. Moreover, a leader incorporating this concept motivates their factions to alter prospects, sentiments, and motivations to work towards common objectives. There are four elements in transformational leadership: idyllic effect, strong motivation, intelligent incentive, and individual contemplation.
Especially, transformational leadership philosophy emphasizes on revolution. The leaders who use this form are viewed as change agents who utilize their abilities and dispositions to encourage other members to realize their objectives, sharing their ideas, and empowering them. Foremost, leaders should create a connection of conviction with their members of staff. This conviction link may be ascertained by being open, just, and truthful with the personnel and inspiring them to be self-governing in their administrative roles. In the scenario, the nurse leader can use transformational leadership to motivate the members of staff at the small medical facility and accomplish the set objectives. Therefore, this will influence the personnel and enhance the level of trust amongst the members of staff.
Evidence indicates that transformational leadership influences the members of staff and obligation to the hospital. As a result of the impacts on personal and institutional results, transformational leadership may be applicable in various aspects. As the nurse leader, exhibiting competence through this style guarantees projected goals while also valuing the power. The style would also help eliminate the implementation of potent authority and encourage each individual to function as a team. Therefore, transformational leadership is of great significance and pertinent to the current situation.
Self-Assessment
The American Organization of Nurse Executive assessment tool aims to enhance, support, and lead nursing leadership. These competencies compare leadership skills such as communication and relationship skills, leadership, professionalism, business knowledge, and knowledge of the health environment. My top scoring areas were professionalism, communication, relationship management, knowledge on the health environment, and leadership, while the low scoring areas were in business knowledge.
High levels of competency were noted in nursing professionalism due to my passion and urgency to speak and learn about nursing proficiency and education. Additionally, I am an effective career planner with personal and professional accountability, ethics, and active membership in professional organizations. I am competent in communication and relationship building due to my ability to make shared decisions, influence behaviors, effective communication, and maintain a staff-patient relationship. For instance, in a nursing home, I can communicate effectively with the patients and make collective decisions to improve patient-centered care. I believe I scored well in leadership competencies because I demonstrated the value of long-life learning and learning from failures, setbacks, and success and promoted system thinking. Throughout my career in the different working areas, I have improved my competence and knowledge in the health care environment, including case management, patient safety, healthcare policy, patient care delivery models, and clinical practice. Low levels of business knowledge competency resulted from poor marketing skills and insufficient knowledge in human resource management and health care financing.
One of my strengths is a shared decision. Considerably, I engage the patient and other staff in decision making to improve patient health outcomes. Shared decision making puts the patients at the center of decisions about their care and treatment. Ideally, care decisions affect the health of the patient and the actions of the care providers. Therefore, patient-centered decision making will improve the health delivery system since it acknowledges the patient's rights and assists in making individualized and informed decisions about treatment and care. Another strength is my curiosity to learn new things. As a professional nurse leader, I am expected to demonstrate professional skills, communication skills, and practice and awareness of health and safety standards. While working in a rural hospital and nursing home, I have improved my professionalism due to my eagerness to learn new things. I am more than prepared to not only improve my current skills but also to learn new things to lead effectively in a multidisciplinary environment. Ideally, learning new things will improve my current abilities, such as care and patient observation, medical administration, and health and safety standards, to improve patients' quality of care.
I recorded a moderate level of nursing resilience regarding the Grit Score. My moderate level of nursing resilience means my ability as a nurse leader to put up with the workplace diversities has influenced how I thrive in the working environment. Additionally, this has affected my ability to lead and thrive effectively in stressful and chaotic working environments. For instance, my resilience level has led to emotional exhaustion and low personal accomplishment due to high levels of stress experienced while leading others, resulting in burnout and moral distress, among other detrimental effects.
Using Theory and an Evidence Base
The major issue facing nurse leaders currently is creating a healthy working environment. Ideally, there are challenges linked with the changing workforce and change management within the working environment, resulting in a high turnover rate, low staff satisfaction, and reduced organizational performance. Nurse leaders play a vital role in developing a healthy working environment with increased accountability and sustained healthcare improvement.
Nurse leaders have failed to directly engage with the staff and lack the necessary skills to manage increased change in the working environment. Additionally, complexity in the changing landscape has led to negative workforce impacts. For instance, Mate and Rakover (2016) argue that many nurse leaders have failed to keep the workplaces secure and safe for the nurses, thus impacting health outcomes within the health care facilities. Considerably, healthcare environments are changing, affecting leaders' ability to meet the undergoing changes' demands. Therefore, there is a need to maintain healthy work environmental standards to encourage a healthy and positive workplace through appropriate staffing, skilled communication, authentic leadership, true collaboration, and effective decision making.
Sullivan and Garland, (2010) argue that nurse leaders must engage openly with the staff through team building, training, day-to-day interactions to consistently function and achieve an improved working environment. Ens, Bazylewski, and Duchscher (2018) argue on the increasing evidence of a healthy working environment and its impacts on staff retention, satisfaction, and organizational performance. Additionally, Ens, Bazylewski, and Duchscher (2018) stated that one of the key factors that have affected the working environment is the multigenerational workforce with distinct work habits, attitudes, expectations, and beliefs. Therefore, nurse leaders need to focus on the changing landscape to employ the necessary skills to manage the working environment changes and boost staff satisfaction.
Transformational leadership theory is the most effective leadership theory in boosting a healthy working environment for nurses. The transformational leadership theory states that effective leadership results from a good relationship between the personnel and leaders. Transformational leadership inspires and motivates through passion and enthusiasm. Creating a healthy working environment and in the most conducive way to staff and patient satisfaction will demand fundamental changes in the ways personnel are deployed and how work is designed. Transformational nurse leaders are not only capable of changing the physical environment but also the practices and beliefs of the nurses. Through transformational leadership, the nurse leaders will engage with the nurses to acquire jointly held objectives. By being committed to communicating and building relationships by creating formal and two-way communication, the nurse leaders will play a great role in nurturing relationships, which will boost a healthy working environment.
Summary
Developing leadership capabilities is significant to improve individual character; it offers leaders with the essential apparatuses to accomplish success within their job as nurses. Still, developing leadership abilities is a constant expedition that starts with understanding oneself. Transformational leaders, for instance, motivate others by enhancing collaboration with to ascertain common standards. Nurse leaders come across numerous diverse circumstances each day, and no specific leadership form is appropriate for every situation. Nurse leaders should, consequently, be accommodating in their leadership forms and modify them appropriately.
References
Ens, B., Bazylewski, S., & Duchscher, J. B. (2018). Emerging Nursing Leadership Issues. Leadership and Influencing Change in Nursing .
Ghasabeh, M. S., Soosay, C., & Reaiche, C. (2015). The emerging role of transformational leadership. The Journal of Developing Areas , 49 (6), 459-467.
Mate, K. S., & Rakover, J. (2016). 4 Steps to Sustaining Improvement in Health Care. Harvard business review .
Sullivan, E. J., & Garland, G. (2010). Practical leadership and management in nursing . Pearson Education.
