Running head: LEADERSHIP PAPER

Leadership Paper Noor Tamari NUR 4287C April 06, 2014

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Introduction Creating a healthy work environment for nurses is vital to preserve an adequate nursing workforce. The nursing profession can become very stressful and lead to burnout, disability, high absenteeism, and ultimately contribute to the increasing shortage of nurses. Leaders play a vital role in the retention of nurses by shaping the healthcare practice environment to produce quality outcomes for staff nurses and patients (Shirey, 2006). For my clinical leadership experience, I was assigned to Mrs. S who is in charge of two med-surgical units. As a nurse manager, her role includes initiating and enforcing the units policies and procedures, coaching and counseling employees, recruiting and hiring staff, addressing staff concerns, assuring high quality care is performed, and maintaining a safe and compassionate work environment. The purpose of my experience shadowing Mrs. S was to observe her leadership style, various responsibilities, communication with staff members, and learn about current issues she is focusing on. The purpose of this paper is to analyze the leadership and management role and the significance of collaboration of the professional nurse. Leadership and management must go hand in hand. However, they are not the same. A leader inspires and motivates others, while a manager plans, organizes, and directs staff according to policy. Not all leaders are managers, and not all managers lead. Leaders should be active role models, exemplify a clear vision, and include and empower all staff in the professional development process (Rokstad, Vatne, Engedal & Selbk, 2013). There are different types of leaders including: transactional leader, transformational leader, authentic leader, and quantum leader. A transactional leader focuses on role of supervision and group performance. They believe that workers are motivated by rewards and punishments. A transformational leader over-achieves expectations by enhancing the motivation of followers and

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inspiring others by being a role model. They also encourage their staff to be creative and innovative. An authentic leader is passionate about creating a quality work environment and generating energy to do the impossible. They are positive leaders who promote openness. Leadership Clinical Experience I would describe Mrs. Ss leadership style as authentic. She speaks to her staff in a friendly manner. She is approachable and advocates an open door policy. She promotes openness and honest relationships with her employees. While observing Mrs. S, she asked one of the PCTs how their school was going. She feels it is important to be personable with each of her staff members so they know she cares about them. The behavior of an authentic leader builds relationships through personal expression that is consistent with values and not merely the result of a desire to please, attain rewards, or avoid punishments (Shirey, 2006). Mrs. S has a great energy and is passionate about having a quality and efficient work environment. Mrs. S also generates energy among the staff and promotes quality bedside care. She is an authentic leader because she is able to improve individual and team performance. Her unit on the second floor progressed from having poor HCAP scores to receiving the highest HCAP score for patient satisfaction in the fourth quarter. Also, if a float nurse/tech does a good job, Mrs. S or the charge nurse sends them an email at the end of the day acknowledging their hard work. Mrs. S. also has her telephone number on all the patient boards. She performs daily patient rounds on her units to ensure that high quality patient care is being given. During her rounds, she brought a charge nurse in training to educate her on what to look for when checking on patients. During her daily patient rounds, she empowers patients to play an active role in their care. One of the ways she does this is make sure patients are educated on how to use the GetWell Network. It is a hospital service that is designed to involve all patients more deeply in their care. The GetWell Network

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includes an electronic education library containing videos on specific health conditions, medications, tests and procedures, and a section for patients to learn more about their medication lists and condition. Mrs. S also informs patients that there is a section to give feedback which the manager directly receives. This is important because it allows patients to feel there is a way to contact Mrs. S if they have an issue they want addressed. Another role of Mrs. S is to take part at management meetings. I was able to attend the monthly meeting along with the patient care director and all the managers. First, they discussed al the patient falls that occurred in the past month. Each manager spoke about the fall that happened on their floor. Mrs. S discussed her patient fall. She spoke about how the patient was assessed to be a risk for fall. However, the patient refused all precautionary measures such as the bed alarm offered by the staff. Nurses from different shifts caring for this patient documented the patients refusal. Even though it is unfortunate that the patient fell, the nurses had previously documented multiple times of their attempts to prevent this incident from occurring and the patients. Therefore the hospital cannot be held financially reliable for this particular fall. Manager S. was proud of her nurses efforts in fall prevention and their proper documentation. She stated she plans on rewarding them with high-five awards. Mrs. S used positive reinforcement to recognize clinical excellence. It is important that employees feel a sense of value and satisfaction in their current position. Collaboration and interdisciplinary practice is important in the profession of nursing in order to provide safe quality care to patient. I have observed Mrs. S collaborate with the interdisciplinary team during rounds. During this meeting, the social worker and charge nurse is present so they are able to discuss each patient case. The team works together to solve problems and make important decisions. Collaboration in nursing is very important for many reasons.

LEADERSHIP PAPER

When health care providers are not communicating effectively, patient safety is at risk because of possible misinterpretation of information, lack of critical information and overlooked changes in status (JCAHO, 2005). Collaboration improves patient outcomes, reduces length of stay, increases nursing job satisfaction, and decreases costs. Professional Nurse Leadership Leadership does not only apply to nurse managers. In order to be effective, the professional nurse must also possess leadership qualities. A professional nurse carries leadership skills such as facilitating, communication, making critical decisions, critical thinking, educating, advocating, and problem solving. Professional nurses also need to delegate patient tasks and patient care assignments. Leadership skills are especially honed when assigned the role of charge nurse. Patients benefit from a nurse with strong leadership qualities. Based on my leadership clinical experience with Ms. S, I believe I can integrate some of the leadership qualities I observed into my role as a professional nurse. I will educate and empower my patients to take part in their care. As a leader, I will collaborate with the interdisciplinary team to provide safe and quality care. I also hope to participate in current hospital research studies. I believe research is a great way to influence the nursing profession by improving the ways we deliver healthcare. Another way I can influence the culture of my nursing unit is through educational opportunities. For example, I can bring in nursing journals and putting them break room for staff to read and gain knowledge and insight. As a nurse leader, I can generate energy and collaborate with my fellow nurses to promote a positive work environment and foster quality bedside care. Lastly, as a nurse I can perform volunteer work that will not only provide comfort to those in need, but help me serve as a positive role model to my community.

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References

Joint Commission on Accreditation of Healthcare Organizations. The Joint Commission guide to improving staff communication. Oakbrook Terrace, IL: Joint Commission Resources; 2005. Rokstad, A. M., Vatne, S., Engedal, K., & Selbk, G. (2013). The role of leadership in the implementation of person-centred care using dementia care mapping: a study in three nursing homes. Journal of Nursing Management Shirey, M. (2006). Authentic leaders creating healthy work environments for nursing practice. American Journal of Critical Care, 15(3), Retrieved from http://ajcc.aacnjournals.org.ezproxy.hsc.usf.edu/Fauth