Leadership and Management in Nursing

This is the fifth article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare

“If a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed-sore, it is generally the fault of not of the disease, but of the nursing. I use the word nursing for want of a better” (Nightingale, 1860, p. 8). While Nightingale stressed the impact of one’s environment to promote healing, Virginia Henderson aimed to establish on the fundamental needs as a knowledge base to guide Professional nursing practice. Henderson emphasized on fourteen components required for effective nursing care which includes: breathing normally, eating and drinking adequately, elimination of body wastes, movement and posturing, sleep and rest, select suitable clothes-dress and undress, maintaining body temperature, keeping body clean and well groomed, avoiding dangers in the environment, communication, worship according to one’s faith, work accomplishments, play or participate in various forms of recreation, and learn, discover, or satisfy the curiosity (Fernandes et al., 2015). Her division of the fourteen components acknowledged patient needs with a holistic approach that is applied through the nursing process in a clinical setting.

Observing and analyzing my leader opened my eyes to the amount of responsibility and knowledge one needs to be a great leader. These responsibilities that were witnessed during the shadowing project included aspects of role modeling, mentoring and educating fellow staff and colleagues alike. My leader possessed a well-rounded amount of experience, skills and knowledge about nursing and her management role. All of these aspects we observed and I feel my leader is not only strong nurse, manger and mentor; all these aspects contribute to making her a fine and valuable assets to our organization.

This paper aims to address and discuss about the leadership and management of the nurse leader interviewed. This experience was a great opportunity to witness first hand how a nurse leader cultivate and manage their staffs in real life setting. Moreover, it provides a great access to gain insight and knowledge about nurse leaders’ vital responsibilities and role diversities in the organizations they work with. Nurse leaders pay more specific and close attention in handling the staffs and most importantly, patient care.

In this essay I will discuss the leadership style of 3 nursing leaders, which I chose from Nursing Leadership DVD (Orazietti & Singh, 2014). I will then describe impact the leaders ' style has on improving nursing care, organizational processes, and inter-professional collaboration. In addition, I will provide some examples of a change process or difficult situation which leaders encountered. Finally, I will explain how I have dealt with difficult situation involving my colleague and one of physician in the hospital department where I worked. Throughout this essay I will analyze what leaders should have done differently. 3 Leaders which I have chosen were Debra Bournes from group 1 because of her political and administrative success, Mina Singh from group 2 because she is renowned for her educational style at York University, and Esther Green from group 3 because she is the sound and knowledgeable practitioner.

The Principles of Nursing Practice were introduced by the Royal college of Nursing (RCN) with the input from the Department of Health, the Nursing Midwifery Council, service users and user organisations. They indicate to the public what they should expect from nursing practice, no matter if they are a colleague, service user, or the relatives or carers of the service users. The Principles explain what makes up the safe and effective nursing care, and encounter the aspects of behaviour, attitude and approach that underlie good quality care. They are important to health professionals, in delivering safe care because they indicate how to follow the principles, to be able to assist you in reflecting on your practice and development as a

identify the next line of action to deliver quality and effective nursing care, relate with patient in friendly manner always so as to gain their trust and all these actions are usually coordinate by the most senior nurse on duty

Nursing guidance is a complex but essential part of the nursing workforce. Guidance can come in the form of management and in the form of leadership. The two terms are often used interchangeably, but do not always mean the same thing. The nurse manager is often someone who has authority from the facility to be in management. The nursing leader may not have authority over other nurses, but may be a strong guide in the workplace for other nurses and nursing staff. Nursing as a profession is ever-changing and increasingly challenging. Nurse managers are tasked with an enormous variety of functions in their respective workplaces, budgeting, scheduling, hiring, disciplinary actions, implementing facility policies and procedures, and the

As a Family Nurse Practitioner teamwork will be uniformly important. This will be extremely important as a novice nurse practitioner. I will need to rely on mentors and experienced nurse practitioners for advice. In addition establishing a rapport with my patients and working together with them as a team is very important. This will enable me to take a leadership role as a provider and take suggestions on how to better manage their health.

Leadership is encountered in every occupation and in everyday life. In nursing, leadership is not only prevalent; it is crucial to patient care and employee satisfaction. The nurse leader that was interviewed was a nurse at the Newport Hospital in Newport, Washington. This is a small hospital in a rural community. She is a charge nurse in the acute care unit, as well as in charge of leading infection control in the hospital. With these roles comes a lot of responsibility, and tasks that must be completed in a timely manner to create a workflow for the rest of the staff. There is a lot of juggling and balancing everything that is included in all of those positions.

Having effective leadership and management is essential for any health care facility to operate. Both leadership and management are an essential part to delivering quality healthcare to the patients that they serve. The foundation to any facility is nursing which must be led by the best leadership and management available for its continued success. This is the key to helping that facility to achieve a high level of patient and employee satisfaction. Having adequate staffing for any facility is an issue that many facilities face due to the shortage of nurses. This paper will compare and contrast nurse leaders and managers thoughts with the use of contract employees to assist with the shortage of nursing staff. It will also show support with theory, principles, skills, and roles of the leader versus the manager. It will also identify the writer’s personal philosophy of nursing as well as explain her own personal style of leadership.

There are many skills, traits, and behaviors one must possess in order to be an effective leader. The American Organization of Nurse Executives (AONE) has compiled a list of competencies and skills that nurse leaders should be proficient in. The five competency domains identified by AONE (2011) are “communication and relationship building, knowledge of health care environment, leadership skills, professionalism, and business skills” (p. 3). The competency domain I believe is essential for one to possess in order to be an effective executive nurse leader is communication and relationship building. The competencies AONE (2011) listed under the domain communication and relationship building are “effective communication, relationship management, influence of behavior, ability to work with diversity, shared decision-making, community involvement, medical staff relationship, and academic relationships” (p.3). I will discuss how Tom (nurse manager of a psychiatric unit) did not meet these specific characteristics under that domain.

Arnett (2013) emphasises care needs are unique to each individual and vital for preserving patients’ health and well being. This links into Roper-Logan-Tierney (1999) model of activities of daily living identifying 16 activities essential to maintaining human life, including: eating and mobilising. Fulfilment and maintenance of these 16 activities indicate an individual is healthy and gives a focus for nurses to deliver targeted patient centred care. This is emphasised in Essence of Care (Department of Health, 2010) which reaffirms meeting essential needs of patients is the main focus point of nursing in contemporary practice. The Essence of Care is made up of 12 categories which health care professionals focus on in order to provide thorough patient centred care. These categories include: bladder, bowel, continence care and personal hygiene. Kitson et al (2013) identified the nurse’s role as being one of promoting good patient

Leadership and management are similar; however, have different definitions. Some leaders have an innate ability to learn whereas others may have to learn how to lead. A manager may not be an effective leader. A leader must possess certain characteristics to be effective. Communication, fairness, and leadership knowledge are the top three characteristics of an effective leader.

Nurse’s roles are expanding according to the need of the patient and society. A nurse has to play roles from bed side nursing to the prevention of disease and illness, educating patient, families and collaboration with different healthcare teams. Howell (2012) indicated