Nursing Assignment: Reflection on Concepts Related to Leading Professional Practice
Question
Task
Written nursing assignment paper: Critical evaluation and reflection of a concept relating to leading professional practice case study (of your choice) reflection (3000 words)
Answer
Introduction
The current reflective practice explored in the nursing assignment is my understanding of concepts related to leading professional practice in nursing. It is crucial to have a theoretical understanding and evidence from research to be able to lead and transform into professional practice. As a nursing leader, it becomes essential to have appropriate learning and apply the same while practicing. In this current reflection, I will make use of theories of clinical leadership and management learned and the ways I plan to apply them for safe and effective person-centered practice. I have also included ways I developed the practice of change management and skills for leadership and change. I have evaluated my leadership and management capabilities and ways I can apply ethical management practices for myself and others.
Reflective Analysis
Underpinning concepts, theories and models of leadership and management for developing safe and effective person-centered practice
Leadership and management are integral for implementing nursing practice and towards the rendering of safe and effective person-centered practice. There are numerous concepts, theories, and models taught in this module regarding leadership which is essential for the fundamental development of the concept in professional practice (BISHOP, 2009). As per Northouse's definition of leadership, it encompasses a process to influence a group or individuals to pursue a common goal. Nursing leaders thus have to take a course of action such that they can achieve a preferred future situation and guide others to resolve complex problems. The research was undertaken by Cummings et al (2008, 2010) focussed on the transformational leadership style in nursing that focusses on people and relationships (Rokstad et al, 2015, p 20). In addition to these qualities a transformational leader needs to lead by example, hence Authentic leadership theory became functional grounded in positive psychology. The knowledge of positive leadership in enhancing the person-centered culture of care was first suggested by Kitwood (1997). This theory was established underpinning the concept of preserving personhood in providing safe and effective care. Therefore, nurse leaders are expected to motivate and guide followers towards a certain course of action. Nurses till a recent period have been led inadequately and over-managed and currently they face a host of unprecedented opportunities and challenges. The rapid transformation of healthcare organizations creates constant challenges that require an adaptive and flexible style of leadership. Adaptive leadership is often referred to as being transformational (BAGNALL, 2012). From my various learning materials, I understood that transformational leadership can motivate followers by appealing to higher ideas as well as moral values. Such a type of leader is assumed by their followers to have a deep set of internal values and ideas. Hence a transformational leader in nursing can sustain greater good as against own interests and supportive environments with shared responsibility between the leader and the team members (JONES, BENNETT, 2012). According to me, a good nurse is one who can inspire others to work together to pursue a common goal, for example, safe and effective patient-centered care. Thus, the qualities of positive leadership can inspire team members and have professional growth and confidence. Thus, each theory and concept has its positives and negatives associated with it. While the transformational style of leadership is effective in empowering self and other staff, yet to implement a patient-centric approach in clinical practice positive leadership style is more appropriate. Thus, evaluating the above theories of nursing leadership, I decided upon the development and applying a positive leadership style in my practice. These underpinning theories have moved me considerably due to their potentiality to deliver effective patient care, hence these theories will be guiding my professional practice as a nursing leader in the healthcare organization.
As per McCormack and McCance (2006), a person-centered nursing framework, which encompassed a conceptual model combining transformational and situation leadership in nursing homes was stated by Lynch et al. (2011). The benefit of this model is its integration of leadership thinking with person correctness to promote staff delivery of person-centered safe and effective care. According to the theory of situational leadership claim, there is no single leadership style that can function across all sets of behavioral settings, such as directing, coaching, supporting and delegating. Kane-Urrabazo (2006) states that leaders need to have support systems that enable staffs to empower themselves (Harrison-Dening et al, 2013, p 152). Through empowerment, it becomes easy to conduct roles in the organization. It provides nurses and as well as staff to undertake decisions and trust their own decisions while making judgments. The principle of empowerment allows contributing to a sense of worth to the carer and creates higher standards amongst nurses as per Covey (1991).This theory is applicable in practice wherewith the application of a positive leadership style it will be possible to empower staff in taking decisions and judgments, this will enable providing effective and safe person-centric care. Adhering to the role of a positive nurse, it will be possible to empower staff which in turn will enable them in undertaking effective decisions. Positive leadership in nursing will motivate employees through the facilitation of their involvement within their governance and engagement in participatory work climate. Thus, I felt that the theory of positive leadership could be applied in my professional nursing practice and could assist in getting positive results. The theory will guide me and allow to achieve my results faster in person-centered practice through the concept of empowerment. Not only me but my team members will be able to make decisions and judgments in an independent manner being empowered and have a more responsible approach towards patient care delivery.
The Bonoma-Slevin leadership model measures the degree of transformational style of leadership that is used. This model assesses the input that leaders provide their employees also including the extent to which leaders act on the ideas generated by the followers. This model categorizes leaders into four main styles. This model of leadership has a shareholder management style of leadership enabling employees to operate with high levels of independence and communication with employees regarding decision making (Castle, and Decker, 2011, p 640). This model of leadership and management can allow a high deal of flexibility for employees to work and it influences the quality of care. This model in several research has shown a positive effect on the overall quality of care. Hence, I will adopt this model for leading my staff such that they can render appropriate quality of care to their patients. Moreover, a degree of freedom as allowed in this model will provide empowerment and a sense of confidence to all staff to manage their patient care outcomes well. I feel that the learning of theories, concepts, and models of leadership will form the backbone for my patient-centric care and success as a nursing leader. Amongst all the models of nursing leadership available, this model will allow me to easily measure my capability to adopt positive leadership attributes in my professional practice (The King’s Fund, 2013). This model is crucial in professional practice as it will help in attaining my desired goals and outcomes.
Analysis and evaluation of research evidence in developing professional practice, policy, strategy and service development
Research-based evidence is crucial and critical in the development of professional practice, policy, strategy and service development. Evidence-based healthcare nursing practices are currently available for several conditions. Varied models of evidence-based practice (EBP) is available in varied clinical settings. While there are available varied types of models, there need to be steps undertaken to adopt the same in professional practice. I feel with all the learning and knowledge gained in the process of translating research into practice is valuable and can enable the implementation of strategies. The AHRQ Patient Safety Research Coordinating Committee developed a conceptual framework for maximizing and accelerating the transfer of research results from the Agency for Healthcare Research and Quality (AHRQ) patient safety into practice (WEST, 2013). To analyze and evaluate research evidence for assimilating into professional practice, policy, strategy, and service development, I realized three stages that I need to encompass. Firstly, I will need to create knowledge and distill them from several available policies and strategies. The relevant research findings from policies and strategies available needs to be put into action. The specific practice recommendations will reveal ways research can be applied in practice. I will distill knowledge from my perspective. I will select that policy and strategies which can be applied within my healthcare organization. For this, I will analyze and evaluate the various policies and strategies applicable in my healthcare organization and which will enable me to render effective patient-care.
The knowledge I will select and analyze to apply will be diffused into my professional opinions. I will disseminate the knowledge gained by identifying staff and employees requiring such knowledge. I will try to guide my professional practice from the synthesis of knowledge gained by evaluating policies and strategies (CLARK, 2009). The updated policies and strategies on nursing available on the Scottish nursing and midwifery professional boards website will guide my practice (SCOTTISH GOVERNMENT, 2012). The implementation process will ensure the transfer of knowledge from EVP is adopted and applied. Hence, I will need to continuously upgrade and update my knowledge such that I can undertake informed decisions and adopt appropriate strategies within my organization.
Exploring person-centered approaches to facilitate the leading and transforming of change in practice
Exploring all the approaches to be applied in the professional domain, I realized person-centered approaches are crucial for the facilitation of leading and transforming change in practice. To attain nursing-specific outcomes, the person-centered approach needs to be adopted. The principles and values surrounding person-centered care are included in contemporary nursing and healthcare strategies as well as policies. Person-centered approaches in nursing focus upon an individual's needs wants desires and goals to the central of nursing care and process. The core process of person-centered care is formed based on knowing the patient as an individual, being responsive, delivering meaningful care, respecting individual's values, preferences and needs, fostering trusting caregiving relationships, emphasizing upon freedom of choice, promotion of emotional and physical comfort and engaging the individual's family and friends and deemed to be appropriate (WONG, CUMMINGS, DUCHARME, 2013). To include a person-centered approach, there might be needed including transformation change in practice and leading such a change.
While being a nursing leader in the healthcare organization, and given the benefits associated with person-centric care, it is crucial to direct all staff and employees towards focusing on the same. In case the organization has a different model as compared to a person-centric care model, then the change management model directed as person-centric care has to be adopted. Skills that are necessary for leadership and change as well include interpersonal skills, skills in bringing about change, assertiveness, negotiation, being able to manage conflicts and self-awareness. I feel that I possess many of these skills apart from self-awareness. I feel this process of reflection will enable to bring out self-awareness skill in me. I realized that a change management model has to be applied within the organization such that person-centric practice development can be attained. There are various change management models and in this scenario, Lewin's change management model will be applied. It will involve three stages of unfreezing, changing and refreezing. I will apply this model, by first visualizing the changes that are needed in the situation and then apply the change management aspect, such as training employees, guiding them regarding the change procedure and asking them to focus on person-centric approach and then refreeze the situation, such that nursing staffs can behave as per the new behavioral norm. Once the staff and employees can follow and adhere to the new processes and procedure then I will regard it as success being a nursing leader. This process will enable me to bring about transformation and change within the organization and my followers.
Critical understanding of processes for developing self and others through the facilitation of learning
In the practice of nursing, it is essential that I continuously develop myself and others by facilitating learning. The role of a leader in management is to ensure that employees and followers deliver safe and effective person-centric care to patients. To implement the same, appropriate learning strategies and steps must be adopted for myself and the team. It includes a continuous review of policies and strategies made available at the NHS and within the healthcare organization (KIM, & NEWBY-BENNETT, 2012). The process of learning will be accommodated by reviewing the skills and knowledge of staff and employees present at the healthcare organization. During our nursing course, we are taught several concepts, theories, and models, but as we enter professional practice, we tend to forget our theoretical learning. For developing oneself and others in a team, it is crucial to facilitate the process of learning. I will take initiative in this domain by initiating the learning process.
Lifelong learning is regarded as a necessity in the nursing profession. As per the Institute of Medicine (I.O.M.) nurses should be engaged in lifelong learning. Accreditation Board needs to coordinate with nursing schools as well as healthcare organizations. There needs to be a collaborated approach amongst the instructor with nursing students, ENs and faculty members to continue with lifelong learning. As a nursing leader, I will assume the central role in updating curricula such that I can create capacity for and creating commitment towards lifelong learning as the new approach within the healthcare organization. UNESCO stressed that on the verge of the 21st century, continuous learning is a necessity in the domain of health. There is tremendous stress on lifelong learning that encompasses official as well as non-official learning. To incorporate such global trends, I will try and include the process of assessment within my healthcare organization abiding by NHS policies and procedures. Such assessments will include the latest aspects of health and updated policies and strategies to be used and applied by a nursing practitioner. This will allow updating skills, knowledge and facilitation of the lifelong learning environment as a principle.
Impact of leadership within their context of practice
In the current healthcare scenario where the healthcare environment is facing such tremendous challenge, strong leadership is necessary for realizing the vision of a transformed healthcare system. Though the public does not view nurses to be leaders, and not all nurses begin their career to become leaders, nurses need to design, implement, evaluate and advocate ongoing reforms to the system as needed. My learning from this module reveals that nursing leaders need skills and competencies to act as full partners with physicians and other professionals in the healthcare organization. Nursing practice and research need to be continued for the identification and development of EVP for improvising care rendered. However, I feel such policies need to be adopted and tested across the health care system. Being a nursing leader in the healthcare system, I will try and translate new findings from research into the practice environment and nursing education in policy and practice. A nursing leader needs to deliver roles as a full partner in transcending at all levels of the nursing profession and collaborate with present skills and competencies within the profession. Full-time partner implies involving greater roles and responsibility for identifying problems and recognizing waste areas, devising and implementing a plan for improvisation to make adjustments to realize established goals. Nursing leaders in the context of practice will act as strong patient advocates and undertake decisions to improve the delivery of patient-centric care.
Acting as a full partner in the health policy arena requires effective reconceptualized roles and being accepted as leaders. I was a nursing leader will try and contribute to the shaping of policies and develop them rather than accepting them as they are. I will effectively engage in the political process and work cohesively to deliver outcomes for my entire team. I will also try and serve actively to the advisory committee, commissions and boards where policy decisions are being made for better healthcare systems and improvising patient health care outcomes. I will try and build new partnerships with clinicians, business owners, elected officials, philanthropists, and the public to help in the realization of improvements.
Conclusion
In conclusion, the role of nursing leaders is tremendous and crucial in healthcare. Nursing leaders need to continue their lifelong learning and also apply the same for their teams. However, documents must be maintained in continuing lifelong learning for nurses. I will maintain self-reflection journals such as this one for my learning. This will help me to refer to them whenever needed and also maintain a collection of integral learning, concepts, and theories. This will form the basis on which I develop further learning during my professional practice.
References
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Castle, N.G. and Decker, F.H., 2011. Top management leadership style and quality of care in nursing homes. The Gerontologist, 51(5), pp.630-642.
CLARK, C.C. 2009. Creative Nursing Leadership and Management. Jones and Bartlett.
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SCOTTISH GOVERNMENT. 2012. Professionalism in nursing, midwifery and the allied health professions in Scotland: a report to the Coordinating Council for the NMAHP Contribution to the Healthcare Quality Strategy for NHSScotland [online]. Available at: http://www.scotland.gov.uk/Resource/0039/00396525.pdf
The King’s Fund. 2013. Patient-centred leadership: Rediscovering our purpose [online]. London: The King’s Fund. Available at: http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/patientcentred-leadership-rediscovering-our-purpose-may13.pdf [Accessed 02 April 2014].
WEST, M.A. 2013. Creating a culture of high-quality care in health services. Global Economics and Management Review, 18 (2), 40-44.
WONG C A, CUMMINGS G G, DUCHARME L. 2013. The relationship between nursing leadership and patient outcomes: a systematic review update. Journal of Nursing Management. 21 (5) pp.709-24.
