Running head: NURSING LEADERSHIP IN CLINICAL PRACTICE

NURSING LEADERSHIP IN CLINICAL PRACTICE

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May 3, 2011
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Introduction

In nursing management, leadership styles remains significant and crucial for the

development of effective nursing service delivery team that is aimed at the satisfaction of the

clients needs. Through leadership model there is empowerment by instilling principles of care

aimed at improvement of their patient care and hence achievement of institutional objective as so

far as nursing service delivery is concerned. The leadership principles provide a leadership

background to the staff to enable the develop effective accountability, decision making skills and

professionalism in their duty and service delivery.

Success in leadership development depends on element of sharing authority

accountability and communicating effectively to the subordinate staff and involving them I

multiple tasks concerning improvement of the nursing services. Nursing leaders play an

important role in innovation and mentoring of the nursing staff by ensuring his leadership has an

impact on many and is accepted by his team members. She incorporates her staff through

effective communication and discussion of the problems facing the organization and how she or

he intends to solve them, she or he listens for the opinion of others before making the final

decision .the decision made is then communicated to the staff who are then equipped with the

necessary skills needed to affect change and lead the organization towards change (Sully &

Dallas, 2005).

Health care system leadership remains a challenge to the nurse leader since its composed

of subsystem characterized by complexity and fragmentation with an aim of delivering quality

health care to its clients who are the patients. In this context of quality services then leadership,

effective communication and management principles, theories and nursing concepts remains
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crucial and hence the nurse leader should come up with policies to achieve this, hence nursing

leadership remains the key to ensure quality in health care service delivery,( Goleman D. 2005).

Leadership Principles and Effective Communication in Nursing

The challenge of the nurse leader is to ensure that the institution, the nursing staff and

other health care team remain accountable for the clinical quality risk issues and malpractices

experienced in the health sector. It’s her role to identify opportunities to improve quality of

healthcare rendered to patients and ensure they are up to standard as so far as professional

standards and institutional objectives are concerned, this is through involvement of subordinate

nurses in quality improvement through effective communication (Sully & Dallas, 2005).

In day to day communication nurse leaders should facilitate clarity and understanding by

being aware of some of the key factors that can be a hindrance of effective communication.

Communication depends on many factors among them is the languege used and the means by

which the message os transmited influence how its percived by the recipient.the languege used

by the leader submits him to critical analysis,certain words and phrases potray emotions and

affects the ability of the leader to communicate with others in a constructive and positive way.its

said that an entire communication can be akltered and affected by a single phrase or word hence

altering the interuction already established between the leadership and the staff (Patterson et al.,

2002).

Listening is crucial if the management has to maintaining an effective communication

with its subordinate,Leaders are expected to pay attention to their staff when communicating

their grievances such as lack of enough facilities to deliver nursing care this should be

demonstrated by maintaining eye conduct, leaning forward this promotes motivation of the
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subordinate nurses as they feel respected.the leader should demonstrate encouraging behaviour

by consenting to what the subordinate nurse is trying to communicate so as to show interest in

the conversation and encourage continuity (Sully & Dallas, 2005).

He or she should ask facilitative questions to demonstrate understanding of the message

being passed.when receiving response to a question possed all the listening skills should be put

in practice,the nurse leader should then acknoledge the staff concerned and approprite action

shuld be taken to address the problem in question that is their should be feedback to the message

passed.approprite response to questions possed by the staff displays the nurse leader as

intelligent and his leadership is percieved to be effective translates to perception of good

leadership (Sully & Dallas, 2005).

Strickland (2000) maintains quality is a freedom from defects with value aimed at

achieving customer expectation. Nurse leaders ensure standards of care and professionalism in

delivery of nursing services by ensuring there are both upward downwards and horizontal

communication between the nurses serving in the delivery of the services. Hence the importance

of effective communication remains fundamental when dealing with doctors, patients, nurses and

other health care delivery teams. Miscommunication always results to misunderstanding hence

causing misdiagnosis, low performance that leads to patient suffering. It’s therefore important for

the nurse leader to equip themselves with communication skills in order to competently

supervise their subordinate staff in delivery of care (Patterson et al., 2002).

Nurse leaders manage many roles including giving instructions to team members,

developing skills of new nurses, sharing needs of patients, establishing goals and assigning

duties to the nurses and ensuring implementation of individual tasks. Patients must always be
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approached with a caring attitude what is commonly referred to as therapeutic communication so

as to raise their self esteem and promote healing process as they feel appreciated. Members of

health care team should be given clear instruction as to what the organization objectives are and

be encouraged to work together as a team towards achievement and this should be communicated

to them as early as possible and frequently reminded of the objectives and mission of the

organization (Sully & Dallas, 2005).

Nurses should be in a position to give the doctor an accurate report about a patient’s

health condition so as the doctor takes an appropriate action to help restore the health of the

patient. According to Senge (1994) effective communication does not only refer to sharing

information and instructing the subordinate staff on what is expected of them but it does include

the style in which the nurse leader pass the information. Intimidating behavior as seen among

nurses and physicians still remains a big threat to effective communication.

The act of taking talking rudely to subordinate by some leaders, maintaining the

dictatorship sort of leadership and allowing only downwards flow of information without

listening to the reaction of others, out talking doctors and failing to listen to them effectively to

what they are instructing in itself is intimidating and threat to achievement of the health care

delivery goal. This goes in line with display of emotions and negative body language in the

process of delivering services to both the staff and the patients hence killing self esteem of others

(Strickland, 2000).

Misfortunes of ineffective communication can be solved by nurse leaders by ensuring

their subordinate receives clear and effective instructions pertaining their significant role in

delivery of nursing care and duties so as to have a smooth running daily operation. A good nurse
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leader facilitates effective running of the team she is in charge of and focuses on her

responsibility area for example the ward. He or she should be in a position to inspire his or her

subordinate and motivate her team members to work harder, since the dynamic of the team and

its effectiveness depends on the team leaders (Senge, 1994)

The nurse leader should be an easily identifiable and approachable by the subordinate so

as to facilitate exchange of information. In the current world nurse leaders aim to have a

democratic kind of leadership where by their staffs are always free to come and share during

designated time commonly known as open door policy. This has been credited with increase in

upwards communication between staff and their leadership hence sharing of ideas and consensus

in decision making whereby individual opinion is put into consideration to arrive at the best

solution to a given problem (Patterson et al., 2002).

Modern nurse leadership incorporates the mentoring principles whereby a new nurse on

the staff is seen on one to one basis and supported, she is given the nursing mission, policy

statement and the objective of the nursing department in line with those of the hospital and

supported to adapt to the organizations environment. Problem arising from the staff or leadership

are identified early and interventions made early so as they are not left to accumulate and get

worse. Despite the fact that modern nurse leaders have busy schedules ,involving regular

meetings and administrative duties she or he has to find time for her staff so as to discuss the

existing problems and come up with solutions to them.

The nurse leader is expected to share out his or her vision with the staff and project his or

her enthusiasm to members of his or her team for them to work towards achievement of the

vision; this will help him or her gain success in leadership. Though variety of communication
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can be utilized personal approach has been found to be the most effective, research has it that

employees feel recognized and appreciated when the team leader addresses them directly than

when other means of communication are used.

Leaders with better emotional stability and intelligence get it easy to achieve the best

from their subordinates as opposed to those with labile emotions. They motivate their staff and

always seek for a common ground to solve their problems and conflicts, manage stress through

communication and provide guidelines for team development. Leaders through effective

communication not only concentrate on managing the nursing staff but also create an

environment of cohesion and creativity among the nursing staff.

Good communication between nursing staff and the leadership make it possible for the

nurses to deliver their services full hence aiming at attaining self actualization in their career,

hence realizing their potential capacities and ability to serve others in their best interest.

Research has it that well motivated people are always happy; self motivated to perform to

increase their productivity and develop a sense of team work. Leadership involves the ability to

encourage your subordinate to look at life on a brighter perspective and maintain a positive

attitude even in time of difficult maintaining a winning attitude and avoiding giving up as they

work harder towards achievement of their goals.

In order to achieve results as a nursing leader, one needs to inspire his or her staff so as to

get the most of their talent and maximize their productivity. This is possible through maintaining

a friendly working environment where everybody is happy, free of stress and there is the ability

and freedom for one to give voice to his or her views constructively.
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A leader needs to be assertive in his management of the nursing staff ,he should be in a

position to stand up for his decision with an aim of achieving the nursing proffessional standards

and institutional objectives are meet even though the stand taken may not be in ageement with

many.a good leader should be able to express to his nursing staff their mistakes and what is

expected of them as so far as delivery of nursing care is concerned openly and be able to stand

up for his view as per the requirement of the basic standards without compromising quality.the

ability to be assertive should not be mistaken by abusive character and aggressive nature of some

leaders as personal discipline and that of the other party is always maintained in assertive

leaders.assertive people always arrive cat a compromise based on the available evidence of

practice.

Helping clients to understand organizational objectives ,how they contribute to

achievement of this objectives ,giving feedback to nurses on how their departments are

performing as it concerns the achievement of organizational objectives and strategic plan and

ensuring you remin visionary and trust worth as a nursing leader should be the aim of every

nurse leader.leaders should know that effective communication is an element of leadership that

promotes trust and confidence of the subordinate in their leadership.

In aplying the principles of leadership a nurse leader shoul know herself or himself and

should always aim to improve on his or her weak points this is achieved by effectively listening

to what others perceive you to be and what they describe your weakness and strength to be.Do

self study on yourself and continuosly update your nursing leadership skills so as to meet the

standarnd and requirement of the current society without compromising quality and develop

positivce self attributes.

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As a nursing service delivery leader one should be familier with what is expected of them

in that position and also should have an understanding to what nursing pertains so as to be in a

position to know wrong practice and correct practice.one should be well versed with thfe

standards of proffessionalism in nursing proffession and know the dos and donts of the nursing

proffession.He should be in a position to understand the needs of his employees and the

necessary interventions required to meet their expectations (Zimmermann, 2002).

The nurse leader is expected to drive the organization and the nursing proffession to a

better position than he found them and should always remain accountable for his action incase

things go wrong or good without blaming others for their misfortunes.He should involve in

research so as to discover new ways of doing things that are beneficial to the organization and

nursing proffession at large (Huston, 2008).

Decision making by a nurse leaer should be sound and timely,as the team leader in

nursing he or she needs to carry out consultative discussion with other nurses concerning an

issue facing them so as to come up with a sound well reserched decision that is acceptable to

all.He should ensure that his decisions are not one sided and they should cut across the line

geared to achievement of the organizations objective and mission for delivery of health care.He

should ensure faireness and avoid making decisions that are oppressive to the subordinate staff

(Russell, 2006).

The nurse leader should be va good role model in so far as time keeping,attendance to

duty and communication with the clients is concerned ,she should as much as possible try to

practice the standards she would expect from her subordinate so as they can emulate her

character.its said that the subordinate will believe what they see from their leader and not what
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they hear hence it’s the resposbility of the nurse leader to set a good role model to the staff.he

should be the first one to work towards achievement of the organizations objective before

compling the subordinate to do it.(Huston, 2008).

You should always know your subordinate and sincerely care for them bearing in mind

their social welfare as low motivated and stressed workers are likely to have a lower input hence

affecting the out put.its important to always know why the employee is behaving the way she is

maybe coming late to work or being rude to client try and interogate the person get to the root

cause of the problem and solve the problem from the root.Dont be overeactive incase

asubordinate has committed a mistake instead try to correct the mistake in a humble and

respectiful manner (Russell , 2006).

As a leader you should keep your workers informed of the new happenings in the

proffession always update them on the seminars attended the requirement of the organization and

the new standards of practice.their should be free flow of information both horiwontal,upwards

and downwards,give the employees a chance to air out their feeling and their solutions to

existing prob lems so as to promote democracy and sharing between different cadre of

nurses.Free communicAatin between management and the subordinates promotes worker

motivation (Morden, 2004).

As a team leader you are expected to have an element of accountability ,ownership and

responsibility in your subordinates so as to help them carry out their proffessional responsibility

without fear .you should demonstrate understanding of their needs and the environment in which

they are excuting their duties and show concernAlmays be accountable to them in terms of
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finances how it has been spent,always inform them why you are taking a given decision or stand

so as they can understand why they should join you.

You have to ensure that tasks are understood supervised and accomplished this is

achieved through effective communication,listening effectively to both verbal and non verbal

communication of the employees.when passing the information and instructions on performance

of a given task always ensure you maintain clarity so as the message is understood.Ask the

employees if they have understood and try and demonstrate if possible so that they get exactly

what you need.Always remain available for supervisin and clarification incase its needed by the

subordinate (Morden, 2004).

Lastly as an organizational leader you have to train your people as team so cas cultivate

team work as they both work towards achievement of the organization objective.Incoperate all

departments together and ensure free interuction between members of different department

giving them a chance to give their view on what they feel would improve the organization.

Conclusion

Leadership and communication are two interelated aspects of management that cannot be

separeted hence for effective leadership one needs to have skills of effective communication so

as to be able to interuct well with his or her subordinate without causing conflict.leaders are

therefore encouraged to create good communicatin channnels in their organization so as to

ensure efficience. In an environment characterized by advancing technology and increase in

diseases as a result effective communication by nurse leaders on the current practices remains the

most essential element to respond to upcoming needs as well as situational crisis likely to occur

like fire outbreaks. Nurse administrators have a role to play in articulating nursing services
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uniqueness and in current corporatized health service delivery system. The administrators assist

their subordinate and colleagues in an organization in ensuring maximum outcomes in delivery

of nursing services and distribution of the necessary resources required to execute the nursing

tasks.
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REFERENCE

Drucker, P. F. (1999). Management Challenges for the 21st century.1st ed. New York, NY:

Harpercollins Publishers Inc.

Goleman, D. (2005). Emotional intelligence: Why it can matter more than IQ. New York

Bantam Dell X.

Hayden T. Renaissance resources: Brunswick county, NC. The Star News. Available at

www.wilmingtonstar.com [Accessed May 1st 2011].

Marquis, B. L. & Huston, C. J. (2008). Leadership Roles and Management function in nursing:

Theory and application. Philadelphia, PA.

Morden, T. (2004). Principles of management .Farnham: Ashgate publishing.

Patterson, K. & Grenny, J. (2002). Crucial conversation: Tools for talking when stakes are high.

New York: NY: McGraw-Hill.

Russell, C. (2006). Management and leadership for nurse administrators. Sudbury, MA: Jones

& Bartlett Learning.

Senge, P. M., Kleiner, A., Robert, C., Ross, R. B. & Smith, B.(1994).The fifth discipline

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Doubleday Dell.

Strickland, D. (2000).Emotional intelligence: The most potent factor in success question.

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Sully, P. & Dallas J.(2005). Essential communication skills for nursing. Philadelphia, PA:

Elsevier Health Sciences.

Zimmermann, P.G. (2002). Nursing management secrets. Elsevier Health Sciences: Philadelphia,

PA: Elsevier Health Sciences.