Within this reflective essay, I will demonstrate my understanding of the leadership skills which are required to make clinical decisions. Leadership qualities are discussed along with the evaluation of supervision and delegation skills required to maintain the secure nursing practice. I will demonstrate the management approaches and comprehension of the requirements of medical professional improvement along with personal improvement. To understand leadership in the nursing profession, a certain day of practice has been selected to demonstrate a clear and precise understanding of different criteria stated. Throughout this day of nursing practice, I was required to observe a period of care for treatment of three patients by a senior nurse, two support staffs and doctor, while under the supervision of my tutor. I worked with my tutor to observe one health care assistant, nurse and a doctor. The characteristics of observation signify that I require observing the activities of nurse and the health care professionals for about 60 minutes with three 20 minutes slots. This gave me perfect opportunity to understand different tasks in the area of nursing and professional practice which assisted towards my management and leadership abilities. I have observed into one key model of reflection which is Gibbs reflection model. It inspired me to think prudently regarding the experience. It includes five aspects which are description, feelings, assessment, conclusion and an action plan. By Jasper (2003), Gibbs reflective model is a cycle of actions for learning. However, the identities of the individuals observed have not been revealed owing to the aspect of confidentiality.
Description Throughout the observation in the nursing, I had the chance to assess three patients. The first patient was 53 years old man who came to the process identified as Paracentesis. It is the removal of liquid elements from abdomen produced by Ascites and afterwards ready to release once the liquid was cleared up from the abdomen. The second patient was a 63 years old man who was suffering from a headache. The third patient was 54 years old man who arrived with unitary swathe infection. The first thing I observed that the night staff had transferred the duties to the day staffs. After finishing the handover, it was time for the first patient to remove the liquid element from the abdomen. The senior nurse has taken the notes and felt that he was the priority, which she told to her superior. The nurse went around to the patient and observed at the drug chart. Before starting the treatment, she also monitors the vital indications such as blood pressure, pulse rate, oxygen saturations and respirations of the first patient. While the nurse was observing the first patient, she noticed that doctor had not approved albumin. She went to look for a doctor who was attending the second patient and proceeded to request the doctor to recommend albumin. The doctor carried out the vital part while the nurse was monitoring and recording the vital indications. The nurse made sure that the staffs are with the first patient all the time, demanding more staffs to attend to the other patients
In the next twenty minutes, I observed that nurse asked the clinical support staffs to obtain urine bottle for the third patient as he was the second priority. Under the direction of the superior, the nurse has assisted in treating the third patient. In the similar context, the third patient is also treated, and time to time, the nurse has assisted the staffs in taking care of patient where needed. However, since there was a shortage of staffs, conflicts arises within the team, resulting in tension. The senior sister has managed the staffs carefully by proper communication and delegation of tasks. She was confident in her job and reminded about the policies of healthcare to the staffs to detriment ill behaviour and ensure safe clinical practice.
In the last twenty minutes, I have observed the treatment of the second patient. The second patient is being released after recommendations provided by the doctor on medications. Furthermore, by an instruction from the doctor, the nurse has explained the aftercare activities to the second patient. The staffs were also to assist by taking the patient down to the main entrance through wheelchair. The staffs also contracted the senior nurse whenever any confusion arises throughout the treatment process.
When I was first observed about taking care of patients, my initial feeling was concern about treatment as there were very few staffs. However, I also felt that the superior has identified the hard work of the staffs and put confidence on the subordinates. Since the subordinates have previously played this role within the team, it was adequate for them. Furthermore, as they had taken care of patients many times, it has developed a beneficial connection with the superior. Besides, it can be observed that the superior has always assisted in putting any kind of anxieties of the subordinates into perspectives. For instance, throughout the initial setting up of removal of liquid elements from the first patient, the staffs has felt quite nervous as what if they had not got every equipment and tool required. However, the support staffs were quite professional in front of the patient and at the same time were quite worried about passing the wrong drug or equipment. Although there was nervousness throughout the treatment procedure, I felt that they have performed the tasks in a confident manner. I felt that the biggest concern of the subordinate came from the responsibilities given to her and she also felt stress under extreme pressure to make everything correct for the first time. There was a certain level of uncertainty among the team member as there was limited supply of staffs but since there was proper communication between support staffs, senior nurse it has inspired proper cooperation. She communicated with firmness in her behaviour, and the charisma in her behaviour, while she informs the staff of NHS vision showed enthusiasm and passion, which motivated another member of staff to emulate her. Her character builds commitment and trust within the team. She listened actively and reassured the staff that they would be supported all through the shift. She contacted the site office, and more nursing staffs were sent to support the team.
While observing the patient care, I feel that the senior nurse was completely conscious regarding the skills required while making decisions on the patients. He did not find it hard to delegate the authority. However, I felt that there is required to be more self-confident to perform the nursing practice. Nagelkerk (2005) suggested that self-confidence led to admiration and acknowledgement as an individual and as a nurse. Throughout the experience in nursing, observation assisted me to enhance my decision making. For instance, I have watched how they have taken care of the first patient in the liquid removal procedure while attending to other two patients. It took on a leadership role. Leadership is a process that is used to influence and move a group of people towards creating a vision and achieving goals through inspiring and motivating them (Barr and Dowding, 2016). Leadership is different from management because management focuses on the system, order and control to maintain stability (Dignam & et. al. 2011). Despite the dissimilarities, there is overlapping between the roles of a leader and a manager in clinical practice. Hence the NHS Leadership Academy (2013) stress that all nurses need to learn management skills to become effective leaders because all nurses are leaders as the influences patient care and promoting change in the health improvement. Leadership is important to all nursing student as it prepares them for the responsibility and accountability when they qualify especially in the third year of transition into practice (Rosser, 2014). In support, the Cognitive learning evaluation theory echoes the importance of extrinsic motivators in practice and education to strengthen leadership learning in practice. Leadership in health and social care is important in the culture of the organisation; however, it is noteworthy to consider the contribution of leadership to organisation culture as regarding the significant “unhealthy and dangerous “lack of quality leadership in Mid Staffordshire. Therefore, the development of leadership skills is fundamental at an early stage in developing professionals to provide safe and effective patient care (Francis 2013).
By evaluating the observation, autocratic style of leadership behaviour was demonstrated. The autocratic leader does not negotiate decision making and control with members. This approach is appropriate in the conflict situation where clear and direction communication is required for quick decision making. However, when used for a long time, it may result in barrier in communication, lack of motivation and reduced morale. Conversely, in this situation, democratic leadership style where open communication is encouraged will not be appropriate, although it will promote shared decision making and activated team where every member feels valued. However the decision-making process may waste valuable time and may further cause more frustration (Pepin & et. al., 2010).
Delegation skill is important in leadership because it is a decision-making process that is required in health care organisation. In nursing, it is an essential competence and part of the nursing role, to share the workload within the team. However, the nurse remains responsible and accountable for the decision to delegate and how the job is done (Nursing and Midwifery Council, 2006). Effective delegation is a way of developing skills, promote team working and help to achieve more. As a third year student, I am going to use mentoring to help me develop my delegation skills. It is evident that mentoring is useful where more senior and experienced staff works with a less experienced person to support their leadership learning (Alleyne & Jumaa, 2007). I am going to use action learning as a resource to help develop my leadership style. Action learning is a group formed of peers to reflect and support each other; they meet under the supervision of a facilitator to set objectives, review progress and share experience it is evident that it is successful in helping individuals to apply theory into practices following an engagement in leadership programs.
As a nurse, it is essential to me that skills continue to be developed, whether as a student or as a qualified professional. By the Groves & et. al., (2008), constant professional development is a lifelong learning for people and team. The learning should satisfy the requirements of patients and provide health consequences and priorities of NHS and must allow health professionals to meet the complete potential. This can be achieved by reflection and action. It is a procedure through which one can encourage someone to accomplish the objectives. Constant professional improvement opens the doors to career advancement from extensive viewpoint. As a student, I have observed that reflection is a very positive instrument. It has assisted in highlighting fields for personal improvement in areas which were not ostensible when essentially finalising an episode of care. In the example of observation of the caring of patients, reflection has recognised a variety of fields which require being enhanced. Student nurses are likely to write reflections to show to the tutors about the learning and demonstrating visions into becoming a heath professional. As a student, I also require concentrating on the leadership abilities particularly the communication skill, teamwork and delegation of responsibility. These are the vital abilities which are required for effective teamwork in health care environment. Besides, it is also essential to use the proper leadership style to motivate the employees and to ensure cooperation within the team.
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Through the reflection, three key needs are identified which are communication skill, emotional intelligence and delegation of responsibility. At first, as a part of constant professional development, I will need to enhance my communication ability. Communication skills are essential for my leadership development because it is the core of delivering quality, compassionate and safe care for the patient. Ineffective communication, which leads to poor co-operation and co-ordination of care, is a major cause of errors and adverse events in patient care (Wong & et. al., 2009). Poor communication in leadership may lead to team members having a different perception of the situation which may lead to conflict communication. Therefore, I will need to focus on how I communicate. I will learn to listen to others so that I can understand any situations and make the appropriate decision. To achieve this, I will need to reflect regularly using a reflective model. Preceptorship programme will be useful to develop my communication skill when I newly qualified. This is a formal support system for newly qualified graduates, and it is important during the transition period. I will use the Clinical supervision programme available. Personal and professional development review.
The second key need for professional development is teamwork which is crucial for nursing profession as well as for effective leadership to encourage positive healthcare consequences. Effective team working is an essential factor in successful leadership. In support, The Code, Nursing and Midwifery Council (2006), states as nurses you must work effectively as part of a team. Therefore, this is important for my development as a newly qualified nurse. In other to achieve this, I will assess a course of study on team building. It is evident that team building training has positive effects on leadership development and organisation improvement. Engaging in development assessment centres which involve different type of feedback process, group exercises, and writing of reflection will support my leadership development. Action learning in a group meeting under the supervision of a facilitator to set objectives, review progress, share experience and support each other will enhance my leadership development. Practising my team working skill in practice in different context and situation will support my development. Applying the team leading skills acquired in training into my practice will help my development. When I qualify, I will engage in job rotation system to encourage my leadership development. I will also involve in reading books and articles on developing my team working skills. The time frame to achieve this is within nine months (Bramhall, 2014).
The third important skill identified through reflection is the delegation skill. It is important in leadership because it is a decision-making process that is required in health care organisation (West & et. al., 2015). In nursing, it is an essential competence and part of the nursing role, to share the workload within the team. However, the nurse remains responsible and accountable for the decision to delegate and how the job is done. Effective delegation is a way of developing skills, promote team working and help to achieve more. As a third year student, I am going to use mentoring to help me develop my delegation skills. It is evident that mentoring is useful where more senior and experienced staff works with a less experienced person to support their leadership learning. I am going to use action learning as a resource to help develop my leadership style. Action learning is a group formed of peers to reflect and support each other; they meet under the supervision of a facilitator to set objectives, review progress and share experience it is evident that it is successful in helping individuals to apply theory into practices following an engagement in leadership programs. The developmental assignment will help in my leadership development. This is learning through experience rather than formal training. It is based on the giving challenging assignment and feedback.
Since constant professional development is crucial in healthcare, once I am qualified, I will set various objectives and enrol in staff development courses. Some of the objectives will be to enhance additional abilities and to enhance the experience in nursing. The courses will assist in updating my abilities so that I can pursue my career with confidence as a qualified nurse. Moreover, I will further my improvement on delegation, leadership role, communication and decision making as it will progress me further throughout my career in nursing.
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Rosser, E., 2014. What role can education play in developing leadership? Bournemouth University. [Online] available at: http://dx.doi.org/10.12968/bjon.2014.23.17.952 [Accessed 27 January 2017].
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