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Critical Essay

Clinical leadership has emerged in a revolutionized manner from this pandemic as it demands for high quality patient care and collaborative efforts for the management of this pandemic. The leadership is the process of influencing the subordinates in the clinical setting to meet requirements that is placed on them as it ensures high quality patient care (Stanley & Stanley, 2018). This critical essay aims to provide an insight of nursing leader qualities and their way of work during this time of pandemic.

Effective leadership at this time specially is very important to ensure effective care delivery to the patients who have COVID- 19 and also for others who are not infected by this virus. This essay identifies four major problems from the case scenario given based on the four different categories. These categories are conflict management, delegation, change management and clinical leadership. The appropriate style of clinical leadership that is required for “clean are” management of staff and patients is critiqued in this critical essay along with the problem solving cues. It also emphasize on the big changes for the staff members as a clinical leader to ensure that there is a maintenance of safe environment for temporary staff members, patients and the students.

The team leader for the clean area (no COVID – 19 infection) has a major role to perform in planning different ways that will facilitate effective care delivery to the non- COVID- 19 patients in the changed inpatient setting. The staff members assigned under the clinical team leader for the clean area are two RN’s who are new to this ward, one RN who has been not in this profession from past three years, one EN who is well experienced and a newly registered EN. The team is also inclusive of three UG nursing students who are employed as AIN’s, six student nurses who are on clinical placements, one ward clerk, ne wardperson and one cleaner.

The first major problem identified in the scenario given is of the rising conflict between the team members that will have a significant impact on the care delivery to the patients. The conflict is that some of the nurses who are senior to the student nurses are refusing to percept that the students do not have enough time and they believe that the students must be well- prepared prior to coming to the ward because the patient care and safety is primary purpose. This issue can be managed by conducting a meeting with all the subordinates that includes the nurses and students. The most effective clinical leadership style that should be facilitated in this scenario for conflict management is transformational style of leadership. This is an advantage because it inspires and motivates the nurses to recognize the better opportunities that will assist in achieving a goal of clean area patient care (Fischer, 2017).

The transformational leadership style enables the leaders to excel at conflict management and resolution. It is very important to have a strong and clear relationship between the team members as it ensures cohesiveness and collaborate working. In this meeting, the nursing leader will allow the input from all the subordinate members and would motivate the nurses to take ownership of their roles. The nurses will be made aware of the lack of experience and the inculcation of only theoretical knowledge that these students have so that they can better understand the situation. The transformational style of leadership is the management style that enables the workers to think beyond just acting on the work assigned and also it makes the leader and the subordinates understand attitude that facilitates greater integrity at the workplace (Krepia et al., 2018). The nurses will be influenced to help these students in working with the patients and allowing them to work only as per their scope of practice. This style is also effective in a clinical setting as it allows the engagement of followers to create a connection that helps in raising a level of effort and moral aspiration in both the students and the nurses (Bakhtawari, Saeed & Zaidi, 2016).

The second problem identified under the category of delegation is that a staff member who is practicing under the scope of practice does not appear to be competent in working. This means that the nurse lacks a motivation in performing the assigned task. this problem marks the low category of nurses’ competence and confidence within the workplace. Delegation is effective for everyone and when a nursing leader delegates then the nurses become more confident because they believe that their talent and competency is being recognized by the leader (Baddar, Salem &Hakami, 2016). The two most important explanatory constructs of the nursing practice are leadership and confidence.

The ineffective care environment is the result of the lack of a relationship between confidence in delegating and a leadership style to the nurses. The transformational leadership style is effective in the delegation of tasks because it stimulates the subordinates to work effectively using their competent skills and the critical thinking skills (Yoon, Kim & Shin, 2016). It motivates the nurses to take ownership of their roles and allows them to be accountable for their work. If one of the nurses who is practicing within the scope of practice is not competent in doing a task assigned so the nursing leader will motivate her to apply her skills and perform the task that ensures high quality of patient care and safe care delivery. The nurses are expected to utilize individual competence and qualification while performing a task. Rhabi, khalid and Khan (2017) argues that the democratic leadership style is more effective in motivating the team members in meeting the challenges that are for short time like this challenge of the nurse not appearing to be working with competence.

The nursing leader must be confident in delegating a task to the nurse and ensuring that the nurse performs with full dedication using her competency skills. High competency skills are required to work in a clean area in order to prevent the spread of infection and to ensure that the patients are safe and healthy. Thus, a transformational leadership style is best suited for motivating the nurse to perform using best of her skills and to work for the patient’s interest (Edwards et al., 2018). The nursing leader will talk to the nurse and will motivate her to work effectively using her competency skills and to develop observable competencies to improve the patient outcomes.

The third issue is identified from the category of change management that is the difficulty in introducing the major change in workplace area that has been implemented in this unit. The workplace area has been divided as the clean area and dirty area thus it is important to introduce this change effectively. The change management requires effective leader who is able to deal with staff directives and also provide supplies and manpower for the patients. the leader must assist the team members in making them understand their new roles and responsibilities. The leader must keep the team members informed and must calm their fears about this pandemic situation on coronavirus by addressing their questions. Thus, this type of change management requires democratic style of leadership. The democratic style of leadership is effective in the change management because it allows the input from the staff members and a proper communication session can be held (Janicijevic, 2017). The nursing leader will conduct a meeting wherein all the staff members will be invited to design a plan for effective work protocol in this pandemic resulted changed setting.

This change in work practice will be introduced there and the input for their opinions will be invited from each member of the team so that each and every member participate in the team meeting to plan care and to update on the patient care. The fears will be calmed and they the entire team will be motivated at one time so that each and every member gets equal share of motivation to perform their best level of work. Actively managing the process of change holds paramount importance to the patient safety and the delivery of adequate resources and manpower will also be performed. According to Jones et al. (2017), transformational leadership style is most effective change management style because it provides strategic direction for the changes within the health care environment that is effective in providing safe environment for the workers and the patients. The democratic style of leadership is most effective because it allows the input from each team member and the introduction for change in the area can be best done when all of the subordinates equally participate in this setting (Lumbers, 2018).

The nurse managers’ attributes plays very important role in promoting the change in the ward and they must show their belief on the health care workers and also empathize with the staff nurses in achieving goals that are self- explored. All these attributes of the nursing leader reflects the democratic style of leadership that is most effective in introducing the change in the ward setting. This application of a nurse managers’ leadership style with the organizational culture of a changing healthcare system in pandemic situation is the reflection of their work abilities (Alharbi, 2017).

The fourth identified problem belongs to the category of clinical leadership that is several members of the team are reluctant in providing direct patient care because of the fear of getting sick from the Coronavirus. This issue can be best managed using effective clinical leadership skills of spreading awareness and ensuring that the staff understands the flow and supply of PPE for them. The nursing leader would use several measures to mitigate their risk of falling sick from the infection of the infected Coronavirus patient (Frost et al., 2020). The democratic leadership style is most effective in educating the nurses to take this as an opportunity and channel it to create a center of excellence. The democratic leadership style would allow effective communication where the subordinates can keep their reasons of being reluctant in providing the direct patient care. The nurse leader can then provide the coaching and direction to make themselves safe and the patients safe in the clean area. The democratic leaders are appropriate for this purpose because they are confident in their abilities and they are able to make the shift with their team members (James & Bennett, 2020).

At this time, the nurses require leaders who would advocate for them so the nurse leader would advocate for the shortage of PPE if any so that they can ensure the safety of the staff members and the patients. The staff members needs to have their leaders who ensures that they will be safe as they care for the patients. The nursing leader will motivate them to perform their best and provide direct patient care by ensuring that they are full covered with PPE and are working with precautions that would minimize the risk of infection of Coronavirus (Shinners&Cosme, 2020). They will be motivated by making them pledge to work together to fight against Coronavirus and to ensure their primary purpose of patient safety.

The conclusion drawn is that the two major leadership styles that ae democratic leadership style and transformational leadership style are most important to be used at this time of pandemic. The health care setting has been changed after the admission of COVID- 19 positive patients and their area has been named as dirty area because it has the highest risk of infection spread. The transformational leadership style will be effective in managing the issues that are related to the conflict resolution and delegation because it is the management style. The rest two issues that are based on change management and clinical leadership can be well dealt with the democratic style of leadership as it allows the inputs from the subordinates and also facilitates effective communication between the team members that is very important for patient safety. The leadership strategies mentioned are in compliance with the nursing leaders’ attributes.

References

Alharbi, A. Y. (2017). Leadership styles of nurse managers and their effects on nurse and organisational performance, issues and problems. International Journal of Information Research and Review, 4(9), 4516-4525.Baddar, F., Salem, O. A., &Hakami, A. A. (2016). Nurse Manager's attitudes and preparedness towards effective delegation in Saudi Hospitals. Health Science Journal, 10(2), 1.Bakhtawari, N. Z., Saeed, M. A., & Zaidi, E. (2016). Effect of transformational leadership style on choice of strategy in conflict management in the service sector of Pakistan. Global Management Journal for Academic & Corporate Studies, 6(2), 90.Edwards, S. T., Helfrich, C. D., Grembowski, D., Hulen, E., Clinton, W. L., Wood, G. B., ... & Stewart, G. (2018). Task delegation and burnout trade-offs among primary care providers and nurses in veterans affairs patient aligned care teams (VA PACTs). The Journal of the American Board of Family Medicine, 31(1), 83-93.

Fischer, S. A. (2017). Developing nurses’ transformational leadership skills. Nursing Standard, 31(51).

Frost, D. W., Shah, R., Melvin, L., de Juana, M. G., MacMillan, T. E., Abdelhalim, T., ... & Cavalcanti, R. B. (2020). Principles for clinical care of patients with COVID-19 on medical units. CMAJ.James, A. H., & Bennett, C. L. (2020). Effective nurse leadership in times of crisis. Nursing Management, 27(3).Janićijević, N. (2017). Organizational models as configurations of structure, culture, leadership, control, and change strategy. Economic Annals, 62(213), 67-91.

Jones, P., Polancich, S., Steaban, R., Feistritzer, N., & Poe, T. (2017). Transformational leadership: The chief nursing officer role in leading quality and patient safety. The Journal for Healthcare Quality (JHQ), 39(3), 186-190.

Krepia, V., Katsaragakis, S., Kaitelidou, D., &Prezerakos, P. (2018). Transformational leadership and its evolution in nursing. Progress in Health Sciences, 8(1).Lumbers, M. (2018). Approaches to leadership and managing change in the NHS. British Journal of Nursing, 27(10), 554-558.

Rahbi, D. A., Khalid, K., & Khan, M. (2017). The effects of leadership styles on team motivation. Academy of Strategic Management Journal, 16(3).Shinners, J., &Cosme, S. (2020). COVID-19: Perspectives from nurses across the country. The Journal of Continuing Education in Nursing, 51(7), 304-308.

Stanley, D., & Stanley, K. (2018). Clinical leadership and nursing explored: A literature search. Journal of Clinical Nursing, 27(9-10), 1730-1743.

Yoon, J., Kim, M., & Shin, J. (2016). Confidence in delegation and leadership of registered nurses in long‐term‐care hospitals. Journal of Nursing Management, 24(5), 676-685.

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