Leadership when described, mainly involves the capability of assessing, developing, maintaining and changing as well, the culture of the organization and the strategic system in order to meet the requirements of the external environment. It is a significant skill, necessary for the development of organizations and developing a vision for which the individuals will want to strive for (Scully, 2015). When it comes to healthcare, leadership proves to be an effective way of navigating through the complicated environment and culture of the healthcare systems. Specifically talking about nursing leadership, it is essential that nurses develop effective leadership skills to be able to deliver high-quality care to patients with specific patient-centred care delivery (Mannix et al., 2013). As nursing leaders, the nurses have the duty to provide support and direction, participate in collaboration and coordination, motivation and developing effective communication as well. It also involves proper delegation of work and advocating for the patients in order to achieve optimal and effective patient outcomes. The importance and significance of delegation and advocacy as a part of nursing leadership will be discussed in this article.
In simple terms, delegation can be defined as one individual transferring to another individual some responsibility, authority or power to carry out a particular role or task or responsibility, whilst also maintaining the accountability for the outcomes of the tasks. Care delegation in nursing has its specific, personal and clinical significance. It helps reduce the over-all workload of the unit or team. It is of equal importance at all the levels of management – starting from the higher levels, to nurse managers, to staff nurses, to newly graduate registered nurses as well (Gassas et al., 2017). The idea and principle of delegation as a part of nursing leadership makes the nurses and the healthcare teams they work in more effective, productive and efficient in their outcomes-especially patient centred care and quality of care as well. Effective delegation is a very useful solution to handle and overcome work stresses, agitation, anger and aggression. It also helps in building more strong and collaborative relations with the staff (Sayani., 2016). The increasing demands in the healthcare sphere and the leadership roles the nurses are supposed to take in leading and managing inter-disciplinary teams and multi-disciplinary collaborations for the delivery of care to patients requires effective delegation of work and tasks. This will lead to better contemplation of the professional nursing tasks by the nurse managers as well (Yoon et al., 2016).
Advocacy can be described as the act or process of supporting a cause or proposal. It is very frequently used to develop and describe the relationship between the nurses and the patients. Advocacy for the patient in nursing leadership is defined as the promotion of, advocacy of and protection of the rights, safety and health of the patient keeping patient care-centric (Antill., 2015). This advocacy in nursing leadership involves the evaluation and assessment of the needs of the patient, identification of the goals of patient care, setting an advocacy plan for the achievement of the desired goals by the health care team and assessment of the results of the advocacy in terms of patient satisfaction and treatment goals. Advocacy as a part of leadership in nursing helps in taking action and addressing the concerns of the patient with respect to his/her care and treatment goals and help improve quality of care and provide care which is patient-centric (Tomajan., 2012). Both advocacy and the ability to delegate work are described as essential characteristics and qualities of a graduate registered nurse as a part of her leadership duty and as an effective team player to provide adequate and high-quality care to the patients.
Effective or proper delegation of care helps in improving health outcomes for patients in terms of improved quality of care and maintenance of adequate patient safety as well. For example, in a hospital setting where the head- registered nurse does not delegate her responsibilities or tasks and thinks it appropriate to do everything on her own will not be able to function effectively all the time. If she thinks it best to do everything on her own, and not delegate the tasks to her team, it will lead to a decrease in the quality of her work and a decrease in her work output as well. This decrease in work efficiency will reflect on the quality of care being provided to the patient because the same head nurse cannot be present with every patient in the ward for post-op, pre-op and provision of quality care all the time. It requires a dedicated team with different roles and responsibilities to carry out in the provision of care for a particular patient to ensure the highest quality of care. Improper delegation or no delegation of work will lead to a compromise in the quality of care being provided to the patient and thus, negatively impact the patient outcomes (Sayani., 2016). Thus, quality of care will be compromised for the patient and cause a reduction in the patient satisfaction as well. On the other hand, if the various steps of care being provided to the patient example, rounds, follow-up, post-operative care etc. are delegated to a team effectively, it will help prevent exhaustion and stress burnout for a single individual and also help in provision of adequate and high-quality of care to the patient.
Another significant aspect of care or patient outcome that can be affected with the way work is delegated in nursing care is patient safety. If proper delegation of care steps such as promptness to respond to the call button, managing pain control and staff working together to provide care in cases of reduction in falls and pressure ulcer development as a part of patient safety outcomes is done, then it helps in improving the patient safety. On the other hand, if the same work is not delegated to a team or delegated in an improper and ineffective way, and is the sole responsibility of an individual, then it will increase the number of falls for the patients and the incidence of development of pressure sores as well, thereby negatively impacting patient safety (Sayani., 2016). Thus, patient outcomes are negatively or positively impacted with the way a nursing leader or a graduate registered nurse is capable of allocating and delegating care and work to her peers and subordinates. This delegation determines the care outcomes for the team as well as helps in reduction of stress, work exhaustion and burden on the nurses as well.
It can be effectively concluded that leadership is a significant and important attribute of nursing which is required by the nurses in order to work collaboratively and in a multidisciplinary team as well. Delegation of care and advocacy are significantly important aspects of this leadership that nurses need to learn in order to be able to deliver and impart good and high quality care and maintain and improve positive patient outcomes as well. Thus, it is imperative that these leadership skills are effectively taught to the graduate RNs and they are able to practise the same in their everyday professional life.
Antill, C. (2015). Rocking the boat: the link between transformational leadership and advocacy. British Journal of Healthcare Assistants, 9(2), 93-99.
Gassas, R. S., Mahran, S. M., & Banjar, H. I. (2017). Nurse managers’ attitude and competency towards delegation in Jeddah City. American Journal of Nursing Science, 6(2), 72-79.
Mannix, J., Wilkes, L., & Daly, J. (2013). Attributes of clinical leadership in contemporary nursing: an integrative review. Contemporary Nurse, 45(1), 10-21.
Sayani, A. H. (2016). Delegation, a strategy to prepare second line nursing management in health care setting. International Journal of Innovative Research and Development, 5(13), 149-52.
Scully, N. J. (2015). Leadership in nursing: The importance of recognising inherent values and attributes to secure a positive future for the profession. Collegian, 22(4), 439-444.
Tomajan, K. (2012). Advocating for nurses and nursing. OJIN: The Online Journal of Issues in Nursing, 17(1), 4.
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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