Introduction

Leadership is defined as an interactive process in which a clinical nursing leader undergoes several collaborative and interactive sessions for empowering and motivating the staff as well as the patients (Chen et al 2018). Leadership is a skill that helps a nurse to deliver patient-centered quality care. It enables a nurse to use critical thinking skills and make effective clinical decisions for the beneficence of patients. Acquiring the principles of clinical leadership influence a nurse to deliver high-quality care to the patients. Healthcare and nursing is a critical profession. The nursing leaders face several patient dilemmas that require them to use their critical thinking skills. An efficient nursing leader can make decisions while analyzing the consequences of those decisions.

Collaborative practices are a core function of the clinical nursing. A patient must be treated effectively and collaboratively by active communication and participation. Clinical leaders that utilize collaborative practices, critical thinking skills and reflective practices tend to deliver effective and safe care to the patients. The assignment aims to use the principles of clinical leadership in a collaborative environment and clinical reasoning processes to identify the areas of concern for the patients and deliver safe and effective care to them.

Health-Related Priorities and Concerns for The Patient

The clinical reasoning cycle uses critical thinking skills to collect information about the patient, process that information, develop an understanding to the patient's condition, plan interventions, evaluate the interventions, and reflect to the process (Croft et al 2018). Brendan Penn is a 25 years old male who was admitted to the hospital following an accident. He had a compound fracture in the right femur bone and closed fractures in the right ulna and radius. He had a surgery for his fractures which was followed by infection in his leg. He was provided with antibiotics and the wound is now recovering. But, he requires significant care and regular dressing for the wound. He have a previous history of anxiety and now he has gone from being withdrawn and tearful to angry and agitated.

Brendan Penn requires acute nursing care from a multidisciplinary healthcare team. According to Bucknall et al (2019), collaborative practices from a multidisciplinary healthcare team divide the workload among nurses and reduce the risk of errors. Penn requires special attention for his health-related priorities which are wound management and anxiety control. Moreover, elements of safety and quality for Penn are the major concerns for the collaborative nursing team. Wound management and Anxiety control are two different specializations of healthcare hence Penn requires individual assistance for his wound and anxiety. A mental health nurse will be appointed to control and manage anxiety for Penn and a nurse specialized in traumatic or wound care will be appointed for wound and infection management. According to the stage of developing an understanding for the patient's problems in the clinical reasoning cycle, the major area of concern for Penn are fracture recovery, wound management and infection control and anxiety control.

Scope of Practice and Opportunities for Collaboration

The multidisciplinary healthcare team will include an RN, members from the mental health department, orthopedic department and trauma and wound management department. According to Hegney et al (2019), it is always effective for the healthcare management to divide workload for greater management of the patient’s problems. A nurse specialized in wound care cannot help a patient with anxiety or depression. Similarly, a nurse specialized in mental health management cannot provide assistance related to infection control and fracture management. An RN can provide basic assistance to the patient but she cannot provide specialized assistance with competence (Sheridan et al., 2018).

According to the standard 6 of the registered nurse standards for practice NMBA (2017), the registered nurses are expected to practice within their scope of practice. Nurses that practice beyond their scope not only risk their professional lives but also risk patient’s safety and wellbeing. Healthcare is a dynamic process and slight negligence or misconduct can lead to mortality or morbidity (Sheridan et al., 2018). Since, Penn already has an infection in the leg so it is important for nursing leaders to assign wound and infection management to a specialized nurse. A multidisciplinary healthcare team that follow collaborative practices must have a nursing leader to guide and direct them toward effective communication and patient management (Bucknall et al 2019). Nursing leaders can enhance competencies in patient care and it can thus result in reduced hospital stays and cost savings.

The multidisciplinary healthcare team for the management of Penn requires significant collaboration and cooperation. Primarily, the wound management nurse needs to collaborate with the orthopedic nurse. According to Stott and Wells (2016), an orthopedic nurse is a nurse that helps patients with musculoskeletal conditions such as arthritis, fractured bones, joint replacements and osteoporosis. However, these nurses are not skilled in wound and infection management. A nurse specialized in traumatic care must be approached and collaborated to manage the wound for the patient. According to Goldberg and Quinlan (2020), a trauma nurse is a nurse who has a specialization in infection management, wound management and injury treatment.

A collaboration between the orthopedic nurse and the trauma nurse can minimize the risk of infection for Penn and this can bring up positive and safe results for him. Moreover, Penn has a condition of anxiety which is indicated by his symptoms of withdrawal, teary eyes, agitation and aggression. A mental health nurse is specialized in dealing with patients suffering from conditions such as depression, anxiety, eating disorders and other mental health conditions. A collaboration with the other two nurses can help the mental health nurse to analyze the patient’s condition better and this can improve both the patient safety and quality (Olsson and Landgren 2020(. Collaboration of an RN as a nursing leader can ease the process of communication and this can enhance patient results.

Principles of Clinical Leadership in Supporting Rn Role in Collaborative Practices

According to the NSQHS standard of communicating for safety standard ACSQHC (2019), the nursing leaders are expected to maintain system and collaborations through effective communication with the care providers, patients, multidisciplinary teams, clinicians and families of the patients. According to Massey, Chaboyer and Anderson (2017), effective communication is required throughout the nursing care as it reduce the risk of health deterioration. Effective communication acts as a bridge for sharing critical information related to the patient’s condition while transitioning the patient’s care (Massey, Chaboyer and Anderson 2017).

The RN has a major role as a nursing leader to enhance and maintain communication and collaboration in practice. Effective communication can not only enhance patient safety and care but it also enhances patient satisfaction and decrease the risk of negligence or medical error. However, Lambert et al (2017), have stated that working in collaborative multidisciplinary teams can be can lead to conflicts and mismanagement. The presence of an RN as a nursing leader can minimize the risk of conflicts and maximize information exchange among the multidisciplinary teams. An effective nursing leader can develop a supportive environment that can motivate every member of the multidisciplinary team to perform better and effectively.

Having an RN as a team leader can develop confidence within the team members. It can encourage the team members to have open discussions about the patient conditions and treatment priorities and this can improve patient safety and care. According to standard 3 of the registered nurse standards for practice NMBA (2017), the registered nurses are expected to undergo a continuous process of learning and development of self and others. This can enable them to hold accountability and responsibility which can thus motivate them to undergo effective critical thinking and decision making processes. A nursing leader should always continue a series of development and learning to enhance competence. Educating and informing the multidisciplinary team members about the mental health of Penn can motivate them to be empathic and supportive toward Penn and this can ease recovery for him.

Opportunities for Development in Terms of Scope of Practice and Clinical Supervision

There are several opportunities for the personal and professional development of scope of practice and clinical supervision for me and other team members. It is the responsibility of a nursing leader to maintain and establish systems that promote comprehensive care toward the patients. Having a team focused on patient supervision and scope of practice can lead to comprehensive and safe care to the patients. According to Perry, Henderson and Grealish (2018), a nursing leader needs to engage in practices that provide supervision over the nursing team. Although collaborative practices reduce the risk to patient health and safety but improper supervision and control over the team members can bring up health risks to the patients (Perry, Henderson and Grealish 2018).

Moreover, it can leave things unnoticed and unrecognized. For example: sharing of information among the orthopedic nurse and the trauma nurse for Penn can speed up the recovery. However, if the nurses fail to share relevant information on time then it can make the infection worse and reduce the pace of recovery. Lack of supervision can reduce the information exchange. However, proper supervision to the multidisciplinary activities can regulate the flow of information exchange. I need to engage myself in proper team supervision and patient supervision to minimize the health and safety risk to patients.

According to Benton et al (2017), it is always important for the nurses to identify their scope of practice and function accordingly. The nursing leader needs to divide roles and responsibilities according to the nurse's scope of practice. I must learn about the roles and responsibilities of different nurses in the multidisciplinary teams so that I can help them with their roles and responsibilities. Informing every nurse about their role can minimize clashes and conflicts and this can lead to greater patient satisfaction and health improvement.

Opportunities for Improved Patient Outcomes Through Multidisciplinary Team Engagement

Multidisciplinary team engagement can bring up positive outcomes for the patients. According to NSQHS standard for comprehensive care ACSQHC (2019), the nursing leaders are expected to deliver collaborative and comprehensive care to the patients in order to prevent and manage risks of harm. It is coordinated delivery of healthcare and it is focused on the priority problems of the patients. Coordinated care and open engagement among the multidisciplinary teams can make the nursing care more goal oriented (Yousefi et al 2019). Nursing leaders that work on increasing engagement among the multidisciplinary staff bring up patient-centered and effective care. Team members can face conflicts such as lack of trust and personal clashes with each other.

However, a nursing leader should motivate the team members to engage in practices that provide them space for open communication and interaction. According to Weiss, Co and Bagian (2018), open communication and interaction among the team members without disrespect and dishonesty can lead to an effective healthcare team. Respect, empathy and support toward the team members as well as the patients can encourage positive information exchange and engagement. As an efficient nursing leader, I will try to develop a culture of respect, empathy, collaboration and cooperation among the multidisciplinary teams to enhance their efficiencies as an individual team.

Conclusion

Nursing leaders play an active role in the management of multidisciplinary teams within the healthcare environment. A patient can have multiple healthcare issues that can require specialized assistance. The assignment informed the key principles of nursing leadership as collaborative practices, effective communication, encouragement and support and respect and empathy. Collaborative and comprehensive practices among the nurses of multidisciplinary units can increase patient satisfaction and decrease the risk of harm. Further, open and interactive communication among the team members can develop trust. Open communication can enhance the flow of information exchange and it can increase patient safety and quality in healthcare. Further, respect and empathy toward the team members create opportunities of active engagement within the multidisciplinary teams and this can indeed reduce the risk of harm to the patients. Encouragement and support through proper supervision and engagement can further enhance patient outcomes and safety. Nursing leaders play an important role in functioning of the multidisciplinary teams by enhancing collaboration, personal and professional growth of self and others.

Reference

ACSQHC. 2019. Partnering with consumers standard. Available at {https://www.safetyandquality.gov.au/standards/nsqhs-standards/partnering-consumers-standard} Accessed on {24 may 2020}.

Benton, D.C., Cusack, L., Jabbour, R. and Penney, C., 2017. A bibliographic exploration of nursing's scope of practice. International Nursing Review, 64(2), pp.224-232.

Bucknall, T., Fossum, M., Hutchinson, A.M., Botti, M., Considine, J., Dunning, T., Hughes, L., Weir‐Phyland, J., Digby, R. and Manias, E., 2019. Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting. Journal of Advanced Nursing, 75(6), pp.1316-1327.

Chen, S., Dzewaltowski, D.A., Rosenkranz, R.R., Lanningham-Foster, L., Vazou, S., Gentile, D.A., Lee, J.A., Braun, K.J., Wolff, M.M. and Welk, G.J., 2018. Feasibility study of the SWITCH implementation process for enhancing school wellness. BMC Public Health, 18(1), pp.1-11.

Croft, H., Gilligan, C., Rasiah, R., Levett-Jones, T. and Schneider, J., 2018. Thinking in pharmacy practice: a study of community pharmacists’ clinical reasoning in medication supply using the think-aloud method. Pharmacy, 6(1), p.1.

Goldberg, S. and Quinlan, P., 2020. Professional nursing practice in the orthopedic care setting. In Perioperative Care of the Orthopedic Patient (pp. 419-425). Springer, Cham

Hegney, D.G., Rees, C.S., Osseiran‐Moisson, R., Breen, L., Eley, R., Windsor, C. and Harvey, C., 2019. Perceptions of nursing workloads and contributing factors, and their impact on implicit care rationing: a Queensland, Australia study. Journal of Nursing Management, 27(2), pp.371-380.

Lambert, V., Matthews, A., MacDonell, R. and Fitzsimons, J., 2017. Paediatric early warning systems for detecting and responding to clinical deterioration in children: a systematic review. BMJ Open, 7(3), p.e014497.

Massey, D., Chaboyer, W. and Anderson, V., 2017. What factors influence ward nurses’ recognition of and response to patient deterioration? An integrative review of the literature. Nursing Open, 4(1), pp.6-23.

NMBA. 2017. Registered nurse standards for practice. Available at {https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx} Accessed on {24 may 2020}

Olsson, A. and Landgren, K., 2020. Getting Well Is More Than Gaining Weight–Patients’ Experiences of a Treatment Program for Anorexia Nervosa Including Ear Acupuncture. Issues in Mental Health Nursing, pp.1-11.

Perry, C., Henderson, A. and Grealish, L., 2018. The behaviours of nurses that increase student accountability for learning in clinical practice: An integrative review. Nurse Education Today, 65, pp.177-186.

Sheridan, B., Chien, A.T., Peters, A.S., Rosenthal, M.B., Brooks, J.V. and Singer, S.J., 2018. Team-based primary care: The medical assistant perspective. Health Care Management Review, 43(2), pp.115-125.

Stott, A. and Wells, L., 2016. Arthritis and musculoskeletal conditions. Chronic Care Nursing: A Framework for Practice, pp.194-209.

Weiss, K.B., Co, J.P.T. and Bagian, J.P., 2018. Challenges and opportunities in the 6 focus areas: CLER National Report of findings 2018. Journal of Graduate Medical Education, 10(4s), pp.25-48.

Yousefi Nooraie, R., Khan, S., Gutberg, J. and Baker, G.R., 2019. A network analysis perspective to implementation: the example of health links to promote coordinated care. Evaluation & the Health Professions, 42(4), pp.395-421.

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