Leadership and Management in Mental Health Nursing - Case Study Example

Leadership and Management in Mental Health Nursing. Introduction The World Health Organisation estimated that approximately 450 million people worldwide have a mental health problem. In Great Britain, one in four British adults experience at least one diagnosable mental health problem in any one year, and one in six experiences this at any given time according to the Office for National Statistics Psychiatric Morbidity report (National Statistics Office 2001). Moreover, UK statistics indicate that British people have the highest rates of self-harm that may culminate in suicide. This huge population of service users has been consulted and they have been clear about what they value and what they want from their nurses according to the Royal College of Nursing (2005) so mental health nurses are now facing the challenge of meeting those expectations. Nursing leadership is significant in shaping the future of healthcare especially in the field of Mental Health Nursing. However, there is a need for efficient action plans to turn this idea into reality—focusing on the development and realisation of essential management and organisation. There is always a leader trait within a person because leadership is for everyone and it does not necessarily just for the one in-charge. Nevertheless, one cannot become a leader until he or she understands what leadership is about and the driving force for others. This essay aims to explore and critically analyse the management skills and leadership qualities a newly qualified nurse will need in leading others to deliver services in a rapidly changing practice environment; and to provide conclusions and recommendations. The Mental Health Nursing Practice Mental health nursing is at the core of recent healthcare system. They comprise the largest professional group in mental health services with nearly 47,000 qualified nurses working in the NHS in England, and another 30,000 support staff working with them (NHS 2006). Health Minister Rosie Winterton (NHS 2006) has expressed that mental health nurses have always been a vital part of effective mental health services and in recent years they have played an absolutely key part in the ongoing transformation of mental health services. The NHS is changing—new roles and new skills of mental health nurses have been developed. Never before had the nurse practitioners face so many challenges with the structure of the NHS likely to be different from what is known by previous generations. New ways of organising, planning, commissioning and delivering services are all now the new reality for nurses and other professions working in the UK (Association Nurse Consultants 2006). All mental health professionals have to recognise the part they will play in the services of the future because they are at the forefront of changes in how services provide for the needs of people with mental health problems. Management Skills and Leadership Each core of the mental health profession, including nurses, is challenged to play a leadership role that supports the widespread implementation of collaborative care models in the primary health care setting (Feldman 2008). Nurses are considered key workers who work with the service user and carer to assess needs, develop and implement a care plan with the primary aim to improve the delivery of care to people with severe mental illness (Forster 2001). Figure 1 illustrates several imperatives critical for all nurse leaders. Figure 1. Critical leadership and management imperatives Source: Daly et al. (2003). Daly et al. (2003) argued that it is important for organisations to clearly understand and evaluate both their internal and external social, economic, political, technological and professional environments—because of the pace and complexity of change experienced by health organisations, these issues raise critical question for nurse leaders and managers with respect to the deployment of scarce resources, and the recruitment and retention of competent staff. Building shared vision is about making an assessment of the current reality, determining what a desired state would be, and managing the resultant tension between these two states in a manner that is constructive and productive (Yoder-Wise 1999, cited in Daly et al. 2003); and to be able to conceptualise a vision and to communicate it to others is a critical issue for nurses. Being able to foster nurses’ attitude, reputation, organisation and service will be an important part of creating and maintaining system-wide continuity of quality care in the face of significant challenges (Daly et al. 2003). The creation and maintenance of positive work environment provides meaning for employees and still significant to nurses because amongst other things, this concept requires respect and professionalism towards co-workers for a better healthcare system. The capacity to foster creativity and innovation encompasses the ability to see relationships between unrelated parts or, in other words, relevance and fit between things that have not yet previously been connected together—to see the big picture and analyse how things work from a systems perspective (Daly et al. 2003). By transcending traditional practice, a leader should be someone who can motivate others to perform to the full capacity by influencing a change in perceptions and by providing a sense of direction (Daly et al. 2003). The nurse executives have to coalesce the technical demands of a management with the visionary dimensions of leadership if nursing is to survive into the next century as a discrete entity (Fedoruk and Pincombe 2000, cited in Daly et al. 2003). Becoming the Leader Daly et al. (2003) describes in the nursing context, the leader is a visionary with a concentration of time and effort who looks outward to how the unit, organisation or profession can go forward. The excellence of leadership requires seeing beyond the plethora of paper, policies and procedures required to maintain the functionality of the workplace but rather a leader needs to be a negotiator with a broader worldview about how the area of responsibility will grow and develop within overall bureaucratic influences (Daly et al. 2003). At this point, one can clearly emphasise that anyone can assume a leader’s role even the newly qualified nurses, provided: The nurse knows and recognises oneself as a leader and manager The nurse looks beyond the pragmatism of nursing delivery care and carries the essential knowledge and principle of leadership and management The nurse possess the skills of a leader and a manager The nurse possess the personality trait of a leader and a manager Skills for the leaders and managers To convey management and leadership concepts, there are essential skills paramount to the practice which needs to be acquired and enhanced: An ability to communicate decision and visions decisions and visions to individuals and groups and this is a hallmark of being able to influence peers and others (Huber 2000, as cited in Daly et al. 2003). An ability to discipline oneself regarding time management—working at a fast pace may not equate to achieving a great deal (Tappen et al 2001, as cited in Daly et al. 2003); and An ability to deal with stress by setting personal and professional goals, establishing priorities, practising good health habits and relaxation techniques, improving self-esteem by obtaining necessary skills, and using support systems (Marriner Tomey 2000, as cited in Daly et al. 2003). Mental Health Nursing Leadership Nurses have different roles in the mental health care setting but whether he or she is acting as a ward manager or a primary nurse, the coordinator role is important. Coordination relates to assessment and the delivery and monitoring of client’s care plans, different aspects of care provided by different mental health workers includes co-nurses, medical staff, psychologists, occupational therapists and other, client’s views of their care plan, the views of their carers and relatives and of the formal care team (Forster 2001). The Department of Health (2003) issued a review entitled From values to action: The Chief Nursing Officer’s review of mental health nursing and had the following recommendations for the practice: Mental health Nurses (MHNs) should focus on the wider needs of the patient, using their skills to improve physical well-being through better assessment and health promotion activities, and by providing more psychological therapies. Inpatient care should be improved by increasing the time MHNs spend in direct clinical contact with service users and minimising the time they spend on administrative roles. Career structures for MHNs should be reviewed according to local needs and a range of new nursing roles developed and supported. MHNs should promote social inclusion for service users and their carers. The recruitment and retention of MHNs needs to be improved through initiatives such as linking with schools and colleges and presenting positive messages about mental health to the media. Discovery and Conclusion The mental health nursing practice is at the forefront of the developments for change needed to provide the best health care for the mentally ill persons. These developments in practice require nurses to become leaders in their own right and potential—the leader within them should come out in the open and be recognised. To meet the demands of a multidisciplinary care for the mentally ill patients, strong professional support and leadership is required and essential to strong and confident nurses. Leaders are required at all levels of health care, not specific to a position, but they will be obliged to produce the skills and qualities necessitated in a leader. References: Association Nurse Consultants. (2006). Valuing and Developing Mental Health Nursing Leadership, York. Daly, J., Speedy, S., Jackson, D. (2003). Nursing Leadership, Australia: Elsevier. Department of Health. (2006). From values to action: The Chief Nursing Officer’s review of mental health nursing, London: Crown Copyright. Fedman, H. (2008). Nursing Leadership: A Concise Encyclopedia, USA: Springer Publishing Company. Forster, S. (2001). The Role of the Mental Health Nurse, London: Nelson Thornes. Huber, D. (2000). Leadership and nursing care management, 2nd ed, Philadephia: WB Sauders. National Statistics Office. (2001). Office for National Statistics Psychiatric Morbidity Report, London: Crown Copyright. National Health Services. (2006). From Values to Action, London: Crown Copyright. Royal College of Nursing. (2005). The Mental Health Nurses Association, Available at http://www.dh.gov.uk, accessed 17/01/2009. Read More