Nursing Management Leadership in Health Care Institutions - Research Paper Example

Nursing Management – Leadership in Health Care Institutions It is a fact if not an opinion that all nurses should strive to couple managerial roles with leadership roles. The essential elements to striking a balance include critical thinking skills, good coping skills, as well as active listening skills (Stanley, 2006). These elements are no doubt what a creative nurse practitioner requires to help build a formidable nursing workforce. All professional nurses are managers and leaders at some level and that is what any professional, in whatever capacities, would always strive to achieve. It is all about striving to balance between doing the right thing at the expected time in the correct manner and doing such things right. The rapid and dramatic transformations in health care systems make these skills even more vital than ever. Both managers and leaders should envision the future to provide a leading role towards an efficient and productive unit with satisfying personnel. As leaders, it is never possible to stop seeking professional growth and opportunities that can help guarantee a difference in our own profession. Certainly, there exists many ways that can help in accomplishing this, including reading professional journals, being politically active and aware, as well as attending continuing education relevant to the nursing practice (Sehested, 2002). As good leaders, nurses are expected to take advantage of such opportunities for their advantage (Sehested, 2002). As a means of seeking professional growth, an article that entails balancing leadership roles and practicing nursing roles has been chosen to guide the process. This paper, therefore, intends to critically evaluate a research article titled, ‘leading nurses in dire straits: head nurses' navigation between nursing and leadership roles.’ by Sørensen e., Delmar c. & Pedersen b.d. (2011). This article was published in the Nursing Management Journal. This paper intends to critique a study reports and the findings from a study focusing on the nursing and leadership roles of head nurses’ in the hospitals. The reason as to why this article is chosen is because of the conflict head nurses face as they perform their nursing and leadership roles in the health care settings. The debate is centered on how management reforms challenge professional leadership roles in public organizations (Sehested, 2002). This study is vital in the sense that it helps in improving nursing practices to patient care and exploring how successful nursing leaders tend to navigate between the two roles. In this case, the two roles are; nursing and leadership roles. The findings in the study are properly done to comprehensively validate the nursing practice. Therefore, there is a need to critically put forth the worth of this study and the evidence in it, thus appraising the study. The title of study define clearly what the study is all about, that is, to investigate the negotiation between nursing and their leadership roles in hospital practice. The study population, a brief description of the methodology and the key outcomes being investigated are all included in the title of the study. The study populations in the study is the nurses in leadership positions working at a first line level and at a departmental level whose age range is 39-57 years with an experience of 3-4 years in either of the leadership roles. The key outcome of the study was Closeness distance and the recognition game. The methodology applied in this study was participant observation and ethnographic interviewing techniques where nurses in leadership positions acted as informants. They were selected in a stratified fashion to ensure diverse, rich and nuanced data the informants were gathered. Here, the inclusion exclusion criteria were not satisfactory, for instance, the leadership experience number of years was limited to a maximum of only 4 years. This should have been extended to about 8 years to get the views of the most experienced nurses in leadership roles hence a more valid, representative and reliable study results. The purpose of this study is feasible, appealing and relevant. The study subjects here were humans and the issues of ethics arises. This study did seek for an ethics committee approval and mentioned ethical guidelines outlined in nursing research of Nordic Countries were adhered to in the research process in relation to information given to interviewees and observations in the formulation of declarations of consent and secrecy. This is a score to the researcher. In addition to the above, the researcher would have included a section of informed consent to provide the participant with vital information of the study. This has not been addressed by the researcher. The study provides a summary that quickly provides the essential and necessary information concerning the research activity. In this study, the abstract is divided into sections: aim, background, methods, results, conclusions and implications for nursing management. This section is particularly prominent especially for the busy reviewers with limited time allotted for going over the proposal. The abstract is exhaustive and comprehensive covering the main sections of study at a glance. The introduction of the study needs to directed and should have a purpose. The purpose of this is to define the research problem and to provide the justifications for getting the answers to the question at hand. This segment is always dived into sections consisting of the background, conceptual framework and the rationale among many others. This is has not been addressed in this paper. The introduction is unusually brief, and it was not divided into sections. However, it provides the question to be uncovered and the justifications for finding the answers to the question raised in the research problem. The researcher pointed out that even though studies for instance, Scandinavian research in nursing leadership has studied a range of issues from leadership styles (Aiken, Buchan, Ball, J, & Rafferty, 2008), hospital head nurses’ leadership practice at the first line and a department level (Sørensen, 2006) to job satisfaction and clinical wisdom among leaders (Miles, & Huberman, 1994). Research into nurses’ motivation for choosing leader career and connections between leadership and development in nursing (Bondas, 2006, 2009) is also noteworthy. Exploring nurses’ motivations for entering a management career and their leader assertiveness, positive attitudes towards management were identified. The obvious shortcomings were found in nurses’ adoption of the manager role (Dixon, 1999). There are still arguments against recruiting nurses and doctors as leaders have been supported by health professionals’ purported overemphasis on professional development to the detriment of leadership and management. Hildebrandt et al. (2003) and Yukl (2009) support the recruitment of professional managers from outside hospitals whereas Llewellyn (2001), who studied managing doctors’ performance, insists that a medical, rather than a managerial background, is favorable. In spite of the intense debate, the question of how nurses navigate the troubled waters of nursing and leadership has received minimum attention in the literature. The issue that is of concern is that, since the days of Florence Nightingale, nurses have managed their own professional ranks. An unsurprising fact in light of the autonomous role that professionals tend to enjoy in professionalized bureaucracies (Sehested, 2002). Nightingale has been hailed as a great leader, but her status as either a practical nursing leader or a clinical leader is still controversial (Stanley, & Sherratt, 2010). The issues raised suggest that nurses are far from an agreement on the problems surrounding nursing and leadership and their interconnections (Stanley, 2006). The methodology section is one such important element outlined in this paper and it explained the methods used, the participants, the setting, the design and how the data was collected and analyzed. It also gave reasons why the study design is used thus catering even for readers who are not from the medical field. It is expected that the methodology section, chronologically describes the study design and conduct. It should also describe the analysis of the data to provide answers to specific objectives. The methodology section should have partitioned into subheading for ease of review. This paper did not have subheadings, yet they are different. Moreover, it did provide a clear description of data collection and analysis. The data analysis was a complicated one based on the fact that themes and subthemes were developed both in the main finding of closeness vs. distance and the recognition game. The results section of the study has been comprehensively explained to a clear understanding of the study findings and results tabulation criteria formulation from data gathered by the researcher. These results can be used both by the nursing student and the practicing nurses. This results would not be applied to the patient population directly since the subject of study in this study were the nurses in leadership roles, and the conflict head nurses face as they perform their nursing and leadership roles at the hospital. In this paper, patients were not the target study subjects. As a nursing student, the study highlights the roles and challenges nurses in leadership roles face in negotiating between nursing and leadership in hospital nurses' and that leadership practice depends on the professional role that the nurse leader assumes. A student, therefore, identifies three roles, which are labeled as the clinician’s, the manager’s or a hybrid role. Both the nursing student ant the practicing nurse are able to draw and empress the fact that the clinician’s leadership practice is characterized by a preoccupation with clinical work and development. This may be associated with a weak leadership identity combined with a strong professional nursing identity, in which the negotiation between nursing and leadership roles is absent or tends to be regarded in a short-term leadership perspective. The consequence may be unstable, reactive and adaptive practices. The practicing nurse would also lean that the managerial leadership practice is described by the strong priority given to management and daily operations. This may be the expression of a weak nursing and leadership identity accompanied by strong management identity. This combination is associated with the absence of negotiation between nursing and leadership roles, which may lead to management practices that stimulate professional isolation, short-term adaptive behaviors and harmful alliance formation that hinder their roles as nurses and leaders. In my own opinion, the general nursing community is not aware of the research findings. To start with, this is a new study that targeted only nurses in the leadership roles, in a sampled population. There is a high possibility that the study results have not been disseminated to the entire community of nurses and if at all it has been disseminated then to nurses in leadership roles. The general nursing community here also includes the nursing students who also in my opinion are not updated to this finding since they are still in their study and not in leadership roles. There is evidence from data in support of Walby and Greenwell’s findings from 1994; whose study of the division of labor between British nurses and doctors demonstrated that professionals’ leadership practice occasionally benefitted locally defined or personal projects and goals rather than broader aims. This has also contributed to the discussion of whether a strong nursing identity in leaders tends to reduce leader. Keeping in mind that this is a qualitative research I would inductively analyze the data and develop theories through a process that Strauss called “developing grounded theory". I would also use purposive sampling to select the subjects to study since subjects are selected based on what they know and who they are, rather than by chance. Some of the caritas processes and universal needs implied in this research are in reference to what Watson (2009) stated, that a person is either an organism or simply a spiritual being, but embodied in experience in nature, and in a physical world. He can transcend the physical world by subduing it, changing it, controlling it, or living in harmony with it. He also foresees the capacity of human to co-exist excellently with past, present and future. This healthier life is what should be the main target of the nurses as they pursue their roles at any capacity. Total healing would occur when nurses get the chance to teach, share and learn the connections of the patients. For this to be a success, nurses in leadership roles would have to successfully navigate between nursing and leadership to meet patients’ needs. The nursing process often serves as a framework for an organizational for the practicing nursing. The process involves all of the steps that are taken by the nurse while caring for a patient. The rationale that is used in each step is founded within the nursing theory. The steps include assessing, nursing diagnosis, planning, implementing, and evaluation. In the context of this article, its findings are quite applicable to each of the nursing process outlined above. The findings of the article were that there are two types of leadership coupled with nursing roles. These were identified as closeness distance leadership and the recognition game leadership. In this case, there are those nurses in leadership position who work at departmental level and those nurses in leadership positions who work at a first line level. The departmental level nurses do not work closely with the patients but rather they interact with the patients through the first line nurses. The first line nurses, on the other hand, meet the patient in person interacting with him on daily basis. The two leadership types are all aimed at fulfilling the demands of the nurses hence achieving the nursing process. The first line nurses gather information concerning the patient and in coordination with the departmental nurses, they identify the needs of the patient, they, as well work in coordination to develop a plan of care for the patient to respond to these needs. Furthermore, the two leaders, while working at their different levels, would coordinate to see to it that the plan of care is implemented, and finally they evaluate the wholesome effects of the implementation. It is clear that the implementation of each nursing process requires the fused efforts of the two leadership types as outlined in these findings. The nurse has to involve the patient, the family of the patient, and significantly others in every step of the nursing process to the greatest extent possible while compensating for and acknowledging the factors that could impact on the provision of care by the staff and nurse. References Aiken L, Buchan, J, Ball J. & Rafferty A.M. (2008).Transformative impact of magnet designation: England case study. Journal of Clinical Nursing 17, 3330–3337. Bondas T. (2006). Paths to nursing leadership. Journal of Nursing Management 14, 332–339. Brock D., Powell M. & Hinings B. (1999). Restructuring the Professional Organization. Routledge, London. Dixon D.L. (1999). Achieving results through transformational leadership. Journal of Nursing Administration 29 (12), 17–21. Klausen, K.K. (2001).Is that Supposed to be Something Special? Organization and Leadership in the Public Sector. Børsens Forlag, Copenhagen, Denmark. Llewwellyn, S. (2001). Two-way windows: clinicians as medical managers. 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Professions in a Changing Health Service. Sage, London. Yukl, G. (2009). Leadership in Organizations, 7th International edn. University of New York, Albany, NY. Read More