Designing a New Health Care Unit: The County of Newell Primary Care Rural Health Clinic - Essay Example

? Designing a New Health Care Unit The County of Newell Primary Care Rural Health Clinic of Introduction Primary health care is important for everybody, but in rural areas it is very difficult to acquire premium health care services. Numerous rural areas have encountered difficulties in the recruitment and retention of primary healthcare professionals. Those who were raised in a rural community are more likely to reside in or go back in a rural community than those who have grown up in urban areas (Kaeding & Rambur, 2003). Recruiting healthcare providers for rural health facilities is a very difficult endeavour. Rural areas evaluating these attempts confront further problems, such as availability of sufficient time for recruitment and inadequate financial resources to offer premium services. They usually have inadequate knowledge of potential healthcare delivery alternatives (Vetter-Smith et al., 2012). Thus, I will design a new rural health care unit that will address these abovementioned concerns. The name of the organization is County of Newell Primary Care (CNPC). The type of unit is a rural health clinic. Rural communities are experiencing scarcities in healthcare providers due to having a larger number of elderly locals simultaneously with the increasing number of retiring healthcare providers. According to Glasser and associates (2003), the Urban and Rural Health Chartbook reports greater health inequalities confronting rural populations. Young adults and children in rural areas have the highest rates of mortality, and rural inhabitants have the largest number of fatalities due to accidents and vehicle-caused damages. Rural males are mostly prone to heart illnesses and suicide; rural females are mostly at risk of obesity; and rural populations are more susceptible to smoking (Glasser et al., 2003). Most of the time rural residents, especially the elderly, have to travel far to obtain medical services. Thus, it is important to form adequately staffed and premium healthcare clinics in rural areas. Mission Statement and Values The mission of County of Newell Primary Care is to offer inexpensive, inclusive, and efficient primary healthcare to individuals in the County of Newell, Alberta. CNPC is dedicated to enhancing the education and training of healthcare providers by developing educational programmes for healthcare delivery. The vision for the CNPC is to be the leading health care facility in the County of Newell which provides comprehensive and integrated primary care services involving mental health, preventive care, nutrition, dental procedures, and medical practice. To be the leading health care facility in the County of Newell we are highly educated, trained, and experienced in patient management and are known for providing premium, inexpensive, compassionate, courteous health care services for everybody. In essence, our behaviour and activities give reality to our mission. As a rural health care clinic, we are committed to supporting the population by offering services derived from the following values: affordability—provision of reasonably priced services, and performance of activities that give support to vulnerable individuals; accessibility—provision of accessible, inclusive services; integrity—every action or operation will be performed based on ethical standards; quality—provision of premium, modernised health care services; patient-oriented services—patients will be encouraged to take part in the decision making process with regard to their care. The objective of the County of Newell Primary Care is to enhance the quality of patient care, interaction, problem-solving skills, and retention of rural nurses. The programme was based on a specific set of values. Nurses gain knowledge of and become skilled at rural nurse practices when they establish objectives and evaluate results; when the rural nursing field is acknowledged and understood; and when familiarised and engaged into the facility and the community. Organizational Chart Numerous individuals are sought to support and mentor new nurses. The CNPC recruits an administrative assistant, a clinical director, and a program manager. Instructors are employed based on their expertise. The organisation requires sympathetic peers, capable preceptors, and committed administrator. The chief nursing officer (CNO) would be the most hectic individual in CNPC as administrative and patient management obligations preoccupy the job. The primary responsibility is transforming culture. Administrators apply transformational theories to advance the CNPC from an aggressive, competitive approach to recognition, accountability, and improvement. Initiating changes requires time, continuous efforts, and commitment. Every resident needs a knowledgeable preceptor to shift from academic education to professional growth. The preceptor is the main catalyst of the transformation. The challenging role of clinical educators needs certain personal attributes and professional abilities possessed by a few nurses. Preceptors are obliged to exhibit knowledge about newest developments and most recent practice; and, the capacity to identify communication capabilities and efficiently, rationally solve healthcare issues. CNPC residents portray effective preceptors as dynamically engaged in the everyday practice of the resident. The optimistic mindset, valuable listening abilities, and instructive feedback of the preceptor boost the job fulfilment or satisfaction of the resident. The challenging responsibility calls for preparation. Transformational Leadership The transformational leader should wilfully decide to lead. Most of the time, knowledgeable and experienced nurses are assigned to the position of manager or supervisor, but competent leaders decide to lead. I choose to be the leader of our organisation. I will seek to develop four of the major attributes of a transformational leader—individual consideration, intellectual motivation, vision and empowerment, and charisma. The transformational leader has a sense of humbleness that takes into consideration the organisation’s mission and the importance of the role and efforts of others. S/he puts to good use a variety of professional abilities, such as recognition of the work of subordinates, support, compassion, mentoring, and listening. The transformational leader encourages his/her followers to pursue a common vision. The competent leader acknowledges and endorses the work of others and builds a culture of teamwork and shared goal within the organisation. It is not important who receives the most recognition; what is important is how the members of the organisation support and reinforce the efforts of each other. I will strive to learn these attributes and incorporate knowledge from various practical models and leadership theories to develop, improve, and broaden clinical capability from an emphasis on individual care to an emphasis on the care of whole populations and groups in the County of Newell. The transformational leader is a knowledgeable, thoroughly educated person who analyses previous problems innovatively. S/he transcends his/her limitations, encourages creativity, and uses a wide array of models, theories, and disciplines in resolving problems. This requires boldness and risk taking (Kelly, 2011). In order to acquire this attribute I will read extensively, learn from various disciplines outside of the nursing field, and get involved as an empathic citizen in open discussions on an entire array of issues. I may discover strategies from other disciplines. I will cultivate problem-solving skills. The transformational leader believes that people are enthusiastic and ready to gain knowledge and skills and verify new ideas. Several scholars emphasised that genuine transformational leadership should be based in the leader’s moral nature, a basis of ethical principles, and shared ethical procedures. Another crucial component is goal orientation. The transformational leader builds a clear picture of a desired future from an ethical basis (Rigolosi, 2013). As stated by Kouzes and Posner (2007), “Every organisation, every social movement, begins with a dream. The dream or vision is the force that invents the future” (p. 17). In order to do this I will inspire my colleagues to work towards our desired future. I will encourage productivity and excellence and fill others with a sense of commitment and optimism. I will embody a meaningful intention that produces the motivation to realize goals. Lastly, the transformational leader is an embodiment of ambitions and values for subordinates. S/he builds confidence and dedication to a goal. Charisma is defined as the capacity to rouse a vision. Not like self-absorbed charisma, which is centred on the self, the ‘charisma of idealised influence’ is rooted in trust (Kelly, 2011, p. 82). It is the capacity to inspire others, to motivate not merely to obey or conform, but also a belief in success. Charismatic leaders have a definite understanding of their own self and the direction they are taking in life. They are devoted to ethical principles; inspire other people to contribute to the greater good (Kelly, 2011). Health care organisations require this kind of leader. In fact, it is empirically known that followers of a charismatic leader have a greater sense of fulfilment and motivation. Charismatic leaders usually appear in periods of disorder. They display personal attributes that encourage people to trust in them. They are not necessarily showy or loud. In fact the most competent leaders, according to Collins (2001), “blend extreme personal humility with intense professional will...” (p. 21). These leaders are usually “self-effacing individuals who display the fierce resolves to do whatever needs to be done to make the [organisation] great” (Collins, 2001, p. 21). In order to become a successful charismatic leader I will surround myself with people who can help me become an inspiration to others and an influential visionary. The element of charisma will definitely help me align individual goals with the objectives of the organisation. Charisma may bring about trust, accountability, and sincerity that will draw my followers to me and motivate them to internalise the vision and make the best effort towards the greater objective. I will lead as a role model. Five Strategies to Empower Staff Members Nursing leaders are the most important instrument in empowering staff members. In fact, effective leadership has been discovered to be a determinant of staff nurses’ view of empowerment on their groups or departments. Empirical evidence on the impact of leadership on empowerment and studies associating empowerment with the leadership element of nursing practice shows a strong correlation between empowerment and leadership (Krebs, Madigan, & Tullaj-McGuinness, 2008). Abdelrazek and colleagues (2010) discovered a connection between the empowerment of frontline managers and the leadership style of their senior nurse leaders. It suggests that for leaders to be successful in empowering their followers, they themselves have to be empowered. Nursing leaders should be endowed with resources that allow them to restructure nursing work conditions and nursing practice, which consequently, will lessen the possibility of medical mistakes. As a senior nurse leader, I will adopt the following five strategies to empower our staff members: 1) Formal power. This is achieved through the flexibility, value, and visibility of an individual’s work tasks. Nurses who have the ability to create and sustain flexibility in patient care can facilitate empowerment (Nagelkerk, 2005). Here are the following steps to promote empowerment through formal power: - create independent work groups and facilitate participative management; - create prospects for knowledge and skills development; - recognize staff nurses’ contribution to patient management and care processes; - align nursing practice with organisational objectives; - facilitate professional nursing practice through clear, thorough job analysis; and - give adequate recognition of the responsibility and role of staff nurses 2) Informal power. This arises from a person’s network of relationships. Informal power can be cultivated in staff nurses when nurse leaders promote the building of relationships between staff members and others members of the organisation (Kelly, 2011). In order to achieve empowerment through informal power, the following techniques will be used: - promote teamwork and cooperation; - promote interdisciplinary work; - develop abilities to build relationships through teambuilding activities; and - create opportunities to interact or socialise with colleagues 3) Provide staff members the opportunity to learn, develop, and progress. This can be successfully done through participating in major organisational groups; creating skill-based career steps; developing new missions and developmental activities; participating in workshops, seminars, and training; and promoting higher educational opportunities. 4) Provide continuous, accessible support through providing connections to important individuals and/or groups when needed; providing assistance; promoting cooperation and solidarity among staff members; promoting independent work; giving appropriate recognition to positive contributions; giving unambiguous, prompt, useful feedback; and exercising an encouraging, mentoring, and interactive leadership approach. (5) Provide access to important information through promoting different mediums of communication; giving appropriate, relevant, prompt information; communicating existing and projected future status of the organisation; communicating organisational objectives; disseminating important, up-to-date information; and exercising open, accommodating communication. A number of studies have demonstrated that empowerment is related to perceptions of the value given to professional nursing practice and, afterwards, high quality patient care and nursing practice (Krebs et al., 2008). This section shows that empowering work settings can significantly influence professional nursing practice by reinforcing work settings that facilitate the empowerment of both patients and nurses, thus guaranteeing safe, premium patient care in a rural health care environment. The Team of Preceptors A team that will be the key to the successful formation of organisational culture and implementation of necessary changes within the CNPC are the preceptors. This team is made up of new preceptors who are apprentices and clinical specialists needing continuous support and guidance. Creating a strong, productive organisational culture requires numerous components. Several components can be easily applied whereas others call for continuous assistance. Residencies rely on the professional guidance and instruction of clinical mentors. Preceptors promote professional nursing practice and practice philosophies. Because the role of the preceptors is quite difficult, an instructor is assigned to the new preceptor. The instructor functions as a problem-solver and adviser. Education and training is a vital component. Several health care organisations do not train preceptors and merely hope for quality performance. The CNPC trains, educates, evaluates capability, and teaches preceptors. Training sessions involve putting into practice rural nurse theories, instructional approaches, conflict management, communication processes, problem-solving skills, emotional strength, and team work. Competence measurement is an instrument that will determine if this team of preceptors is functioning effectively. The CNPC carries out an assessment of attitude, behavioural, skill, and knowledge development. Support for personal advancement through appreciation of apprentice position and goal setting are also useful in guaranteeing competence. Preceptors have to self-evaluate personal development as they keep an eye on the progress of other staff members. CNPC preceptors are provided with access to electronic library database for relevant information that they can use on a group discussion for personal development. The organisation helps preceptors by providing instructional materials and administrative support. A safety and quality manual helps preceptors evaluate and mentor competence. Managing and Resolving Conflict Another important skill that nurse leaders should possess is resolving conflict. Conflicts between staff members, such as those related to the delivery of supplies, are normal occurrences in health care organisations. The challenge to nurse leaders is how to handle such situations. The most preferable technique for resolving conflict and making complex decisions require identification of the problem and determining the best steps to resolve it. There are six steps to resolve conflict between two staff nurses with regard to delivery of supplies. First is to define the problem. Identify the specific source of conflict, whether it is about the suppliers, the quality of the supplies, or how the suppliers were delivered. Put into clear words the position of both sides if they cannot express it themselves. Intently listen to the opinions of both sides. Ensure that both sides recognise my desire and dedication to fairly resolve the conflict. Second is to create potential solutions to the problem. If the conflict involves the quantity of needed supplies, then analyse and talk about problems in identifying the exact quantity of needed supplies. Think broadly. Exhaust all possible alternatives. Ask both parties to recommend solutions. Third is to assess the suggested solutions. Attentively listen and sincerely take into consideration the preferences of both parties. Choose a single solution to ensure that both sides are beginning to agree or cooperate. Fourth is to choose a mutually favourable solution. Avoid insisting my own solution. Fifth is to execute the solution. Assign tasks to each party. Show them that I trust them to do their jobs and avoid bringing up failure possibilities. And lastly, assess the chosen solution. Every decision can be changed or invalidated collaboratively. Conclusions People living in rural areas should receive primary care, and it is the mission of County of Newell Primary Care to accomplish such. The new healthcare unit have two primary objectives: (1) to provide quality primary care to residents; and (2) develop, educate, and train new staff nurses and nurse leaders. It is the goal of the organisation to recruit and retain high-performing healthcare providers. In order to achieve these objectives, the nurse leader should be transformational and open to changes. Education and training of all members of the organisation would be the top priority. Quality primary care emanates from highly trained, skilled, and empowered healthcare providers. References Abdelrazek, F. et al. (2010). Leadership and management skills of first-line managers of elderly care and their work environment. Journal of Nursing Management, 18(6), 736-745. Collins, J. (2001). Good to great. New York: Harper Business. Glasser, M. et al. (2003). Meeting the needs of rural populations through interdisciplinary partnerships. Family Community Health, 26(3), 230-245. Kaeding, T. & Rambur, B. (2003). Rural Nurse Leadership Project. Policy, Politics, & Nursing Practice, 4(4), 250-252. Kelly, P. (2011). Nursing Leadership and Management. Mason, OH: Cengage Learning. Kouzes, J. & Posner, B. (2007). The leadership challenge. San Francisco: Jossey-Bass. Krebs, J., Madigan, E., & Tullaj-McGuinness, S. (2008). The Rural Nurse Work Environment and Structural Empowerment. Policy, Politics, & Nursing Practice, 9(1), 28-39. Nagelkerk, J. (2005). Leadership and Nursing Care Management. New York: Elsevier Health Sciences. Rigolosi, E. (2013). Management and Leadership in Nursing and Health Care: An Experiential Approach. New York: Springer Publishing Company. Vetter-Smith, M. et al. (2012). Providing Diabetes Self-Management Support in Rural Primary Care Clinics with Nurse Partners. Western Journal of Nursing Research, 34(8), 1023-1042. 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