Application of Leadership and Management - Essay Example

Application of leadership and Management Reflective Journal Reflective journal is an important tool for personal and professional advancement (John,2006). It helps to identify and evaluate one’s weakness and strengths for improving and improvising performance. My reflective journal is primarily focused on identifying my strengths and shortfalls so that I could work on them and apply them within the broader scope of optimized healthcare delivery. The intended objective of my reflection is to develop managerial and leadership traits which could be effectively exploited for enhancing the quality of service delivery. Boud et al., (1985) believe that reflective diary promotes deeper understanding of events, giving wider perspective of the issue so that they can be further analysed for improved outcome. My present position as senior staff nurse in A&E department necessitates leadership initiatives for managing crisis situations and motivating the nurses for delivering high quality services. For maintaining and optimizing work performance, I have used Belbin’s self-perception invention in my reflective journal to explore personal narratives and assumptions to innovate on past experiences. Hendry (2010: 73) asserts that ‘narrative is not just a method of analysing story but the primary process of all inquiry’. This was vital aspect of my reflective journal as the process of enquiry was not bound by the confines of rigidity but tended to explore the virgin path of new perspectives that could open wide areas of opportunities and challenges. Indeed, the wide range of responsibilities of the job and the need to mentor the junior was hugely crucial issue for maintaining high standard of ethically delivered healthcare services at A&E. The reflection on the events helped to provide deeper insight into the assumptions, challenges, influencing factors, myriad opportunities and relevant theories that could be exploited for optimizing outcome. Moreover, the experiential learning model of Burnard (1989: 4) exploits the referral structure of what, so what and now what to explore the unexamined thoughts and tasks which greatly facilitated in expanding critical competencies for greater productive outcome. The journal has therefore been used to explore incidents which have prompted deeper reflection and application of relevant theories to evolve new solutions and perspectives. What? A&E department is broadly described as a consultant-led 24-hour service with full resuscitation facilities and designated accommodation for the reception of accident and emergency patients (doh, 2008). The department is hugely critical ingredient of effective healthcare delivery especially in its ability to meet the challenges of emergency medical needs and to provide the same to a sudden fast increase in numbers of patients when a major incident or accident occurs. As a senior nurse of the department, I have the responsibility of managing different areas of the department, relieving, shadowing the nurse in charge every shift. The shift breaks and work breaks are important for delegating work and helping the staff to distress from the hectic work schedule in A&E department. Moreover, delegation of tasks also becomes critical issue to meet the urgency of the situation, especially when diverting medical staff to the triage area. Recently, while working in the resuscitation area with a newly qualified staff and a third year student who had joined A&E department, I found that with the demands of the job, especially with critically and airway compromised patients, teaching and delegating work to the mentees was hugely difficult as they were not exposed to resuscitation area before. With the overflow of emergency inpatients, I find it easier to finish the work myself rather than delegating which is very exhausting and often makes me irritable and short tempered with the mentee and the staff. I tried to facilitate break so that resuscitation area is settled and ready to be used by the new trainee staff. The delegating nurse-in-charge had unfortunately not checked with the new staff, resulting in chaos as trainee staff did not have any idea about what to prepare and where to obtain the equipment while the Anaesthetist wanted to insert an arterial and central line to a very unwell patient which would have been fatal! I realized that to meet the rush, instead of delegating tasks, I was doing all the work so that deadline could be met with high standard of service delivery. I was also frustrated and short tempered with the juniors. Being a senior nurse, it was my duty to oversee the smooth working of the A&E department. Central line and arterial line preparation, transducing and zeroing are important procedures that need to be done quickly to resuscitate and treat patients and the delay had really been very frustrating. Delegation was not easy as I was quite fastidious regarding the quality of services and wanted the staff to have the same standard of service delivery. It was only at the end of the shift that I was able to show the trainees how to setup the equipment and other necessary procedures necessary for resuscitation. At yet another time when I was in charge of the PIT-STOP area (Rapid Assessment and Treatment Unit) of the emergency department, I had ended up doing everything alone rather than delegating work to the assistant staff. I did not trust the newly qualified staff as she had no skills and training in venepuncture and cannulation, intravenous drug and fluid administration. PIT-STOP is an area where rapid assessment and initial treatment of sick patient brought in by the Paramedics are started. Looking at the rush, I was more focused on the need to move the patients from PIT-STOP to the departments where the patients’ needs could be best met according to the Manchester Triage (Mackway et al., 2006). My distrust in their abilities to cope with new situations or their learning capability was an important barrier not only in their learning new skills but it also questioned my competencies as an effective mentor and a leader who is able to delegate work efficiently (Piton, 2009; Northouse, 2004). One of the most significant learning experiences was when I had made arrangement for alternate placement at A/E department from resuscitation area. I wanted Registrar to assess me in the clinical setting with a real patient to complete my Health Assessment portfolio for my first module. The department was very busy with constant priorities and trauma calls. So I just sat down and observed how the nurse in charge managed the department in that busy and stressful day shift. There were no beds in the wards and patients were waiting for beds in the department for nearly 12 hours. They often had to be moved from one area to the other to accommodate the ambulances queuing. I observed that sick/critically-ill patients needed urgent treatment and despite long working hours, the staff had not started their break. I was very impressed at the way the nurse in-charge was calmly delegating work to the nurses and assistants according to their skills and capabilities. Every staff was assigned to areas where they were comfortable and could work competently. I also saw that the senior most member who was responsible for assigning tasks to its team of nurses was always calm which helped in making crucial decisions, knowing fully that nurses would learn from their small mistakes so that they do not commit blunders. His trust in his staff was admirable and revealed strong traits of transformational leadership that thrives on delegation (Adair, 2011). This was important lesson which taught me the virtues of being calm and focused and to work as effective team rather than trying to complete the work alone! So what? Brookfield (1987) informs that it is important to reflect on the incidents which have significant impact and where the performance could have been improved. Looking back at the emergency, identifying the basic interventions needed to assess critical cases was essential to give adequate medical aid. I realized that reflection on the incident had prompted considerations of other similar situations in the hospital and despite being fully equipped to deal with such cases, I still had lacked confidence. In my position, I needed to have leadership initiatives that would enhance teamwork, leading to effective healthcare delivery. I have therefore used I have used Belbin self-perception inventory to assess my leadership qualities. The Belbin self-perception inventory has shown that I am a shaper and complete finisher (Belbin, 2010). My lowest scores in the Belbin inventory are in plant and team that means that I am less likely to trust others in achieving the given target, thus delineating the importance of teamwork. Belbin’s inventory has been important facilitator in evaluating my strength and weaknesses of leadership that can be improved and improvised for higher performance outcome. I am very ambitious and my professional goal encompasses leading my department in near future. Presently, I am a senior staff nurse in A&E department of a well-known hospital. I have derived my strengths as a senior nurse who is goal driven and tends to be focused on the task so that deadlines are met efficiently and services delivered with high ethical considerations. Shaper and complete finisher accurately define my character as I tend to set task and complete it with focused approach. As a shaper, I am ready to challenge the ineffectiveness and as a finisher, I have the ability to finish the work and follow routine way that often frustrates intuitive members who believe that more innovative approach could expedite the goal delivery. I also tend to be perfectionist which often makes me have less confidence on my colleagues/ staff competencies to complete the given task with the same high standard. I have a perfectionist attitude towards my work wherein I am more concerned with successfully and efficiently completing the task within the given time frame. When the standard of service delivery gets deteriorated or delivery is delayed, I become negative that leads to short temper, frustration and irritated behaviour. These are the qualities that need to be addressed so that I could inculcate strong leadership traits, especially transformational leadership qualities that motivate others to excel (Cummings et al., 2008). I was motivated by the nurse in the A&E where she had managed the heavy inflow of emergency patients by delegating work efficiently and letting the mentees and staff learn through their mistakes. Delegation and teamwork are hugely vital ingredients for meeting the challenges of busy shifts. Belbin’s self perception had revealed my locus of control was internal as I was able to control situations and cope with stress (Rotter, 1982). I was therefore quite equipped to meet the external challenges with high initiatives. But as my low score as planter and teamworker showed, I am less likely to trust others and adopt innovative approach and paradoxical thinking. This could explain my irritation if my expectations regarding the work outcome are not met by the team of nurses. I am also not able to promote strong teamwork and my personal insecurities create barriers for building constructive work relationships with my staff. Though I can take initiative and make empowered decisions but work methodology lacks cohesive delivery which becomes especially visible during rush hours when delegation and teamwork become critical part of effective healthcare delivery. Emergency area requires quick responses and fast decisions for optimal performance whereby various processes and procedures for resuscitation are completed diligently and efficiently so that the critical patients can be referred/ sent to the appropriate departments for best medical aid. My lack of coordination with other staff and delegation of work seriously obstructs the efficient delivery of services. This could also prove to be a big hindrance to my personal and professional growth as a nurse manager. Belbin’s self-perception inventory greatly facilitated in assessing my strength and weaknesses as effective leader. It also gave me opportunities to improve and improvise my learning capabilities and helped develop traits of effective transformational leadership who is better able to delegate work and motivate team members for higher service delivery (Shaw, 2007). I also realized that mentorship is vital ingredient of nursing profession that highlights their role as practice education facilitator for guiding and evaluating student nurses in clinical setting (Bayley and Bayliss-Pratt, 2010; Carlisle et al., 2009). Through feedbacks and active inputs by the mentors, the students acquire skills and achieve professional competencies with high ethical considerations. My initial foray into being mentor was probably not up to the mark because it lacked the inherent trust that is placed on the student’s ability to learn. I needed to have more confidence in the team and sometimes, let them learn through their mistakes. Most importantly, the reflection revealed my personal insecurities and my inability to work as a team were vital obstructions on being an effective and dynamic leader. It was also important process for understanding self and developing skills and traits of effective leadership which would enhance my skills and competencies to handle crisis situations. The negative feeling and sense of incompetency that had assailed me during the critical event was so strong that it had permeated my thought patterns and lowered my self-confidence and belief in my competencies as a senior nurse. I knew that my experience and my present position is clear reflection on my abilities and competencies as a medical professional. When I reflect back and try to identify similar situations and my behaviour, I find the parallel situation to be diabolically connected in context and relationship with respect to my sense of inadequacy and in my inability to delegate. I feared that if the staff was not able to complete the task satisfactorily it would adversely impact the performance of the department. Now what? The reflective journal has given pertinent insight into my leadership traits and enabled me to understand myself and my inner narratives and dialogues with more clarity. I am a nurse who is focused towards delivering high standard services to the patients. I need to align my personal goals with the goals of the department and develop traits of transformational leadership that encourages proactive participation of team members to achieve the defined targets and goals (Barr, 2012; Bass, 1985). I need to overcome the negative attitude and thoughts through a positive approach and critical thinking that helps to give wider perspectives of the issues and make decisions based on informed choices. A good leader is endowed with the exemplary qualities like honest disposition, trust building capabilities, effective communicator, good listener and above all as a team leader who can motivate others to excel and can turn adversities into new opportunities of growth (McGuire & Kennerly, 2006). My major challenge is to tackle the ineffectiveness, indolence and self-deception in the team of nurses and empower them with knowledge and skills (Amsale, 2005). It would help develop wider perspectives and innovative thinking to overcome .workplace uncertainties and challenges with greater confidence and knowledge. Moreover, my mentorship had lacked trust and a sensitive approach that could turn the insecurities of the new staff and trainee nurses into self-confidence (Dowie, 2008). I need to guide the mentees with better understanding of their capabilities and improve their nursing competencies and managerial skills through feedback and active inputs in clinical settings so that they can gain knowledge through practice. Supervisors as mentors are very relevant as they facilitate mentees’ professional and personal development pertinent by helping them to become more understanding, empathetic, ethical and competent for delivering quality healthcare services (Hawkins and Shohet 2006). Watson (1925) argues that human behaviour is inherently linked to a cause and anomaly in behaviour can be contributed to the phases/ events in man’s life. Often social conditioning and past experiences dominate the present and therefore, if the individual is either bullied or consistently belittled in his childhood, tends to exhibit lack of leadership in his adult life. Moreover, Byrne (2005) also states that rational dissolution is crucial psychological paradigm that encourages sense of doubt and the normal reasoning is interspersed with the imaginative if and buts. These imagined counterfactual if and buts become dominant element when the bad experience tends to impact social relationships leading to lack of confidence and initiatives. These theories have become pertinent to the development of my adult personality. As a child, I was often bullied in class and abused by my close relatives. My distrust in others had become an intrinsic part of my adult personality which was holding back personal and professional growth. It was later in my academic life that I was encouraged by my professors who encouraged me to develop skills and competencies which I was naturally endowed with. My compassionate nature and my strong inclination to help people in distress was key factor of motivation for my current profession. The narrative summary forges vital linkages with not only the past but also opens new ways thinking that evaluates and analyses the complex nature of enquiry, the underlying assumptions and doubts which could hinder the progress. The importance of student’s question lies not in my competencies as nursing professional but as a leader and manager who need to assess, diagnose and implement solution to the problem (Shirey, 2009; Oliver, 2006). The leadership initiatives of manager nurse become important as it can innovate and evolve creative mechanisms to meet the challenges of the situation (Sullivan & Decker, 2009). The long waiting list in the hospital and lack of staff etc. become pertinent issues that need to be considered at the time of emergencies. My aim now is to develop and apply leadership skills in delivering high standard of healthcare services and develop high performing team of nurses that are capable of meeting new challenges of A&E department successfully. I would make efforts to inculcate positive attitude and remain calm in stressful situation. At the same time, I would ensure that my team-members, including newly qualified nurses and trainee students are actively involved in the clinical setting so that they not only learn to use myriad medical equipment but also the procedures within the different departments of the hospitals for responding quickly to the emergency calls and set priorities. I need to give them leverage and freedom to experiment so that they learn from the clinical setting and are able to use evidence-based practice. I believe that creative approach and positive attitude, developed within the wider scope of leadership skills, would significantly contribute to the higher performance of the A&E department. At the same time, identifying my weakness would help me to improve and exploit my strength to enhance the quality of service delivery which would increase the level of patients’ satisfaction. 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