Nursing Clinical Leadership - Case Study Example

358210 - Nursing Clinical Leadership Nurses are the most influential personnel in a hospital or in other health institutions. This is because they constantly come into contact with the patients and their families regularly. They implement the treatment plans of their patients and liaise with the physicians incase of an emergency. They also maintain clients’ register in a hospital. Nurses are the heart of success in any hospital or health institution. Consequently, they are the pacesetters in the provision of healthcare services. Nurses’ pivotal role in the provision and implementation of treatment regimes demands that they provide clinical leadership at all times. If they fail, the image of the hospital and its clinical services will crumble because patients and other stakeholders will loose faith in the clinical services. Emergency Nursing Department is facing credibility crisis. Description of the issued identified Emergency Nursing Department is in big trouble. Between January and July 2009, there were over two hundred official complains reported and recorded at the customer care desk. The patients, general public and physicians are simmering with discontent at the way nurses are discharging their services. The magnitude and the intensity of dissatisfaction have reached the levels that cannot be ignored or tolerated. To illustrate the effects of the ensuing discount, the numbers of patients visiting the hospital have fallen drastically from an average of sixty eight patients daily to an average of forty. Reduction of patients has drastically reduced nurse and physician productivity. Furthermore, the income from hospital services offered to patients has dropped by thirty six percent in the last six months. The future of Emergency Nursing Department is bleak and if no concrete steps are taken, its demise is inevitable. Nurses were reported to have been non responsive to the clinical needs of their patients. Treatment queues were longer, there were outright discrimination of patients based on race, sex and age. The nurses were hostile, unconcerned and less cooperative. Some patients reported to have experienced first hand bullying from the very persons who should have been caring and friendly. The above allegation s was not far from the truth. It was discovered that most nurses were arrogant and uncooperative. The case of Emergency Nursing Department was pathetic especially considering the nature of services they were offering to the general public. The patients and the general public had formed the conclusion that the hospital was not responsive to their clinical needs. In response to the allegation against Emergency Nursing Department, the administration appointed the task force to look deeper into the allegations. The task force committee underscored that nurses provided poor health care services that caused diminishing value of the company in the face of patients and the general public. There was renewed urgency to regain the image and splendor of the organization. To rebuild trust, integrity and the image of the organization, strategies were identified ad the best strategy was earmarked for implementation. Analysis of a set of strategies with reference to the literature The chief concern of all leadership strategies in nursing is to restore reliability and dependability on nurses as they provide health care treatments. To achieve the above aims and deal with the concerns raised, applicable ad genuine integrity should be the driving force. This is because it strengthens the will and honesty of the nurses. Integrity saves both time and energy. It is also an indicator of strength. The nurses have been competently trained and with improvement of their integrity through good leadership, they are able to deliver quality health care to those who need clinical services (Fabre, 2008). There are various leadership approaches of redeeming waning integrity of the nurses. However, four leadership approaches has been identified. They are visionary leadership, coaching leadership, affiliative leadership and democratic leadership. The leadership strategies identified above can assist in redeeming the waning image of the nurses and place them in a unique position. The new realm will promote clinical leadership and promote treatment of the patients. Visionary leadership These approach to leadership rally people behind a vision and drive people towards achieving the vision via a set of predetermined mission. The leader gives people a sense of a dream and rallies them behind shared values that brought them together. The visionary approach demands that a leader becomes transparent and honest. This type of leadership is more action oriented. It involves retaining the most valued employees of the organization who resonate with the values, goals and mission of the company. This type of leadership is utilizes mission and vision because it offers their employees a unique way of distinguishing themselves from other identical players in the industry. It assists people to see how their jobs and contributions fit the bigger picture of the organization. Visionary leaders keep reminding people of the importance of their work. Such leaders believe in vision and mission and are emotionally mature and intelligent. The leader should be able to read people’s mind to be able to influence them. Transparency is important because it removes barriers and smoke screens (Nagelkerk, 2005). In addition, it helps the employees to freely share information and knowledge. Visionary leadership may not work well when working with a team of experts or people more knowledgeable than the leader. Incase of a mistake in this leadership, it may result to poor performance, especially when the leader is overbearing. It may undermine the spirit of a working team. Coaching approach to leadership Coaching is among the best leadership styles. Coaching is a process where an employee is guided by a competent superior person to establish and practice long term development goals of both the company and the employee. A coach is appointed by the leader of the organization for each employee who needs to improve. A coach may be appointed from within or outside the company. A coach is charged with a general responsibility of bringing the best out of the people. They do so by exploring the goals and values of their employees before they counsel them. They help the employees to identify their strengths and weaknesses and realign them to their personal and career aspirations. They also encourage employees to develop their own long term goals and assist them conceptualize a practical plan that will actualize their long term goals and objectives. They guide the employees in developing and mastering their abilities together with their capabilities. This is done by delegating more challenging work based tasks and assignments to stretch their abilities and capabilities. As a result, employees performances improve thus promote higher self esteem and enable the employees to function independently. Coaches should be competent, emotionally intelligent and helpful so that they will be able to connect and advice them genuinely. Coaching is appropriate with employees who exhibit initiative and want increased professional development. However, it does not work when employees lacks motivation or need excessive feedback and personal direction. If coaching is executed poorly, it leads to micromanagement or excessive control of an employee. Consequently, it undermines employee self confidence and may lead to poor performance. Affiliative leadership approach Affiliative leadership involves creating harmony and connecting with people whom you choose to lead. It also uses a lot of praise extensively as a way of creating connections. Through this approach, leaders put first the people and their feelings. Organizational goals and mission comes second. Such leaders aim at building tremendous loyalty and trust amongst the people they lead. The leaders achieve trust and loyalty by creating harmony, motivating employees during the time of stress and anxiety. In addition, they strive to keep the employee happy and offer emotional support during trying moments in their private lives. The affiliate leadership approach is appropriate when they are rifts in the organization. It is also needed when it is necessary to work under teams, improve moral of the employees and repair broken trust and communication in an organization. This approach foster harmony and promotes friendly interactions. To be effective in this type of leadership, a leader must have great competence in collaborations and posses empathy. However, this approach may lead to poor performance if leaders exclusively focus on praise and personal issues rather than performance, especially when poor performance is not rectified (Huber, 2006; Tomey, 2004). Democratic leadership approach Democratic leadership makes use of participation or consensus to develop commitment. Leaders who use this approach values the ideas and contributions of all the people they lead. To be effective in this approach, leaders must be open, transparent, good communicators, rich in empathy and collaboration. They must also be good in influencing their followers and solving conflicts amongst the people they lead. This approach is very appropriate when the leader is not certain about which direction to take. The employees will freely generate ideas for executing the work of the organization. However, this approach is not appropriate when there is crisis in the organization. It is not also appropriate when there is no adequate time to make decision. If not applied correctly may lead to endless meetings, confusion and delays in execution of activities in the organization (Goleman & Boyatz, 2004). Explication of and rational for the chosen strategy Visionary leadership approach Visionary leadership has highly positive impact if it is applied appropriately. This is because redeeming the nurses’ image calls for articulation of new vision and mission of the Emergency Nursing Department. The vision will be “to be the leading provider of treatment and nursing service in the Australia”. The above vision will be achieved by promoting development of the nurses and defining their roles and responsibilities, maintain expert credibility, promoting overall quality and strengthening clinical practice. In addition, the right caliber of nurses will be recruited and nurtured. Effective communication systems will be put in place and the organization shall strive to establish effective working relationships. The visionary leader will have to create, model, and align new principles and objectives to achieve the vision and make the nurses live the mission. The leader will also have to push the nurses to produce the much needed results and meet the set expectations. This approach of leadership allows the leader to fire nurses who fail to improve their work and retain those who are willing to align to the vision and mission of Emergency Nursing Department. The leader will be able to apologize for the sorry state of the hospital and promises to act appropriately in future. The explanation, atonement and apology are meant to provide an environment for healing (Greene & Burleson 2003). To be effective, the leader must make the nurses to know and understand that their past behavior and actions caused a lot of damage not only to the organization but also to the patients who got worse and hurt in the process. The leader should prompt the nurses to strive for excellence in provision of excellent nursing services to all its customers without any form of discrimination. In addition, they have to create and nurture trust by being reliable, dependable and responsive to the clinical needs of the customers. The leader should also ensure that nurses remain committed to integrity at all times so as to build sustainable relationships. Building relations demands that the organization apologizes for those who were wronged and promise to better in future. He or she shall reward good work and reprimand unacceptable work performances of the nurses. The leader will strive to create a culture of hard work and competence in the provision of the clinical services. The nurses should adopt blameless and accountability should be the virtue at all times. This will give the leader the mandate to hold every nurse accountable their actions and behavior. In addition, nurses will be encouraged to maintain open communications at all times. The strategy to be used to redeem the positive image of the nurse fraternity is the self directed strategy. The leader will make the nurses and management to identify their mistakes before they develop the plan for the future. The leader will also have to demand the nurses to build trust, skills, competencies, abilities, noble motives, good judgment and respect. They have to be open and transparent to all the people they interact with at the course of duty it will be important to nurture nurses who are alive with passion for their patients. Nurses will also be encouraged to apply the highest professional and ethical standards in caring the sick. It is building the quality and integrity of the nursing fraternity (Nagelkerk, 2005). Identification of the stakeholders The stakeholders that would be affected by the visionary leadership approach will include the general public, the patients, the state agencies, physicians, the hospital as an institution and other employees of the hospital. However, the leader, the management, nurses and patients would be central in ensuring that the hospital develops and retains it leadership in the field of clinical nursing. The nurses will be encouraged to use their experience and competence they acquired during their practice. The management is responsible also for the sorry state of affairs and they should be made t realize that they have to provide enabling environment for working for all the employees of the organization so that nurses will live to the mission of the organization. The patients and the entire community will have to be apologized and asked to provide the organization with their own expectations. Emergency Nursing Department will then use the feedback to align its objectives to the expectation of the public and other stakeholders. There is need to negotiate with all the stakeholders to remove the barriers of implementing new policies and principles aimed at improving the services of Emergency Nursing Department. The leader will also have to understand the values and aspiration of the nurses so that he or she will be able to align them with the value system of the organization. The leader will have to collaborate with other stakeholders to ensure that they are no people who are sabotaging or acting foolishly among the employees. Collaboration ensures that people are align to the goals of the organization and are in harmony with the policies set to promote provision of exemplary clinical services. As a result, the employees and the management will be aware and conscious of the repercussions of every step they take. The management will realize that as they restore their integrity, they help nurses to build theirs too. They also set positive example for those around them and increase their capacity to influence good clinical practice. The nurses will be made to understand that they should lead in setting better example. They will also be encouraged to admit their past errors as this will allow the management and the patients to trust them. They will also be made to understand that by opening up to the feedback and adopt flexibility, they will allow themselves to grow and expand in the careers and service delivery. Consequently, their weights of the past will b lifted and will be free to step forward into the future with increased level of confidence (Greene & Burleson 2003). Use of best available evidence to support the strategy There are various successful leaders who have applied the visionary leader approach. Example of visionary leadership in action is illustrated by Shawana Leroy. Leroy was appointed a leader to a development agency. She inherited myriad of problems from her predecessors. The employees’ emphasis on following the bureaucratic rules and regulations more than the mission need to be addressed. This led to slow pace of work, objectives were never achieved and the influence of the organization to improve the lives of people was formed minimal. She sought to identify the aspirations and the values of the people she led before developing her own strategies. At every opportunity, she questioned her employees whether they were living their mission to help the poor. Leroy scrapped off rigid practices and changed them with the help of her team. Ideas and rules that did not work were replaced with new and relevant ideas and policies. There was a complete overhaul on how things were done in the organization. Her initiatives paid off in short time. The emotional environment of the organization improved significantly and reflected the passion as well as the commitment of all the employees and the entire organization (Goleman and Boyatz, 2004). A second example of a person who utilized visionary leadership successfully is Bob Pitman of the Six Flags Entertainment. There was a problem in the organization, customers were unhappy and the janitors were discouraged. The Janitors were unfriendly to the customers. Pitman decided to identify what the problem is by working undercover as a janitor. When he was sweeping the streets, he began to know and understand the underlying problem. Managers were ordering the Janitors unnecessarily and customers were littering the street freely. Janitors felt misused and unappreciated. Pitman together with his team managers redefined the mission of the janitors. The mission was to keep customers happy. Consequently, their job was to clean the streets but in a spirit that was friendly to the customers (Goleman and Boyatz, 2004). Dr. Thomas, who is the president of Eden Alternative use visionary leadership to improve the clinical services for the aged. In the process, he His initiatives led to cultural change and transformations. He questioned the status quo in nursing and brought about new ideas and principles that revolutionized the nursing fraternity worldwide. Revolution brought more caring, love, and humane environment to the old persons. In addition, his ideas prolonged lives of older patients and brought laughter into the lives of old. His ideas are being replicated in Europe and Asia (Changing Aging, 2009; Clark, 2008). Through the above illustrated example, it is certain that clinical leadership will be achieved through visionary leadership approach and Emergency Nursing Department image will be saved. 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