Leadership and Delegation: the Role Tthey Play in Nursing - Term Paper Example

Leadership and Delegation: the role they play in nursing 1 Introduction: 1 Delegation: 2 Case Study: 5 Conclusion: 7 Reference: 7 Leadership and Delegation: the role they play in nursing Introduction: The science art and craft of nursing and the nurse itself touch and have touched lives almost wherever they have lived over the ages. Nurses are usually women and in number they are usually more in number than other counterparts who participate in the practice of medicine (Marx E S and Micle D G, 2008 pp53-55). The history of nursing has been placed uniquely to contribute to the history of health and that of women. Yet, nursing as a profession and its various, aspects have received scant attention from historians of medicine and health and until more recently, from feminist historians. Nurses rarely emerge in accounts of pioneering medicine and are awarded little space in the history of hospitals itself. For all traditional aims and purposes, the history of nursing and its leaders has been overshadowed, dominated, and swamped by the iconic figure of Florence Nightingale. As she, herself said: “Let whoever is in charge keep this simple question in her head (not, how can I always do the right thing myself, but) how can I provide for this right thing always to be done?” This statement in itself embodies what has come to be seen as the principles of nursing as well its goals. Delegation: Delegation is a process of entrusting work to someone or the assignment of responsibility (Hansten and Washburn, 1999). It is a legal and management oriented concept, there are those that define it as being an art and a skill, a decision-making process; as a process delegation can never be absolute; the one delegating a task maintains ultimate answerability for the delegation and the decision-making process, and for the results of the task being delegated (Hansten et al., 1999). Efficient nursing delegation in a clinical setting is important for the proper management and implementation of the patient care process. In fact, its importance cannot be stressed enough because it is the efficiency of the nursing delegation process that decides ultimately, the level of comfort that is provided to the patient and ensures faster recovery essentially.   The registered nurse (RN) is accountable for to the public for providing culturally, competent, safe, and effective nursing care for patients in a variety of settings across the continuum of health care (Anthony et. al., 2001). These may include hospitals, long-term care facilities, nursing homes, and community and public health centers among many others. These are the clinical settings within which the RN needs to operate. It is the RN that is responsible for the supervising those to whom they have delegated certain tasks. The RN has significant responsibility as a supervisor of delegated or assigned activities (Lipe S K and Beasely S, 2003 pp151-152). Each person involved in this process is accountable for his or her own actions or inaction and is potentially liable if competent and safe care is not provided. Certainly, the educational preparation and demonstrated ability of the person who will perform the designated act must be evaluated by the RN making the decision to delegate tasks to others. Inappropriate delegation may be specifically stated as grounds for disciplinary action by your Board of Nursing.  The Current Scenario:  The nursing profession is in the midst of a national nursing shortage. Researchers estimate that by the year 2020, the available registered nurse workforce will fall 20% below projected requirements (Buerhaus, Staiger, & Auerbach, 2000). While the shortage affects nurses in direct patient care positions, the inadequate supply of nurses to meet the growing care demands of an aging population will also affect the availability of qualified nurse managers. The nursing shortage literature extensively explores the staff nurse and direct caregiver perspective, but limited literature is available to explain the growing shortage of nurse managers (Anthony, MK, Casey D, Chau T, and Brennan, P F, 2000 pp285-293). Given that nurse managers play an integral role in creating the work environment, a potential shortage of capable nurse managers poses a further threat to recruiting and retaining staff nurses in the profession. There has been recognized by the Council of Deans of Nursing and Midwifery that there is infact a number of problems with the existing system of health workforce, especially with an ageing workforce. The Productivity Commission’s Position Paper on Australia’s Health Workforce submitted a report. Out of these, the council agreed that: “An ageing population and an ageing workforce place strains on the health workforce □ Supply and demand projections should be based on differing scenarios □ there is a need to allocate more funding to educate more nurses (and other health professionals) □ It recognizes that the shortage of nurses is caused largely by failure to retain them in their profession after graduation and registration. We submit that this can only be addressed by changes in workplace relations and conditions □ It advocates a peak national body to advise on all aspects of ensuring an adequate health care workforce. This could help to address proposals such as the Nurse Practitioner without such developments being blocked by political debate or turf wars such as has been the case for the NP. Issues of national importance do deserve to be decided at such a level rather than as in the current system. □ It advocates a peak national body to oversee all aspects of accreditation and registration. We would expect that nursing is represented on all panels and that nursing courses were accredited by nurses. The issue of credentialing is linked to accreditation/registration but not mentioned by the Commission. This is important; we do not want a proliferation of credentialing bodies being set up in the near future. Perhaps competency assessment also fits here. □ It supports an increase in the number of Nurse Practitioners. For every one per cent of RNs qualified as Nurse Practitioners, on the 2001 figures that would mean 1740 NPs – a useful supplement to the 52000 medical practitioners □ It suggests that rural and remote health care would be helped by greater delegation of tasks, and by provision of education and training opportunities in these areas □ It suggests block funding of communities for health care rather than top-up payments to providers for individual services □ It proposes wider scopes of practice for Aboriginal Health Workers and increased education and training for Indigenous students, in or near their communities □ It recognizes that there should be more evaluation of all health care measures and initiatives.” (Productivity Commission 2005) Due to this there has been observed that there is a shortage of nurses in the country as there has been a failure by the system to retain the nurses after they have studied and registered (Lawton S, Centrell J and Harris J, 2000 pp188). Thus, there have been various case studies that have been conducted to observe the reason behind this shortage and how can the work environment be improved upon so that there is an improvement made in the existing system so that the trained nurses can be retained. Case Study: There was a case study conducted where there was observed the implementation of the NPM, which is the New Public Management on the nursing administration and how it has affected the work environment of the area. The study observed that after the implementation of the NPM, there was a greater increase in the communication system and the relationship between the nurses and the nurse managers improved to a great extent due to which the job satisfaction also was seen to rise. “The implementation of NPM may have changed the nature of superior-subordinates relationship between nurses and nurse managers, especially if managers have been forced to increase the workloads of nurses. In turn, this could affect their performance and job attitudes. Hence, the quality of superior-subordinate communication is an important component when examining the impact of increased managerial control on nurses’ satisfaction with communication processes and, in turn, their perception of workplace autonomy in the workplace.” Even though the work of the nurse can be delegated, the fact cannot be ignored that the role and knowledge of an RN cannot be replaced. While nursing tasks may be delegated, the RN’s generalist knowledge of patient care indicates that the practice-pervasive functions of assessment, evaluation, and nursing judgment must not be delegated. A task that has been delegated to an unlicensed assistive person cannot be redelegated by the unlicensed assistive person to someone else (Brunetto Y, Wharton R. F). Consumers have a right to health care that meets legal standards of care. Thus, when a nursing task is delegated, the task must be performed in accord with established standards of practice, policies, and procedures. Finally, the RN determines and is accountable for the appropriateness of delegated nursing tasks. Inappropriate delegation by the nurse and/or unauthorized performance of nursing tasks by unlicensed assistive personnel may lead to legal action against the licensed nurse and/or unlicensed assistive personnel. Conclusion: In conclusion, it can thus be said that leadership, management and administration are important components in the working and the establishment of a healthy working environment and it plays an important role in ensuring that the working of the system is running smoothly, be it for any organization. NPM is an important methodology that can be adopted by various organizations in order to meet the growing needs (Rainey, H 1997). Delegation is also essential in various cases, but for any organization to sustain itself in the long run and function economically and efficiently it is important that it has a stable base of employees who are satisfied with their work. Reference: Anthony, M.K, Standing T, and Hertz JE, 2001, Factors influencing outcomes after delegation to unlicensed assistive personnel, pub, Journal of Nursing Administration, Vol.30 No.10, pp474–481  Anthony, MK, Casey D, Chau T, and Brennan, P F, 2000, Congruence between registered nurses and unlicensed assistive personnel perception of nursing practice, pub, Nursing Economics, Vol. 18 No.6, pp285–293  Brunetto Y, Wharton R. F , A Case Study Examining The Impact Of Public-Sector Nurses’ Perception Of Workplace Autonomy On Their Job Satisfaction: LESSONS FOR MANAGEMENT Hansten, R.I. and Washburn, M J, 1999, Individual and organizational accountability for development of critical thinking, pub, Journal of Nursing Administration, Vol.29 No.11, pp39–45  Hansten R I, Washburn M, Jackson M, Kenyon V, 1999, Home Care Nursing and Delegation Skills, pub, Jones and Barlett Publications, pp73-76  Lawton S, Centrell J and Harris J, 2000, District Nursing, pub, Elsevier Health Sciences, p188  Lipe S K and Beasely S, 2003, Critical Thinking in Nursing, pub, Walters Kluwer Health, pp151-152  Marx E S and Micle D G, 2008, Leadership and Management Skills for Long-Term Care, pub, Amazon Books, pp53-55  Productivity Commission 2005: Response from the Council of Deans of Nursing and Midwifery to the position paper on Australia’s Health Workforce pp 2-4 Rainey, H 1997, Understanding and Managing Public Organizations, 2nd ed, Jossey-Bass, San Francisco. Read More