Clinical Leadership/Management Nursing Issue

Clinical Leadership/Management Nursing Issue

The work environment is one of the domains which needed strategies in order for the nursing profession to move on to greater heights. The work environment is viewed as an area so basic to the future of the nursing profession. Improving the work environment of nurses can optimize the quality of patient care and there will also be retention of the professional nursing staff.

            The deterioration of healthcare work environments is a major problem of concern to the nurse leader or manager. A healthy work environment is necessary to bring about quality healthcare service to the clients. An unhealthy work environment would create a devastating impact not only to the nurses and the clients but most importantly on the effectiveness of the entire healthcare system. This issue or problem is one which could be attributed to delegation.

            The possible root causes for this apparent deterioration of healthcare work environments are outlined in the succeeding sentences. (1) The nurses are placed in leadership positions even if they are not adequately prepared and without adequate support for their roles. (2) Each individual nurse is assigned to handle many clients than they can handle. (3) Decision-making within the work environment is done only by one department, without consultation of all the other parties that are involved.

            The resulting environment created by these situations brings about many negative results in the working environment. When inadequate leaders are placed in positions, there will be dissatisfaction and high turnover for nurse leaders and the staff as well. When each nurse is assigned to handle many clients, this would result in confusion and the clients are placed at risk for errors and injury. The nurses are also frustrated, angry and stressed out. Decisions that are made without consulting all the parties involved places everyone involved – clients, nurses, managers and other staff – at risk. The overall quality of care offered by the healthcare service would be diminished.

 

Action Taken

The nursing staff and managers are the ones responsible for the problem. The lack of leadership skills is one major factor. In order to solve this problem, focus should be given to the nursing leaders and managers. Leadership training programs should be offered and nursing managers and leaders should be required to attend. These managers and leaders in turn should perform their responsibilities of teaching and guiding the rest of the staff in promoting a healthy work environment.

With the particular problem concerning the deterioration of the work environment, a change is needed. This change would include on a large scale the leadership and management styles within the work environment. To start the action step in changing the work environment into a healthy one, there should first be mutual trust and encouragement in all the parties involved. Each and every opinion should be respected and given consideration in the decision-making process. There should also be an all-out support for this desire for change.

            Effective leadership style is an integral part of creating an environment that nurtures the development of an empowered nursing staff.  (1997) defines leadership as “a process of social influence in which one person is able to enlist the aid and support of others in the accomplishment of a common task.” The major points of this definition are that leadership is a group activity, is based on social influence, and revolves around a common task. Although this specification seems relatively simple, the reality of leadership is very complex. Intrapersonal factors (i.e., thoughts and emotions) interact with interpersonal processes (i.e., attraction, communication, influence) to have effects on a dynamic external environment (1997).

In the current work environment, the people should be ready for a new way to share the power and the responsibility that goes with it. They should be ready for partnering relationships, collaborative work relationships and shared leadership. For this particular problem, shared leadership has to be employed. Shared leadership provides an organizational framework that offers the nursing staff maximal participation in decisions about work and the work environment. Every staff has to be given a chance what he or she thinks about a current situation and what they think can help such issues.

 

Analysis

As previously mentioned, in order to achieve all these, the management style of shared leadership should be employed in the hospital setting for the nurses. Shared leadership is a nursing management model that supports staff nurses in extending their influence about decisions that affect their practice, work environment, professional development, and self-fulfillment (2001). As previously mentioned, leadership is a group activity. In shared leadership, every voice is heard and given consideration.

Shared leadership is a collaborative team process in which team members share key leadership roles (2004). Shared leadership is empowering employees to act autonomously, be decisive at the point-of-service, and create a shared vision aligned with organizational goals. Shared leadership development and autonomously practicing nurses appear to be the equation for success in delivering quality patient outcomes in today’s organized health care delivery systems. Employees must develop or refine new behaviors and skills in empowerment, facilitation, negotiation, systems thinking, and accountability on behalf of patients (2002).

Shared leadership is a way to strengthen continuous learning and enhance relationships between leaders/managers, staff and clients, which are the foundation upon which the nurses can develop a new type of relationship with management and with each other. This in turn could significantly improve the work environment. There is an emphasis on ‘relationships’ since these relationships can be tenuous at times as both managers and staff members adopt attitudes of contention and competition with each other.

The demands of the health care environment have brought about changes that have not always contributed to positive work environments, and nurses have been concerned about the impact this has had on client care. Managers have had to develop ways to achieve expected outcomes and meet targets required by their organizations. To address all these issues, nurses need to focus on developing relationships that facilitate working with each other from strengths and not just criticizing weaknesses (2001).

 

Evaluation

In the implementation of the new policies or rules, the staff was allowed to contribute to the decisions made. Goals have also been set. The nurses were mentored by the manager and clinical nurse specialist to apply the shared leadership skills during their daily work to achieve the goals that are set. This is to support the nurses’ use of shared leadership behaviors in the clinical setting.

In every nurse is the individual’s willingness to see the vision and make the personal changes necessary to connect with that vision. It is how the concept of shared leadership works (2002). Evaluation of the plan showed that all management staff played an important role in leading the emergence of legitimacy of this “new professional authority.” The encouragement of individual nursing staff to establish individual goals that achieve more self-direction, more knowledge and self-confidence, and more networking ability by the process of shared leadership led to a more committed employee. A more committed employee in turn contributed to a positive and healthy work environment, solving the problem of deteriorating work environments for nurses.

 

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