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Nursing Leadership

Nursing Leadership

Leadership refers to the process of social influence in which an individual enlists the support and aid of others in order to accomplish a common task. Leaders have numerous issues and are continuously competing for their time and attention. These tasks range from day to day duties to strategy development. Leaders are charged with the management of the long-term organizational vision. They have to play a balance and prioritize tasks that demand immediate attention (Smith, Profetto-McGrath, & Cummings, 2009).

One of the main areas of leadership is ‘creative thinking and continuous improvement’ which some people refer to as ‘creative thinking for continuous improvement’. Creative thinking plays a critical role in high-performance organizations. It ensures that leaders perform a rewarding work (Johnson & Rea, 2009). However, all employees or juniors must be familiar with the vision of the organization. Leaders are charged with the responsibility of letting their juniors know that they play a meaningful role in accomplishing the organizational vision; this can be achieved through the creation of an environment where team members express their opinions and concerns willingly and openly. When team members feel that their voice is being heard, they are more engaged and tend to feel that their roles are vital to the overall well-being of the organization.

‘Creative thinking and continuous improvement’ is one area of leadership that I would like to study to enhance my nursing practice; this is because I would like to see that all people are satisfied with the nursing services provided. They should be provided with the utmost respect, dignity, sincerity and professionalism. With the advancement in communication and increased complexity in the workplace, there is a need for continuous improvement for excellence. Creative thinking and continuous improvement can only be achieved with creative thinking; it leaves all stakeholders satisfied. In the nursing practice, nurses deal with diverse people who are more informed about their rights (Smith, Profetto-McGrath, & Cummings, 2009). Nursing requires a high level of understanding and patience. However, nursing organizations and institutions also demand time management by nurses. It is difficult to find balance between the mode of delivery, time management, professional courtesy and client satisfaction.  With creative thinking and continuous improvement, it is manageable to find solutions to these problems. The nursing leadership can assist people in lower levels of management understand the significance of creative thinking in solving day to day challenges (Laschinger, Finegan, & Wilk, 2009).

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Critical thinking refers to purposeful, self-regulatory judgment that employs cognitive tools such as analysis, evaluation, interpretation, inference, and rationalization of the evidential, methodological, conceptual or contextual basis through which judgment is made. Critical thinking skills used in the delivery of client care and those used in leadership are similar. Just like in leadership, a nurse’s ability to offer safe, high-quality service/care is to a large extent dependent upon the capability to reason and judge; reasoning and judgment can be inhibited by the lack of experience. Therefore, nurse’s expert performance relies on constant learning and performance appraisal.

Just like in leadership, nurses have to be self-disciplined, self-directed and self-monitored in the delivery of client care. Nurses have to go along with meticulous standards of excellence and strive to attain them.  For example, they should not steal time attending private matters as opposed to attending their clients. Furthermore, they need to have effective communication and problem solving abilities. Leaders that want to elicit willingness from their juniors, and act within the confines of organizational and state laws, should overcome sociocentrism and native egocentrism. They respect power structures and cannot, for example, issue ultimatums. Similarly, nurses have to determine the structures of the clinical practices and traditions within which they should make decisions and respond timely to specific clinical situations. For example, they can focus on patients with critical problems but still make comfortable the clients who are not in need of urgent attention.

In my profession, I have encountered many nurses who cannot distinguish between critical reflection and ethical, clinical, or even creative reasoning. These nurses have one or a combination of modes of thought such as evaluation of evidence, creative thinking, clinical reasoning and application of standards of practice. They are all distinct from critical reflection and tend to be included under the critical thinking rubric. Even the nursing education literature, nursing scholars and accrediting bodies do not make a distinction between clinical reasoning and critical thinking. The development of my leadership skills has been inspired by the need to help others discern when each of the above modes of thought is better suited; as all nurses may be required, by circumstance and/or policy, to apply standards and use evidence-based practices, and creative thinking.

Interview with a Nursing Leader

I had a cherished opportunity to interview a nursing leader in my organization whose leadership skills I greatly admire. We talked about many attributes that make an exemplary nursing leader in the organization. One of the leadership skills we discussed is integrity. This topic was timely in that there are many ongoing reports on the lack of integrity in the nursing profession. Integrity is defined by behavioral characteristics such as high ethical standards, honesty, and maintained moral principles. Lack of integrity in nursing is manifested in the form of forgery, lying, and discrimination against clients and colleagues. Discrimination against clients may stem from the urge to earn more through tips and commissions from clients or their families (J. N., personal communication, September 24, 2014). Leadership with integrity inspires people in lower levels of management to follow suit. Unquestionable leaders are internally motivated to voice or defend organizational policy.

Courage is one of the most significant issues in nursing leadership. Courage is the ability to identify and pursue a particular course of action. Courage means that one has to be confident in pursuing all those intelligent decisions, and it enhances contextual perspective, open-mindedness, perseverance, and reflection (J. N., personal communication, September 24, 2014). Courage also means that one is not reluctant to engage in fair and thoughtful actions. Without courage, even the best personnel endowed with analyzing and predicting ability cannot take timely actions (J. N., personal communication, September 24, 2014). Courageous leaders not only inspire others through their course of actions, but they are also receptive of new ideas.

Quite often, nurses will portray behavior that reveals that they are incompetent. Incompetent nurses become the lure of most hiring managers as there is always a growing demand for nurses (J. N., personal communication, September 24, 2014). Some nurses have a negative work history; hiring consequently requires screening. Demand for nurses is fed by the aging patient demographics, an aging nursing workforce, increased life expectancy and the consequent need for nursing homes, and fewer equipped candidates entering the profession (J. N., personal communication, September 24, 2014). In spite of the realization of the reduced number of nurses, increased patient acuity and fiscal constraints, nurses have to be competent and morally honorable. This not only improves the image of the organization but also reduces stress among both nurses and clients. Competent organizational leaders are familiar with all aspects of leadership and work, and do not shy off from letting their juniors know what they should do.

The exemplary nursing leader exhibits integrity and courage in what they do. For example, they fired a nurse who had forged patient’s records. They also let their juniors know about the forgery and the firing. Charismatically, they let all juniors know that their efforts were greatly valued; that they helped the organization make numerous strides of achievement. No one would be allowed to negate the progress made so far. By making juniors know that they were highly valued, J. N. exhibited both humility and courage. Additionally, they were positive about an idea of one of the nurses on saving time. Rather than let clients choose the nurse that will attend them, clients would be encouraged to be familiar with nurses who lived near their homes. At the same time, nurses would be encouraged to be friendly to the clients and offer regular check-ups; this way, nurses would become familiar with patients and when the latter preferred to be at home, nurses would still attend them. Not only would the cost of movement be greatly reduced, but a lot of time would be saved. J. N. organized a team to look into the viability of the initiative and start the project.

Incorporating Integrity, Courage and Competence in Nursing Leadership

Nursing leadership requires integrity, courage and competence. Integrity is significant in promoting a good leadership and corporate image enhancing fairness and promoting personal discipline (Laschinger, Finegan, & Wilk 2009). Courage ensures that nurses try positive and imaginative ideas. On the other hand, competence in nursing leadership enables people to execute their mandate in the best way possible. The potential changes needed in my organization include changing of mindset of nurses so that they employ evidence-based approaches, clinical reasoning and critical thinking skills in their work. Nursing leadership can influence the outcome of this needed change through short informative training sessions. Additionally, leadership can encourage critical thinking skills and reward nurses on the same.

My view of leadership is oriented towards critical thinking and problem-solving approach to all issues concerning the nursing profession. I can incorporate integrity, courage and competence in my nursing leadership through regular practice and reinforcement. Practicing integrity is not wholly dependent on a strict policy of honesty; it calls for practice so that I will not bend the rules when the situation becomes personal or emotional. Although I have many ideas, I may need to be more confident to try them as well as invite others to contribute. Additionally, I need to exercise my leadership and nursing skills more so that I can learn and become competent in both.