Clinical Leadership in Nursing

Running head: NURSING CASE STUDY
Nursing Case Study
Name of the Student
Name of the University
Author Note

1NURSING CASE STUDY
Introduction
Clinical leadership in nursing has a crucial role to play in ensuring quality of patients’
care while increasing the safety in the overall healthcare service delivery. Poor quality of the
patients’ care along with increase in the reported cases of medication error has forced the
healthcare professionals to give importance to the overall concept of clinical leadership
(Mianda & Voce, 2017). The hall-mark of clinical leadership among the registered nursing
(RN) professionals mainly encompass proper application of the critical thinking skills, proper
decision making process, taking active action on behalf of the group of team members, doing
advocacy for the clients and their family members in order to gain informed consent and to
improve the decision-making skills (al Dossary, 2017).
Case Study 1
The application of the clinical reasoning process in the case study of Pearl highlighted
several aspects that must be worked on in order to increase the overall safe and quality of
care. The number of theatre orderlies is two and they are rostered for the whole service
however, they are mainly located between the theatres and first stage recovery. In order to
increase the quality and safety of care, the number of orderlies must be increased who can
work between the first and second shift. Griffiths et al. (2016) stated that based on the cost
benefit analysis the increase in the level of staffing of the nursing professionals and other
allied healthcare professionals help to improve the quality of care by reducing the rate of
error and by reducing the job pressure over other working professionals. Other staffing of the
nursing professionals in the first and the second stage is adequate as per the strength of the
patient. In the first stage, there 6 bays with Pearl working as a graduate RN with an
experience of 9 months and he is being monitored and guided by Sandy, a senior RN having
experience in advanced life support. They are further assisted by Ray, an RN with three years
of experience to execute the work in the first stage of sedation. Nieuwboer et al. (2019) stated
that one of the important aspects of the clinical leadership is promoting skill-based training in
order to improve the overall quality of care. From the case study, it is evident that Pearl and
Wade were absent from the Inservice arranged by Dr. Trout under the supervision of NUM.
This Inservice focused on effective communication skills that must be used to deliver right
information to the patients during the time of discharge. Nieuwboer et al. (2019) further
argued that educating the patients about the care plan during the time of discharge helps to

2NURSING CASE STUDY
increase the participation of the patient in the care plan and thereby increasing the therapy
adherence and improving the process of recovery. Thus in order to increase the quality and
safety of patients’ care, second round of Inservice must be arranged for Pearl (who have only
9 months of experience) and Ray (who is new to Oceania and is not aware of communication
approach to patients of Oceania).
According to the Decision Making Framework by Nursing and Midwifery Board of
Australia (NMBA) (2019), it is the duty of the nursing professionals and midwives to
delegate the nursing workforce based on the severity of the patients’ situation and as per the
skill and experience of the nursing professionals. In this case study, the first delegation
should be for Miss Fisher who is a 22 years old patient and is suffering from tonsillectomy
and adeniodectemy. Her blood pressure is dropping (90/60) and pulse is increasing. with
blood around her mouth. This might be a due to misplacement of the endotracehal tube (ET)
due to movement of head and neck position. Hyzy (2017) stated that movement of ET tube
might hamper the proper functioning of the cardiac muscles leading to chaotic signaling.
Chaotic signaling signifies poor efficiency of heart leading to higher heart rate and gradual
drop in the blood pressure. Since Ray is new in the Oceania Day Surgery, he might
experience lack of knowledge in resource allocation. In such case, Pearl with 9 months of
experience must assist Ray to promote medical emergency call. Ibrahim (2017) stated that in
clinical nursing leadership, delegation of the nursing workforce must be done based done
based on the seriousness of patients’ situation and based on the experience and skills of the
nurses. According to the standard 2 of NMBA code of professional conduct for nurses, it is
the duty of the nursing professionals to practice in a safe and effective manner while working
collaborate with the other allied group of professionals. Working in active collaboration,
Pearl and Ray, helps to adjust the medical emergency in an appropriate manner. According to
the case study, Pearl has only one eye patient left, thus it would be wise for Pearl to conduct
the DD check for Mr. Riggs as Ray is engrossed in caring for Fisher. It is also the duty of
Day to communicate the concern to Miss Fisher to the senior doctors, taking into
consideration the urgency of the medical situation. Pearl must also actively assist Ray in
conducting the basic care process for Miss Fisher. The condition of Miss Fisher is critical and
thus can be considered as care priority in comparison to the eye patient in the second stage.
Vaismoradi et al. (2016) stated that it is the duty of a clinical leader to execute leadership
with the help of the transformational leadership format. Transformational leadership styles
help to increase the provision for collaborative practice among the allied healthcare