Leadership in Clinical Practice: Importance of Communication and Feedback

Leadership in Clinical Practice 1
LEADERSHIP IN CLINICAL PRACTICE
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Leadership in Clinical Practice 2
Introduction
Health care professions are of great importance to the general population. There is need
to keep health care professionals in check in whatever they do. Nursing, as a profession, forms
an integral part of the health care professions and has developed a well-informed idea about
mentorship and clinical supervision (Butterworth and Faugier 2013). According to American
Psychological Association, (2015) a seven pillar supervision guideline was developed to inform
training and education in order to realize a competent base of supervision. This consist of
competence of a supervisor, their multiplicity, relationships, proficiency, legality, ethics,
drawbacks of professional competence, monitoring and evaluation and regulations. The
supervisor and the supervisee have to have a cordial relationship for good clinical supervision to
be realized as this has a range of benefits to the patient and health institution and the health
workers (Martin and Milne 2018). Over last two and a half decades, major developments in
clinical supervision have been reviewed, and compared to how it was in its early stages of
initiation (Bernard 2014). Mentorship is a pivotal role in the nursing sector. A good mentor
should be able to envision, prod and challenge the person they are mentoring (American
Psychological Association, 2015). Nowell et al. (2015) see mentorship as an important tool to
attract, train and retain nurses in addition to maintaining quality education curriculum. Nurse
mentor and student nurse is the earliest contact towards achieving a good mentoring environment
in the profession.
Analysis of Leadership Principles
Communication is a two way traffic between the sender and the receiver. It involves
exchange of information and thoughts using either verbal or non-verbal cues. Good
communication is an integral part of any profession. When it comes to the health care system,

Leadership in Clinical Practice 3
good communication between the nurses and patients enhances success of nursing care of each
patient assigned to them. This is according to Kourkouta and Papathanasiou, (2014). In nursing
profession, communication is necessary in all tiers of interventions like preventive medicine,
curative therapy, rehabilitation and even health promotion. Barnlund, (2017). Describes the
transactional analysis (TA) model of communication. In the analysis, verbal cues used as means
of communication assigns a meaning to the matter being discussed. TA is a powerful tool that is
used to psychoanalyze communication between individuals. A structural analysis aspect of this
model focuses on personality development of an individual as a driver towards the type of model
someone will gear towards.
Keshavarzi et al. (2016) analyzes how transaction analysis program affects emotional
regulation on adolescents. The authors say that personalities are made up of three ego states.
They include parent (P) adult (A) and child (C). Each ego state has a unique set of behaviors,
thoughts and feelings. Parent ego state is initiated into an individual through the feelings,
behaviors and thoughts they learnt from their parents during the childhood days. A parent can be
of the controlling type or nurturing type. Controlling parent (CP) is usually judgmental and view
mistakes as blunders. The nurturing parent (NP) is usually understanding, advices the child and
accepts them the way they are. The child ego relates to one’s personality as part of their
childhood emotions and thoughts. It is further subdivided into free child (FC) and adapted child
(AC). The free child is usually oblivious of the rules and will do anything not thinking of its
consequences. The adapted child usually grows into a community where there are social norms
and has to conform to them, thus always aware of the rules. This type of personality proceeds
cautiously when doing things. The last ego state is the adult one. The adult ego deals with facts,
they are rational and unemotional when handling problems, which they easily identify.

Leadership in Clinical Practice 4
The video provided provides a good scenario of the type of communication interaction
between the mentor nurse and the student. Communication must have a sender and a receiver,
and the senders should have certain words and gestures that will have a good effect on the
receiver (Wong, Yee and Turner 2017). In the video, both the mentor nurse and the student are
senders and receivers. But according to the TA model, the communication interaction between
them is such that the mentor nurse, as a parent is a sender and the student nurse as a child is the
receiver. The mentor is domineering and orders the student to take the blood pressure and vital
signs of the patient, and the student willingly responds to that. Ego states of both mentor nurse
and her student have been depicted in the video. The mentor nurse has the parent ego which is
commanding and judgmental. She orders the student to take the vital signs of the patient without
considering that she (the student) is not conversant with the automatic blood pressure machine.
When the mentor nurse realizes that the student is unable to do the task, she judges her harshly
that she is does not know how to do the procedure and that she is not up to the task. The student
nurse in this case is the child. With the training in the nursing profession she chooses to obey the
mentor nurse orders and even after failing to perform her task, she asks for an apology.
Keisler (2017) vividly describes TA. Transactions are made up of a stimuli that initiates a
response. They are grouped into crossed, complementary or ulterior (Boden 2015).
Contemporary transaction is an example of adult to adult communication. In this model, the
agent receives the response they expect and communication is smoothly processed. Crossed
transactions show a parent to child model. It results when the respondent does not produce the
expected stimuli thus communication is not smooth. Ulterior transaction, on the other hand
results from surface message with a hidden meaning. This results from an ulterior stimuli that
elicits ulterior response. In the video, the type of transaction is a crossed one. The student nurse