Leadership in a Nursing Team | Report

Running head: LEADERSHIP IN A NURSING TEAM
LEADERSHIP IN A NURSING TEAM
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LEADERSHIP IN A NURSING TEAM1
Introduction
According to the Australian College of Nursing (ACN 2015), the principles of clinical
leadership involve continuous deliverance of evidence-based practice, mitigation and assessment
of patient risks, practicing patient advocacy and facilitation of strong collaborative
communication across nursing and multidisciplinary team members. The following paper will
thus extensively and elaborately discuss on the major roles of leadership and delegation required
to be undertaken by the nurse with respect to the following two clinical scenarios.
Clinical Scenario 1
Leadership Role of the Nurse
As per the National Safety and Quality Health Service Standards (NSQHS) developed by
the Australian Commission on Safety and Quality in Healthcare (ACSQHC 2017), the leadership
role of the graduate Registered Nurse (RN) Pearl, in this scenario is to adhere to the standards
1.6 of ‘Clinical Leadership’ and standard 1.10 of ‘Risk Management’ standards for the purpose
of delivering safe and quality care. According to NSQHS standard 1.6, healthcare professionals
designated with clinical leadership responsibilities, such as the RN, must support clinicians
within the multidisciplinary team by informing of the issue of patient safety and performing with
their delegated scope of practice for the purpose of delivering care services which are safe and of
high quality to the patient (ACSQHC 2017). Pearl must assist or collaborate with Ray to inform
Dr. Rivers immediately of the critical condition demonstrated by his patient Miss Fischer.
Administration of medications without clinician orders is not within the scope of practice of RNs
(Martyn and Paliadelis 2019). Considering their scope of practice of conducting patient
assessments as nurses, the above collaborative communication can then be followed by
immediately delivering information Dr. Rivers regarding the relevant observations and
assessments demonstrated by Miss Fischer. To collect this information, Ray or Pearl must adhere
to NSQHS standard 1.10 which directs clinical leaders like nurses RNs to document risks
demonstrated by Miss Fischer via comprehensive risk assessments and communicating the same
immediately to her family and the multidisciplinary workforce, in this Dr. Rivers (ACSQHC
2017). The implementation of such assessments can be done by adhering to the clinical
reasoning cycle process of cue collection and information processing which comprises of

LEADERSHIP IN A NURSING TEAM2
evaluating the medical history and assessment scores of Miss Fisher and evaluating the same to
interpret her status of risk or deterioration (Levett-Jones, Courtney-Pratt and Govind 2019).
Considering that Pearl is yet to discharge her third eye patient, she can only assist Ray
after commencing her discharge duties or alternatively, delegate the duty of discharge education
of third patient to Sandy, considering her lack of knowledge on the specific discharge education
instructed by Dr. Trout. Such details of delegation will be expounded upon in the succeeding
sections.
Decision-Making Framework
According to the decision-making flowchart developed by the Nursing and Midwifery of
Australia (NMBA 2020), the decisions to delegate clinical responsibilities to nurses must be
based upon objectives of ensuring positive patient outcomes, capacity of the organization,
nursing risk assessment, delegation to an appropriately competent person and providing
supervision as per competence. In case of the scenario, considering the risk to Miss Fisher’s
safety and lack of experience in Ray to address the same, it can be implied that Ray is not
competent on his own to address the safety outcomes of Miss Fisher’s critical condition. Thus,
an RN like Pearl can adhere to NMBA (2016) professional standard 6 and delegate the task of
discharging her third patient to Sandy while simultaneously supervising Ray regarding
management of Miss Fisher. This is because as per the ‘Nursing and midwifery guides to
practice decisions’ by the NMBA (2015), nurses must delegate or supervise tasks as per the
competency and scope of practice of nursing team members. In this case, delegating the task of
discharging to a competent RN like Sandy would be appropriate since she is well aware of Dr.
Trout’s preferred discharge education. Additionally, as per the NMBA’s (2020) decision making
tree, Pearl must then supervise Ray in conducting risk assessments for Miss Fisher as per
standards ordered by the organization and multidisciplinary team.
Delegating as per the above raises the issue of DD discharge for Mr. Riggs. In this case,
considering the critical condition of Ray and Pearl, Sandy must follow the NMBA (2020)
decision making flowchart and delegate this task based on competence, appropriateness, need for
supervision and readiness of accountability. Delegating the task to an experience RN and EN
Wade would be most appropriate since he has only one patient to discharge and has the
competency of addressing Mr. Riggs without any supervision.