Nursing Leadership: Factors Impacting Leaders and Professional Practice

This paper discusses the challenges faced by nursing leaders, clinical leadership expectations for new graduate nurses, and the application of Gibbs model to develop personal and professional resilience. It also highlights the qualities of an effective leader and the importance of effective communication in the nursing profession.

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Nursing Leadership
Student’s Name
Institutional Affiliation

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Nursing Leadership
Introduction
Nursing leadership refers to the act of trying to influence others to ensure improvement in
the quality of care along with the unswerving participation in clinical care. Nursing leadership
also includes trusting in and respecting human dignity as far as healthcare is concerned (Traynor,
2018). Leadership also incorporates paying attention, inspiring, motivating and always
maintaining a rewarding culture in the nursing profession. It means being able to offer a type of
leadership that is of sound quality and admirable by both co-workers and the patients. Great
nurse leaders (seniors, administrative directors or managers) should ensure that they inculcate a
shared vision among their employees. This vision should be focused primarily on ensuring that
they provide high-quality care to their patients. Excellent nursing leadership should be
consumer-focused. Genuine consumer orientation means considering all patients holistically
instead of looking at them solely in terms of their sicknesses (Frankel, 2019). This paper will,
therefore delve and take a critical look at the various aspects that build an excellent nurse leader
while applying Gibbs model with respect to the case study provided. Most importantly, the paper
critically evaluates a case study involving Kim who is shouted by a registrar for failing to present
the right equipment during the placement. With respect to the case study, the paper shall address
various factors impacting nursing leadership and professional practice, clinical nursing
expectation for beginning new nurses, application of the Gibbs model to the case presented and
qualities of an effective leader while anticipating ethical considerations, laws and policies
predetermined in the nursing practice.

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Issues and factors that impact on nursing leaders and professional practice
Nurse leaders are faced with a lot of challenges as far as their careers are concerned.
These challenges circumnavigate there everyday struggle with their families and daily stress that
they encounter. It takes the ultimate courage to brace oneself and become a nurse leader. Firstly,
nursing leaders face challenges in dealing with stress and distress among employees (Peterson,
2017). For instance, in the case provided, the Nursing Unit Manager thinks that she is helping
Kim when she tells her to go for counseling before people. However, the ultimate outcome of
this initiative might not be effective as Kim seems to be disturbed to have not only left a
workload to the colleagues but also for the matter having been addressed before the public.
Usually, the primary point at which this stress originates is from the management. The
management puts so much pressure on their employees, such that they become depressed. Nurses
are faced by bullying and harassments (Grossman and Valiga, 2016). Like in the Kim’s case, the
registrar is the origin of her stress since she shouted at her due to lack of knowledge regarding
the identity of the equipment to provide during intubation. Furthermore, the fact that Kim feels
disturbed after being asked to go to the office due to internal worries of overwhelming
colleagues with tasks reveals staff shortage as a fundamental problem that impacts nursing
leadership. Nursing leaders are the Centre of everything that happens in the hospital, hence
expected to deliver outstanding performance.
Nursing leaders are expected to exercise a higher degree of professionalism (Regis
College, 2019). If I were the Nurse Unit Manager, I could have written an official letter to Kim
instructing her to come over the office during her free time. This would have not only maintained
her privacy and build her confidence but also ensure that the ongoing operations in the hospital

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setting are not interfered. Furthermore, I could have approached the registrar and talked to her
regarding the implication of her actions.
Registered Nurse Standards (RNS) serve a significant role in while negotiating with the
parties. For instance, Kim has to be advised to maintain capability of practice. It is Kim’s Duty to
ensure that he is aware of all the information and tools required in the nursing practice. Hence,
Kim should learn from mistakes rather than getting depressed about the situation. He should
engage colleagues and reflect on his area of practice (NSW, 2017). However, this aspect does not
guarantee the registrar a right to mock other employees. Nurses are expected to collaborate and
maintain respectful relationship with the core workers in all sectors (ICN Code of Ethics for
Nurses, 2012). Registered Nurses are responsible for their personal development and
development of others. Hence, the registrar should be advised to maintain this principle in the
area of practice. Furthermore, it is significant for Registered Nurses to evaluate outcomes and
inform the nursing practice. In this case, the registrar should be advised to evaluate the outcomes
her reactions and engage in personal professional development (NMBA, 2018). On a similar
note, Kim has to view the situation as a learning point and initiate strategies to promote personal
competence in the nursing practice (NSW, 2017). Finally, the unit nurse manager should plan for
nursing practice as required by the standards. She should not handle things casually and before
the public but instead plan and act in a professional manner regarding the situation.

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Clinical leadership expectations for beginning new graduate nurses: scope of practice, legal
and ethical boundaries
For a new RN in a traditional medical setting, ethical decisions occur occasionally, and at
times they may face legal dilemmas. It is essential, thus as a new RN to adhere to the six ethical
principles as stated: Right for persons, Beneficence, justice, Nonmaleficence, Veracity and
Fidelity. These principles guide any RN in making ethical decisions (Ellis, 2019). On the other
hand, legal implications of nursing are tied to licensing, constitutional laws, the scope of practice
and the view of the community that nurses should perform exemplary work.
Kim is expected to have adequate knowledge in the nursing practice. With respect to the
International Council of Nurses (2012), nurses carry personal responsibility and accountability
for nursing practice and maintaining competence through continual learning. Therefore, she is
expected to be aware of the equipment used in the nursing practice. However, she fails to provide
the wrote equipment as required. On a similar note, under the principles and standards of a
registered nurse, Kim is expected to maintain a strong collaboration with colleagues.
Collaboration has also been emphasized by the NSW Health Policies (2015). Furthermore,
collaboration is a necessity for patients’ safety as enshrined within the NMBA Code of Ethics
(2018). Therefore, she was expected to ask to clarify which equipment is required in case she
doubted. In this case, Kim complied with the ethical considerations in the nursing practice.
Furthermore, Kim is concerned with leaving colleagues with a workload while visiting the NUM
due to her desire to promote collaboration in the area of practice.
However, again Kim fails when she is stressed and depressed with her encounter with the
registrar. Following the Registered Nursing standards, nurses are expected to evaluate outcomes

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to inform the nursing practice. The nurses are also expected to engage colleagues in reflecting
upon their practice by the NMC, 2017. In this case, Kim is expected to have conducted a
personal assessment and development program and come up with strategies that will prevent the
reoccurrence of such a scenario in the future. Kim could have initiated strategies such as periodic
reading of books regarding the nursing area so as to be conversant with all the requirements.
Instead, she decided to keep quiet about the matter and get stressed and depressed in the long
run.
Gibbs model of reflection: strategies to develop personal and professional resilience
(DESCRIPTION, FEELING, EVALUATION, ANALYSIS, CONCLUSION & ACTION PLAN)
As viewed through the case studied, stress is a fundamental problem facing nursing
leadership. However, resilience is the ultimate solution in offering strength to overcome the
negative implications imposed by stress in the work environment. Furthermore, resilience serves
a significant role in promoting effective leadership and collaboration among nurses in the work
area. Additionally, stress promotes flexibility, adaptability and wellbeing with respect to curbing
work related stress. Thus, is shall place myself is Kims shoes and apply the Gibbs model with a
fundamental aim of generating strategies that promote effective handling of work related stress
in the nursing situation.
Step 1: Description
This is the initial step of the Cycle that describes what happened (Thomas and Asselin,
2018). Following the case study provided, Kim is in the hospital dealing with a patient. Kim is
trying to help a patient, as she is pursuing Transition to Practice (TTP) program at a tertiary

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hospital in western Sydney. Kim is with an attending Registrar. Kim fails to identify one of the
equipment that the Attending Registrar asks her to pass. As a result, Kim becomes hopeless and
feels useless in the area of practice. The NUM meets Kim on the way and raises the issue before
the public asking her to go for counselling at her office. Kim feels unconfident about the same
following the fact that the issue was raised in public and also in fear that she might overwhelm
colleagues with work.
Step 2: Feelings
Before the scenario, Kim feels motivated, and on top of her carrier. She feels like her
dream of becoming a nurse is on its way. She is hopeful that she will become one among the best
nurses in Western Sydney. I have a similar feeling at the start of the incidence because Kim has
been faring well in the area of practice. However, the middle of the event is quit discouraging
and makes Kim to feel useless. I have a similar feeling since the registrar exercises
unprofessionalism in responding to Kim’s inability to identify the correct equipment. Also, I feel
bad because the manner in which the NUM handles the matter is unprofessional. The matter is
raised before the public including patients whom I think would have lost their satisfaction upon
hearing such a story. Furthermore, the manner in which the NUM handles the matter makes Kim
more distressed. However, I like Kim’s anticipation of the situation. The fact that Kim is worried
about overworking colleagues while in NUM’s office indicates her humility and passion towards
her job. It is a clear indication that she is a competent nurse. Thus I feel overwhelmed and happy
with the way Kim express herself at this point.

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Step 3: Evaluation (Bass et al., 2019)
As much as the situation was demotivating, it was not that negative. The situation acts as
a foundation for further learning and development. Kim should learn to accept rejection on her to
being among the best nurse. The negative part of the situation is that it is demotivating. Shouting
at someone while others are around is unethical. Again, the Nursing Unit Manager approached
Kim in front of her colleagues and other patients telling her to go the office for counselling. In
this case, the NUM does not anticipate the implication of her actions on patient satisfaction. This
also makes the negative part of the story.
However, several positive events occur about the story. For instance, the resuscitation
went smoothly. Also, Kim’s thoughts reveal that she is a competent and human worker who is
concerned with collaborative work in the scope of nursing practice. Furthermore, the fact that she
will be advised by the NUM present’s a sense of optimism in her career progress.
Step 4: Analysis
As much as am concerned, this case is a learning point in the nursing profession. I don’t
view the negative parts of the story as blame on the either party but a realization of the fact that
individuals learn from mistakes in their profession. I have realized lack of resilience pose a
fundamental challenge in meeting clinical expectations. With respect to the positive side of the
story, I have realized that collaboration play a significant role in promoting good outcomes
among patients.

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Step 5: Conclusion
Following the case provided, it is fundamental for nursing leaders to approach scenarios
in an ethical manner which considers professional, emotional and social obligations. For
instance, the manager could have approached the matter professionally. On the other side, Kim
should consider the scenario from a learning point of view. In summary, the registered nurse
standards should be adhered to in the nursing practice.
Step 6: Action plan
Assuming Kim’s position I shall adopt the strategy of socializing with colleagues
(Kendall, 2018). This will ensure that she is not ashamed in future when she is being summoned
for a mistake that she makes. Moreover, I shall maintain confidence as a professional way of
creating resilience. Confidence forms a crucial part of the nursing career, and a failure to be
confident is deemed a weakness (Powell, Froggatt and Giga, 2019). As a NUM I shall encourage
the whole team to help Kim as she goes through the traumatizing moment. By doing this, Kim
will be able to understand that her perspective on her colleagues was wrong which, therefore,
means that she will be able to appreciate the role of her colleagues in her life. Furthermore, as
NUM I shall advise the management to foster socializing within the organization. It is essential
that the management adapts an informal conference program which allows members to mingle
freely. As a NUM, I shall also advise all employees to have lunch together as a strategic
approach in promoting social wellbeing within the organization. Moreover, there is need to adopt

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the culture of motivating and correcting each other politely. After a month, there is need to
review the progress registered. As a NUM, I will encourage Kim to attend in service sessions,
available training related to clinical skills and guidelines in the hospital, offer meditation before
starting the shift offer and make her involved in any activities within the organization.
Supportive elements in effective leadership
Great nurse leader must possess numerous leadership qualities. There is in need to have a
vast wealth of knowledge both about your colleagues and profession (Spehar, Frich and
Kjekshus, 2015). Leaders are meant to guide others (Clements, 2015). Therefore, knowledge is
where their power lies. They need to be able to execute decision making when their juniors are
calling for their help and should be able to create an environment whose competence is
appreciated by other staff (Mannix, Wilkes, and Daly, 2015). Like in the case provided,
knowledge included general information regarding various equipments in the area of practice.
Also, knowledge encompasses a step by step guide on how to perform a personal assessment and
development using appropriate models. The knowledge should be backed by appropriate
evidence based literature like the registered nurse standards and other evidence based literature
on models of self-assessment.
Moreover, to become a leader, one needs to appreciate the importance of effective
communication (Halcomb et al., 2016). Communication is the key to establishing knowledge and
knowing how to deal with individual circumstances. Furthermore, in a medical setting where
professional resilience is needed, communication is crucial, and the primary element that ensures
survival and alleviates stress (Evans, Costello, Greenberg & Nicholas, 2013). There is a need to
socialize with staffs and identify their preferences so as to apply an approach that is appropriate.

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The nine essential qualities of nurse leadership include emotional intelligence, integrity, critical
thinking, and dedication to excellence, communication skills, respect, mentorship and
professionalism (Regis College, 2019). Furthermore, it is vital as a leader to ensure that there is a
network to which the juniors can reach the seniors and vice versa. This ensures smooth
operation. Failure to come up with a systematic order of doing things is a root of chaos.
Conclusion
Nursing leadership forms a critical part of the medical setting. Great nurse leaders are,
therefore expected to create a facilitative environment in their medical settings. Furthermore,
these nurse leaders must create a work environment where all their employees feel safe to share
their feelings and their opinions with them. Depression is a critical issue in the medical setting.
Therefore, communication should be encouraged as far as this issue is concerned.

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