Reflecting on Leading and Managing Care Services

This essay discusses the importance of leadership in nursing practice and reflects on personal strengths and weaknesses in leadership. It explores the role of leadership in delivering quality patient care and the need for nurses to adopt effective leadership strategies. The essay also outlines a development plan to become a transformational leader and more assertive in nature.

REFLECTING ON LEADING AND MANAGING CARE SERVICES
(1442 words)
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Introduction
The purpose of this essay is to demonstrate leadership potential in nursing practice (Bulman and
Schutz, 2013, pp. 213). One strength ad one weakness of mine has been selected to demonstrate
ways in which they have contributed in practice and relevant health and social care issues. The
vision of leadership is crucial in National Health Services (NHS) as studies reflect strong
correlations between leadership and organizational performance (Doody and Doody, 2012,
pp.1212-1218). Leadership has been categorized as one of the influential factors that shape the
organizational culture and enables development of rights skills and values within employees such
that sustainable delivery of health services can be met. NHS requires high-quality leaders at
every area and every level to deliver high-quality compassionate care for the people that it
serves. Leadership in nursing is crucial as health services are continuously changing to deliver
new models of care and to respond to efficient challenges depicted in the Five Year Forward
View (Nagendran, Maruthappu and Raleigh, 2012, pp 525).
Leadership in Practice
Leadership is defined as the ability and capacity to influence and lead others, as a way of
personal attributes in order to attain common goals (Lauren Caldwell RN, 2013). Leaders are of
varied forms and operate at various levels. As NHS is becoming agile, hence there is needed
understanding regarding leadership. The transformational and transactional models help guide
leadership in level 6 adult nurses. Transactional leadership is regarded as short-lived, episodic
and task-based in nature whereas transformational leadership helps build a long-term relationship
(Hutchinson and Jackson, 2013, pp. 17). Adair (2002) proposes a three-circled model of strategic
leadership that is able to meet the needs of the individual, task and the team.
The importance of leadership can be understood from the detailed Francis reports
recommendations and proposals made (Curtis, de Vries, and Sheerin, 2011, pp. 307). The
Nursing and Midwifery Council (NMC) applied the lessons learned from the Francis report. It
included varied programs and processes, including codes and practices that are to be applied by
Nurses and midwives. The recommendation by Robert Francis QC included patient-centered
leadership and culture. NHS leadership has an integral role to play in bringing about any desired
changes at the national level (The King’s Fund, 2013, pp. 24). Effective leadership can depict
compassionate and caring, reflecting core values within the service framework. Nurses as
effective leaders can build teams by creating space in knowing about colleagues and discussing
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challenges or influences. Nursing leaders can facilitate greater staff empowerment and build
resilience among staff members. Nursing leaders can enable development of supportive local
care climate and also in setting a positive emotional ‘tone' towards the delivery of care.
With NHS facing a funding gap of GBP 30bn by 2020, NHS leaders need to undertake decisive
action towards protection of the quality of service (Nursing Times, 2009, pp. 28). Effective
leadership working in NHS can be demonstrated by seeing the service NHS renders to be
sustainable in the future. The Five Year Forward View predicts that NHS could possibly close
the funding gap with effective nursing leadership in action (Artac et al, 2013, pp. 432).
Leadership could go wrong as NHS commits to provide patients more control over their care
along with health and social care. Leadership could also go wrong for patients, who live longer
with more complex conditions.
The CNO outlined the six Cs, care, compassion, communication, competence, commitment and
courage as being their core elements (Keepnews, Brewer, Kovner and Shin, 2010, pp. 158).
Nurses need to be posses capability to be compassionate and truly care. The six C’s provides
standards and quality expectation from nurses and enables measuring of culture. The NHS five
framework domains set out high-level national outcomes that nursing leaders can aim at
improving and to reduce inequalities in health.
Self-Reflection
Leadership has been diagnosed above as an integral aspect of achieving better patient care and
outcome (Thompson and Pascal, 2012, pp. 312). I follow the transactional style of leadership and
I am extremely task centered. I take up tasks that I am assigned and complete them effectively.
However, my weakness is that I work at my individual level and ignore the team completely
while determining goals for patient care. Being hardworking and task-oriented, I am successfully
able to accomplish my own tasks, however, often my team is not able to accomplish the six C's
for all patient care. I generally tend to provide stringent orders and demand stringent outcomes
on operations. I value rules and regulations, I am extremely self-motivated (Lilford et al, 2010,
pp 4413). I depend on the structure of the organization and depend upon a directed environment
in achieving the outcome. I am a firm believer of results and I strive to pursue tasks that I have
been provided and do not aim diverge from the specific path of my task. I am extremely serious
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regarding patient-centered outcomes and I am compassionate towards my goals. I feel that
striving towards patient betterment is my only duty.
The situation that can effectively depict my leadership style is when I was assigned award of the
patient to take care of. I administered their medication and conducted duty diligently from time
to time. I did not miss out on a single work assigned and each time I completed an action, I
checked on the checklist to make sure that I was conducting my functionalities appropriately.
Often my colleagues used to not be able to accomplish the goals that I attained easily. This often
created a competitive atmosphere with my colleagues as they felt I behaved differently at
different times. I barely interacted on my duty, except when needed, this decision I took as I felt
these minor decisions could influence the quality of service that I provided. My patients were
content with the service that I was rendering, however, there were some gaps in the relationship
that I had with my colleagues and that which existed amongst other colleagues. I felt attending to
patient care is important however, I needed to establish a good relationship with my colleagues
and peers in which I was lagging.
Analyzing my weakness, I can say that I am not assertive. I continue to strive towards goals and
work hard however, there is an element of assertiveness lagging in me. At various instances
when I had to make a choice between roles I had to undertake, I found my self selecting the
inappropriate role. This happened as I was not assertive and I felt that this weakness of mine I
need to improvise. Often my colleagues and peers misunderstood my not being assertive to be
defensive and this further split my relationship with them. Therefore, I needed to overcome this
weakness of mine and become an effective leader.
In order to overcome my weaknesses, I need to chart out a development plan using SMART
goals. SMART goals of mine will include changing myself to become a transformational leader
and becoming more assertive in nature. The table below highlights my SMART goals;
Table 1: SMART Goals
Specific (S)  Transformational leader
 Assertive
Measurable
(M)
 Able to take decisions appropriately
 Be able to work in teams, with individuals, and on tasks
Achievable
(A)
 Becoming a transformational leader from a transactional leader might
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be difficult
 Practicing to be assertive
Realistic (R )  Yes becoming a transformational leader is realistic
 Yes becoming assertive is realistic
Time-bound
(T)
 Within 1 year
 Within 6 months
The above SMART goals I will strive within the time frame that I have adopted. I will maintain a
self-journal where I will note down the points which I need to accommodate to become a
transformational leader and assertive. I will regularly update the journal on a 3-month basis to
ascertain whether I have reached my goals or not.
Conclusion
Leadership is an integral characteristic of rendering quality in patient care. An appropriate leader
is one who is able to adopt an individual, team and task-oriented outcome. Characteristics of a
good leader are also who accommodates the 6 C's inpatient service. At NHS the role of
leadership has emerged to be extremely crucial in the recent time period. Therefore, at all levels,
especially nurses need to adopt strategies and ways of leadership for quality patient care.
The above summarisation of my personal strengths and weaknesses reveals that I will need to
follow the development plan and maintain a self-journal. This will allow me to adopt a
transformational style of leadership and also emerge to be an assertive nurse in the long-term.
Though I have other weaknesses which I need to attend to I feel that overcoming assertiveness
will be a concrete step towards my becoming an effective leader in nursing.
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References
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Appendices
Strength
 Task Orineted
 Leadership Style-Transactional
 Committed to increasing patient
confidence
 Getting involved with patient
Weakness
 Lack of assertiveness
 Not able to meet patients enough
 Narrow focus on open events
Opportunity
 Active participating in new courses
 Adopting transformational leadership
style
Threat
 Confidentiality at risk
 New standards of patient care
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