Reflective Journal on Effective Teamwork and Autocratic Leadership

This reflective journal discusses two incidents related to effective teamwork and autocratic leadership in healthcare industry. The author reflects on the incidents and identifies the negative impacts of ineffective teamwork and autocratic leadership. The author also proposes action plans to develop skills and knowledge on effective teamwork and transformational leadership style.

Running head: REFLECTIVE JOURNAL
REFLECTIVE JOURNAL
Name of the student:
Name of the university:
Author note:

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Introduction:
Reflection and composing a piece of self reflecting writing are intricately associated with
one of the best effective healthcare practices by the professionals. This procedure helps in the
developing of the skills along with the proper reviewing of the effectiveness in place of carrying
on doing actions that are always done (Lutfiya et al., 2016). This helps in improving the ways by
which healthcare professionals work and also help in carrying on the learning procedures
throughout their lives. It helps in developing confidence and thereby makes the healthcare
professionals become more proactive and qualified professionals (Wald et al., 2015). Some of
the benefits are increased learning from an experience or situation, promotion of in-depth
learning, identification of the personal and professional strengths and area of improvement,
educational needs and many others (Tolks et al., 2016). This assignment would be mainly based
on the reflection carried out on some of the most important incidents that occurred and will also
shed light about how reflection on such incidents had helped me to develop as better
professionals. Gibb reflective framework would be used.
Journal 1: effective teamwork:
While working in the rehabilitation ward, I was given the duty of nursing and caring a
65-year-old woman who had faced stroke and was shifted to the ward after emergency treatment
as care-coordinator. During the time of working in the ward, I saw different issues coming up
every day that affected the patient care and the patient satisfaction. Medication error had
occurred where the delegated nurse did not communicate with the nurse f the previous shift and
administered the medication again resulting in increasing of the dose. When I tried to inquire
about the situation, blames games started where one nurse was blaming the other entirely and no

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one was ready to accept their faults. Moreover, the different experts like physiotherapist, the
occupational therapist and the dietician contradicted each other’s treatment to the patient. This
made the patient nervous as she though the other expert was providing the worn treatment and
care. Moreover, they complained about the other professionals on different notes and all these
created several issues. The senior nurses went to the patient and saw her having a particular diet
given by the junior nurse and shouted on her in front of the patient. Although the junior nurses
stated that she had followed the doctors’ guidelines, the senior nurse did not trust her and took
away the food. I was not able to understand why so many issues occurred and tried my best to
reach to the root of the issues. More, I tried to solve their conflicts, more they were seen to be
becoming rebellious. I received a complaint from the family members that we were not
providing effective and safe care and that they are concerned with health of patient.
I was quite upset from the occurrence of the entire situation. I was quite shocked about
how the rehabilitation professionals lacked proper team building spirits that affected the mental
and physical health of the patient. I was disappointed that being the care-coordinator, I could not
fulfill the responsibility that was assigned to me for managing and coordinating with the
healthcare professionals and maintain the healthcare functions smoothly. I was feeling helpless at
one time; where I noticed that nothing was going according to my plans and advises. I felt bad
that my poor management of the teamwork ultimately affected the health of the patient and she
was not being able to receive high quality and safe care that met her requirements. However, I
did not lose confidence over my skills and attributes. Therefore, I decided to undertake more
researches into the incident and find out the cases so that such issues do not repeat in the future.
Ineffective teamwork was mainly found to be the reason that resulted in failure of proper
evidence-based care of the patient that resulted in patient and family dissatisfaction. One of the

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most important outcomes that resulted in ineffective outcome was negative health impacts of the
patient. Researchers are of the opinion that ineffective teamwork results in communication
issues, missed interventions, long waiting times of the patients, medication errors, and trust
issues with the patient, emotional turmoil in the patients (Casimiro et al., 2015). The patient in
the incident had noticed ineffective teamwork that had affected the patient resulting in concerns
between the patient and loss of trust. Therefore, the bad part of the incident was that the
ineffective teamwork had affected the health of the patient both physically and mentally. This
even affected the reputation of the hospital. The only good part was that it helped me in learning
that I do not have proper knowledge about the team working attributes and i needed to develop
more knowledge and skills in maintaining effective teams.
On close analysis, I came to understand certain important attributes of team learning
which I have not emphasized before the rehabilitation planning took place. One of the most
important attribute that I had noticed in the incident was entire lack of trust and bonding.
Researchers are of the opinion that the presence of trust and bonding among the members are
extremely important for maintain of effective teamwork. This helps each of the employees in
understanding each other’s strengths, weakness and interest (Rosen et al., 2018). Often, this is
shown to reduce stress and fatigue among the members by the distribution of emotional and
physical work burden and helps in achieving the team goals effectively. Complete lack of trust
and bonding were found between not only the junior and the senior nurses that reflected from the
food incident of the patient but also among the junior nurses who made the medication errors.
Power struggle was also observed among the different healthcare professionals from the various
incidents that were reported to me (Weller, Boyd & Cumin, 2014). Power struggles also impact
effective teamwork as different types of complexes are seen to play among the employees that

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make them undertake various negative approaches towards ach other and this impact the final
goals that are needed to b achieved. Complexes, egos, turf protection as well as negative
attitudes, lack of communication, effective feedback sharing and many others affect the power
dynamics making teams suffer massively. These impacts need to be cared by every team so that
they can overcome the barriers and provide high quality care to the patients effectively.
John Adair - Action-Centered Leadership is one of the most renowned teamwork theories
that are used in management of teams and helping teams to smoothly reach the goals. This model
is mainly based on three overlapping circles that are achievement of the task, building and
maintaining teams and developing each of the individuals. This team states the importance of
defining the task with SMART goals for setting objectives to all employees and effective
planning should be done. Team briefings and controlling activities need to be imposed by the
leader to get maximum results for minimum purposes. The leaders should motivate, organize,
evaluate and set examples for the team-workers (Maharajan et al., 2017). When such cases
would occur in future, I should strategically call for team meetings and discussion where I would
be applying the above-mentioned steps to help in proper team building and planning. I would be
identifying any of negative aspects identified above and accordingly take interventions. I would
try my best to motivate the team-workers and implement the Maslow’s The Hierarchy of Needs
so that I can help the team overcome their negative aspects. This is a team development theory
where the five aspects called the “survival, security, social, ego status and self actualization” are
provided importance by the author. I would look after aspects of each of the individuals in the
teams for effective relationship development and team building. I would apply these
management theories in the conditions to develop my teamwork development skills.

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In action plan, I would be mainly focusing on developing more skills and knowledge on
effective teamwork and the ways to lead them. I would find more evidence based articles and
follow books on teamwork in healthcare proposed by my mentor. These would be helping me to
gain more knowledge and I would be able to mange teams effectively.
Journal 2:
The higher authority provided me the opportunity to become a leader of the team of 5
new nursing students who came for clinical placement in the medical surgical ward. I accepted
the responsibility and introduced myself to the new entrants. However, I did not ask them to
introduce themselves and told them that I would get to know about their names in course of time.
Following this, I allocated them to different tasks and fixed a definite deadline to them within
which they need to complete their work. After two days, they came to me with complaints that
they were not being able to complete the tasks. They were explaining their difficulties when I cut
them short thinking that they were making excuses and being lazy in their work. I cut them short.
I stated that I would not accept any excuses and that they needed to complete the work within the
allocated time. Two of the members came to me stating that the ways I have asked them to
complete the work was taking more time and that they proposed a better way that would help
them in completion off the work faster. However, I did not accept any of the feedbacks and
asked them not to come to me until the work would get completed. I clearly stated them to
complete the work as faster as they could without trying to modify any of the working styles and
working patterns that were dictated by me. On the final day of the deadline, I noticed that none
of the work as finished and many of the new student nurses had complained about me to the
higher authority stating that they would like to have another member as a leader as they were not
comfortable with me.

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I was highly confused and upset about the entire incidence. I could not understand what
went wrong. I had been strict with them as I though that this would be helping them to work in a
discipline manner. I also asked them to follow my procedures without following their own as I
assumed that they are novices and therefore, they could learn appropriate approaches of
healthcare activities if they would be following my procedures. However, I felt guilty when I
found that they were hurt and offended by leadership styles and that they have complained about
me to the higher authority. I was also upset, as I could not properly complete the responsibility
that was given to me by the higher authority.
Effective evaluation of the incident showed that the members of the team were highly
discouraged and they had developed a negative idea about the working environment of the
healthcare organization. They had been de-motivated and they did not feel like working in the
healthcare centre and wanted to change their placement arena. Moreover, the higher authority
made me know that the members also wanted to leave the profession as they had developed very
poor idea about hoe healthcare teamwork (Demo et al., 2015). They had lost their confidence and
self-esteem and they felt humiliated by the leaders. The leadership style that I had applied was
autocratic in nature. Such leadership style affects the morale of the employees making them feel
that they were not cared in the organization. They feel that their suggestions and feedbacks are
not respected and this makes them feel humiliated in the organization. This style also
discourages group input making the members feel that their skills and knowledge were not
respected or paid importance. Hence, this leadership style is criticized nowadays as it increases
the turnover rates of the employees (Weberg et al., 2016). Therefore, the new nurses wanted to
leave the organization or wanted to change their leaders. This was the bad part of the incident as
the healthcare centre was on the verge of losing human resources due to poor leadership traits.

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However, the only goof point was that it helped me realize that my leadership style was not
appropriate and that I needed to undertake good practices.
I needed to undertake proper analysis to understand the negative aspects of incident to
develop valuable insights from the incident. Autocratic leadership styles mainly invite little or no
input from the group members and the leaders are seen to make almost all the decisions. The
leaders are seen to dictate all the work methods as well as the processes and they are seen to
rarely trust their employees with any important task or decisions. The work under such
leadership is seen to be highly structured and very rigid. In this form of leadership, creativity as
well as out-of-the-box thinking is seen to be discouraged (Watkins et al., 2016). Rules are mainly
seen to be important and they tend to be clearly outlined as well as communicated. Researchers
are of the opinion that autocratic leadership remains associated with poor performance from the
employees, low morale among the employees, de-motivation, discouragement as well as many
other aspects. Moreover, the employees can also discuss their concerns and therefore, they tend
to work out them by themselves and these affect their working capability making them feel
distressed. Many researchers are of the opinion that this leadership is essential for inexperienced
employees but the leader needs to modify the traits in way by which the employees should feel
respected and cared for without feeling stressed about the strict environment. In such situations,
researchers are of the opinion that transformational leadership style is more important and
helpful in such situation so that employees feel comfortable, discuss their concerns and get
scopes for learning skills of working in healthcare environment (Lin et al., 2015).
While working in the healthcare industry, I might need to lead both experienced as well
as inexperienced healthcare professionals and therefore, I need to develop leadership traits that
would help the members to work effectively and reach their goals successfully. Therefore, I need

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to develop effective traits for transformation leadership style. One of the most important aspects
is the idealized influence where I would myself participate in the work as the role model. The
subordinates will see me working with them making them believe that the goals are achievable
and belong them to know how to complete the work. The next trait that I would develop is the
individualized motivation where I need to motivate the employees in ways by which they can
work beyond their potential helping the employees to achieve the goals much easily (Troung et
al., 2014). Another is the intellectual stimulation where I would be involving the members in
decision-making procedures and exchange feedback exchange process. This would make them
believe that they are cared and their suggestions are worthy and valuable for the organization.
Another important trait that I would be developing is the individualized considerations where
leaders would know the concerns faced by individuals and help them in overcoming the barriers
by giving them effective strategies. If I had applied these traits in leading the new nurses, the
situation would not have resulted in negative outcomes.
In the action plan, I would be undertaking evidence based studies, attend seminars on
effective leadership traits, interview eminent healthcare leaders, and discuss with me mentors
effectively. These would help me in developing my leadership skills effectively.
Journal 3:
While working in team that comprised of healthcare professionals coming from various
nations, various backgrounds and races, I had also gone through several incidents that had made
me understand that I have poor cross-cultural communication skills. The team comprised of
healthcare professionals from Asian backgrounds, aboriginal backgrounds, Australian
backgrounds and many others. Moreover, there were many members who belonged to different

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religions like that of Christian, Muslim, Hindus and many others. I have never paid importance
in developing culturally competent communication styles and I always applied personal style
while communication with many of the members. I maintained eye contacts with the Asian
workers who consider direct eye contacts to be rude and dishonorable during communication. I
often made curious comments to many of the Muslim workers which affected their self esteem
and made them upset. Although, I had no intention of harming their self-respect, but they felt
humiliated. In many arenas, I often made jokes on their names which often seemed innovative
me. However, they took me as a negative person as they felt that I was doing the purposely to
dishonor their cultures, backgrounds, transitions and many others. Soon they started to avoid me
and I could easily understand their ways of avoiding me.
I felt upset thinking that the members were avoiding me thinking me to be an insensitive
person. I felt guilty of affecting their motions and making them feel disrespected. I understood
that I wanted to develop my cross-cultural communication skills so that I can develop good
relationships with all members of the team o that I can provide high quality service as a part of
the healthcare team effectively.
The negative part of the incident was that I communicated insensitively with the
members of the team making them feel hurt. Therefore, the relationship that I shared with the
members of the team had become affected. As a result of this, the communication between us
was also hampered and the smooth workflow by the teams was affected. They were not ready to
interact with me and the team members could not work in a united manner. The care that was
provided to the patients was inappropriate. The only good part was that the incident taught me
that I have poor cross-cultural communication skills and that I needed to develop them so that I
can work properly along with other members of the team.

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Cross-cultural competence and effective communication are highly important while
working in the egalitarian society (Betancourt et al., 2016). The society has become the resident
of various kinds of people coming from different backgrounds and as part of the society, it is the
duty of members to develop cultural sensitivity, cultural competence and overcome biases.
Healthcare professionals need to develop both verbal and non-verbal communication skills that
would align with the cultural traditions, perception and inhibitions with the members with whom
they are working and along with the service users. This helps in biding a trustworthy
relationship. Trusts and bonds are crucial in team working and cultural competence helps in
maintaining these aspects (Teunissen et al., 2017). When members feel that their cultures and
backgrounds are respect, there would be increase in transparent and closeness among the
members (Silverman et al. 2016). This would help in reducing work burden and help in better
service delivery by the teams.
Therefore, I should try to develop cultural knowledge and cultural awareness about the
different backgrounds of the people working with me. Accordingly, I would be not only careful
but also sensitive and biased towards the other cultures. This would help me in communicating
with them respectfully and would help me in developing effective teamwork and prevent any
conflicts.
I would follow internet sites; evidence based articles, and attends workshops and many
others to develop such skills successfully. I would also engage in constructive feedback sessions
so that the relationships are based on transparency and no hard feelings are harbored by any
members.

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Conclusion:
From the above discussion, it becomes clear that there are certain aspects which are very
important and needs to be managed effectively to ensure smooth flow of work in the healthcare
centers. These are effective team working, proper leadership and cross-cultural communication
and competence. It is also important for every nursing professional to develop proper attributes
associated with these three aspects. These would not only help in preventing any form of
conflicts among the professionals but would ensure effective boding and coordination. These
will have positive impact on the health of the patients ensuring high patient satisfaction.

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