Analysis of RN Leadership in Clinical Practice and Quality Healthcare

This essay critically analyzes the responsibilities of registered nurses (RNs) in leading clinical teams to ensure adherence to the National Safety and Quality Health Service (NSQHS) standards. It explores the evolution of RN roles, highlighting the importance of leadership in maintaining patient safety and improving the quality of care. The essay discusses two key leadership styles: autocratic and democratic, and their application in clinical settings. It emphasizes the RN's role in team delivery, multidisciplinary collaboration, and bridging the gap between practice and policy. The importance of RNs as role models, educators, and the need for continuous improvement are also highlighted, along with the role of NSQHS standards in guiding practice. The conclusion underscores the critical role of RNs in the healthcare sector and the significance of their leadership in fostering high-quality patient care.

Running head: TEACHING, LEARNING AND LEADERSHIP FOR CLINICAL
PRACTICE
TEACHING, LEARNING AND LEADERSHIP FOR CLINICAL PRACTICE
Name of the Student:
Name of the University:
Author’s Note:

1TEACHING, LEARNING AND LEADERSHIP FOR CLINICAL PRACTICE
According to the World Health Organisation (WHO), the quality of care has defined
the scope of the healthcare services are provided to either individual or patient population in
order to improve the health outcome of the society (Salmond & Echevarria, 2017). The
concept of quality of care and patient safety are intertwined with each other and allow in
accelerating the reduction of the mortality rate related to diseases. Therefore, quality of care
is stated to be a major component with respect to the right to health and allowing equity and
dignity of patients in the healthcare sector. Among all the members of the healthcare team,
nurses are considered to play a vital role in ensuring patient safety and improving the quality
of care. This can be done through clinical practice and a continuous environment of teaching
in dynamic paradigms. The focus of clinical teaching is on the patients and mitigating the
health issues in order to uphold their rights and improving the health and wellbeing of the
community as a whole. The aim of the essay is to critically analyse the responsibilities of the
registered nurses (RNs) in leading a team for guaranteeing the abidance of the National
Safety and Quality Health Service (NSQHS) standard through clinical teaching.
In the past few decades, the roles and responsibilities of the nurses have changed
dramatically. This is because it has been identified they are an integral part of the life-saving
team and thus, the emergence of nurse leaders occurred. The task of the nurse leader is to
guide other nurses and ensure that high standards of safety and quality are being maintained
in the healthcare setting. The two most significant leadership styles that are commonly
adopted by nurse leaders are autocratic and democratic leadership styles. According to Al
Amiri et al. (2019), the autocratic leadership style is characterised by the control of an
individual in decision-making and accepting less or no input from the group. The tasks of the
nurses are dynamic and challenging as a result; it is liable that they might miss a critical
chance of growth, communication, and education, thus affecting the overall care process.
Therefore, the nurse leaders take complete control of it and bring the team together by setting

2TEACHING, LEARNING AND LEADERSHIP FOR CLINICAL PRACTICE
rules and regulations strictly followed by the RNs. This also includes ensuring that the nurses
are religiously obeying high standards of care and quality in patient treatment. In case the
nursing team is unaware of the protocol, the nurse leaders adopt the role of an autocratic
leader by providing them strict guidance on educating them. Moreover, the leader ensures
that complacency and comfort of the nursing team do not affect the quality of care. In
addition to this, it can be noted that in several instances, the nurse leaders adopt the use of a
democratic leadership style. Marquis and Houston (2017) opined that democratic leadership
involves a form of participative approach where inputs from members of the team are
considered during decision-making. This ensures that the team members are valuable and
thus, it provides better productivity among staff, especially old employees. It can be seen that
the nurse leader conduct team meetings in several instances, and discuss several relevant
issues with the nursing team as well as other members of the team (Giordano-Mulligan &
Eckardt, 2019). This helps in taking a collaborative approach toward any problem and the
leader can gain trust and support of the group.
It is the responsibility of an RN to use the combined efforts through a model of team
delivery; thus, offering comprehensive care to patients. As per the opinion of McKenna and
Stockhausen (2013), the RNs have stated an integral part of the healthcare team because they
spend most of the time with the patients and the families, easy to access and with the virtue of
education, skills and interest in offering care. They are considered as one of the most
qualified professional team leaders in the settings. The leadership role and collaborative
approach of the team member allowing in maximising the healthcare outcomes. The RNs
facilitate care cost-effectively and comprehensively by involving a multidisciplinary team
from different disciplines. This brings in specialised perception and expertise within the team
as well as helps in balancing the various needs and preferences in order to optimise the
outcomes. The nurse maintains a strict module for each member and conducts a weekly

3TEACHING, LEARNING AND LEADERSHIP FOR CLINICAL PRACTICE
review of each team using a checklist. The maintenance of a rigorous standard of care based
on the national framework is performed by RNs that is expected by the patient and their
family member from reputed healthcare facilities. Another important responsibility of the RN
leader is to bridge the gap between the actual practice and policy guidance by confirming that
the members of the team are obeying the safety protocol during care delivery. In this way, the
patient’s safety is ensured as well as the reputation of the team and the nursing profession as
a whole. Thus, it can be seen that the RN leader need to conduct several dynamic and
complicating roles and responsible for monitoring, maintenance, and ensure proper and
appropriate care is offered to each of the patients. This also involves understanding and
acknowledging the issues and wellbeing of the team in order to attain the highest level of
staff productivity.
A debate among the healthcare professionals related to addressing the issues of
suboptimal care, abuse, and neglect in the healthcare sector. The cases related to such issues
are increasing exponentially on a global basis. Adams et al. (2018) opined that the solution
that is likely useful in improving the care is to develop the leadership skills of the front-line
nurses. It can be seen that the behaviour and action of the nurses is a predominant
determinant in the healthcare experience of patients and their opinion related to the high
quality of care. The nurse leader needs to be a role model for all the team. As per the opinion
of Whitby (2018), the aspect of innovation and interdependency needs to be considered as the
core concepts that will in offering adequate information with respect to clinical leadership,
development and education. In addition to this, attained advanced knowledge, abilities, and
skill for improvement and development of new strategies in care need to be promoted by the
leader. The role of the leader is to offer training and awareness about all the dynamics in
nursing as a junior nurse, or an intern is not aware of it. According to Joseph and Huber
(2015), nursing professionals present a multitude of issues such as complexity, high rate of

4TEACHING, LEARNING AND LEADERSHIP FOR CLINICAL PRACTICE
change, chaos, safety and quality problems, and shortage of workforce that has a detrimental
impact on the care. The role of the team leader is to identify the issue or predict them and
take the necessary steps to mitigate them. Even though it is difficult to forecast the future,
however, evidence from the past indicated that clinical leadership plays a vital role in
effective healthcare delivery systems all over the world. According to a study conducted by
Smolowitz et al. (2015), 16 primary healthcare practice utilised RNs in extending their scope
as a team leader and observed that there was an improvement in various areas such as chronic
disease management, preventive care, and practice operations.
The RN standards of Practice provides direction to the nursing professionals present
in various settings. Seven standards are stated that the clinical supervisor needs to be aware of
as well as the changes in order to offer more vivid knowledge to the team member and
assessing the competency level of each of the standards in the respective fields (Terry et al.,
2017. The nursing team needs to perform based on these standards, thus, facilitating the
progression of care and support to patients. According to WHO, a competent workforce is
required for achieving universal health coverage and thus, quality education forms the basis
of such competency among health workers (O’Neill, 2016). According to the report of the
Nursing and Midwifery Board of Australia, the practice of RN is person-centric and based on
evidence with respect to various elements of health (Nursingmidwiferyboard.gov.au, 2020).
Thus, the RN has to work in a professional and therapeutic relationship with patients,
families, groups as well as communities. The Australian society is found to be culturally
diverse and thus, its incorporation in the health and wellbeing is identified. Ossenberg et al.
(2019) opined that the practice of RN demonstrates that there is an understanding of the past
concerning the social, cultural and spiritual elements of the Aboriginal and Torres Strait
Islander people, where the issue of health inequity in the nation is predominant. Standard 1
involves critical thinking and analysis of nursing practice that involves various strategies and

5TEACHING, LEARNING AND LEADERSHIP FOR CLINICAL PRACTICE
evidence in making decisions. Standard 2 involve engagement through professional and
therapeutic relationship; thus, help in the development of trust and respect in the profession.
Standard 3 mean maintenance of capability for a practice offering education and information
for enhancing the control of people over health. Standard 4 consists of conducting assessment
and standard 5 include the development of the plan in practice. Standard 6 is related to
providing appropriate, safe and responsive care, and standard 7 is associated with the
evaluation of outcome (Cashin et al., 2017). The role of the RN team leader is to ensure
disseminating information, overlooking that the team maintains the standards and providing
information about the scope of practice to the team.
The National Safety and Quality Health Service (NSQHS) Standards had been
developed by the Australian Commission on Safety and Quality in Health Care with the
collaboration with the government, state and territories, clinical expertise, private sectors,
health carers, and care receivers. The standards aimed to safeguard the public from any
potential risk and improve the level of healthcare service (Racp.edu.au, 2015). This involves
offering a quality assurance mechanism that evaluates the operations of the relevant system
and aligns with the expected standards. Eight NSQHS Standards include various sectors of
the healthcare department and it offers consistency in the national level of the standard of
care the client should receive from a healthcare setting (Racp.edu.au, 2015). Among the eight
standards, the most critical standards are 1, 2 and 6. The first standard is related to clinical
governance that incorporates the legislative aspect of safety and quality of care that need to
be maintained for offering reliable, safe and high-quality care. The second standard involves
partnering with consumers thus, focusing on person-centred care, including the opinion of the
patient in the care process and decision-making and protecting the rights of the patient in
establishing and catering quality healthcare services. The six standards are communication
for safety that include various systems and strategies leading to effective communication

6TEACHING, LEARNING AND LEADERSHIP FOR CLINICAL PRACTICE
among all the stakeholders such as patient, healthcare profession, team, and families in the
healthcare setting. The other standards are important and critical for specific fields of care,
such as blood management, acute care, comprehensive care imposing medical safety, and
healthcare-associated infection (Safetyandquality.gov.au, 2020).
From the essay, it can be concluded that the role and responsibilities of RNs are
critical in the healthcare sector. They are the first-line professionals that form a bridge
between the doctors and patients; thus, their purpose is stated to be the most critical. In due
course of time, the role of RN as a leader has been identified and promotion of the function
has been found globally. The leadership styles that are promptly adopted by RNs in managing
and handling large and small size nursing team are democratic and autocratic style. The
leadership styles can be implemented individually or in combination based on the situation
posed. The team leader act as a role model, teacher and guide in helping and supporting the
team in the shift to offering high-quality care to the patient and prioritising positive health
outcomes. The RN Standard of Practice is one of the standard practices adopted by the RN in
Australia based on which the care process is developed. In addition to this, the NSQHS
Standard that promotes evidence based practice and person-centred care process are taken
into consideration for meeting the quality patient care in the healthcare organisations.

7TEACHING, LEARNING AND LEADERSHIP FOR CLINICAL PRACTICE
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