Leadership for Beginning Practices: Factors and Expectations

This report delves into the multifaceted aspects of leadership within nursing, examining the influence of various factors on nursing leaders and the expectations placed upon new graduate nurses. The analysis incorporates the application of RN standards of practice and the Gibbs model to a case study involving a newly qualified nurse facing challenges in a clinical setting. The discussion addresses effective communication styles for leadership, the role of the nursing unit manager, and ethical considerations. The report offers insights into how the Gibbs model can be utilized to navigate difficult situations and develop effective leadership skills. It emphasizes the importance of support, training, and adherence to professional standards in fostering confidence and competence among nursing professionals. Furthermore, the report examines the expectations of clinical leadership and the importance of ethical and legal boundaries in patient care, providing a comprehensive overview of the key elements of effective nursing leadership.

LEADERSHIP FOR BEGINNING PRACTICES
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LEADERSHIP FOR BEGINNING PRACTICES
Introduction
Leadership can be defined as the vital aspect associated with management practices which
bring reform in the environment of health care (Asif et al., 2019). The organization has been
restructured in order to satisfy specific demands for safe, affordable, efficient and accessible
health care. There are certain nurses who play an important role based on management in
order to formulate certain skills. NUM is an acronym where N stands for Nursing, U stands
for Unit and M stands for Managers. The NUM has proper management as well as a
leadership skill to operate efficiently in their field.
The paper has focused on certain questions on the basis of certain factors that affect the
nursing leaders. In addition, it has also discussed a situation based on the expectation of new
leaders which contains scopes of practices, ethical and legal borderlines. Moreover, it has
also focused on explaining a situation that can be elaborated based on the Gibbs model.
Furthermore, it has described a situation grounded on certain elements which are supportive
in the field of effective leadership.
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Discussion
Effects of various factors over nursing leaders: Being a Nurse Unit Manager, it is very
essential to pay attention on the performance of the nurses and have to remain calm and cool
minder to handle various unexpected situations. In order to relief Kim from stress and
emerging feelings of under confidence, I would also provide her support that may help her to
gain her lost confidence. Neither I am going to advise the nurse, nor I am going to judge as
well, rather I would accompany her to deal with the problems to get rid of them. Initially, I
would call Kim to my clinic to make her comfortable so that she can reveal the problems in
front of me. Then I would slowly and patiently discuss the relevant issues to decrease Kim’s
anxiety and distress. I would help the nurse to the best possible extent to regain the lost faith
because due to her under confidence, she is thinking herself to be hopeless and worthless at
the same time. There are several RN Standards of practice, mainly implemented for the
purpose of efficient nursing, have been discussed below.
Standard 1 of RN practices helps in critical thinking and evaluation of skills based on
nursing practice. Standard 2 of RN practices, denotes engagement in therapeutic as well as a
professional relationship. Standard three bits of help in the maintenance of capability
associated with practices, while standard four helps to conduct certain assessments
comprehensively. Standard 3 of RN practices, helps to maintain the capability of practices
that accepts accountability for decisions, behaviors, actions and responsibilities related to a
nurse job role. According to NMBA (2019), this standard helps to identify and promote the
integral role of nursing practices that influences people to take care of themselves for gaining
better health. Standard 4 of RN practices, depicts a range of assessment techniques to collect
accurate information and data of nursing practices. Standard 5 of RN practices, focuses to
help in the development of certain plans based on nursing and standard six ensure appropriate
quality of nursing practices. Standard 6 of RN practices, provides safe and appropriate as
well as good nursing quality by following relevant polices, guidelines and regulations.
Furthermore, Standard 7 of RN practices, helps in the evaluation of outcomes based on
practices of nursing. With the help of RN standard, I would help Kim to regain her capability
to improve the quality of work which refers to standard three. As per standard three, the
regulated professionals would ensure their safety as well as their capability associated with
practices (NMBA, 2019).
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In this case study the newly joined nurse faced an issue related to equipment handling
practices, that made her distressed and also decreased her confidence level. In her first phase
of working life she needed to get proper guidance about nursing practices instead of getting
criticism (Chapman, 2015). According to the case study it was not the nurse’s fault that she
did not know the use of intubation equipment, it was lack of university who failed to give
exposure of handling all type of medical equipment.
With the help of the discussed RN standards, I would make her learn effective procedures
about managing herself. Further, these standards would also aid her to improve herself
professionally so that she may provide assistance to others. This would help Kim to avoid the
attitude of giving up and would make her stable enough to take fruitful decisions. It would
also help her by providing proper education which would prevent her from making mistakes
(Edward et al., 2015). Last time she did not know the functioning of specific equipment used
for intubation due to which all trouble has aroused. Hence with the help of these standards,
she would acquire certain skills that would provide give knowledge regarding the utilization
of equipment (Brown, 2017).
Expectations of Clinical Leadership: Clinical leadership expectations have been
characterized as the performing duties that should be undertaken by the doctors, nurses and
other staffs of the healthcare unit. The expectations include the framing of knowledge,
potentialities, capabilities and practices of the new graduate nurses that will benefit them to
take a step forward into the duties that are required. Practices of the nurses involve
safeguarding, advancing and escalation of health and capabilities; avoidance of illness and
bruises; abetment in healing; and mitigation of pain with the help of diagnosis and
medication. A nurse has a legal and ethical permission to acknowledge the appeal of care and
should treat the patient with equal care and truthfulness. The nurse must estimate the health
requirements of the patient that can be handled within the practice. However, if the nurse
finds that a critical level of treatment is needed, then he or she should transfer the patient to
the respective physician (Brown, Dewing and Crookes, 2016).
Based on the above analysis, it can be observed that Kim does not meet the commitments that
are expected from the new graduate nurses. First and foremostly, Kim was a fresher and
needed to be more concentrated about her duty of medicating a cardiac arrest patient, in
which she was involved. After the patient’s recovery, Kim was scolded by the attending
Registrar for an unintentional wrongdoing, as mentioned earlier. Due to this incident, she
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utilized herself as an incompetent nurse, and this feeling led her to desolation. As a nurse,
Kim's first duty is to take care of the patients and to gather knowledge from her ongoing
nursing practice. However, her scolding made her feel humiliated and embarrassed, and
instead of safeguarding and healing the patients, she needs counselling to reconstruct her
confidence. In order to meet the requirements of a nurse, it is significant for Kim to undergo
counselling procedures to work efficiently in her assigned role (Rosser et al., 2017).
Influencing communication style for leadership: Effective communication skill, expected
from a leader in order to influence other followers to make them obey the directives. This
also helps in maintaining relationship between leaders, patients and followers. According to
the situation and goal, a leadership style should be different and sometimes it depends on
effective actions that are taken in that respective. On the other hand, communication style of
leaders varies from person to person based on the personal behavioral style. In a hospital,
effective communication is essential for a leader to communicate with follower nurses and
has to dictate them the norms of the work accordingly. Moreover, a doctor is a leader in
respect to hospital and has to communicate with patients to know about their diseases that
make the treatment path easy (Dahiya, 2019).
The RN standards of practices that are relevant to Kim's case are Standard 1, 2 and 3 of RN
Practices. Standard 1, utilizes diverse thinking procedures and possible evidence in framing
statements by accomplishing secured and best nursing training to the individual nurses (Lane
et al., 2017). In Kim’s case, the attending registrar could have acted in a polite way to make
Kim understand the wrongdoing instead of scolding that made Kim distressed. Standard 2
involves collegial kindness by constructing reciprocal trust and dignity in professional
relationships. In the mentioned case, this standard can be applied as the attending registrar
has scolded Kim in front of her colleagues due to which she felt insulted that resulted in
lowering down of confidence level in her duty. Standard 3, ensures the ability of practice like
responding carefully when there is any patient-related issue. Though it was unintentional
wrongdoing, then also Kim should have been more careful about what apparatus is necessary
for intubation as she is a graduate nurse (Patterson et al., 2016).
Application of the Gibbs Model: Kim, a Registered Nurse, was involved in a duty where a
patient was admitted due to the cardiac arrest. After that, the patient was shifted into the
intensive care unit for proper treatment, and there Kim passed through the trouble, that she
did not know the functioning of equipment for intubation. For this reason, Kim was facing
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embarrassment, lack of confidence and distress. I feel that Kim was not responsible for this
trouble, as she had just started practising after passing out from the University of Technology
Sydney in the year 2018. As she is a fresher, so she should be trained by the hospital, if she
faces any trouble handling any equipment. I think this situation is embarrassing, and after
passing through it, I would also be depressed, but it can be improved by further training and
guidance. It is just the first phase of her career, and it is time to prepare herself to become a
professional nurse. Through experience, she can improve herself and become efficient for any
kind of equipment handling.
I would recommend the Gibbs model that is required in the case of trainee nurses within an
organization. This model is also known as the Gibbs reflecting cycle that includes six steps
starting through the description, continues with feelings, evaluation, analysis, conclusion,
and ends with an action plan. This description has been discussed in the above part of the
paragraph and feels that leading up the event is distressful (Barksby, 2015). With occurrence
of the event, other colleges of the nurse and all the patients in the ward felt that the nurse was
incapable of doing her duty. After that, the evaluation part describes that after happening the
event the Nursing Unit Manager was guiding Kim through counselling process to remove her
distress and will result in gaining her lost confidence (Swiger, Vance and Patrician, 2016).
Then comes the analysis part where I can learn from the experience, and according to the
case study, the nurse should learn from the event to control the situation and mind setup
instead of getting depressed. It can be concluded, that happening of a similar event in the
future, the nurse could cop up with the situation remembering her past experience and will
take the measure. In the context of the action plan, this model supports the resilience-
building strategy that involves social support, adverse event debriefing protocols and
organizational mindfulness practices (Urden, Stacy and Lough, 2018). It refers to build
psychological fitness and personality trait and self-care practices that will increase individual
performance.
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Figure: Gibbs Cycle
(Source: Gibbs' Model, 2019)
Role of nursing manager unit: Nursing Unit Manager plays an important role in providing
proper training as well as guidance to the freshers. The manager would assist in establishing a
certain standard of care based on nursing for units. She would focus on removing the
communication barrier that may hamper the development of the nurse who is a fresher. He or
she must have the liberty to disclose the problem to the manager, and this would help both the
managers as well as freshers to develop appropriately. The leader or manager should
incorporate new findings from research while providing training to them as well as in certain
policies based on nursing. The manager must possess certain qualities of leadership skill as
well as competencies that would help her in collaborating all other health professionals. She
must take the initiative to identify certain issues and should also invest her time in
implementing new plans for improving or to make a certain adjustment needed to achieve
goals as well as objectives.
Mentorship is crucial in improving the leadership expertise for nurses and performs smoothly
in discovering a leader and being a leader (Duffield et al., 2015). NUM should train the new
graduate nurses like Kim in a more polished way than what the NUM has pursued during
his/her training. Mentorship also involves shadowing the fresh graduates to make them learn
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the skill that will permit them to employ with and inspire both peers and patients in future
(Fleiszer et al., 2015).
Confidence also plays a significant role in developing the leadership skills in case of newly
graduated nurses. It first involves a vigorous dosage of confidence in the nurses. However, in
Kim case, just the opposite matter has happened. In order to build confidence, self-awareness
and framing trust between each and every member is much needed. In Kim's matter, it was
the duty of the NUM to delve deeper into the stability and weakness of the trainees so that
they can be improved for better performance. It is the core duty of the leader, that is the NUM
to be careful about the emotions that might disturb others. Positive emotions can affect other
trainee nurses, while erroneous emotions can result in lowering the confidence that is evident
in Kim's case (Ortiz, 2016).
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Conclusion
After analyzing the entire event, it can be concluded the nurse, Kim was embarrassed and
distressed for the scolding that she faced. For this purpose, several RN standard practices are
applicable to Kim's as she was newly joined and started practising in the hospital. RN
standard practices include maintaining the professional relationship between collogues and
engaging therapeutic practices that can be trusted. According to RN standard nurse should be
responsible for giving safe and professional treatment. Thus, the nurse was responsible for
incapable of handling the intubation equipment, and she should be properly trained and
equipment handling.
However, the Nursing Unit Manager was very understanding and without scolding, gave her
a counselling to cope up with the situation. Moreover, the Gibbs reflecting cycle would help
the nurse to understand the situation and the action plan will help to apply the appropriate
strategy of resilience. According to a resilience strategy, the nurse should be trained to
develop personality traits and psychological fitness in order to gain professional skill in the
field of work. This resilience strategy would help to minimize the negative impact of the
work adversity on the area of healthcare performance.
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