Leadership in Healthcare: Analyzing a Clinical Nursing Scenario Report

This report presents a case study analysis of a critical clinical situation in a heart specialty hospital, focusing on the role of nurses as leaders. The scenario involves a medication error and the subsequent actions taken to manage the crisis, highlighting the application of contingency theory and different leadership styles. The report delves into the initial reflection on events, critical analysis of the situation, and the implications of leadership practices, emphasizing effective communication, decision-making, and the importance of motivating team members. The analysis underscores the significance of leadership in healthcare settings, particularly in ensuring patient safety and improving outcomes. The conclusion summarizes the key findings, emphasizing the importance of strong leadership in healthcare and the need for nurses to develop leadership skills to handle complex situations and guide their teams effectively. The report also references relevant literature on nursing leadership and healthcare management.

NURSES AS LEADERS IN
HEALTH CARE SETTINGS

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
Overview of clinical situational situation ..............................................................................1
Initial reflection on events......................................................................................................2
Critical analysis of the situation ............................................................................................3
Implications of leadership practice.........................................................................................5
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Strong leadership is considered as critical if there is a need to realize a vision of
healthcare information. All the nurses will begin their career with a thought of becoming a leader
(Yoder-Wise, 2014). As per the research, the nurses' profession must also produce leaders
through the system of health and social care, from the beside to the board room, who can serve as
full partners with other health professionals and always be accountable for their own
contributions in providing high quality care while working collaboratively with leaders from
other health professionals.
Overview of clinical situational situation
In order to provide a complete understanding about the clinical situation which I have
faced in professional career while working as nurse in a well-known Heart speciality hospital
(Giallonardo, Wong and Iwasiw, 2010). The situation was happened due to wrong vaccination
given by one experienced nurse. For determinations of situation I have used contingency theories
which has described a how the situation influence good leadership. In this fielder's contingency
model has been discussed which has provided an understanding that there is no best style of
leadership. Instead, a leaders' effectiveness is based on situation. This is mainly the results'
leadership style and situational favourableness.
Initial reflection on events
For handling a critical situation, it is essential for every individual to work effectively and
perform the tasks which are assigned by leaders to handle a particular situation. There are
various critical situations needed to be faced by individuals while working in health and social
care sector. As a part of Heart speciality hospital, I have also observed various critical situations
which are faced by the doctors and assisted them by handing the patients. In the present scenario,
the situation which I have discussed has provided me both positive and negative experience as I
have faced many challenges to handle that situation (BRADY GERMAIN and Cummings,
2010). My personal review about the situation was positive as all other members have followed
the instructions which I have provided while doing treatment of patient. With effective
communication and application of previous experience, I have handled the situation and also
analysed that which types of medicines and anti-doss should be given to patient. Further, all
members that provided support was experienced in their field and provided effective suggestions
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to provide medicine to patient. In this whole, my feeling always remain positive and I have
thought that we will be able to complete the task successfully. For getting contribution of staff, I
have provided them motivation through making continuous interaction and consulting them
about completion of task (Wang, Chontawan and Nantsupawat, 2012). From the contingency
theory perspective, a leader I considered as effective as per his ways of handling the situation
and decision taken by him to attain positive results. The main objective of member behind this
successful operation was saving the patient who has faced the problems due to mistake of one
staff member. Through effective leadership practice, I have able to change my perception
towards some member, for whom I have from other that they are not effective to handle the
work. By doing this, me and other staff has proved them wrong. Appreciation of doctor has
provided a feeling of motivation and they have also suggested some direction to use, if this type
situation will occur in the future .In present context, a reflection on clinical practice situation is
described in which I have faced in my career as nurse in heart speciality hospitality (Laschinger
and et.al., 2010). Well educated and experience people was there in the hospital which has
managed the work of hospital and most effective in providing appropriate service to patients.
The management has assigned me the duty to assist two senior doctor and also to handle the
patients whose treatment is done by senior doctors. One day clinical problems have been caused
due to wrong vaccination which was given by nurse to patient. This problem is considered after
analysing the symptoms of patients as the patients was not feeling well. After some time, patient
condition went critical and there was only some other nurses were there who didn't understand
about the problems. That day doctors were not present in hospital and without waiting for
doctors to come we all have discussed handling the situation. There were not group of five
people were there to handle the patient. For treatment we have shifted the patient in intensive
care unit. There we have started the treatment and given the anti-doss to patient to remove the
effective of wrong. All five member were given responsibility to arrange appropriate
arrangements to make the treatment. With effective leadership, I have utilized my experience
which I have learnt by observing the doctors. Patient’s condition and pulse rate was continuously
monitored by me and other members. With an effort of six hours, we have successfully handled
the critical situation. Patient was continuously monitored before the doctor arrival and after their
arrival we all have informed them about the situation. Doctors have suspended the nurse by
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whose fault this situation has been arises and appreciated me and other member for resolving the
situation.
Critical analysis of the situation
Leadership is considered as most effective task that enable a person to prove his
experience, potential and abilities of successfully accomplishing the group task. It involves an
activity of being a role model for other so that they can perform well by observing the leader
(Ritter, D., 2011). For accomplishment of task, it is essential for leaders to motivate his team
member and provide appropriate directions so that they will be able to accomplish the work
effectively. In present scenario, in order to provide an understanding that about the effectiveness
of leaders and the traits which are needed to handle the situation. Fielder's contingency model is
an effective and appropriate leadership theory model which provided an understanding that
leaders' effectiveness is based on the situation (Weberg, 2010). Which is a result of two factors
that is leadership style and situational favourableness. These two effective factors are being
discussed below:
 Leadership style: Identification leadership style is the first step in using the model which
reflects our own understanding about the situation and also provided a critical reflection
about the situation (Fiedler’s Contingency Model, 2017). In the situation which was
discussed earlier I have applied effective leadership style and also attained the
participation of co-workers. This problem is considered after analysing the symptoms of
patients as the patients was not feeling well. After some time, patient condition went
critical and there was only some other nurses were there who didn't understand about the
problems. That day doctors were not present in hospital and without waiting for doctors
to come we all have discussed handling the situation. There were not group of five people
were there to handle the patient. For treatment we have shifted the patient in intensive
care unit. There we have started the treatment and given the anti-doss to patient so that
reaction of wrong vaccination will get removed.
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 Identification of situation: With democratic leadership style, I have handled the critical
situation also achieved the support of other people. The model says that task-oriented
leaders usually view their LPCs more negatively, resulting in a lower score. Fielder
called these low Loss-leaders. He said that low LPCs are very effective at completing
tasks. They're quick to organize a group to get tasks and projects done. Relationship-
building is a low priority. In order to handle the situation, all the task needs to be
performed by person who can effectively able to perform the job. This is used to perform
the task of identification of resources which are needed to complete the task.
The situation was quite favourable as there was effective relation between me other
members through which we have successfully accomplished the task. The task which I have
assigned to my co workers was totally structured as all the instruction which I given was
effectively followed by them to handle problematic situation of managing a patient. Other than
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Illustration 1: Fielder's contingency model

this, I was having strong power on my member. Therefore, they were being able to complete the
task and work effectively that is why we have achieved proper and effective results.
 Determination of most effective leadership: The leadership is considered as most
effective when the task which are delegated by leader to its subordinates will get
accomplished effectively. It can also be analysed a situation in which the persona is able
to work effectively. The most effective leaders in this situation would be with high LPC
that is the leaders who may focus on building relationship. In this context, I have also
developed effective relationship and mutual understanding with my colleges therefore we
were all being able to face the situation effectively.
Implications of leadership practice
The leadership style shows that the decisions made by the leader at the time critical
situation like this are based on situation. The situation can be related to anything. In this situation
the leader should take the decision of its subordinates as they help in giving suggestions. This
style of leadership makes the leader more effective as he is involved with his subordinated in
decision taking (Smith, 2011). Situation is the major factor that effects the quality of decision
taken by leader.
Many leaders take decision by analysing the situation that what will be the effect of
decision afterwards if this decision is implemented. It also provides insight to employees that
how to handle the situation. It helps in maintaining high quality health care system in the
hospital. It also consistently provides safe and effective care has been taken (Huis and et.al.,
2013). Clinical leadership is optimized for care delivery. The leadership must be skill driven as
well as situational driven in nursing sector. The leaders' responsibility is to take proper decision
regarding the health of the patient and to provide the best medical care by taking effective
decisions. For this a leader must be trained with different situations in which he must have given
different task and situations so that he is able to take proper decisions in critical times. The
leadership style in this situation must be democratic it means that the leader must involve his
subordinates in decision taking. The pressure on the leader is intense on this situation which
makes him very stressed because of this he might not be able to take proper decisions. Also,
hospitals are under incre4ased strain and scrutiny. So in that there is a high demand of leaders
who are able to take corrective decisions in difficult situations. The leaders have to go through
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difficult training in order to guide his employees and subordinates. The leaders are responsible
for guiding the team in right direction. Also, the environment in hospital is complex means it is
affected by social, culture and political which also pressurizes the leader to take corrective
decisions. The leadership style is affected by discipline, dynamics and many other factors within
the hospital. That's why every decision taken by the leader is crucial.
CONCLUSION
In the present report, it has been concluded that leadership has its importance in every
sector as it provides a major experience to individuals to work within group of people. It
involves an activity of being a role model for others so that they can perform well by observing
the leader. For accomplishment of tasks, it is essential for leaders to motivate their team
members and provide appropriate directions so that they will be able to accomplish work
effectively. This report has provided a complete understanding about various leadership style
should be utilized in every sector to achieve success in professional work as leader.
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REFERENCES
Books and Journals
Bamford, M., Wong, C.A. and Laschinger, H., 2013. The influence of authentic leadership and
areas of worklife on work engagement of registered nurses. Journal of nursing
management. 21(3). pp.529-540.
BRADY GERMAIN, P.A.M.E.L.A. and Cummings, G.G., 2010. The influence of nursing
leadership on nurse performance: a systematic literature review. Journal of Nursing
Management. 18(4). pp.425-439.
Giallonardo, L.M., Wong, C.A. and Iwasiw, C.L., 2010. Authentic leadership of preceptors:
predictor of new graduate nurses' work engagement and job satisfaction. Journal of
nursing management. 18(8). pp.993-1003.
Huis and et.al., 2013. Impact of a team and leaders-directed strategy to improve nurses’
adherence to hand hygiene guidelines: a cluster randomised trial. International journal of
nursing studies. 50(4). pp.464-474.
Laschinger and et.al., 2010. New graduate nurses’ experiences of bullying and burnout in
hospital settings. Journal of advanced nursing. 66(12). pp.2732-2742.
Ritter, D., 2011. The relationship between healthy work environments and retention of nurses in
a hospital setting. Journal of Nursing Management. 19(1). pp.27-32.
Smith, M.A., 2011. Are you a transformational leader?. Nursing management. 42(9). pp.44-50.
Wang, X., Chontawan, R. and Nantsupawat, R., 2012. Transformational leadership: effect on the
job satisfaction of Registered Nurses in a hospital in China. Journal of advanced nursing.
68(2).
Weberg, D., 2010. Transformational leadership and staff retention: an evidence review with
implications for healthcare systems. Nursing Administration Quarterly. 34(3). pp.246-
258.
Yoder-Wise, P.S., 2014. Leading and Managing in Nursing-E-Book. Elsevier Health Sciences.
Online
Fiedler’s Contingency Model, 2017.[Online]. Available through:<http://www.academic-
capital.net/2013/05/effective-leadership-under-fielders.html > [ Accessed on 2 December
2017].
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