Nursing Leadership in the NHS: Styles, Self-Assessment, and Goals

This essay provides a comprehensive analysis of nursing leadership within the context of the National Health Service (NHS). The author begins by defining leadership and its importance in healthcare, referencing key reports and literature to highlight the significance of effective nurse leadership in improving patient outcomes and addressing issues such as high mortality rates and staff attrition. The essay then delves into various leadership theories, including transformational and situational leadership, explaining their application in nursing practice. The author reflects on their personal leadership style, emphasizing the preference for transformational leadership, and shares a real-world scenario that revealed both strengths (communication skills) and weaknesses (conflict resolution). Based on this self-assessment, the essay concludes by outlining a SMART goal-oriented plan to enhance conflict resolution skills, with specific, measurable, achievable, relevant, and time-bound objectives. The essay underscores the importance of continuous self-improvement and the development of effective leadership qualities to ensure patient safety and improve healthcare quality.

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

1NURSING
Introduction
The chief purpose of this essay is to demonstrate an insight into my leadership potential as a
potential nurse leader. In order to become an effective healthcare leader, it is highly crucial for
an individual to have adequate self awareness that understands of one’s strengths and
weaknesses (Fischer 2017). Along with an in-depth understand, an efficient nurse leader requires
having the capability to analysis contemporary nursing leadership theories and developing
effective plan to deal with his/her weaknesses. In this essay, a detailed discussion of leadership
theory styles within the context of the NHS and specifically nursing has been performed.
Additionally, in this essay, I have discussed about a my own leadership style, specific situations
that helped me to identify my strength and weaknesses. Finally on the basis of my discussion, I
have developed a plan to eradicate my weakness with the help of SMART goals.
Body of essay
Leadership has been defined by NHS leaders as an individual's actions when leading a
group's efforts towards a common objective. The main facets of leadership position are to affect
community behavior and to deal with transition. A challenge in contemplating healthcare
practitioners' leadership is that most ideas were not formulated within a framework of healthcare,
but were usually established for the business environment and only extended to health care.
According to Sir Bruce Keogh, the medical director of NHS, Health care failures are usually
the product of lack of expertise and clinical leadership (Keogh 2013). After conducting a review
in NHS England, Keogh stated that lack of efficiency of nurse leaders to manage the staffs and
retain efficient nurses has resulted in enhanced mortality rate at 14 NHS trusts. Additionally,
disconnection between board level and clinical level leadership within the organization has been

2NURSING
pointed out to be another major issue. Similar leadership issues have been detected in Francis
report. The study investigated what led to inadequate health care quality, premature patient
deaths, and why there was little awareness of the warning signs of significant deficiencies. It has
been found that inefficient leadership of the nurse leader have resulted in deterioration of
healthcare due to high attrition rate of skilled nurses (Fischer 2017). In order to deal with high
mortality rates due to low quality care provided to patients, the Berwick’s report has suggested 4
aims to be followed by the nurse leaders:
 Putting the standard of health care, in particular, health safety of the patients, first and
foremost (Lynch et al. 2018)
 Involving, motivating and listening patients and careers at all times
 Promoting the growth and advancement of all staff, including their capacity and
encouragement to enhance the systems through which they operate
 supporting openness unambiguously and anywhere in the field of accountabilities
Special training needs to be provided to the nursing staffs by the leaders so that they can
demonstrate effective compassion and in practice. According to Transactional nursing theory,
nurse leaders should have effective understanding of their own strengths and weaknesses
(Andrigue et al. 2016). Not only has this, a culture of learning and transparency as per Keogh’s
review, needed to be implanted in order to enhance the skills of employees so that higher quality
of care can be provided. Additionally, NHS has launched a long term plan. The 10-year program
includes steps to reduce 150,000 cases of heart attacks, strokes and dementia and increased
access for adults and children to mental health facilities (Plan 2020). The Long Term Strategy for
the NHS is a revolutionary framework for increasing the quality of patient services and health

3NURSING
outcomes. The aim of this plan is to enhance the skills and efficiency of the nurse leaders
through appropriate training as well as education so that effective leaderships can be provided.
As a nurse leader, the leadership style that I prefer to follow is transformational leadership.
The transformational leadership theory states that leaders should work with the followers in
order to identify the required change and should possess the vision to guide the change through
inspiration along with executing the change in order to reach the organizational goal (Zigarmi
and Roberts 2017). In nursing practice, transformational leadership motivates people by reaching
towards greater ideals and universal principles, as the individual has a broad range of beliefs and
solutions inside (Lynch et al. 2018). This encourages nurses to act for maintaining the common
good, rather than their own needs, and structures of encouragement in which accountability is
shared. As a transformational leader instead of instructing the followers, I prefer to work with
them in order to understand the specific areas of needs so that they can be fulfilled.
Another leadership style that I have participated on is situational leadership. The situational
leadership theory refers to the leadership style where leaders adopt their leadership tactics based
on the situation and for the development of their team. Like transformational leadership,
situational leadership has received a huge amount of attention in nursing practice. Nurse leaders
who embody the situational leadership style have gained high success in their field. While
transformational leadership is driven by one approach, situation leaders in nursing multiple
approach to tackle situations. (Andrigue et al.2016) Transformation leaders come up with new
strategies to get people inspired to accomplish projects, and situational leaders place more
emphasis on understanding and adjusting to a situation. Considering the fact that that as a
nursing leader, my target is to ensure patent safety by understanding eradicating the difficulties
faced by my nursing team, I chiefly follow transformational leadership.

4NURSING
One of the major scenarios faced by me during my nursing practice had helped me to understand
my strengths and weaknesses. In my workplace, I had been allocated 4 patients, 2 of whom
needed to be provided with medication before meal as per the instruction of the doctor. However,
within a few days, I noticed that the nurse looking after them is not following the doctor’s
instruction as they are being provided with medication either during or after meal. As a nurse
leader, I conducted a face to face meeting with the nurse. While communicating I noticed that the
nurse is completely reluctant to change and unaware of the adverse affect of providing
medication at wrong time on the health of the patient. While I was trying to explain the same to
me, she seemed to be reluctant to listen to me since I was a student. In order to handle the
situation, I involve a senior member and then clearly communicated why it is crucial to provide
medication and time and how her act can impose negative impact on the patient’s health. The
nurse understood the issue and apologies stating that a huge amount of work pressure and stress
has resulted into the action and ensured that this type of reluctance would be shown by her in
future.
From this scenario, I identify that as a leader I can effectively communicate with my follower
and help them to understand the issue and thus communication skill is my strength. However,
since I had to involve a senior ember in order to resolve the conflict, I understood that conflict
resolution in a major weakness of mine. In order to eradicate the same, I have developed the
following SMART Goals.
Specific To increase conflict management skills
Measurable by measuring the number of successful conflict
handing in workplace
Achievable for achieving 95 percent successful resolved cases

5NURSING
Relevant That will enable me to improve nursing leadership
skill
Time-bound Within a 6-10 months time period.
Conclusion
Lack of effective leadership in nursing is imposing highly negative impact on the patient’s health
and safety. After conducting a review in NHS England, Keogh stated that lack of efficiency of
nurse leaders to manage the staffs and retain efficient nurses has resulted in enhanced mortality
rate. Inefficient leadership of the nurse leader has resulted in deterioration of healthcare due to
high attrition rate of skilled nurses. In order to deal with such situations Plans and reports has
been produced by NHS.. As a nurse leader, I have identified conflict resolution in my major
weakness. In order to deal with the same, I have developed smart goal. In order to reach my goal,
I will start reading conflict resolution related books written by leaders and also consult with my
colleagues in order to understand ho they improve their conflict resolution skills.

6NURSING
Appendix
Strengths
1. communication skills
2. Emotional intelligence
3. Respect towards employees and
patients
4. Professional socialisation
5. Critical thinking capabilities
Weaknesses
1. Lack of conflict resolution skills
2. Lack of cultural competence
3. Lack of capability to take instant and
effective decision during conflict
situation
Opportunities
1. Implement effective strategies to
eradicate the weaknesses.
2. Communicating with colleagues in
order to understand how they deal with
their weaknesses
3. Develop strategies by reading books
written by nurse leaders.
Threats
1. Higher number of conflict within the
staffs resulting in deterioration of
health care
2. Staff and client dissatisfaction due to
lack of cultural competence
3. Ineffective uses of oppertunties due to
lack of effective decision making
capability.

7NURSING
References
Plan, N., 2020. NHS Long Term Plan. [online] NHS Long Term Plan. Available at:
<https://www.longtermplan.nhs.uk/> [Accessed 19 April 2020].
Fischer, S.A., 2016. Transformational leadership in nursing: a concept analysis. Journal of
advanced nursing, 72(11), pp.2644-2653.
Vaismoradi, M., Griffiths, P., Turunen, H. and Jordan, S., 2016. Transformational leadership in
nursing and medication safety education: a discussion paper. Journal of nursing management,
24(7), pp.970-980.
Fischer, S. A. (2017). Transformational leadership in nursing education: Making the case.
Nursing science quarterly, 30(2), 124-128.
Lynch, B.M., McCance, T., McCormack, B. and Brown, D., 2018. The development of the
Person‐Centred Situational Leadership Framework: Revealing the being of person‐centredness in
nursing homes. Journal of clinical nursing, 27(1-2), pp.427-440.
Andrigue, K.C.K., Trindade, L.L., Amestoy, S.C. and Beck, C.L.C., 2016. Situational leadership
style adopted by nurses in the hospital field. Rev Eletr Enferm., 18, p.e1191.
Zigarmi, D. and Roberts, T.P., 2017. A test of three basic assumptions of Situational
Leadership® II Model and their implications for HRD practitioners. European Journal of
Training and Development.
Keogh, B., 2013. Review Into The Quality Of Care And Treatment Provided By 14 Hospital
Trusts In England: Overview Report. [online] Nhs.uk. Available at:
<https://www.nhs.uk/nhsengland/bruce-keogh-review/documents/outcomes/keogh-review-final-
report.pdf> [Accessed 19 April 2020].