Leadership in Clinical Practice: Nursing Team Scenario Analysis Report

This report examines leadership within the context of nursing practice, analyzing two distinct clinical scenarios to illustrate the responsibilities of registered nurses. The first scenario presents a situation in a daycare hospital, focusing on the roles of senior and junior nurses in patient recovery, delegation, and the importance of effective communication and support within the team. The second scenario addresses a respiratory/oncology ward, highlighting leadership in managing patient care, particularly considering emotional support, critical analysis, and the application of NMBA guidelines. The report emphasizes the significance of delegation, supervision, and the need for experienced nurses to guide and support their colleagues to ensure efficient and effective healthcare service delivery, while adhering to professional standards and providing optimal patient care in challenging situations.

Running head = Leadership 0
Leadership
Leadership in nursing
Student Detail
[Pick the date]

Leadership
1
Contents
Introduction......................................................................................................................................1
Scenario 1........................................................................................................................................1
Scenario 2........................................................................................................................................3
Conclusion.......................................................................................................................................5
Reference.........................................................................................................................................6

Leadership
2
Introduction
Leadership is one of the prime necessities for the efficient and effective working of any
healthcare service. The leadership in the field of nursing is an integral part and in the current
scenario could be considered the single largest part of the healthcare system (Sandström et al.,
2011). Although there are an ample amount of research present in the literature regarding
leadership and management in the organizations, however studies in the context of leadership in
nursing practice have been rarely reported (Daly et al., 2014). The present report described the
role of leadership in the context of the registered nurse based on the two scenarios.
Scenario 1
The first scenario provides a situation at a Daycare hospital, generally dealing with patients
related to eye, ENT, and Orthodontist. The registered nurses have been situated at different
locations three of them, Pearl, Ray, and Sandy have been situated in the first unit, where a patient
generally resides for thirty minutes after the anesthesia and fifteen minutes after the sedation
period. Pearl has worked at the facility for the 9 months, Sandy is a senior nurse, and Ray has
three-year experience but quite new at this facility. In the second stage of the facility, two more
registered nurses have been allocated, also two orderlies have been appointed for the theatre;
they are usually present in the area between theater and first stage recovery. On the day it was
observed that the patient of ENT service of taken care of by Ray after the operational procedure
in the recovery room. It was observed by Ray that patient blood pressure was dropped to 90/50
with an increase in pulse rate to 85, and blood could be observed around her oral region. On the
other bed, sandy is working on a patient with plate insertion at the humerus, and it was observed
that the patient was ion severe pain, At that moment sandy has asked form both Ray and Pearl
for a DD check. As Pearl has already been assisting two patients from eye problems and a third
one is coming also here absence at the time of in-service has been noted by the authority. The
doctor working on eye surgery has made it already clear that proper care and instruction should
be given to the patients before their discharge. As the pressure of the work is getting stronger on
all of the staff one of the senior registered nurses must step up as per the teaching provided by
NMBA standard and clinically analyses the situation.

Leadership
3
The NMBA statement indicates that an experienced registered nurse should provide
encouragement and suggestion for the exploration to the nursing staff, that could help in the
improvement of the quality of health care service provided along with the efficiency in the cost-
saving and cost-effective service for a specific population (Ross et al., 2013). As Sandy is the
senior-most registered nurse on the floor flowed by pearl, and Ray being an experienced nurse
still new to the place, therefore, it is a leadership responsibility of Sandy and pearl to make the
working environment more helpful for Ray so that, they could overall provide an effective
service. The NMBA also states that the registered nurse should guide the new person in the
nursing staff so that workers could work more effectively and efficiently. Ray is little
uncomfortable at the work that could be attributed to the new working environment, as Ray was
working on the patient who had just been operated by the ENT and the vitals collected by Ray
reported patient’s blood pressure drop of 90/50 with an increase in pulse rate to 85 along with the
blood in the oral region. As pearl observed this situation of Ray and Sandy has asked for the DD
of the third patient from both the nurses. It was evident from the circumstances that Ray will not
be able to give a correct response at that particular time, hence Sandy being the senior-most
nurse at the floor should have gone to Ray and helped towards analyzing the situation regarding
the ENT patient further could have suggested the placement of essential products nearby so that
at the time emergency they could find it without any difficulty. While telling Ray regarding the
methodology at the workplace Sandy should keep in mind that the moral of Ray should not be
disturbed by the teaching methods. The explanation should be carried out positively so that Ray
could learn the work without any stress, which is very important in the workplace for efficient
and effective work to be carried out (Anderson et al., 2018).
However, in case if Sandy is not able to consider Ray due to her busy working schedule, Pearl is
the second experienced nurse on the floor, although she had taken care of two patients of an eye
surgeon, and expecting a third patient any time soon (Doyle et al., 2015). As she can observe
Ray is not able to properly conduct his work, therefore she could take over his work, along with
her work and should help Ray by teaching him how to cope up with the situation. As the patient
under Ray was having low blood pressure along with the high blood pressure, it indicates that the
patient is going under a shock (Asfar et al., 2014), therefore extra care must be given to the
patient at that time. Pearl being there for more time must have learned regarding the patient in

Leadership
4
shock, therefore first thing they should tell the senior nurse regarding the vitals of the patient. As
it is evident that Ray is not able to perform his work, therefor Pearl could help Ray in terms of
working towards patient care and tech Ray regarding the work effectively and efficiently so that
Ray could work efficiently in the coming time. It was observed by Pearl that there is only one
patient at stage 2 and there are 2 experienced registered nurses at stage 2. The leadership is all
about utilizing the resource in the best possible way so that an effective and efficient service
could be provided (Chiu et al., 2016). Therefor Pearl could suggest that one of the registered
nurses could be employed at the floor so that, the patient could care and Ray who is not able to
work could learn from the registered nurse under the guidance of a registered nurse.
Scenario 2
The second scenario deals with the case of Respiratory/Oncology wards, where most of the
patients are admitted are treated for cancer and some of the patients are in other emergencies.
There are 4 single rooms and 1 with 4 beds. The staff on the shift for 1330-2130 is Robyn in her
graduate year of a registered nurse, Jay who has experience as EN and currently in the third year
in registered nurse degree. It was in common knowledge that the consultant for respiratory
problems and oncology problems were present on the floor and Robin was aware that Hedwig
was working as the team leader. In terms of the patient in each of the single room, room 1 has a
61-year-old male, the patient of non-Hodgkin’s lymphoma who is needed his folinic acid
treatment at 1500, which comes under the shift timing of Robyn as she has been asked by Jay to
take care of single rooms. In-room 2 a female of 52 years of age, with metastatic melanomas,
who needs a refill at her in situ syringe driver at 1600 hours, it was reported that there are family
members were present at the place due to very emotion situation, everybody was very emotional
in the room. In the third room, a 25-year-old female with cervical cancer has been providing
treatment of brachytherapy and going for the next round on Tuesday due to that patient is under
distressed. In-room 4 a male is admitted with lung cancer, his pleasures drain fitted in situ has
resulted in some discomfort to the patient. The oncology team has already checked him, provided
detailed written information regarding the treatment option, the patient is with his wife and needs
some clarification regarding the treatment, so-called for the nursing assistants. Room 5 having 4
beds one-bed number 1 female 59-year-old with breast cancer getting chemotherapy treatment,
she needs a dose of antibiotics at 1800 hours. On bed number 2 a 19-year-old female is admitted

Leadership
5
after she suffered an acute attack in the previous night, it was reported by the morning shift
registered nurse that the patient has not taken preventive drugs also nobody knows about her
whereabouts. On bed number 3 a 24-year-old male is been admitted to managing the
spontaneous pneumothorax. On bed 4 a 68-year-old male is admitted who is undergoing for the
treatment of head and neck cancer. The patient is admitted with a situation of increased
dysphagia and weight loss after the completion of therapy, with the occurrence of recurrent
diseases his PEG feed will be monitored overnight.
Out of the total 8 patients present in the care area the patient room number 2, room number 3 and
room number 4 need more attention in the context of practical dealing and emotional care of the
patient. In terms of leadership development skills as per the guidelines of NMBA, the registered
nurse needs to be able to critically analyze the condition and provides the best diagnosis based on
their knowledge and experience (Hodgson & Scanlan, 2013). As Hedwig is the leader of the day
it is her duty at the time of her shift that all the health care operations should be carried out
smoothly. As Robyn is working in single rooms, in the context of room number one the leader
could observe the working of Robyn as the patient only requires folinic acid treatment at 1500
hours. The patient in Room number 2 requires extra care as her condition is not curable and the
presence of family could make the task of nursing little bit difficult due to the emotional stress in
the room, therefore, it very important that Hedwig should supervise the situation, which could
prevent Robyn from making any mistake and if Robyn is not able to perform her task, she could
smoothly take Robyn place and take care of the patient and simultaneously teach Robyn
regarding the handling of work in the emotional situation. In the case of a patient in Room
number 3 the patient is distressed due to the treatment she is undergoing for her cervical cancer,
Hedwig should provide comfort to the patient and explains to her that the benefits of the
treatment and the importance of the treatment. The patient at the room number 4 has asked for
the assistance, due to the confusion of the type of treatment suggested to him it is very important
for the registered nurse to properly diagnosis of the condition and provide suggestion to the
patient. As the patient need to know why he cannot get surgery for the treatment, and why the
other therapy method have been suggested to him. Although the patient is in distress appears
calm so the registered nurse should explain to him based on the diagnosis why surgery is not the
option for the treatment and what are the benefits of the treatment that have been suggested. In

Leadership
6
the bed bay, the patient in bed number 1 is going to be discharged, however, the leader should
make sure that the patient gets all the information before the discharge along with the
requirement such as to request form for a blood check. The patient on bed 2 was missing it a very
difficult situation of the leader and the leader should make sure that the staff should not panic
under this condition and should search for the patient without creating a panic. The bed 3 patient
needs medical imaging and Ray has clamped the patient so Robyn should inform this to Hedwig
as she could determine the best course of action. Hedwig should check once the condition of the
patient at bed number 4 as his PEG needs to be monitored overnight. The leadership role of
Hedwig is more towards the control of the patient in distress which could be carried out through
proper information conveying to the on-duty nurse and helping the patient to understand their
situation.
Conclusion
The clinical practice circumstance represents the basic issues associated with healthcare services
practice fundamentally to registered nurses since they are increasingly engaged with a tolerant
mind and decide the administrations gave. The adequacy of nursing practice decides the patient
results; in any case, it's likewise subject to the nursing administration received since it impacts
the other medical attendant's preparation in social insurance settings. In the first scenario, the
new nurse was not able to concentrate on the work so the leader should come forward and guide
the nurse towards effective medical care. In the second scenario registered nurse should explain
the procedure and importance of the procedure to the patient along with the handling the
situation of missing patient.

Leadership
7
References
Anderson, C., Moxham, & Broadbent, M., 2018. Teaching and supporting nursing students on
clinical placements: Doing the right thing. Collegian, 25(2), pp.231-35.
Asfar, P. et al., 2014. High versus low blood-pressure target in patients with septic shock. N Engl
J Med, 370, pp.1583-93.
Chiu, C.-Y.C., Owens, B.P. & Tesluk, P.E., 2016. Initiating and utilizing shared leadership in
teamThe role of leader humility, team proactive personality, and team performance capability.
Journal of Applied Psychology, 101(12), p.1705.
Daly, J. et al., 2014. The importance of clinical leadership in the hospital setting. Journal of
Healthcare Leadership, pp.75-83.
Doyle, K., Hungerford, C. & Cruickshank, M., 2015. Reviewing Tribunal cases and nurse
behaviour: Putting empathy back into nurse education with Bloom's taxonomy. Nurse education
today, 34(7), pp.1069-73.
Hodgson, A.K. & Scanlan, J.M., 2013. A concept analysis of mentoring in nursing leadership.
Open Journal of Nursing, 3(5), p.389.
Ross, K., Barr, J. & Stevens, J., 2013. Mandatory continuing professional development
requirements: what does this mean for Australian nurses. BMC nursing , 12(1), p.9.
Sandström, B., Borglin, G., Nilsson, & Willman, A., 2011. Promoting the implementation of
evidence‐based practice: A literature review focusing on the role of nursing leadership.
Worldviews on Evidence‐Based Nursing , 4(212-223), p.8.