Nursing Leadership: Analysis of Issues in Professional Practice Report

This report examines nursing leadership, focusing on issues and factors that impact professional practice, particularly for new graduate nurses. It analyzes a case study involving a nurse's transition to practice, highlighting ethical dilemmas such as autonomy and communication gaps, and factors like conflicts of interest. The report explores various leadership styles, including democratic, transactional, and transformational, and emphasizes the importance of NMBA nursing standards in guiding practice. It also discusses leadership expectations for new nurses, including scope of practice and ethical boundaries, as well as the development of personal and professional resilience through strategies like fostering social connections and promoting positive self-care. The report concludes with an action plan for improvement and emphasizes the importance of knowledge, evidence, and effective communication in providing patient care and maintaining a healthy organizational environment.

Running head: NURSING LEADERSHIP
NURSING LEADERSHIP
Name of the Student
Name of the University
Author notes

1NURSING LEADERSHIP
Introduction
The concept of leadership is very much significant to the nursing profession. The nurses
need to develop the qualities of effective leadership in delivering a high quality of care, ensuring
the safety of the patient by getting engaged in several leadership roles of daily activities. I have
recently completed my graduation in nursing. At this stage, it is expected that I can work self-
sufficiently as well as in the part of the team (Fischer, 2016). So it is essential to develop
leadership skills so that I can fit myself within the organization. I must ensure the safety of the
patients as well as maintain my well-being (Endacott et al., 2015). This assignment is dealing
with a case study where a nurse was undertaking the transition to practice program at the
hospital.
Issues and factors which impact on the leaders of the nurses and the
professional practices.
Issues and Factors
The issues the affects nursing leadership and the level of the professional practice is the
ethical dilemma. The main ethical dilemma experienced by the nursing leaders is autonomy.
While giving care to the patients suffering from the mental health, the context of the informed
consent and autonomy create a gap in implementing comprehensive nursing practices. For
example, the older adults suffering from dementia at times lack the critical thinking skills in
order to assist in proper autonomy and informed decision making and thus creating a barrier in
implementing best practice. The patient from the ethnic minority group suffers from significant
communication gaps and has orthodox values and principles. Therefore it becomes difficult for

2NURSING LEADERSHIP
the nurse leaders to co-ordinate care in a manner that is alignment that is alignment with the
cultural background of the patient (Zanchetta et al., 2016).
Conflict of interest is the main factors that affect the professional practice in the nursing
leadership. Roux and Halstead (2017) stated that differences in opinion can occur between
multidisciplinary team members regarding the type of treatment. Whereas, differences in
opinions, can occur between nursing professionals and the hospital administrative authority,
regarding implementation of new nursing guidelines. Under this condition face nursing leaders
experience problem in implementing nursing interventions focused towards the clinical priority
of the patients.
While the program was going on, the nurse was involved in a case of cardiac arrest.
However, the patient was resuscitated smoothly and was then transferred to the intensive care
unit. She started feeling herself to be an incompetent nurse and became hopeless regarding her
work. The nurse unit manger must understand about the different issues and factors which
impact the leadership qualities of the nurses, and the clinical expectations need to begin the
practices of nursing (Park, 2015). The nurse manager has to work as a leader who contributes to
the welfare of the patients by following an authentic leadership style. The leadership styles
which are mostly followed by the nursing managers are democratic, transactional and
transformational. The nurse manager would have asked Kim to improve the nursing practices
rather than felling herself to be a hopelessnurse and blaming herself for the incident (Rokstad et
al., 2015). The standards 1, 2 and 7 of the NMBA nursing standards describe how a nurse must
analyze, perform and evaluate the nursing practices(NMBA, 2019). It is the most critical nursing
aspect to get involved in the therapeutic nursing practices for both taking care of the patient as

3NURSING LEADERSHIP
well as improving the nursing professional identity. The manager would have analyzed the
incident and suggest methods and new ways to improve professional nursing practices.
Leadership expectations for new nurses
A new graduate nurse can be expected to know all of the scopes the nursing practices and the
ethical and legal boundaries of the nursing practices. A nurse must know all the clinical practices
in order to prevent the occurrences of any ethical and legal issues.
Kim could not be able to meet the obligations of a graduate nurse. According to the
standards 5 and 6, the nurse must provide the patients with a comprehensive and complete care
plan by ensuring that the services provided are safe and appropriate (NMBA, 2019). The patients
come in the hospital to get proper treatment and become cured; however, it becomes an ethical
issue if they do not receive improper care services. Kim, in this case, violatedthe code of nursing
conducts by not treating the patients under proper hygienic conditions. It is not expected from a
professional nurse that she does not know about the instruments used in clinical practices(Linet
al., 2015). The nurses are responsible for providing improved quality of nursing services, but if
the hospital fails to provide such services, them the reputation of the hospital also goes down.
The nurse manager would have tried to make Kim and other nurses understand the requirements
to provide comprehensive treatment to the patients of the hospital(Spano-Szekely et al., 2016).
We were also able to make the organization understand the need to prepare new rules and laws
about maintaining the hygienic condition of the hospital. If the required steps are not taken, then
it can take a fatal form shortly. A registered nurse must know the legal and ethical boundaries of
their practices as strict moral actions can be made if the nurses breach their nursing conducts.

4NURSING LEADERSHIP
Gibb’s mode reflection
Description
It is essential for nurses to develop personal and professional resilience. To improve the
strength, Kim should learn to maintain a positive and good relationship with other peoples. Kim
must know to accept the circumstances. She must hope the best for her future and sustain long
term perspectives. I am going to analyze and evaluate the strategies required to develop both
personal and professional resilience.
Feelings
Before starting the leadershipactivities, it is indispensable for the leader to choose the
appropriate leadership style. The next strategy is encouraging the leadership activities and
serving as the role model so that the other nurses can follow the actions of the leader. The
strategies to in fostering nursing resilience are facilitating the social connections, promoting
positives, increasing the nursing strengths, growths and self-care. The other strategies are making
the nurses towards their works and conveying altruism.
Evaluation
The leaders must also have the capabilities to listen andcommunicate effectively to avoid
any miscommunications among the nurses. The leaders must encourage other people to
contribute to the activities, motivatethe followers to get involved in new practices and rewarding
those who are performing well in the events (Merrill, 2015). In this activity, I tried to follow all
the leadership strategies for motivating the nurses in achieving their goals(Park &Han, 2015). As
per standard 1 of the NMBA nursing practices, a nurse must critically think about the nursing
practices and then only proceed with the treatment procedures(NMBA, 2019). As a nursing

5NURSING LEADERSHIP
manager, I tried to inform the other nurses about the strategies of resilience for serving the
patients with the best nursing practices and if required, implementation of new innovative
measures can be done.The standard 3 of the nursing practicesfocuses on the capability to
maintain the professional practices of the nurses. So a nurse must actively engage herself in the
profession of nursing.This was my first experience as a nursing manager.
Analysis
Before the starting of the experience, I was not much confident about the several
activities and strategies which are to be executed as a professional leader. However, I have been
able to complete all the activities satisfactorily. Not only me, but all of the nurses who were
involved in the event also participated actively for improving the personal and professional
resilience. It was not only possible for me to carry out all the activities single-handedly. I
received the cooperation from all of the participants because of which the activity was done
fruitfully. The most crucial thing which went well throughout the event was the active
cooperation of all of the participants. The nurses, including Kim were found to have improved
both personal and professional resilience.Kim started improving her nursing practices along with
the other nurses of the hospital. The nurses learnt to work collaboratively in a team which will
surely enhance their professional identity in future. They will be able to accommodate any
environment. Everything went well except that during the early stages of the activity, I failed to
maintain the cooperation and integrity of the nurses, and as a result, a few biases occurred which
affected the prosecution of the business.

6NURSING LEADERSHIP
Conclusion
I have become much more confident in leading a group of nurses for any particular
activity.However if any such condition arises I will try to solve issues in new innovative ways in
order to make the fellow workers motivated towards their work.
Action plan
If I look back, I can measure the changes that the nursing leadership qualities had done in
my life. I have become much confident about nursing practices than I was before. Now I will be
able to perform the activities of a leader and lead any group of people. From the next leadership
activities, I will try to overcome the negatives that I had faced this time and will perform the
exercises with full confidence.
Supportive elements require in leadership
Knowledge, evidence and communication are the other important aspects of providing
the patients with effective treatments. A nurse until knows how to communicate effectively with
the patients, the patients will not feel comfortable in revealing about the health issues that they
are suffering from (Heckemann, Schols & Halfens, 2015). The nurses must apply the best of the
evidence-based practices for treating the patients. Not only is taking careof the patients, but
effective communication is also required in maintaining a healthyrelationship with the
organization. I communicated with the organizational body for the implementation of new laws
about hygienemaintenance.The nursing standards of 2, 3, 6 and 7 emphasize on the need to
increase the knowledge and confidences of the nurses.In the given case, Kim lacked the
knowledge and confidencerequired for treating a patient. She lacked the knowledge of nursing
needed, which reduced her confidence level. A nurse will only become proficient in her

7NURSING LEADERSHIP
profession if she can execute professional practices. Proper communication is another aspect
which must be used to build a productive therapeutic relationship with the patients. If a nurse is
not able to include all these elements in the practices, the care services will not be sufficient. As
a nurse manager, it was my responsibility to make Kim understand that she needs to improve her
knowledge and confidence about the nursing practices.
Conclusion
From this assignment, the effectiveness of the nursing leadership in implementing
nursing activities and policies in the hospital can be understood. Efficient nursing leadership
helps in encouraging the other nurses to function as units of a team. Nurses as a leader must have
well-built interpersonal skills to be victorious. They must be skilful at communicating with each
other, with the doctors and also other staff, with the patients and even the families of the patients.
Effective communication and strong team work help in providing effective care to the patients.

8NURSING LEADERSHIP
Reference
Endacott, R., Bogossian, F.E., Cooper, S.J., Forbes, H., Kain, V.J., Young, S.C., Porter, J.E. &
First2Act Team, 2015, 'Leadership and teamwork in medical emergencies: performance
of nursing students and registered nurses in simulated patient scenarios,' Journal of
clinical nursing, vol. 24, no. 1-2, pp.90-100.
Fischer, S.A. 2016, Transformational leadership in nursing: a concept analysis.', Journal of
Advanced Nursing, vol.72, no.11,, pp.2644-2653.
Heckemann, B., Schols, J.M. & Halfens, R.J., 2015, 'A reflective framework to foster
emotionally intelligent leadership in nursing,' Journal of Nursing Management, vol. 23,
no.6, pp.744-753.
Lin, P.Y., MacLennan, S., Hunt, N. & Cox, T., 2015, ' The influences of nursing
transformational leadership style on the quality of nurses’ working lives in Taiwan: a
cross-sectional quantitative study. ' BMC nursing, vol. 14, no.1, p.33.
Merrill, K.C., 2015, 'Leadership style and patient safety: implications for nurse managers.'
Journal of Nursing administration, vol. 45, no. 6, pp.319-324.
NMBA (2019). Nursing and Midwifery Board of Australia - Registered nurse standards for
practice. [online] Nursingmidwiferyboard.gov.au. Available at:
https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards/registered-nurse-standards-for-practice.aspx [Accessed 18 Sep. 2019].
Park, H.J., 2015, 'Correlations among nursing professionalism, critical thinking disposition and
self-leadership in nursing students, ' J Korean Acad Soc Nurs Educ, 'vol.21, no.2, p.227.

9NURSING LEADERSHIP
Park, H.S. & Han, J.Y., 2015, 'Self-leadership, critical thinking disposition, satisfaction of
clinical practice and clinical practice competency of nursing students. ' Journal of the
Korean Data and Information Science Society, vol. 26, no. 3, pp.695-706.
Rokstad, A.M.M., Vatne, S., Engedal, K. & Selbæk, G, 2015. 'The role of leadership in the
implementation of person‐centred care using Dementia Care Mapping: a study in three
nursing homes', Journal of nursing management, vol. 23, no. 1, pp.15-26.
Roux, G., & Halstead, J. A. (2017). Issues and trends in nursing. Jones & Bartlett Learning.
Spano-Szekely, L., Griffin, M.T.Q., Clavelle, J. & Fitzpatrick, J.J., 2016, 'Emotional intelligence
and transformational leadership in nurse managers,' JONA: The Journal of Nursing
Administration, vol. 46, no.2,p.101-108.
Tyczkowski, B., Vandenhouten, C., Reilly, J., Bansal, G., Kubsch, S.M. & Jakkola, R. 2015,
'Emotional intelligence (EI) and nursing leadership styles among nurse managers',
Nursing Administration Quarterly, vol.39. no.2, pp.172-180.
Zanchetta, M. S., Edwards, S., Salami, B., Osino, E., Yu, L., Babalola, O., & Cooper, L. (2016).
Partnership, Trust and Leadership among Nursing Researchers. Nursing leadership
(Toronto, Ont.), 29(2), 82-97.