Reflective Essay: Leadership in a Nursing Clinical Incident, 2021-22

This reflective essay analyzes a clinical incident involving a patient experiencing self-harm, focusing on the application of leadership and management theories within a nursing context. The essay details the incident, which involved a patient admitted for a knee fracture who exhibited self-harming behavior, and the leadership approaches employed to manage the situation, including Contingency Leadership Theory and Human Relations Theory. The essay explores the effectiveness of patient-centered care and discusses the potential benefits of a patient-led approach. It further examines the role of inter-disciplinary teams in providing comprehensive care and highlights the importance of supervision and assessment. The author reflects on the experience, evaluating the strategies used and the outcomes achieved, and discusses how these experiences have contributed to their professional development as a nurse. The essay also highlights the importance of the Nursing and Midwifery Council's code of conduct to provide quality patient care.

LEADERSHIP

Table of Contents
REFLECTIVE ESSAY....................................................................................................................3
Introduction......................................................................................................................................3
Main Body.......................................................................................................................................3
Conclusion.......................................................................................................................................8
REFERENCES................................................................................................................................9

REFLECTIVE ESSAY
Introduction
Leadership is referred as the ability of a leader to have a significant influence on their
team members with the help of their guidance and support. This is essential for increasing the
overall effectiveness of the staff members to reach the organizational goals successfully
(Nieuwboer and et.al., 2019). The current reflective essay will explain the details of a clinical
incident which occurred in my nursing career. This incident explains the situation of self-harm
which was caused by a patient due to his mental instability. He was admitted in the hospital for a
surgery following a fracture in his knee which happened due to an accident. Post-surgery, while
the patient was recovering in the hospital, he started depicting a tendency of self-harm as he was
suffering from mental health issues as well. This led to the creation of a critical situation
whereby the patient was to be treated as well as protected from self-harm. There was also a need
to protect the nursing staff as he may have harmed them as well. The learnings from this
experience are briefly discussed in the essay, evaluation of different approaches which worked
for the patient will be analysed. The nursing leadership which worked with the inter-professional
teams and the supervision activities are also discussed.
Main Body
In this incident, I was working as a nurse at the hospital having a team of staff members
which had a role to provide services to the patients for their rapid recovery. This incident
describes the situation of a patient who have been admitted due to a knee injury. It was found
that he had a fracture and need to be at rest for a matter of 2 weeks in the hospital. The situation
was critical as the self-harming behaviour was negatively impacting the recovery of the patient
as well as the work of the other nursing staff.
I have dealt this situation with the help of Contingency Leadership Theory which is a
suitable theory that majorly focusses on the situational aspects of the failure or success of a
leader. Proper emphasis is given on the need of the situation which is suitable in order to make
appropriate decisions. With the help of this leadership theory appropriate changes can be made
which are useful to manage the effectiveness of the process (Stanley and Stanley, 2018). This
theory was crucial for me to understand the critical aspects of the condition of the patient
appropriately. I have been able to increase my effectiveness to deal with the critical situation at

hand which can have a negative impact on the health condition of the patient. The standards of
the nursing midwifery council were appropriately followed by in order to provide quality care to
the patient (The Code, 2022).
It was beneficial for me to understand the need of the situation and provide better
assistance to the staff members for handling the condition of the patient successfully. The
contingency leadership theory has been useful in increasing the understanding of the nursing
staff in regards with the care which is to be provided to the patient. The organization of all the
equipment and staff members according to the need of the situation is undertaken in order to gain
better advantage in solving the issues with the patient. It is also identified that this theory is
beneficial to clarify the roles and responsibilities which has been helpful for me to understand
the different instructions which are given to the team members and increase their overall
productivity in solving the problems appropriately.
The management of medical activities and staff was necessary for achieving effective
results in order to handle the critical situation properly. The Human Relations Theory is
understood as the management theory which is beneficial for increasing the efficiency of the
medical staff to conduct the operational practices carefully. This management theory provided
me with a better opportunity to empathize with my teammates and increase their trust towards
the decision-making (Connolly, Jacobs and Scott, 2018). Due to these aspects, I have been able
to gain better advantage in managing the work and increasing the effectiveness of medical staff
in this critical situation. The principles of human relation management theory have explained that
a suitable environment must be created for staff members where they can flourish and satisfy
their needs. Effective changes can be made in the frameworks for providing a proper support to
the staff members as nursing is a highly sensitive area. Therefore, with respect to this theory I
handled this situation by fulfilling the needs of my staff members which is necessary for
managing the case. The support and resources which are required by them were duly provided by
me for increasing their convenience in solving the critical case. This was an effective decision
which provided better help in assisting the staff members to achieve better results in this
treatment.
Different approaches have been developed by professionals to provide appropriate care
and support to the patients. One of these is the patient-centred care approach which is beneficial
for providing individual consideration to the needs of the patients. Under this approach the care

team is motivated by the leader to develop a better understanding of the individual requirements
of the patients in order to treat them successfully. This approach has been crucial for me to deal
with the critical incident been discussed in this essay. The difficulties to manage in the clinical
environment were analysed by the nursing team with the help of this approach and suitable
measures were taken under my surveillance. This has been a better solution to establish
coordination between the teams to focus on a common goal and resolve the problems with the
patients successfully. In this case it is highly necessary to understand the problems which are
being faced by the patient as it had a negative influence on his recovery as well as the staff
(Pizzirani and et.al., 2020). Due emphasis needs to be given on the mental condition of the
patient as it will provide a better knowledge to the staff regarding the reason for self-harm which
is done by him.
The patient-centred approach has been essential for me to support the nursing team and
provide better assistance to the patient for better recovery from his emotional and physical pain.
Counselling sessions were organized for him to sympathize with him and improve his overall
mental stability. Efforts were initiated by me to allot a 24/7 staff with the patient to reduce the
possibility of self-harm activities which are conducted by him. This has been beneficial for
reducing the instances where the patient tries to harm himself and create a negative environment
for the surrounding people. These efforts were further beneficial for increasing the recovery of
the patient from the fracture.
However, the patient-led approach could have been effective as it is a more detailed and
effective approach for treating patients on the basis of their needs and wants. It has been
developed as a new framework which allows options to the patients to make their own choices
and take appropriate control of the treatment which is provided for the betterment of their health
condition (El Haddad and et.al., 2022). It could have enhanced the recovery procedure and
provided better support to patient and the team members to enhance the personalized care which
was being provided to him for satisfying his needs successfully. With the help of patient-led
approach, I would have been able to take the inputs of the patient to eradicate his issues and
concerns which acted as problems in his overall betterment.
This approach could have strengthened the relationship between the patient and the
support staff as the ideas and suggestions of the patients are equally important for increasing the
overall success of the recovery. The want of patient is necessary for providing appropriate care to

him which could have increased the effectiveness of the overall treatment which was provided to
him (Hofmann and Vermunt, 2021). Both approaches have been crucial for improving the health
condition of the patient successfully. It has been beneficial for me to give more emphasis on the
different ways through which the critical situation of the patients can be successfully dealt with.
The nursing theories were followed by me with the help of the inter-disciplinary team
approach which is effective for collaborating team members from various disciplines in order to
fulfil a common aim. They were motivated to treat a patient who is facing multiple issues and
have to be dealt with utmost care and sensitivity in order to achieve better results. This approach
was crucial for me to deal with the critical incident and supporting the nursing staff for achieving
better results. The patient was dealing with the pain post-surgery and mental issues which lead
him to undertake self-harming activities. In order to deal with this critical situation involving
self-harming behaviour of the patient, inter-disciplinary teams were assigned from the trauma
team as well as the physicians which provided a collaborative treatment for the patient (Boamah,
2018). This practice has been essential in order to lead a successful treatment and establish better
coordination among the members of both the groups to enhance the recovery of the patient.
Effective strategies were prepared by me to provide appropriate consultation to the team to
manage the abusive patient behaviour.
Another approach of team management is inter-professional team where team members
related with multiple professions are consulted in order to treat the patient. In the case of this
patient, this approach could also have been effective in order to collaborate different healthcare
professionals like physicians, nurses, community health workers etc. to manage the critical
incident properly. It might have been an appropriate solution for treating the patient and reducing
the inconvenience which has been caused to him due to the inappropriate mental condition. A
personalized therapist could have understood the need of the patient and provided better
consultancy to him for reducing the self-harm activities which were initiated by him on a regular
basis (Duignan, Drennan and McCarthy, 2021). This could have been beneficial for the patient
from recovering through the physical pain of fracture as well. The issues in the mental stability
often acts as a hindrance in the recovery of the patient which has a negative impact in their
overall growth and sustainability. It is required to provide personalized and professional care to
the patient for solving the issues from the root level.

Although, the former strategy has been fruitful in the case of the patient and I have
managed the things effectively in order to increase the overall quality of care which has been
provided to him for the recovery. With the help of a successful intervention of the family of
patients, appropriate care has been provided to the patient which is effective in order to generate
better results for him. I have shown better leadership skills to organize these activities for the
patients and create better opportunities for him to find peace and stop the unusual behaviour at
his end. With the help of different activities and procedures, I have been able to grow as an
individual and understood the core concepts of being a successful Nurse. The critical aspects of
sensitive situations have been understood by me with the help of these effective approaches. The
support of my team members has been crucial in the overall management of the nursing tasks
which has increased the productivity of the treatment successfully.
I was supervised by the doctors and other health care professionals who were involved in
this particular case. They provided me with the proper guidelines and tools to give appropriate
care and support to the patient for increasing the speed of his recovery. All the suggested tools
and techniques were explained by the doctors to me for carrying out a successful treatment of the
patient as his situation was highly critical, and he was suffering both mental and physical pain
(Thiagarajan and McKimm, 2019). Appropriate training and development were provided by the
assigned healthcare expert in order to reduce the problems which have been dealt by the patient.
Several tricks and tips have been suggested by them to enhance my nursing services regarding
the overall treatment process of this patient who was suffering from a critical condition.
I have further provided support in this case through my nursing team members by
providing them with the specific guidelines which were important for considering in this critical
incident. I have given importance to minute details which were related to the health condition of
the patient. This has been beneficial for me and the team to understand the real situation which
needs to be dealt. I have followed a specific plan which was provided by the superiors that listed
specific roles and duties which is crucial for organizing a proper care for the patient (Buchlak
and et.al., 2020). This has been beneficial for increasing the clarity between staff members and
enhancing their overall performance in order to provide quality care to the patient. With the help
of these aspects, I have been able to enhance the coordination between the nurses which
increased the possibility of an easy recovery for the patient.

I monitored the growth of the support staff to provide appropriate care and support to the
patient for dealing with the physical and mental pain appropriately. This has been beneficial for
controlling the efforts which were put in by the nurses to provide care to the patient successfully.
I tried to establish proper communication between the team members to reduce the possibility of
conflicts between them which was a critical move in order to enhance their performance. These
support activities have been beneficial for me to create better opportunities for the patient to find
peace in the clinical environment and lead towards a speedy recovery. The other nursing staff
was also satisfied with the instructions which were provided to them and execution was
successful. They provided quality care to the patient and understood the appropriate aspects of
the case and the required equipment and care which was necessary for a proper recovery of the
patient successfully. This has been one of the major aspects which resulted in the development of
an appropriate treatment of the patient which was necessary to reduce his pain (Sanders and
Balcom, 2021). The supervision which was provided by healthcare professionals to me was
helpful for me to understand the actual aspects which are related with the case and what aspects
are necessary to deal with. This has been a major experience which has further increased my
ability to provide effective nursing services to the patients and increase my overall performance
in the industry.
Conclusion
It has been concluded from the above essay that leadership is necessary for management
of the different critical situations that arise while providing treatment and care to the patients.
With the help of effective leadership and management theories and concepts, I have been able to
enhance my performance in dealing with such incidents and organize appropriate services for the
patient to successfully recover (Gupta, Neely and Wilkinson, 2021). The patient-centred
approach has been crucial for me to create better opportunities for a speedy recovery of the
patient and satisfy his needs successfully. Working with inter-disciplinary teams have provided
better support for enhancing the physical as well as mental condition of the patient. Appropriate
supervision of the activities has been crucial for the success of the overall treatment process of
the patient.

REFERENCES
Books and journals
Boamah, S., 2018. Linking nurses' clinical leadership to patient care quality: The role of
transformational leadership and workplace empowerment. Canadian journal of nursing
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Buchlak, Q.D. and et.al., 2020. Ethical thinking machines in surgery and the requirement for
clinical leadership. The American Journal of Surgery. 220(5). pp.1372-1374.
Connolly, M., Jacobs, S. and Scott, K., 2018. Clinical leadership, structural empowerment and
psychological empowerment of registered nurses working in an emergency
department. Journal of nursing management. 26(7). pp.881-887.
Duignan, M., Drennan, J. and McCarthy, V.J., 2021. Impact of clinical leadership in advanced
practice roles on outcomes in health care: A scoping review. Journal of Nursing
Management. 29(4). pp.613-622.
El Haddad, M. and et.al., 2022. Nurse unit managers’ work and impacts on clinical leadership: A
cross-sectional study. Collegian.
Gupta, A.K., Neely, J. and Wilkinson, C., 2021. Clinical leadership training: a clinician's
perspective. Clinical Radiology. 76(4). pp.241-246.
Hofmann, R. and Vermunt, J.D., 2021. Professional learning, organisational change and clinical
leadership development outcomes. Medical education. 55(2). pp.252-265.
Nieuwboer, M.S. and et.al., 2019. Clinical leadership and integrated primary care: a systematic
literature review. European Journal of General Practice. 25(1). pp.7-18.
Pizzirani, B. and et.al., 2020. Clinical leadership development in Australian healthcare: a
systematic review. Internal Medicine Journal. 50(12). pp.1451-1456.
Sanders, J. and Balcom, C., 2021, November. Clinical leadership during the COVID-19
pandemic: Reflections and lessons learned. In Healthcare Management Forum (Vol. 34,
No. 6, pp. 316-319). Sage CA: Los Angeles, CA: SAGE Publications.
Stanley, D. and Stanley, K., 2018. Clinical leadership and nursing explored: A literature
search. Journal of clinical nursing. 27(9-10). pp.1730-1743.
Thiagarajan, P. and McKimm, J., 2019. Mapping transactional analysis to clinical leadership
models. British Journal of Hospital Medicine. 80(10). pp.600-604.

Online
The Code. 2022. [Online]. Available Through:< https://www.nmc.org.uk/standards/code/>