SNPG902: Management Journal - Reflective Healthcare Practice

This management journal, submitted by a student, details experiences in a healthcare setting, focusing on leadership and teamwork challenges. The student utilizes Gibbs' Reflective Cycle to analyze situations involving communication barriers with a new team member, cultural differences, and conflicts. The journal entries chronicle specific incidents, feelings, and thoughts over three weeks, including difficulties arising from language barriers, differing cultural perspectives on patient care, and conflicts regarding work schedules. The student, in the role of a team leader, explores various management strategies, including the importance of effective communication, conflict resolution, and the need for cultural sensitivity. The analysis reveals the impact of these challenges on patient care, team dynamics, and the student's professional development. The journal also explores the application of leadership techniques, such as situational leadership, and the need for organizational changes to address future conflicts. The student reflects on the importance of understanding diverse cultural backgrounds and implementing effective communication strategies to improve teamwork and patient care. The journal concludes with an analysis of the events and a call for improved management techniques within the healthcare setting.

Running Head: MANAGEMENT JOURNAL
Management journal
Name
University affiliation

MANAGEMENT JOURNAL 2
Management journal
Introduction
There are numerous acceptable models of reflection commonly used in healthcare.
The reflective journal, centres on my own involvement at the workplace. Therefore, my
experiences and involvements include having troubles interacting with my co-workers which
often lead to conflicting situations in my workplace (Ahmed, 2018). From a personal
perspective as a healthcare employee in a local nursing hospice, these conflicting situations
have been bothering me. The conflicting situations have been happening for the past three
weeks which is generally because of a personality rattle with one of my fellow co-worker
(Igo, 2017). In several occasions I end up feeling angry as well as anxious and therefore
causing adverse effects when it comes to my daily work schedule as well as on my personal
productivity. From a my personal perspective, I however feel that it is possible to avoid such
happenings within any healthcare system through the use of several interventions of our
nursing management as well as situational leadership qualities. Additionally, as a healthcare
worker, I treasure the simple prompt problems enhancing my thoughts in numerous conducts
based on the formal reflective practice. I jotted down every detail in regards to my conflicting
happenings for the past three weeks. The details included in the journal have also been
presented as single weekly records which will help when it comes conducting further analysis
as well as personal insights in regards to the incidents. Additionally, original entries in my
reflective journal is a representation of specific events, feelings and thoughts.
Journal entries.
My career and that of my team in the local nursing home as registered professional
nurses involves provision of better health care as well as social care to our patients visiting
the nursing home whether is for their personal medical treatment of their personal medical

MANAGEMENT JOURNAL 3
care. As part of my professional career at the nursing home I am responsible of leading a
group of six healthcare workers where as their leader, I offer guidance on the provision of
appropriate and improved care to our patients regardless of their state of illness. Recently, a
member of my staff from the team shifted to a different city. In this, case her position was
vacant. I therefore, replaced the vacant position by hiring a migrant healthcare worker from
India. Additionally, I am responsible for training her on the basic duties around the nursing
home as I simultaneously familiarize her with the nursing home’s protocols. However, she
speaks little English making communication between inefficient from the first day because of
our differences when it comes to cultural backgrounds. Communication problems are not
only between me and her but between other members of team as well. It is evident that
efficient interactions between members of the team and the new healthcare co-worker are
fruitless leading to a lot of frustrations within the group because of poor communication.
My personal preference when it comes to using an acceptable of reflection is to use
Gibbs reflective cycle to focus on three elements “what”, “so what” as well as “now what”. In
this case, a practitioner as described by Antonakis & Day (2017) during the initial stage, is
obligated to reflect upon the issues as well as the experiences while he simultaneously
describe the situation at hand (Nayak, Sahoo, Mohanty, & Sundaray, 2016). During the
second stage, all the emphasis is channeled into structuring the concept as well as the
knowledge where the practitioner is given the chance to acquire skills and knowledge from
the different practices. Lastly, the third stage is associated to the replications of the
practitioner when it comes to comes to the considered actions as well as in pinpointing the
direction in which to improve the situation (Antonakis & Day, 2017). This reflection model
provided me with guidance throughout the entire process of self-awareness as well as
improvement in a precise circumstance thus making it probable for me to recognize the

MANAGEMENT JOURNAL 4
magnitudes of my engagements as well as the steps necessary when it comes to enablement
of both my individual and professional development.
10th July 2019: The newest member of my team from India speaks very little English making
communication between us and between the other members of our team very difficult. This
means that the other five members of our team are facing the same problem and therefore
creating barrier when holding discussions in regards to our plans of medical treatment of our
patients. Since we all complete our duties as a team, we tend to make as well as create
strategic and particular procedures for our respectively patients based on their specific
illnesses and special medical needs. As developed by previous researchers such as Yoder-
Wise (2014) and Urden, Stacy & Lough (2017), communication in any healthcare setting
plays a substantial role among professional nurses and healthcare providers. In this case, in
order to create an effective plan in regards to healthcare workers taking shifts to give
medicine and other forms of treatments to their patients, every member of the team is
obligated to share their personal knowledge about the health progress of their patients.
However, it is difficult to acquire any accurate and proper information about the patients
from the new member of the team because of language barriers. In other cases, she finds it
difficult to follow our daily routine to the latter.
Later that week, there was a new conflicting situation where the new member in our
team seem to lose motivation because of difficulties when it comes effective communication
where in most cases she lagged behind her prescribed duties. In such cases, the other
members of the team had the responsibility to compensate for her as they simultaneously
worked for extra hours at the nursing home in order to cover the remaining duties. As the
leader of the team, it was my duty to offer necessary guidance in regards to the different
processes of healthcare. However, at this point I was struggling to effectively manage the
team as well as in distributing different duties equally. As a result, later that week other

MANAGEMENT JOURNAL 5
members of the team got really frustrated and the management of the nursing home realized
that my patients are not receiving the correct treatment and appropriate amount care because
of the work done by the new member in the team. I was therefore, obligated to implement a
solution in regards better time organization so that each patient is able to get the required
quality care and treatment services they are worthy.
17th July 2019: During the consecutive week, I experienced a major conflicting situation
which came to my attention when my team and I were assigned by the nursing management
to new patient who required special intensive care. Nursing guides formulated by the nursing
management of the nursing required us as healthcare workers never to be sensitively involved
to our patients because it tends to obstruct the prescribed care and treatment. From the
information provided by the doctor, the patient was experiencing severe allergic responses.
The doctor therefore, informed us to provide the patient with a precise diet plan along with
medications which will help him attain his full recovery in a short time. Nevertheless, the
new member of our team due to different cultural reasons, she instantly became attached
emotionally with the patient despite of her being aware of the strict rules to follow the
specific diet plan. She offered the new patient foods that might trigger his allergic reactions
causing harm to his health. Particularly, the patient was experiencing severe pains due several
allergic reactions and he therefore ask the new health co-worker to him with prohibited
delicious which will help to ease the pain (Fontaine, 2018). Our new member in the team
sympathized with the patient and instead offered him food outside of the prescribed plan. I
was both greatly exasperated as well as annoyed by her actions leading to a conflicting
situation because we had different perspectives in regards to how patients especially those
who need special care and treatment, should be treated (Smith, & Field, 2018). Later that
week, I discovered that the new health care co-worker was still offering the patient with foods
mot prescribed to him and outside of the intended nutrition chart despite several warnings. I

MANAGEMENT JOURNAL 6
was obligated to address the situation by reporting the matter to the head of the nursing
management in our organization for advanced involvement of greater power in order to
handle the situation.
In approaching the nursing management, it was made clear that the new healthcare co-
worker is one of my team members and I should take the responsibility of dealing with her
and that their intervention is not necessary (Sherwood, Cherian, Horton-Deutsch, Kitzmiller,
& Smith-Miller, 2019). Additionally, the leader of the nursing management informed me that
I ought to develop and employ my personal management abilities more so that I can bring
together as I simultaneously manage my employees and get the work completed effectively.
24th July 2019: During my third week, conflicting situation with the newest member of my
team took a new turn leading to hard heated disagreements with the other members of my
team. The two healthcare co-workers were arguing in regards to their alterations for taking
care of a patient (Sethares, & Asselin, 2017). I was obligated step in to address the situation
and regardless of my efforts to calm the two down, my efforts to calm down my newest
member of the team were rendered fruitless since she kept speaking in her native language. I
waited for her calm down later that day so that I could talk to her as well as try to hold a
sensible conversation based on her ability to make adjustments especially when it comes to
her time slot so that the other members of the team could have equal job schedules. In her
response, she was very much unwilling to make any compromises and she clearly stated that
she will not make any rearrangements to working schedule (Paterson, Pearson, & Johnson,
2019). In the spirit of convincing her make compromises, I clearly stated that the adjustment
would benefit every member of the team especially the patient and the organization as whole.
According to research conducted by Antonakis & Day (2017) healthcare providers and
professional nurses are required to work together in order to promote the well-being of their
patients. however, I was unable to convince her despite my several attempts and I was

MANAGEMENT JOURNAL 7
viciously infuriated as well as tempted to ask for the nursing organization’s intervention by
shifting her to another group under another professional nurse especially who belong to same
cultural background to deal with her.
It was evident that the management of the nursing home requires new management
techniques as well as professional developments which will help when it comes to dealing
with such situations (Kumar, 2016). The nursing management gave me the responsibility of
identifying as well as analyzing any personal changes within the healthcare settings as well as
different ways to respond to those changes. Even altering the organization objectives would
be a sustainable preference if it would help to handle such a conflicting situation in the future.
Analysis
Based on the events of my first week, it is evident that multi-cultural surroundings are
common in most healthcare facilities around the world (Caley et al. 2017). Therefore, it was
crucial for me as the leader of my team to come up with techniques which will help me
manage every member of my team despite their cultural backgrounds. According to a
research conducted by Jacob Arriola et al (2016) people from different cultural backgrounds
tends to have different values and beliefs and they sometimes prioritize different aspects at
the workplace based on their upbringing (Snowdon, 2018). However, language barriers
remain among the major issues related to differences in cultural backgrounds and instead of
getting frustrated and angry, leaders not only within the healthcare systems should strive to
encourage their team members to work collaboratively as well as work in coherence in order
to achieve greater productivity within the organization (Hoch et al, 2018).
During my second week, I should have handle the situation better when a major
conflicting situation by keeping my cool. I realized now that I handled the situation poorly
when my newest member of the team offered the patient food outside of the prescribed diet

MANAGEMENT JOURNAL 8
plan. Instead of addressing my complains to the nursing management of the nursing home, I
should have been more respectful to the differences in cultural practices and try to understand
some people from different cultural backgrounds may be more thoughtful as well as
sympathetic to other individuals especially those who are experiencing ailments of any kind.
However, Even though it is advisable not to get emotionally invested with our patients, but,
when my newest member of the team was doing the same because of differences in cultural
backgrounds, instead of becoming irritated and exasperated about it, I ought to have
individually talked to her in private on how we handle our patients here and how that helps to
deliver the quality healthcare services to them. By doing this, it should have instead created a
strong relationship between us which would have enabled me to persuade her on the different
on why it was it was important to work together as a team in collaboration as well as how to
treat patients especially those with special needs in order to achieve a more productive and
effective outcome.
During my experiences on the third week, I resolved to focus more on resolving the
conflicting situations by employing my leadership skills as well as time management skills
which help my entire nursing practice when it comes to organizing an appropriate working
schedule (Ramadevi, Gunasekaran, Roy, Rai, & Senthilkumar, 2016). Additionally, in order
to achieve better outcomes, all members of the team should help out each other when needed
as they simultaneously make necessary comprises and readjust their working schedules as
required by other team members. Reflecting back of the events of that week I should have
organized an effective working schedule for my team by implementing a proper time
management schedule as well as step in as soon as conflict took place between two members
of my team. According to research conducted by Urden, Stacy & Lough (2017) conflicts at
the workplace are not good especially within the healthcare system because it causes adverse

MANAGEMENT JOURNAL 9
impacts to the quality of healthcare provided by the professional nurses and other healthcare
providers.
Literature review
Previous researches such as Manzoor et al (2019) and Berry, Broadbent & Otley
(2016) recommended transformational leadership style theory especially when it comes the
healthcare sector. As developed by Manzoor et al (2019) transformational leaders have the
responsibility to always empower their employees and members of their team when it comes
to discovering their inside enthusiasm and succeeding at their duties in their line of work
(Husebø, O'Regan, & Nestel, 2015). Additionally, working together as a team towards
accomplishing a specific goal plays a significant role in helping leaders inspire their
employees towards transcending their self-interest as they simultaneously join in the mutual
objective of the nursing which is to provide the best and quality medical care service to our
patients. Additionally, transformational leaders should also develop as well as implement
new ideas for the organization as they simultaneously strive to maintain a positive working
culture and environment where employees would love their environment Hoch et al (2018).
Rosenberg Hansen & Ferlie (2016) developed that, employees tends to feel appealed towards
a good transformational leader and in most cases, and they adhere to his ideas, principles and
standards within the place of work. Therefore, it is important to employ transformational
leadership style theory within healthcare systems to solve incidents that happened during the
first and the third week where my transformational leadership skills would have been useful
in managing the conflicting situations within my team. Rosenberg Hansen & Ferlie (2016)
during his study developed that employing transformational changes within the organization

MANAGEMENT JOURNAL 10
promotes increased future development as well as rapid growth to the entire organization.
Based on the evidence presented by Manzoor et al (2019) and Berry, Broadbent & Otley
(2016) it is possible to enhance transformational theory by enhancing it with behavioral
theories of leaders and based on the type of situation, autocratic leadership, democratic
leadership and Laissez-faire leadership can be implemented.
Both leader and organizational managers are obligated to handle members of their
team and other employees, processes as well as information based on the situation and
necessity. Hoch et al (2018) discussed that management theories can be broadly classified
into classical management theory, behavioral management theory and modern management
theory. The classical management theory mainly channels their focus on the execution of
different tasks within the organization as well as ensure there is maximization when it comes
to production output produced by each employee within the organization (Stonehouse, 2015).
Additionally, according to research conducted by Hoch et al (2018) behavioral management
theory aims at treating the organization as a social environment as it simultaneously put its
focus on the human elements. The modern management theory is based on the two theories
and also tends to utilize scientific techniques as well as systems thinking. All the type of
theories as developed by a researches conducted by Berry, Broadbent & Otley (2016) and
Fallatah & Syed (2018).are applicable in any healthcare setting however based on the
necessary requirements as well as different happenings that are likely to occur. In my case
three week experience at my workplace at the nursing home, I should have employed
behavioral management theory especially on my first and second week. This would have
helped me gain a much better understanding when it comes multi-cultural ethnics and their
values and beliefs as I simultaneously help my newest member of my team adjust to our
working schedule more effectively with a lot of ease. Additionally, I realized that modern
management theory would have played a significant role during my third week at the nursing

MANAGEMENT JOURNAL 11
home when it comes to establishing as well as implementing new changes within the
organization to avoiding such conflicting situations in the future.
Conclusion and suggestions
It is evident from the evaluation and analysis of my three week experiences at the
nursing home as registered professional nurse that problems with my co-workers and other
additional problems taking place at the workplace in any healthcare system can be avoided.
For example, being a team leader I had the responsibility to consult several leadership as well
as management theories in order to gain a better understanding of different situations as I
simultaneously handle them with minimal effort and maximum output. Additionally, it is
clear to me now that maintaining multicultural ethnics within the organization would have
played a significant role when I was dealing with my newest member in team in a much
swifter way as well as handle the problem in regards to cultural differences with a lot of ease.

MANAGEMENT JOURNAL 12
References
Ahmed, F. (2018). Leadership and management influences on personal and professional
development and group dynamics: a student’s experience. Nursing children and
young people, 30(2).
Antonakis, J., & Day, D. V. (Eds.). (2017). The nature of leadership. Sage publications.
Berry, A. J., Broadbent, J., & Otley, D. T. (Eds.). (2016). Management control: theories,
issues and practices. Macmillan International Higher Education.
Caley, L., Pittordou, V., Adams, C., Gee, C., Pitkahoo, V., Matthews, J., ... & Muls, A.
(2017). Reflective practice applied in a clinical oncology research setting. British
Journal of Nursing, 26(16), S4-S17.
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management.
Elsevier Health Sciences.
Fallatah, R. H. M., & Syed, J. (2018). A Critical Review of Maslow’s Hierarchy of Needs.
In Employee Motivation in Saudi Arabia (pp. 19-59). Palgrave Macmillan, Cham.
Fontaine, S. J. (2018). Becoming a reflective practitioner. The Veterinary Nurse, 9(4), 180-
187.
Hoch, J. E., Bommer, W. H., Dulebohn, J. H., & Wu, D. (2018). Do ethical, authentic, and
servant leadership explain variance above and beyond transformational leadership? A
meta-analysis. Journal of Management, 44(2), 501-529.

MANAGEMENT JOURNAL 13
Husebø, S. E., O'Regan, S., & Nestel, D. (2015). Reflective practice and its role in
simulation. Clinical Simulation in Nursing, 11(8), 368-375.
Igo, L. C. (2017). Leadership Behavior Change in Conflict Resolution: Insights From Online
RN-BSN Students.
Jacob Arriola, K. R., Hermstad, A., St. Clair Flemming, S., Honeycutt, S., Carvalho, M. L.,
Cherry, S. T., ... & Kegler, M. C. (2016). Promoting policy and environmental change
in faith-based organizations: outcome evaluation of a mini-grants program. Health
promotion practice, 17(1), 146-155.
Kumar, K. (2016). Reflection and its uses in Problem Solving and Personal Development.
GRIN Verlag.
Manzoor, F., Wei, L., Nurunnabi, M., Subhan, Q. A., Shah, S. I. A., & Fallatah, S. (2019).
The impact of transformational leadership on job performance and CSR as mediator
in SMEs. Sustainability, 11(2), 436.
Nayak, T., Sahoo, C. K., Mohanty, P. K., & Sundaray, B. K. (2016). HR interventions and
quality of work life of healthcare employees: an investigation. Industrial and
Commercial Training, 48(5), 234-240.
Paterson, D. B., Pearson, S. M., & Johnson, C. A. (2019). Implementation of radiation
therapist cylinder insertion for vaginal vault brachytherapy. Journal of medical
radiation sciences, 66(2), 133-138.
Rosenberg Hansen, J., & Ferlie, E. (2016). Applying strategic management theories in public
sector organizations: Developing a Typology. Public Management Review, 18(1), 1-
19.

MANAGEMENT JOURNAL 14
Sherwood, G., Cherian, U. K., Horton-Deutsch, S., Kitzmiller, R., & Smith-Miller, C. (2019).
Reflective practices: meaningful recognition for healthy work environments. Nursing
Management, 26(3).
Smith, B., & Field, L. (2018). Nursing Care: An essential guide for nurses and healthcare
workers in primary and secondary care. Routledge.
Stonehouse, D. (2015). Reflective practice: Ensuring quality care. British Journal of
Healthcare Management, 21(5), 237-240.
Ramadevi, D., Gunasekaran, A., Roy, M., Rai, B. K., & Senthilkumar, S. A. (2016). Human
resource management in a healthcare environment: framework and case
study. Industrial and Commercial Training, 48(8), 387-393.
Sethares, K. A., & Asselin, M. E. (2017). The effect of guided reflection on heart failure self-
care maintenance and management: a mixed methods study. Heart & Lung, 46(3),
192-198.
Snowdon, K. (2018). Humour in reflective practice. Journal of Paramedic Practice, 10(4),
144-146.
Urden, L. D., Stacy, K. M., & Lough, M. E. (2017). Critical Care Nursing-E-Book:
Diagnosis and Management. Elsevier Health Sciences.
Yoder-Wise, P. S. (2014). Leading and managing in nursing-E-Book. Elsevier Health
Sciences.