Abstract This paper argues that nursing in the 21st century will require a more direct focus on leadership and communication skills. As the baby-boomer generation begins to retire and enter their elderly years, nursing will be tasked with a growing number of patients that require specialized care. This fact, coupled with the evidence that there is already a nursing shortage throughout the world, will force modern nurses to contemplate leadership skills, as well as their ability to successfully communicate with patients and staff to ensure that quality care remains the profession's first priority.
Introduction
Leadership
From the Paper "Nursing in the 21st century will require a more direct focus on leadership and communication skills. As millions of individuals of the "baby-boomer" generation begin to retire and enter their elderly years nursing will be tasked with a growing number of patients that require specialized needs. This fact, coupled with the evidence that there is already a nursing shortage throughout the global society, will force modern nurses to comprehend leadership skills, as well as the ability to successfully communicate with patients and staff to ensure that quality care remains the profession's first priority. II Leadership."
Abstract This paper discusses the issue of patient safety with regard to nursing and nursingleadership. As highlighted in this paper, nurses are the driving force behind patient safety. This paper examines the statistics surrounding the need for patient safety followed by a brief literature review and recommendations for implementing nursing leader based patient safety education and cultural changes.
Abstract The assignment in this paper calls for the application of nursingleadership principles to reduce medical or medication errors in an ICU of a healthcare facility. In addition a discussion is presented with respect to risk management situations and programs as well as how to effectively implement a risk management program. Although not called for, but important, is a presentation on EMR with respect to nurse managers.
From the Paper "There exists today a significant need to foster a healthcare environment wherein there exists a partnership amongst educators, government regulatory agencies, practitioners, and professional organizations to assist the nursing profession with an insurmountable task; namely, to combine nursing education, experience, and learning into a best fit practice for the management of optimal patient care. In order to accomplish this challenging task there must exist, on all sides of education, an acceptable and proactive understanding of that which constitutes management in a nursing healthcare environment, regardless of the nursing healthcare delivery area. However, a state of effective management in nursing does not exist in a vacuum. The focus of this paper will be, therefore, on that which constitutes a sound leadership dais with respect to an important issue concerning all healthcare practitioners, namely, medical errors in an Intensive Care Unit (ICU)."
Abstract This paper discusses how true nursingleadership evolves when a person has demonstrated, beyond any shadow of a doubt, a pure passion for the ultimate exercise of thorough competence and professionalism in medicine and that indeed can ? and must ? create of climate of core ethical values for others to thrive in and follow as an example of good work principles. It analyzes those qualities and competencies a nursing leader must demonstrate, day in and day out, in order to create an ethical workplace environment and an ongoing process of efficiency based on principled thinking and accurate data. It also looks at the importance of a climate where individual virtues are extolled and rewarded among staff and where moral conflicts are mediated in a calm, dispassionate format, and where enthusiasm, total commitment to the patient, and intelligent decision making, dominate the environment.
Outline
Introduction
In Search of Ethical Values
Virtue and "Goods Internal to a Practice" as Pivotal Ingredients in Ethics
Florence Nightingale's Style of Powerful Leadership Need for Stronger NursingLeadership in Australia
NursingLeadership at the Highest Level of Nursing The Ethics of Individuals at the Grassroots Level of the Nursing Field
Addressing Negative Forces Prior to Inspiring Moral Reasoning
Conclusion: Core Ethical Values Found in the Nursing Code of Ethics
From the Paper "By breaking down local leadership into two prevalent types ? motivational and inspirational leadership ? Dot Baker, writing in Nursing News, provides some cogent guidelines and guide posts for what to do, and what not to do, for future and present nursing leaders. In seeking to motivate their constituents to do the proper thing, some leaders may use extrinsic rewards like money, celebrations, taking someone to lunch as a reward, or even fear and punishment strategies, to elicit desired behaviors. But is that the best way to truly motivate staff? Baker believes that "manipulate" becomes the accurate word for this particular form of ?motivation.? "
Abstract This is a brief paper that answers three questions relating to nursingleadership and nursingleadership skills. The paper focuses on the issues from the standpoint of the labour and delivery nurse, particularly discussing how it affects their ability to perform their nursing role.
From the Paper "Critically analyze the leadership concepts in relationship to the nursing profession and to your role. Leadership in nursing is a shared responsibility between the nursing supervisor/administrator and the nurse responsible for direct healthcare delivery (George, Burke, Rodgers & Duthie, 2002). Shared leadership empowers employees to perform their responsibilities independently and enables nurses to make decisions and then act upon them. Shared leadership is a new construct that many nurses are not accustomed to; for example, most nurses in the labour and delivery unit are responsive to medical orders from physicians and generally need approval before initiating patient care that requires decision making authority. In a landmark study on shared leadership, Aiken (1994 cited in George et al., 2002) demonstrated that "greater nurse autonomy and control in the point-of-service...affected patient outcomes by their direct actions and their influence over the actions of others.""
Abstract In this article, the writer highlights that the nursing leader has great potential for her or his effect on others. The writer discusses the story of one ordinary nurse with a particular vision of nursing that demonstrates the qualities of a leader. The writer points out that two of those qualities are courage and patience, since this nurse was not popular for a long time. Further the writer notes that her beliefs were not understood as other nurses perceived her as a stickler for rules and theory and that she often found herself frustrated when she made suggestions or corrected others because fellow nurses would remind her that she was not a supervisor.
Abstract This paper examines nursingleadership, a highly valued attribute in healthcare. The paper asserts that the visible role of the nurse executive in healthcare organizations is dynamic and evolving. Nurses are well-positioned to take the lead in strategic planning and organizational development. The paper maintains that effective nurse leaders look ahead, monitor trends, and engage others in conversations about strategies that influence change. It adds that nurse leaders represent patient care and nursing practice perspectives at the executive level, influencing both the organization's leadership team and the governing boards. The paper concludes that advancing knowledge related to quality, customer service, information technology, patient safety, and care delivery will be the key to success for executive nurses in the future.
From the Paper "The presence and impact of nursing on nursing administration can be traced back to Florence Nightingale. She was born in England in 1820 and lived until1910. Her work gained recognition during the Crimean War (1854 to 1956). It was just the beginning of her life efforts towards army sanitation reform and unofficial government advisor. Florence Nightingale is remembered for her qualities of hard work, anonymous service, and as the founder of modern nursing. Her influence and achievements formed a generation of change. She demonstrated leadership and administrative qualities that are still important today. The literature describes a range of definitions, theories, and beliefs in relation to clinical supervision, and suggests that "it is perhaps intrinsic to the nature of clinical supervision that no single definition or theory exists" (Ryan, 1998, p.3). Early American authors defined this new idea of clinical supervision for nurses as a democratic process focused on professional growth (Day, 1925). Hollis (1938) expanded the description to include it as a collaborative process based on participatory discussion."
Abstract In this article the writer notes that nurses find themselves in a unique position when compared to other professions. Although highly educated themselves, many nurses in management positions find themselves automatically being placed in a reduced position of power. The writer points out that this subordinate position is often apparent when dealing with other healthcare professionals, supervisors, and management. This essay looks at several issues regarding power and management, particularly in how it relates to nursing. The writer concludes that power is a term used to refer to an inherently unequal position between people and that it is used to gain control over an individual or event.
Outline:
How Does Leadership Differ from Management?
What is Power?
Seven Bases of Power
Conclusion
From the Paper "The seven bases of power are reward, punishment, legitimate, expert, information, and connection. The use of these seven bases of power enables the nurse to shift this unequal relationship to some degree. Every nurse must, at some time, deal with individuals who are not nurses and still affect patient care. Some of these people are family members or are people with that share a relationship with the patient outside of the care facility. Others of these people are those individuals from other departments such as social services or radiology. And, of course, nurses must deal with physicians on a daily basis."
Abstract This essay explains the contingent leadership model and the Myers-Briggs Type Indicator. The paper examines the controversy surrounding this model and challenges the Myers-Briggs Indicator and how it is used to match a leader to the situation. The paper also examines the 9-11 tragedy as a a tool for analyzing how leaders can rise to the occasion and lead effectively in a given situation. The paper then uses the example of nursingleadership, as it relates to patient care, discussing the nurse's necessity to adapt their leadership skills to the situation.
Table of Contents
Contingent Leadership The Problem
The Issue
Leadership Styles
The Controversy
Current Leadership Trend
The Leaders Role
Conclusion
References
From the Paper "There is fault with this theory because as a society and in many organizations our leadership structure is one of "Commander and Chief" and does not match leadership to a given situation. Through out history we can point to many leaders that have had to adapt and lead despite their leadership style not matching the given situation. Leadership requires one to utilize knowledge, skills and abilities in fulfillment of an assigned leadership role. We expect and demand those in leadership to lead when the situation calls for it. If this theory is absolute then we would have to accept that one can not learn and grow as a leader. More importantly it would limit you to situations that match your skill set. So, instead of expecting you to lead in various situations you would need to be matched the situation."
Abstract The paper reviews the work of Peter Senge and his 'mental model'. The paper makes an assessment of a nursing unit, including a staff profile, turnover and retention statistics and provides a cultural assessment and personal observation. The paper discusses experiences that have served to shape a vision of what a nursing unit or department should be and how the transformation might be led.
Outline:
Objective
Introduction
Communication: Issue Identified Within the Department
Identification of Core Values/Principles
Positive Advocacy and Inquiry Elements
'Creative Tension': What Is It?
Dissemination of Information
Summary & Conclusion
From the Paper "Nursing leadership is a role within an organization that carries with it great responsibility and as well great accountability standards. It is critical that the entire organization have the self-same vision or mental image of what the organization intends to aim for insofar as structure, management and organization in terms of changes. Peter Senge writes that "mental models determine not only how we make sense of the world, but how we take action." Senge reminds the reader that many times the plans that are conceived of never come to fruition and he states that this is not because of "weak intention, wavering will, or even nonsystemic understanding" but instead is due to the "...conflict with deeply held internal images of how the world works....[and that limit humans] "...to familiar ways of thinking and acting." (Senge, 1990) According to Senge: "Mental models can be simple generalizations...or they can be complex theories..."(1990)"
Abstract In this article, the writer notes that methicillin-resistant staphylococcus aureus (MRSA) is a serious concern for many hospitals. The writer points out that not only are morbidity and mortality rates due to MRSA infection significant, but longer hospital stays, higher costs of treatment and the specter of treatment failure compared to methicillin-sensitive organisms are all realities that are faced. This paper outlines a proposition to implement a hospital-wide change in the hospital's handwashing policy to that utilizing a chlorhexidine-based foam. Budgetary considerations as well as a strategy for implementation and evaluation of effectiveness on MRSA infections after one year of implementation are discussed.
Outline:
Abstract
Introduction
Literature Review
Current Practice
Proposed Practice
Budgetary Considerations
Concerns Regarding Change
Values and Roles
Conclusion
From the Paper "In order to improve the rate of infection from 10 cases per year to less than one per year, a new practice will be instituted based on the redundancy principle regarding implementation of handwashing procedures. Similarly redundant handwashing facilities (both handwashing stations and foam chlorhexidine gluconate) conveniently located at strategic locations. This solution will include new dispensers at strategic locations with high personnel traffic such as nurses' stations, patient rooms, specific bedside sites (e.g. in intensive care units, labor and delivery bedsides), communal areas for nurses and physicians and outpatient examination rooms. It is expected to be accomplished within 3 months with a reduction in overall and MRSA nosocomial infections after one year."
Tags: health, care, infection, mortality, hospital
Abstract This paper explores the issue of the nursing shortage from a critical feminist perspective, Everett Rogers' model of "diffusion of innovations", and transformational leadership. The paper asserts that all nurses today can and must assume leadership positions in every area of health care delivery and reform. It adds that nursing leaders today must be fully informed of the issues affecting their organization and also must be capable of anticipating future change. The paper explains that a transformational leader is able to create an innovative type of supportive environment that is marked by effective communication and recognition of human resources as well as diversity and individual differences. The transformational leader is also able to influence commitment both at the individual and organizational level so that organizational goals can be achieved. The paper concludes that the solution to the current nursing shortage can only come about through the level of motivation and inspiration which the transformational leader can provide.
Outline:
Introduction
The Nature of the Issue
Literature Review
Analysis of the Issue
Change Theory
Transformational Leadership Conclusion
From the Paper "According to Beugre (2006), transformational leadership can be defined as "a leadership type in which leaders possess charisma and provide intellectual stimulation, individualized consideration and inspirational motivation to followers". The RNAO (2004, p. 1) defines leadership as "a combination of sound knowledge, an unwavering passion for a cause, and the courage to share these with others". In contrast to the transformational leader the transactional leader tends to try and control others instead of motivating them. The transformational leader is able to create a supportive environment by providing others with inspiration and focusing on human resources (Skelton-Green, 2006). The transformational leader is able to inspire a deep commitment in others through intrinsic motivation as a result of the value and importance of that leader's goals. The transformational leader's approach to inspiring acceptance of innovation is through the development of trust and openness (Aarons, 2006). The importance of transformational leadership at the present time is that nurses come to realize that a new image of the nursing profession is possible. As Beugre (2006) maintains, the leader through means of inspirational motivation is able to energize the members of the organization even under the most stressful conditions."
Abstract This paper examines how nurses, as leaders of their profession, are responsible for shaping the future of the nursing profession as a whole in accordance with societal needs and in conformity with law. The paper explains that as time passes and the professional identity of nursing and leaders becomes more prominent, especially in the face of sweeping health care changes, the issues pertaining to role development and goal-setting will eventually be addressed adequately. The paper then looks at how, in practice, it is the nurses who play a large part in formulating and implementing patient care plans, evaluating their outcomes and continuously improving the quality of care. The paper concludes that the nurse leader's expanded role as researcher, planner, policy-maker, educator, leader and collaborator testify to the greater ethical responsibilities nurses share towards patients, colleagues and the populations they affect through their decisions.
Outline:
Introduction
Impact of Formal and Informal Power within the Organization
Personal Leadership Style
Leadership Challenges
Leadership Analysis
Conclusion
From the Paper "The impact of formal power within this organization is unique in that a military component is prominent. Informal power, on the other hand, is less prominent. As a formal power structure, the military hierarchy is prominent but not as rigid as in combat (line) settings in that seniority (i.e. rank) can override decisions irrespective of health profession affiliation. Nonetheless, the military hierarchy is still respected. While this is usually not the case with respect to clinical decisions (as expert power is still respected between disciplines), administrative decision making is different. Regardless of the assignment duration of senior ranking officers, their decisions are followed."
Analyzes the organization at Sanford USD Medical Center (SMC) based on the 14 Forces of Magnetism as developed by the American Nurses Credentialing Center (ANCC).
Abstract This paper explains that Sanford USD Medical Center (SMC) has an infrastructure, including extensive nursingleadership in upper management, which supports a professional nursing practice. One of the mechanisms in place to identify nurses' needs, the author relates, is SMC's shared governance model of decision making, which supports all nursing roles. The paper describes the Nursing Senate, which has staff nurse representatives from all nursing units, strategic improvement and case management, including nursing staff from non-traditional nursing care units.
Table of Contents:
Organization Overview
Forces of Magnetism Consistencies and Inconsistencies
Quality of NursingLeadership Organizational Structure
Management Style
Personnel Policies and Programs
Professional Models of Care
Quality of Care
Quality Improvement
Consultation and Resources
Autonomy
Community and the Healthcare Organization
Nurses as Teachers
Image of Nursing Interdisciplinary Relations
Professional Development
Identified Strengths and Weaknesses
Analysis Support
Conclusion
From the Paper "Force 4: Personnel Policies and Programs looks at competitive salaries and benefits, flexible staffing models, direct care nurse involvement, and opportunities for professional growth. SMC conducts market surveys for wage comparison and gives employees cost of living raises based on these findings. Wage adjustments are also made with yearly performance appraisals. In addition, SMC supports lifelong learning and provides financial support for continued education that will develop or increase our employee's competence in their current positions or enhance their employability within the organization."
Tags:leadership, staffing matrices, best practices, quality care, front-line
Abstract This paper examines the relationships between nurses in the same unit by drawing upon the author's own personal experiences and the experiences of other nurses in the field. Three proposed questions are answered using the author's unit as a kind of ?test case.' The writer uses this case to aid in making larger generalizations about nursing and about the nature of leadership in a unit of nurses.
From the paper:
?As I have said above, nurses are often thought of as part of a "second tier" of authority, between that of doctors and physicians assistants (as well as other non-medical personnel on the ward, such as secretaries and receptionists). But on the unit I was assigned to, a clear hierarchy of leadership presented itself within the unit of nurses themselves. This hierarchy was partially determined by assigned authority.?
