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Leadership in healthcare organisations
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Leadership in healthcare organisations
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Ineffective Leadership Scenario
When I was on a post surgical floor I witnessed a scenario where leadership was ineffective. It involved an RN and the nurse manager for the floor who was responsible for assigning the patients to nurses. The nurse manager on this floor usually only had one or two patients and spent most of their time dealing with any problems that arose on the floor. One RN was very upset with her patient load and said it was unfair and wanted to have at least one less patient as she said all 5 of her patients were going to be a lot of work. The nurse manager dismissed the RN and said there were care aides on floor to help so she would be fine and told her to get to work. The leadership issues here were a lack of communication
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If the other RNs on the floor agreed that everyone would have to be helping the one RN who had a heavy workload or that the care aides would all be busy with only caring for the patients in the one RN’s care this would show that they believed that enabling others to act would involved spreading out the work more equally. A response from the nurse manager could involve her saying that she had not thought about how the heavy workload would affect the rest of the floor, and the other RNs. The outcome might have been the nurse manager asking one of the other RNs to switch one of their more stable patients for a less stable, and heavier workload …show more content…
If the other RNs all agree and look to the nurse manager to make sure that that is an ok solution it shows they all support the initiative taken but still know the nurse manager is the leader. The nurse manager’s response could be that she appreciates the RN’s initiative to find a solution and that she will look at the schedule to see if she thinks that the RN’s solution would work. Also that the RN that switches patients also agrees and is happy to help out others knowing that if that happened to be her then the other RN would also help her out and switch patients. The outcome could be a switch of how the patients are assigned for the time being and that those five unstable, heavy workload patients are not assigned together for any other
The problem, as defined for my argument research paper, is that to cut costs, hospitals have been steadily increasing the number of patients nurses must care for. In many areas it's not uncommon for one nurse to have to assess, give medications to, and manage the care of as many as 12 patients. This puts tremendous strain on nurses. Many of the studies I have seen in my research indicate that a high ration of patients to nurses increases the rate of death or other poor outcomes for patients. It also leads to increased nurse burnout and higher turnover, though at this point I believe my paper will focus on patient outcomes.
First, the increased workload due to staff shortage is putting patient care in jeopardy. Sue need to be aware of facility policies and guidelines about staffing flexibility and accepting an assignment to provide safe care. As stated by Martin (2015),”When nurse staffing is inadequate, the ability to practice ethically is questionable” (p. 4). The Safe Harbor Act protects nurses from the unsafe nurse-patient ratio, but the nurse should be aware when to utilize this resource to protect patient safety and her for liability is compromised due to staff shortage. In this situation, nurse staffing in an ongoing problem and Sue should discuss with the management to employ the policies such as the Nurse Reinvestment Act, the Registered Nurse Safe Staffing Act, and mandated nurse-patient ratio (Martin, 2015). Also, the Guide for the American Nurses Association (ANA) Principles for Nurse Staffing should be utilized in this situation (Cherry & Jacob, 2014). Secondly, Sue’s stress is to provide quality care to indigent patients who are uninsured or underinsured. The uninsured population cannot afford preventative care, and by the time they come to the hospital, the acuity level is high, and treatment is expensive. Many facilities have policies regarding indigent population care. Some facilities have charitable policies to pay medical bills for uninsured or underinsured patients. Sue also needs to be aware of any policy related to lowering
The success of the organization depends on how the leaders utilize their management and leadership skills in the organization. Mission, vision and core values of the organization are posted everywhere in the organization to remind every stakeholder about their accountability and responsibility in accordance to the corporate goals. This can’t be effective without successful leadership approach. Effective leader must know how, when and where to communicate the shared vision of the organization to its stakeholders. The goal is to align personal values with the corporate values to reach optimum level of satisfaction towards the work, and the company expectations to its stakeholders. Ineffective leaders are not capable of employing this. They are not capable of employing management by objective or the ability of the managers to align the objective of the all the units and departments of the organization into the organizational goals and values. MBO starts with setting organizational objectives, followed by cascading objectives down to employees-cascading objectives down to employees requires adoption of SMART approach to ensure that goals are attainable and accountable (Mindtools, 2014)
On my assigned unit in Napa State Hospital, there are a nursing supervisor and a nurse lead on my shift. The nursing supervisor will be sitting in her own office and working on things that are related to the unit except for the patient care; the nurse lead is the one that sit behind the nursing station and assign nurse staff to their daily duties and does not have to deal with management issues. For example, the nursing supervisor will be participate on all types of meeting with the management from Napa State Hospital, she is also present on every staff hands off meeting, she also will be the one that is talking about what she had in plan for improvement for the unit and the patient care. The nurse lead would delegate nurses to work in the
More often than not RN’s are not prepared for the responsibility of delegating tasks to co-workers. Being able to delegate takes a certain level of confidence. Anytime that the nurse delegates a task they are held responsible for seeing it through to the end. They are required to assess the situation and evaluate the patient care being given. After the task is completed it is important to appraise the competence of the nurse’s aide. The whole concept of delegation has been around for quite some time now that it dates back to the early nursing efforts that Florence Nightingale that started the movement of nursing. Florence nightingale described delegation to be on the more entry level side of nursing. With this being said it shows that nursing programs of today need to provide more experience with delegation tasks and to stress the importance of being able to work in a leadership role when faced with a situation that makes it necessary to do so. An example of this would be when a code blue is called and many health care team members are together in one room, sometimes it is appropriate for someone to take the leadership role and assign everyone a task.“Forty-one percent of RN’s in the US report that they were not exposed to delegation and supervision content in their nursing curriculum”(Saccomano, 2011). This is a large number of nurse’s that were
The American Nurses association defines delegation as, ‘The transfer of responsibility for the performance of a task from one individual to another while retaining accountability for the outcome’ (Saccomano, 2010, p. 523). When delegating to staff or members of your team, it is important that it is used appropriately and within the proper guidelines. It is common to see RNs delegating in the hospital setting to the LVN or nursing assistant, however, the RN must know the limitations and what is within their scope of practice. Unfortunately, even if the nurse uses these guidelines, conflict can still occur with other staff making the process more difficult. Having the responsibility to delegate, especially as a new registered nurse, can be daunting,
Some aspects of the nurse’s job have been made easy and facilitated with the aid of other well trained professionals within their working environments. According to the American Nurses Association (ANA) (2012), registered nurse’s performance has greatly improved over the years as a result of their coordination and partnership with the health care system with other health care providers. As a result, registered nurses are today seen to occupy important leadership positions in the healthcare system and they participate when they are making decisions for patients as well as for other
Low nurse staffing levels are an issue hospital-wide at St. Vincent Healthcare, particularly observed during my management hours with a House Supervisor. A responsibility of a House Supervisor is to ensure efficient utilization and allocation of nurses among the floors, so I have had the opportunity to thoroughly discuss and personally observe a variety of causes and consequences of low staffing with my preceptor. A primary reason for inadequate staffing appears to be due to finances; along with making patient safety a continuous priority, St. Vincent Healthcare must strive for good financial outcomes as well. There are certainly challenges that arise in maintaining a balance between providing adequate staff to deliver safe patient care and delivering services at lower costs. Other causes of low staffing are employee conflicts, management and/or leadership discrepancies, heavier patient loads/higher acuity patients, floating to other units, or decreased job ...
disconnect between what nurses perceive to be the right thing to do and what they are told to do. In some clinical areas, there can be as many as 15-20 patients assigned to one nurse with increased patient
The traits of a leader can extend to any individual, not just those in a management position. Leaders can arise in a variety of roles. Staff nurses and charge nurses can be effective leaders by simply assisting other staff with difficult assignments, encouraging others to keep morale up and being a team player. Research has emphasized the importance of leadership at all levels of nursing. A systematic review of literature revealed a positive relationship between relational leadership styles and higher patient satisfaction, reduction in medication errors, decreased patient mortality, decreased use of restraints, and a decrease in hospital-acquired infections (Wong, Cummings, & Ducharme, 2013).
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they give each nurse more patients to care for to compensate for the lack of staff. There are several reasons to why
This critical cognitive work has to cross boundaries which are established either from historical factor or current structure system. It is necessary to set up an interprofessional working system to prevent information breakdown in a fast-pacing patient care unit. Practice-based training will help nurses and other professionals to realize the importance and working forward together to aim a deep understanding of team association. All the professionals need the skills of coordination and collaboration with clinical competencies to successfully support each others for the heavy workflow (Gilardi, Guglielmetti, & Pravettoni, 2013). History excuses is not enough for real nurses to give up their active role in patient care. Nightingale made great comments on communication in teamwork. Nurses are generally expected to be a careful observer and a clear reporter to communicate accurately within whole health care team linked to patient’s safety and positive outcomes. Many researches also indicate nurses are seeking more opportunities for decision making involvement about patient care. All these powerful forth will drive the change at personal and organizational levels (MacMillan, 2012). Research studies suggest that organizational structure of nursing work can affect nurses’ perceptions of power, emotions, and behavioral responses greatly, and then has excessive impacts for their
Azaare, J., & Gross, J. (2011). The nature of leadership in nursing management. British Journal of Nursing, 20(11), 672-680. Retrieved from EBSCO host
Effective leadership has a great impact in what direction the team takes. They have great communication skills and are very easy to talk to and approach. Employees look up to the nurse leader for reassurance and comfort when things are not so bright. Leaders are very compassionate and caring individuals. They are not afraid to take risk in order to reach their goals. Nurse leaders will go the extra mile for his or staff and patients. From a leader standpoint, providing quality care to every patient is a priority. Leaders are usually on the floor with the nurses and are very aware of the work load. Leaders can better understand the nurse’s frustration about the staffing ratio. Sometimes having four patients feels like six because of the acuity level. When faced with a situation like not having enough staff to work a shift, leaders are quick to call in an extra nurse to come and work. Reducing the work load and proving effective quality care to the patients is what a leader usually has in mind. Leaders are not thinking about the hospital budget and deficits. They look at the big picture which is staff shortage and the work that needs to get done. The leaders goal is to keep everyone safe and happy. According to Stanley (2006), leaders tend to be solitary, proactive, intuitive, emphatic and attracted to situations of high risk; they ask the 'why not ' question and 'do the right thing. Therefore, a leader will do everything he or she can to accommodate patients and nurses
The plan was updated in June of 2014. The policy states that “ The Clinical Nurse Manager (CNM) are responsible for routine scheduling to allow for provision of quality patient care for every patient on his/her unit 24 hours a day” (Helen Keller Hospital,2014). The policy states that care levels from one to seven are assigned to each patient at the end of the shift and patient assignments are dispersed based on the care levels. Although our nurse manager does not follow the policy in fact I do not believe any nurse manager does for staffing. This assignment was difficult for me because I am a pre-operative nurse and so are all my co-workers we all left from medical units due to the issues of staffing. So instead the author decided to use comparison and contrast to develop this interview. The author chose pre-operative nurses with medical nursing backgrounds because she would not dare bother medical surgical nurses because they are understaffed and overwhelmed from patient care. For pre-operative nursing a certain amount of nurses are scheduled to work based on the number of surgical patients, so sometimes some nurses are sent home due to low census. On the medical surgical floor the amount of patients are just decided by the number of scheduled nurses. The requirement of care and skills are not taken into account when making out the assignment. My nurse manager makes a schedule for 28 days, she decides how