The objective for the most recent four site visits included continuation of the core competencies, which are personal journey disciplines and change management. During these last site visits, I continued to work on process improvement project. On June 22, TV sat down and looked at the remainder of my core competencies. We also reflected back on the previous competencies to check if anything was missed or if I had any questions. One of my learning activities for this competency is to interview a nursing administrative leader and attend a meeting on succession planning. TV reached out to one of her peers to see if they would allow me to interview them. She found NH who is the administrative nursing director for the neuro service line. She was …show more content…
busy on this particular day but set up a calendar appointment for me during my next site visit which is on June 24. The remainder of today TV wanted to spend time rounding on all her units and also a few patients from each unit. I shadowed her and along the way found her leadership style to most definitely mimic that of a transformational leader. During the rounds, it was obvious to me that her team of nurses respect her and are comfortable engaging in conversations with her. On June 24, TV and I again went over the plan of the day which included an appointment with NH. This day turned out to be a very busy one for TV, the Joint Commission was here for the hospitals stroke certification program. TV is not a part of the stroke unit in the hospital, however, since she is over the emergency room the surveyors certainly went down to the emergency room to see their process when a stroke patient arrives. TV and I attended the opening meeting then I just shadowed her during the day. From a leadership perspective this wasn’t really a productive day. Being that NH is the administrative director over the entire neuro service line, which included the stroke unit, NH was not able to keep her appointment with me for the interview. We did reschedule the interview for the next site visit which will be on June 29. Since this site visit did not go as planned, I decided to see if I could find information on the responsibilities of leadership when it comes to Joint Commission. According to Joint Commission (2014), leadership must be able to speak to their responsibilities for planning, management, oversight, resource allocation, performance improvement, and support for the organization’s mission and strategic objectives. In regards to improving performance improvement, senior leadership must be prepared to discuss how they set expectations, assess, plan, and measure the initiatives that improve the quality of service. The survey activity guide also goes on to explain that the surveyors may request samples of performance improvement initiatives, including proof that the project was attained and continued (Joint Commission, 2014). On July 6, today was the day that I conducted my interview with NH. After rounding with TV in the morning and attending a few meetings here and there, I went on to meet with NH. I must say that NH is a very busy person, during our interview she was interrupted several times. However, I noticed that each time she was interrupted, she had a smile on her face and never once complained. Recognizing NH’s reactions to the interruptions was not one of the leadership behaviors that I was expecting to identify. I spoke with NH about change management and what her feelings were about this model. NH explained that without change management, there will never be improvement in the quality of care that we deliver. She went on to explain that you must first identify a problem, or an area of improvement. Second, she explained that planning for the change is probably the most important step in the implementation. Third, is the actual implementation of whatever improvement, or change you are trying to make. Finally, NH described why sustaining the change may or may not be good. She explained that if the improvement or change was effective, then great, you will want to sustain the change. If the project or idea didn’t work as planned, then sustaining the change is not necessary. However, she went on to explain that the idea should not be abandoned either. If there was a problem, or a change that was necessary, then going back to the most important part of change management and starting over might be the next step. During my interview, it was obvious to see that NH had many of the same leadership styles and behaviors that my preceptor TV has.
Earlier in one of my journals I spoke about the previous Chief Nursing Officer (CNO) being a transformational leader. In listening to NH, it was apparent that she was as well. When I asked NH what type of leadership style she most relates to, she stated that of a transformational leader. I wondered if she had this leadership style in prior leadership roles, or was she inspired by the previous CNO. She explained that it was a little of both, she did find our previous CNO to be very inspirational not just to the bedside nurses, but to other leaders as well. This activity helped me to also be inspired to grow and continue to learn more about transformational leadership. This is the leadership style that I desire to have, be able to demonstrate that to others, and be an inspiration to them. Being a transformational leader means that you have a higher level of morality and have the ability to inspire and motivate others. These qualities are incredibly important when allowing your followers to take responsibility by being a part of the decision making. According to Doody and Doody (2012), nurse leaders have a responsibility to make sure that bedside nursing staff are represented and participate in decision making. The article explains how some institutions have leaders represent the frontline staff; however, those type of institutions miss out on …show more content…
the benefits and perspectives that frontline staff have to offer. On July 14, TV and I went over my competencies and learning activities.
One of the activities I had planned was to attend a meeting on succession planning. There were no meeting scheduled, so TV and I sat down and she spoke about what succession planning is about and the importance. TV explained that it is important to strategically plan for future leadership. In order for the leaders of today to become strong leaders of tomorrow, there must be succession planning. TV went on to explain that back in the day, succession planning was typically for higher positions like CNO positions; however, she explains that best practice states succession planning models should include all leaders and management positions. TV explained that succession planning puts an emphasis on identifying high performers who may or may not currently in a leadership role and prepare them for the future of leadership. TV described the type of succession planning that is done in this facility. This is called talent review and the OD’s in HR help with this each year. They use what is called a nine block system to identify where leaders are within the organization and are they ready to be promoted to a higher level of leadership. TV isn’t a big fan of the nine block, however, she does believe in mentorship programs which also aid in succession planning by identifying and developing those
individuals. During this site visit I was also able to sit down with the manager who is heading up the process improvement project that I took a part in. My involvement in the project was data collection. In a previous meeting the manager asked me to put the information in graph form and also include who the stakeholders in the process improvement would be. I gathered all the data and presented my contribution to the project via a power point presentation. The individuals present included the manager and three other members of the team. TV was also present and said that I did a great job with the presentation and that she believed the data I gathered would be valuable to the project. She said that she can’t wait until the project is implemented. The ultimate end goal for this project when completed will be to decrease the delay time from the emergency room to the critical care areas, therefore decreasing mortality and increasing quality of care.
For this assignment I was able to interview Regina Bowman RN, BSN. Her current position is that of the Director of Medical Surgical Nursing. Her position places her over top of seven nursing units between two facilities. Regina graduated from the Mercer Medical School of Nursing in 1979 with her diploma in nursing. The Mercer medical school of nursing is still in operation although it has been renamed the Capital Health School of Nursing. Her return to school started after graduation. She enrolled at Mercer County Community College to obtain her Associates. Secondly she attended La Salle University and received her Bachelor’s in Nursing in 2003. Lastly she is currently enrolled at the Thomas Edison State University, and has a prospective graduation of 2011 with her Masters Degree in Nursing. Regina has work in many clinical jobs, both in and out the hospital. Initially she began her nursing carrier as a medical surgical nurse shortly after graduation. After she gained experience she worked in the emergency room only to return to med-surge as an assistant manager. Subsequently the unit in which she worked closed and Regina was placed in an outpatient setting managing hospital owned physician groups. This position leads to her return as the manager of 7 East a general medical unit. This position eventually gave her the opportunity to hold her current position as a hospital director.
Nurse managers are responsible for nurse performance and retention, and the manager’s leadership style is critical to the achievement of these outcomes (McGuire & Kennerly, 2006). Transformational and Transactional leadership theory are two leadership styles that have attracted the interest of many researchers. An analysis of these two leadership models will identify strengths and weaknesses of both theories in relation to Hospital medical errors.
Even though leadership can be an essential place for development, if certainly not of greater importance, is the desire to create your conditions, which service and boost new models of leadership. Another dimension regarding consideration inside the implementation regarding clinical governance as well as leadership would be the disempowerment from the nursing profession. Hitchcock (2013) supported this view, asserting that yesterday’s methods do not work in the permanent white-water world, where managers traditionally manage within the system and focus on doing things according to the rules.
The leadership clinical preceptor that I have had the opportunity to work with throughout the semester considers herself to be a transformational leader (J. P., personal communication, March 23, 2014). The preceptor displays transformational leadership behavior characteristics such as showing charisma, inspiring and motivating the unit, viewing each employee as an individual (Yoder-Wise, 2011). For example, she makes an effort to get to know each employee individually by gaining knowledge about their personal lives such as likes, dislikes, hobbies, and family life front the point of hiring the employee (J. P., personal communication, March 23, 2014). She also promotes and encourages her unit employees to function as a team not as individuals (J. P., personal communication, March 23, 2014).
In healthcare it is very important to have strong leaders, especially in the nursing profession. A nurse leader typically uses several styles of leadership depending on the situation presented; this is known as situational leadership. It is important that the professional nurse choose the right style of leadership for any given situation to ensure their employees are performing at their highest potential. Depending on which leadership style a nurse leader uses, it can affect staff retention and the morale of the employees as well as nurse job satisfaction (Azaare & Gross, 2011.) “Nursing leaders have the responsibility to create and maintain a work environment which not only promotes positive patient outcomes but also positively influences teams and individual nurses” (Malloy & Penprase, 2010.) Let’s explore two different leadership styles and discuss how they can enhance or diminish the nursing process.
In order to better understand the role of an Advanced Practice Nurse (APN) and how the core competencies work in their role I conducted an interview with
Why now? Why are we focusing on transformational leadership? Healthcare costs are continuing to rise. Some of the critical problems and active debates prevalent in many hospital organizations include the rapidly intensifying healthcare costs, funding and reimbursement cutbacks, and concern regarding the overall quality and safety of health care. “Healthcare systems have come under pressure to improve performance and manage productivity” (Botting, 2011). To be successful in the 21st century, there is a demand on healthcare systems to have a vision and executive and clinical leadership to inspire the change process and make the difference between success and failure in change.
During the final stage broadening the perspective, the APN is starting to settle in in his/her new role, the NP experiences realistic expectations and a feeling that they are competent. During this phase, I will focus on identifying my strengths and work on strengthening them further. I will do this by seeking for biannual and annual evaluations from management/administrator. I plan on making changes in my work environment in order to increase the care delivery system.12
As a nurse, I feel that at many times I am placed in a situation, where I need to use my leadership skills in order to provide efficient care by managing the limited time. According to CNO guideline, leadership is a process of influencing people to achieve common goals. It requires self-awareness and commitment towards profession, ability to delegate, manage time and to communicate effectively within the health care professionals.
Nurses are uniquely qualified to fill a demand for change through leadership. Unlike business minded individuals whose primary outcome concern is monetary, a nurses’ primary concern is organic: a living, breathing, tangible being. In a leadership role, a nurse might consider an organization as if it were a grouping of patients, or perhaps an individual patient, each limb with its own characteristics and distinct concerns. They can effectively categorize and prioritize important personal and professional matters and are therefore ideally positioned to lead change efforts. Perhaps most importantly, effective nurse leaders can provide clarity to the common goal and empower others to see their self-interests served by a better common good (Yancer, 2012).
When talking about leadership, one cannot help but wonder how it relates to nursing. If the focus of nursing should be caring for patients who are either well or ill, then why is there a need to tackle leadership? Unlike before, today’s health care environment is complex, rapid and continuously changing. This development prompts an upcoming danger to the nurse’s skills, identity and ability to coordinate with other health care professionals. On the other hand, this also makes nurses challenge their own into taking the lead, developing goals, consolidating a purpose and moving towards an attainable vision. A nurse leader then needs to combine clinical, administrative, financial and operational skills to effectively solve various clinical challenges. These challenges are the rationale behind tackling the need for leadership in nursing.
During my interview with Regina Martinez, BS RN and currently an Assistant Director of a home health agency, I discovered her leadership style matched the above quote. Martinez had extensive experience in management prior to joining the medical field. As a single working mother, she worked her way up from waitress to manger of a popular seafood restaurant. However, her dream had always been to become a nurse and she began her medical career as a certified nurse’s aide (CNA), while working through college. She graduated from nursing school with a Bachelor’s degree in Science and has been a Registered Nurse (RN) for more than two decades. She quickly earned the respect of doctors and fellow nurses, becoming a Charge Nurse on the floors she worked. She has worked as Medical Surgery nurse, emergency room, and as Director of Nursing for home health and long-term care facilities where she was responsible for over 150 employees.
Doody, O., & Doody, C. (2012). Transformational leadership in nursing practice. British Journal of Nursing, 21(20). Retrieved from http://web.b.ebscohost.com.proxy.library.ohiou.edu/ehost/pdfviewer/pdfviewer?sid=3655bc92-b9ec-4a08-84d8-f5d3098ddfdf%40sessionmgr120&vid=17&hid=116
Being at the apex of the chain of command, the administrative nursing supervisor has numerous responsibilities including but never limited to staffing, conflict resolution, and or crisis. In many circumstances, an administrative nursing supervisor must make timely, prioritizing decisions based on the resources available at any given time. The ultimate outcome ideally is patient and staff safety, and positive patient experiences and outcomes. Throughout the different departments in the facility, there are several governing unions with guidelines and contractual requirements. The facility also has policies and procedures that must be adhered to. Katie remains updated on all guidelines by attending conferences, in-services and administrative meetings. Eason, (2010) stated that, “lifelong learning allows nurses to develop confidence and skill in service provision that is evident to patients, their families, and other health care practitioners” (p.157). I believe that Katie is proficient, has strong leadership skills and is capable of unraveling conflict while following
Some of the managers felt that a transformational leader is essential to survive in the future because of the rapidly changing complex healthcare environment. Luzinski said, "Transformational leadership is formally defined as a leadership process that is systematic, consisting of purposeful and organized search for changes, systematic analysis, and the capacity to move resources from areas of lesser to greater productivity to bring about a strategic transformation." I think this definition of transformational leadership applies perfectly to the leaders of the new Hillsborough Hospital