Clinical Leadership Reflection

Introduction

Clinical leadership is one of the crucial components of modern-day patient care and the health care system in general. Leadership’s importance is determined by the fact that a capable leader is able to ensure high-quality patient care while also establishing the proper working environment. Naturally, there is a great deal of responsibility involved in becoming a recognized leader and maintaining such status. Qualified specialists are able to develop personal qualities required to perform as a leader while also following certain guidelines provided by researchers and other clinical specialists. Across the decades of improving health care in general and health care science, researchers were able to determine a number of attributes that each leader must-have in the framework of clinical practice. Some of the most recent publications on this topic include an article by Mannix, Wilkes, and Daly (2013) who aimed at determining “current understandings of defining attributes or characteristics of clinical leadership” (p. 11). The purpose of this paper will be to report about a leader and determine their approaches and qualities in the framework of clinical leadership. The paper will be divided into eight parts with the following conclusion.

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Qualities and Characteristics of the Leader

The leader selected for the purposes of this paper is chosen because of the extensive amount of time spent with them. It is the leader that is known best which means that the analysis will be most precise.

In order to begin the analysis of a leader in the clinical framework, one would first have to identify the leader’s qualities and characteristics. This paper’s descriptions of these elements will be based on the list of core elements of the leadership competency provided by Hamric, Hanson, Tracy, and O’Grady (2013). The authors describe three elements that are then divided into sixteen sub-categories, all of which represent vital traits that a successful clinical leader possesses. The three elements are mentoring, innovation, and activism. Mentoring is made by the shared vision, ability to receive and provide mentoring, desire to share authority, empowerment of self and others, and self-reflection. Innovation is divided into the knowledge of leadership and change models, systems thinking, skills required to evaluate systems, flexibility, ability to take risks, broad communicative skill set, credibility, and ability to pioneer changes. Finally, activism is composed of knowledge and understanding regarding change-evoking factors that are present in the health care system, involvement in legislative activity (local, regional, national, or global) regarding health care, and ability to advocate for patients, practicing nurses, and the nursing profession in general.

It becomes evident that a successful leader must possess a bride variety of qualities and competencies. The leader described in this paper has all of the qualities related to mentoring. Although lacking most of the components of activism, most of the innovation-connected characteristics are present. Therefore, it may be stated that this leader focuses more on working with patients and employees of the hospital in current circumstances. They mostly concentrate on using available assets and improving the current working environment rather than focusing on health care in a more general sense.

Leadership Domain

The leader primarily works in the clinical domain described by Hamric et al. (2013) while also taking major influences from the professional domain. The clinical domain mainly deals with providing patients with the highest possible quality of treatment while also creating and maintaining a healthy environment. As claimed by Wong, Cummings, and Ducharme (2013), positive patient outcomes and decreased mortality rates are influenced by certain leadership approaches. This means that a virtuous leader is likely to ensure that the patient outcomes are significantly better. Arguably, to achieve such an environment and treatment quality, a virtuous leader must also focus on establishing professionalism amongst their subordinates. Better patient outcomes are a direct result of the work of highly skilled personnel that possesses both extensive knowledge and practice in health care. To achieve this, a leader must be aware of the employees’ strengths and weaknesses while also implementing measures to improve the strength-to-weakness ratio.

The leader described in this paper pays a great deal of attention towards improving the environment for both patients and employees, which also indicates that the professional domain is partly representative of the leader. It is achieved by various means. Firstly, high levels of professionalism were evaluated and ensured at all times. When hiring a nurse or a physician, the leader makes sure that they either have a lot of knowledge and extensive medical practice or are willing to achieve these competencies. Regardless of the situation, newly-employed personnel has to demonstrate their abilities or determination. These characteristics are monitored and evaluated which helps the leader to assess the quality levels of treatment that the hospital is able to provide. Nurses and physicians are encouraged to determine their patients’ needs and provide them with everything required. The leader is also very attentive to patient privacy which is important to create a proper environment for a patient to recover. Evidently, there is a great focus on establishing high-quality patient care supported by professionalism and a healthy environment. Various types of managerial measures are implemented to share experience and ensure support amongst personnel. Therefore, the leader is able to use components of their domain effectively.

Leadership Definition

The definition provided by Hamric et al. (2013) that represents the leader described in this paper is transformational leadership. As mentioned above, the leader is very attentive towards the encouragement of their subordinates ensuring that each of their requirements is met. Additionally, the leader pays a lot of attention to motivating patients to recover more efficiently.

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As confirmed in an article by Bellé (2013), transformational leadership implementation has a significant positive influence on the working environment amongst nurses. This is stipulated by the fact that nurses who realize that their performance impacts other peoples’ lives become more involved in a patient’s recovery. Both nurses and physicians are then encouraged to make sure that they have a positive impact on both their colleagues and patients. Therefore, a highly effective environment that stimulates better patient outcomes is established. Moreover, the ability to influence other employees’ actions allows for shared vision and experience. Colleagues are then able to both motivate each other and exchange valuable information while also sharing their perspectives on various challenges or approaches to providing health care.

Thus, by implementing the transformational approach, the leader is able to further improve the working environment that promotes better patient outcomes and more efficient recovery. This is one of the reasons why the leader was chosen to be analyzed in this paper. Naturally, situational leadership also provides a number of benefits and, although approaching health care differently, promotes a professional environment and better patient outcomes. However, transformational leadership is better suited for the approach that the leader is implementing. Achieving a common purpose and goal, establishing encouragement and sharing experience are the main focus points that the leader is taking into account. They are always searching for better ways to ensure that these elements are on a proper level. Therefore, this leadership definition is the one that characterizes the leader described in this paper.

Leadership Model

The leadership model best suited for the leader mentioned in this paper is the “model of microsystems in health care: high performing clinical units” (as cited in Hamric et al., 2013, p. 274). This model was developed by Nelson et al. based on twenty different microsystems. The authors identified nine characteristics of a successful leadership model. These features ensure that high-quality, cost-efficient health care is provided to each of the patients. The nine components include leadership, culture, organizational support, patient focus, staff focus, the interdependence of care team, information and information technology, process improvement, and performance patterns (as cited in Hamric et al., 2013, p. 274). These elements are determined for successful systems. This means that they are approved to provide vital improvements for a system despite its current state. Implementation of the model is also supported by the determined leadership type.

This model describes the leader analyzed in this paper because it is mostly focused on patients and staff. As mentioned by Wong, and Laschinger (2013), a correctly set leadership model also allows providing significantly more empowerment to staff. This means that employees are becoming more confident which leads to increased quality of care and negation of adverse patient outcomes. Therefore, the leadership model implemented by the leader described in this paper is the one that focuses on patients’ recovery by increasing quality of care through the empowerment of personnel. Additionally, it provides a possibility for the advanced practicing nurses as well as for the rest of the employees to find ways to improve the working environment. Therefore, as an interdependent unit, hospital personnel have the ability to both the focus on needs of each other while also searching for possible enhancements. This model of leadership also works effectively when the leader mostly applies transformational approaches. Therefore, the leader is able to both personally influence their subordinates while also creating a setting in which each employee is interdependent and, therefore, must rely on the experience and support from their colleagues.

Support for Cultural Diversity

Cultural diversity is important to address due to various reasons properly. As claimed by Mareno and Hart (2014), “health care professional (HCP) demographics have not changed along with the population” (p. 83). This means that a leader is required to ensure proper levels of cultural diversity awareness amongst their subordinates since their demographics are not as varied as that of their patients. A successful leader is, therefore, able to ensure that their employees possess extensive knowledge about their patients’ possible cultural peculiarities and are able to make sure that a care plan fits them. This may be achieved by different means. Naturally, the most important of any of those would be to incorporate a proper database or educational services that every staff member has access to and is able to research at any moment. It is equally as important to select applicants based on their knowledge of the aspects of various cultures. The applicants must also be able to adjust their treatment so that no disregard towards a patient’s culture is implemented.

The leader described in this paper uses both of these methods. While the latter (selecting applicants with extensive knowledge) is not predominant, it is also taken into account. The former line of measures is implemented and maintained. Therefore, cultural diversity amongst patients is established. Cultural diversity amongst staff, in turn, is addressed by providing equal rights to each employee despite their racial or regional characteristics. Each culture is respected, and violations of an employee’s cultural rights are prevented and heavily punished. The focus of the leader, however, is on providing education and making sure that any possible conflict is resolved as quickly as possible.

For example, recently, a woman of Indian descent arrived in the hospital. After examination, her nurse provided information about the woman’s treatment plan. The woman expressed significant dissatisfaction since she only considered being treated by traditional means. The leader that this paper focuses on intervened. However, the intervention was not direct, since the leader decided that it would be better for the nurse to resolve this situation using her efforts. The leader provided a rationale for not using traditional medicine to make sure that the nurse had enough facts supporting her position. After a long conversation, the patient agreed to be treated according to the plan. Thus, the cultural conflict was resolved.

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Handling Controversy in the Work Settings

As stated by Iacobucci, Daly, Lindell, and Griffin (2013), conflicts and controversy in the nursing profession are currently becoming more apparent than ever due to various reasons. These reasons include ethical considerations, increasing advancements in technology, and “rising conflicts between personal, professional, and organizational values” (Iacobucci et al., 2013, p. 479). This leads to such problems as short staffing or overstaffing, excessively long shifts, decreasing salary, discrimination for a large variety of reasons, and certain job hazards. There are, of course, many more controversial challenges. Overcoming these requires combined efforts of a leader and employees as well as determination to change certain working conditions. An experienced leader is able to find a way to regulate most of these challenges. However, it is often impossible to address them all without causing some damage to employees personally or to the institution itself. For example, a while ago, the leader described in this paper faced a problem of understaffing which caused nurses to work excessively long. Although this issue mostly does not depend on a leader’s effort, there are certain ways to overcome the challenge.

The way that the leader chose to resolve to issue is by promoting their hospital among pre-graduate and graduate students as well as making sure that a significant amount of the students are willing to choose the hospital as the one in which they will undertake their practice. The leader was then able to demonstrate a high professional and supportive environment in which the students felt confident. Thus, a lot of students decided to proceed to work in the hospital, while some of them initially thought about moving to other states to work there. Other problems such as discrimination are rarely faced by the hospital’s staff due to the reasons mentioned above. The leader was able to establish an environment where each patient and staff member feels confident and safe. Each attempt to discriminate against another person may result in the hospital ceasing to work with the person provoking discrimination.

Promotion of Collaboration

Collaboration is one of the core aspects of improving the quality of health care as well as establishing a professional working environment. As reported by Ma, Shang and Bott (2015), increased levels of collaboration within a health care unit result in significant improvement of health care quality and the unit’s effectiveness. There are many ways to both establish and promote collaboration. The ways that the leader described in this paper uses are mostly related to encouraging hospital personnel to exchange experience and combine efforts whenever needed or possible. This way, the hospital’s staff members are able to overcome challenges that may have proved too hard for a single employee to handle. Therefore, they are able to reach significantly better patient outcomes as well as the quality of health care provided in general.

An example of promoting collaboration is the meetings that the staff members are required to have scheduled each week. During these meetings, nurses are able to exchange their experiences and support each other. These meetings are proceeding in an informal atmosphere. This kind of conversation allows employees to feel safe and supported by their colleagues. The leader is also present at each of these meetings to both provide guidance and take note of the current challenges that their subordinates are facing. Additionally, the leader is able to contact their staff directly should some more personal problems arise.

Additionally, the leader makes sure that no excessive shifts are being assigned to any nurse. In case if some nurse needs replacement or requires a sick leave, the leader encourages other nurses to support them and, if possible, take their shift. Naturally, this creates an environment that is even more supportive. The hospital’s staff considers working there to be a very positive and encouraging experience that provides possibilities for personal and professional growth.

Self-reflection

My qualities as a leader are, of course, not on the same level as those of the leader described in this paper. However, I possess most of the mentoring and activism qualities. It would be reasonable to develop more qualities related to innovation. I aspire to work in the professional domain, as I believe that a lot of health care effectiveness comes from collaboration and communication among medical specialists. To achieve this, I would most likely follow the transformational leadership definition to be sure that this focus on collaboration is shared amongst my colleagues. The model that would be implemented is the same as the one executed by the described leader (microsystems model).

The prime example of the way I make sure that no cultural interests are threatened is that I always make sure that I know enough about a patient’s background and cultural features. This way, cultural diversity is intact at all times. Controversy, in turn, would be regulated the same way as the described leader handles it. I believe that establishing a supportive and professional environment is the best way to handle controversy while also improving the quality of health care delivered. I would collaborate with other health care workers, for example, by exchanging experience and providing or receiving mentoring.

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Conclusion

The purpose of this paper was to analyze the characteristics and approaches of a certain leader from a clinical leadership perspective. The main points of this paper included describing the leader’s qualities, their model of leadership, determining the appropriate definition of their leadership type, and providing coverage of their ability to resolve various challenges. Additionally, this paper contained a part about self-reflection that is determined to express the way the leader’s influence and information researched helped the author to assess their potential as a possible leader. The leader described in this paper proved to be significantly influential while also demonstrating the high efficiency of their approaches and methods implemented in both working with patients and subordinates.

References

Iacobucci, T. A., Daly, B. J., Lindell, D., & Griffin, M. Q. (2013). Professional values, self-esteem, and ethical confidence of baccalaureate nursing students. Nursing Ethics, 20(4), 479-490.

Bellé, N. (2013). Leading to make a difference: A field experiment on the performance effects of transformational leadership, perceived social impact, and public service motivation. Journal of Public Administration Research and Theory, 24(1), 109-136.

Hamric, A.B., Hanson, C.M., Tracy, M F., & O’Grady, E.T. (2013). Advanced practice nursing. An integrative approach. St. Louis, MO: Elsevier Saunders.

Ma, C., Shang, J., & Bott, M. J. (2015). Linking unit collaboration and nursing leadership to nursing outcomes and quality of care. The Journal of Nursing Administration, 45(9), 435-442.

Mannix, J., Wilkes, L., & Daly, J. (2013). Attributes of clinical leadership in contemporary nursing: An integrative review. Contemporary Nurse, 45(1), 10-21.

Mareno, N., & Hart, P. L. (2014). Cultural competency among nurses with undergraduate and graduate degrees: Implications for nursing education. Nursing Education Perspectives, 35(2), 83-88.

Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of Nursing Management, 21(1), 709-724.

Wong, C. A., & Laschinger, H. K. S. (2013). Authentic leadership, performance, and job satisfaction: The mediating role of empowerment. Journal of Advanced Nursing, 69(4), 9947-959.

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