The Field of Adult Nursing: Importance of Leadership

Introduction

This commentary aims to study and analyse the existing approach to leadership competencies in nursing. This paper discusses various approaches to determining the importance of leadership in the activities of medical professionals in the field of adult nursing. Particular attention is paid to the use of various modern leadership theories and their impact on the activities of nurses. All this is considered in the context of the use of modern methods and approaches to the organization of interaction within the organization (Smallheer, 2022). The field of adult nursing requires special attention since a large number of medical workers take part in helping patients, which makes the process sufficiently complex. A special place is given to nurses who connect critically with patients and other workers.

This work is divided into two main parts. The first of them deals with the main issues related to the theory of leadership. Various approaches and methods to the organization of multidisciplinary teams are considered. Special attention is paid to nurses’ activities, manifested in the introduction of leadership competencies. The second part presents personal observations concerning teamwork within a medical organization. Consequently, various observations and observations on the experience gained are presented.

It should be noted that this topic is of particular interest and is relevant since the medical activity is undergoing constant changes and is being improved. Thus, it is necessary to systematize various knowledge to understand the importance of leadership competencies in the activities of medical professionals (Jones, 2022). Special attention is paid to nurses throughout the system since this profession serves as a mediator between patients and the entire medical organization (NHS, 2018). Therefore, in order for the entire mechanism of work to improve and the quality of services provided to improve, it is necessary to develop various approaches to improving leadership qualities.

Commentary: Context

In order for the NHS to deliver high-quality services and maximize the effect of its resources in the face of rising healthcare demand, good management is essential. The several variables that caused nurses, physicians, and management to lose sight of quality are pointed out in the Francis Report, the Keogh Report, and the Berwick Review into patient safety, as well as the necessity to draw lessons from these failures. In order to create the appropriate atmosphere and offer clear direction to patients, therapists, professionals, and colleagues, everyone involved in the delivery of care needs to contribute (Jones, 2022). As a result, patients and employees will receive safe, high-quality treatment and have a great experience. Teamwork is the joint efforts of a group to achieve a common goal of treating a patient or performing a task in the most effective and efficient way. Many of the best-performing provider organizations in England have prioritized creating an inclusive and courteous culture (NHS, 2018). It encourages effective communication among their staff, in addition to preserving stability at the executive level regarding people and strategic approach.

Additionally, leadership is the skill of inspiring and motivating people to act in a certain way in order to forward a common objective. The mission of NHS Leadership is to provide outstanding leadership throughout the NHS and to influence patient care directly (NHS England, 2022). The significance of leadership in health care was highlighted in a 2015 study by the Faculty of Medical Leadership and Management (FMLM), The King’s Fund, and the Center for Creative Leadership (CCL). According to the review’s findings, there is convincing evidence that there is a connection between leadership and several crucial outcomes in the health services sector, including patient satisfaction, patient mortality, organizational financial performance, staff well-being, engagement, staff turnover, and overall quality of care (NHS England, 2022). Delegation is the transfer of tasks or competencies from a supervisor to a subordinate, the work of a nurse is associated with risks, therefore, this process should be transparent and accessible. The staff’s expertise, compassion, and devotion are the primary determinants of patients’ standard of treatment. The results for patients and the organization depend on team engagement.

Discussion

The Importance of Leadership

The creation of comfort, calm, close to a home environment depends entirely on the nurse. The doctor monitors the patient’s general condition, and the nurse, who is constantly in the department, has the opportunity to get to know the patient better and provide all possible assistance in adapting to new conditions (Naughton, O’Shea and Hayes, 2019). In modern conditions, a nurse is not only a medical worker but a specialist of a broader profile and orientation. Healthcare must keep up with the rapidly changing world, trying to change it for the better (NHS, 2018). All these aspects are reflected in Francis Report, the Keogh Report, and the Berwick Review (NHS England, 2018). The development of leadership in nursing will help this, as it will increase the nurse’s responsibility and role in organizing medical care.

In the field of healthcare, the managerial and leadership competencies of nurses and doctors are similar, but there is a need for a general and non-professional system of teaching leadership and management skills. This approach provides a common understanding of governance and leadership issues across the healthcare system (Bailey, 2022). The NHS Leadership Academy commissioned research that examined a leadership paradigm that the NHS may utilize in 2018 (NHS England, 2018). According to the study’s preface, technical proficiency, professional aptitude, and management excellence contribute to effective leadership (NHS England, 2018). The care, compassion, and genuine investment in personnel that outstanding leaders see as the essential difference between competent technical, clinical care and excellent healthcare service is the real test of what distinguishes such people in an organization like the NHS.

Relevant Leadership and Management Theories

Situational leadership is a leadership style in which managers take into account the level of training of employees and the uniqueness of each situation. Situational leadership can help nurses to establish relationships with patients since they adjust their leadership style to their level of preparedness (Agus Sudrajat, Zulfikar and Lindayani, 2020). Each patient requires a unique level of practical and communicative attention. The main task is to assess their patients’ skills, confidence, and motivation and determine which leadership style to use (Belrhiti, Nebot Giralt and Marchal, 2018). This is especially important when working with adult patients who may be in various conditions. This also applies to working with the family, as members can react to the diagnosis in completely different ways (Lynch et al., 2018). Therefore, it is necessary to observe external factors that can signal nurses about how to behave with patients. A service leader can be considered one who creates conditions to meet the needs of his followers in professional and personal self-realization.

On the other hand, it is necessary to highlight the theory of servant leadership, which can be applied in nursing. Indicators of the effectiveness of this theory are individual professional growth and personal development of followers, free, independent actions on their part, the emergence of their desire to support others, and the formation of a self-serving and self-supporting professional community (Best, 2022). In the case of working with patients, this type of leadership is aimed at teaching patients to take care of themselves and their families on their own (Jing, 2019). When working with adult patients, servant leadership helps motivate them and creates an environment and atmosphere of mutual understanding and assistance (Kiwanuka et al., 2020). Another characteristic of service leadership is reliance not on authority, but persuasion, especially in matters of organizational decision-making (Best, 2022). The serving leader does not force but leads others to consent by convincing. This characteristic makes it possible to understand the main difference between the situational leadership model and service leadership.

The Role of Leadership in Quality Improvement

Despite the fact that the healthcare industry is changing rapidly, leadership qualities in the field require constant updating and confirmation. Within the framework of this model, special attention is paid to the responsibility of senior nurses for creating safe, healthy, and professional conditions conducive to the work of interdisciplinary medical teams and the optimal outcome of patient treatment (Dempsey and Assi, 2018). The model emphasizes a general sense of responsibility for the successful provision of services. Acts of leadership can come from any member of an organization focusing on the achievements of a group rather than an individual (Bailey, 2022). Effective management of modern healthcare institutions is associated with creating a well-functioning and effective system of powers associated with the practical application of the concept of leadership competence (Mannion and Davies, 2018). It should be noted that it plays a decisive role in the importance of leadership in improving the quality of care for adult patients.

Nurses should be able to manage the process and establish direct close contact with each patient to best understand their interests. The mood of patients to establish trusting relationships with medical staff depends on this, which has an exceptional effect on the quality of medical services provided (Heinen et al., 2019). The importance of leadership is also determined by the ability to create a certain atmosphere throughout the medical institution (Cummings et al., 2021). This directly affects the success of the organization and the fulfilment of its social mission, which is to improve the quality of medical services to the community (Sundberg, Vistrand, Sjöström and Örmon, 2021). The application of the most modern leadership theories will allow nurses to respond to a rapidly changing world. In the field of adult nursing, this is especially necessary since many patients may face feelings of depression, distrust, or despair (Heinen et al., 2019). The task of implementing leadership competence for nurses is quite important, as it allows them to demonstrate to patients the necessary criteria for improving their condition.

The Key Theoretical Concepts in Team Working within MDTs

Modern MDTs have pronounced tendencies to complicate and increase their structural and functional composition. Normal team dynamics to high-performance work is possible if team cohesion is ensured. Therefore, it is necessary to understand that the role model and the development of teamwork skills is an important aspect. This is due to the fact that the efficiency of each individual team member improves. Problems arise at the level of decision-making and different values. It is necessary that each team member has an understanding of what is a priority for the patient. Consequently, such attributes of teamwork and leadership solve the problems of the development of a medical institution (Burgers-Pas and Seckler, 2022). There is a need to maximize human potential by delegating responsibility, which requires the introduction of more effective organizational forms and methods of collective management.

This implies that they must abide by laws governing the collection, use, and sharing of information. In addition, the development of education and modern technologies requires using multiple work skills in work, not just performing one or two specific operations (Flores‐Sandoval, Sibbald, Ryan and Orange, 2020). A highly effective self-learning organization is a group of people working together in order to expand their opportunities to achieve results through the organization of a continuous learning and development process. Thus, in such MDTs, it is the type of leadership that determines whether an organization will be highly effective or not.

The Concept of Delegation as a Leadership and Management Tool

Delegation is a purposeful activity of the heads of nursing services of medical and preventive institutions and their departments using various management mechanisms and communication channels. This is done to ensure well-coordinated, qualified work of nursing staff to provide adult patients with appropriate quantity and quality nursing care. Delegating nurse responsibilities is essential for managing a medical facility’s workload (Ver Woert and Hansten, 2022). By assigning tasks to other employees, nurses can focus on other responsibilities that may require closer attention. A competent delegation of authority frees time to solve strategic tasks and build plans (Barrow and Sharma, 2022). This aspect significantly strengthens the team spirit and motivation of employees, opens the potential of employees, contributes to their development, and strives to achieve the organization’s goals.

The manager acts through many delegations, the achievement of the tasks and goals depends on their quality and quantity. Delegation promotes motivation, development, and discovery of the potential of employees and the organization and reflects the ability to manage personnel. Delegation can help nurses effectively handle their many responsibilities (Barrow and Sharma, 2022). There are several ways in which nurses are responsible for their own practice. The Nursing and Midwifery Council regulates them, and they are required to adhere to the guidelines outlined in The Code, Professional standards of practice, and behaviour for nurses and midwives (NHS England, 2018). However, various difficulties may arise when delegating. They may be associated with the wrong choice of tasks that may not correspond to the employee’s qualifications (Miles and Scott, 2019). This can lead to various organizational problems, which can worsen patient care.

Digital Data and Information Technology

Information technology is the process of creating, storing, transmitting, perceiving information and methods of implementing such processes. Within the framework of medicine, digital data allows medical professionals to easily store and reproduce information about patients (Murray et al., 2017). Examples include electronic doctor’s appointments, medical history, medical image management, laboratory diagnostics, accounting, and administrative processes (Krick et al., 2019). In the NHS Long Term Plan, released in January 2019, the goal was established for digitally enabled care to become standard across the NHS (NHS England, 2022). A renewed commitment to ensuring better data exchange throughout the health and care system and the digital transformation of care pathways was made evident in the White Paper (February 2021) (NHS England, 2022). Moreover, it allows nurses to ensure the implementation of the therapeutic and diagnostic process quickly and efficiently, which justifies the need for the introduction of new technologies into the practice of nursing staff (Ristikivi et al., 2022). Information technologies are becoming increasingly in demand in healthcare, including remote monitoring of patients’ conditions and MDTs managing.

A Gap that Needs Improvement Through Innovative Practice

In bureaucratic structures with strict adherence to hierarchy, the creation of project teams is complex. In such organizations, project teams are created nominally, and the project management procedure corresponds to the current procedure for performing functions while maintaining the existing hierarchy of decision-making and execution (Taylor et al., 2021). The noted problem may be caused by the fact that the use of various existing management tools and process management tools within the framework of the program-target approach makes it necessary to form such a management system in the organization that would allow combining opposite concepts (Cushen-Brewster et al., 2021). However, as practice shows, it is complicated to create a standard management structure that would be able to simultaneously ensure the effectiveness of processes and the effectiveness of projects or programs (Cable and Graham, 2018). Thus, the existing problem requires a solution to realize the full potential of MDTs. The following steps will be taken for the development:

1. to study the relevant approaches to the creation and processing of the MDTs organization
2. to analyze the current problems of the organization in which the practice takes place
3. to conduct a survey among medical professionals in order to identify potential problems
4. to systematize the problems and identify possible ways to overcome them.

Year 1 Reflection

The Importance of Team Working in Healthcare

My latest placement was in the acute frailty unit – patients above 76, often admitted due to falls or self-negligence and often diagnosed with dementia or related conditions. One of the illustrative cases was working with an elderly patient of 80 years of age. The patient’s problems are caused by age-related features of anatomical, physiological, and psychosocial characteristics and age-related changes in needs. Thus, a healthy person in old age is at the centre of the gerontological nursing process. The central aspect was that the patient needs medical help, does not need advice, and is learning to live in new conditions. Not solving problems leads to the development of a number of diseases. In this case, team interaction determines the sequence and clarity of building the process of providing medical services.

Often, such patients’ needs are ignored, making me feel helpless because sometimes it is difficult to convince the higher management. It is essential to understand that many expensive tests and examinations are often prescribed, which can aggravate the patient’s psychological state. Thus, in this case, teamwork allows me to avoid unnecessary processes and provide the patient with the highest quality solution for a specific case (Rosen et al., 2018). In this case, the following MTD members were involved: psychologist, social worker, and therapist. However, special attention is paid to adult nurse, as it is necessary to understand the patient’s needs in this situation and assess the general condition and mood (Lavelle et al., 2020). All this will allow us to work out solutions with other team members who will be able to use their skills to create a comfortable treatment plan for the patient, which will avoid unnecessary stress on the physical and mental state of the patient.

Delegated Task

My experience of delegation is that I was given the authority to assess the department’s psychological climate. This task was focused on conducting a comprehensive survey of patients about their condition and satisfaction with the services provided in the clinic. The difficulty was that during the day, it was necessary to interact with a large number of people who were set up completely differently. In my opinion, the mistake was that I was too focused on completing the assignment and not on actually finding out the condition of the patients. This would make it possible to make changes immediately, providing alternative solutions for those patients who experienced any difficulties or dissatisfaction. This approach would improve the overall condition, directly affecting the manager’s report. However, the very feeling that the task was delegated made me more motivated and interested in my activities. The responsibility that was transferred to me developed various complementary qualities in me, which helped me cope with several fears and insecurities. Working with adult patients requires confidence from the nurse, which should be reflected in the clarity and consistency of decisions made.

Conclusion

Summary

Maximizing what goes right and minimizing what goes wrong for patients getting medical treatment is the goal of patient safety. Along with efficacy and patient experience, it is a critical component of the NHS’s concept of quality in healthcare, and it aspires for continuous patient safety development in addition to broader quality improvement. Leadership and teamwork are essential aspects of the implementation of the organizational work of the clinic. The improvement of these qualities is a determining factor in providing the most modern medical services. The field of adult nursing requires special attention since nurses are a critical factor in the interaction between all the components of the treatment process.

Recommendations

1. From the practical experience gained, it becomes evident that delegation is an essential part of motivating employees to perform tasks efficiently. Thus, medical staff should pay more attention to this aspect. However, the distribution of tasks should be made following the qualifications of employees.
2. The field of adult nursing strongly depends on nurses’ leadership competencies. Consequently, the development of this skill is crucial in improving the quality of medical services provided. More attention should be paid to conducting various pieces of training.

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