NS60241W Leadership and Management in Nursing Essay Sample

Introduction

The reflective essay is based on a clinical experience in my nursing practice in a busy ward of a hospital. The case presented a patient in a situation that needed urgent care, and the main issues were leadership, communication, and teamwork in order to guarantee patient safety. In this incident, I needed to be responsible, communicate with other team members and make decisions on short notice. This experience brought about critical dimensions of leadership and management in nursing practise.

The key themes identified in this reflection include leadership, communication, decision-making, and teamwork. Specifically, the case has shown the value of effective communication among the nurses and other medical staff, as well as the skill to handle stress and to act in a difficult setting effectively. It also brought about concerns of emotional intelligence, where I had to handle my feelings as well as those of other people in the team.

To direct the reflection, Gibbs (1988) Reflective Cycle will be applied to this essay. The model consists of six phases, namely description, feelings, evaluation, analysis, conclusion, and action plan. It is practical since it can give a systematic method to reflect on experiences and aid in determining areas to develop as a person and professional.

This experience is also important as it allowed me to realise my leadership and communication strengths and weaknesses. It also helped me be more conscious of how my activities can influence patient outcomes and team performance. The contemplation of this scenario will help me grow as a nurse by enhancing my confidence, decisions and skills in working as a team. On balance, the reflection will show how practice-based learning can be used to build lifelong learning in nursing.

Vignette Description

In the course of my clinical placement in a busy medical ward, I participated in the treatment of an aged patient who was admitted with a chest infection. The situation of the patient was abruptly deteriorating during my shift. I was on a small team consisting of a registered nurse, a healthcare assistant, and a junior doctor who was assigned to several wards. My role was to check the vital signs of the patient and inform them about the changes.

During the examination, I realised that the patient was breathing more slowly and with more difficulty. They had low oxygen saturation levels and seemed more and more disoriented. I had realised that these were deteriorating signs. I notified the registered nurse immediately and told him about my concerns. Nevertheless, the ward was extremely active, and the nurse had another patient with whom they needed to attend, who was in need of urgent medication.

I took additional measures as the condition of the patient kept deteriorating. I have re-evaluated the vital signs of the patient and made sure that the patient was in a comfortable position to facilitate breathing. I also requested the healthcare assistant to keep guard with the patient as I made another call to the nurse. I made it clear this time how serious the situation was.

This patient was then reviewed by the registered nurse, and it was decided that she required urgent medical care. The junior doctor was called, and there was a lag in his arrival since his workload was straining him. Throughout this period, the nurse educated me to pack the required equipment, such as oxygen therapy and to keep on checking the patient more often.

Upon the arrival of the doctor, the patient was examined, and immediate treatment was commenced. Oxygen therapy was provided, and additional investigations were scheduled. This eventually stabilised the situation, and the patient later on improved his condition during the shift.

I was with the team all through the incident and took the order of the registered nurse. I paid attention to monitoring the patient, informing the team, and helping the team where necessary. The case involved rapid thinking, effective communication, and collaboration in order to make sure that the patient got the necessary prompt care.

Feelings

In this case, I felt a variety of emotions. In the very first moment, I was concerned and even a bit nervous after realising that the state of the patient was deteriorating. I also cared about the safety of the patient, and I wanted to make sure that I acted fast and accurately. Simultaneously, I experienced certain pressure due to the fact that the ward was extremely busy, and I was not sure whether my concerns could be discussed as soon as possible

The fact that the registered nurse was not available initially made me feel confused and somewhat stressed. I was asking myself whether I had done enough or whether I needed to do something. Nevertheless, I also believed that I was responsible, and this prompted me to re-evaluate the patient and articulate my issues further. This indicated that I was making an effort to remain focused even when I felt nervous.

The more the situation persisted, the more I was confident in what I was doing. I was relieved that the patient was getting the care that she needed when the nurse and the doctor responded and commenced treatment. Once the situation was contained, I experienced the feeling of achievement due to the fact that I had been involved in the process of recognising the deterioration of the patient.

My emotional response was another thing I got to think about with regard to this experience. I also realised the relevance of emotional intelligence, particularly when it comes to dealing with anxiety and remaining calm in a stressful situation. It also taught me that being mindful of my emotions assisted me in behaving more responsibly and effectively communicating in a stressful scenario.

Evaluation

There were a number of things that performed well in this case. Among the good aspects was the ability to detect deterioration in the patient (evidence of changes in breathing, oxygen levels, and confusion) early. This demonstrated that I was a good listener and capable of implementing my clinical knowledge in practice. My communication was also another good thing. I ensured that I informed the registered nurse about my issues despite the hectic nature of the ward and then reiterated my message more effectively when the condition of the patient deteriorated. This contributed towards making sure that the gravity of the situation was realised.

Another strength in this case was teamwork. I was under the supervision of the healthcare assistant and under the guidelines of the registered nurse. The team reacted fast when the nurse became available, and relevant measures were implemented. The team's assistance allowed coping with the situation and provided the patient with timely attention.

Nevertheless, certain difficulties were also present. Delay in immediate response because of the busy ward was one of the issues. This posed a certain danger to the patient and gave me more anxiety. Secondly, my initial communication might not have been assertive, as the urgency of the situation was not identified initially. This implies that there are areas in which I can work on my communication skills under stressful circumstances.

On the whole, in spite of the fact that the patient outcome was positive, this experience taught the lesson that in a busy clinical environment, effective prioritisation and unambiguous, confident communication should be considered important. It further demonstrated that I can work on improving my escalation of concerns.

Analysis

This part is a critical analysis of the clinical scenario concerning emotional intelligence, resilience, leadership, management, and communication within a healthcare team. The debate will use the applicable theories to enhance the understanding of the steps taken, as well as seek ways to improve them.

The factor of emotional intelligence was significant in this case. Emotional intelligence means the capacity to identify, comprehend and control personal emotions and feelings and those of others. Goleman (1995) has described emotional intelligence as self-awareness, self-regulation, motivation, empathy and social skills. The student nurse in this case showed self-awareness because he realised emotions of anxiety and concern as the condition of the patient became weaker. These emotions notwithstanding, the student could go ahead and carry out clinical tasks, which is an expression of self-regulation. This is pertinent in nursing practice because emotional control works in patient safety when the situation becomes stressful.

Nonetheless, the scenario also revealed that emotional intelligence could be improved. As an example, hesitation in the communication could have been caused by a lack of confidence. This implies that although the student was conscious of what was going on, emotional restraint and confidence would have enhanced the response. Studies indicate that emotional intelligence is helpful in making decisions and communicating at a higher level within clinical settings. Hence, it is vital to acquire emotional intelligence in order to perform successfully as a nurse.

Another concept that can be used in this case is resilience. Resilience is the capacity to manage stress, pressure and difficult situations. The nursing environment is usually quite hectic and unpredictable, and one has to be calm and focused. In this case, the student nurse was resilient since she monitored the patient and made additional steps even when she was experiencing stress and uncertainty. Re-evaluation and re-escalation of the patient are other signs of persistence that form a significant component of resilience.

However, resilience does not only relate to coping but also to experience learning. The pressured situation in the incident makes it clear that it is essential to acquire more effective coping skills. As an example, one can discuss the assistance of colleagues, reflective practice, and continuous learning as methods that would increase resilience over time. This implies that resilience must be in a continuous development process to facilitate personal well-being as well as performance at the workplace.

This analysis is also focused on leadership and management. Nurse leadership is the act of influencing others, decision-making, as well as assuring safe patient care. In the case scenario, the registered nurse showed an aspect of clinical leadership in the evaluation of the patient, decision-making, and team delegation. The student nurse was also demonstrating initiatives in leadership behaviours as she identified that a patient was getting worse and took a step to communicate the issue.

Theoretically, the current situation can be associated with the situational leadership theory, which says that the style of leadership has to vary according to the situation. After realising the state of the patient, the registered nurse changed his or her approach and became more directive because of the urgency of the situation. This was befitting, since fast decisions had to be made. Nevertheless, the first delay in response suggests that there might be a problem of prioritisation within a congested setting.

Moreover, the role of the student nurse emphasises the role of followership in leadership. A successful healthcare needs both good leaders and team members who are capable of making decisions by themselves. The student was able to show this by re-examining the patient and raising concerns once more. This indicates that the senior staff are not the only ones who can demonstrate leadership, but any level can exhibit leadership.

One of the most important aspects in this case is communication. Healthcare communication is important because it leads to the exchange of information in a clear and accurate manner that eliminates the chances of making mistakes. The student nurse in this case reported to the registered nurse about the concerns, but the preliminary communication might not have been good enough to bring out the urgency. This is an indication of the significance of assertive communication in clinical practice.

It is possible to analyse the situation through the use of the SBAR (Situation, Background, Assessment, Recommendation) communication tool that is prevalent in healthcare. SBAR assists in organising the communication in a meaningful and concise manner. In case the student had adopted a more organised method, such as SBAR, the message might have been clearer and more urgent. This implies that patients' understanding of a team can be improved through the use of the communication tools.

In this case, no conflict was actually present; however, there was a challenge that involved workload and late response. This may be regarded as system pressure that may influence communication and decision-making. Priorities in a busy environment are not necessarily very effective when it comes to the important information being prioritised. This indicates the necessity of high communication competence and boldness to bring up issues when required.

Another aspect that is relevant is delegation. The registered nurse assigned tasks properly, including requesting the student to pay attention to the patient and collect equipment. Efficient delegation will make sure that tasks are done in an efficient manner without compromising the safety of the patients. Delegation in this instance was in support of teamwork and enabled the nurse to be able to handle various tasks. It is also worth noting, though, that the tasks delegated must also be supported by clear instructions and supervision.

All in all, this discussion reveals that the case was a mix of emotional, leadership, and communication. Although the patient also walked away with a positive outcome, there were places that could have been developed, especially in the assertive communication and confidence in escalating the concerns. The application of theory can aid in gaining a better understanding of the situation and create a basis on which future practice can be improved.

Conclusion

To summarise, this experience has enabled me to have a more profound comprehension of the role of leadership and communication in nursing practice. I was taught that one of the most important responsibilities is to realise patient deterioration early, but communication must be clear and confident in order to take measures in time. This experience demonstrated to me that despite my feelings of uncertainty or anxiety, I still have a role to play in raising a voice to promote patient safety.

I also got to know that emotional intelligence is significant in dealing with stressful situations. Knowing my emotions and remaining calm allowed me to continue being helpful to the patient and the team. Nevertheless, I realise that I should work on my confidence and become more resolute when raising urgent issues.

Teamwork and leadership are other aspects that I have learnt through this experience. I also realised that leadership does not just involve senior positions, but it is also about taking charge and being responsible as a member of a team. Collaborating with other people and acting as guided served to produce a positive effect on the patient.

I will strive to enhance my communication abilities in urgent scenarios, in particular, in the future, and improve my belief in clinical tasks. In general, this reflection has assisted my personal and professional growth and will make me a better and more responsible nurse.

Action Plan

After this experience, I have found aspects that I should improve on during clinical practice in terms of my communication and confidence. I understand that I will be more assertive in the process of escalating patient concerns, particularly urgent cases. I will also train my communication skills to do this by practising formal communication tools like SBAR in my placements. I will also discuss with the registered nurses how I articulate clinical information to enhance my clarity and confidence.

Moreover, I will also strive to become more emotionally intelligent and capable of controlling stress. I will achieve this through frequent reflection following clinical shifts and finding out the way I reacted to various situations. It will make me more conscious of my feelings and develop better emotions to remain calm under pressure.

In order to facilitate my professional growth, I will have certain SMART goals that are present in the appendix. These objectives will be geared towards enhancing my communication, confidence and decision making within a set period. Attaining these objectives will help me be a better and more assured nurse in practice in the future.

Appendix: SMART Goals 

SMART Goal 1: Improve Assertive Communication in Clinical Practice

• Specific: I will enhance my skills of articulating patient issues using the SBAR (Situation, Background, Assessment, Recommendation) tool in a clear and commanding way during clinical placements.
• Measurable: I will apply SBAR in no less than 3 clinical cases in a week and ask a registered nurse to comment on my communication.
• Achievable: I will use SBAR in simulations, train with more experienced nurses, and use it in the real clinical setting.
• Relevant: This will enable me to be effective in the escalation of patient concerns and enhance patient safety.
• Time-bound: I will have accomplished this in the next 6 weeks of my clinical placement.

SMART Goal 2: Develop Emotional Intelligence and Confidence Under Pressure

• Specific: I am going to become more emotionally aware and confident in dealing with stressful clinical situations.
• Measurable: I will write a minimum of one reflective log per week that will be dedicated to my emotional reactions and the way I handled them.
• Achievable: I will apply such models of reflection as Gibbs Reflective Cycle and will involve mentors to help me in learning.
• Relevant: This will enable me to remain calm, make more effective decisions, and communicate effectively under high-pressure situations.
• Time-bound: I will persist with this throughout the next 8 weeks.

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