Critically analyse your leadership role and your management role in relation to an aspect of your practice. Word limit 1200.
This essay will explore an aspect of my practice, which I will reflect on my leadership and management role undertaken in an aspect of care. Rowe (2019a) defines leadership as striving to motivate and inspire staff to achieve shared goals. However, management entails planning and organising resources and staff to reach agreed organisational goals (Rowe, 2019b). The aspect of care I have chosen, will focus on managing a patient with a learning disability, who had severe decreased nutritional intake while as an inpatient on an acute mental health ward. I have anonymised the patient, whom I will refer to as ‘John’, following the Nursing and Midwifery Council (NMC, 2018) guidelines on confidentiality. Then I will critical analyse how I applied leadership and management skills to the situation, using Borton’s (1970) reflection model.
The Healthcare Leadership Model (2013) is valuable in healthcare to understand how leadership behaviours affect the working environment. I will explore how my behaviour in this scenario is structured within the HLM (2013) leadership dimensions. An element of the HLM (2013) within my scenario was ‘inspiring shared purpose’, which is key to improving services, by inspiring individuals with a shared vision. My scenario while communicating with John, I discovered he felt uncomfortable eating with other patients he did not know, unlike when he was at home with family. By listening carefully to John, I had the confidence to explore where John could eat confidently, within the ward. Health and Social Care (2019) notes, by listening carefully gives understanding and what action is required to care and support patients and ourselves. I shared and discussed examples of how to manage John’s embarrassment eating within the ward. In doing so, I was actively seeking to improve services, by looking at alternative ways to overcome John’s decreased appetite and engaging with colleagues to deliver a shared purpose. Although this was difficult to establish initially, from differing understandings and priorities within the ward, I was able to share my experience working within learning disability to achieve the set goals. This would indicate that I am predominately ’strong’ under the element of ‘inspiring shared purpose’. To enable myself to achieve a higher level of the scale, I need to have the courage to challenge and take responsibility, to create and improve care and services. On reflection, I was nervous approaching the team with these suggestions, which I could have easily kept to myself. Another dimension of the HLM (2013) that was pertinent was ‘engaging the team’. This fosters teamwork by respecting their ideas and contributions (HLM, 2013). With regards to the scenario, I was advocating examples to encourage John to increase his nutritional intake. I involved the team in discussions and shared ideas, while I valued their knowledge to identify any problems, to continually improve outcomes. Health and Social Care (2017) commits to working together, share learning and to problem solve to deliver world class care. In doing so, I was involving and respecting individuals’ contributions, where my colleagues were compassionate and committed to delivering care. This would suggest I am predominately ‘proficient’ within ‘engaging the team’ dimension. To achieve a higher level, I need to encourage and support the team to use their skills and share their pressures when services are challenged. I will continually strive to be an effective leader, as Goleman et al (2001) cited in Rowe (2019c, p20) notes, this requires a combination of emotional intelligence skills to achieve this preferred outcome. After completing Activity 1.7 ‘Emotional intelligence’ (Rowe, 2019d) and discussing the outcome with a colleague, preparing to be a leader is a continual learning process, while acknowledging my abilities and managing my emotions to improve my performance and that of my colleagues. However, Rowe (2019e) suggests emotions can have a negative impact on effective practice.
I will now explore my management role that occurred during my scenario and how clinical governance is associated within healthcare practice. Clinical governance is a framework used within healthcare organisations to continually improve services, creating excellence in delivery of care and being accountable to patients (Scally and Donaldson, 1998, p.61 cited in Rowe, 2019b). A few elements of clinical governance that was prominent within my scenario was ‘patient involvement’ and ‘staffing and staff management’. For example, I ensured I effectively communicated with John, discussing his needs and views to gain a better understanding of how to overcome his anxieties. I involved John throughout the entire process of locating a suitable area to dine in, working in partnership with him and putting his interests first (NMC, 2018). Though I was surprised about his anxieties of eating in unfamiliar surroundings, since he was medically reviewed for possible physical symptoms. I was able to identify the importance of gaining views from patients and involving them in the processes, thus ensuring person centred care – the core of nursing care. To improve services, I would consider liaising with other patients and services for feedback and monitoring the treatment outcomes, which is central to Quality Improvement (Quality 2020, 2019). Another aspect of clinical governance was ‘staffing and staff management’, where I actively discussed with team members John’s needs and plan of care. I encouraged sharing ideas and alternatives, however I experienced some difficulty from colleagues’ perspectives, of where John could have his designated dining area. I sought advice from various Trust departments on area suitability within the ward setting. Enabling John to dine was a matter of urgency, to encourage his nutrition intake. This enabled me to provide the team with relevant information, which was vital to have an efficient and supported team. I felt it necessary to seek advice to avoid conflict and any misunderstandings, by being accountable for my decisions and equipped with the relevant information. Rowe (2019f) suggests respecting and good communication between individuals, promotes a professional image and a healthy culture. Although I was supported with implementing alternative practices to benefit John, however I may have been perceived as being too persuasive. Rowe (2019g) indicates being a persuasive manager seeks to influence others to make the right decision. To develop my management skills, I need to gain more experience working within ward settings and recognising when to ask for support. This will enhance my confidence and build trust between team members. Which is key for managers, creating trust and empowering staff to achieve high quality care (Mullarkey et al. 2011 cited in Rowe, 2019h).
The aspect of care I critically analysed, focused on John overcoming his anxieties and supporting him to increase his appetite within the ward setting. My leadership styles of ‘inspiring shared purpose’ and ‘engaging the team’, based upon the HLM (2013) was beneficial because it showed how teamworking is effective, allowing sharing of ideas and overcoming challenges to achieve the desired goal. Also, the importance of being self-aware allowed me to identify my strengths and areas I also need to develop. Whereas my management style was helpful with patient involvement and with staff, because this enabled my accountability. Also ensuring safety and quality of care for my own practice and ensuring the team was prepared and supported to deliver the agreed care. This has equipped me to explore the impact of clinical governance and how culture shapes behaviours and values within organisations. Self-awareness is essential to understanding my own leadership and management styles and committing to lifelong learning. This is pivotal to continually striving to improve patient outcomes, which ultimately delivers high quality and person-centred care.
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