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Leadership and management are vital in nursing and have a major influence in the clinical environment. Discuss.

Leadership and management are vital in nursing and have a major influence in the clinical environment. Discuss.

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An essay for the 2011 Undergraduate Awards Competition by Ruth Phillips. Originally submitted for Management and Health Policy at Trinity College, Dublin, with lecturer Margaret Mc Adam in the category of Nursing & Midwifery
An essay for the 2011 Undergraduate Awards Competition by Ruth Phillips. Originally submitted for Management and Health Policy at Trinity College, Dublin, with lecturer Margaret Mc Adam in the category of Nursing & Midwifery

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Published by: Undergraduate Awards on Aug 29, 2012
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10/27/2013

 
Question 2: Leadership and management are vital in nursing andhave a major influence in the clinical environment. Discuss. A leaderis anyone who uses interpersonal skills to influence others toaccomplish a specific goal ( Sullivan, E J, Decker, P J;2009). An effective leader is one who is successful in attempts to influenceothers to work together ( Tappen, R, 2000).The relationship betweenleadership and management continues to prompt some debate,although the literature demonstrates the need for both (Trent, 2003).It is considered vital that all good managers are also good leaders and visa versa. However, one may be a good manager of resources and not be much of a leader of people. Likewise, a person who is a good leaderand has good social skills may not manage organisation well. Theideal is to strike a balance between the two. The process omanagement is said to involve 5 phases ( Marquis and Huston, 2006).The first phase is the planning of goals, formulating policies andsetting objectives. The second phase involves organisation. The 3
rd
component involves managing staffing levels including recruitment,interviewing, developing staff and forming a team. The fourthcomponent involves directing which encompasses human relationissues, dealing with possible conflicts in the work environment anddelegating duties and responsibilities. The last phase is controlling.This involves addressing legal and ethical issues, estimating andreviewing the budget and assessing staff progress in their quality of professionalism. To be a successful manager or leader there are many facets to the profession that must be acknowledged.One of the most important tasks of a manger is to encourage andimplement team building among staff. “Kramer and Schmalenberg(2004) state that educational support is essential for creating amagnetic work environment“. “The leadermanager has aresponsibility for maintaining a competent staff, but thisresponsibility is shared with other members of the organization( Marquis and Huston, 2006).Managers have a greaterresponsibility for seeing that staff is properly trained . Huszczo, G.(2004) describes seven steps in team formation that the nursemanager must under take to ensure effective team building. Thesesteps are to develop clear goals within the team, to identify andrecognise talents of individuals and encourage the utilisation of thesetalents. Defining roles and responsibilities amongst the stafstrengthens the team and gives direction in addition to evaluatingstrengths. Planning and gaining a consensus amongst all for proposedmeetings and the implementing of things is also a required task of themanager. Developing positive interpersonal communications andrelationships and encouraging open communication is a vital task of the manager. Recognising and praising efforts by an individualshould come naturally to a good nurse manager. Building ties with
 
other members of the multidisciplinary team and recognising theircontribution of work is the final step in building a successful team.Methods of team building on the mangers part can involve arrangingsocial events outside the work environment in addition to educationalevents in a neutral location.Conflicts within a team are inevitable and even necessary sometimes.“As a general rule conflict is neither to be avoided nor stimulated, butmanaged (Tappen R, 2000).“Health care organisations areparticularly vulnerable to conflict as the context and nature of healthcare professionals’ work may be difficult and stressful ( Hipwell etal,1989). “Too many conflicts can reduce the effectiveness of theteams work but suppressed conflict can and will eventually surfaceand cause more issues. There can be occasions when the leader orClinical nurse managers authority is challenged by their ownsubordinates. When these situations are severe and persistent,conflict may emerge leading to inadequate health care delivery. According to Forte (1997), such a conflict among health careprofessionals has an influence on patients. Therefore, to learn tomanage and resolve conflict in the most effective way should be apriority amongst all members of the multidisciplinary team. This is aresponsibility of the manager to initiate. The five commonapproaches or strategies to contribute to conflict resolution have been identified as competition, avoidance, accommodation,compromise and collaboration (Rahim&Magner,1995). an efficientmanager should work to resolve intrapersonal conflict and they should addresses conflicts appropriately as soon as it is perceived toprevent manifestation. The manager should attempt to seek asolution that acceptable to both parties whenever feasible. A managershould also attempt to lessen the gap of understanding between bothof the concerned parties and to widen their view of each othersopinions. In addition to this they can Advise staff members onmethods of conflict resolution to empower them to resolve conflicts inthe future. There are methods a manager can adopt in an effort toprevent friction and disquiet amongst the staff. Creating a worenvironment that does not aggravate staff is a good starting point. Themanager should facilitate a private meeting with any member of staff if it is requested of them. In the case that initial attempts to resolve aconflict fail the manager should seek an alternative resolution to thedispute A vital component of a mangers job requirement is to delegate.“Delegation is both an art and a science. It includes cognitive,affective and intuitive dimensions ( Barter, M 2006)”. At its most basic, delegation is empowering one person to act for another.(Susanne A. Quallich ,2005). Delegation is the transferring of responsibility to complete a task from one person to another. In
 
relation to delegation managers and leaders should be a role model.They should seek to use time effectively and to delegate tasks withinthe scope of practice of whomever the task is being assigned to. They should review and reward a task that is completed correctly andensure staff safety at all times. Delegation is an essential element of the directing phase of the management process(Marquis&Huston,2006). Delegation is a necessity as often there is too high a workloadfor the manager to complete alone meaning they are required totransfer and spread the workload amongst their colleagues in orderto maintain the best quality of care for patients. The manger has tomake the decision as to who is best suited to complete the task according to their level of experience. Tasks are delegated with thepatients safety, condition and the complexity of the task involved being the first points of consideration. The nurse manager needs toensure that all adequate educational programmes are available forother members of staff who may require the need to delegate tasks toothers. In delegating a task the delegatee should ensure that they communicate clearly and assertively the task that is required.Situations that are appropriate for delegation should be obvious to allmembers of staff. Individuals should remain within their scope of practice at all times. Management should be knowledgeable regardinglegal liabilities of subordinate supervision. Provides recognition orreward for the completion of delegated tasksChange is the process of making something different from what it was(Sullivan and Decker, 2005). That the manager’s role in leadingchange is crucial seems widely accepted among scholars andpractitioners in the field ( Higgs, 2002).Many forces are drivingchange in contemporary health care, including rising health carecosts, workforce shortages, increasing technology, and a growingelderly population. Change can be planned, unplanned, sudden, slow,evolving and can occur after people slowly consenting with it. One key role, then, of health care leaders today is “facilitating changes in the workplace to continually improve care and meet fiscal realities”(Cummings & McLennan, 2005). Initiating and co-ordinating changein a successful manner requires considerable leadership andmanagement skills in the person who is attempting to implement sucha change. The Rogers Diffusion Model (1998) is a successfulframework to observe in relation to change. It highlights knowledge,persuasion, decision, implementation and confirmation as thenecessary ingredients to promote an idea of change. A managershould view change as an opportunity or challenge rather than athreat. Any changes should be implemented only to achievesomething positive. The role of the manger in identify areas that needaltering is paramount. They should also facilitate other staff membersinput in planned change and provides them with adequate

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