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This essay will focus on the leadership-related issue that took place in a healthcare facility where I worked as a healthcare assistant during my clinical placement. The incident occurred during childbirth by a 42-year old pregnant woman, who has a medical history of chronic obesity and diabetes. The healthcare assistants have the responsibility of protecting the confidentiality of patients receiving care under them. This is in accordance with the Data Protection Act (2018). Hence, the names of the patient, members of the healthcare team and healthcare facility will be omitted in order to adhere to the confidentiality required in the nursing profession. This is a problem as you are not a nurse.The situation occurred in a child delivery room for pregnant women who were placed under bed rest and were receiving treatment and care for various forms of pregnancy complications. An incident occurred during labour and delivery of the pregnant woman, who has a medical history of chronic obesity and diabetes with resultant high blood pressure. The patient had undergone previous cesarean delivery twice and is of an older age (42-year old) which prompted the doctor to recommend bed rest, avoiding intercourse, avoiding pelvic examinations, limiting travel and cesarean delivery. During the start of the shift on that fateful day, the nurse manager (leader) delegated explicit roles to the healthcare team which was made up of permanent nursing staff, two healthcare assistants, assistant practitioner and four trainee nursing associates. One of the new healthcare assistants, who was in charge of routine blood pressure check as well as administering of the prescribed medication for the care of the patient’s high blood pressure forgot to do so. This is usually the case with new healthcare assistants because they are yet to get acquainted with their new roles routine. In the course of the routine check by the assistant practitioner, it was discovered that the patient was running temperature with raised blood pressure. Further investigation revealed that the patient was bleeding and the fetal heart reading was abnormal. The situation was however well managed by the timely intervention of the nurse leader, who requested the assistance of the response team (nurses, healthcare assistants, assistant practitioners, doctors and surgeons) for immediate cesarean delivery to save the life of mother and child.A leader is a person who has the capacity to influence others to accomplish more than is ordinarily expected of them (Northouse, 2016). To achieve effective healthcare delivery, the nurse leader has an ethical duty to attend to the needs and concerns of followers. Moreover, the healthcare leader is saddled with the responsibility of the effective organization of the day to day health and social care of patients which entail managing resources, decision-making skills, supporting the development of colleagues, managing and leading change (Yukl, 2013). In other words, the nurse leader must have the requisite leadership skills to be able to manage the day to day challenges facing the health and social care professionals in order to promote efficient healthcare delivery to patients. Yurl (2013) asserted that researchers usually define leadership with respect to their individual views as well as the areas of the leadership phenomenon that is of most importance to them.Effective leadership is a vital component of health care systems aimed at improving organizational effectiveness and efficiency by overcoming day to day challenges encountered in the health care systems (Ghiasipour et al., 2017). Irrespective of the prevalent acknowledgement of the importance of effective clinical leadership to patient outcomes, there are several hindrances to achieving effective clinical leadership. Daly et al. (2014) identified the following as the hindrances to effective clinical leadership: poor communication; clinician cynicism; lack of incentives; lack of confidence; poor preparation for leadership roles, deficiencies in the curriculum of medicine and health professional courses, lack of vision and commitment at the higher levels; wrong perceptions of leadership; poor interdisciplinary relationships; resistance to change; conflict of clinical role; poor teamwork; and inadequate resourcing of development. These hindrances must be addressed to enhance the quality of clinical leadership in a health care facility. As long as there is an increasing emphasis on hospital performance, there will be increasing demand for leadership to increase efficiencies and improve the quality of health care delivery (Daly et al., 2014). In other words, effective clinical leadership that ensures the effective integration of the various components of the health care system is associated with optimal hospital performance. Daly et al. (2014) identified leadership as co-produced where all staff have the responsibility to lead interdependently in interaction with others in order to be able to influence others, display inter-personal skills and show ability to lead a health care team; leadership as collective where all staff sees each other as complementarity co-leaders to ensure they enable each other to act advocacy skills, be approachable, works well in team, and become effective communicator of care; leadership as boundary spanning where all staff against all bureaucratic and interdisciplinary boundaries have the ability to work across teams that links across point-of-care microsystems; and leadership as exchange relationships that provide support, motivates, empowers others and role models inspiring a shared vision. However, the issue of the disconnect between the managers and clinicians on who is best positioned to lead health care service delivery is yet to be resolved.Person theory unlike other theories of leadership focuses on the traits, attributes, qualities and characteristics of a great leader. Anonson et al. (2014) identified some common characteristics of good nurse leaders to include a sense of optimism; excellent role modelling and mentorship; a passion for nursing; the ability to manage crisis; and the ability to form personal connections with their staff while guided by a set of moral principles. One of the most important characteristics of exemplary nurse leaders is the ability to manage a crisis without compromising a set of moral principles. Ability to manage the crisis by the nurse managers (leaders) is born out of knowledge and expertise in the field of healthcare. A nurse manager must strive to gain information from all angles to be knowledgeable and have the capacity to make informed decisions in a time of crisis as seen in the scenario portrayed in the essay. In relation to the scenario used in this essay, the nurse manager possesses a good decision-making skill which was shown in the ability to make a decision quickly and very efficiently that resulted in saving the child and the mother. However, her style of leadership which is transactional leadership lacks the power to help the new healthcare assistant remember her new role, unlike the transformational leadership style that is capable of motivating and supporting the new healthcare assistant as well as preventing human fallibility. Another major characteristic of an exemplary nurse leader is the ability to form personal connections with nurses. Nurse leaders are people who could connect with their staff and communication skills are key to achieving unity and facilitating strong team ethic in nursing practice. A nurse leader must be patient and have tolerance for the imperfections of nurses under her supervision. This was observed in the way the nurse manager manage the failure of one of the healthcare assistants, who forgot to carry-out routine blood pressure check and to administer the prescribed medication for the care of the patient’s high blood pressure. The nurse leader was able to accept human fallibility exhibited by the trainee nursing associated and quickly took a timely decision on how to remedy the situation which resulted in saving the lives of the pregnant mother and child. A good nurse leader must not trade blames in time of crisis to prevent having casualties as a result of human errors and mistakes. Anonson et al. (2014) demonstrated that nurse leaders’ personal connections with their nursing staff have the potential of creating the feelings of care and respect in the nurses. The nurse manager has the responsibility of ensuring teamwork among nurses and other health care professionals. In the case scenario used for this essay, the nurse leader manages the crisis created by the trainee nursing associate by seeking for the assistance of the response team which was made up of nurses, doctors and surgeons for immediate cesarean delivery to save the life of mother and child. It is important to note that nursing leaders can have a positive impact on other nurses by possessing the characteristics of an exemplary nurse leader. There is therefore a need for the nurse manager to learn more about contemporary leadership models, such as transformational leadership aimed at increasing motivation for all workers and improving collaborative partnerships among all the healthcare professional team (Tuyinshime et al., 2017) just like the exemplary leadership exhibited by the nurse manager in the scenario used for this essay.Another leadership theory that is related to the scenario used in this essay is the action-centred theory. The action-centred theory focuses on the impacts of the involvement of a team of people and the nature of the task on how leadership is practised (Goodman, 2019). This means that action centred theory is based on leadership originating from three elements which include the team, the task and the person. It deals with the importance of both follower and leadership behaviour for the effective functioning of the team. Although tasks were assigned to the members of the team as observed in the scenario used in the essay, leadership must be exercised in such a way to get the job done especially when the team have many new members like the case with the new trainee nursing associate, who was unable to carry out the assigned duties. The action centred theory of leadership provides the new healthcare assistants with an alternative working solution for preventing human fallibility. Using this theory, the person would have to consider the nature of the task, and the team they work with and come up with a better and more flexible way of working that fits the situation. This could involve the setting of alarms or use of tag reminders by the trainee nursing associate to solve the problem of human forgetfulness and fallibility.The evolving leadership approaches of the 21st century include authentic leadership, spiritual leadership, servant leadership and adaptive leadership (Northouse, 2016). The contemporary theory of leadership is made up of a combination of transformational, transactional, system, and servant leadership (Gopee and Galloway, 2017). Transformational Leadership is similar to relational (person – oriented) leadership because it focuses on the interpersonal relationships between team members and the nurse leader (Goodman, 2019; Keane, 2017). A transformational leader inspires team members to achieve a common purpose whereas transactional leader causes a follower to act in a certain way in return for something the follower wants to have (Goodman, 2019). The transformational leaders play a vital role in understanding and managing complexities in any organization since health care organizations are faced with daily challenges to change, revise, and adapt to new ideas and strategies to promotes health care outcomes and ensures cost savings (McCaffrey and Reinoso, 2016; Saravo et al., 2017). These unending changes in the health care system and their associated challenges have prompted the need for strong and effective leadership aimed at ensuring efficient health care delivery (Anonson et al., 2014). Silva et al. (2017) argued that nursing managers that offer support and communication by means of transformational leadership impact positively to the participation in the work of the team by healthcare professionals as well as improve the organizational outcomes of the health care delivery facility. Other types of leadership styles include relational leadership styles and task-oriented leadership style, (McCay et al., 2018). For the purpose of this essay, emphasis will be placed on the transformational (person-oriented) leadership styles and task-oriented (transactional) leadership style since they are more relevant to the scenario. People-oriented leadership style focuses on organizing, supporting, and developing the team members. This style of leadership promotes good teamwork and ensures creative collaboration. Task-oriented leadership style, on the other hand, focuses on getting the job done. It involves the situation whereby a nurse manager defines and assigns the work and the roles to the team members, puts structures in place to facilitates planning, organizing, and monitoring of the work (Goodman, 2019). The nurse leader (manager) in the scenario used in this essay used task-oriented (transactional) leadership style and this was obvious in the way the manager delegated explicit roles to the healthcare nursing team without providing support for the members of the team which resulted in the crisis created by one of the new healthcare assistants. The use of the transactional style of leadership by the nurse manager has been the reason for the recurrence of this scenario whenever there are new healthcare assistants. A possible solution to preventing the nature of the crisis in the case scenario would be for the nurse manager to use people – oriented (transformational) style of leadership which will offer support for the new healthcare assistant as well as promotes teamwork and creative collaboration. McCay et al. (2018) established that task-oriented styles do not generally result in positive staff outcomes but may rather result in decreased satisfaction of the employee. Transformational (person – oriented) leadership traits have shown to have positive effects on job satisfaction and organizational commitment which result in efficient care delivery (Feather et al., 2015). Although, transformational style of leadership may be better than the transactional style of leadership, a combination of the two leadership styles will ensure a more effective care delivery.Nurse Managers (leader) should understand the impact of their leadership style on organizational commitment of team members and should make sure they give effective leadership that will result in efficient health care delivery. The nurse manager should practice collaborative leadership to make sure mutual respect between the different roles of the professionals that make up the multi-disciplinary team. Hence, the success of clinical leadership does not depend solely on the nurse leader, but also on the effective participation of the team members.Irrespective of the prevalent acknowledgement of the importance of effective clinical leadership to patient outcomes, there are several hindrances to achieving effective clinical leadership. These hindrances must be addressed to enhance the quality of clinical leadership in a care facility. As long as there is an increasing emphasis on hospital performance, there will be an increasing demand for leadership styles that will increase efficiencies and improve care delivery.

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