This reflective essay will use a case study approach to critically evaluate leadership, management and collaborative interprofessional practice used in nursing ( 1.Harvis and Mayo, 2018). The scenario took place in an elderly ward where the nursing and medical team participated in seizure care (see Appendix). The contextual focus of this essay is on the nursing leadership and management style used. Firstly, defining and introducing the importance of leadership in healthcare, followed by analyzing effective leadership, some theories of leadership and styles. Furthermore, an evaluation of relational leadership in the role of ‘self’ discussing the roles of multi-professional team working, specifically the student nurse. Interprofessional collaboration benefits, challenges and different approaches will be critically reviewed. Finally, the conclusion will highlight main points of the essay. Complying with the Nursing and Midwifery Council (2. NMC) (2018) of maintaining confidentiality names of colleagues, hospital trusts, patient and family have not been mentioned but links will be made to the scenario and patient-centred care.
Definition of leadership.
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Leadership ………………………………The National Health Service (NHS) needs effective leadership and collaboration in today’s complex system, due to the challenges of improving patient care in climate of workload pressures and workforce shortages and high level of stress among staff (3. Ham, Berwick and Dixon, 2016). This is combined with ageing population, complex health issues and poor life style (4. Department of Health, 2008; NHS, 2014). Therefore, there is a greater need for efficiency to meet these demands and to sustain a comprehensive high-quality NHS (5. NHS, 2014). 6.Sullivan and Garland, (2013); 7.Field and Brown, (2016), adds other reasons such as social and cultural diversity; high expectations to provide quality patient-care; current state of public finances and new emerging roles call for effective leadership.
An effective leader will know what it is they want to achieve, communicate this to their followers, and effectively delegate tasks (8. Ellis and Bach, 2015). 9. Skinner (1965) behavioral theorist states that nobody is born a leader and leadership is learnt with time and grown into whereas Great Man theory by Carlyle (1840) believes been a leader is hereditary, certain people are born with leadership traits (Stodgill, 1948 cited in 10. Yoder-Wise 2011; 11. Hughes et al., 2014) the idea has been developed into the trait theory by Kirkpatrick and Locke (1991) where several traits of good leadership were identified and believe aids to achieve the skills required to become an effective leader but not sufficient enough on their own to ensure success. Some of these traits include knowledge of business, motivation, drive and self-confidence (12. Kirkpatrick and Locke, 1991).
This reflection highlights some of the leadership theories, used in nursing particularly the one I witnessed in the scenario. The ward manager in the scenario, leading the care, portrayed some of these traits like motivation and drive, easily taking on her role as a leader and delegating effectively, showing her confidence and knowledge of the organisation, she knew the strategic steps to follow and the seizure protocols. As a leader she applied staff competencies towards attainment of goals by her allocation of task (Sygue, 2006). However, although Kirkpatrick and Locke (1991) states that these traits are not enough for a successful leader, they do agree that they make the necessary actions for success more achievable, such as role modelling, creating a vision and goal planning. Therefore, this suggest that aspiring leaders who do not have these traits are at a significant disadvantage of leading successfully, contradicting the idea (point) raised by Ellis and Bach (2015) that anyone can be a good leader.
There are theories that look at types of leadership when reviewing effective leadership and some were applied in the scenario. The manager appeared to have adopted an autocratic leadership style since she was directive in her approach, delegated task accordingly and made swift decisions regarding patient’s care increasing productivity.
13. Seow (2013) states that in emergency circumstances, research shows that leadership requires quick analysis of complex situation and effective management of individuals and swift effective decision making, that requires experience and knowledge, which goes beyond basic skill (Seow, 2013). Which is similar to autocratic style of leadership, mostly suitable for emergency circumstances and ensure the best outcomes for patients (Seow, 2013; Sullivan and Garland, 2013 and 15.Sfantou et al., 2017). However, autocratic style requires the leader to possess power and authority to change the teams behaviour in achieving goal (14. Stetler et al., 2014). This comes with some challenges like lack of flexibility leading to hostile, unmotivated and uncommitted team in relation to the leader’s control and directness (Sullivan and Garland, 2013). It can be argued that the manger observed in the scenario which is an emergency management of seizure used the best and most effective leadership approach, to achieve goal, lead inexperienced staff well.
On the contrary, it would have been inappropriate for the manager to adopt a different style like laissez-faire, where the leader makes no decision or little direction is given, team makes their own decision with no supervision (Sfantou et al., 2017). Laissez-faire may be appropriate on a ward with a team of highly skilled and experienced professionals (Hughes et al., 2014but not with staff nurse, student and healthcare assistant in an emergencies situation (Hughes et al., 2014; Sfantou et al., 2017). This would have led to delay, an unsafe practice and impacted on patient’s health according to the Nursing and Midwifery Council (NMC) 2018).
A flexible leader sometimes applies situational leadership approach depending on the commitment and competence of staff (Hersey and Blanchard, 1988) This is the part where relational leadership is added.
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