Contemporary Challenges In Care Delivery Facing Nursing Leadership

Major Issues Affecting Nursing Leadership

Leadership refers to encouraging, upholding a rewarding culture, being attentive, listening and inspiring others. Leadership in nursing focuses on the quality of care given to patients as well as feedback from patients. Nurse leaders should be customer oriented and role models to encourage a common vision within their staffs focusing on quality patient care as the main key. The purpose of this paper is to explain the impact of contemporary challenges experienced in nursing leadership. Firstly, the paper will explain issues experienced by nurse leaders in their duty of patient care. Secondly, the paper will outline option for addressing the problems from a system perspective and their effects on patient care. Thirdly, the paper will discuss qualities and traits of a nurse leader. Finally, there will be a discussion on the impact of not successfully resolving the issue in future health care delivery.

There are five major issues affecting nurse leader. This includes giving direct honest feedback, peer today boss tomorrow, influencing others especially those that do not report to them directly, dealing with difficult people and providing delegation to their team (Wong, Cummings & Ducharme, 2013).

1. Giving direct feedback. Majority of nurses fear to hurt other people´s feelings especially to the patients or reports from other nurses who report to them. The main cause for this challenge is nurses training focuses on clinical care to patients but there is a gap in addressing feedback delivery by the nurse leader. Incorrect feedback delivered by nurse leaders can lead to wrong assumptions on issues affecting patients and care delivery system and approach. This can affect the quality of care given to patients due to wrong interventions because of wrong information delivered by a nurse leader. Wrong or lack of feedback may affect proper planning and health decision on approaches that are working in healthcare delivery including those approaches that need adjustments for effective healthcare delivery to the patients  (Saleh, Mahran & Taher, 2017).
2. Peer today boss tomorrow. Majority of nurse leaders today lead teams that they were peers with. Within the team they lead,  there are other nurses who are older to them or more experienced than them. This problem gives a nursing leader difficulty in giving directions to a team consisting of experienced nurses, some older to them and others whom they were a peer with. The cause of this challenge is that nurses are not trained about leadership before they are promoted to a leadership role within healthcare organizations. The impact of this issue is associated with the lack of individual responsibility in handling duties they are assigned to which may affect commitment to provide quality care to patients. Different staffs within the healthcare facility report to a nurse leader. Lack of proper coordination among departments and staffs in terms of directives may affect the quality of care given to patients negatively (Tourigny, 2016).
3. Influencing others. Nurse leaders have a responsibility of influencing others in terms of behaviors change to make other nurses follow what they need to get done because they are reporting to them. Nurse leaders have to view decisions of other clinicians and nurses and ensure that all actions they undertake comply with ethics and set performance indicators for effective care delivery to patients. The major cause of this challenge is associated with lack of proper training by nurses on management and organization planning to ensure the team a nurse leader is dealing with is positively inspired. Leading a team that is not positively motivated may lead to demoralization accomplishing their duties leading to laziness in providing quality care to their patients with total commitment  (Dickson, Bliss & Bowers, 2015).
4. Dealing with difficult people. This is among the major challenges affecting nursing leadership. Nurse leader experience difficulties when giving directives or instructions to difficult persons within his or her team especially those who do not follow their duty instructions. Difficult people at work are associated with lateness in reporting on duty, absenteeism and incomplete duties. They affect the quality of care given to patients in terms of timely attention to patients concerns due to their lack of commitment to their work. Difficult people are likely to make patients feel their concern or conditions affecting their health are of less concern to their health professions (Yorke, 2017).
5. Delegation of duties to team members. Nurse leaders are used to being a high performer and doing care services to patients on their own. They understand how clinical or patient care work should be done which is an advantage to their position as leaders. The disadvantage is nurse leaders may find it challenging to delegate duties to people who interact directly with patients especially their peers, the experienced nurses or those nurses or clinicians who are older to them. They also fear to hurt other? feelings and also they may not be used to delegating duties. Lack of proper duty delegation can lead to negative patient satisfaction during evaluations indicating care given to patients is not enough (Firdaus, 2017).  

In order to ensure quality care is given by nurse leaders in our health facilities, stakeholders, health partners, and other organizations who support health should focus on training nursing leadership. The role of the nurse leader in healthcare delivery to patients should be given priority since they supervise, coordinate care provided by a healthcare team within a clinical setting through designing, implementation, and evaluation. Improved training on nurses before they are promoted to leadership roles can help improve care delivered to patients through effective management and coordination of patients, staffs and health departments. Stakeholders and other organizations can help improve on challenges faced by nurse leaders through evaluation of training provided to nurses and propose on training programs for nurses such as leadership roles other than clinical only. Addressing challenges affecting nurse leaders can help improve the quality of care given to patients which can similarly improve patient satisfaction rate (Mannix, Wilkes, & Daly, 2013).

A nurse leader needs to be a confident, self-motivated and an exemplary leader. A nurse leader should be able to direct and coordinate other nurses and clinicians including their peers and experienced nursing to effectively do their duties. This can be achieved through creation of awareness to other nurses about the work they are supposed to do through constant delivery of feedback on issues affecting care provided to patients. They should have confidence in delegating duties to other nurses and clinicians without looking at their experience or peer relationship. A competent nurse leader should also employ transformational leadership theory in influencing and inspiring other nurses and medical staffs who directly interact with patients. This can include behavior change education to make their services acceptable to patients (Mango, 2018). According to AONE Nurse Manager Competencies, nurse leaders are supposed to assess and evaluate care provided to patients and decide on changes to ensure quality care is provided to patients and services provided are acceptable and of satisfactory (Hutchinson & Jackson, 2013). 

Lack of resolving the issues affecting nursing leadership may affect the quality of care provided to patients as well as increased patient dissatisfaction from services received from medical care providers. The issues may also lead to uncoordinated duties and healthcare programs and decreased performance from healthcare workers. Nursing leadership issues may also increase the gap in identifying approaches and interventions of improving quality of care provided to the patients and improving patient satisfaction. This can easily be achieved through evaluation of services provided and assessing feedback from patients about the services they received from healthcare providers (Rashoud, 2017).

Conclusion

Contemporary issues affecting nursing leadership need to be solved for effective care delivery to patients. Nurse leaders neeed frequent trainings and education to add their knowledge on proper coordination of health services. Stakeholders support can help in addressing challenges experienced by nursing leadership hence helping in designing proper interventions to overcome challenges. Lastly, nurse leaders need to be supported to build their confidence and competence in leading other nurses and clinicians to ensure high-quality care is provided to patients.

References

Dickson, C., Bliss, J., & Bowers, B. (2015). Shaping future delivery of care: district nurses seizing the day!. British Journal Of Community Nursing, 20(6), 266-267. doi: 10.12968/bjcn.2015.20.6.266

Firdaus, M. (2017). Nursing-the Profession that Demands Attention. BAOJ Medical & Nursing, 3(1). doi: 10.24947/baojmn/3/1/137

Hutchinson, M., & Jackson, D. (2013). Transformational leadership in nursing: towards a more critical interpretation. Nursing inquiry, 20(1), 11-22.

Mango, E. (2018). Rethinking Leadership Theories. Open Journal Of Leadership, 07(01), 57-88. doi: 10.4236/ojl.2018.71005

Mannix, J., Wilkes, L., & Daly, J. (2013). Attributes of clinical leadership in contemporary nursing: an integrative review. Contemporary Nurse, 45(1), 10-21.

Rashoud, O. (2017). Challenges facing overseas nurses practicing. Primary Health Care Open Access, 07(03). doi: 10.4172/2167-1079-c1-010

Saleh, N., Mahran, G., & Taher, A. (2017). Challenges and work crisis facing critical care nurses. Nursing Journal, 14(3), 235. doi: 10.4103/enj.enj_27_17

Tourigny, L. (2016). Nursing and Patient Care. Journal Of Nursing & Patient Care, 01(01). doi: 10.4172/2573-4571.1000e101

Yorke, D. (2017). Patient care: what is it?. Journal Of Patient Care, 02(02). doi: 10.4172/2573-4598.1000e10

Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: a systematic review update. Journal of nursing management, 21(5), 709-724.