The workplace under the healthcare settings experiences a number of challenges. These challenges are mainly guided by the increase in the expectations of the service users, more focus over the patient centred care, reduction in the cost of care, reducing unwanted hospital admission and increase in the level of patient satisfaction (Stanley & Stanley, 2018). These challenges are mainly pronounced under hospital or the nursing home settings and are mostly experienced by the nursing professionals who spent majority of the time in ward, serving for the patients. Thus, proper management of the challenges experienced by the nursing professionals require optimal application of clinical leadership (Stanley & Stanley, 2018). The following paper aims to examine the importance of clinical leadership in nursing professionals for increasing the overall quality of care. In doing so, the paper will critically analyse 4 research papers published online which are based on the central theme of clinical leadership in nursing. This assignment will analyse the study conducted by Démeh and Rosengren (2015), Stanley (2014), Mannix, Wilkes and Daly (2013), Martin et al. (2012). The critical analysis will be based on leadership styles highlighted in the paper along with a focus on the limitations. At the end the paper will highlight possible recommendations for the further research in clinical leadership as stated by the authors of the four papers and how clinical leadership styles can be effectively implemented.
Démeh and Rosengren (2015) conducted a qualitative descriptive style study under the healthcare settings of Jordan with an aim to describe the experiences of the nursing students in the domain of clinical leadership during the final year of the undergraduate course. The data was collected in a written narrative format from 20 nursing students. The analysis of the content highlighted that clinical leadership model is a valuable tool for bridging the gap between practice and theory in the nursing education. Effective clinical leadership model helps in smooth transition of a nursing student to a qualified yet competent registered nurse who is capable to executing the duties under tight work pressure. The main limitation of the article is low sample size. Sample size below 100 restricts the generalizability of the data leading to the generation of biased results (Parahoo, 2014). From the overview of the paper, it can be gauged that the main leadership model highlighted is affiliative leadership. Affiliative leadership is helpful in the establishment of harmony and augment morale. This help to increase the interaction among the members (Pundt & Herrmann, 2015). This friendly leadership styles motivates the aspiring nurses to get accustomed with the work culture of the nursing professional through overcoming the hurdle of job stress. This approach is relevant in nursing profession as friendly leadership styles executed by the nursing mentor help the newly recruited nurse to get accustomed with the clinical proceedings. It also helps to manage job stress and workload (Chávez & Yoder, 2015). However, Démeh and Rosengren (2015) recommended proper focus over the views of the associated stakeholder will help to design the pillars of clinical leadership in a succinate manner.
Stanley (2014) conducted comparative study in order to compare and contrast results of two studies undertaken by the same researcher in order to study the important characteristics of clinical leadership in nursing. The two studies which were compared used almost identical questionnaire but the only different is the data of conduction of the two studies is 6 years apart. The main focus group of the study is the healthcare professionals. The findings of the study showed that though the difference is 6 years, the under clinical leadership in nursing leaders are followed as the role models and they are known for their values, clinical competency, communication skills inspiring confidence and integrity. The findings are relevant in nursing profession as because it upholds the concept of visionary leadership. Visionary leadership theory is somewhat identical to transformational leadership. The only difference is the leaders mainly look up to the prospect in the future. In order to make the future smooth, the leader inspires, train and motivates the team mates. This help to increase the level of positive energy and an optimistic attitude of visionary leader help the members to stay focused and hopeful (Van Knippenberg & Stam, 2014). According to Hall et al. (2016), a positive attitude in the work environment is effective in nursing professions as it helps the nurses to stay focused, overcoming the job stress and thereby helping to reduce the chances of medication errors. One of the limitations of the study conducted by Stanley (2014) is, it selected comparison of two studies conducted by same author and thus might include observational bias (Parahoo, 2014).
Mannix, Wilkes and Daly (2013) also conducted a study with an aim similar to Stanley (2014). However, the research approach used by Mannix, Wilkes and Daly (2013) was systematic review. The authors selected 10 research papers in their review in order to understand the important attributes defining the contemporary clinical leadership in nursing. The review highlighted that both practical and technical skills are important for effective clinical leadership in nursing. Apart from these skills, effective communications also holds importance in nursing leadership. It helps in the establishment of friendly relationship and this creates positive work environment. The review mainly highlighted the concept of clinical leadership in nursing as a positive leadership approach which helps to increase confidence and reduces stress. This approach of clinical leadership highlighted in the review is relevant in nursing research because it coincides with the transformational leadership theory. Transformational leadership style in nursing deals with the encouragement of the employees to deliver their best at work through motivating them with awards and recognition (Avolio & Yammarino, 2013). Dumdum, Lowe and Avolio (2013) stated that an effective transformational leaders help the nursing professionals to work in a positive environment and this helps the nursing professionals to overcome their professional stress. Though the importance of effective leadership in nursing is highlighted under the light of transformational leadership theory by Mannix, Wilkes and Daly (2013), the authors further recommended more research over the topic so that it becomes easier for the nursing professionals to quickly adopt this leadership approach. However, the study has one limitation, it reviewed only 10 articles, this might decrease the generalizability of the research.
The aim of the study conducted by Martin et al. (2012) was to evaluate the impact of clinical leadership program in establishing the competencies of leadership skills among the nursing leaders. The study approach was missed method analysis of quantitative data which were extracted from 420 participants with the use of 42-self assessment questionnaire. The overall study is based on the set up of health care domain of Switzerland. This can be considered as one of the limitations of the study is prevented from get more generalised data which can be applied across different healthcare sectors. This mixed method study mainly highlighted the transformational leadership model just like the study of Mannix, Wilkes and Daly (2013). Martin et al. (2012) highlighted that transformational leadership is crucial for delivering care for the nursing professionals working in the healthcare organisation. The analysis of the survey results highlighted that transformational leaders are inspiring and their inspiring vision help in the generation of positive work environment which promotes highest level of clinical interaction. Here comes the relevancy with the nursing leadership. According to O’hagan et al. (2014), effective clinical interaction both with the patients and with the healthcare providers helps to facilitate clinical interventions. Effective communication among the members of the same team helps in the upliftment of the idea of multidisciplinary team which will help to increase the overall outcome of the patients. In relation to transformation leadership, Dumdum, Lowe and Avolio (2013) stated that transformational leadership might hamper the discipline such that transactional leadership is important thus the nursing leadership styles must change as per situation giving hint towards the situational leadership. Effective transactional or situational leaderships also helps in reporting of the mistakes and thus helping to train the nursing professionals accordingly. While in the training process, transformational leadership needs to be followed (Dumdum, Lowe & Avolio, 2013).
Conclusion
Thus analysis of the four literary articles highlighted three main aspect of nursing leadership styles and this include transformational leadership, affiliative leadership and visionary. The critical analysis also highlighted transactional and situational leadership styles in order to maintain strict discipline within the ward. All the articles highlighted one common concept in the clinical leadership in nursing and this is effective leadership in the nursing professional helps in the promotion of positive work environment which helps to motivate the nursing professionals. Thus positive motivation helps to overcome the job stress, high workload and burn out and thereby helping to delivery best quality care. Moreover, analysis of the articles in clinical leadership in nursing also highlighted that effective nursing leaderships is important in order to reduce the chances of medications ward which mainly results from increase in work load. Thus of environment is positive, then the nursing professionals can work with motivation while effectively communication with the other professionals of the multidisciplinary team this further helps to improve the overall health outcome of the patients.
References
Avolio, B. J., & Yammarino, F. J. (Eds.). (2013). Introduction to, and overview of, transformational and charismatic leadership. In Transformational and Charismatic Leadership: The Road Ahead 10th Anniversary Edition (pp. xxvii-xxxiii). Emerald Group Publishing Limited.
Chávez, E. C., & Yoder, L. H. (2015, April). Staff nurse clinical leadership: A concept analysis. In Nursing forum (Vol. 50, No. 2, pp. 90-100).
Démeh, W., & Rosengren, K. (2015). The visualisation of clinical leadership in the content of nursing education—a qualitative study of nursing students’ experiences. Nurse education today, 35(7), 888-893.
Dumdum, U. R., Lowe, K. B., & Avolio, B. J. (2013). A meta-analysis of transformational and transactional leadership correlates of effectiveness and satisfaction: An update and extension. In Transformational and Charismatic Leadership: The Road Ahead 10th Anniversary Edition (pp. 39-70). Emerald Group Publishing Limited.
Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O’Connor, D. B. (2016). Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PloS one, 11(7), e0159015.
Mannix, J., Wilkes, L., & Daly, J. (2013). Attributes of clinical leadership in contemporary nursing: an integrative review. Contemporary Nurse, 45(1), 10-21.
Martin, J. S., McCormack, B., Fitzsimons, D., & Spirig, R. (2012). Evaluation of a clinical leadership programme for nurse leaders. Journal of Nursing Management, 20(1), 72-80.
O’hagan, S., Manias, E., Elder, C., Pill, J., Woodward?Kron, R., McNamara, T., … & McColl, G. (2014). What counts as effective communication in nursing? Evidence from nurse educators’ and clinicians’ feedback on nurse interactions with simulated patients. Journal of advanced nursing, 70(6), 1344-1355.
Parahoo, K. (2014). Nursing research: principles, process and issues. Macmillan International Higher Education.
Pundt, A., & Herrmann, F. (2015). Affiliative and aggressive humour in leadership and their relationship to leader–member exchange. Journal of Occupational and Organizational Psychology, 88(1), 108-125.
Stanley, D. (2014). Clinical leadership characteristics confirmed. Journal of Research in Nursing, 19(2), 118-128.
Stanley, D., & Stanley, K. (2018). Clinical leadership and nursing explored: A literature search. Journal of clinical nursing, 27(9-10), 1730-1743.
Van Knippenberg, D., & Stam, D. (2014). Visionary leadership. The Oxford handbook of leadership and organizations, 241-259.
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