Prepare a reprot on leadership role in health care services.
Health care system is a complex network of inter-connected system which encompass a large number of individuals both patients and healthcare professionals along with different organisations with different expertise. In order to function in a proper manner, in this interconnected system, the healthcare professions are required to understand the importance of working as a team under the guidance of a leader who deliver the best to the patients at the time of emergency. The following report aims to analyse the main role of nursing leader in the healthcare profession and how these roles are successful in bringing change in the quality of the cure plan while working in unison with different organisations and different group of professionals. The analysis of the leadership role will be based on the face to face interview conducted with leader of nursing department, director of nursing. The answers of the interview questions will be critically analysed under the light of the available yet relevant literary papers and subsequently a conclusion will be draw abased on the available literary evidence and the response of the interviewee.
According to the reports published by Gleeson (2018) effective leadership is a pillar of any organisations and not all the situations demands identical leadership styles. It is the duty of an effective leader to bring changes in his leadership styles based on the need of the surrounding environment and thereby helping team to perform better during stringent situations. Some of the unique leadership approach that has been described by Gleeson (2018) has been elaborated below in a tabular format.
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Leaders having faith on their own leadership styles |
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The ability of a leader to make hard choices during emergency situations |
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Knowing the team members from core |
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Giving proper recognition to the talents via recognising members of the team as a principal key towards success |
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Pushing the members of the team beyond their limit in order to achieve their best |
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Helping the team to serve for the better cost |
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Active help and support for the team members via providing proper education, motivation and delegation |
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Never leading the team via force while on contrary, leading the team via inspiring without intimidation |
Table: Traits of an effective leader
(Source: Gleeson 2018)
The organisation selected for the conducting the interview is the emergency department (ED) in one of the leading Australian health care organisations (hospital). The reason behind the selection of ED, there is always a high pressure environment in the ED (Flowerdew et al. 2012). The main reason highlighted behind this is high level of workload along with shortages of staffs along with a target for 4 hours (Flowerdew et al. 2012). According to the government of Australia, patients are required to be admitted or discharged from the ED within 4 hours of arrival (Sullivan et al. 2016). According to Flowerdew et al. (2012), this high work pressure is accompanied with lack of proper co-operation along with numerous conflicts which further contribute towards the escalating work pressure. This increase in work stress further leads to the development of the emotional exhaustion along with diminished personal accomplishments and these together cumulates into increase in compassion fatigue along with urn out (Gökçen et al., 2013). Rouleau et al. (2012) is of the opinion that increase in burnout along with decrease in job satisfaction creates an intention to quit the job and thereby causing high turnover rate. Thus tracking the leadership styles in ED department will be helpful in analyzing the process of improvement of quality care in Ed along with decrease rate of employee turnover.
A 30-minute face-to-face interview was conducted with the director of nursing who is the special in charge of the emergency department of the chosen hospital. The medium of the face-to-face interview was 10 open-ended questionnaires.
According to Jacob and Furgerson (2012), collection of consent is an important part before initiation of an interview. Thus following the guidance of Jacob and Furgerson (2012), a consent form was signed by the prospective interviewee, in the consent form, it was written that all his personal identification details like name, address will be kept confidential, moreover, the consent form also stated that he leave the interview at any point of time without any prior intimation. The detailed structure of the question was giver to the interviewee before the onset of the interview and he was allowed to study the question while getting notified about the cause of the interview. The interview time was selected as per the convenience of the interview so that his job duty does not get hampered (Jacob & Furgerson, 2012). Verbatim transcript was generated and the transcripts were then returned to the interviewee to clear up any transcript content related disagreement. This technique helped to increase the authenticity of the data (Czabanowska et al. 2014).
The main results and findings as decoded from the transcript of the interview have been highlighted below.
Definition of leadership: complex phenomenon
According to the interviewee, “leadership is a complex phenomenon which needs to be exercised in an evolving environment.” The main synopsis that emerged from the interview highlighted that leadership styles deals with the combination of interpersonal skills, communication skills, motivation, facilitation and empowerment of personal values, attitudes along with respect for the cultural diversity, responsibility, commitment, hard work, loyalty and strategic planning. The interview also reported that “in order to maximise the benefits of the healthcare organisations it is the duty of the leader to identify the windows of opportunity via recognising the gaps in the system along with talents among the team members who are capable of fulfilling the gap”.
Personal leadership styles: Situational leadership
According to the interviewee, “my personal leadership styles involve proper mentoring, situational teaching along with stimulation for training”. The main synopsis of the interview highlighted that situational leadership style is what the interview prefers to implement in the ED. Situational leadership style under high work pressure settings helps in the improvement of the relationship between the colleagues and thereby helping the employees to work together under optimal co-operation. Interviewee also opined that “Situational leadership style helps to improve the team cohesion especially during the night shift and thereby helping the team to cope up with the high demands under working in the ED”.
Factors influencing the leadership styles: Changing environment
According the interviewee, “The ED has ever changing environment filled with increase job stress, emotional burnout and compassion fatigue and these entire changing work situation helped in the generation of my leadership styles”. The main synopsis of the answers is, emergency department has diverse group of patients’ admission including critically ill patients, accident patients, paediatric patients, patients for maternity treatment and other palliative disease. Thus each patients demands a different set of care plan and a situational leadership styles designed with advertising breaks, practising back-up behaviour, maintaining calmness and motivation of staffs help to adjust the workforce to cope up with the changing climate and situational demands.
Public health leadership: culturally diverse
Under this context, the interviewee is of the opinion that, “there is a major shift in the workforce which generates diversity in the healthcare industry. In order to establish the public healthcare workforce, the public health leaders or the nursing leaders have to critically analyse the current health problems first and then modify their leadership styles accordingly”. The synopsis of the interview process highlighted that confronted with major shifts in the nature in the nature of the ill-health along with the growing diversity of the population in Australia (both Australian originals and aboriginals), the nursing leaders working for the betterment of the public health are required to streamline the decision making process in accordance with the increasingly complex and ever changing environment.
Leadership in public health sector and business sector: Ever changing goals in health care domain
Interviewee opined that, “there is a sharp difference between the public health leader and business health leaders”. The synopsis is, the senior leaders of the business industry have the luxury of the clear mission but the healthcare organisation have complex environment and thus the focus or the mission keeps changing with the scenario.
Critical strengths of a public health leader: autonomous decision making
According to the interviewee, “critical strength of a public health leader is to support the nurses towards the autonomous decision making along with greater access to work empowerment, opportunity and relevant information”. The synopsis can be highlighted autonomous decision making process help to undertaken prompt actions under the busy schedule and stringent deadline while making the nurses or the healthcare professionals staying responsible for the decision and thereby increasing the importance of any actions undertaken.
Major challenges in public health: Culturally competent care
The major challenge in the public health sector in Australia as highlighted by the interviewee is the increase in the demand of the culturally competent nurse. The main synopsis of the answers in Australia there is a growing number of culturally diverse communities and hence it is the duty of the nurses working under any sector of the public health to work in a culturally competent manner.
Culturally diverse workforce: Proper education and training
According to the interviewee, cultural competence is important for developing realistic training techniques and education, which will lead to improvement of the quality nursing practice for increasingly diverse group of populations.
Leadership styles and its difference with other business sectors
According to Wong, Cummings and Ducharme (2013), leadership styles in health care domains or especially in the nursing sector is a complex phenomenon and at the same time important for the improving the patient outcome. Doody and Doody (2012) have opined that a nursing professional must adapt a flexible leadership styles based on the communication strength and intrapersonal skills. Good communication and rich intrapersonal skills of the nurses helps in understanding the essence of the ever changing environment along with change patient’s changing requirement and thereby framing the leadership styles accordingly (Kourkouta and Papathanasiou, 2014). However, the leadership styles in healthcare are different from that of other business. According to Al-Sawai, (2013), a health care leaders have complex environment with multiple parities who define the score card of success both internally and externally thus it is difficult for a healthcare leader to have a definite plan with clear mission, as unlike the other business leaders the target is ever changing along with the situation.
Situational leadership styles in healthcare
The healthcare domain is ever changing however; the main role of nursing leader is to improve the overall health outcomes while decreasing the cost of care provision (Fischer, 2016). According to Fischer (2016) for improving the overall health care outcomes, a nursing leader must be accustomed with the ever-changing leadership styles as per the situations. Fischer (2016) person-centered care is the pillar behind the improved patient’s outcome under changing surrounding environment. Rokstad et al. (2015) have further opined that the person centred care helps in the overall improvement of the patient health outcomes via helping the nursing to draft a care plan that lies in sync with both the mental, physical and spiritual demand of the patients. Chaudhuri, Yeatts and Cready (2013) are of the opinion that autonomous decision-making is the critical strength of the nursing leader. This autonomous decision making skills guides the nurse to undertake the prompt yet best possible therapy plan under extreme pressure.
Culturally competent nursing care
According to Renzaho et al. (2013), the immigration in Australia has increases and such change is reflected especially in public sectors like healthcare where the workforce and the client base are becoming increasingly multifarious in the domain of culture and ethnicity. Successful delivery of the healthcare under multicultural setting is frequently hampered via communication barriers, lack of awareness and respect for the cultural traditions and beliefs in healthcare professional and client relationships. Culturally competent care (CC) models help the nursing and other healthcare professionals to work effectively under cross-culture situations. Renzaho et al. (2013) have opined that CC centers on dogging the cultural barriers between health care provider and client and thereby maximizing the outcomes of the patient health along with the refinement of the patient centered care plan.
Conclusion
Thus from the above discussion it can be concluded that emergency care settings is ever changing along with increase in the infiltration of communities from different cultural settings. Thus in order to improve the overall health come, it is the role of a nursing leader or a public healthcare domain leader to work effectively under the ever changing atmosphere. Thus situational leadership is the most agile leadership styles under this complex healthcare environment. However, situational leadership styles must be practised under a special highlight towards the patient centred care and culturally competent care models.
References
Al-Sawai, A. (2013). Leadership of healthcare professionals: where do we stand?. Oman medical journal, 28(4), 285.
Chaudhuri, T., Yeatts, D. E., & Cready, C. M. (2013). Nurse aide decision making in nursing homes: factors affecting empowerment. Journal of clinical nursing, 22(17-18), 2572-2585.
Czabanowska, K., Rethmeier, K. A., Lueddeke, G., Smith, T., Malho, A., Otok, R., & Stankunas, M. (2014). Public health in the 21st century: working differently means leading and learning differently. European journal of public health, 24(6), 1047-1052.
Doody, O., & Doody, C. M. (2012). Transformational leadership in nursing practice. British Journal of Nursing, 21(20), 1212-1218.
Fischer, S. A. (2016). Transformational leadership in nursing: a concept analysis. Journal of advanced nursing, 72(11), 2644-2653.
Flowerdew, L., Brown, R., Russ, S., Vincent, C., & Woloshynowych, M. (2012). Teams under pressure in the emergency department: an interview study. Emerg Med J, 29(12), e2-e2.
Gleeson. B., (2018). 10 Unique Perspectives On What Makes A Great Leader. Forbes. Access date: 16th April. Retrieved from: https://www.forbes.com/sites/brentgleeson/2016/11/09/10-unique-perspectives-on-what-makes-a-great-leader/2/#
Gökçen, C., Zengin, S., Oktay, M. M., Alpak, G., Al, B., & Yildirim, C. (2013). Burnout, job satisfaction and depression in the healthcare personnel who work in the emergency department. Anatolian Journal of Psychiatry/Anadolu Psikiyatri Dergisi, 14(2).
Jacob, S. A., & Furgerson, S. P. (2012). Writing interview protocols and conducting interviews: Tips for students new to the field of qualitative research. The Qualitative Report, 17(42), 1-10.
Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia socio-medica, 26(1), 65.
Renzaho, A. M. N., Romios, P., Crock, C., & Sønderlund, A. L. (2013). The effectiveness of cultural competence programs in ethnic minority patient-centered health care—a systematic review of the literature. International Journal for Quality in Health Care, 25(3), 261-269.
Rokstad, A. M. M., Vatne, S., Engedal, K., & Selbæk, G. (2015). The role of leadership in the implementation of person?centred care using Dementia Care Mapping: a study in three nursing homes. Journal of nursing management, 23(1), 15-26.
Rouleau, D., Fournier, P., Philibert, A., Mbengue, B., & Dumont, A. (2012). The effects of midwives’ job satisfaction on burnout, intention to quit and turnover: a longitudinal study in Senegal. Human resources for health, 10(1), 9.
Sullivan, C., Staib, A., Khanna, S., Good, N. M., Boyle, J., Cattell, R., … & Scott, I. A. (2016). The National Emergency Access Target (NEAT) and the 4-hour rule: time to review the target. The Medical Journal of Australia, 204(9), 354.
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
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