Term Paper: Nursing Leadership Reflecting on My Management Role

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Nursing Leadership

Reflecting on my Management Role

Identify your highest and lowest scores from the "Check your effectiveness" Slips (Facts, 1997).

My highest score of "58" is the Mentor Role (Facts, 1997).

My lowest score of "48" is in both the Initiator Role and the Service/Care Provider Role (Facts, 1997).

Identify two significant experiences from your recent practice that reflects aspects of this role.

Use your experience identified with the highest score as the basis for a reflective analysis.

Write about your experience identified using the following frame (painting the picture).

When writing a reflective analysis of myself in the Mentor Role, I know that a key competence of the Mentor Role is to understand myself as well as others. I have a positive image and see myself as intelligent and respectable and I treat others as such. I know myself very well, and I am confident and have high expectations of myself. I would never set standards for someone to achieve if I am unable to achieve them myself. I would like to say that I understand my peers, although I do not always agree with their decisions. In regards to interpersonal communication, being an effective leader requires the use of excellent communication and interpersonal skills. I personally speak with a European accent and my communication may be perceived differently because of this. Sometimes this can lead to the misinterpretation of the meaning of my message. I consciously speak slow and punctuate words with a non-European accent when giving instructions and guidance. Since facial expression and body language are a large part of communication, I always strive to use a receptive facial expression as well as non-threatening body language. Communication is the most important factor that reflects who we are, our reactions, and how we approach problems and interpret them. Developing subordinates as a mentor requires not only patience, but the ability to active listening and the willingness to teach. It certainly requires the clinical expertise to perform in this role and most certainly needs the establishment of a trusting report with the mentee to optimize learning. Vestal (1999) states: "We need to work together, as a nursing profession, as a healthcare profession, and as a society, and we need to understand each other's perspectives." I like to mentor because I love to share the knowledge that I have acquired. Teaching a skill to a new nurse is rewarding because of my personal mastery and self-assurance. The mentee will be successful if he/she implements newly learned techniques and perfects them.

I am employed as a Registered Nurse on a general 12-bed Pediatric Ward, primarily in a charge nurse capacity. I assign patient care based on acuity and according to education, training, and skill level. Compared to any other unit in our hospital, excluding the Neonatal Intensive Care Unit (NICU) and the Intensive Care Unit (ICU) where the patient to nurse ration is six to seven patients to one nurse, our floor has a patient to nurse ratio that seldom exceeds two patients to one nurse. As the charge nurse my duties include establishing acuities, interpreting lab results, managing telephone calls, solving problems, taking a patient census, and orienting new nurses. I often take on my own patient load to assure that the patient to nurse ratio is consistent and to provide ultimate patient care. Overall, my staff consisting of Licensed Vocational Nurses and Certified Nursing Assistants is a group who demonstrate professionalism by providing the utmost of professional and compassionate care to our pediatric patients as well as their parents. It is a personal challenge to me, because it requires the key competency of understanding myself and others. One of my most challenging experiences as a mentor was with a LVN that has been on staff now for 17 months. I experienced an internal struggle to challenge and develop her. Her average skill level determines her daily assignments and often times they are not as difficult as some of the others. She demonstrates negativity either verbally or via body language by displaying a non-team-playing attitude. She complains to others about her assignment, or makes comments regarding an admission, but this has not yet disrupted our daily routine.

My observations of her when she is charting behind the nurses station include not responding to a call-light unless it is her patient. Even then, she still has to be told that her patient is requesting her attendance. Quite often she seeks a second opinion for reassurance prior to making any permanent entries in the patient's chart. Due to this, I conclude that she is very insecure about her assessment findings. Many times her failure to maintain a patient's IV site via flushes on her patient requires a new IV site to be started, which is always very traumatizing to our little patients as well as their parents. The most upsetting things is that she ignores our "Save Haven" policy. Her attempts to belittle the certified nursing assistants with minor tasks, such as emptying the urinal she already holds in her hand next to the bathroom, or bringing the dirty linen hamper to her patient's room vividly demonstrates poor task planning. With all this said, she makes me feel annoyed, irritated, and even frustrated at times. As a leader I have to maintain calm, remain rational (Nursing, 2003), analyze the entire picture, and resolve it to a productive and reasonable intervention. Many times I am successful, but there are times when I have failed. I express my frustration by performing an assessment myself just for reassurance, but also mainly because my time is of the essence. Especially frustrating to me is when someone is unable to count manual respirations or is unable to decipher lung sounds. This is basic knowledge required and is taught at every entry-level nursing program. Since I am in a charge nurse capacity, neglect or inadequate patient care would burden me, and ultimately reflects on my staff and most certainly on my licensure. Due to my high expectations and being aware of the staff on hand I plan my day for those anticipated "mishaps" by allowing additional time. After report and having delegated assignments I ask my staff to work together and to have a great day. By allowing adequate time for morning assessments, I make my morning rounds and introduce myself to the patients as well as the parents and make myself available for any concerns or questions that may arise throughout my shift. Following that routine, I also inquire with the nurses about their assessment findings, which may warrant a call to the resident or the physician prior to grand rounds. Previously, in casual conversations with the individual that upsets me, I attempted to gain an understanding of her as a person, which may have explained her behavior and actions better to me. Immediately annoyed with her unreasonable (to me) justifications, I am unable to put myself in her position or to gain her understanding, and I feel that she does not have a good work ethic. Because of this I have come to the conclusion that simple common sense is natural as well as adapted. I self-talk to myself and justify certain actions by her as "a lot of growing and learning to do," and although at times I feel like shouting, I control my emotions. I would like for this LVN not to be on my shift, but in previous discussions with my head nurse I came to realize that we cannot pick and choose who we work with. I cannot change the person and therefore it is much easier to accept them as the individual that they are and hope that they can adapt and learn something that I have taught them. As I self-evaluate I realize that I do not even know how others feel about my leadership.

Although I have read and learned in the past about various leadership styles, I am just as unique as the next person, especially with my patient care and in my leadership. This is a continuing path of professional as well as personal growth and only practice shall perfect this, if it can ever actually be perfected. There is still so much I have to learn professionally. It is up to me to seek further guidance, education, and allow myself to become the best that I can be. The key competencies for the successful mentor are "to understand myself and others," and to "develop others," along with "interpersonal communication" (Quinn, Faerman, Thompson, & McGrath, 2003), which makes me reconsider my approach. However, it will not change my expectations in regards to patient care and health care delivery. I now realize after studying the text that I need to spend a lot more time analyzing my strengths and weaknesses in management. I make it a daily event to adapt to various leadership styles and to find a happy medium. Although I always thought I was very balanced, after studying this management module I see that this… [END OF PREVIEW]

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