- Published: October 31, 2021
- Updated: October 31, 2021
- University / College: University of Westminster
- Language: English
- Downloads: 37
Leadership Shadowing Experience
Nurse shadowing is an effective way for nursing students and people interested in getting into nursing as a career to get experience on day-to-day activities of a nurse. Shadowing involves following an experienced nurse and learning through observation and asking questions. This report is a shadowing experience for an intensive care nurse leader. The report covers the observed management and leadership styles, problem-solving skills, communication skills, interpersonal relations, and workplace diversity. Further, the author compares the management theories taught in school with the concepts applied in the clinical setting.
The nurse I shadowed is a nurse manager atan intensive care unit. She employed strong leadership with an inclusive approach. She would often ask for the opinions of the other nurses, solicit suggestions and feedback before setting goals and making decisions that affect her nursing team and the wellbeing of patients. Additionally, the nurse manager emphasized team-work, personal and professional development. During nurses’ meetings, she would divide the nurses into groups with each group tasked with a specific duty such as determining the ‘how’ and ‘why’ of hospital procedures and policies to determine which policies should be changed. These opportunities gave the junior nurses an opportunity to develop their leadership and communication skills in a group setting. The nurse manager adopted a strict approach on adherence to hospital policies, and improving the quality of care offered to patients and their families. Although the strict approach reduced staff autonomy, it ensured tasks are completed quickly and efficiently and is the best approach when supervising the nursing team.
Using a mixture of management styles is an indication of effective leadership (Grimm, 2010). Every management style has its advantages and disadvantages. For instance, an all-inclusive, democratic approach where the manager solicits the opinion of the other nurses improves morale, job satisfaction, and results in widely acceptable solutions, but does not encourage supervising the junior nurses. In contrast, a strict approach is effective for supervising the junior nurses but does not foster team spirit because it lacks consultation. By using a combination of these two management styles, the intensive care unit nurse manager was able to foster a team spirit and ensure effective supervision while giving all nurses a chance to develop and improve their leadership skills.
Problem-solving is an important skill in a team setting. The process of problem solving involves identifying the problem, and using a systematic approach to getting solutions through root-cause analysis. Being the nurse manager, the nurse I shadowed solved problems and viewed them as opportunities to improve. The problems solved included patient care plans, interventions, disputes between staff, and challenges facing the intensive care nursing unit. After identifying the problem, the nurse manager collected background data on the problem. The nurse manager used two main styles to solve problems. The first one was a rational and logical approach based on knowledge and judgment. To advance this problem-solving skill, she encouraged evidence-based care as a way of solving problems regarding patient care and interventions. The nurse manager encouraged strict observation of hospital procedures and practices and to solve all problems within the framework of these policies. Where no policy existed, the nurses were encouraged to conduct research on the problem and develop evidence-based policies.
The second problem-solving method was a phenomenological approach that was dynamic. This method of solving problems was mainly used in solving problems that arise unexpectedly or ethical and cultural dilemmas. In the intensive care unit, patients could sometimes respond differently to the optimum intervention. In this situation and when dealing with ethical and cultural issues, the phenomenological method of solving problems enabled nurses to draw from their experience and non-nursing knowledge to solve problems. For instance, incorporating cultural and religious knowledge encourages developing patient care solutions that are acceptable to the patient and their families. The nurse manager encouraged the unit nurses to embrace problems and view them as opportunities to improve care. During nurse meetings, she would encourage retrospective analysis of problems solved to ensure that nurses learned from the problems encountered on a day-to-day basis. If I were in the nurse manager’s position, I would have encouraged the junior nurses to be more involved in problem-solving in order to encourage skills development.
Communication pattern and interpersonal dynamics in the unit
Communication among the intensive care unit nurses varied from formal to informal channels. The nurse manager was often used the formal channels such as circulars and official emails. The other nurses usually used informal channels such as word of mouth and posts on an online forum hosted in the hospital website. The unit had an effective patient handover communication protocol at the end of the shift that ensured continuous patient care. I observed that there was better communication between nurses in the same level. This is because the practice nurses shared more on the online forum than they would share with the senior nurses. However, communication was effective in the intensive care unit nursing team since the nurse manager solved very few problems arising from communication failure.
Communication encouraged positive interaction between the nursing unit members. This was evidence since all members could interact freely and work any shift. The nurse manager encouraged all unit nurses to use the communication skills developed when interacting within the unit in patient and family education. This improved the quality of care offered because the patients were able to make informed decisions and participate effectively in health care service delivery.
Respect of Diversity
The intensive care unit exhibited diversity in terms of the nursing team members and the patients. The nursing team had members from diverse cultural and religious backgrounds including nurses born in other countries. The nurse manager encouraged the nursing team to leverage on their diversity to improve the quality of care offered. Often, nurse would be encouraged to educate the other team members on their cultures such as how to address the family members of the patient. This ensured that patients from various cultures were offered culturally acceptable care. Cultural diversity among the nursing team members was important in times of disaster when culturally acceptable patient care decisions had to be made in a timely manner.
The nurse manager encouraged all unit nurses to view patient diversity as an opportunity to offer quality patient-centered care. She often encouraged the use of culturally acceptable interventions. The most important thing I learned during the shadowing experience was to remember the patient needs always. Respecting the patient’s culture means more than being aware of the patient’s race. It is about offering health services that meet and exceed the patient’s expectations. In the intensive care unit, it was important to extend culturally acceptable care to a family member to relieve their anguish and suffering.
Comparison of leadership and management concepts in reading assignment vs. practice in clinical settings observed
The reading assignment gives leadership and management concepts based on nurse leadership and management theories. According to Giltinane, (2013) nursing management, leadership styles and theories are designed for ideal situations where the variables can be accounted for in the theory assumptions. The five common leadership styles are servant leadership, transformational leadership, democratic leadership, authoritarian leadership, and laissez-faire leadership. These leadership styles differ on the basis of interaction between the leader and the team. Authoritarian leaders are micromanagers while the democratic leaders adopt an all-inclusive approach. Laissez-faire leaders adopt a hands-off approach with little supervision while transformational leaders encourage innovations to solve problems. The servant leaders often lead by addressing the needs of the individual team members.
In the clinical setting, however, these leadership styles are used together in order realize synergy from the advantages of each theory. This is a contrast to the learning assignment implication that each leadership theory could be used independent of the other theories. The shadowing experience taught me that effective leadership is not about adopting and consistently implementing a particular leadership style but it is about knowing which leadership style to use in which situation. For instance, while democratic and Laissez-faire leadership may be effective when promoting staff autonomy, they cannot be used to foster changes. On the other hand, transformational leadership fosters change while authoritarian leadership is important in chaotic and emergency situations when there is little time to engage the team and collect the views of each team member (Johnson, 2002).
Giltinane, C. L. (2013). Leadership styles and theories. Nursing Standard, 27(41), 35-39.
Grimm, J. W. (2010). Effective leadership: making the difference. Journal of Emergency
Nursing, 36(1), 74-77.
Johnson, J. E. (2002). Leadership in a Time of Disaster: Being Prepared for New Age Threats*.