NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

leadership Theories and Personal Identification of Style and Strengths

Resources

Media

Course Media: Laureate Education, Inc. (Executive Producer). (2010).Leadership competencies in nursing and healthcare.Baltimore: Author.
“Leadership in Nursing and Healthcare,” featuring Dr. Kenneth J. Rempher, Dr. Diane Mancino, Dr. Don Arthur, Dr. David Nash, Dr. Cecilia K. Wooden, and Dr. Leslie Mancuso. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

Required Readings

Course Text: Sullivan, E. J., & Decker, P. J. (2013).Effective leadership and management in nursing(8th ed.). Upper Saddle River: Pearson Prentice Hall.
Chapter 4, “Leading, Managing, Following”

Course Text: American Nursing Association. (2010).Nursing: Scope & standards of practice.Silver Springs, MD: Nursesbooks.org. Retrieved from.waldenulibrary.org/limited/ANA.htm”>http://ezp.waldenulibrary.org/limited/ANA.htm

Course Text: Fowler, M. (2008).Guide to the Code of Ethics for Nurses: Interpretation and application.Silver Springs, MD: Nursesbooks.org. Retrieved from
.waldenulibrary.org/limited/ANA.htm”>http://ezp.waldenulibrary.org/limited/ANA.htm

Articles:
Jackson, J. R., Clements P. T., Averill J. B., & Zimbro K. (2009). Patterns of knowing: Proposing a theory for nursing leadership.Nursing Economic$,27(3), 149-159.
Kerfoot, K. M. (2009). Denial and immunity to change: It starts with the leader.Nursing Economic$,27(6), 422-423. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

Optional Resources are listed in the Week 1 Learning Resources.

Threaded Discussion

Leadership Theory and Health Care

Reflect on the information presented this week and on your own work environment. Then, respond to the following:
Which theory of leadership do you think is most effective in today’s health care environment? Why?
How does ANA’s Nursing: Scope & Standards of Practice influence nursing leadership?

Support your response with references from the professional nursing literature.

Post your response by Day 3of this week. Respond by Day 7to at least twoof your colleagues’ postings. See the Week 1 Discussion area for details.

Application

Leadership Theory Paper

Throughout this degree program, you have been exposed to many great leaders in nursing and health care. Reflect on the leadership demonstrated by individuals such as Dr. Maggi McClure, Dr. Diane Mancino, Dr. Karen Drenkard, Ms. Joan Marren, Dr. Leslie Mancuso, Maria Manna, and Dr. Kenneth Rempher. Great leaders share common characteristics. As you have heard in this week’s media presentation, leadership skills can be learned and developed. The first step in developing leadership skills is increasing your self-awareness of your leadership qualities and abilities. In order to be an effective leader, you must find a style, or styles, that meet both your needs and those of the institution. Complete at least one of the following assessment inventories. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay
Gallup Strength Finders
Myers-Briggs
DiSC

Review your assessment results, and determine your leadership style, strengths, and growing edges. Consider how your leadership strengths are demonstrated in your nursing practice. Then, review the list of leaders presented below.
Winston Churchill
Margaret Thatcher
Eleanor Roosevelt
John F. Kennedy
Martin Luther King, Jr.
Mahatma Ghandi
Rudy Guiliani
Abraham Lincoln
César Chavéz
Mao Tse Tung
Lillian Wald
Mother Teresa

Select one person from the list. Research that individual, and write a 2–3 page summary of the selected leader’s leadership style and specific leadership characteristics demonstrated. Include in your summary any strengths or characteristics you have in common with the leader you selected. Also include how your identified strengths demonstrate mastery of ANA’sNursing:Scope & Standards of Practice, Standard of Professional Performance: Standard 12: Leadership as evidenced in your nursing practice. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

Due byDay 7. See the Week 1 Application area for complete instructions.

Virtual
Practicum
Team
Discussion

Practicum Activities: Identify a Change Project
This week introduced the concepts of leadership and leadership theories. In addition, the media presentation and textbook readings discussed the difference between leadership and management. As you begin your practicum this week discuss with your manager possible change projects needed in the agency. Observe your manager and other leaders at your location. Identify how management and leadership activities contribute to successful change initiatives. Informally discuss options with your manager
Please address the following:
What did you see as the difference between a leadership activities and a management activities?
How do management and leadership activities contribute to the success of change initiatives
What change projects are needed in your agency at this time. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

11 core competencies in nursing

1.safe and quality nursing care
2.management of resources and environment’s
3.health education
4.legal responsibility
5.ethic/moral responsibility
6.personal and professional development
7.quality improvement
8.research
9.record management
10.communication
11.collaboration and teamwork
CONCEPTS UNDERLYING CORE COMPETENCIES

I. PATIENT CARE COMPETENCIES

1. Safe and Quality Nursing Care

Core Competency 1: Demonstrates knowledge base on the health /illness status of individual / groups •Identifies the health needs of the clients (individuals, families, population groups and/or communities) •Explains the health status of the clients/ groups

Core Competency 2: Provides sound decision making in the care of individuals / families/groups considering their beliefs and values •Identifies clients’ wellness potential and/or health problem •Gathers data related to the health condition. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

•Analyzes the data gathered
•Selects appropriate action to support/ enhance wellness response; manage the health problem •Monitors the progress of the action taken

Core Competency 3: Promotes safety and comfort and privacy of clients •Performs age-specific safety measures in all aspects of client care •Performs age-specific comfort measures in all aspects of client care •Performs age-specific measures to ensure privacy in all aspects of client care

Core Competency 4: Sets priorities in nursing care based on clients’ needs •Identifies the priority needs of clients
•Analyzes the needs of clients
•Determines appropriate nursing care to address priority needs/problems

Core Competency 5: Ensures continuity of care
•Refers identified problem to appropriate individuals / agencies •Establishes means of providing continuous client care

Core Competency 6: Administers medications and other health therapeutics •Conforms to the 10 golden rules in medication administration and health therapeutics

Core Competency 7: Utilizes the nursing process as framework for nursing
7.1 Performs comprehensive and systematic nursing assessment •Obtains informed consent
•Completes appropriate assessment forms
•Performs appropriate assessment techniques
•Obtains comprehensive client information
•Maintains privacy and confidentiality
•Identifies health needs. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

7.2 Formulates a plan of care in collaboration with clients and other members of the health team •Includes client and his family in care planning
•Collaborates with other members of the health team
•States expected outcomes of nursing intervention maximizing clients’ competence •Develops comprehensive client care plan maximizing opportunities for prevention of problems and/or enhancing wellness response •Accomplishes client-centered discharge plan

•Implements planned nursing care to achieve identified outcomes •Explains interventions to clients and family before carrying them out to achieve identified outcomes •Implements nursing intervention that is safe and comfortable •Acts to improve clients’ health condition or human response •Performs nursing activities effectively and in a timely manner •Uses the participatory approach to enhance client-partners empowering potential for healthy life style/wellness

7.3 Evaluates progress toward expected outcomes
•Monitors effectiveness of nursing interventions
•Revises care plan based on expected outcomes. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

2. Communication
Core Competency 1: Establishes rapport with client, significant others and members of the health team •Creates trust and confidence
•Spends time with the client/significant others and members of the health team to facilitate interaction •Listens actively to client’s concerns/significant others and members of the health team

Core Competency 2: Identifies verbal and non-verbal cues
•Interprets and validates client’s body language and facial expressions

There are many core competencies needed by a graduating student into the field of nursing. Many are defined, but many also remain unnamed. This paper will address only three of those defined core competencies.

The difference between a new nursing student and a senior one can be seen in many ways, but can still be difficult to define. The knowledge base and experience level is greater in the graduating nurse, and these can be measured by standardized testing and observation. The difference that is more difficult to measure in the senior nursing student can be seen in the confidence and competence displayed in providing physical and emotional care in the course of this/her daily work. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

Discussion

Collaboration

Collaboration is a competency that is used continually in the medical field, especially demonstrated by nurses. “Collaboration is a substantive idea repeatedly discussed in health care circles. The benefits are well validated” (Gardner, 2005). Gardner continues, stating that “a collaborative outcome is the development of integrative solutions that go beyond an individual vision to a productive resolution that could not be accomplished by any single person or organization” (2005).

Although it is the responsibility of all team members involved in client care to communicate and contribute in the decision making process, it is the nursing staff that is key in the client care management. Social and interpersonal skills need to be sharp in order to provide the client with the best outcomes. the nurse is the liaison of the client to other members of the team, as well as the advocate. Without proper communication, it is difficult to provide quality care. “Interdisciplinary collaboration is critical to excellence in patient care delivery” (Ponte et al, 2010). NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

Collaboration may best be facilitated in the classroom initially in small discussion groups. After the groups have had time to discuss their topics, the smaller groups can then be convened into the large classroom structure. Collaboration can be learned in every setting, so the clinical area is also an important environment in addition to the classroom. In either setting open, friendly, and supportive conditions foster the best communication.

In the classroom setting, students would be assigned to roles commonly found in the medical environment (nurse, physician, pharmacist, patient, family member, nursing assistant, etc). A mock scenario would be created by the teacher, and the students assigned would be asked to role-play in front of their remaining classmates. A group discussion would then ensue, evaluating and examining each perspective. The next scenario would then be assigned, and this would continue until everyone in the class had a chance to participate.

In order to evaluate this thoroughly, the students would present their role-play discussions in front of the the class while being video-taped. The interaction from the class response would be educational, as well as the the group being able to watch themselves replay on video. In this way, each person in the group would be able to effectively examine his/her demeanor, body language, and effectiveness of communication during their presentation. The students would be evaluated from a checklist designed by the instructor and surveys to be completed by the class, their fellow teammates, and finally themselves. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

In a clinical situation, the nursing student would be observed and evaluated during his/her interactions randomly over the course of their shift. The evaluation would not only come from the instructor, but include anyone the nursing student came in contact with. People such as their preceptor, other nurses, physicians, patients, unit secretaries, etc, would be asked…

References: American Association of Colleges of Nursing (2008). The essentials of baccalaureate education for professional nursing practice.

Difference in competencies between nurses prepared at the associate degree level vs. the BSN Associate degree Nurse (ADN) nurses has 2 years training and diploma in nursing has 3 years of training .whereas Baccalaureate degree in Nursing has 4 years of training .The passing rate for NCLEX exam and basic clinical skills are the same example of I/V insertion, administering medicine and wound care. BSN training means Bachelor of Science in nursing are more focused in critical thinking skills, decision making skills, dealing with legal and ethical decision in evidence based practice and research based North Dakota was the first state that told about getting BSN after 10 years of diploma in nursing .Initiatives taken by these states New York, New jersey to increase stronger work force in nursing .AACN also emphasis of higher education level of nurses because of health care is changing more rapidly and more research is taking place and need for BSN education is increasing too. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

BSN nurses can work as team leader and can have many management skills because they have trained to do research and their focus is to go in depth of a problem rather than what book has stated. BSN nurses can manage and delegate nursing task to other personnel in a professional manner.

BSN nurses verses ADN nurses competencies also defer in manner of decision making skills, critical thinking skills .BSN nurses involve and work with other interdisciplinary professional to solve the problem and help make new policy for their specialty of care.

Decision making will be different of Associate Degree Nurses vs. BSN. Patient admitted to critical care unit and he is not alert and awake or oriented to time place and person and patient’s son comes and he wanted to know about patient condition .But ADN nurse will not give information to his son because of HIPPA policy and tells patient’s son we are not allowed to give information because of privacy reason whereas BSN nurses will go in depth.

The quiz which was part of the assignment 3 resulted that this author is a participative leader. It explains that the participative leaders involve the group in decision making. However they make the final say on decisions. This author agrees with the quiz result. This author believes that a leader should be more participative and less delegative and authoritative. When leaders are more authoritative than participative, the group may get offensive or dishonest to the leader. The participative leadership style can bring up better outcomes from the group. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

There are many attributes of leadership needed for graduate level nurses. The leaders should have a vision of the future and be able to communicate it with the group. Enacting at the right time is another attributes of leadership. The leaders should have self-confidence and willingness to take risk and fail at times. They should be able to build good relationship with their group and other professionals through effective communication, and make or guard boundaries in the profession. Another important leadership attribute that graduate level nurses possess is self-reflection. Self-reflection helps the leaders to look back to their experiences and learn from it. They should be able to understand and respect the diverse culture of their patients and the group members. They also have to find a balance in personal and professional life (Spross & Charlene (2005).

This author has very strong understanding of cultural diversity which is one of the main leadership attributes. Cultural competence is a continuing process which includes setting one’s beliefs on the side, and accepts and respects the cultural differences of others (Giger et al., 2007). Since this author is coming from a different culture than the main stream culture, it is easier for her to understand and respect the other cultures. This background will help this author to provide effective care to her patients from diverse culture, and to lead a culturally diverse group without hurting their cultural believes. NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

This author believes that she needs to develop self-confidence and risk taking attributes of leadership. According to Spross & Hanson (2005) a true leader should be willing to take chance, try it out and fail occasionally. This author used to work only in comfortable zones. However, she understands that in graduate nursing role in order to achieve certain outcome, she needs to be more self-confident and risk taking. Even after failing a few times, the leader has to repeatedly try to accomplish a desired goal through negotiation and collaboration with others (Spross & Hanson (2005).

Leadership is a core competency of graduate nursing. The characteristics of APN leaderships are “mentoring and empowerment, innovation and change agency, and activism” (Spross & Hanson (2005). As a part of advanced practice nurses’ job, they have to teach their patients, nurses and other nurse practitioners. They also have to speak up, negotiate and intervene with policy makers, insurance companies and other organizations to provide adequate care to their patients, and to attain better working conditions. Therefore, leadership is an inevitable role of graduate nursing.

According to Spross and Hanson graduate nurses practice leadership in four domains, which are clinical practice, nursing profession, system level and health policy (Spross & Hanson (2005). This author needs to develop her leadership skills in the health policy arena. Since there is an increase in rules and regulations influencing APN role, it is important to know about health policies as an APN leader. The leaders in this domain should be able to evaluate health care systems, understand their own leadership qualities and use them at the right time. The APNs can develop their leadership skills in health policy arena by becoming a political activist, using professional organizations and political action committees, being part of internships, fellowships and special interest groups, raising awareness through communication, and educating policymakers, legislators and public (Spross & Hanson (2005). NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay

Empowerment is one of the characteristics of the advance practice nurse leadership. It is a developmental process that the leader acquire over time to encourage others, giving power to them, and letting them to work their own. In order to empower others the leaders need to give them adequate education, inspiration, encouragement, protection, security, support, direction, and resource to act their own appropriately (Spross & Hanson (2005). In health policy arena the APN leaders should empower others by using all above methods, so that they can build up future APN leaders who can speak up and act on at the right time.

Leadership as a competency helps clarify graduate nursing in this author’s mind. This author understands that leadership is correlated in every aspects of advanced practice nursing role. She recognizes that leadership is not an option; rather it is a daily practice to be an effective graduate nurse. “Effective nursing leadership is key in providing quality patient care. Widespread changes in the healthcare delivery system have prompted nurses to develop leadership skills to manage the challenges of shorter hospital stays, high patient acuity, and reduced nurse staffing. Advance practice nurses (APNs) are in a unique position to influence practice and implement change as intervention nurses” (Monturo, 2003).

Hamric, Hanson, O’Grady & Tracy (2014) define competencies as “a broad area of skillful performance.” Competencies include activities implemented by advanced practice nurses while providing direct patient care and the processes, knowledge and skills used in all aspects of advanced practice. There are seven core competencies associated with the advanced practice registered nurse. In addition to the seven core competencies, nurse practitioner education and nurse administrator education have additional competencies needed to become proficient in each of those roles (The American Organization of Nurse Executives (AONE) 2011; The National Organization of Nurse Practitioner Faculties (NONPF), 2012). NURS 4220 – Leadership Competencies in Nursing and Healthcare Essay