As noted above, one of the most prominent leadership theories that has been applied to the nursing profession is transformational leadership. Properly applied and managed, transformation leadership can also be used to facilitate creativity in the workplace. For instance, according to Vesterinen, Isola and Paasivaara (2009, p. 504), transformational leadership can create changes and, by definition, is capable of transformed individuals and the organization in which they work. By providing the leadership needed to motivate employees to bigger and better aspirations, transformational leaders can therefore encourage the creative spark among their followers in ways that might not otherwise be possible (Vesterinen et al. 2009). Indeed, Vesterinen et al. (2009, p. 504) specifically state that, "A transformational leader motivates inspirationally, stimulates intellectually and considers employees individually." Taken together, these positive outcomes are valuable in any organizational setting, but they can be particularly important in health care settings.
Why understanding organisational culture is an important part of facilitating change
In order the change an organization, leaders must understand how it works. Just as definitions of effective leadership and clinical leadership vary, there is no universal definition of organizational culture. The description of organizational culture provided by Recardo and Jolly (1999), though, provides some useful insights concerning what is meant by the term. According to Recardo and Jolly (1999, p. 4), "When people talk about corporate culture, they are generally talking about a set of values and beliefs that are understood and shared by members of an organization." Moreover, while many organizations may share some core values and goals, by definition, every organizational culture is unique in some fashion. In this regard, Recardo and Jolly (1999, p. 5) add that, "These values and beliefs are specific to that organization and differentiate it from other organizations. An organization's culture helps to shape, and quite frequently to determine, the behaviors of the members and the practices within the organization." In sum, organizational culture describes the processes and procedures that define "how things are done around here" and are defined in a top-down process that can change with changes in organizational leadership (Recardo & Jolly 1999).
While definitions of organizational culture vary, one consistent theme that recurs in the relevant literature is the fact that meaningful organizational change cannot be effected without a corresponding change in the organizational culture (Anson 2000). Changing organizational cultures can be a challenging enterprise, though, because it involves more than superficial changes and can include changes in the manner in which information is shared, how individuals within the organization are treated, how work is assigned as well as the manner in which decisions are made (Anson 2000). Therefore, understanding organizational culture is the first step to implementing any change initiative in any workplace setting, including health care environments (Anson 2000).
The research showed that the nursing profession has been heavily influenced by various mainstream management theories, including transformational leadership, transactional leadership, authentic leadership, contingency theory, servant leadership and others, but most especially transformational leadership. The research also showed that definitions of leadership and how it can be applied as an ideal model of leadership for the clinical environment vary, but a useful definition would include a purpose for clinical leadership that is related to the empowerment and creation of a consistent focus on the needs of the patients being served as well as one that includes effective nursing leadership as being a vehicle through which healthcare delivery and consumer demands can be fulfilled. In addition, the research showed that cognitive dissonance can create conflict during a period of change, but there are some steps that nursing leaders can take to help manage change more effectively. Understanding the organizational culture is an important part of this process, and this understanding together with transformational leadership techniques can help facilitate creativity in the workplace.
Anson, BR 2000, 'Taking Charge of Change in a Volatile Healthcare Marketplace,' Human
Resource Planning, vol. 23, no. 4, pp. 21-29.
Curtis, EA, de Vries, J & Sheerin, FK 2011, 'Developing leadership in nursing: exploring core factors,' British Journal of Nursing, vol. 20, no. 5, pp. 306-313.
Doody, O & Doody, CM 2012, 'Transformational leadership in nursing practice,' British Journal
of Nursing, vol. 21, no 20, pp. 1212-1220.
Edwards, M, Throndson, K & Girardin, J 2012, Fall, 'Survey of Canadian critical care nurses' experiences of conflict in intensive care units,' Dynamics, vol. 23, no. 3, pp. 15-19.
Ellis, P & Abbott, J 2013, 'Leadership and management skills in health care,' Nurse Prescribing, vol. 11, no. 5, pp. 251-256.
Fontenot, HB, Hawkins, JW & Weis, JA 2012, 'Cognitive dissonance experienced by nurse practitioner faculty,' Journal of the American Academy of Nurse Practitioners, vol. 24,
pp. 506 -- 513.
Janss, R, Rispens, S, Segers, M & Jehn, KA 2013, 'What is happening under the surface? Power,
conflict and the performance of medical teams,' Medical Education, vol. 46, pp. 838
Giltinane CL 2013, 'Leadership styles and theories,' Nursing Standard, vol. 27, no. 41, pp. 35-
Recardo, R & Jolly, J 1999, 'Organizational culture and teams,' SAM Advanced Management
Journal, vol. 62, no. 2, pp. 4-5.
Stanley, D 2008, 'Congruent leadership: values in action,' Journal of Nursing Management, vol.
16, pp. 519 -- 524.
Taylor, R 2009, September 8, 'Leadership theories and the development of nurses in primary
health care,' Primary Health Care, vol. 19, no. 9, pp. 40-45.
Vesterinen, S, Isola, A & Paasivaara, 2009, 'Leadership styles of Finnish nurse managers and factors influencing it,' Journal of Nursing Management, vol. 17, pp. 503 -- 509.
Wetcher-Hendricks, D 2005, Summer, 'A Practical Lesson in Cognitive Dissonance,' Academic
Exchange Quarterly, vol. 9, no. 2, pp. 235-241.
Provide the goal that was to be achieved (this can range from introducing a new evidence-based safety policy or providing nursing education)
An unfortunate consequence of on-the-job injuries in health care settings is the fact that each incident will be included in an aggregated analysis and inordinately high rates of accidents are cause for management intervention. Sharps disposal-related injuries in particular represent a preventable case of injuries, and given the potential life-and-death nature of such incidents, safety policies must ensure that all employees that are injured on the job feel free to report such injuries (Russell & Ross 1999). According to Russell and Ross (1999, p. 16), "The sharps hazards arising from hospital and medical clinic waste are well recognized, and much attention has been paid to the development of safe methods for handling and disposing of such waste." The goal that was achieved in this case was the successful reporting of the incident by student (A), but this goal was only achieved following encouragement by student (B) to do so.
Discuss who the key members of the team were and identify your position within the team
There were five key members involved in this case. The first member was student A who incurred the sharps injury. The second member was student B, the author. The third member was responsible registered nurse and the fourth and fifth members were the nurse unit manager and the hospital nurse educator, both of whom provided support to student A following her injury.
Reflectively discuss any positive or negatives involved with the event/experience in regards to leadership/teamwork and provide insight as to how this event/experience could have been improved.
Sharps disposal-related injuries have long been a concern for healthcare practitioners based on the fact that these injuries can result in the contraction of blood-borne diseases (Fourie & Keogh 2011). In spite of a wide range of interventions that have been designed to minimise harm to health care professionals, especially nurses, the common use of needles and syringes in health care settings continues to cause an unacceptable number of injuries (Fourie & Keogh 2011).
The fact that student A was reluctant to report her injury to the registered nurse for fear of further recriminations concerning her on-the-job performance suggests that this nursing unit had its priorities topsy-turvy. Indeed, the lengthy delay in reporting the injury may have prevented student A from receiving medications or other interventions that could have mediated the effects of the incident. This reflection is reinforced by the reaction of the registered nurse upon learning about the incident which was one of exasperation and disgust for the amount of paperwork that was involved rather than the potential injury incurred by student A and why she had delayed reporting the incident in the first place.
First and foremost, there is a need for ongoing education concerning proper sharps disposal protocols in health care settings in general, and in this nursing unit in particular. Just as importantly, though, there is also a need for a change in the organizational culture that places a higher emphasis on providing the training need to ensure employee welfare and safety than it does on the paperwork and red tape required for reporting injuries after the fact. In this case, there is a glaring need…