Nursing Leadership the Task That Awaits a Term Paper

Excerpt from Term Paper :

Nursing Leadership

The task that awaits a newly hired nurse unit manager in this particular care facility is going to be challenging. With nurses complaining out loud about assignments, and with nurses calling in sick, being late to work and not being productive, the new unit manager has her hands full. This paper uses scholarly literature to propose steps to be taken to get the care facility back to operating the way it should be operating. The two most important components of her plan to get the unit back to being fully productive are conflict resolution and problem-solving.

Conflict Management Should Come Into Play

Before any major overhaul of the policies in the care unit can be completed, the new unit manager must deal with the conflict that exists. And so, because there is a great deal of literature on managing conflict, and because the manager has had experience in resolving conflicts in other venues, the new manager decides to go in that direction first.

An article in the peer-reviewed journal Dimensions of Critical Care Nursing points out that when there is conflict in a nursing environment, along with that conflict the leadership will encounter "negative feelings" (Kelly, 2006, 22). Negative feelings in turn generate hostility and discomfort, Kelly explains, and these conditions have a way of "…draining energy and reducing focus," and hence, it is obvious that quality nursing care is not likely when these conditions exist in a care unit.

After being on the job for a day or two, the manager realizes that some of the more experienced nurses among the thirty-seven nurses she is responsible for have been using the tactic of "avoidance," as a way to attempt to stay out of the tensions that sometimes boil over in the unit. But as Kelly points out, and as the manager well knows from past experience, avoidance as a way to reduce conflict will not be successful because it only postpones the implementation of a solution. In addition, Kelly maintains that taking a "passive role" is a "recipe for low morale" and so in order to improve the morale of this unit the recommendation is to "confront conflict openly and respectfully" using "assertive behavior" (23). Advocating the use of assertive behavior doesn't mean nurses snipe at each other or become bullies; it means for example that nurses should be provided with "…emotional intelligence training" so they can bring a sense of "rational thought" rather than anger and tension into a conflict-ridden situation.

Transformational Leadership rather than Transactional Leadership

The manager in this instance, being fully aware of the conflict that exists, should avoid using transactional leadership as a strategy and instead she should engage in transformational leadership, according to Kelly (26). Transactional managers tend to "honor stability" and they insist that nurses must concentrate on their patients and their tasks and therefore tensions are ignored in many cases (Kelly, 26). However, the transformational nurse leader utilizes tactics like "inspirational motivation," "idealized influence," intellectual incentives and she uses creative assertiveness when it comes to conflict resolution.

In The New York Times-owned publication, journalist Kendra Cherry explains that transformational leaders are "…energetic, enthusiastic and passionate." Transformational leaders challenge the status quo -- which in this case is vitally important -- and they encourage their staff professionals to "…explore new ways of doing things" (Cherry, 2013). Moreover, transformational leaders gain respect through the following behaviors: a) they make sure to keep "lines of communication open" and they welcome contributions from staff; b) they have a "clear vision" and they articulate that vision often and with credibility; c) they serve as a role model for their followers; and d) through their dynamic approach to nursing, they inspire others to "change expectations, perceptions and motivations" so that the unit can function more productively (Cherry).

How to Solve Problems -- Create a Healthy Work Environment

While the new nurse manager is providing the leadership that addresses conflict in the unit, she must also be focusing on creating a healthy work environment. She can do this by setting a course that will lead to problem solving (Wiggins, et al., 2011, 1). One could argue that providing leadership vis-a-vis conflict management is a way of solving problems, but there is a bigger picture that goes beyond just putting out fires and getting nurses to confront issues (rather than avoiding issues). Wiggins and colleague assert that in order to create a healthy work environment, the manager must seek to help bring about the following dynamics: a) employees must be treated with respect and fairness; b) trust must be established between management and employees; c) good communication and collaboration must be present; and d) nurses on the floor must have a sense of physical and emotional safety (Wiggins, 1).

If the new unit manager is to be successful in bringing about stability and productivity, Wiggins insists that she must engage in the following five management practices, which may overlap with some of the previously mentioned goals, but which go along with the concept of transformational leadership. The five are as follows: a) she must balance the tension between "production and efficiency"; b) she must work hard to create an atmosphere of trust and this atmosphere must be sustained through any tensions or crises that may arise; c) the process of change must be managed on a daily and hourly basis; d) staff must be included in decisions that affect the quality -- and the flow -- of services provided to patients; and e) the unit must become a place of learning through "knowledge management" strategies (Wiggins, 2).

Gaining the Support of Staff

Clearly the situation that the new unit manager walked into requires, above all, a sense of change, big change, in the way problems are resolved. Indeed, solving problems and curtailing conflict in a unit presents challenges to a nurse manager that test the leader's competencies, experience, and creativity. Angela May and Jayne Norbury present ways in which major steps can be taken regarding the way in which change can be implement and tensions can be eased in this unit. One of the suggestions May puts forward is to listen to all perspectives from the nurses working in this unit, and by doing so the new manager will "…seek mutually agreed ways to deliver change" (May, 2007).

The listening part of the new manager's duty in terms of welcoming change is a key to successful leadership; but there are things that the new manager should avoid. Those include: a) making "long lists"; b) creating strict schedules; c) spending time detailing specific new project plans; and d) engaging in "traditional time management techniques" (May). What should be happening (rather than the a-d list above) is the new manager should be focusing on her own "interactions" with people and she must "…invest time and energy into…relationships." How will the new manager establish trust that she has the capability to bring positive change to the unit unless she establishes that she can be a good listener and can be transformational in the sense of being down-to-earth and showing charisma and humor as well?

Before the new manager can approach the nurse's complaints about inadequate compensation for the amount of work that is expected of them, the manager must help staff "…gain insights into their own behaviors" (May). By using the previously-mentioned transformational strategies, and by training nurses to find more effective ways to communicate with one another, nurses will have more realistic approaches to their own attitudes and work ethics. The nurse manager should be conducting leadership sessions during which: a) honest communication is encouraged and rewarded; b) nurses more fully understand how their behaviors impact others in the unit; c) the manager's enthusiasm and positive vision for the future becomes contagious; d) nurses come to understand the roles and responsibilities of others in the unit; and e) networks are established among nurses for a smooth resolution of problems rather than a festering of old issues which leads to conflict (May).

Evidence-Based Practices and Mentoring

As part of the problem-solving efforts of the new unit manager, she should be open to using progressive policies (which comes with the territory when embracing a transformational style of management), and among those polices she should include is mentoring as a best practice tactic (Lusardi, 2012). The idea of mentoring doesn't always mean that "experts" are brought into the unit to teach new tricks to nurses (although that is a workable tactic). Mentoring in this context means that more experienced nurses in the unit -- nurses that have been given paid time to study and adopted the newest innovative techniques for patient care -- spend time in small groups with newer nurses to share those helpful innovations and techniques.

Moreover, the new manager should select a group of experienced nurses in the unit to serve as a planning committee to determine (through regularly scheduled sessions) what problems are "real" and what problems simply result from a lack of communication or from a…

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