Nursing leadership is an essential part of professional practice. Since the curriculum is modeled towards the realization of patient-centered care, the different areas of the care delivery require aspects of leadership. I learned this from the registered bedside nurse leader that I interviewed. I chose her because, after my BSN degree, I intend to be a bedside nurse pending my becoming a nurse manager. I also opted for her, because, as Larsson and Sahlsten (2016) opine, such nurses oversee the completion of patient care and provide safe client services. The fact that I had done my student attachment at the facility allowed me to meet and interact with her during my bedside rotation. She was articulate, well-informed and her decisions were well-grounded in nursing theories, norms, and EBP. I felt that she was a useful resource person whose experiences and leadership will inform my knowledge on bedside patient management. As a result, the purpose of my interview was not only to gain an understanding of nurse management at the bedside but also identify the existing gaps in my training that may impede my future role as a bedside nurse.
Nursing Leadership and Theories
As mentioned earlier, the interviewee had well-grounded knowledge in nursing theories, and her decision was well informed by existing research on her actions. Apparently, her development as a nurse and the subsequent attainment of nurse management position were influenced by transformational leadership. She was always open to suggestions and gave a chance to anyone speaking before interrupting. According to Larsson and Sahlsten (2016), leaders that idealize the above acts portray transformational leadership. Besides, she hinted that she gives her subordinates the necessary instructions and allows them to carry on with patient management, though with close supervision. Research indicates that leaders who exhibit the above leadership styles empower and motivate their juniors towards a shared goal, and promote active participation among the subordinates (Lorber & Savic, 2011). Apparently, her leadership style allowed her to develop a conducive environment for a shared responsibility with other nurses.
Evidence-Based Practice and Other Practice Tenets
The nurse leader affirms that her knowledge in leadership and practice is grounded on the existing evidence bases. She categorically states that her daily activities at the unit entail championing a healthy working environment for the bedside nurses. She does this by structuring work equitably before each shift, promoting dialogue for problem identification and causal analysis, and makes herself available to subordinates and patients throughout the day. In response to her management duties, existing research shows that a conducive working environment provides an atmosphere where nurses deliver safe, and quality patient care (Larsson & Sahstein, 2011; Lewis & Malecha, 2011; Warmer et al., 2016). I commend the nurse leader for leveraging on her transformative leadership skills to empower her subordinates to provide safe and quality client care at the bedside.
Even though she works towards establishing a healthy environment at the unit, the nurse leader also focuses on quality improvements. She vocalizes that she always looks for ways of interacting with her junior staff better. The facility has open access to varied nursing journals, which she continually refers to for the most current guidelines. She engages in reflection both on and in the job and uses them to identify existing gaps in her specialty. She also engages her juniors to document their experiences on their professional portfolios and mandates them to provide evidence of reflection. She believes the acts above, coupled with on-job training and workshops, will enable them to continually focus on quality improvements at the hospital (Larsson & Sahlsten, 2016). Therefore, through reflection, she intends to improve the level of bedside care at the hospital continuously.
Notwithstanding the EBP models and quality improvements at the hospital, the nurse leader articulates that she routinely uses standard nursing practices at the facility. In fact, to her, those norms are essential for patient safety. She trains new staff in their adherences while supervising compliance among other bedside nurses. Lorber and Savic (2011) note that compliance with standards of care shows a level of managerial competence, which facilitates safe and efficient care. I believe that sticking to nursing norms may be the borderline between wellness and ill health among patients, and non-adherence to even one of them could trigger exacerbations that could compromise patient recovery and prognosis.
The nurse leader hints that she deals with relationship management on a daily basis. She confirms that interpersonal relationships are some of the hardest to handle at the unit. She has to monitor her relationship with junior staff, among the subordinates themselves, and between the nurses and the patients. As a result, she redirects most of her focus to these relations, because imminent threats could trigger conflicts, whose occurrence may sometimes be deleterious. Nonetheless, since she understands the inevitability of conflict in group settings, she has an elaborate program intended to solve those squabbles. According to Larsson and Sahlsten (2011), leadership entails working well with followers to achieve the desired results. And since conflicts impede the realization of these goals, having a comprehensive conflict resolution program inculcates the maintenance of interpersonal relations through respect.
Despite the above operational issue, the nurse leader faces the challenge of incivility at the unit. The perpetrators mainly target new nurse and interns. At first, she thought it was a subtle issue of the new environment, but when it persisted, she was forced to investigate and develop an appropriate action. Warmer et al. (2016) highlight that incivility emanates from the lack of support to rude or humiliating comments, which may contain verbal threats. Its prevalence in hospitals is variable, and victims may confront the offender or report the matter (Lewis & Malecha, 2011; Warmer et al., 2016). Since incivility can wreak disruptions in the existing conducive work environment, the nurse leaders option to offer cognitively rehearsed responses and awareness creation of the issue led to its eventual decline.
Personal and Professional Growth
Personally, I think the nurse leader demonstrates a lot of leadership competencies. The most important attribute that I learned is that leaders inspire subordinates. The nurse leader above has managed to empower her juniors by guiding them through various aspects of bedside care. She invites deliberations before making crucial decisions, delegates some responsibilities, and is respectful of staff diversities. As a transformational leader, the nurse recognizes diversity and individual differences and has since acted on them to enable the staff to realize their leadership potentials (Larsson & Sahlsten, 2011). As a result, the staff are more respectful of each other and perform most of the duties with minimal supervision. Moreover, her comprehensive conflict resolution program has minimized interpersonal squabbles at work, and the staff can collaborate well in teams. Her actions have inspired me to be a bedside nurse, and I hope that her mentorship will enable me to rise to a management position at the hospital.
BSN and Career Enhancement
BSN degrees focus more on management roles than the practice functions. For instance, BSN nurses do less with their hands (skills-based work) and more with information (mind work). Besides, the degree offers opportunities for research and career development. Coyne and Chatham (n.d), acknowledge that continuing education deepens and broadens skills and knowledge competencies. This observation exposes BSN nurses to many opportunities that call for career advancements. The ability to use reflection in and on practice facilitates the realization of gaps will mediate career advancements. As a result, I believe that my enrollment into a BSN degree will broaden and widen my knowledge gaps to become a nurse leader. By becoming a manager, my position will facilitate my personal and career developments.
Nurse leadership is an essential aspect of nursing practice. The ability to demonstrate leadership is crucial in the attainment of a safe and efficient patient care. Although several leadership styles exist, Transformational leaders empower their subordinates towards the realization of patient-centered models of care. In as much as the democracy is essential in engaging and empowering followers, it may suffer the challenges of inadequate direction, especially when decisive action is needed. Nonetheless, the democratic approach is useful in relationship management and the creation of a conducive working environment, which reduces workplace incivility. The BSN degree is essential for career advancement because it focuses on information and administration duties, which enables personal and professional development.
Coyne, M.L., & Chatham, C. (n.d). Advancing and managing your professional nursing
career. (n.p): Jones & Bartlett Learning.
Larsson, I.E., & Sahlsten, M.J.M. (2016). The staff nurse clinical leader at the bedside: Swedish
registered nurses perceptions. Nursing Research and Practice, 2016, 1-8.
Lewis, P.S., & Malecha, A. (2011). The impact of workplace incivility on the work environment,
manager skills, and productivity. The journal of Nursing Administration, 41(1), 41-47.
Lorber, M., & Savic, B.S. (2011). Perceptions of managerial competencies, style, and
characteristics among professionals in nursing. Croat Medical Journal, 52(2), 198-204.
Warmer, J., Sommers, K., Zappa, M., & Thornlow, D.K. (2016). Decreasing workplace
incivility. Nursing Management, 47(1), 22-30.
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