Discussion:
Response 1:
Hi there, my name is Elizabeth Rostron and I am currently a School Nurse for a private school in Massachusetts that specialized in children with autism and behavioral diagnoses. I manage nursing services for our school and also have a background as a Nurse Manager for a private home health care company. I learned early on in my education that effective leadership in healthcare is essential to the success of the patient and facility and in the same turn is certainly not for everyone.
Leadership in healthcare is a role that must be carefully selected, as those at the helm of a department must be dedicated to their position, educated in their practice, fluid in their adjustment to change, and compassionate for not only their patients but also their staff. While all factors are important, success will specifically be seen in the leader who can adjust appropriately, learn quickly, and educate themselves along the way in a fluid manner. According to the authors, "Fluidity has become a characteristic of doing business and managing life in every human arena" (Porter-O'Grady & Malloch, 2018, p. 2).
When delving into the practice of a healthcare administrator (HA), perhaps in an ambulatory surgical center setting, the HA must possess valuable traits to not only manage their own duties but also encourage and educate their staff and ensure quality and safe practice across the facility. Improving the clinical microsystem that the HA is managing will take patience, deviating away from the older linear thinking module, encompassing whole-systems thinking, and encouraging valuable feedback from employees and teams (Porter-O'Grady & Malloch, 2018). As we continue to learn more about clinical microsystems and leadership, these questions will become building blocks and allow for improvement in understanding leadership in healthcare.
References
Porter-O'Grady, T., & Malloch, K. (2018). Quantum leadership: Creating sustainable value in health care (5th ed.). Burlington, MA: Jones & Bartlett Learning. ISBN: 978-1-284-11077-7
Response 2:
There were many similarities noted, when reflecting on my experiences and this module's readings. Organizationally, my facility plans for timely, accessible, and safe client-centered services, as outlined by Lazar, Godfrey, Nelson, and Batalden (2011). We anticipate for common health and social related events, as well as having consideration for how we may benefit our community in the near and distant future. For example, the influenza vaccine is made available to our facility no later than October of each year. Knowing and planning for this, allows us to have consents ready ahead of time, as well as the time to audit charts to know if there are current glomerular filtration rates in the patient charts, in the event an antiviral should be needed during an outbreak. Roles are clear for who is responsible for which aspect of each task, however, there is flexibility. Both nursing and social services will work together to obtain consents, as nursing may see family when they visit in the evening after social services have left for the day, while other families may be unable to visit and will need for social services to mail the consent for a signature. Distant future planning would include meeting quarterly with area health agencies to discuss services being accessed in the community, patient demographics, and comorbidities. For example, an increase in bariatric services in the home healthcare system will trigger an internal review at my facility to determine if equipment should be budgeted for the coming year, as well as having room dimensions and client areas evaluated for accessibility.
My vision of leadership in healthcare has been molded by what has been presented within my workplace culture, through television, social media, literature, and in the classroom. Many, many years ago, a high school teacher had advised me that for every action there is potential for an equal and opposite reaction. Which is summarily how Porter-O'Grady and Malloch (2018) characterize Quantum theory (p. 15). Would you agree? Based on this, characteristics a Chief Nursing Officer should possess, in order to lead healthcare teams and improve the function of clinical microsystems, include: flexibility (knowing what leadership style is needed in a given situation), ability to communicate effectively (listening to understand, clarifying statements, and transparency), the ability to know an organization as a whole and how it interrelates with other healthcare systems, regulations, and laws, have their clients at the epicenter of their work, and to be one who takes action.
Regards,
Lynn
References
Lazar, J. S., Godfrey, M. M., Nelson, E. C., & Batalden, P. B. (Eds.). (2011). Value by design: Developing clinical microsystems to achieve organizational excellence (2nd ed.). San Francisco, CA: Jossey-Bass.
Porter-O'Grady, T., & Malloch, K. (2018). Quantum leadership: Creating sustainable value in health care (5th ed.). Burlington, MA: Jones & Bartlett Learning.
Response 3:
Nurses are generally regarded as possessing the qualities of caring and compassion, and interestingly these two qualities should be a component of effective nursing leadership. A nursing leader/ manager must have care and compassion for staff as well as patients. An effective manager/ leader will work to share their vision of optimal teamwork in order to provide better care for patients, most appropriate utilization of resources, and an ability to act as a mentor for personal and professional growth within the team. Effective communications with others will help the leader to advocate passionately for team staff members and patients, listen to others who may provide solutions to problems, and make changes accordingly.
The nurse leadership style that has been used in my school district is the democratic style where all nurses meet to solve issues, write policies, and receive education on current best practices in school nursing. I really don't feel that this approach has been effective because input from some team members is consistently ignored and the majority rules. There are three elementary schools in the district, a middle school, and a high school. So elementary nursing issues seem to dominate every discussion. Students at the upper levels have different needs that may not necessarily be seen at lower levels. Approximately sixty-five percent of the students who come to my office have mental, behavioral, or socio-emotional difficulties which means I have had to develop a set of skills for behavior management. Lately, the management has been more laissez-faire as the nurse leader nears retirement, and not much team collaboration and growth has taken place in the past 2 years.
The approach that I have been drawn to is the Leadership-By-Walking-Around (LBWA) model, simply because I feel that it would work best for my district. A leader who remains entrenched in their office proves to be demoralizing for staff because it feels as if management doesn't care about our day-to-day activities, needs, frustrations, and challenges. I have suggested that once week a month everyone rotates to a different school per day. This would work out well because we have five school buildings in our district. I believe that would relieve a lot of interprofessional tension if we all had to experience another team member's day through our own eyes. The team would gain valuable insight into each other's workday, which would allow for more understanding and compassion between team members. Hopefully this would help strengthen the bonds between team members and create a positive environment that is respectful of the differing roles that other team members must play to reach the organizational goal of optimal free and equitable nursing care for district students.
References
Pullen, R. L. (2016). Leadership in nursing practice. Nursing Made Incredibly Easy 14 (3). doi: 10.1097/01.NME.0000481442.05288.05
Savel, R. H. & Munro, C. L. (2017). Servant leadership: the primacy of service. American Journal of Critical Care 26 (2). doi: 10.4037/ajcc2017356