Unit-3-Notes - Lecture notes 3 PDF

Preview

Summary

Alexandra Hodson is the professor....

Description

Unit 3: Objectives Describe the relationship between the vision, mission and values and the nurse leadership style within the organization. 2. Describe how demographic forces, social forces and technological forces impact nurse leadership within the Canadian health care system. 3. Describe the relationship among leadership, workplace empowerment, spirit at work, job satisfaction and organizational commitment. 4. Look at leadership styles and a) Describe common leadership styles i.e. servant leadership, resonant leadership (emotionally intelligent styles described as visionary, affiliative, coaching and democratic), dissonant leadership (pacesetting and commanding), management by exception, and laissez-faire leadership. b) Identify his/her preferred leadership style.

1.

Chapter 1: Identifying Your Leadership Strengths and Opportunities for Growth, Joan Wagner Research Note: “Spirit at Work”  spirit at work (SAW) is a work place construct that describes individuals who are passionate about their work. Composed of 4 concepts: engaging work, sense of community, spiritual connection and mystical experience. Engaging work: feel that their work is meaningful Sense of community: employee trusts and respects their coworkers Spiritual connections: feel that they contribute to something larger than themselves Mystical experience: transcendence state that has a positive state of energy for vitality, experience of joy and bliss  When a nurse has strong SAW, everyone around them benefits, have a strong sense of wellbeing, and increased productivity and energy.  Relationship between SAW and patient outcome has not been studied yet. Absence of evidence.  The research took place between two care settings: surgical RNs practising in an acute care environment and home care RNs providing care in the client’s home.  Similarities: most nurses found their working environment to be sufficient. SAW had a significant positive impact on work place.  Differences: education had an impact on SAW for surgical nurses, where education had no impact on SAW for home care nurses. This meant that a surgical environment was more appealing for nurses with a higher education such as an RN compared to an LPN.  For both settings, engaging work and mystical experiences accounted for the majority of variance in job satisfaction.  In conclusion, SAW is a more holistic view of the workplace and provides a better measurement of RN workplace perceptions than existing measurements.

Chapter 5: Providing Nursing Leadership within the Healthcare System, Joan Wagner 5.1: systems theory and health care  causality in a complex adaptive system is not linear: difficult to predict the end result of a specific employee- or patient-focused intervention. How can we be successful leaders if we can’t predict? 2 Principles of the complex adaptive system: lens of complexity and good enough vision. Provide us with clues to lead others. Organizations and nurse leaders acknowledge that they cannot control change. Successful health care leaders give a general sense of direction to employees, rather than specific details. Leaders also encourage to develop responses that meet their individual strengths and needs to meet the goal of quality patient care. 5.2: organizational vision, mission, and values  Organization’s vision statement: defines why the organization exists, how the organization is unique, and specifies where the leaders hope the organization is going  Mission: how the organization will fulfill its vision and establish a common course of action Values: developed to assist with the achievement of the vision and mission and provide strategic guidelines for decision making by members of the organization. Visions, mission and value statement provide guidelines to “walk the talk”. Constantly changing and adapting to ensure its meeting the needs of the consumer or patient.  Leaders look the lenses of the vision, mission and value statements for guidance when determining appropriate responses.  Employees who understand the relationship between their own work and the mission of the organization will contribute to a stronger health care system that provides exceptional patient care. 5.3: organizational culture and nursing leadership  organizational culture: implicit knowledge or values and beliefs within the organization that reflect the norms and traditions of the organization.  Since individual organizations have their own vision, mission, and value statements, each organization has a different culture.  With the increasing emphasis on collaboration, it is essential to understand how to overcome the challenges of cultural differences.  An example of the role of organizational culture is the UK’s National Health Service health trusts response to the unnecessary death of 1,200 people between January 2005 to March 2009. Encouraged organizations to stablish “Schwartz rounds”- supported all disciplines to reflect on the emotional aspect of their work, enhance communication and improve relations with patients. Leaders play a big role in inspiring change. When introducing change, it is important to recognize that cultural change can’t be commanded but can only be inspired.  When caregivers have adequate resources, support and respect= increased job satisfaction and reduced patient morbidity and mortality.  Holistic leadership: focus on relational leadership and staff empowerment, foster a strong care provider culture within the organization. Research indicates that successful and effective nurse leaders have a positive impact upon the well-being of nurses, which converts into improved patient- client outcomes. Activity 5.3.1: Spirit at Work Can Make a Difference 1. What is spirit at work? Term used to describe the experience of individuals who are passionate about and energized by their work

2. What are the four dimensions that make up spirit at work? Describe them. -Cognitive Dimension: engaging work characterized by a feeling of well-being, a belief that one is engaged in meaningful work that has a higher purpose, an awareness of alignment between one’s values and beliefs and one’s work, and a sense of being authentic -Spiritual Dimension: spiritual connection characterized by a sense of connection to something larger than self -Interpersonal Dimension of a Sense of Community: characterized by a feeling of connectedness to others and common purpose. -Mythical Dimension: mystical or unitive experience characterized by a positive state of energy or vitality, a sense of perfection, transcendence, and experiences of joy and bliss. 3. Does resonant leadership have an effect on structural empowerment? On psychological empowerment? On spirit at work? Resonant Leadership: art of persuading people to work toward a common goal. Structural Empowerment: employees should be given control over their circumstances if they are to reach their optimal performance. Psychological Empowerment: psychological state that employees must experience for empowerment interventions to be successful  resonant leadership has a direct effect on structural empowerment and SAW. It does not have a direct effect on psychological empowerment. Rather, structural empowerment has an effect on psychological empowerment. 4. How can spirit at work research contribute to the development of healthy workplaces? -identifies positive links between leadership research, workplace empowerment research and SAW: this knowledge will assist in the creation of a healthy work environment, thus facilitating improved patient outcomes and reduce workplace bullying. -the use of SAW as a measure implies that spirit is a significant component in the health care workplace. Nursing Organizations: Nursing Leadership in action (Fundamentals: Perspectives on the Art and Science of Canadian Nursing) PP 87-91  leadership: study of how men and women guide us through adversity, uncertainty, hardship, disruption, transformation, transition, recovery, new beginnings and other significant challenges. Leadership Styles: Relational; -Transformational: four characteristics including idealized influence, inspiration motivation, intellectual stimulation and consideration. Sensitive to needs of others -Resonant: relational energy is made evident by building relationships and managing emotion in the workplace -Individualized consideration: attentive to the needs of each staff member and supports individuals to reach their full potential. -Servant: displays stresses service to others and recognizes that the role of organizations is to create people who can build a better tomorrow. -Quantum: change agent Task-focused; -Management by exception: focuses on appropriate

-Laissez-faire: not concerned about organizational outcomes or follower behaviour -Transactional: clarify expected performance and provide rewards for good performance, correct variations from the expected standard and work to prevent problems -Dissonant: lack empathy, and tend to be negative, lacing emotional intelligence -Passive avoidant: often avoid taking action, reacting with corrective action once problems are serious -Instrumental: not values-based, rather focused on strategy and facilitation of work outcomes -Initiating structure: define individual’s roles, focused on goal achievement and create clear communication channels.

Video: Reflections on Indigenous Nursing Leadership, Sharon Ahenakew  Leadership from a Cree perspective.  Sought after literature to determine “who am I and what do I have to offer” with no results. This caused Sharon to consult back to who she was as a Cree leader and teachings she had received over the years.  Cree leadership perspective: not a model or theory, rather a way of life that is guided by a value system that is rooted in spirituality. Primary Cree values of a good leader: kinship, getting along well together, working cooperatively, respect, speaking on behalf of others, accepting guidance, a keen sense of observation, obedience and listening with an open heart, compassion, love and kindness, honesty and clean living, sharing, generosity, and humility.  From a Cree perspective, becoming a leader means to connect with the creator, other and oneself. Holistic process of awareness and self-discovery.  CNA code of ethics incorporates many of the Cree leadership values such as; shared responsibility, supporting and advocacy

ADDITIONAL READINGS:

1) Qualities of exemplary nurse leaders: perspectives of frontline nurses Results  The frontline nurses described several common characteristics of exemplary nurse leaders, including: a passion for nursing; a sense of optimism; the ability to form personal connections with their staff; excellent role modelling and mentorship; and the ability to manage crisis while guided by a set of moral principles. All of these characteristics pervade the current literature regarding frontline nurses' perspectives on nurse leaders. Anonson, J., Walker, M. E., Arries, E., Maposa, S., Telford, P., & Berry, L. (2014). Qualities of exemplary nurse leaders: perspectives of frontline 742.nurses. Journal of Nursing Management, 22, 127-136. doi: 10.1111/jonm.12092 https://www.researchgate.net/publication/24502645

Group Summaries: Group 1: This week, group one answered a couple of questions about leadership based on this week’s readings and any outside sources that were appropriate. 1.

When do you think it is most appropriate to employ a relational leadership style? Why? Give an example.

Our group agrees that nursing is an excellent example of relational leadership; task-oriented leadership would lead to missing out on relationships with our patients and their families. We also focus a good portion of our practice around being ethical and promoting patient wellbeing which once again relates back to the relationship or connection we form with our patients. We also discussed showing concern for other members of staff and our coworkers; we work with them as a team and try to help each other out when another nurse has a heavier patient load. We hope that implementing a relational leadership style within nursing practice could improve patient outcomes and reduce the pressure placed on nurses (which decreases near misses or adverse events). Relational leadership is not only beneficial to the followers or peers, but also beneficial to the leader as it reduces the conflict the leader may have to deal with. 2. Is it ever appropriate to employ a task-focused leadership style? If it is appropriate, when would you use a task-focused leadership style? Give an example Task-focused leadership is a style heavily focused on a ‘to-do’ list of goals and deadlines, often with disregard for relationships or staff morale. We agreed that this style of leadership could be appropriate when used in the correct setting. One example of a setting where this is appropriate is in an environment heavily focused on appointments or timely assessments where the structure and timing are of utmost importance related to patient health. But the rigidity of task-focused leadership, may cause the staff to get caught up in meeting the goals set by the leader and focus less on patient satisfaction. Another instance where it might be appropriate is when the group is unable to function or cooperate with an open deadline. This can cause a leader to be frustrated with the group and have to enforce more rigid expectations with consequences to ‘encourage’ participation. Task-focused leadership may lead to poor morale among staff members, unrealistic expectations, and/or poor outcomes when used incorrectly. Using only this style in nursing practice causes nurses to lose sight of patient empowerment and satisfaction. An excellent point brought up during the discussion was that task-focused leadership may be effective in nursing but should not be the main leadership style. Rather, it could be introduced for certain situations and circumstances where the deadline or clear goal setting could motivate staff to achieve said goals.

We also talked about our own leadership styles and how we think we try to lead. It was extremely helpful to reflect on our own leadership and how it is changing throughout the semester! I’ve also included some of the resources our group found helpful for this discussion at the bottom. And here is an NCLEX question based on relational nursing!

The nurse knows which of the following statements made by the nurse manager would be considered an example of relational leadership: a. “Everyone must have completed their charting of morning assessments by 0900 regardless of what is happening with your patients” b. “It doesn’t matter what everyone gets done today, I’ll be in my office” c. “I encourage you to build a report with not only your patients but also their families” d. “I’m giving everyone a list of tasks that are to be done around the unit today. Please see me when they are complete” The answer is C! While these seem like exaggerated or unrealistic statements, they are the foundation of different leaderships styles. By breaking down more complex questions about leadership into simple statements of what the nurse manager is really asking, it will be easier to answer these kinds of questions! Sources: Cummings, G. G., Macgregor, T., Davey, M., Lee, H., Wong, C. A., Lo, E., . . . Stafford, E. (2010). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies,47(3), 363-385. doi:10.1016/j.ijnurstu.2009.08.006

Isnowden1. (2014, March 6). Relational Leadership. Retrieved from: https://leadershipforhighered.wordpress.com/2014/03/06/relational-leadership/

Memorial Student Union. (2006, October 30). The Relational Leadership Model. Retrieved from: http://www.mu.uri.edu/leadership/pdfs/relationalleadership.pdf

Wong, C. A. & Cummings G. G. & Ducharme L. (2013). The relationship between nursing leadership and patient outcomes: a system review update. Journal of Nursing Management. 21, 709-724. https://doi-org.libproxy.uregina.ca/10.1111/jonm.12116 Group 2: This week our topic was “Providing Leadership to Indigenous Communities”. Our question to stimulate discussion was: “How, as a nurse leader working with Indigenous peoples will you look at ways to be effective in empowering clients and families?” Our group came up with many ways that we, as nursing students and future nurses, could empower our Indigenous patients and their families. Many of us discussed the power that education, of both us as health care providers and our patients, could have to increase empowerment. We also discussed how the recognition and elimination of our own personal biases and stereotypes would empower Indigenous peoples by positively impacting the care they receive. Another way that we thought would help to empower our Indigenous clients and their families was involving them directly in their care and asking what they wanted to happen. If we

are able to understand what they want and why they want it, this will increase collaboration and increase positive patient outcomes. Cultural awareness was another common theme in our discussion. We discussed the medicine wheel and how it is important in Indigenous cultures when they think of health and well-being. In Indigenous cultures, there is a heavy emphasis on community. Treating the patient, and whoever they consider family will also help to empower and increase Indigenous patient satisfaction. Also we discussed how the recruitment of Indigenous peoples into health care leader positions can ensure the incorporation of culturally sensitive care to patients, thus increasing empowerment. We also mentioned access to resources, poverty, and other elements of the social determinants of health and how they can impact the Indigenous populations health experiences. Being aware that inequities exist, and how to help solve these inequities is also an important factor in the empowerment of Indigenous peoples. Lastly, we discussed how nurse leaders can not only educate themselves, but their Indigenous patients on resources that are available to them in the community as a form of empowerment.

NCLEX question: The nurse on a busy med-surg unit has a full patient load. One of their patients, who identifies as Indigenous has had many visitors in and out of their room all day. The nurse is frustrated due to the fact that the number of people in the room at one time is congesting their work space and also not allowing the patient to rest. What would be the nurses most appropriate response to the influx of visitors? 1. 2. 3. 4.

Understand and accept that this is an aspect of the patient’s culture Tell the patient that the visitors need to be limited in both number and length of visit Put a sign up on the patient’s room saying “No visitors at this time” Talk to the charge nurse and have them approach the family

Answer = 1. Understand and accept that this is an aspect of the patient’s culture

Group 3: Group 3-Discussion 3.3 (Vision, Mission and Value and Influential Forces) This week we collaborated to develop a vision, mission and strategic priorities/goals for a special care home in rural Saskatchewan community (we chose Kyle, Saskatchewan). Overall, this special care home aims to be centered around the resident and their family. The goal is to create a home in which resident's are able to maintain their independence, participate in community activities (as much as they wish) in a safe and supportive environment. In our group discussion this week a few sayings were shared that reflect the type of philosophy for the home:

“Treat others as you would like to be treated” and “Residents do not live in our workplace, we work in their home”. Our vision, Mission, values and influential forces are as below: Vision statement: “Enriching lives holistically with dignity, respect, and compassion" Mission: “To build a home that supports and cares for people of all types of necessities and deliver exceptional community activities to better serve our residents and their families.” Cores Values          

Excellence in care and service Resident/Famil...