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Essay: Leadership in Adult Nursing (reflective)

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Introduction Leadership is a process which involves individual activity to state desire objective and vision in a situation, providing support and motivating other people to attend set goals (Swearingen, 2009). Danae et al. (2017) believe that leadership is broadly recognised as a key aspect of overall effective healthcare. Therefore, nurses require strong leadership skills to accomplish various tasks to improve care quality. In this assignment, I will cross reference six experts (see appendices) from my professional development portfolio related to the four domains of standards of competence for preregistration nursing (NMC, 2010). Additionally, I will address each domain using Rolfe, Freshwater and Jasper (2001) reflection model, which is composed of three stages ‘what’, ‘so what’, and ‘now what’. This model is suitable to link practical experiences with theory, it helps to improve clinical practice and identify further learning opportunities; which will be addressed by formulating a S.M.A.R.T action plan (Doran, 1981). Domaine 1: Professional values What? Appendix 1 shows aspects of the professional values that I need to address. It contains mentor’s comment about patient advocacy skill. During my Nursing Practice 5 (NP5), I looked after a 56-year-old disabled woman with Spina Bifida who was alert and orientated, unable to move on her own, but, had clearly expressed her need to be moved every two hours to avoid another pressure ulcer as she had one before. This was not respected by health care assistant taking for excuses “the ward is very busy, she is not the only patient”. I regret I didn’t advocate for her. Furthermore, appendix 2, which is the leadership framework self-assessment tool demonstrates aspects of personal quality that I need to review. These are related to the (NMC, 2010) instructing nurses to take all reasonable steps to protect people who are vulnerable or at risk from harm, neglect or abuse. So what? Professionalism means practice through the application of the Code (NMC, 2017). In the UK, nurses must act as advocates for their patients, challenge poor practice and discriminatory attitudes and behaviour relating to the care of vulnerable people, (NMC, 2015). This is supported by the Royal College of Nursing (RCN) stating that speaking on behalf of another is an integral part of the nurse’s role (RCN, 2008). Moreover, The International Council of Nurses emphasises the need for nurses to respect the rights, values, customs and beliefs of individuals and families, and to advocate for equity and social justice in resource allocation and in access to health (ICN, 2012). Such endeavours are central, as illness nearly always increase levels of patient vulnerability and dependence (Marquis and Huston 2012). Emphasizing the fact that nurses should influence the way care is given in a manner that is open and responds to individual needs (RCN, 2015). Unfortunately, there have been cases where nurses have failed to provide fundamental care to patients. The report into the failing at the Mid Staffordshire Hospital identified poor leadership coupled with clinical staff accepting standards of care that should not have been tolerated (Ellis and Bach, 2015). More recently, Care Quality Commission (CQC) has issued a Warning Notice requiring some trusts to improve safety, patient consent and overall leadership (CQC, 2017). This accentuates the role of leadership in prioritising patient safety and in listening to and learning from patients (storey and Holti, 2013). Stressing the need for nurse leaders to be self-aware and recognise how their own values and principles may affect their practice (NMC, 2010). Leaders encourage teamwork by appreciating individuals’ contributions and ideas; this creates needed behaviour, such as shared respect, compassionate care, attention to detail, between team members (NHS Leadership Academy, 2013), and create a motivating work environment (Adair, 2002). Therefore, the quality of leadership has a direct impact on the quality of service provided at all levels. The leader’s obligation is to create an environment in which good people can provide good care (Engard, 2017). Pointing out personal attributes of nurses that help to enable advocacy like flexibility, empathy, self-motivation, professional commitment, sense of responsibility, and the ability to cope with stress (Choi, 2015). Reflecting on the above scenario, transformational and transactional leadership can both play a role in the negotiation of a win-win situation. Transformational leadership is defined as a leadership approach that causes changes in individuals and social systems. It is about having a vision of how things should or could be and being able to communicate this idea effectively to others (Ellis and Bach, 2015). Whereas transactional leadership is based on contingent rewards and can have a positive effect on followers’ satisfaction and performance (Tomlinson, 2012). Transformational leadership plays a more critical role in the present scenario. it can motivate and inspire healthcare assistant and have a more significant impact to change both their thinking and behaviour Jie-HuiXu (2017), thus, allowing them to reach their potential and deliver sustainable changes to care. Now what? Now I should strive on developing and sustaining my engagement in patient advocacy by the end of NP7. In my Ongoing Achievement Record document, I will work with my mentor to complete competency 1.2. called: Understand and apply current legislation to all service users, paying special attention to the protection of vulnerable people, including those with complex needs. I will actively seek mentor, patients, family and others health professionals’ feedback and reflect on when I have been involved in patient advocacy during placement and review this with my mentor at mid- and end-point review. Domain 2: Communication and Interpersonal Skill What? Communication and interpersonal skill are vital parts of collaborative working (NMC, 2010). I reflect on communication using Situation, Background, Assessment and Recommendation (SBAR) mentioned in appendix 3, which is a reflective writing during placement 5. In a surgical ward, during routine observation of a patient who had undergone a cystectomy, I noticed that the patient was spiking in temperature (38.5) although NEWS score was 1, I immediately informed my mentor who directed me to blip the doctor in charge of his care. While communicating with him I was unable to give a clear response to questions about the patient’s condition. Even though he reassessed my patient immediately, I regret I didn’t use SBAR tool, because it could have helped to communicate clearly and prevent any potential delays. Appendix 1 in the section ‘working with others’ further shows that I need to improve my interpersonal skills. These relate to part of the NMC (2010) stating: nurses must use a range of communication skills and technologies to support person-centred care and enhance quality and safety. So what? Bach and Grant (2010) state that good communication and interpersonal skills are essential characteristics of high-quality nursing practice. The NMC (2010) also said that all nurses must use the full range of communication methods, including verbal, nonverbal and written, to acquire, interpret and record their knowledge and understanding of people’s needs. Emphasizing the use of communication tools like SBAR. SBAR is a tangible approach to framing conversations, especially critical ones that require a nurse’s instant attention and action. It promotes the provision of safe, efficient, timely, and patient-centred communication (Chaboyer et al., 2010; Day, 2010). Moreover, SBAR can be used for multiple forms of communication. It can be a change-of-shift report (Pope et al., 2008; Thomas et al., 2009), or can be applied to written communication (Perry, 2014). In addition, SBAR helps nursing students and recent graduate nurses organize their thoughts prior to calling physicians, to save time, reduce frustration, and improve overall communication (Pope et al., 2008). Furthermore, the use of SBAR communication tool temporarily flattens the hierarchy perceived in most healthcare settings, resulting in more effective channels of communication between healthcare providers (De Meester, Verspuy, Monsieurs, & Van Bogaert, 2013). According to Hackman and Johnson (2013), leadership is first, and foremost, a communication-based activity. Depending on the circumstances, a leader should try to be more authoritarian, democratic or laissez-faire (Mitchell, 2012); or should focus the communication on the tasks or use a more interpersonal style (Hackman and Johnson 2013). Reflecting on the scenario related to this domain, an assertive, clear and focus communication using SBAR format would have provided a brief, organized, predictable flow of information improving critical thinking communication skills and patient safety (Olin, 2012). It can be argued that it is hard to serve as an effective leader without effective communication (Hackman and Johnson 2013). This is agreed by Perry et al (2014) stating that effective commutation is a central attribute of clinical leadership. Clinical leaders can influence their colleagues with effective communication skill such as good listening skill and extremely good at explaining things at the right level that can be understood by followers. However, it is important to note that each clinical leader has a preferred style of communication that would not necessary works every time. Hackman and Johnson (2013) recommend choosing a leadership communication style that will work best according to the situation and the level of knowledge of followers. Now what? During next placement (NP7), I will strive to change communicating SBAR in a more professional, concise, clear, in a timely manner when communicating with the multidisciplinary team to improve patient outcome. I will actively seek feedback from my mentor and other professionals at mid- and end-point reviews. I will also change my preferred communication style from passive aggressive to an assertive communication style. For that, I will use the communication style questionnaire at the beginning then altered my behaviour during the first part of the placement, then repeat the questionnaire at mid-point and ask for feedback to my mentor base on the comparison on two questionnaire results and base on her observation. And repeat this again by end-point. Domain 3: Nursing Practice and Decision Making What? Here I reflect on nursing practice and decision making, see appendix 4, which is an end-point mentor comment during NP3 showing that improvement is needed in this domain. This is underpinned by appendix 5: a reflection done at the beginning of NP6 when I looked after a patient with hypoxic brain damaged who had a seizure. On my entry into his room, I found the patient unconscious, I took the decision to clear his airway before pressing the emergency bell which could have jeopardised patient safety. This is related to the NMC (2010) stating that nurses must be able to recognise and interpret signs of normal and deteriorating mental and physical health and respond promptly to maintain or improve the health and comfort of the service user. My behaviour pointed out the need to enhance my skill and knowledge in this domain. So what? Judgement and decision-making are important facets of healthcare for nurses (Traynor et al., 2010). Judgement is defined as weighing up different alternatives; while decision-making involves choosing a specific course of action to follow between alternatives (Lamb and Sevdalis, 2011). Hence, (Undre et al., 2009) define efficacious judgement and decision-making as skills that go beyond clinical knowledge and technical competence, highlighting the fact that nursing judgement and decision-making contribute significantly to the safety and quality of patient care (Traynor et al., 2010). However, several studies have high-pointed that when given the same information, and undertaking the same decisions, nurses will make consistently different judgements and decisions (Thompson et al., 2008; Thompson and Yang, 2009). Differing judgement and decision indicate different types of reasoning, in situations where time is not constrained, newly qualified nurses will make structured judgments with a rational-analytical decision. For those situations where time is limited, information is perceptual, and the nurse has some perceived expertise, it is appropriate to use intuition as the basis for judgement (Hammond et al., 1987). Thompson et al (2008) suggest that the key to successful reasoning is to adapt reasoning to the demands of the task. However, such adaptive reasoning by nurses is sometimes absent. Thus, good decisions and judgements are not independent to the cognitive process but can be influenced by how information is prioritised and the nurse’s ability to identify and respond to vital aspects of the clinical situation (Pearson, 2013). Thompson et al (2013) state that recent studies have shown positive benefits associated with the introduction of Computerised Decision Support Systems (CDSS) to support nursing decisions. Hence, helping to promote patient’s safety and improve their outcome. Reflecting on the scenario related to this domain, future decisions making process, whether they are based on normative, prescriptive or descriptive theory must include clinical expertise, patient value and best available research evidence (Sackett, 1996). because evidence by itself, does not make the decision, but it can help support the patient care process. In the same order, Marquis and Huston (2015) suggest that to be effective as a leader, one needs certain skills for making decisions, such as self-awareness, fairness and transparency which are skills also needed in decision making. This is supported by Thompson and Dowding (2009 p5) affirming that “One of the distinguishing features that mark out exceptional nurses is their skills in judgement and decision making”. Decision making is considered important leadership skills and is recognised by Sofarelli and Brown (1998) as qualities associated with transformational leadership. Now what? I have realised that decision making, particularly in nursing, is vital as it influences patient safety and outcomes (Ellis and Bach, 2015). It has been mention earlier that experience is a factor that affects decision making. To gained experience in judgement and decision making, I will use every opportunity during NP7 to practice evidence base in nursing practice and decision making by always based my decision on useful information sources like clinical guidelines, protocol and policy and patient preference. After what I will actively seek feedback from my mentor and others healthcare professionals and of course to patients to check their satisfaction about their involvement in the decision-making process about their own care at mid- and end-point reviews. . Domain 4: Leadership, management and team-working What? My leadership, management and team working skill are measured in appendix 2 and appendix 6 which are both leadership self-assessment tools. The first one showing aspects of my leadership that needs to be improved and the second one showing my leadership style which is “guiding” needing improvement to become more empowering. These are further supported by appendix 4: mentor end NP3 comment. During the leadership module, I took part in several group activities, which enabled me to understand team role importance and that there is no leader without followers. This part relates to NMC (2010) stating that nurses must work independently as well as in teams; be able to take the lead in coordinating, delegating and supervising care safely, managing risk and remaining accountable for care given. So what? Tomlison (2012) states that self-assessment helps individuals to appreciate their qualities, strengths and weaknesses thereby, enabling better transformational leadership. Bass (1985) found that transformational leadership contributes to individual performance and motivation. Whereas transactional leadership (Burns, 1978) is short-lived, and task-based, with the leader intervening with negative feedback when things go wrong. Adair (2002) proposed a three-circle model of strategic leadership, with the circles being the needs of the task, the individual and the team. This is a democratic model of leadership matching the NMC code, where Individuals and groups are involved in decision-making processes concerning their work (Adair, 2002). Management skills are as important as leadership skills in addressing some failings like those identified in the Francis report (Kerridge, 2013). Kerridge suggests they are closely linked, effective management and leadership both require putting first thing first. The King’s Fund report (2011) concurs, defining leadership as the art of motivating people toward a shared vision and management as getting the job done, suggesting that the exercise of leadership across shifts could be extended to management practice; pointing out that every member of healthcare team has some management and reporting functions as part of their job (Baker et al., 2012). Lord Darzi (2008) said: ‘Leadership is not just about individuals, but teams’. A successful leader will see each person as an individual, recognising their unique set of needs, as not everyone will perform at the same level (Hackman and Johnson 2013). This rejoins the description of team role by Belbin (1996) as he described a team role as ‘a tendency to behave, contribute and interrelate with others in a particular way’. Suggesting that Belbin assessment would be an ideal way for a team to examine: the roles they play, how these fit in with the team and the contribution of roles to the team (Frankel, 2011). Therefore, it would be advisable that team members use the questionnaire to helps identify individuals’ preferred roles, their manageable roles and their least preferred roles within the nine teams’ roles as described by Belbin in-order-to improve the success of teamwork. Nurse leaders need also to be able to respond to an ever-changing healthcare environment (Frankel, 2011). The literature suggests that leadership, effective communication and team working are among the most important elements for planned change (Schifalacqua et al., 2009a). Kurt (1951) identified three steps of change: unfreezing, moving and refreezing. This work was modified by Rogers (2003) who described five phases of planned change: awareness, interest, evaluation, trial and adoption. Another change theorist, Ronald Lippitt (Lippitt et al., (1958), identified seven phrases. Mitchell (2013) advises that Lippitt’s work is likely to be more useful to nurses because it incorporates a detailed plan of how to generate change and is underpinned by the four elements of the nursing process: assessment, planning, implementation and evaluation. Now what? To improve my Leadership, management and teamwork skills, I will use the first week of my MP7 to observe my mentor and nurses in charge leading some shifts, then, I will seek clarification on grey areas of my understanding and ask to have my own patients. This will enable me to practice leading others, managing patients and working with the multidisciplinary team. I will actively seek feedback till mid-point review, then, I will lead and manage my mentor whole set of patients under her observation and correction whenever needs arise till end-point. This will help me to move toward an empowering leadership style. Conclusion I have learnt that: a good leader or manager remains grounded in the values, beliefs and behaviours that guide professional nursing practice; understanding your role and that of other will nurture clear communication thus improving the success of the team; safe decision-making must be evidence-based; and effective leadership fosters a high-quality work environment leading to positive safe climate that assures better patient outcomes.

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Examples Of Leadership In Nursing Essay

Type of paper: Essay

Topic: Leadership , Health , Communication , Culture , Medicine , Nursing , Patient , Leader

Words: 2750

Published: 03/05/2020

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Leadership is essential to the successful management in the field of nursing. However, nursing leaders and employees have different views on the type of leadership style to be adapted for best results. Owing to the challenges in the nursing leadership, re-evaluation of current managerial tactics is necessary. A nurse leader must master delegation because it constitutes a critical portion of the effective leadership and success in the patient care. Since we live in a multi-cultural nation; good leaders should consider all aspects of a person including cultural diversity. Time management skills, self-efficacy and assertive communication are the other significant qualities of nurse leaders. All the attributes of a nurse leader influence the quality of care provided to the patients. One of the nursing leadership approaches is transformational style. A transformational leader is the one who employs good and qualitative styles associated with improvement in patient care. This style inspires the others to develop and implement leadership qualities. It comprises charisma, self-confidence, inspiration, intellectual stimulation and individual consideration. The transformational leader motivates the other nurses; he is sensitive to the needs of his subordinates and communicates effectively. This style of leadership increases the staff satisfaction leading to an overall reduction of nurse turnover and an increase in patient satisfaction (Smith, 2011). Though transformational leadership promotes nursing excellence, the difference in the interpretation of the nursing styles between the nurse leader and the staff is often associated with decreased satisfaction with the leadership (Andrews, 2012). Several studies have been done to establish a relationship between managerial competencies, personal characteristics and leadership style of the nursing leaders. Managerial competencies refer to the ability of the nursing leaders to manage the other nurses well. The managerial competencies of nurse leaders consist of characteristics like visionary leadership, conflict resolution, effective communication, problem solving abilities and teamwork. The issues requiring apt management by nursing leaders include conflict resolution and addressing the laziness of employees. A leader must, therefore, have qualities or competencies that help in problem solving and conflict resolution. A leader who is a great manager is the one who is long-sighted. A leader must be a person who considers the future and not just the present. The leader must know that future healthcare depends on the present health care. Another important attribute of a nurse leader is delegation. Delegation of work by the leaders increases the satisfaction amongst the employees and nurses working under them. All these characteristics and attributes positively correlate with the patient care both in the short- and the long-terms (Lorber & Savic, 2000). There is no dearth of knowledge regarding the appropriate leadership styles for nursing fields. However, inappropriate leadership styles are used by the nursing leaders in many healthcare set-ups. Therefore, a uniform and unique healthcare model for all institutions must be formed so that the country can properly facilitate the reforms needed in the healthcare system or sector. The country must also facilitate the competency evaluation and consistent monitoring of the leader’s work so that the results can be seen and appreciated. The leaders that do not furnish appropriate results may be denied their leadership roles (Lorber & Savic, 2000). The definition of leadership is multi-faceted. All sectors in the society, from the business to the financial sector and even the nursing or the healthcare sector require good leadership for greater productivity. According to Giltinane (2013), leadership in the working environment is of utmost significance. Direct involvement of the leadership is advised because leaders motivate the employees to go beyond the call of duty. The leader’s role is to ‘elicit effective performance from others.’ The leader influences and guides others towards positive results and productivity. They empower the employees and, therefore, increase organizational loyalty, job satisfaction and reduce sickness levels. The direct involvement of nursing leaders in the actual work of taking care of patients encourages the other nurses to work and to take care of the patients in a better way. Hence, the nursing leader must have personality traits, emotional intelligence and apt cognitive responses that are able to inspire others to work harder and better in their work stations. Thus, a positive productivity is associated with good leadership styles. Effective leadership also requires trust between the leader and the staff. Therefore, the leader should treat them fairly and acknowledge individual achievements. A good leader shows interest in the working of the staff, listens to their problems and helps them in decision making (Giltinane, 2013). The leader is a person who can inspire those behind him. This means that the followers should be able to agree with their leader, and the leader should be able to make them see the things the way he sees them. Overall, there should be an agreement between the leader and the followers regarding the goal(s). A respectful leader is the one who inspires the subordinate(s) to achieve the positive and effective results of the laid plans (Boyle & Kochinda, 2004). The registered nurses are trained to use techniques of the goal-oriented path to delegate more effectively to the patient care tasks. Delegation is an entry level skill and is the ability to be able to assign duties well to the respective people. Lack of delegation skills is a potential cause for negative and adverse outcome(s) resulting from ineffective supervision (Boyle & Kochinda, 2004). A good nursing leader must learn the skill of delegation through educational and practical experience. Thus, a nursing leader can’t live without the delegation power, and every success of a registered nurse will depend on their power to effectively delegate duties well. Delegation has the major role in leadership and has the determination of how the leaders perform their duties. The results in positive or negative outcomes in patients measure the level of delegation in nurses. Therefore, a successful leader is the one who possesses the qualities to delegate duties well to the subordinate staff (Dunham-Taylor, 2000). Confidence is the value of self-belief that a nurse should possess to be able to delegate patient care tasks. Research shows that demographic variables, registered nurses leadership skills and confidence in delegation are related to the outcomes of patient care in a community teaching hospital. The level of confidence is vital in the process of delegating duties among the registered nurses. The low level of confidence affects the delegation of tasks by the nurses adversely and may result in poor patient outcomes. Therefore, the level of confidence in the nurse leaders directly influences to the productivity in the health centers (Saccomano & Pinto-Zipp, 2011). In a recent study, it was hypothesized that registered nurses who demonstrated a supportive leadership style will report more confidence in delegating patient care tasks than the ones with either directive or participative styles. The hypothesis failed to hold from the research conducted and thus, the level of confidence was not justified as a measure to alter the delegating process. The level of confidence was then correlated to the delegation of duties by the nurses. In a healthcare setting, some departments help to develop the delegating skills while others do not. Therefore, the skill may or may not develop in the leader. Also, the level of confidence in the nurses will help in increasing the productivity level as they are aware of what they are doing and are not undertaking a trial process. If the nurses undertake their duty with confidence, their productivity levels are bound to increase (Saccomano & Pinto-Zipp, 2011). The nurses serve the patients with very distinct cultural beliefs. Some of the issues that face the nurses due to such occurrences include the language barrier in cases where the nurse is serving a patient from a different ethnicity or with communication problems. Secondly, there can be the cases of prejudice. They may serve the patients with their belief about the patient or what they think rather than taking keen interest in the problem faced by the patient. Thirdly, they could be ethnocentric. The issue is more problematic where a nurse is serving patients from a country that has different ethnicities, religion and/or cultural beliefs. The nurse may serve in favor of some ethnic groups, religions or communities. In the case, a hospital is not in the position of solving the issue of biasness, the simple acts of favoring one group of patients and not-favoring the other group(s) may settle an institutional trend. This type of trends may lead to the loss of nurses as well as the healthcare organization(s). Therefore, much needs to be done about the issue of cultural competence in nursing students and faculty. Psychological empowerment is considered as the best option to enhance the cultural competence. Nurses should be trained on how to give equal treatment to the patients of different backgrounds. They should have the capacity of understanding that every patient is as important as the others and the services and resources should be allocated equitably and not by bias of issues such as ethnicity, religion or race. A perception is very powerful and can lead to justice in any service. The decisions of nurses should be autonomous with a professional basis in the decision making process. This can be installed by bringing in such study fields in nursing schools as well as seminars in places of work. The nurses should be empowered by the knowledge and not pressure (Dreher, & MacNaughton, 2002; Lipson & Desantis, 2007). A nursing leader has several roles in a culturally diverse healthcare system. In any hospital setting with culturally diverse nursing workforce, the nurse leader should be fair and unbiased towards all the staff members irrespective of their background. Leadership directly affects the staff retention, level of motivation and quality of the care provided. Therefore, a good leader should be able to generate and maintain a diverse workforce for the provision of culturally relevant care. According to Skim and Miller’s theoretical framework (1999),(I could not find this reference??) there is a given process of achieving a sensitive process of changing the perception of a nurse or healthcare provider. The process involves the steps mentioned below:

• Understanding cultural diversity: Learning different cultural practices from other countries from where the practitioner might get clients.

• Increasing cultural awareness: It involves teaching the nurses to be mild on cultural decisions and not acting in the favor of some patients at the expense of others. • Minimizing cultural sensitivity by uniting the community: This means that the patients work together with the medical practitioners in improving health standards. They communicate well and try to understand each other. • Eradicate cultural competence behavior in the individual(s): In cases of cultural differences, the different cultures may be competing on usage of health resources. Nurses are not supposed to be a part of this fight. Therefore, they should remain neutral.

Such a process has the capacity of making a nurse act more professionally and avoiding being biased (Dreher, & MacNaughton, 2002).

In a study conducted in Australia, there was much effect of diversity on medical practices as well as medical practitioners and patients. Biases were noted in the nursing practice, and the patients with chronic diseases were very much affected in terms of the provided healthcare. Therefore, medical professionals need training on how to be of higher importance to such patients. The patients include diabetics, cardiovascular patients and others chronic disease patients. These patients need medical training on how to manage the illnesses and conditions when the medical practitioners are not around. The healthcare of these patients may be adversely affected if they are subjected to bias. Hence, the medical practitioners are needed to ensure a diverse cultural understanding of the community they are dealing with (Pardue & Morgan, 2008). Another study was done in three different first world countries viz. the USA, Canada, and Switzerland. In all the three countries, the research gave a positive report about the diversifying services in the medical sector. Such diversities included overcoming language barriers. One of the best examples of the study was in the USA, in a clinic where physicians were facing a little challenge with language problems with some of their patients. They were not in a position to communicate perfectly with other patients other than the ENL speakers (ENL- English Native Language). The researchers brought interpreters of other languages and communication flow was improved. The result was evident from the customer satisfaction analysis. It proven that the services were appreciated 140% of the previous level of appreciation, an implication that diversifying cultural practices, such as teaching nurses different languages is of utmost significance to service improvement process in hospitals as well as clinics and also medical practices at homes (Pardue & Morgan, 2008). Cultural diversity has been discussed as a way of improving the services of nurses and medical practitioners. It is of high importance to consider communication. To get better services, a nurse or any other practitioner must be in a position of understanding the language of the patient quite vividly, implying that the practitioner will be able to know the problem faced by his or her patient. For example, if a French speaking patient who does not communicate in fluent English is assigned to an American nurse, a communication breakdown is expected since most American health workers are trained in English (Flores, 2006). In order to come up with a better understanding, medical practitioners should have cultural diversities. They should understand several languages and, therefore, be able to serve patients better. There is also a possibility of working with interpreters. It is, however, not only a matter of spoken language; the dumb might also need to be served in a hospital. They communicate using sign language. Interpreters of such signs should be available to ensure communication between the patient and the nurse (Gerrish, Chau, Sobowale & Briks, 2004). Patients and medical practitioners need to work together interactively. Hence, there should be a clear understanding of communication from both sides. The nurses need psychological preparations that are of importance to them during the process of providing medical services to patients. Language barrier and other issues due to culture should be dealt with; they are a barrier to communication as well as efficient medical services. Patients with chronic diseases need attention and well stated instructions, since in the absence of doctors and medical practitioners they are supposed to nurse themselves. The process of treating them, therefore, needs to be communicated well to them, to avoid misunderstanding due to cultural differences including the language barrier (Flores, 2006).

Andrews, D. R. (2012). The influence of staff nurse perception of leadership style on satisfaction with leadership: A cross-sectional survey of pediatric nurses. International Journal of Nursing Studies, 49(28), 1103-1111. Boyle, D. K., & Kochinda, C. (2004). Enhancing collaborative communication of nurse and physician leadership in two intensive care units. Journal of Nursing Administration, 34(2), 60-70. Dunham-Taylor, J. (2000). Nurse executive transformational leadership found in participative organizations. Journal of Nursing Administration, 30(5), 241-250. Dreher, M., & MacNaughton, N. (2002). Cultural competence in nursing: Foundation or fallacy? Nursing Outlook, 50(5), 181-186. Flores, G. (2006). Language barriers to healthcare in the United States. The New England Journal of Medicine, 355(3), 229-231. Gerrish, K., Chau, R., Sobowale, A. & Briks, E. (2004). Bridging the language barrier: the use of interpreters in primary care nursing. Health and Social Care in the Community, 12(5), 407-413. Giltinane, C. L. (2013). Leadership styles and theories. Art and Science, 27(41), 35-39. Lipson, J, G. & Desantis, L. A. (2007). Current approaches to integrating elements of cultural competence in nursing education. Journal of Trans-cultural Nursing, 18(1), 10S-20S. Lorber, M., & Savic, B. S. (2000). Perceptions of managerial competencies, Styles and characteristics among professionals in nursing. Public Health, 52(198), 199-204. Pardue, K. T., & Morgan, P. (2008). Millennials considered: A new generation, new approaches, and implications for nursing education. Nursing Education Perspectives, 29(2), 74-79. Saccomano, S. J., & Pinto-Zipp, G. (2011). Registered nurse leadership style and confidence in delegation. Journal of Nursing Management, 19, 522-533. Smith, M. A. (2011). Are you a transformational leader? Nursing Management, 42(9), 44-50.

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Home — Essay Samples — Nursing & Health — Nursing — Nursing Leadership: Inspiring Excellence in Healthcare

Nursing Leadership: Inspiring Excellence in Healthcare

• Categories: Nursing Nursing Theory

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Published: Sep 1, 2023

Words: 599 | Page: 1 | 3 min read

Table of contents

The essence of nursing leadership, the impact on patient outcomes, qualities of exceptional nurse leaders, conclusion: shaping the future of healthcare.

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Inspiring Leadership in Nursing: Key Topics to Empower the Next Generation of Nurse Leaders

This article was written in collaboration with Christine T. and ChatGPT, our little helper developed by OpenAI.

Nursing leadership plays a crucial role in the healthcare industry, influencing the quality of patient care and the overall performance of healthcare organizations. As the nursing profession continues to evolve, aspiring nurse leaders must stay informed about the latest developments and best practices in nursing leadership. This comprehensive guide explores essential nursing leadership topics, offering valuable insights and strategies for success.

The Importance of Nursing Leadership

Impact on patient care.

Effective nursing leadership directly impacts patient care, ensuring that nurses provide safe, high-quality, and evidence-based care. Nurse leaders play a critical role in developing and implementing policies, protocols, and standards of practice that promote positive patient outcomes.

Topic Examples

• The role of nurse leaders in reducing hospital-acquired infections
• How nurse leaders can improve patient satisfaction
• The effect of nursing leadership on patient safety initiatives
• Combating health care-associated infections: a community-based approach
• Nurse leaders’ impact on the reduction of medication errors
• Promoting patient-centered care through nursing leadership
• The role of nurse leaders in implementing evidence-based practices to improve patient outcomes
• How transformational leadership can positively impact patient satisfaction
• The impact of nurse leaders on patient safety and error reduction initiatives

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Influence on Organizational Performance

Nurse leaders contribute to the overall performance of healthcare organizations by guiding and supporting nursing teams, managing resources, and participating in decision-making processes. Their leadership helps create a positive work environment, reduce staff turnover, and improve patient satisfaction.

• How nurse leaders can contribute to reducing staff turnover
• The role of nurse leaders in improving the hospital’s financial performance
• Nurse leaders as drivers of organizational culture
• The integral role of nurses in healthcare systems: the importance of education and experience
• The relationship between nurse leadership and hospital readmission rates
• How nurse leaders can contribute to reducing healthcare costs
• The role of nurse leaders in promoting interprofessional collaboration to improve organizational performance
• Strategies for nurse leaders to foster a positive work environment
• The impact of nursing leadership on employee engagement and satisfaction

Advancement of the Nursing Profession

Nurse leaders advocate for nursing, promoting professional development, innovation, and research. They also work to elevate the nursing profession’s status, fostering collaboration and interdisciplinary partnerships.

• The role of nurse leaders in shaping the future of nursing education
• How nurse leaders can advocate for the nursing profession
• The impact of nurse leaders on the development of nursing standards and policies
• Encouraging research and evidence-based practice among nursing teams
• The role of nurse leaders in promoting interprofessional collaboration
• Encouraging the pursuit of advanced nursing degrees and certifications among nursing staff
• The impact of nurse leaders on shaping healthcare policies and regulations
• How nurse leaders can advocate for improved working conditions and fair compensation for nursing staff

Essential Nursing Leadership Skills

Communication and interpersonal skills.

Effective communication and interpersonal skills are crucial for nursing leaders. They must listen actively, express themselves clearly, and demonstrate empathy and understanding when interacting with colleagues, patients, and families.

• Active listening skills for nurse leaders
• Developing emotional intelligence in nursing leadership
• The role of nonverbal communication in nursing leadership
• Strategies for nurse leaders to improve communication with their teams
• How nurse leaders can facilitate open and honest feedback
• The importance of emotional intelligence in nurse leadership
• Strategies for nurse leaders to improve their communication skills with diverse populations
• The role of nurse leaders in fostering effective communication within interdisciplinary healthcare teams

Decision-Making and Problem-Solving Abilities

Nurse leaders must be skilled in making informed decisions and solving complex problems. They should be able to analyze situations, weigh the pros and cons of various options, and choose the best course of action.

• Critical thinking skills for nurse leaders
• Ethical decision-making in nursing leadership
• The role of evidence-based practice in nursing leadership decisions
• Strategies for nurse leaders to develop effective problem-solving skills
• The importance of collaboration and teamwork in decision-making for nurse leaders
• The role of nurse leaders in crisis management and emergency preparedness
• How nurse leaders can develop effective problem-solving strategies to address complex healthcare challenges

Time Management and Organization

Managing time and resources effectively is essential for nurse leaders. They must be able to prioritize tasks, delegate responsibilities, and balance competing demands to ensure the smooth operation of their teams and organizations.

• Prioritization techniques for nurse leaders
• The role of delegation in effective time management for nursing managers
• Strategies for nurse leaders to manage workload and reduce stress
• Balancing clinical and administrative responsibilities as a nurse leader
• Time management tools and techniques for nurse leaders
• The importance of delegation in nurse leadership
• Strategies for nurse leaders to effectively manage their workload and prioritize tasks
• The role of nurse leaders in creating efficient workflows and processes within nursing teams

Embracing Diversity and Inclusivity in Nursing Leadership

The value of a diverse nursing workforce.

A diverse nursing workforce brings unique perspectives, experiences, and skills to the healthcare environment, benefiting patient care. By embracing diversity, nurse leaders can foster a more inclusive and supportive work environment that encourages collaboration and innovation.

• The benefits of diverse nursing teams for patient care
• The role of nurse leaders in recruiting and retaining diverse nursing staff
• Addressing health disparities through a diverse nursing workforce
• The impact of cultural competence on nursing practice and leadership
• Encouraging diverse perspectives and experiences in nursing teams
• Global health learning in nursing and health care disparities
• The benefits of having a diverse nursing workforce on patient outcomes and satisfaction
• Addressing health disparities through culturally competent nursing leadership

Strategies for Promoting Diversity and Inclusion

Nurse leaders can promote diversity and inclusion by implementing hiring and promotion practices that support equal opportunities, offering cultural competency training, and actively addressing discrimination and bias within their organizations.

• Overcoming unconscious bias in nursing leadership
• The role of nurse leaders in fostering an inclusive work environment
• Strategies for promoting diversity and inclusion in nursing education
• The impact of diversity and inclusion on nursing team performance
• Encouraging cultural competence and sensitivity among nursing staff
• Implementing diversity and inclusion training programs for nursing staff
• The role of nurse leaders in fostering a culture of respect and inclusivity within nursing teams
• Strategies for nurse leaders to address unconscious bias and promote equity in the workplace

Developing and Mentoring Future Nurse Leaders

Identifying and nurturing leadership potential.

Nurse leaders play an essential role in identifying and nurturing the leadership potential of their staff. By offering guidance, encouragement, and opportunities for growth, they can help prepare the next generation of nurse leaders.

• Recognizing leadership potential in nursing staff
• Strategies for nurse leaders to develop their team’s leadership skills
• The importance of succession planning in nursing leadership
• Encouraging a growth mindset among nursing teams
• The role of mentorship and coaching in nurturing future nurse leaders
• Strategies for nurse leaders to identify and develop emerging nurse leaders within their teams
• The role of nurse leaders in creating leadership development programs for nursing staff

Mentorship and Coaching

Mentorship and coaching are invaluable for aspiring nurse leaders. By sharing their knowledge, experience, and insights, experienced nurse leaders can help guide and support those looking to advance in nursing.

• The benefits of mentorship for both mentors and mentees in nursing
• Developing effective mentoring relationships in nursing
• The role of nurse leaders in fostering a mentoring culture
• Strategies for providing constructive feedback and coaching to nursing staff
• Encouraging professional growth and development through mentorship
• The benefits of mentorship relationships for both mentors and mentees in nursing
• Strategies for nurse leaders to establish effective mentorship programs within their organizations
• The role of nurse leaders in providing coaching and feedback to nursing staff for professional growth

Promoting Teamwork and Collaboration in Nursing

The importance of teamwork in healthcare.

Teamwork is crucial for delivering safe, high-quality patient care. Nurse leaders must foster a culture of collaboration, encouraging open communication, mutual support, and shared decision-making among their teams.

• The role of nurse leaders in promoting effective teamwork
• Strategies for building trust and collaboration among nursing teams
• The impact of teamwork on patient care and safety
• The benefits of interprofessional collaboration in healthcare
• The role of nurse leaders in fostering a positive team culture
• The role of nurse leaders in promoting collaboration and teamwork among nursing staff
• Strategies for nurse leaders to address and resolve conflicts within nursing teams
• The impact of effective teamwork on patient outcomes and staff satisfaction in healthcare settings

Strategies for Building Effective Nursing Teams

Nurse leaders can build effective nursing teams by promoting shared goals and values, providing clear expectations and feedback, and recognizing and celebrating team achievements. Additionally, they should facilitate team-building activities and opportunities for professional development, which can strengthen team cohesion and performance.

• The importance of clear communication and expectations in nursing teams
• Strategies for addressing and resolving conflicts within nursing teams
• The role of team-building activities in fostering collaboration and trust among nursing staff
• The impact of shared decision-making on nursing team performance
• Encouraging a culture of continuous improvement and learning within nursing teams
• The role of nurse leaders in selecting and retaining top nursing talent
• Strategies for nurse leaders to create a positive work environment that fosters teamwork and collaboration
• The importance of team-building activities and exercises for nursing staff

Advocating for Nursing and Improving Patient Care

Policy and advocacy.

Nurse leaders are responsible for advocating for policies and initiatives that support the nursing profession and improve patient care. They should be informed about healthcare legislation, engage in advocacy efforts, and encourage their teams to participate in policy-making.

• The role of nurse leaders in shaping healthcare policy
• Strategies for nurse leaders to advocate for the nursing profession at the local, state, and national levels
• The impact of nursing leadership on the development and implementation of healthcare policies and regulations
• Engaging nursing staff in policy discussions and advocacy efforts
• The importance of staying informed about current healthcare policy issues for nurse leaders
• The role of nurse leaders in advocating for policies that improve patient care and support the nursing profession
• Strategies for nurse leaders to effectively engage with policymakers and stakeholders
• The impact of nurse leaders on shaping healthcare policies at the local, state, and national levels

Driving Quality Improvement and Innovation

Nurse leaders must be committed to continuous quality improvement and innovation in patient care. By staying informed about evidence-based practices and encouraging their teams to adopt innovative approaches, they can drive positive change within their organizations and the healthcare industry.

• The role of nurse leaders in promoting a culture of continuous quality improvement
• Strategies for nurse leaders to identify and address areas for improvement in patient care
• The impact of nursing leadership on the implementation of evidence-based practices and innovations
• Encouraging a culture of creativity and innovation among nursing teams
• The role of nurse leaders in driving change and improvement in healthcare organizations
• The role of nurse leaders in leading quality improvement initiatives within their organizations
• Strategies for nurse leaders to foster a culture of continuous improvement and innovation among nursing staff
• The impact of nurse-led quality improvement projects on patient care and organizational performance

Fostering a Positive Work Environment

Creating a supportive and respectful culture.

A positive work environment is essential for nursing staff satisfaction, retention, and performance. Nurse leaders should foster a culture of support and respect where staff feels valued, empowered, and motivated to provide the best possible care.

• The role of nurse leaders in fostering a positive work environment
• Strategies for nurse leaders to promote a culture of support and respect among nursing staff
• The importance of addressing and preventing workplace bullying and incivility in nursing
• Encouraging open and honest communication within nursing teams
• The role of nurse leaders in promoting work-life balance and well-being among nursing staff

Addressing Workplace Challenges and Conflicts

Nurse leaders must be proactive in addressing workplace challenges and conflicts. They can maintain a healthy and productive work environment by developing and implementing strategies to manage issues such as workload, burnout, and interpersonal conflicts.

• The role of nurse leaders in conflict resolution within nursing teams
• Strategies for nurse leaders to address common workplace challenges, such as staffing shortages and burnout
• The importance of developing a proactive approach to addressing conflicts and challenges in nursing
• Promoting a culture of accountability and responsibility among nursing staff
• The role of nurse leaders in providing support and resources for nursing staff facing challenges and conflicts
• Conflict resolution strategies for nurse leaders
• The role of nurse leaders in mediating and resolving interprofessional conflicts within healthcare teams
• Strategies for nurse leaders to prevent and address workplace burnout among nursing staff

Lifelong Learning and Professional Development

Commitment to continuing education.

Lifelong learning is essential for nurse leaders to stay current with healthcare and nursing practice advances. They should pursue continuing education opportunities, research, and stay informed about industry trends and best practices.

• The importance of lifelong learning for nurse leaders and nursing staff
• Strategies for nurse leaders to promote a culture of continuous education and professional development within their teams
• The impact of continuing education on nursing practice and leadership
• Encouraging nursing staff to engage in professional development opportunities
• Transforming advanced nursing practice: embracing IOM recommendations and higher education
• The role of nurse leaders in staying informed about current nursing research and best practices
• The impact of continuing education on nursing practice and patient outcomes
• Strategies for nurse leaders to support and encourage continuing education among their nursing staff
• The role of nurse leaders in staying up-to-date with the latest nursing research, guidelines, and best practices

Encouraging Professional Development in Nursing Teams

Nurse leaders should support and encourage the professional development of their nursing teams. By providing resources, opportunities, and encouragement, they can help their staff grow professionally and contribute to advancing the nursing profession.

• The role of nurse leaders in identifying professional development opportunities for nursing staff
• Strategies for nurse leaders to create individualized professional development plans for their team members
• The importance of fostering a growth mindset among nursing staff
• Encouraging nursing staff to participate in conferences, workshops, and other professional development activities
• The role of nurse leaders in providing mentorship and guidance for nursing staff seeking career advancement
• The benefits of ongoing professional development for nursing staff and healthcare organizations
• Strategies for nurse leaders to create professional development opportunities within their organizations
• The role of nurse leaders in developing and implementing career advancement pathways for nursing staff

The Power of Inspiring Leadership in Nursing

Nursing leadership is a critical component of the healthcare industry, impacting patient care, organizational performance, and the advancement of the nursing profession. By mastering essential leadership skills, embracing diversity, promoting teamwork, and fostering a positive work environment, aspiring nurse leaders can make a meaningful difference in the lives of their patients, colleagues, and organizations. Committing to lifelong learning and professional development will ensure that nurse leaders remain at the forefront of their field, inspiring and empowering the next generation of nursing professionals.

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Published on: May 6, 2023

Last updated on: Jan 29, 2024

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Many nursing students struggle with writing effective nursing essays, which are an essential part of their education and professional development.

Poor essay writing skills can lead to low grades and an inability to effectively communicate important information.

This blog provides a comprehensive guide to writing nursing essays with examples and tips for effective writing. Whether you are a nursing student or a professional looking to improve your writing skills, this blog has something for you. 

By following the tips and examples provided, you can write compelling nursing essays that showcase your dedication to the field.

Let’s get started.

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What is a Nursing Essay?

A nursing essay is a type of academic writing that aims to explore a particular topic related to nursing. It also presents a clear and concise argument or viewpoint supported by evidence. 

Nursing essays can take many forms, including:

• Descriptive essays
• Reflective essays
• Analytical essays
• Persuasive essays

What is the Importance of the Nursing Essay?

Nursing essays are important for several reasons. First, they help nursing students develop critical thinking skills by requiring them to analyze and evaluate information.

Second, they help students develop research skills by requiring them to locate and use credible sources to support their arguments. 

Third, nursing essays help students develop communication skills by requiring them to present their ideas clearly and concisely in writing. Finally, nursing essays are important for nursing education because they prepare students for the types of writing.

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To help students better understand how to write nursing essays, it can be helpful to review examples.

Below are some examples of nursing essays.

Nursing School Essay Examples

College Nursing Essay Examples

Graduate Nursing Essay Examples

Nursing Scholarship Essay Examples

Nursing Essay Conclusion Examples

Nursing Essay Examples of Different Fields

Nursing is a diverse field with many different specialties and areas of focus. As a result, nursing essays can take many different forms and cover a wide range of topics. 

Given below are some examples of different types of nursing essays:

Personal Philosophy Of Nursing - Essay Examples

Cal State Fullerton Nursing Essay Examples

Evidence Based Practice Nursing In Medical Field - Essay Examples

Leadership In Nursing And Healthcare Professionals - Essay Examples

Principles Of Professional Practice Of Nursing Professionals And Pharmacists

If you're seeking additional examples of nursing essays, you're in luck! 

Below are some more examples that can help you gain a better understanding of nursing essays:

Health Care And Reflective Models For Nursing - Essay Examples

History Of Nursing Essay Examples

Ethical Dilemma In Nurses Work - Essay Examples

Mental Health Nursing Essay Examples

Why I Want To Be A Nurse Essay

Working In A Team And Collaboration In Nursing

How to Write a Nursing Essay

Writing a nursing essay can seem daunting, but with the right approach, it can be a rewarding experience.

Here are the key steps involved in writing a nursing essay:

Understanding the Topic and Question

The first step in writing a nursing essay is to carefully read and understand the topic and question. 

This will help you determine what information you need to research and include in your essay. Make sure you understand any key terms or concepts related to the topic. Consider different perspectives or viewpoints that may be relevant.

Researching the Topic

Once you have a clear understanding of the topic and question, it's time to research. 

Start by gathering information from credible sources such as academic journals, textbooks, and government websites. 

Consider both primary and secondary sources, and make sure to take detailed notes as you read.

Organizing and Outlining the Essay

Once you have completed your research, it's time to organize your ideas and create an outline for your essay. 

Start by identifying the main points or arguments you want to make, and then organize them into a logical order that flows well. 

Your outline should include an introduction, body paragraphs, and a conclusion.

Writing the Essay

With your outline in place, it's time to start writing your essay. Make sure to follow your outline closely, and use clear and concise language that effectively communicates your ideas. 

Use evidence from your research to support your arguments, and cite your sources appropriately.

Editing and Revising the Essay

Once you have completed a first draft of your essay, take some time to edit and revise it. Look for any errors in grammar, spelling, or punctuation, and make sure your essay is well-organized and flows well. 

Consider asking a peer or instructor to review your essay and provide feedback.

What To Include In Your Nursing Essay

When writing a nursing essay, there are several key elements that you should include. Here are some important things to keep in mind:

• Introduction

Your introduction should provide a brief overview of the topic and purpose of your essay. It should also include a clear thesis statement that presents your main argument or point of view.

• Background Information

Provide some background information on the topic to help the reader better understand the context of your essay. This can include relevant statistics, historical information, or other contextual details.

• Evidence and Examples

Use evidence and examples from your research to support your arguments and demonstrate your knowledge of the topic. Make sure to cite your sources appropriately and use a variety of sources to strengthen your argument.

• Analysis and Evaluation

Provide analysis and evaluation of the evidence and examples you've presented. This can include discussing strengths and weaknesses, comparing and contrasting different viewpoints, or offering your own perspective on the topic.

Your conclusion should summarize the main points of your essay and restate your thesis statement. It should also offer some final thoughts or suggestions for further research or action.

Nursing Essay Topic Ideas

Choosing a topic for your nursing essay can be challenging, but there are many areas in the field that you can explore. Here are some nursing essay topic ideas to consider:

• The role of technology in nursing practice
• The impact of cultural diversity on healthcare delivery
• Nursing leadership and management in healthcare organizations
• Ethical issues in nursing practice
• The importance of patient-centered care in nursing practice
• The impact of evidence-based practice on nursing care
• The role of nursing in promoting public health
• Nursing education and the importance of lifelong learning
• The impact of nursing shortages on healthcare delivery
• The importance of communication in nursing practice

These are just a few ideas to get you started. You can also explore other topics related to nursing that interest you or align with your academic or professional goals. 

Remember to choose a topic that is relevant, interesting, and feasible to research and write about.

Tips for Writing an Effective Nursing Essay

Writing a successful nursing essay requires careful planning, research, and attention to detail. Here are some tips to help you write an effective nursing essay:

• Writing Concisely and Clearly

Nursing essays should be written in clear and concise language, avoiding unnecessary jargon or technical terms. Use simple language and short sentences to help ensure that your ideas are communicated clearly and effectively.

• Stating a Clear Thesis Statement

Your thesis statement should clearly state your main argument and provide a roadmap for the rest of your essay. It should be clear, concise, and located at the end of your introduction.

• Using Proper Citation and Referencing

Citing and referencing your sources is crucial in any academic writing, including nursing essays. Make sure to use proper citation and referencing styles, such as APA or MLA. Include a reference list or bibliography at the end of your essay.

• Seeking Feedback and Revising

Before submitting your nursing essay, seek feedback from peers, professors, or writing tutors. Use their feedback to revise and improve your essay. Make sure that it is well-structured, coherent, and effectively communicates your point of view.

By following these tips, you can write a nursing essay that demonstrates your knowledge and skills in the field.

In conclusion, writing a successful nursing essay requires careful planning, research, and attention to detail. 

To showcase your knowledge in the field of nursing, it is important to have a clear understanding of the topic at hand. When writing your nursing essay, be sure to include relevant examples, incorporate current research, and use proper citation and referencing. 

And remember , seeking feedback and revising your essay is key to ensuring that it effectively communicates your ideas and arguments.

If you need help with your nursing essay or any other type of academic writing, consider using our AI essay writer . 

Our nursing essay writing service can provide personalized support to help you succeed in your academic goals.

So, why wait? Contact us to get college essay writing help today! 

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PICOT Question Examples on Nurse Leadership Challenges and Opportunities Plus, EBP & Capstone Project Ideas, Nursing Research Paper Topics, and 30 Nursing Essay Topic Ideas

• Author James Harley
• Published September 12, 2023

Nurse leadership is a vital component of the healthcare system, encompassing a diverse array of roles and responsibilities. Nurses are not just caregivers; they are also leaders who play a crucial role in ensuring the quality of patient care and the efficient functioning of healthcare organizations. However, like any leadership role, nursing leadership comes with its unique set of challenges and opportunities. In this article, we will explore nurse leadership challenges and opportunities; highlighting some of the pressing challenges they face and the potential opportunities for innovation and improvement. Here are PICOT Questions Examples on Nurse Leadership challenges and opportunities, Plus, EBP & Capstone Project Ideas, Nursing Research Paper Topics, and 30 Nursing Essay Topic Ideas.

Table of Contents

Nurse leadership challenges and opportunities.

Nurse leaders, regardless of their specific roles and settings, encounter several common challenges and opportunities:

• Staffing Shortages and Nurse Burnout: In an era of healthcare workforce shortages, nurse leaders often grapple with inadequate staffing levels. The challenge lies in maintaining high-quality patient care while addressing nurse burnout. An opportunity exists in exploring strategies to alleviate burnout through EBP interventions.
• Interprofessional Collaboration: Effective collaboration among healthcare professionals is crucial for optimal patient outcomes. Nurse leaders must foster collaborative relationships among teams, which can be both a challenge and an opportunity for enhancing interdisciplinary communication.
• Leadership Styles: The choice of leadership style significantly impacts the work environment and staff satisfaction. Nurse leaders must navigate the balance between authoritative and participative leadership styles, adapting to different situations and teams.
• Ethical Dilemmas: Ethical challenges are inherent in healthcare, and nurse leaders are often at the forefront of addressing them. Opportunities arise in researching ethical decision-making frameworks and their application in nursing leadership.
• Healthcare Technology Integration: The rapid evolution of healthcare technology presents both challenges and opportunities. Nurse leaders must ensure the effective adoption of technology while addressing concerns about its impact on patient care and job satisfaction.
• Patient-Centered Care: Nurse leaders play a pivotal role in promoting patient-centered care. They must continuously strive to align care delivery with patients’ needs and preferences while overcoming potential barriers to patient-centeredness.
• Resource Allocation: Managing limited resources efficiently and equitably is a constant challenge. Nurse leaders can explore EBP strategies for resource allocation that optimize patient outcomes.
• Education and Professional Development: The nursing field is continually evolving, necessitating ongoing education and professional development. Nurse leaders must create a supportive environment for staff growth and development.
• Quality Improvement: Nurse leaders bear the responsibility of ensuring the delivery of high-quality care. Opportunities for research and projects exist in the realm of quality improvement, including patient safety initiatives and outcome measurement.
• Healthcare Policy and Advocacy: Advocating for nursing and healthcare policy changes is essential for nurse leaders. This presents an opportunity for nurse leaders to engage in policy discussions and research the impact of policy changes on nursing practice.

You can also check out Ways of Ensuring Safety of Healthcare Workers

PICOT Question Examples on Nurse Leadership

• In hospital settings (P), how does transformational leadership (I) compared to transactional leadership (C) affect nurse job satisfaction (O) within one year (T)?
• In long-term care facilities (P), what is the effect of nurse-to-patient ratios (I) on the incidence of medication errors (O) compared with standard ratios (C) within six months (T)?
• In primary care clinics (P), how does shared leadership (I) compared to traditional hierarchical leadership (C) affect interprofessional collaboration (O) within three months (T)?
• In academic nursing programs (P), what is the impact of mentorship programs (I) on the retention of nursing faculty (O) compared to no mentorship programs (C) within two years (T)?
• In home healthcare agencies (P), how does the implementation of EHR systems (I) compared to paper-based documentation (C) affect patient satisfaction (O) within six months (T)?
• In pediatric intensive care units (P), what is the effect of nurse-led quality improvement initiatives (I) on the incidence of central line-associated bloodstream infections (O) compared to no initiatives (C) within one year (T)?
• In nursing homes (P), how does the use of shared decision-making models (I) compared to traditional decision-making (C) affect resident outcomes (O) within three months (T)?
• In community health clinics (P), what is the impact of leadership development programs (I) on nurse leadership competencies (O) compared with no programs (C) within one year (T)?
• In emergency departments (P), how does effective nurse leadership (I) compared to ineffective leadership (C) affect staff turnover rates (O) within six months (T)?
• In psychiatric units (P), what is the effect of regular debriefing sessions (I) on nurse resilience (O) compared to no debriefing sessions (C) within three months (T)?

Evidence-Based Practice (EBP) Projects Ideas on Nurse Leadership

• Implementing Lean Principles in Nursing Units : Streamlining processes to reduce waste and improve efficiency.
• Reducing Medication Errors through Nurse-Led Initiatives : Implementing strategies to enhance medication safety.
• Enhancing Nurse Leader Communication Skills : Developing communication workshops for nurse leaders.
• Promoting Nurse Resilience : Creating programs to support nurse well-being and resilience.
• Patient-Centered Care Models : Implementing models that prioritize patient preferences and values.
• Improving Handoff Communication : Developing standardized handoff protocols to improve patient safety during shift changes.
• Enhancing Interdisciplinary Collaboration : Promoting teamwork and collaboration among healthcare professionals.
• Reducing Hospital-Acquired Infections : Implementing evidence-based practices to minimize infections.
• Leadership Development Programs : Providing leadership training for aspiring nurse leaders.
• Nurse-Led Telehealth Services : Expanding telehealth services under nurse leadership.
• Patient Education Initiatives : Developing patient education materials and programs.
• Improving Pain Management : Enhancing pain management protocols and practices.
• Nurse Leader Rounds : Implementing regular rounds by nurse leaders to assess and address patient needs.
• Nurse Staffing Ratios : Analyzing staffing ratios and advocating for appropriate staffing levels.
• Crisis Management Protocols : Developing protocols for nurse leaders to manage crises effectively.
• Improving Nurse-Patient Communication : Providing training on effective communication with patients and their families.
• Nurse Leader-Led Quality Audits : Conducting regular audits to monitor and improve the quality of care.
• Reducing Readmissions : Developing interventions to reduce hospital readmissions.
• Nurse Leader-Led Research Initiatives : Promoting research projects led by nurse leaders to advance nursing practice.
• Promoting Diversity and Inclusion : Implementing initiatives to foster diversity and inclusion in nursing leadership.

Nursing Capstone Project Ideas about Nurse Leadership

• Developing a Leadership Development Program for Nursing Students
• Analyzing the Impact of Nurse Leadership on Patient Satisfaction
• Assessing the Efficacy of Nursing Leadership Styles in Crisis Management
• Implementing a Shared Decision-Making Model in a Healthcare Facility
• Investigating the Relationship Between Nurse Leadership and Staff Retention
• Enhancing Interprofessional Collaboration in a Long-Term Care Facility
• Evaluating the Effect of Leadership Training on Nurse Resilience
• Reducing Central Line-Associated Bloodstream Infections through Nurse-Led Initiatives
• Implementing Telehealth in Nurse Leadership Education
• Exploring the Role of Nurse Leaders in Healthcare Policy Advocacy

You can also check out Role of Nurses in Providing Palliative Care to Patients with Chronic Conditions 

Nursing Research Paper Topics on Nurse Leadership

• The Impact of Nurse Leadership on Patient Safety
• Ethical Decision-Making in Nursing Leadership
• Nurse Staffing Ratios and Patient Outcomes
• The Role of Nurse Leaders in Healthcare Quality Improvement
• Leadership Styles in Nursing: A Comparative Analysis
• Interprofessional Collaboration and Patient-Centered Care
• The Influence of Nurse Leaders on Staff Job Satisfaction
• Nurse Leadership and Healthcare Technology Integration
• Leadership Development Programs in Nursing Education
• Healthcare Policy Advocacy by Nurse Leaders
• The Influence of Nurse Leadership Styles on Patient Outcomes
• Nurse Leader Resilience and Its Impact on the Work Environment
• The Role of Nurse Leaders in Promoting Evidence-Based Practice
• Nurse Leader Advocacy for Safe Staffing Ratios
• Nurse Leader Communication Strategies in Healthcare Organizations
• The Impact of Nurse Leader-Led Quality Improvement Projects
• Patient-Centered Care Models and Their Implementation Challenges
• Nurse Leader Training Programs and Leadership Development
• The Relationship Between Nurse Leader Burnout and Staff Turnover
• Nurse Leader Involvement in Telehealth Services
• The Effectiveness of Nurse Leader-Led Patient Education Initiatives
• Handoff Communication Protocols and Patient Safety
• Nurse Leader-Led Research Initiatives in Nursing Practice
• The Role of Nurse Leaders in Reducing Medication Errors
• Nurse Leader-Led Mental Health Initiatives for Nurses
• Diversity and Inclusion Initiatives Led by Nurse Leaders
• Nurse Leader Involvement in Chronic Disease Management
• The Impact of Nurse Staffing Ratios on Patient Outcomes
• Nurse Leader-Led Crisis Management in Healthcare
• Telehealth Education for Healthcare Professionals and Nurse Leader Support

You can also check out Maternal-Child Health Disparities Nursing Research Paper Topics

Nursing Research Questions about Nurse Leadership

• How do nurse leadership styles impact patient safety outcomes in critical care units?
• What ethical dilemmas do nurse leaders encounter in resource allocation decisions?
• What are the key factors influencing interprofessional collaboration in healthcare settings?
• How does nurse leadership affect the implementation of healthcare technology in hospitals?
• What are the outcomes of nurse-led quality improvement initiatives in long-term care facilities?
• How does shared leadership influence staff job satisfaction in primary care clinics?
• What are the barriers and facilitators to implementing nurse mentorship programs?
• How do nurse leadership competencies evolve throughout a nurse’s career?
• What role do nurse leaders play in advocating for healthcare policy changes?
• How does nurse resilience affect patient outcomes in psychiatric units?

Nursing Essay Topic Ideas on Nurse Leadership

• The Impact of Transformational Leadership on Nursing Practice
• The Ethical Dilemmas of Resource Allocation in Healthcare
• Interprofessional Collaboration: A Critical Component of Patient-Centered Care
• Nursing Leadership Styles: Which One Fits Best?
• Nurse Staffing Ratios: Striking a Balance between Quality and Quantity
• Technology in Nursing: A Blessing or a Burden?
• The Role of Nurse Leaders in Quality Improvement Initiatives
• Mentorship in Nursing: Nurturing Future Nurse Leaders
• Leadership Development Programs: Investing in Nursing’s Future
• Advocating for Change: The Nurse Leader’s Role in Healthcare Policy
• The Role of Nurse Leaders in Transforming Healthcare Delivery
• Nurse Leadership Styles and Their Impact on Team Dynamics
• Nurse Leader Resilience: Navigating the Challenges of Healthcare
• The Importance of Nurse Leader Advocacy for Patient Safety
• Effective Communication Strategies for Nurse Leaders in Healthcare
• Nurse Leader-Led Quality Improvement Initiatives: Success Stories
• Patient-Centered Care: A Paradigm Shift in Nursing Leadership
• Nurse Leader Training Programs: Bridging the Leadership Gap
• Balancing Act: Nurse Leader Burnout and Retention Strategies
• Telehealth and Nurse Leaders: Pioneering Virtual Care
• Empowering Patients Through Nurse Leader-Led Education Programs
• Handoff Communication in Nursing: The Critical Role of Nurse Leaders
• Nurse Leader-Led Research: Advancing Evidence-Based Practice
• Medication Safety and the Impact of Nurse Leaders in Healthcare
• Mindfulness and Mental Health Initiatives for Nurses: The Nurse Leader’s Role
• Diversity and Inclusion: The Nurse Leader’s Imperative
• Chronic Disease Management and the Nurse Leader’s Toolkit
• Nurse Staffing Ratios: Advocacy and Accountability
• Crisis Management: Nurse Leaders in the Eye of the Storm
• Telehealth Education for Healthcare Professionals: The Nurse Leader’s Guide

Nursing Essay Example on Nurse Leadership

• Nurse Advocacy And Leadership
• Nursing Leadership And Management
• Approaches In Leadership And Management
• Preparing Competent Nurse Leaders
• How Nurse Leaders Serve As Advocates For Their Employees

Nurse leadership is a dynamic field filled with challenges and opportunities that have a profound impact on patient care and healthcare systems as a whole. As nurses continue to assume leadership roles in various healthcare settings, research, evidence-based practice, and capstone projects become essential avenues for addressing these challenges and harnessing the opportunities to improve patient outcomes and the nursing profession’s overall quality. The PICOT questions, EBP project ideas, capstone project suggestions, research paper topics, research questions, and essay topic ideas provided in this article offer a wealth of avenues for nursing students, educators, and researchers to explore and contribute to the ever-evolving landscape of nurse leadership.

1. What are the challenges of transformational leadership in nursing?

• Lack of encouragement from the institution for the training of leaders;
• Professional inexperience and young age;
• Resistance to leadership and insubordination.

2. What are the weaknesses of democratic leadership nursing?

The decision-making process is slow due to the increased participation of all team members.

3. What makes effective leadership in nursing?

Commitment to excellence, passion for their work, clear vision and strategic focus, trustworthiness, respectfulness, approachability, empathy, caring, and commitment to coaching and developing staff.

4. What are the 5 key characteristics of clinical leadership?

Effective communication, clinical competence, approachability, role model and support.

• Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application. Lippincott Williams & Wilkins.
• Northouse, P. G. (2021). Leadership: Theory and practice. SAGE Publications.
• Kelly, P., & Tazbir, J. (2019). Nurse leadership: Theoretical approaches and methodologies. Springer.

James Harley

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Nursing Leadership Skills Development Essay

Introduction, my leadership skills, reference list.

As Benner (2001) points out, “senior nurses are likely to engage in a range of leadership activities in their daily routine and some may find the concept hard to understand”. Leadership in nursing is an art that involves quality delivery of care and facilitating positive nursing growth among other nurses. Leadership skills and capabilities among nurses can be judged by their ability to manage time, organize the team under them, and maintain professional ethics. It is also judged on the basis of how well they can solve problems and make decisions in the face of a crisis. As a nurse, adhering to professional ethics and acting with integrity is key in developing leadership skills.

As a registered nurse for 11 years and a master of science program, my practice and experience has put me in situations where my leadership skills have been constantly put to test. Currently, I have adopted an effective leadership style that allows me to exercise basic leadership duties such as offering proper instructions to the nurses I work with. My responsibilities include coordinating the day/night shifts of my team and supporting them by giving directions. It is also my responsibility to help the new nurses fit into the system and grow their careers through effective training. However, I realize that an effective leader needs more than the ability to give instructions and supervise those under him/her. It is for this reason that I intend to work on having better leadership skills in the years to come.

Leadership skills in the nursing industry are categorized into different classes. They include organizational management, creation and vision, communication and strategy. The first step towards being a good leader is realizing that leadership roles are different from management functions (Benner, 2001). By realizing this, a good leader is willing to stay in touch and in line with the management and follow the hospital’s policies and regulations. As a leader, I intend to work on being more visionary and equip myself with the required strategies. Such qualities will help me direct my team and services to a better future in the industry. To be an effective leader, I also intend to work on my problem-solving skills and develop my group.

Looking at the future, I desire to be a dynamic and a passionate leader and seek to inspire my team. Managing time and managing information are part of the process. In the nursing profession, time management is of essence and could make a difference on the quality of care accorded to patients. This is also in consideration to the fact that leadership in nursing involves caring for the safety of patients. Safety is ensured when patients are attended to on time, given medication on time and followed up in a timely manner.

As Benner (2001) points out, “leadership for senior nurses is primarily about making decisions, delegating appropriately, resolving conflicts and acting with integrity”. My experience and skills as a leader allow me to manage the schedules and shifts effectively and ensure that patients are well cared for. The elements I intend to add to my leadership capabilities will enable me effectively develop my team and serve patients under my care in a better way. As a senior nurse, I also intend to develop my leadership skills through mentoring and coaching interventions. Part of the process will include training, attending leadership conferences and furthering my studies to give me a more professional approach to my career.

Benner, P.E. (2001). From novice to expert: Excellence and power in clinical nursing practice . Upper Saddle River, N.J.: Prentice Hall.

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A nursing college essay is not about career prospects; it is more about the challenges medical personnel face daily, sacrificing their sleep, comfort, and even personal needs. In hospitals, nurses take care of patients not only in issues connected with their physical health and treatment. From time to time, they have to contact hopeless patients, find words to support them, and bring hope for recovery.

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Adult Nursing - A Transition Essay Sample

High-quality care prevents adverse outcomes and is linked to effective nursing leadership styles. Leadership entails setting goals, motivating, and influencing others towards meeting a common goal.

This essay aims to critically evaluate my professional practice against the standards expected of a registered nurse based on the Code Nursing and Midwifery Council (NMC, 2018). The paper will analyse the knowledge, skills, and competence required for effective leadership and teamwork in nursing practice. This will be mapped against personal learning needs, including prioritisation and leadership theories outlined in Appendix 1. Additionally, the essay will critically appraise the political and professional influences on health care delivery and nursing practice based on evidence-based practices and peer-reviewed literature. Also, it paper will provide a personal reflection on my experience during placement and address the emerging issues that impact my transitions from a nurse student to a registered nurse. This will demonstrate identification of the learning needs and ongoing development required to ensure the delivery of safe and effective patient care in my future practice. Finally, the paper will provide and evaluate the strategies needed to support my continued professional development (Appendix 2). The conclusion will give a summary of the critical points identified throughout the essay. The names of individuals involved throughout the paper will be anonymised in compliance with NMC (2018) confidentiality requirement.

According to Marsh (2021), the contemporary healthcare system is complex, under-resourced, and often pressurised, particularly in the UK. The clinical and support staff have a duty of care to provide care to multiple patients with varying needs and health conditions, often concurrently, while competing with a range of associated management and care duties within a definite timeframe. The competing demand and high workload could contribute to "missed care" and "rationing of care." Suhonen et al. (2018) defined missed care as care delayed or omitted and rationing of care as a failure of withholding to conduct necessary nursing measures for patients due to limited resources such as staff shortage, time or skill mix. Ludlow et al. (2020) stated that missed care and rationing of care are consequences of healthcare practitioners' prioritising decisions and are positively associated with medication errors, pressure ulcers, nosocomial infections, critical incidences, patient falls with injury, urinary tract infections, and mortality. Also, rationed and missed care is negatively linked to patient satisfaction and quality of care.

Registered nurses must ensure the delivery of safe and high-quality care to patients based on their obligations outlined in the Code (NMC, 2018). These include accepting their duties and professional accountability in administration, which require knowledge, competence, and skills in clinical judgement, decision-making, and prioritisation. Marsh (2021) stipulated that prioritisation is a concept based on sound clinical judgement, critical thinking, time management, and decision-making skills. It entails defining the aspects of clinical needs considered to be managed in order of urgency and importance (Appendix 1).

Déry et al. (2018) asserted that effective clinical judgement results from the influence of competence, knowledge, and skills in prioritising, effective reasoning, and communication among multidisciplinary team members in clinical decision making. NMC (2018) indicates that registered nurses must make person-centred, evidence-based judgement and decisions and work in partnership with others to ensure safe and high-quality care. Ludlow et al. (2020) further added that nurses must recognise the complexities in the clinical decision and use their specialist expertise, knowledge, and abilities and consult or refer where necessary. Hence, prioritisations should focus on promoting patient experience, care quality, and safety through measures aimed at reducing missed care, rationed care, and adverse patient outcomes (Barker et al., 2016). Déry et al. (2018) also confirmed that unfinished care, including missed care and rationed care, could cause patient safety issues. Hence, student nurses transitioning to registered nurses must have competence, knowledge, and skills to prioritise and plan nursing care to improve the patient care experience and care outcomes.

According to Doucette (2016), knowledge and skills in prioritisation are often gained over time. Hence, newly qualified nurses often have difficulties prioritising care in their clinical practice (Appendix 1). Thus, Marsh (2021) recommended adequate support and guidance to help newly qualified nurses during their transition to registered nurses to improve their prioritisation, clinical judgement, time management, and decision-making skills. In other words, Suhonen et al. (2018) argue that priority setting in nursing involves nurses' ability to make decisions regarding the importance of patients' needs and problems and the evidence-based actions that should be implemented in response to promote patient safety and wellbeing.

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According to Doucette (2016), the pressure to prioritise patient experience exists at all levels of leadership throughout the healthcare system. NMC (2015) cited the need to enhance the patient experience by promoting safety, quality, and service. Safety supersedes everything nurse leaders do, and they must focus their efforts on creating a highly reliable process, eliminating or minimising the variations, and delivering the best possible outcomes. However, Ludlow et al. (2020) cited that prioritising care is influenced by time management skills (Appendix 1), and nurse leaders have to deal with time pressure to make an effective decision. According to Suhonen et al. (2018), effective prioritising skills are crucial in nurse leadership. Déry et al. (2018) also observed that effective nursing leadership is vital in ensuring a successful health care environment for patients, carers, and staff. Skirbekk, Hem, and Nortvedt (2018) demonstrated that the characteristics of high-quality care comprise safe, effective, reliable, person-centred, efficient, and equitable care. High-quality care prevents adverse outcomes and is linked to effective nursing leadership styles. Sfantou et al. (2017) stated that leadership entails setting goals, motivating, and influencing others towards meeting a common goal.

The registered nurses and directly involved in clinical care and provide leadership by making decisions and influencing team members to improve the quality of care and optimise patient experience (Skirbekk, Hem, and Nortvedt, 2018). NMC (2018) outlines that registered nurses should provide leadership to facilitate quality improvement and enhance patients' wellbeing and healthcare experiences. This requires competence in identifying priorities and managing time and resources effectively to improve the quality of care. NMC (2015) also, registered nurses must have the competence in leadership skills and be accountable to lead and delegate tasks in nursing care. Hence, transitioning student nurse leaders need to practice within their knowledge and competence while prioritising care using effective approaches, including communication, planning, organising, and coordinating resources.

Moreover, Sfantou et al. (2017) stated that healthcare practitioners should develop effective time management skills and techniques to ensure high efficiency, less burnout, and generate higher productivity. Time management skills are critical for newly qualified nursing in managing work-life balance and improving their productivity in a clinical setting (Lumbers, 2018). Nevertheless, Giddens (2018) cited that the daily nursing environment is very dynamic, informing the application of varying leadership styles to get work done. According to Collins et al. (2019), the common leadership styles applied in clinical settings include transactional, transformational, situational, and authoritarian. According to Lumbers (2018), the transactional leadership style focuses on the importance of leadership, supervision, organisation, and performance of the group. The nurse leaders applying transactions leadership style reward or punish staff respective of how they complete assigned tasks. Cardiff, McCormack, and McCance (2018) added that nurse leaders using transactional leadership style prioritise tasks to the team, set short-term goals with clear guidelines and documentation, and motivate, direct, and encourage the team to complete the tasks to gain rewards.

According to Giddens (2018), the transformational leadership style in nursing entails encouraging staff to do their best and motivating them to stay positive while performing their tasks. This leadership style uses effective communication to create a healthy clinical environment where team members share responsibilities leading to engaged and productive teams (Kirkham, 2020). The incident outlined in Appendix 1 could be associated with situational leadership style. According to Lumbers (2018), the situational leadership style in nursing is influenced by the existing needs and work requirements of the clinical setting. It requires nurse leaders to analyse the existing clinical situation and adopt the best strategy to lead to the best outcomes.

In a situational leadership approach, registered nurses are expected to prioritise, allocate, and delegate tasks to care team members based on their unique skill, competence, and professional qualifications. In delegating, the practitioner assigned the task must have the qualification and competence to perform the delegated role (NMC, 2018) effectively. Doucette (2016) confirmed that effective leadership skills in nursing correlate with high-quality care, positive care outcomes, patient satisfaction, and safety. Hence, as a student nurse, I must have effective leadership skills and competence to systematically assess the patients, prioritise their needs, and work with teams to provide safe and high-quality care.

The King's Fund (2021) stated that politics greatly influence health and healthcare delivery. Politics influence budget allocation and funding of healthcare services. According to Buchan et al. (2019), lack of funding to the healthcare system affects the staffing levels. For instance, Millar (2019) noted that National Health Service (NHS) experiences severe funding problems, leading to inadequate resources to meet the demand levels. According to Cardiff, McCormack, and McCance (2018), the political influence is responsible for the nursing staff shortage in the NHS due to the abolition of the student bursary, impacting the quality of health care services delivered to the patients. Millar (2019) stated that staff shortage in the NHS is associated with adverse impacts, including increased patient mortality as more nurses resign or retire from their jobs due to fatigue, workplace pressures, and burnout. This promotes limited patient care as hospitals lack adequate staffing levels to meet the patients' demands.

Care Quality Commission indicated that understaffing in NHS facilities directly impacts the quality of patient care (The King's Fund, 2021). Cardiff, McCormack, and McCance (2018) also cited that workforce shortage NHS increases the waiting time leading to missed and rationed care. This situation has had an overwhelming impact on the Covid-19. According to Giddens (2018), there is a need for high-quality nursing leadership to develop a culture that supports staff and enhances patient care. Buchan et al. (2019) also cited that the workforce crisis in NHS can be addressed through effective government policies, especially those seeking to improve recruitment and expand funding.

The UK government had developed diverse strategies to address the staff shortage, including recruiting non-registered nurses from overseas with no formal nursing qualification to work with registered nurses (Barker et al., 2016). This approach has improved staffing levels and the delivery of quality care. However, it also introduces diverse workplace cultures. Hence, as a student nurse transitioning to registered nurse, I could have knowledge and competence in cross-cultural management to respect diversity and work in teams with people across cultures to improve patient care. Besides, understanding an individual's skill set, knowledge, and competence will help me in delegation when prioritising care (Doucette, 2016).

Reflecting on my care episode

My reflection is based on personal experience during my community placement. During my orientation at the placement centre, my supervisor informed me that the facility was understaffed and did not have adequate resources. In this reflective account, my practice supervisor assigned me in charge of patients, where I was required to oversee them, print out a list, and prioritise them in order of their visit.

In compliance with my supervisor's instruction, I printed out the cases of vising patients from the RIO software and allocated them to the staff available. I relied on the institution's guidelines to classify, prioritise and allocate the patients. Additionally, I considered the available staff's competence, knowledge, and expertise during the allocations. Besides, I considered the importance and urgency of each case and relied on the Matrix Prioritisation tool to prioritise each case (Appendix 1). Ludlow et al. (2020) emphasised the importance of prioritising activities, delegation, and time management. I considered the time, resources available, and demand for care while performing my assigned tasks to ensure that patients whose conditions could easily exacerbate were prioritised to improve their health and wellbeing (Déry et al., 2018).  

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NMC (2018) requires registered nurses to maintain their duty of care and prioritise and ensure the safety and effectiveness of care delivered to patients. According to Barker et al. (2016), the first step to improving patient safety and quality of life is holistic and systematic assessment. The registered nurse must have the competence to ensure that patient's physical, psychological, and social needs are adequately identified to inform effective prioritisation and care planning. Cardiff, McCormack, and McCance (2018) also asserted that registered nurses must preserve patients' autonomy by engaging them throughout the nursing process to help them make informed choices. This also conforms to NMC (2018), which stipulates the professional codes of conduct and guidelines that are expected to guide the conduct of registered nurses.

The four critical standards of practice that informed my approach to patients include prioritising people, effective practice, preserving safety, and promoting professionalism and trust. According to NMC (2018), prioritising people involves putting service users' interests first by making their safety and care quality my primary concern and preserving their dignity, actively engaging them by listening to them and responding to their concerns and preferences. This requires practitioners to pay attention to individuals' social, biological, and psychological needs and act in their best interest (NMC, 2018). Also, effective practice comprises evidence-based practices to expedite care interventions to service users, involving them through effective communication in their care, recording details, and optimising their care experience.

Additionally, under preserve safety (NMC, 2018), the registered nurse is required to be responsible and accountable and delegate tasks to other practitioners based on their competence and qualifications. The practitioners are also required to maintain the safety of patients and the public and exercise their professional duty of candour and raise concern immediately safety issue is suspected. Besides, the registered nurses are also required to reduce or minimise the possible risk of near misses, mistakes, harm, and impact of harm to the patients. Professionalism and trust also need registered nurses to uphold professional reputations by remaining committed to the standards of practice and behaviours and maintaining positive attitudes to nursing duties (NMC, 2018).

Despite my efforts to adhere to the nursing standards of practice, I found it challenging to fully adhere to the NMC code of standard. The staff shortage meant that not all patients could receive safe and effective care. Available healthcare providers could not pay adequate attention to specific patients due to increased demand and the need to preserve safety and reduce delays. Besides, it was challenging for the care team to provide continuity of care, leading to unfinished care (Barker et al., 2016) and safety issues. The student nurses must be adequately prepared to deal with a challenging situation in a clinical setting and attain the necessary knowledge and competence to improve their decision-making and prioritisation before becoming registered nurses (Appendix 1). Skirbekk, Hem, and Nortvedt (2018) recorded that lack of appropriate nursing skills after becoming a registered nurse may make one feel incompetent and develop feelings of isolation and frustration, leading to low job satisfaction, increased vulnerability to medical errors and low-quality patient care and health outcomes.

Wray et al. (2021) cited that student nurses often find the transition to registered nurses challenging; hence, they need adequate support to improve their competencies, knowledge, and expertise to improve their ability to deliver quality care. Déry et al. (2018) also suggested that student nurses develop resilience and confidence to enhance their transition experience. Barker et al. (2016) stated that nursing practice is complex and dynamic due to the new evidence-based practices, policies, and improvement needs, thus, the need for continued professional development (CPD).

Based on my care experience, learning, and development needs, I could use strategies to support my continued professional development in transitioning from student to registered nurse, including preceptorship. Taylor, Eost‐Telling, and Ellerton (2019) defined preceptorship as a period when a newly qualified nurse is supported and guided to successfully transition from a student to a competent and qualified practitioner. The newly qualified nurse is supported by a preceptor who helps them develop confidence as independent professionals, support career progression, build and refine knowledge and competence (Wray et al., 2021). In preceptorship, the mentor works as the learners' role model and sets up transition-practice programs closely supervised to ensure the student meets the required competency levels (Appendix 1). Taylor, Eost‐Telling, and Ellerton (2019) confirmed that preceptorship programs enable one to develop confidence and competence as a newly qualified nurse, enhance transition, and improve retention.

Additionally, one can use reflection as a strategy to support continued professional development (Appendix 1). I employed reflection as a strategy to help me gain insight into my strengths, weaknesses, opportunities, and threats. The reflection on SWOT analysis creates awareness of areas that a student nurse needs to develop to improve personal competence and skills for nursing practice as a registered nurse. The use of reflection helped me evaluate my practice, actions, and abilities and identify areas that require development to improve the quality of my future practice.

NMC (2015) encourages nurses to engage in CPD through reflective practice. Hence, I will regularly engage in reflective practice to develop my knowledge, skills, and competence. Effective reflection will help me develop the skills required to prioritise my learning needs (Appendix 1) and create an informed career path based on adherence to nursing standards and code of conduct (NMC, 2018). These will also help me develop clinical decision-making, critical thinking, and judgment competence to prioritise patients and meet their holistic needs effectively. This will improve my effort towards delivering safe and high-quality patient care in my future practice as a registered nurse.

In conclusion, this paper has demonstrated issues often involved in transitioning from student nurse to newly registered nurse. It has also highlighted the political influence of health regarding funding and how reduced budget allocation contributes to staff shortage, patient safety incidences, and low-quality health care. The essay also shows how nursing leadership impacts the quality of care, including influence on productivity, decision-making, patient safety, and quality care. The newly registered nurses should develop competence, knowledge, and expertise in prioritisation, leadership, and clinical decision-making to improve patient care and outcomes. The transition process from student nurse to newly registered nurse presents varying challenges that impact patient care and staff attitude towards work and job satisfaction. The newly student nurse needs to use various strategies such as preceptorship and reflective practice to enhance continued professional development and define their career path to become competent and skilled practitioners. Developing effective skills and competence will positively contribute to my transition from a student nurse to a newly registered nurse and help me improve the quality of my future practice.

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You must use this form to record five written reflective accounts on your CPD and/or practice-related feedback and/or an event or experience in your practice and how this relates to the Code. Please fill in a page for each of your reflective accounts, making sure you do not include any information that might identify a specific patient, service user or colleague. Please refer to our guidance on preserving anonymity in the section on non-identifiable information in How to revalidate with the NMC .

 Appendix 2:

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