nursing leadership essay

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Developing effective nurse leadership skills, denise major deputy director of nursing, salisbury nhs foundation trust, salisbury, wiltshire, england.

• To enable you to outline the various types and characteristics of leadership

• To understand the importance of effective nurse leadership and its effect on patient care

• To identify ways to enhance your leadership skills and apply these in your everyday practice

Leadership is a role that nurses are expected to fulfil, regardless of their job title and experience. Nurses are required to lead and manage care as soon as they have completed their training. However, the development of leadership skills and the associated learning can be challenging, especially for less experienced nurses and those at the beginning of their careers. This article examines the importance of effective leadership for nurses, patients and healthcare organisations, and outlines some of the theories of leadership such as transformational leadership. It also details how nurses can develop their leadership skills, for example through self-awareness, critical reflection and role modelling.

Nursing Standard . doi: 10.7748/ns.2019.e11247

Major D (2019) Developing effective nurse leadership skills. Nursing Standard. doi: 10.7748/ns.2019.e11247

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

@denisemajor4

[email protected]

None declared

Published online: 07 May 2019

clinical leadership - leadership development - leadership frameworks - leadership models - leadership skills - transformational leadership

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Leadership in nursing: The importance of recognising inherent values and attributes to secure a positive future for the profession

• PMID: 26775531
• DOI: 10.1016/j.colegn.2014.09.004

Nursing is a dynamic and challenging profession requiring engaging and inspiring role models and leaders. In today's ever changing and demanding healthcare environment, identifying and developing nurse leaders is one of the greatest challenges faced by the nursing profession. The concept of leadership is a complex and multi-dimensional phenomenon; research conducted for over a century concludes that although it is one of the most observed concepts, no universally accepted definition or theory of leadership actually exists. There is increasing clarity surrounding what true nursing leadership is, and how it differs from management. This discussion will outline the nature of nursing leadership and importance of nurse leaders in advancing the profession; clarify definitions and differentiate between nurse managers and nurse leaders; describe the evolution of nurse leadership by identify theories and styles of leadership relevant to nursing practice; and highlight the importance of identifying leaders in the nursing profession. The paper also serves as a caution to recognise, avoid and discourage "negative" leaders in the pursuit of a bright future for the nursing profession. With appropriate identification, support and development of future nurse leaders, an acknowledgement of the shifting paradigm of leadership theory and the context in which future nurse leaders are destined to grow, the ultimate goal of the nursing profession--excellent in person centred care--can be achieved. It is essential to the future success of the nursing profession that informal, negative "leaders" be discouraged and positive leaders, possessing the evidence-based qualities of leadership be identified and nurtured to lead the profession.

• Leadership*
• Nursing Theory

Leadership Styles of a Nurse Leader

This essay about leadership styles in nursing explores how nurse leaders utilize different approaches to effectively manage healthcare settings. It discusses three primary leadership styles: transformational, transactional, and democratic. Transformational leaders inspire and innovate to improve patient care, while transactional leaders focus on efficiency and adherence to protocols, crucial in high-stakes environments like operating rooms. Democratic leaders emphasize collaboration and consensus, beneficial in complex care scenarios. The essay highlights the adaptability of nurse leaders to blend these styles according to situational needs, underscoring their critical role in enhancing team performance and patient outcomes.

How it works

Within the dynamic realm of healthcare, leadership emerges not merely as a role but as a cornerstone pivotal in shaping both the milieu and the outcome of care provision. Nurse leaders, wielding considerable influence in this domain, adopt diverse leadership modalities, each exerting distinct impacts on their teams and the care dispensed. Delving into these styles unveils a nuanced tapestry of leadership in nursing, transcending mere administration to embody mentorship, advocacy, and strategic acumen.

Transformational leadership stands tall among the pantheon of styles embraced by nurse leaders.

Distinguished by its emphasis on vision, inspiration, and catalytic change, this style transcends mere guidance to instill inspiration within the team. Practitioners of transformational leadership cultivate an environment wherein team members feel valued and empowered to contribute innovative ideas. This proves particularly efficacious in healthcare milieus, where innovation can yield substantial enhancements in patient care. For instance, a transformational nurse leader might galvanize their team to forge novel patient care paradigms, fostering efficiency and compassion, thereby augmenting patient outcomes and staff contentment.

Conversely, transactional leadership gravitates towards the conventional ethos of management and oversight. Anchored in structured tasks, unequivocal objectives, and performance-based incentives, this style operates within a realm of procedural rigor. While seemingly less dynamic than its transformational counterpart, it finds resonance in settings necessitating meticulous adherence to protocols, such as operating theaters or intensive care units. Here, nurse leaders establish a clear hierarchy and ensure strict adherence to guidelines, fostering a milieu of safety and efficacy. The clarity and predictability inherent in transactional leadership markedly diminish errors and amplify operational efficiency.

Democratic leadership resonates deeply within the nursing fraternity. Epitomized by its collaborative ethos and reverence for individual input, democratic nurse leaders often base decisions on collective consensus. This collaborative stance engenders a sense of camaraderie and shared ownership among staff, proving invaluable in contexts demanding multifaceted care, such as psychiatric or chronic disease management. Here, collaborative decision-making engenders holistic, patient-centric care strategies.

Each leadership style boasts inherent strengths, tailored to the exigencies of the moment and the aspirations of healthcare facilities. However, the efficacy of any leadership paradigm in nursing pivots on its capacity to adapt and evolve amidst the ever-shifting healthcare panorama. This adaptive prowess proves indispensable not only in addressing diverse patient needs but also in navigating the labyrinthine tapestry of healthcare regulations, technological innovations, and evolving healthcare methodologies.

Furthermore, effective nurse leaders are adept at amalgamating these styles to suit specific circumstances. For instance, a nurse leader might deploy a transactional approach during exigencies demanding swift, directive action, while seamlessly transitioning to a transformational paradigm when endeavoring to instigate enduring enhancements in patient care modalities.

In summation, the leadership styles of nurse leaders wield profound influence in shaping the ethos of healthcare settings. Whether through the visionary tenets of transformational leadership, the precision of transactional leadership, or the inclusivity of democratic leadership, these modalities assume a pivotal role in advancing healthcare outcomes. A comprehensive comprehension and adept application of these leadership styles not only enhance team efficacy but also elevate patient care, rendering nursing leadership a beacon of influence and inspiration within healthcare.

Remember, this exposition serves as a springboard for inspiration and further inquiry. For tailored guidance and adherence to academic standards, consider consulting professionals at EduBirdie .

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Dover N, Lee GA, Raleigh M A rapid review of educational preparedness of advanced clinical practitioners. J Adv Nurs. 2019; 75:(12)3210-3218 https://doi.org/10.1111/jan.14105

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Hamric A, Hanson C, Tracy M, O'Grady E. Advanced practice nursing. An integrative approach.Philadelphia (PA): Elsevier Saunders; 2014

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Heinen M, van Oostveen C, Peters J, Vermeulen H, Huis A. An integrative review of leadership competencies and attributes in advanced nursing practice. J Adv Nurs. 2019; 75:(11)2378-2392 https://doi.org/10.1111/jan.14092

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Better leadership for tomorrow: NHS leadership review. 2015. https://tinyurl.com/ev7thw68 (accessed 24 February 2021)

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Leadership and management for nurses working at an advanced level

Senior Lecturer, Leadership and Management: Public Health, Birmingham City University

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Leadership and management form a key part of advanced clinical practice (ACP) and work in synergy with the other pillars of advanced practice. Advanced clinical practitioners focus on improving patient outcomes, and with application of evidence-based practice, using extended and expanded skills, they can provide cost-effective care. They are equipped with skills and knowledge, allowing for the expansion of their scope of practice by performing at an advanced level to assist in meeting the needs of people across all healthcare settings and can shape healthcare reform. Advanced practice can be described as a level of practice, rather than a type of practice. There are four leadership domains of advanced nursing practice: clinical leadership, professional leadership, health system leadership and health policy leadership, each requiring a specific skill set, but with some overlaps. All nurses should demonstrate their leadership competencies—collectively as a profession and individually in all settings where they practice.

Leadership and management form an essential part of advanced clinical practice, as outlined by Health Education England (HEE) in 2017:

‘Advanced clinical practice is delivered by experienced, registered health and care practitioners. It is a level of practice characterised by a high degree of autonomy and complex decision making. This is underpinned by a master's level award or equivalent that encompasses the four pillars of clinical practice, leadership and management, education and research, with demonstration of core capabilities and area specific clinical competence …’

There is an appreciation that leadership and management skills work in synergy with the other pillars of advanced practice. Stanley et al (2008) advised that advanced clinical practitioners (ACPs) can shape healthcare reform, are trained to focus on improved patient outcomes, and with application of evidence-based practice, using extended and expanded skills, they can provide cost-effective care. ACPs are equipped with skills and knowledge, allowing for the expansion of their scope of practice by performing at an advanced level to assist in meeting the needs of people across all healthcare settings.

When considering a nursing context, the Royal College of Nursing (RCN) defined advanced practice as:

‘A level of practice, rather than a type of practice. Advanced nurse practitioners are educated at master's level in clinical practice and have been assessed as competent in practice using their expert clinical knowledge and skills. They have the freedom and authority to act, making autonomous decisions in the assessment, diagnosis and treatment of patients.’

Rose (2015) advocated that ACPs also need to respond to, inform and influence policy, and political and practice changes, while being aware of the complex needs of patients and new healthcare demands. Hamric et al (2014) delineated four leadership domains of advanced nursing practice:

• Clinical leadership
• Professional leadership
• Health system leadership
• Health policy leadership.

Each requires a specific skill set, but with some overlaps. These four leadership domains will guide the discussion that follows, with a focus on advanced nurse leadership.

Background: leadership and autonomy

Revisiting the HEE (2021) use of the word ‘leadership’ and the RCN's (2018) use of the term ‘autonomy’ as part of the definition of advanced nurse practitioners will set the scene and enable these two terms to be briefly examined. Naively, or perhaps traditionally and historically, we tend to put administrator and manager roles into a metaphorical box that considers them as formal leaders, while nurses in clinical roles are either not considered as leaders or they are identified as in formal or clinical leaders. As Scott and Miles (2013) stated, leadership is an expected attribute of all registered nurses, and, yet, leadership in the profession is often considered to be role dependent. All nurses—from student to consultant—are leaders, yet defined clinical leadership competencies are often not reflected in undergraduate nurse education. Research examining the impact of leadership demonstrated by nurses on patients, fellow nurses and other professionals and the broader health and care system is deficient ( Cummings, 2011 ). Nurses need to accept that leadership is a core activity of their role at all levels—once this is acknowledged the transition to advanced roles will be easier. Frequently, nurses approach the topic of leadership when studying for advanced practice as if it is something that they have never done and know little about. Yet they already have an enhanced leadership skill set developed throughout their careers, although they often fail to appreciate this. A solid foundation and affirmation that all nurses are leaders should form the basis of advanced practice.

Despite a blurring of boundaries between management and leadership, the two activities are different ( Bass, 2010 ). Working out who leads and who manages is difficult, with the added anomaly that not all managers are leaders, and some people who lead work in management positions. Kotter's seminal interpretation articulated that leadership processes involve setting a direction, aligning people, motivating and inspiring, and that management relates to organisational aspects such as planning, staffing, budgeting, controlling and solving problems ( Kotter, 1996 ). So leaders cope with new challenges and transform organisations, while managers maintain functional operations using resources effectively.

These explanations direct us to consider what is meant by the allied term of autonomy from the individual and organisational perspective. The Cambridge Dictionary (2020) defines autonomy for an individual as ‘independent and having the power to make your own decisions’ and for a group of people as ‘an autonomous organization, country, or region [that] is independent and has the freedom to govern itself’ (https://tinyurl.com/2h5canfa). In nursing, the concept of autonomy has a range of definitions. Skår defined professional autonomy as:

‘Having the authority to make decisions and the freedom to act in accordance with one's professional knowledge base.’

Skår, 2010:2226

In a clinical practice setting, Kramer et al (2006) outlined three dimensions of autonomy: clinical or practice autonomy, organisational autonomy, and work autonomy. However, they also advised caution with the use of the term autonomy because it has different meanings across the literature. Nevertheless, it has a place within advanced nursing roles, especially in connection with leadership.

Leadership and management for advanced practice

Recent research has examined leadership in advanced nursing practice. Hamric et al (2014) delineated four leadership domains. These link with the findings of Heinen et al (2019) in their review of leadership competencies and attributes in advanced nursing practice. The purpose of their research was to establish which leadership competencies are expected of master's level-educated nurses, such as advanced practice nurses and clinical nurse leaders, as described in the international literature. Note that in North America ‘advanced practice nurse’ is used as an umbrella term to include nurse practitioners and clinical nurse specialists ( Sheer and Wong, 2008 ).

Boxes 1 to 4 are based on the competencies identified by Heinen et al (2019) for the four leadership domains ( Hamric et al, 2014 ), and Box 5 gives some generic competencies that span each of these.

Box 1.Clinical leadership

• Provides leadership for evidence-based practice for a range of conditions and specialties
• Promotes health, facilitates self-care management, optimises patient engagement and progression to higher levels of care and readmissions
• Acts as a resource person, preceptor, mentor/coach, and role model demonstrating critical and reflective thinking
• Acts as a clinical expert, a leadership role in establishing and monitoring standards of practice to improve client care, including intra- and interdisciplinary peer supervision and review
• Analyses organisational systems for barriers and promotes enhancements that affect client healthcare status
• Identifies current relevant scientific health information, the translation of research in practice, the evaluation of practice, improvement of the reliability of healthcare practice and outcomes, and participation in collaborative research
• Acts as a liaison with other health agencies and professionals, and participates in assessing and evaluating healthcare services to optimise outcomes for patients/clients/communities
• Collaborates with health professionals, including physicians, advanced practice nurses, nurse managers and others, to plan, implement and evaluate improvement opportunities
• Aligns practice with overall organisational/contextual goals
• Guides, initiates and leads the development and implementation of standards, practice guidelines, quality assurance, education and research initiatives

Source: adapted from Heinen et al, 2019

Box 2.Professional leadership

• Assumes responsibility for own professional development by education, professional committees and work groups, and contributes to a work environment where continual improvements in practice are pursued
• Participates in professional organisations and activities that influence advanced practice nursing
• Participates in relevant networks: regional, national and international
• Develops leadership in and integrates the role of the nurse practitioner within the healthcare system
• Employs consultative and leadership skills with intraprofessional and interprofessional teams to create change in health care and within complex healthcare delivery systems
• Participates in peer-review activities, eg publications, research and practice

Box 3.Health system leadership

• Contributes to the development, implementation and monitoring of organisational performance standards
• Lead an interprofessional healthcare team with a focus on the delivery of patient-centred care and the evaluation of quality and cost-effectiveness across the healthcare continuum
• Enhances group dynamics, and manages group conflicts within the organisation
• Plans and implements training and provides technical assistance and nursing consultation to health department staff, health providers, policymakers and personnel in other community and governmental agencies and organisations
• Delegates and supervises tasks assigned to allied professional staff
• Creates a culture of ethical standards within organisations and communities
• Identifies internal and external issues that may impact delivery of essential medical and public health services
• Possesses a working knowledge of the healthcare system and its component parts (sites of care, delivery models, payment models and the roles of healthcare professionals, patients, caregivers and unlicensed professionals)

Box 4.Health policy

• Guides, initiates and provides leadership in policy-related activities to influence practice, health services and public policy
• Articulates the value of nursing to key stakeholders and policymakers

Source: Heinen et al, 2019

Box 5.Generic competencies spanning the four domains

• Possesses advanced communication skills/processes to lead quality improvement and patient safety initiatives in healthcare systems
• Uses principles of business, finance, economics, and health policy to develop and implement effective plans for practice-level and/or system-wide practice initiatives that will improve the quality of care delivery
• Advocates for and participates in creating an organisational environment that supports safe client care, collaborative practice and professional growth
• Creates positive healthy (work) environments and maintains a climate in which team members feel heard and safe
• Uses mentoring and coaching to prepare future generations of nurse leaders
• Provides evaluation and resolution of ethical and legal issues within healthcare systems relating to the use of information, information technology, communication networks, and patient care technology

The findings presented in Boxes 1 to 5 provide a research-based scoping of the international literature to identify aspects of leadership competencies connected with advanced nursing practice ( Heinen et al, 2019 ). Revisiting the theoretical differences between leadership and management ( Kotter, 1996 ), it can be appreciated that many of these competencies are blurred, with both existing as part of advanced roles. The clinical, professional and health system domains dominate the number of competencies recorded, giving an idea of the weight given by nurses to different areas of leadership. Competencies relating to the health policy domain were minimal. This is supported by a study describing the leadership capabilities of a sample of 14 advanced practice nurses in Canada using a qualitative descriptive study ( Lamb et al, 2018 ). Two overarching themes describing leadership were identified: ‘patient-focused leadership’ and ‘organisation and system-focused leadership’. Patient-focused leadership comprised capabilities intended to have an impact on patients and families. Organisation and system-focused leadership included capabilities intended to impact nurses, other healthcare providers, the organisation or larger healthcare system. Figure 1 summarises the leadership themes and capability domains identified in Lamb et al's study (2018) .

These findings also support the theory that advanced nurses do not recognise their wide reach as a major leadership part of their roles. In addition, it should be stated that all advanced nursing roles have their own idiosyncrasies based upon the individual practitioner, the environment and organisational needs; there is no ‘one size fits all’.

Multiprofessional working, leadership and the ACP role

With a move in the UK to multiprofessional working, especially in England, and changes towards core advanced practice skills crossing professional boundaries ( HEE, 2021 ) ACPs need proactive skills in cementing their leadership roles within teams. Anderson (2018) advised that successful multiprofessional working needs the individual professional to know the ‘standpoint’ of other professionals to enable their own understanding of complex problems. Edwards (2010) cautioned that professionals may work together and share personal values, but rarely do they work inter-professionally. The ACP role is complex, requiring autonomy and leadership of self within various aspects of the roles required of the individual in distinctive settings, in addition to performing and leading in teams often with professionals from other specialties.

What overt leadership skills may assist in delivery multiprofessional integrated care? Writing from a UK primary care perspective, Swanwick and Varnam (2019) described a necessary shift from the traditional individualistic hierarchical leader, working within and for single teams, to collective leadership encouraging a compassionate and inclusive culture. De Meyer (2011) also advised providing responsible collaborative leadership using the skills of co-operation, listening, influencing, and flexible adaptation, in contrast to what he terms the traditional ‘command and control’ top-down hierarchical approach. It could be suggested that this ‘way of being’ is aligned with the core skills of nurses but these may not be recognised by them as ‘real’ leading.

To ensure the success of the ACP role across the four pillars framework ( HEE, 2021 ) requires that the educational pathway and role has clarity, consistency and standardisation ( Dover et al, 2019 ) so that everyone will feel that they are entering on a level playing field. The framework ( HEE, 2021 ) represents a step forward by providing an overarching structure to align practice and education and creating greater consistency across ACP workforce developments. As the framework is implemented, it will be imperative to have an evaluation of its impact ( Evans et al, 2020 ).

The ACP is tasked with operating at an autonomous advanced level across the four pillars of education, leadership, research and clinical practice, and to be competent in the core capabilities for each pillar. Understanding the ACP role as a level of practice rather than a specific role with the distinguishing feature of autonomy may add clarification. Leadership is a crucial part of the ACP role and advanced nurses therefore need to conduct themselves as leaders so that others can recognise that they embody these skills. Yet, the time has come for all nurses to demonstrate their leadership competencies, collectively as a profession and individually in all settings where they practice. If every nurse is recognised as a leader, the transition to advanced practice will be fluid, streamlined and less of big deal.

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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The Shared Leadership in Nursing Report (Assessment)

The shared leadership (SL) model receives increasing recognition and support within the modern leadership theory. According to Zhu et al. (2018), shared leadership is characterized by three main features: horizontal hierarchy, team-level cooperation, and distribution of influence across many individuals. This assignment attempts to relate SL to the role of Advanced Practice Nurse (APN), making the case that SL benefits APNs on several levels. The paper draws evidence from academic sources to define additional SL characteristics that enhance patient care quality. Overall, collected evidence demonstrates that SL receives well-deserved acclaim and should be considered in APNs’ training and education.

In conclusion, one can support the initial positive assessment of the SL model. In addition to its natural features, SL facilitates the development of such important characteristics as caring relationships, ownership mentality, and constructive feedback (Wei et al., 2020). These characteristics create favorable conditions for APNs’ increased participation in the patient care process, contributing to their professional growth. In addition, the SL model provides the grounds for patient care quality improvement since SL facilitates the diffusion of innovation. Given these findings, one can recommend the SL model to healthcare organizations interested in the professional development of APNs and the overall improvement of patient care.

Currie, G., & Spyridonidis, D. (2019). Sharing leadership for diffusion of innovation in professionalized settings . Human Relations , 72 (7), 1209-1233. Web.

Goldsberry, J. W. (2018). Advanced practice nurses leading the way: Interprofessional collaboration . Nurse Education Today , 65 , 1-3. Web.

Lamb, A., Martin‐Misener, R., Bryant‐Lukosius, D., & Latimer, M. (2018). Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study . Nursing Open , 5 (3), 400-413. Web.

Wei, H., Corbett, R. W., Ray, J., & Wei, T. L. (2020). A culture of caring: the essence of healthcare interprofessional collaboration . Journal of Interprofessional Care , 34 (3), 324-331. Web.

Zhu, J., Liao, Z., Yam, K. C., & Johnson, R. E. (2018). Shared leadership: A state‐of‐the‐art review and future research agenda . Journal of Organizational Behavior , 39 (7), 834-852. Web.

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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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