The attending nurse identified the deterioration and alerted the arrest team

2018 Sample Assessment

The delivery of healthcare requires strong leadership at all levels. Critically discuss this

In this piece, the author will examine the essential attributes of a strong leadership in modern healthcare and the methods which can strengthen the quality of their practice. An example of a cardiac arrest situation will be used to explore relevant concepts of leadership and the potential impact they can have on a workforce. These concepts include leadership styles, resilience, and emotional intelligence. The aetiology, causes, strategies for development, and liturgical contributions will be critically discussed in relation to each concept.

What makes an effective leader?

Cummings (2012) drew a parallel between the standard of patient care and effective leader- follower relations. A plethora of evidence is available to support the association between successful leaders and nurse retention, constructive work atmosphere, and thus optimised patient safety and delivery of care (Hendricks, Cope and Baum, 2016), (Wong, Cummings, and Ducharme 2013), (Duffield et al., 2011).

Being an effective leader is not an inherited or predisposed skill but can be acquired by way of specialised education and guidance (Fischer, 2016). Mahoney (2001) identify that one of the greatest challenges of the caring profession is developing future leaders. To combat this challenge, Benner et al. (2010) indicate that student nurses should be primed for leadership and be guided in the development of appropriate attitudes, decision-making skills, and problem-

3: Demonstration of competence and confidence in the delivery of high quality, evidence-based practice and high-level decision-making abilities in emergency situations.

4: Being competent in the integration of quality and safety into the daily running of a clinical area.

(Hutson, 2008)

What makes an ineffective leader?

Clinical Relevance

Three key elements which are essential for strong leadership will be elucidated through an example of a cardiac arrest situation which the author experienced first-hand. She was able to identify, compare, analyse and synthesise critical positive and negative aspects to the approach of the two leaders involved in this emergency situation.

The anaesthetics consultant arrived and immediately took control of the situation with

continuous	communication	in relation	to drug administration,	compression

The style demonstrated by the anaesthetic consultant can be described as transformational (TFL) and is considered the gold standard of leadership. Anonson et al. (2014) described transformational leaders as working well under pressure, setting inspirational examples, working for and with their team. Those who adapt this style have earned staff respect and inspire their colleagues to perform beyond their perceived abilities through motivation and genuine praise (Frandson, 2014). Kanste et al. (2009) advocate the use of TFL in healthcare systems as its use has been closely linked with increased staff effort, willingness to learn, and job satisfaction. It has been noted by Outhwaite (2003) that transformational leaders interact and integrate into the daily workings of their environment and share the workload. Involvement enables the leader to comprehensively evaluate practices of the services, effectively troubleshoot, and gain insight into the perspective of the workforce. Sabina et al. (2003) deem TFL as the most appropriate style for modern healthcare organisations where versatility and adaptation are critical for success with rapid development in technology, evolving illness’, and staff/ population expectations. They elucidate the relationship between TFL and optimum staff performance, thus enhancing patient safety and quality of care.

The author acknowledges that although the outcome of the scenario was grave, the anaesthetic consultant constructed a genuine trust with all staff present, including his anaesthetic team, staff nurses, and healthcare assistants alike. He shared the workload and participated in a motivational and sensitive manner.

their intentions must be rooted to moral foundations. For a strong healthcare system with effective leadership to be developed and maintained, clinicians at all levels must be familiar, able to identify and avoid this illegitimate form of TFL (Bass and Steidlmeier 1999).

difficulty monitoring and responding to the responsibilities of their followers. It is only effective in limited scenarios. He also advocates that a versatile leader is a strong leader who can effectively interchange between leadership styles dependent on the situation, workforce and clinical area (Yang, 2015).

2. The facilitation of reasoning by use of emotion through problem solving techniques. 3. Understanding the emotion identified, even if complex. Understanding the transient nature of emotions and how they relate to individual circumstance.

As per Olawoyin (2018), to be emotionally intelligent, one must possess the following characteristics: empathy, emotional stability, motivation, social skills, and self-regulation. Managerial emotional intelligence has been associated with increased patient and staff satisfaction, nurse retention, teamwork, and a more positive work environment (Munro, 2011) (Marvos & Hale, 2015). Unlike the CNM described above, an emotionally competent leader is proficient in the utilisation of compassion, sensitivity and direct decision making when dealing

Although there is a plethora of evidence to support the concept of emotional intelligence, there is also rampant criticism, with accusations of immeasurability, irrelevance, and poor-quality theory-dependent definitions. Locke (2005) suggest that emotional management does not merit any form of specialized intelligence and is just a physiological attribute present in certain individuals. Furthermore, Daus and Ashkanasay (2003) feel that emotional intelligence is nothing but an accumulation of specific personality trait sequences. They acknowledge that

Concept 2- Resilience

This scenario highlighted to the author that she has a higher level of resilience than previously perceived. She was able to identify the stressors of this situation and was enabled to transform it into a learning experience. She accepted the outcome of the situation and through active reflection was compelled to analyse her actions. She did not become upset by the attitude of her CNM and was able to overcome the emotional distress of the arrest by seeking a debrief session with the anaesthetics team. She was encouraged by the feedback provided, making

Kerfoot (2004) highlights the predominantly negative culture in nursing, with attitudes revolving around blame, and feedback focusing on failure rather than achievements. The general atmosphere of tragedy and illness have the potential to negatively impact on an individual’s overall outlook and response to clinical adversity (Kerfoot, 2004). Aside from patient tragedy, all specialties of nursing are exposed to vulnerable individuals and communities whose entire existence revolves around extensive adversity, in which resilience is essential to their way of daily life (Mc Gee, 2006). Nurses and leaders alike must respond

Mc Gee (2006) advocates active reflection and thorough debriefing as an effective strategy of resilience development. Hodges, Keeley and Grier (2005) concur with these recommendations, with further input suggesting positive reinforcement through praise and encouragement to manifest a sense of pride and reassurance amongst staff followers.

Seargeans and Laws-Chapman (2012) have constructed a six-step process for building emotional resilience:

5: Create alternative choices- Once the stressor is identified and isolated, it is encouraged to make positive changes to cancel that stressor out.

6: Evaluate personal behaviour adjustments- stay in tune with how your behaviours are evolving. Mindfulness is pivotal to emotional resilience.

Leadership education has been pivotal in much of the acclaimed research, and through training

can be optimised.

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