In my interactions with the preceptor, I have come to realize that the most fundamental issues about leadership and management in homecare settings do not necessarily revolve around endowments in financial aspects and material resources; rather, effective leadership and management involve collaboration and establishment of mutually fulfilling relationships with colleagues and patients. It is clear how my preceptor collaborates with other nursing officers in certain responsibilities and functions, and how she influences the process of care to achieve positive outcomes for patients and staff. My preceptor, above all things, teaches me that collaboration and establishment of fulfilling relationships with patients and colleagues must increasingly rely on trust, clinical expertise, and professional autonomy. Indeed, through my interactions with the preceptor, I have come to realize that nurses are the face of the care of which the patients are most aware, but continue to be regarded as subordinate and passive recipients of the leader’s influence because most nursing leaders within the institutional setting do not indulge them on collaborative and mutually fulfilling relationships. Now, I can boldly suggest that collaboration and the establishment of mutually fulfilling relationships are, in my view, critical for the health institution’s patient care objectives and the nurses’ personal and professional development and management skills.
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Identified Concepts about Leadership and/or Management
As a direct consequence of my constant interactions with my preceptor in my clinical experience, I have come to identify many concepts, processes, and principles about leadership and/or management that will shape and develop my nursing practice. Some of the most dominant are explained as follows:
Leading Change (Chapter 17)
My constant interactions with my preceptor, who happens to be the Director of Nursing Practice and Hospital Education, have demonstrated that nurses are not only agents of change but visionaries and active participants in learning as well as in the process of giving care. As agents of change, I have come to realize that we also ought to be in the frontline in advocating for the needs of our patients, profession, institutions, and the standards of competency anticipated of registered nurses (RNs). As agents of change, we are not only expected to deal with and enhance the lives of patients struggling with various health-related challenges, but we should go an extra mile to assist colleagues to understand the importance, necessity, and process of change, and to support each other during times of difficult transitions such as those involved in major hospital reorganizations.
Delegation of Authority (Chapter 10)
As demonstrated by my preceptor, delegation of authority in the management of case loads within the homecare setting is extremely important not only because of the recurrent need for skilled nursing care and management to meet complex healthcare needs emerging in communities, but also due to the urge to reconceptualise and manage care in ways that bring economies of scale and successfully meet the needs and expectations of people. I have successfully internalized the facts that delegation of authority not only results in successful caseload analysis, care coordination and prioritization, but ensures that the healthcare needs and expectations of patients and their families are being addressed by the appropriate person at the appropriate time.
Building teams through Empowerment & Partnerships (Chapter 18 and Chapter 10)
My interactions with my preceptor have illuminated an important premise that teams can be developed through communications, but effective teams need to be grounded in empowering the nursing staff and involving them in practice-related decision making processes. It has indeed dawned on me that partnerships and teams can be achieved and enhanced by structurally empowering the nursing staff through availing means to access information, resources, supports and opportunities via formal or informal trajectories of power. My preceptor is particularly effective in using networks among peers and colleagues (informal means) not only to build empowered and satisfied work teams, but also to establish partnerships that draw on increased decision involvement and trust to achieve positive perceptions of an effective patient safety climate.
Staffing & Scheduling (Chapter 14)
Perhaps the most important things I have observed regarding staffing and scheduling of roles is that both processes must be evidence-based but not grounded in popular opinion or tradition, and that the effectiveness of staffing and scheduling of roles in homecare settings has considerable business, patient safety, and quality ramifications that sit at the heart of the nurse manager’s role. The wisdom and experience of the nurse leader, as demonstrated by my preceptor during my clinical trials, has the capacity to influence success in staffing and scheduling.
Evaluating Staff (Chapter 15)
From my clinical experience with my preceptor, I have observed that evaluation of nursing staff by their superiors is a standard managerial practice due, in large part, to the fact that it assists them to select the right staff members for diverse care-related duties. Perhaps this is the major reason why my preceptor always keeps a note pad by her side to note both negative and positive behaviours of nursing trainees with the view to provide a much more focused and accurate assessment of their performance during the clinical trials. The preceptor uses her notes not only to mentor me on my weak point, but also to reinforce my strengths.