Leadership and Management Reflection in the Healthcare Field Essay

Introduction

The analysis of events in a professional setting, in general, and a healthcare setting, in particular, is an invaluable source of information that yields continuous learning and competency improvement. It is particularly relevant for leadership and management since these positions involve a high level of responsibility for a set of decisions within a healthcare facility that might impact the lives and safety of multiple employees and patients. Indeed, reflection as a process of inward inspection of one’s strengths and weaknesses through an objective lens helps in strengthening professional and personal development opportunities. For that matter, this reflection paper is aimed at analyzing an event from a healthcare facility practice in which the leader exhibited weaknesses in staff management to detect the causes of failure, strengths, and paths for improvement. The Gibbs reflection cycle will be used as a reflection model, providing a comprehensive structure for the analysis of the event.

Among the many models for reflection, the Gibbs model allows for conducting a continuous, step-by-step, cyclic process of reflection, which helps inform professional development. Indeed, it allows for intertwining facts, thoughts, emotions, and evidence from both practice and theory to identify weaknesses that require improvements (Ardian, Hariyati and Afifah, 2019). Because the action plan is an inherent part of the reflection process, it provides an individual with an opportunity to make informed decisions through continuous learning and practice in professional and personal development (Elsden, 2022). It is anticipated that this reflective exercise will allow for assessing the drawbacks in the leader’s performance and provide the basis for skill development and knowledge acquisition.

Gibbs Reflection Cycle

Description of Facts

The event under analysis happened during the summer of 2022 at the urology and colorectal ward of the facility where I work. As a leader, I perform the duties of a staff manager, which requires close interpersonal communication with nurses. Among the numerous staff, there was one nurse, referred to as Nurse X for the purposes of this paper, who had been systematically late for her shifts for the past week and a half. I did not attend to the issue until peer nurses started informally reporting the inconveniences in their duty execution due to Nurse X’s lateness. During one of the staff meetings, shortly after the first complaints about Nurse X’s tardiness, I generalized the issue and, without calling names, stated that lateness is not tolerated in our ward and that people who are systematically late will be exposed to disciplinary actions. The next day, Nurse X was late again, in response to which I addressed the issue during the next staff meeting, specifically referring to Nurse X in front of her peers. She did not explain anything and only promised that it would never happen again.

However, in three days, Nurse X was late again; I asked her to meet me, and in a private conversation, I found that she was going through a divorce and had challenges handling her young child. Her schedule was too rough, and she could not manage to cope with her personal issues effectively without it impacting her job performance. During the conversation, we discussed alternative schedules for her and established that a later shift would be more convenient and would allow the nurse to start her work on time without any interference from colleagues.

Description of Thoughts and Feelings

When I was informed about Nurse X’s frequent lateness, I was thinking about the negative impact of such behavior on the ward, patient experiences, and relationships between the nursing staff members. In addition, I thought about the importance of addressing the problem openly and using this case as a warning for others to be properly organized. I did not want to lose my status as an authoritative and strict leader who does not give rootless promises. Moreover, despite having promised to discipline a nurse who does not follow the rules of starting her shifts in a timely manner, I felt insecure when anticipating an open confrontation. I felt empathy toward the nurse and did not want to complicate the problem by punishing her.

When all these attempts to solve the issue failed, I felt anxious, weak, and incapable of conflict resolution. I realized that the only proper way to find a proper solution is by examining the cause of the problem in a face-to-face conversation. During our conversation, I demonstrated my concern and empathy, which allowed us to reach a mutual understanding, find a proper solution, and ultimately eliminate the problem of her systematic tardiness. After the problem was resolved, I felt empowered and confident in my capabilities.

Evaluation

When I recall this situation, I understand that I was not adequately focused on the issue from the beginning. Instead, I was thinking about my image when handling the conflict, the far-reaching implications for the organization, and the perception of my actions by peers. My worries about the employee who caused the problem were secondary, which diminished the opportunity for an effective solution from the very beginning and caused much distress for me personally af in general. Overall, a multitude of factors motivated my behavior in response to the problem.

Overall, this experience might be characterized by several negative features, one of which is the confusion about the multitude of leadership roles. At first, I felt uncertain about the proper way to handle the situations, which caused me some distress. In addition, the problem was not solved fast enough, which made other employees actively involved in the conflict or witnessing it. On the other hand, the positive implications of this event are related to my understanding of the importance of properly organized staff work on the overall functioning of the whole ward. In addition, I managed to engage in an effective face-to-face interaction when attending to a conflicting and personalized issue of an employee, which, although uncomfortable, led to positive outcomes (Saputra, 2021). Thus, it is essential to analyze the event to identify its learning implications of it for the future.

Analysis

When analyzing the described situation’s facts and my thoughts and feelings, I try to connect my experience with the evidence available from the literature to find my weaknesses and possible paths for improvement. Such a contextual reflection is an important element of analysis, where a properly guided process of events investigation is viewed in connection with the psychological and setting-related factors (Mears, 2019). Such an approach validates finding effective learning opportunities and practice-based suggestions for improvement (McCarthy et al., 2021). Overall, the use of analysis within this reflection is essential since it has the potential to result “in positive nursing experiences and positive organizational outcomes” (Crewe and Girardi, 2020, p. 324). Ultimately, analysis is the core aspect of reflective work that helps to outline and set clear goals to be achieved as a part of error elimination and personal and professional improvement for future practice.

The reason why I chose this situation for analysis is based on the multifaceted factors involved in the motivation of my behavior in this seemingly simple situation. This event was one of the turning points in my professional advancement as a leader because it took me outside my comfort zone, showed me my weaknesses, and forced me to pursue my least developed skills. According to Wiewiora and Kowalkiewicz (2019), critical evaluation and reflection on challenging professional situations help in authenticating the professional development path, and “the application of authentic assessment can assist in developing authentic leadership competencies” (p. 415). Overall, scholars state that the use of the Gibbs reflective cycle for professionals in various fields helps “to improve their professional knowledge development and emotional field training” (Li et al., 2020, p. 75). Thus, the use of a reflective analysis as a tool in advancing professional development helps in finding a leader’s identity, which is particularly relevant in my case.

In the course of reflection, I determined that my reaction to the described event and its implications were justified by the general situation in the nursing practice. On the one hand, immediate reaction to lateness-related conflicts in a working environment in a healthcare facility should be enforced due to the far-reaching implications of such a problem on the functionality, productivity, and performance quality of the whole ward. Indeed, research shows that tardiness might be reflected in the poor performance of an employee due to the lack of organization and time management skills (Tran et al., 2018). On the other hand, poor handling of such misbehavior of one of the employees might lead to disruptive collective outcomes. Indeed, systematic lateness of at least one nurse has a negative impact on the work of other nurses due to the complications with the timely starting and finishing of shifts and conducting patient work properly. Thus, when analyzing the event, I examine the severity of the anticipated implications of the issue at hand, which should be used as a guiding point for my future work in the leadership position.

Another significant issue that was involved in my motivation to act adequately was the issue of the workforce’s flexibility in the context of nursing understaffing. Indeed, understaffing in the healthcare setting is a particular concern in the contemporary healthcare industry, which requires compromises in order to eliminate higher rates of turnover. In particular, burnout, volunteer turnover, and heightened workloads in the nursing profession constitute a significant problem for today’s healthcare, causing understaffing across medical fields (Hoff, Carabetta and Collinson, 2019). On the other hand, my elevated concern with the issue was justified by the complaints of other nurses, whose emotional state at work was hindered due to Nurse X’s time management misbehavior. Indeed, research shows that “nurses arriving late for their shift cause emotional stress to their colleagues, as they have no choice but to continue working until being replaced” (Shapira‐Lishchinsky and Benoliel, 2019, p. 662). Thus, when analyzing the situation in the context of larger healthcare concerns, I was able to rationalize my motivation for the decisions I was trying to make.

Importantly, this critical event became a trigger of my insights into the meaning of leadership and its practical relevance to the healthcare setting. In particular, leadership might be defined as an interaction between a leader and subordinates when a leader guides others toward common goals by maximizing the potential and developmental opportunities of the followers (Jiménez, 2018). In this regard, the role contrary to leadership is followership, which entails the process of being guided by someone using skills and performance manifestations to accompany leadership. Thus, leadership and followership are two sides of the same interaction where individuals and groups have different sets of roles and responsibilities, which requires particular competencies and knowledge. However, the type of such interaction depends on the leadership styles used by a leader, which are conceptualized with the help of leadership theories (Daniëls, Hondeghem and Dochy, 2019; Jiménez, 2018). Thus, in the context of my research into the particularities of leadership and followership, I realize my limited ability to practically implement leadership theories in all their diversity, especially in the context of a healthcare setting.

Indeed, since the healthcare sector is a specific work setting where the system of interactions between leaders and subordinates should be properly balanced with the power of influence and freedom on both sides. Indeed, this interaction should be balanced with proper structure, discipline, and protocol abidance, as well as a reasonable amount of employee flexibility, independence, and freedom of decision-making (Belrhiti, Giralt and Marchal. 2018). Indeed, the use of situational, transformational, or other types of leadership predetermines a particular level of flexibility in the framework that would meet the requirements of the healthcare system. For that reason, my confusion about the proper response to the critical event under discussion in this paper has been validated by the omnipresence of the complicating factors.

Importantly, communication as a process of interpersonal exchange of verbal and non-verbal information plays a pivotal role in the establishment of functional relationships between leaders and subordinates. In this regard, my poor communicative performance with Nurse X was an indicator of the risks of the whole interaction failure in the long-term perspective. When handling the situation, I felt responsible for carrying out my duties as an effective manager capable of handling staff issues. In this regard, I was afraid of failing to confront the nurse in a proper and polite manner that would yet demonstrate my power, which is why I decided to address the problem implicitly in a meeting. However, when the nurse was late again, and I had publicly addressed disciplinary actions in response to such behavior, I felt a burden of responsibility for my words and of not humiliating myself in front of colleagues. Thus, the use of proper communication strategies informed by a relevant leadership theory applicable to the healthcare setting would help me avoid the confusion and act effectively (Zhang et al., 2020).

One of the aspects I learned from this experience is the inconsistency of my actions as a leader handling a conflicting situation. I failed to pursue disciplinary actions due to the avoidance of conflicts with my subordinates, which might have a long-term negative impact on my leadership career (Maryani, Entang and Tukiran, 2021). Indeed, I might have referred to the disciplinary solution of the problem without considering the context of the issue but merely referring to the systematic occurrence of the lateness.

Disciplinary actions should take place in accordance with the protocols and rules of conduct in effect at a healthcare facility (Adebimpe, Fatile and Emuze, 2021). My initial motivation was a manifestation of an attempt to engage in charismatic leadership, which entails focusing on the personality of a manager who leads by means of their personal example and charismatic personality (Supratman, Entang and Tukiran, 2021). Indeed, as stated by Zhang et al. (2020), “charismatic leadership is referred to as using personal charm, attractiveness, and persuasive communication to exert influence on employees” (p. 4). However, the lack of a strictly defined leadership style and skills does not allow me to act within the framework of the charismatic leadership theory principles.

On the other hand, my actual effective solution was rooted in the use of situational leadership. It is only after examining my actions in retrospect that I managed to connect my behavior with the principles of the situational leadership theory. Indeed, according to research, “situational leadership theories rather focus on behavior and attitude of the employee and on characteristics of the organization e.g. the staff characteristics, task structure, hierarchy and power relations” (Daniëls, Hondeghem and Dochy, 2019, p. 114). This approach to leadership allows for integrating the context in the decision-making, which helps to build team resilience, flexibility, and productivity in any given circumstance (Belrhiti, Giralt and Marchal, 2018). Thus, in my current performance, the use of leadership styles and theories is inconsistent, which should be corrected given the implications of the analyzed event.

Moreover, my actions in response to the incident with Nurse X’s tardiness on a systematic basis were a sign of toxic leadership. According to Ofei et al. (2022), toxic leadership manifested through ineffective communicative tools leads to diminished job satisfaction and losses in productivity. Therefore, my initial response in the form of addressing the problem implicitly and then explicitly in public was ineffective and served as a source of continuous disagreement and distress in the group of employees. Moreover, the principles of ethical leadership might help me avoid confusion in similar situations in the future by detecting ethical dilemmas in each conflict (Angelos et al., 2021). As an outcome of the analyzed situation, I learned that I have improperly developed communication skills, inconsistent leadership style, and insufficient emotional intelligence, which will be the areas of focus for me in the future.

Reflective Cycle Conclusion

The investigation of the situation helped me clarify the scope of issues I should work on in the future. I have discovered that I am good at handling conflicts in a situational manner, which allows for flexibility and resilience. Furthermore, I learned that I am an empathetic leader, although I do not exert a proper amount of strictness. I discovered that my weaknesses are insufficient emotional intelligence, confusion about leadership styles, and difficulty in interpersonal communication. For that matter, the questions that remain relevant after this reflection exercise are as follows:

• How do I improve my skills in face-to-face communication with employees?
• What practices should I engage in to identify my authentic leadership style, and how do I acquire the necessary competencies?
• What are the effective methods of developing emotional intelligence to assist in my interpersonal communication with subordinates in conflicting situations?

The answers to these questions might be found when attending to a plan of action that would help me achieve improvements in my future performance as a healthcare leader.

Action Plan

The goals I set before myself are specific, measurable, achievable, realistic and time-bound (SMART), which will help in tracking my progress and success (Latham, 2020). The goals are grouped in accordance with the area which they are aimed to improve. The first area of planned learning is face-to-face communication skills improvement. According to research, “in respect of leadership, skills that deserve particular attention include effective listening, getting across a message clearly and vividly, and the ability to provide performance feedback in a supportive manner” (Kwiatkowski, 2019, pp. 121-122). For that matter, the goals within this area include:

• SMART goal 1: Enroll in an online communication skills training program with live communication with peers to complete it within the next two months.
• SMART goal 2: Initiate 10 weekly personal meetings with employees to practice active listening, feedback delivery, and clear message articulation.

The second area of improvement is the identification of a proper leadership style and the development of the necessary skills and knowledge to be able to perform according to the principles of that style. Since “leadership skills and management practices positively influence both patient and healthcare organization outcomes, it’s becoming clear that leadership training should be formally integrated into medical and residency training curricula” (Rotenstein, Sadun and Jena, 2018, p. 2). Thus, the goals within this area are as follows:

• SMART goal 3: Undergo three self-assessment psychological tools to identify leadership and personality types within the next month.
• SMART goal 4: Enroll in a leadership training course within the next month.

Finally, the third area of improvement is emotional intelligence training, which accounts for a significant segment of my work with employees. Although my empathy is helpful in my practice, I will need to develop stress-management skills and social awareness (Drigas and Papoutsi, 2020; Jiménez, 2019). The goals to be completed within the framework of emotional intelligence are as follows:

• SMART goal 5: Enroll in and complete a four-week online emotional intelligence program (Alkozei et al., 2019).
• SMART goal 6: Initiate six consecutive by-weekly meetings with peers for feedback analysis on the leader’s performance.

Conclusion

In summation, this paper has demonstrated the benefits of applying a reflective model to events in one’s professional life. Since the issues of leadership and management were at the core of the analysis, one was able to obtain a proper objective view of the event and build a structured and well-informed plan of action. Ultimately, the reflection practice has created an opportunity for detecting the areas that complicate one’s opportunities for consistent professional growth. The completion of the planned goals will help address the identified issues and leadership performance accordingly in the future.

Reference List

Adebimpe, F.O., Fatile, E.O. and Emuze, J.P.E. (2021) ‘Effects of job satisfaction and job performance of nurses on the wellbeing of patients in the federal medical center, Owo’, LAUTECH Journal of Nursing, 9, pp. 37-44.

Alkozei, A. et al. (2019) ‘Increases in emotional intelligence after an online training program are associated with better decision-making on the Iowa gambling task’, Psychological Reports, 122(3), pp.853-879.

Angelos, P. et al. (2021) ‘A crucial moment for reflection on the importance of ethical leadership in academic medicine’, Annals of Surgery, 273(2), pp.e46-e49.

Ardian, P., Hariyati, R.T.S. and Afifah, E. (2019) ‘Correlation between implementation case reflection discussion based on the Graham Gibbs Cycle and nurses’ critical thinking skills’, Enfermeria Clinica, 29, pp.588-593.

Belrhiti, Z., Giralt, A.N. and Marchal, B. (2018) ‘Complex leadership in healthcare: a scoping review’, International Journal of Health Policy and Management, 7(12), p.1073-1084.

Crewe, S. and Girardi, A. (2020) ‘Nurse managers: being deviant to make a difference’, Journal of Management & Organization, 26(3), pp.324-339.

Daniëls, E., Hondeghem, A. and Dochy, F. (2019) ‘A review on leadership and leadership development in educational settings’, Educational Research Review, 27, pp.110-125.

Drigas, A. and Papoutsi, C. (2020) ‘The need for emotional intelligence training education in critical and stressful situations: the case of Covid-19’, International Journal of Recent Contributions to Engineering Science IT, 8(3), pp.20-36.

Elsden, J. (2022) ‘Using reflective practice for personal development planning’, Dental Nursing, 18(2), pp.76-78.

Hoff, T., Carabetta, S. and Collinson, G.E. (2019) ‘Satisfaction, burnout, and turnover among nurse practitioners and physician assistants: a review of the empirical literature. Medical Care Research and Review, 76(1), pp.3-31.

Jiménez, M. (2018) ‘Leadership style, organizational performance, and change through the lens of emotional intelligence’, Foundations of Management, 10(1), pp.237-250.

Kwiatkowski, C. (2019) ‘Effective team leader and interpersonal communication skills’, in Sustainable leadership for entrepreneurs and academics (pp. 121-130). Springer, Cham.

Latham, G. (2020) ‘Goal setting: a five-step approach to behavior change’, in Organizational collaboration (pp. 10-20). Routledge.

Li, Y. et al. (2020) ‘Nurses’ psychological feelings about the application of Gibbs reflective cycle of adverse events’, American Journal of Nursing, 9(2), pp.74-78.

Maryani, Y., Entang, M. and Tukiran, M. (2021) ‘The relationship between work motivation, work discipline and employee performance at the Regional Secretariat of Bogor City’, International Journal of Social and Management Studies, 2(2), pp.1-16.

McCarthy, B. et al. (2021) ‘Nursing and speech and language students’ perspectives of reflection as a clinical learning strategy in undergraduate healthcare education: a qualitative study’, Nurse Education in Practice, 57, 103251.

Mears, D. (2019) ‘How do the cardiology services for patients presenting with acute coronary syndromes compare between developing and developed countries?’, Nepalese Heart Journal, 16(1), pp.1-6.

Ofei, A.M.A. et al. (2022) ‘Toxic leadership behavior of nurse managers on perceived job satisfaction and productivity of nursing workforce in sub‐Saharan Ghana: a multi‐center cross‐sectional study’, Journal of Nursing Management. Web.

Rotenstein, L.S., Sadun, R. and Jena, A.B. (2018) ‘Why doctors need leadership training’, Harvard Business Review, 17, pp.1-5.

Saputra, F. (2021) ‘Leadership, communication, and work motivation in determining the success of professional organizations’, Journal of Law, Politic and Humanities, 1(2), pp.59-70.

Shapira‐Lishchinsky, O. and Benoliel, P. (2019) ‘Nurses’ psychological empowerment: an integrative approach’ Journal of Nursing Management, 27(3), pp.661-670.

Supratman, O.V., Entang, M. and Tukiran, M. (2021) ‘The relationship of charismatic leadership, employee personality, and employee performance: evidence from PT. Karya Abadi Luhur’, International Journal of Social and Management Studies, 2(2), pp.17-41.

Tran, K.T. et al. (2018) ‘The impacts of high-quality workplace relationships on job performance: a perspective on staff nurses in Vietnam’, Behavioral Sciences, 8(12), pp.1-21.

Wiewiora, A. and Kowalkiewicz, A. (2019) ‘The role of authentic assessment in developing authentic leadership identity and competencies’, Assessment & Evaluation in Higher Education, 44(3), pp.415-430.

Zhang, X. et al. (2020) ‘Heroes or villains? The dark side of charismatic leadership and unethical pro-organizational behavior’, International Journal of Environmental Research and Public Health, 17(15), pp.1-16.