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NHS Hospital Business Management Report


Introduction

This paper seeks to give an intrinsic evaluation of my experience with regards to the concepts of leadership, management and development with a special connection being established between these issues and my prospected job as a business manager at the NHS hospital. In doing so, relevant examples, ideas, opinions, notions, theories and facts from various scholarly quarters will be used to advance the arguments herein.

Even more importantly, the “reading and carrying” framework, advanced by James and Aroba (2005), which emphasizes on the value of emotions in leadership, will be duly applied and relevantly considered regarding my future workplace role as business manager at NHS hospital.

On another crucial note, this paper will blend Johns’ model of structured reflection and Gibb’s reflective cycle in detailing my experiences and reflecting on how they influence my prospected job as hospital manager. In brief, John’s model of structured reflection recommends that, whenever we need to appropriately reflect on issue, we should begin by identifying the incident/experience while putting it into the right context of analysis. Once that is done, John’s model recommends moving into the second stage which entails the actual reflection. This is then followed by the detailing of an alternative action (what you would have done differently) basing your arguments on established studies. Finally, we have the learning stage where one is to indicate what has been learnt from the reflected experience.

On the other hand, Gibbs reflective cycle talks of more-or-less the same facets as John’s model, except for the fact that in Gibbbs model, the key stages of the entire reflection process are summarized in cycle that comprises of the description of the incident, feelings towards the incident, evaluation of the incident, analysis of the incident, conclusion and then an action plan or way forward if the incident was to occur again. It is, therefore, upon these two reflection models that this paper will be written.

The Experience/Incident Put into Context

The incident below essentially occurred when I was a teenager and, as will exhaustively discussed later in the reflection section; the incident greatly affected my dream of being a good leader and business manager at NHS hospital.

In the incident, our biology organized a class trip to St. John’s Hospital which specializes in the treatment of skin related diseases. Unknown to the class, burns made a bulk of the diseases treated at the hospital and there were many patients with varying degrees of burns, that you could have easily confused it for a fire accident scene. Anyway, as a precaution, we were divided into groups of two and distributed to various units to avoid intimidation to the patients. In addition, stern instructions were given before being handed out to doctors and nurses who were doing rounds in the wards. It was in one of these wards, that we encountered a woman who had experienced over 30% degree burns and was undergoing reconstructive surgery on her face.

Her story is the kind that is greatly emotional and one that overwhelmingly shaped my thinking towards emotional issues in life. Allegedly, ethnic groups in that lady’s country of origin had turned against one another after a disputed presidential election, forcing some communities to flee their residences. While fleeing from her place of stay; she and some other members of her community sought refuge in a church. While in the church, some arsonists attacked them, blocked all possible escape routes from the church then set it ablaze. That is how the lady found her way in a hospital bed, miles away from her country. As the doctor told the story, I could see how moved he was judging by the tears in his eyes and the cautious yet heartfelt way he spoke about the incident.

Being from a relatively poor family, the lady was not able to shoulder the entire cost of the treatment. However, as I later came to learn a few weeks later when I visited the hospital voluntarily, the doctor (who told us the story) had been able to solicit funds from well-wishers—in spite of his kind action being against the professional rules of the hospital which stated that “doctors should not fraternize or get too personally involved with their patients.” As a result of his actions, which were deemed “unprofessional” by the manager of the hospital; the doctor was sacked.

When I learnt about the doctor being laid off his duties at the hospital, I could not help feeling confused. On one hand, I knew that being a manager entails correcting problems and ensuring that rules are followed. Basing my arguments on this viewpoint, I told myself that the manager was probably right for sacking the doctor in accordance to the rules and regulations in the hospital.

However, on the other hand, the principles of morality and empathy call for us to be responsible—sometimes even at our own expense. And to this regard, I felt that the doctor was probably right for helping the patient who was in great pain yet had no way of getting help.

For a long time, after that day, I kept on thinking about the incident and wondering how I would have reacted if I was the doctor or the manager. This led me to my quest of digging deep into the annals of history to find out about similar cases and how the people involved in these cases reacted while, unknowingly, orienting me towards the direction of being a manager in a hospital. As of today, I candidly know what I would have done differently; as the doctor, I would have done the same thing that was done by the doctor in my incident. However, as a manager, I would have probably given a lesser punishment like a suspension or even warn the doctor in question. Justifications as to why I would have acted this way will be detailed in the alternative course of action section which comes after the reflection stage.

Reflection

In reflecting over this issue, my arguments will be detailed two-way. In the first part, I will give a general reflection based on my own experiences and general studies by other scholars then in the second part, focus will mainly be on theoretical arguments put forward by authoritative academicians on the incident I had and my prospected job.

General Reflection

To begin with, Bing (2007) asserts that a good leader should be aggressive, talented and skillful so as to be able to handle both internal and external demands of his/her workplace. However, Bing goes ahead to say that the aforementioned traits should be balanced such that the workplace is not “crowded out” by the leaders’ need to be effective. In other words, too much strength and aggressiveness can sometimes weaken and atrophy the workers’ ability to function interdependently, as is required of them. In my future job as business manager of NHS hospital, I purpose to endeavor in spacing out professionalism so that it can encourage the growth and efficacy of other workers. As opposed to the manager at St. John’s hospital who decided to quickly sack the doctor without considering other factors such as the value of what was done by that doctor to the patient; I hope to be considerate such that the doctor is punished in a less cruel way.

The above viewpoint is supported by Bolden and Gosling (2006) who say that leadership is a complex endeavor that calls for astute leaders who are ready to deal with the complexities that come their way. Moreover, Gosling and Mintzberg (2004) state that different forms of leadership require different leadership skills. Whereas leaders in business-oriented organizations should concentrate more on profitability, satisfaction of clients as well as the workers and stakeholders; leaders in institutions like hospitals prioritize on people being healed and the prevention of diseases. In a case like the one earlier mentioned, the manager should be able to balance between the healing needs of the client and the hospital’s rules rather than just concentrating on one end.

According to Vince (2001), organization learning has been repeatedly proven to be a valuable element of leadership. This is not only based on the fact that learning helps us to advance but is also pegged on the argument that learning helps us to avoid mistakes. It is therefore not just enough to look at my incident and think about what might have been done differently; it is much better for me to find a way of forging ahead. It is with this in mind that I endeavor to use the experience, together with the learning I have had, to help better today’s world and that is one of the sole reasons I seek to positively impact NHS when I get to be the manager.

Importantly, the aspect of emotional intelligence by leaders has been strongly supported by many scholars such as Vince (1999); French (2001), Vince (2001) Goleman (2001), James and Arroba (2005), Bolden and Kirk (2006a); Bolden and Kirk (2006b); Kahn and Green (2008); among others. To these scholars, leaders should be emotionally intelligent and be ready to deal with emotional issues. This way, dilemmatic decisions, like that in my incident, will be easily dealt with.

Theory-Based Reflection

Psychoanalytic Theory

The psychoanalytic theory is believed to have originated from the early articulations of Sigmund Freud and other psychology thinkers who supported the ideologies of psychoanalysis. This theory centers on the ideology that our early childhood (usually stored in the unconscious mind) has a lot to do with how we behave or act presently (French, 2001). So if we want to get solutions to certain problems, all we have to do is tap into these memories stored in the unconscious mind– -while considering the hierarchy needs put forward by Maslow in that process (Dyer & Vriend, 1988). Below is a diagram of the hierarchy of needs:

Maslow’s Hierarchy of Needs Theory
Fig 1: Maslow’s Hierarchy of Needs Theory

Then once someone masters his/her mind, he/she is able to find ways of propagating positive ideas while shutting off the negative ones. One of the leadership instruments developed to help leaders know themselves well is the Myers-Briggs type indicator which is essentially based on Jung’s four personality types: extrovert versus introvert, sensor versus. Intuitor, feeler versus thinker and perceiver versus judger (Stech, 2010). Below is a diagrammatic summary of the Myers-Briggs type indicator:

The Myers-Briggs Type Indicator
Fig. 2: The Myers-Briggs Type Indicator

According to Armstrong et al. (1994), the psychoanalytic approach is very important in the “recognition of centrality and emotional experiences” in human beings as conscious and unconscious levels. This is the likely reason why even though the experience at St. John’s hospital happened a while back, the details of the incident are still vivid in my mind to date and I am still seeking to make amends when I become a manager at NHS hospital.

Psychodynamic Perspective Theory

According to Cilliers (2004), the psychodynamic theory is more-or-less an extension of the psychoanalytical theory. However, in psychodynamics, emphasis is laid on the influence of environments with organizations being viewed as external realities that significantly affect individuals in emotional and psychological ways (Bion, 2003). And since proponents of psychodynamics believe that personal experiences greatly affect our learning and development; it is advisable that our learning environments are tailored with leaders and people who encourage positive and insightful experiences (Fulmer, 1997). It is with this in mind that I seek to use my managerial position to positively transform NHS hospital through already proven techniques such as coaching, creating an environment with some modicum anxiety and denial enough to motivate efficacy and productivity at work, proper conflict resolution, and reward and punishment systems (Diamond, 2007; and Koortzen & Cilliers, 2002). Below is a summary of these motivating forces:

Motivating Forces in the Psychodynamic Model
Fig. 3: Motivating Forces in the Psychodynamic Model

Alternative Courses of Action

According to Bing (2007), “It does not feel possible or even advisable to have a goal of changing the leader’s character, both because it does not work and because their character has provided guidance and strength that has made the organization successful.” As an alternative, Bing advises that in the bid to reduce a “crowded out” organization, we should create a situation whereby the leader gives space on which growth of other people can be facilitated. To create this space that reduces overcrowding of the workplace by the leader, Bing gives the following pointers:

  • Use variable techniques and methods of large group design to break monotony in interaction between leaders and workers (Bing, 2007).
  • Creation of deliberate reflective space using structured rituals during company events such as retreats and team meetings (Bing, 2007).
  • Linking the need for various conducts to a higher-level goal of the person in leadership (Bing, 2007)
  • Helping individuals and team members to improve their work skills such that they are in-tandem with the leader’s governing and work style (Bing, 2007).

Therefore, if I was the manager at St. John’s hospital, I would give a less strict punishment like a suspension to the doctor. This would have not only taught the doctor, and other people in the hospital to avoid breaking rules, but it would have also given the doctor an opportunity of continuing with his work while striving to better his professional conduct (Brown & Starkey, 2000).

Based on studies conducted in Africa, Bolden and Kirk (2006a) state that good traits by leaders set a good example on which those below them can emulate. Consequently, by developing a system in which good leaders and good leadership traits are developed, organizations are bound to cumulatively develop as well. Put in simpler terms, “leadership development can act as catalyst for community-level social change by engaging participants in a collective process of identity work – the construction and reconstruction of a concept of self within community” (Bolden & Kirk, 2006a).

In another study by Bolden and Kirk (2006b), the two scholars say that, based on the contemporary changes in the world of leadership; there should be more focus on leadership rather than the leader. To do so, Bolden and Kirk (2006b) propose that the following considerations are made:

  • Shortening time frames: Facilitating interdependency between stakeholders so as to facilitate flexibility, accountability, responsibility and rapid change.
  • Widening scales of operation: This entails breaking down of organizational boundaries and bureaucracies so as to encourage inter-agency cooperation.
  • Remote working: Emphasis is laid on choosing good working environments.
  • Better Money management: This is mainly facilitated through proper budgeting.
  • Encouraging accountability and Transparency in all organizational endeavors.

Based on the above recommendations, if I was the manager at St. John’s hospital, I would have endeavored to change or modify the rules such that they accommodate emotional intelligence at work—up to a level that it is not overused. Again, instead of having to solicit funds in a manner that is against the hospitals, I would have encouraged provisions that enable the hospital to seek support from well-wishers. Alternatively, the hospital would just treat the patient, based on the urgency of her case, then request for the payments later or, as a way of giving back to the community; the management decides to shoulder the entire bill for such needy yet helpless patients.

As a matter of fact, Koortzen and Cilliers (2002) say that, in the psychodynamic model, conflicts and anxieties are viewed as acceptable facets of learning. However, they say that extreme cases of conflict and anxiety (especially those that entail highly emotional endeavors) which, in effect, leads to dire ramifications; should be avoided.

Based on the above assertions, it can therefore be said that the conflict between the manager and the doctor was, to some extent, acceptable. However, sacking the doctor because of a conflict which could have, otherwise been easily resolved in other amicable ways (going by the highly emotional and urgent nature of the patient’s case which required a speedy solution); was not an utterly right action to take.

As a rejoinder, it is worth mentioning that even though I would have done the above-mentioned things differently; it would be unfair to judge the manager of St. John’s hospital for acting the way he did since, back then, there were no pin-pointedly precise laws as to how managers should act in such dilemmatic situations or even deal with highly emotional cases. A SWOT analysis of my potentials as leader and how it would affect my leadership at NHS can be found in Appendix I.

Learning and Conclusion

Looking back at my experience, I am no longer feeling torn between supporting the manager or doctor at St. Johns hospital since I now know the right cause of action that should have been taken. In addition, as earlier mentioned, so many developments have since been made with regards to emotional endeavors which, back then were unavailable. It is for this reason that I am really looking forward to being a business manager at NHS hospital so that I can use my position to rightfully guide people working under me while striving to better the misconceptions that surround emotional involvements at workplaces—especially in hospitals.

Remarkably, from my incident and the extensive research I did thereafter, I was able to learn several lessons. A summary of the major lessons I got are embodied in the points given below.

Firstly, I learnt that the nature of organizations and their operations today are hugely different with those of the past (Bolden & Kirk, 2006b). For example, in today’s organizations, there is more focus on leadership as an entire entity while in the past, main focus was on the leaders (Bolden, 2005). In spite of these changes, there are still a myriad of challenges faced by leaders or leaderships in organizations (Armstrong et al., 1994). This, essentially, means that there is still a lot that needs to be done in order for these leaders and the leaderships in organizations to achieve full efficacy.

Secondly, Bolden (2005) calls for more innovation and creativity to be encouraged among leaders while we continually strive to learn from those around us. By doing this, Bolden says that we will not only be able to keep up with the rest of well-performing leaderships but we will also be able to establish new and better leadership methods that keep us ahead of the rest.

Thirdly, Bawany (2010) articulates that “studies have demonstrated that leaders who consistently outperform their peers not only have the technical skills required, but more importantly, have mastered most of the aspects of Emotional Intelligence.” based on these studies, forums and learning endeavors that encourage emotional intelligence—among other facets of learning, management and development—should be highly encouraged (Vince, 2009; and Kahn & Green, 2008). Goleman et al. (2001) supports the above by reporting that studies from various places indicate that the moods of leaders greatly determine efficacy at work. For this reason, working environments should be established such that leaders’ moods stay positive and jovial.

Fourthly, Bolden and Gosling (2006) state that leadership positions should not be used to encourage negative activities like favoritism since this deviates from the objectivity of leadership which is to offer just and fair guidance to subjects. This point is supported by Kahn & Green (2008) who say that things as such as control and abandonment diminish the essence of leadership. Instead of these negative ventures, leadership should be used to champion the goals and objectives of the organization, reward good workers while punish the bad ones, encourage learning and orient development (Goleman, 2001, Vince, 2001).

In finality, it is worth restating that emotions play a vital role in leadership and that is the reason why I purpose to champion it when I get to be a business manager at NHS Hospital. However, for full efficacy at work, many other leadership essentialities—as discussed herein—have to be duly considered by the leaders.

List of References

Armstrong, D., Bazalgette, J., Hutton, J., 1994. What does management really mean? Presented to the International Consulting Conference

Bawany, S., 2000. Leadership that gets results: impact and measurement of emotional intelligence on leadership effectiveness. Human Capital, 10, (4). Web.

Bing, D., 2007. Crowding out the space: the weakness of a strong leader. Presented at the International Society for the Psychoanalytical Study of Organizations, Annual Symposium, Amsterdam/Haarlem, The Netherlands.

Bion, W. R., 2003. Learning from experience. London: Karnac.

Bolden, R., & Kirk, P., 2006a. Transforming Communities through Leadership Development: A Pan-African Example. British Academy of Management Conference, Belfast.

Bolden, R., & Kirk, P., 2006b. From leaders to leadership. Effective Executive, 8 (10), pp. 27-33

Bolden, R., & Gosling, J., 2006. Leadership competencies: time to change the tune? Leadership, 2 (147), DOI: 10.1177/1742715006062932.

Bolden, R., 2005. What is leadership development: purpose and practice? Leadership South West. Research Report 2. Web.

Brown, A., & Starkey, K., 2000. Organizational Identity and Learning: A psychodynamic perspective. Academy of Management Review, 25 (1), pp. 102-120.

Cilliers, F., 2004. . Department of Industrial & Organizational Psychology, UNISA. Web.

Diamond, M. A., 2007. Organizational change and the analytical third: Locating and attending to unconscious organizational psychodynamics. Psychoanalysis, Culture & Society, 12 (2), pp. 142–164.

Dyer, W. W., & Vriend, J., 1988. Counseling techniques that work. Alexandria: VA: American Association for Counseling and Development.

French, R., 2001. Negative Capability: managing the confusing Uncertainties of change. Journal of organizational change, 14 (5), pp. 480-492.

Fulmer, R. M., 1997. The evolving paradigm of leadership development. Organizational Dynamics, vol. 25 (4), pp. 59-73.

Gosling, J., & Mintzberg, H., 2004. The education of practicing managers. Sloan Management Review, 45 (4), pp. 19-22.

Goleman, D., Boyatzis, R., Mckee, B., 2001. A. Primal leadership: the hidden driver of great performance. Harvard Business review, pp. 42-51.

Goleman, D., 2000. Leadership that gets results. Harvard Business review. Web.

James, K., & Arroba, T. 2005. Reading and Carrying: a framework for learning about emotion and emotionality in organizational systems as a core aspect of leadership development. Management Learning, 36 (3), pp. 299-316.

Kahn, W. A., & Green, Z. G., 2008. “Seduction and Betrayal: A Process of Unconscious Abuse of Authority by Leadership Groups” in S. Cytrynbaum & D. Noumair eds. Group relations reader 3 rd edn, A. K. Rice Institute, Washington, DC.

Koortzen, P & Cilliers, F. (2002). The psychoanalytical approach to team development. In R.L. Lowman (Ed). Handbook of organizational consulting psychology. San

Stech, E. L., 2010. . Web.

Vince, R., 2001. Power and emotion in organizational learning. Human Relations, 54 (10), pp. 1325–1351.

Vince, R., 1999. Uncomfortable knowledge management: The impact of emotion on organizational learning’. University of Glamorgan: the Business School. Web.

Appendices

Appendix I: Personal SWOT Analysis as a Future Business Manager at NHS

Strength Weakness
  • Inter-personal skills
  • Multi-lingual (Fluent in English, Basic French and German)
  • Good Customer care skills
  • Good Organization skills
  • Highly Motivated and good teamwork spirit
  • I have good business connections
  • Strong academic and internship background
  • Can work under minimal or no supervision
  • Minimal work experience
  • Not very good in stress management (short-temper)
Opportunities Threats
  • Interacting with other people will help in bettering my managerial skills
  • Travelling to other places encourages good environmental changes
  • Gaining work experience
  • Chance to educate others on various aspects of management and supervision—especially on the importance of emotional intelligence
  • Chance to practice my theoretical skills
  • Usual economic hiccups can also be very detrimental to progress
  • Adapting quickly to new environments can sometimes be challenging
  • Undue advantage of workers with better education and work experience
  • Competition from other workers
  • Change of laws and political environment in various places can be very challenging.
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