In an institution where patients needing short-term medical treatment for acute illnesses or injury are treated, nursing leadership becomes important in the administration of the critical care required to help restore patients back to health. My study of the leadership roles and management functions in nursing theory and applications both in class and in the clinical preceptorship is enabling an advancement of my skills and nursing practice by the knowledge and experiences impacted in the learning process.
After signing confidentiality forms with the assigned facility at Huntington Memorial Hospital, I met the assigned preceptor for this leadership so that the learning process may begin. This meeting was an introduction to the objectives of the course. The next day was my first clinical day. On this day, staffing, scheduling and communication within both the medical-surgical unit and the epileptic brain mapping unit (EBMU) were highlighted and discussed as if by consultation.
It was an opportunity for me to experience, first hand, the changing dynamics of this new unit. Almost instantly, my sense of belonging to the medical-surgical and the EBMU was confirmed as the consultation and communication made me feel that I was already an employee. From this point, I could already speak of some positive aspects of the hospital environment and how it has impacted my psychosocial system as a nurse.
It was very notable that the staffing pattern at Huntington Memorial Hospital is aligned in accordance with title 22 of the department of health services mandates on health and welfare. For example, the EBMU always had two scheduled nurses at any time of the day, the 4 east medical-surgical staffing grids have 16 nurses for a maximum 24 patients and there is a nurse for every five med-surgical patient. Also, there is a one to four nurse-patient ratio for the telemetry patients and one to three for the neuro-surgical patients. This adherence to nursing standards set by this acute care facilities is one of the most easily identified and my intuition suggests that this does have an impact on nursing practice and the quality of healthcare received by patients in acute care settings.
In an attempt to understand the work-life balance of nurses and for me to better understand and identify stressors facing the nurse in the acute care setting and also to describe the importance of the self-care and effective coping strategies available to them, I realized that just after the staffing discussion was concluded, there was a self-scheduling function in the unit and this function enabled nurses to self schedule days of availability to work and to request days off. The scheduled request is understood by the staff nurses to be subject to change (with notice) upon ratification by the head of the unit.
An important factor in the success or failure in any unit will usually have a direct relationship with the methods of communication for the expression of staff concerns as I can perceive that the most of us will like to have a balanced life while working. In a similar manner as the signing of my confidentiality forms at Huntington Memorial Hospital, nurses are made to understand the expectations from them and rights accorded by their signature to the forms by negotiation and mutual understanding of both parties of the nature of their operations. A notable skill impacted upon me by this understanding is that I can see the expression of the proper use of authority, power and negotiation in conflict resolution within the hospital environment.
My second clinical day was planned for a human resource meeting regarding hospital staffing and then followed up by a quality coach meeting. My exclusion in the human resource meeting came about because I was a student and do not possess the required access permission to such an event at either employee or management level. This experience made me understand that the participation of any one individual is a function of the roles defined by her or his “leadership contract”.
Later in the same day, a code was called in the 4 east unit on the telemetry side. As an observer, I noticed that all personnel that were needed were in attendance but unfortunately the patient was unsuccessfully resuscitated and the nurse felt shocked as a consequence. Immediately, the manager of the unit took over talking to the family to console them while he assigned the primary nurse to comfort the nurse. To contribute in participation, I joined the primary nurse in her effort to comfort the nurse in shock.
On the third clinical day was scheduled Unit Base council meeting with members of the combined units, the unit manager, and the nurse administrator for the Magnet program. The Unit Base council was a forum-like setting where the members are able to have some input into developing standards on goals upon which performance should be judged within Huntington Memorial Hospital. Just before the commencement of the meeting, gratitude was expressed by my preceptor to further consolidate the goodwill of my assistance in the recent unfortunate occurrence. I was excited by this and considered him as a mentor afterward.
Angelini (1995) identified a structural and a process model from the study regarding the mentoring of hospital staff nurses and noted instructing importance within the constructive model to be the populace, occurrences, and surroundings. Nurse administrators established beyond doubt to be the most important people that are significant in rendering basic mentoring elaborate and systematic plan of action.
Finally, it came to record that October 26, 2010 was my last eight hour clinical day and the pleasure was all mine for the privilege afforded to me to sit on the Clinical Leadership Council meeting which included all the managers, supervisors and some of the hospital executive nursing staff. The meeting is an account rendering one where several speakers presented services and issues throughout the hospital.
Issues addressed were September finances, clinical nurse recognition program, critical value reporting, end of the month expiration by human resource, and the review of clinical leadership objectives. When asked, I will tell anyone that the Clinical Leadership Council assumes an active role in defining areas for continued personal and professional growth while developing strategies to deliver appropriate nursing care in an environment of cost containment.
When the meeting ended and it was time for lunch, I received an unexpected invitation for lunch with my preceptor. In the presence of the very vital people who are in the authoritative position to change and improve patient care, I saw myself be in that position sometime in the future where I can be able to change and be proactive in this acute care facility at Huntington Memorial Hospital.
With clarity, the leadership style at Huntington Memorial Hospital is transformational and my attendance of the nursing leadership class and the clinical preceptorship have enabled me advance my nursing practice as well as some of my skills. At this juncture, I just have to assert my belief in the common saying that experience is the best teacher. I have been transformed!
References
Angelini, D.J. (1995). Mentoring in the career development of hospital staff nurses: Models and strategies. Journal of Professional Nursing, 11(2), 89-97.