Strategic and Functional Behaviors for Institutionalizing

Question: Discuss about the Strategic and Functional Behaviors for Institutionalizing. Answer: Introduction: Mr. Jones, a 50 years old Australian male, was admitted to the emergency department. He was diagnosed with acute abdomen. He had a fifteen years history of Crohns disease. He had been on 20 mg. of prednisone each day for the past years. He started to take etanercept (50 mg.) subcutaneously every week from the last three months. He received the last dose four days ago. On admission, he was only allowed total parenteral nutrition (nothing by mouth) through a triple lumen central venous catheter line. But his condition was worsening and the situation became very critical. Mr. Jones was in severe pain. The pain management was the prime challenge. More analgesics were needed for him. There was a need of effective nursing leadership to manage Mr. Jones worsening health condition. One young staff nurse was in charge of Mr. Jones. The staff nurse was proficient but she required the assistance of an experienced person and effective leadership strategy. The young nurse noticed that the patient had not voided about eight hours and forgot to report this. She also forgot to ask about the etanercept. Observing Mr. Jones condition the leading nurse took control over the situation and also discussed the situation with other subordinate nurses as well as the young staff nurse for immediate modifications. The challenge was to make the patients health condition stable by changing and adding new medications. The nurse leader and other nurses worked according to the situation, analysed all health aspects of the patient. His steroids were changed t Solu-Medrol (60 mg.), intravenously (IV) on six hours interval. He was also given several IV medications and antibiotics for pain and nausea. The tomography report showed that the patients blood pressure dropped to 70 mmHg. He was immediately transported to the ICU and intubated. After this change in care procedure the health condition of Mr. Jones became quite stable. The nurse leader worked with her subordinates to identify the required changes, creating a revelation to guide the change through inspiration. Mr. Jones was admitted to the emergency unit for chronic Crohn's disease. The staff nurse failed to ask about the IV antibiotics, steroids, and fluid replacement. She also failed to ask about the etanercept and report about the patient's urine output. The nurse was quite efficient but could not properly evaluate the patients health condition. The experienced nurse leader with the other nurses managed patients situation by applying transformational leadership. The leading nurse also motivated the young nurse to learn from her mistakes and inspired to change her behaviors and develop her up to the expected levels of quality standards. Initial reflections of the events The foremost professional objective of nurses is to deliver care and recover the patients health. Clinical mistakes by new nurses are among the most common health intimidating errors that impact on patient care and health outcomes. Such errors are considered as global problems which increase length of hospital stay, treatment costs, and mortality rates. These mistakes can easily avoid or improvement of the worsening situation can be done by the help of a leading nurse and effective application leadership theories (Vaismoradi et al., 2016). The above-described event is very common in health care settings. Due to the limited workforce, many young and inexperienced nurses get allotted for critical patients. Sometimes they could not critically evaluate the importance or demands of the situation, which can give rise to errors. To avoid these mistakes, supervision of leading nurses is necessary. In the given situation the staff nurse in the care of Mr. Jones committed some errors. But the intervention of the leading and experienced nurses improved the patient's health condition. The nurse leader involved her subordinate nurses for better patient outcomes. She also encouraged the staff nurse to overcome her fear and guilt. This is a perfect example of transformational leadership. In this case, there is no doubt that the staff nurse committed serious mistakes by not reporting about the patient's urine output and forgetting to ask about the etanercept, IV antibiotics, steroids and fluid replacement. But from the personal viewpoint, it can be said that she cannot be blamed alone. The assistance of a leading nurse was required from the beginning. If this leadership was applied from the very beginning, the nurse could have performed more efficiently. When the transformational leadership was applied, the nurses were able to take appropriate decisions about care and the medication which in turn improved the health condition of Mr. Jones. Critical analysis of the clinical practice situation The leadership applied in the case of Mr. Jones was transformational leadership. This leadership technique permits for the recognition of those areas where transformation is necessary and directs the changes by inspiring the subordinates and generating a sense of commitment. This leadership theory was established by James McGregor Burns in the year 1978 (Smith, 2011). The transformational leadership style stimulates others to grow and implement effective leadership features. The eventual aim of transformational leadership is that the leader and the followers to learn purpose and meaning in the context of their work, as well as to grow and mature (Huber, 2013). According to Hutchinson Jackson (2013), the function of a transformational leader in the healthcare settings comprise of upholding collaboration among staffs, promoting affirmative self-reverence, inspiring staffs to effort at a higher level of performance, and empowering staffs to become further involved in the improvement and implementation of procedures and policies. A transformational leader represents reliability and assists as a motivation to the underlings, retaining a positive, optimistic, and heartening attitude. The presence of transformational leadership is vital, mainly in healthcare settings where new graduate nurses work. As stated by Huber (2013), the qualities of transformational leadership stimulate a healthy environment for the employees and the staff members, which in turn produces enhanced work satisfaction, sustainability, and patient satisfaction. As observed in the case of Mr. Jones, the nurse leader managed the situation by the means of effective teamwork. The leader did not reprimand the nurse in the care of Mr. Jones for her mistakes instead she encouraged the staff nurses to learn from her mistakes for better future performance. The leading nurse also involved the young nurse in the management procedure of health condition for Mr. Jones, so she can observe, evaluate and learn from the experienced nurses. A punishment or a drastic step for the mistakes can have a negative impact on young learning nurses (Lavoie?Tremblay et al., 2016). This leadership strategy will make her work more efficiently and will make her more attentive in her future caregiving. Transformational leadership style significantly contributes to superior support. This support in the workplace, mainly from the leader, is a significant facilitator that describes the connection between job satisfaction and transformational leadership. The postulated optimistic associations between transformational guidance and all variables were supported by numerous findings (Wang et al., 2012). Incorrect leadership styles can be one of the core sources of distress among nurses. It is also proposed that work-related hassle has an antagonistic inspiration on the quality of work for the nurses (Lavoie?Tremblay et al., 2016). Mounting a transformational nursing leadership style can be an effective organizational strategy to enhance the performance of the nurses and uphold superior patient care outcomes (Cummings, 2013). According to Hanaysha et al. (2012) and Wang et al. (2012), the transformational leadership style is responsible for the higher level of job satisfaction. These leaders can help to make sure employees are satisfied in their occupational role and also ensure psychological well-being of the staff. A mounting body of nursing research has shown the importance of the connection between transformational leadership and work gratification of nurses. Transformational leadership can create positive work environment by involving staff for better decision making, creates a blameless system and also enhances job performance by creating a motivating vision. A blameless system occurs when mistakes are considered by the nurses as learning prospects rather than ineffectiveness (Nursing Transformational Leadership for Patient Safety, 2016). As observed in the case of Mr. Jones, the leading nurse used transformational leadership style to convert the mistakes of the young nurse to make her more attentiv e in her work. Results of many studies suggested that nurse leaders must focus on developing transformational leadership expertise while also retreating undesirable leadership styles (Lavoie?Tremblay et al., 2016). The application of transformational leadership in nursing is done by the four major components of this leadership style. These components are the idealised influence, intellectual stimulation, inspirational motivation, and individual consideration (Doody Doody, 2012). The main features of transformational leadership embrace prompting faith, esteem, devotion, and admiration among subordinates through the presentation of charismatic visions and behavior. The leading nurse in Mr. Jones case showed all of these characteristics. She already possessed an idealized influence on the young nurse and other nurses also. By involving the young nurse in the problem-solving method the leader created inspirational motivation among all the staff. Advising the young nurse to learn from her mistakes acted as an intellectual stimulation. The leader also treated the young nurse as a separate individual and guided her according to her individual needs. Idealized influence makes the leader serve as a role model, the leaders walk the talk and they are admired for this. Transformational leadership emboldens modification through intellectual stimulation directed at the self-reflective transformation of ethics and dogmas (Gabel, 2013). Transformational leaders elevate awareness among their subordinates concerning difficulties and improve their competence to resolve such complications in various ways. These leaders inspire admirers in the direction of new concepts and aims via inspirational motivations (Kumar, 2013).Individualized consideration is one of the most important parts of transformational leadership among the major characteristics. The transformational leaders treat each subordinate as a complete person rather than just as a worker and consider the talents of each person and their planes of understanding to decide what suits each of them to touch greater intensities of achievement (Ross et al., 2014). Implications for my own leadership practice Transformational leadership is the style I prefer the most in nursing profession. Globally the healthcare settings are frequently changing and increasingly becoming more challenging. By reason of this constantly metamorphic nature of healthcare system, it is imperative for nurse leaders to apply the transformational leadership style, which inspires adaptation to modification (Huber, 2013). Leaders who follow transformational style strive in the direction of fashioning such a state of idyllic impact by sharing risk factors with subordinates, leading by examples and evidence-based practice, articulating visions and clarifying how to achieve the visions in an appealing mode, performing enthusiastically and assertively, exhibiting a higher level of moral and ethical demeanour, highlighting principles and reinforcing them by symbolic activities (Ross et al., 2014). Leaders who use idealized stimulus on their subordinates, easily gain the faith and poise of the subordinates. The subordinat es respect these leaders as their role models and respect the conclusions made by them (Gabel, 2013). This leadership style provides articulation of a clear and appealing vision of the future. The leader also develops a shared vision so that the subordinates can detect the meaning of their effort. Using inspirational motivation a leader can encourage the subordinates to assimilate and become a part of the overall organizational culture and environment (Kumar, 2013). By adopting transformational leadership I may be able to raise people from lower levels of essentials-focused on persistence by alluring toward their congenital desire to achieve advanced levels of expertise. According to Adelman-Mullally et al. (2013), highlighting positive outcomes, giving motivational speeches and conversations, stimulating teamwork and displaying enthusiasm and optimism are very important for becoming an effective leader. Intellectual stimulation is also an essential part of transformational leadership. It can raise awareness among subordinates concerning medical complications and enhance their ability to solve such complications by encouraging the proposal of essential and controversial thoughts deprived of fear of punishments, inspiring innovations and free decision making, generating an environment favourable to the construction and sharing of knowledge and information , enablementand imposition of ideas the leader merely in the absenteeism of feasible ideas from the subordinates and intensifying sensitivity to environmental alterations (Adelman-Mullally et al., 2013). Individualized consideration is one of my preferred characteristic of transformational leadership style. As a transformational leader, I can apply such individualized considerations by confirming unbiased workload distribution, making recognition of achievements and good performances, listening to the needs of each subordinate and th eir concerns and thanksgiving by a means of motivation (Ross et al., 2014). Transformational leadership also promotes evidence-based nursing practice and management. I strongly recommend the evidence-based nursing practice. Thebenefitsof applyingevidence-based practicebynursesand other healthcare providers consequence in the superior quality of care that leads to an enhanced patient outcome, asevidence-based practiceintegrates the most recent researchevidencethat is made obtainable to healthcare professionals at the time of care (Reichenpfader, 2015). Transformational leadership and evidence-based practice play a crucial role in undertaking the modifications necessary in work environments of nurses to improve patient safety.A transformational leader can role model, train, and inspire commitment to one interaction with subordinates at the same time (Huber, 2013). When nurse leaders were conscious of the impact of transformational leadership on the safety practices, it highly improved safety outcomes. Healthcare settings have initiated to place a great deal of significance on transformational leadership models since this leadership style emphasizes the dynamic nature of evidence-based practice-supportive leader behaviors (Stetler, 2014). Healthcare bodies require nurse leaders who can improve nursing care, can be an advocate for the nursing occupation and have a progressive influence on healthcare settings through leadership. Conclusion The transformational leadership method allows detection of areas where changes are necessary and direct changes by motivating subordinates and forming an understanding of commitment. Embracing the assets of transformational leadership will allow nurse leaders to feel more satisfied and self-reliant when engaging in the ever-changing constituents of healthcare technologies, the improvement of healthcare policies, and the mentorship of freshly graduated nurses. From the personal viewpoint, the roles of a transformational nurse leader must include boosting progressive self-esteem, indorsing teamwork and coordination among nurses, stirring nurses to show higher levels of performances, and empowering workforce to become more involved in the development and application of guidelines and techniques. References Adelman-Mullally, T., Mulder, C. K., McCarter-Spalding, D. E., Hagler, D. A., Gaberson, K. B., Hanner, M. B., ... Young, P. K. (2013). 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