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In the work of the nursing staff, not only collective but also individual skills are the important component of effective care. In particular, the leadership qualities of employees, which are manifested in the process of solving certain tasks and fulfilling the instructions of the senior management, may allow changing patient outcomes for the better. In this regard, individual skills in organizing working activity and motivating colleagues are valuable mechanisms that stimulate positive interventions in the mode of specific departments and clinics. In the process of nursing practice, various accompanying nuances may appear, for instance, changes in responsibility, ethical dilemmas, and other ambiguous aspects.
Nevertheless, the correctness of plan implementation and the effective use of essential leadership approaches are the factors that contribute to solving the existing difficulties without violating the standards of professional practice. This work is aimed at identifying the implications of changes in healthcare on nursing leadership, the role of graduate nurses in organizing the workflow, difficulties with ethical decision-making, and the standards of care involved.
Implications of Change in the Healthcare Delivery System on Nursing Leadership
In case changes occur in the healthcare delivery system, implications on nursing leadership may be different. Everything depends on the nature of those amendments that are made to the mode of employees’ work. According to Clarke and Marks-Maran (2014), the modernization of the nursing process implies “the need for determined, focused and inspirational nursing leaders” (p. 220). It, in turn, increases the requirements for training employees and complicates leaders’ task. In order for the changes proposed by the management to be implemented rationally, it is crucial that certain individuals control this process and are able to intervene timely if necessary. As a result, a higher degree of responsibility is placed on team leaders.
Moreover, responsible employees, as a rule, should themselves look for ways to introduce actual changes in the process of healthcare delivery. According to the American Nurses Association (2010), a professional leader “mentors colleagues for the advancement of nursing practice” (p. 75).
Based on this working standard, the search for rational solutions that can influence the quality of care provided positively characterizes the leader as a competent employee who can take appropriate initiatives. Therefore, changes in the mode of operation may have a significant impact on nursing leadership, stimulating the involvement of responsible persons and the improvement of their professional skills.
Role of the Graduate Nurse as a Leader
The empowerment of a leader requires for an employee to not only follow specific working rules strictly but also to have special professional training since corresponding theoretical basis is necessary background. As Marquis and Huston (2011) remark, nursing education determines the qualifications of a specialist and, in many respects, influences his or her role in the team. The lack of knowledge, on the contrary, complicates the process of implementing ideas and positive changes and does not allow employees to act in accordance with a properly constructed working plan. The role of graduate nurses as leaders is significant because the professional knowledge that they have gained is the evidence of their competence and ability to make adequate and timely decisions.
One of the most important tasks of a professional leader is to create a working atmosphere that contributes to the highest possible productivity of group members. According to Marquis and Huston (2011), strategic and operational planning is the area that requires adherence to well-defined instructions. High-performance results may be achieved through experience and knowledge, and graduate nurses are those employees who are able to organize the care process and cooperate with colleagues fruitfully to maintain a desire to self-develop. Therefore, the importance of appropriate preparation determines the nature and quality of changes.
Challenges to Ethical Decision-Making in Nursing Practice
Nurses’ work is associated with the constant need to make decisions that can have a positive impact on the recovery process and, at the same time, not to violate the ethical standards of interaction. Challenges in practice may depend on various factors, and one of them is the specific field of activity. For instance, Teixeira, Ribeiro, Fonseca, and Carvalho (2014) argue that working in intensive care units is associated with constant ethical difficulties.
As the authors remark, at the end-of-life-care stage, employees have to not only perform immediate duties but also to act as psychologists, communicating with patients and supporting them (Teixeira et al., 2014). Challenges, in turn, are expressed in the necessity to discuss the nuances of the treatment course and follow the ethical norms of behavior, despite increased workload.
Compliance with the ethical code of work in nursing practice is not just desirable but imperative. According to the American Nurses Association (2010), a professional employee “participates in interprofessional teams that address ethical risks, benefits, and outcomes” (p. 48). At the same time, the members of the team can be indifferent to demonstrating initiatives on this issue. In this case, the leadership role manifests itself again, and the quality of help provided by caregivers depends on the degree of nurses’ motivation. Therefore, when maintaining the conditions of the ethical norms of interaction, the interest of all team members is crucial.
Standards of Nursing
The qualified activity of the nursing staff should meet certain standards established as working norms. According to the American Nurses Association (2010), these rules include “the standards of practice and the standards of professional performance” (p. 9). Based on the provisions of these norms, employees have an idea of what requirements are imposed on their productivity and the mode of operation.
The standards of practice consist of such aspects as assessment, diagnosis, outcomes identification, planning, implementation, and evaluation (American Nurses Association, 2010). Performance includes modes such components as ethics, education, evidence-based practice and research, quality of practice, communication, leadership, collaboration, professional practice evaluation, resource utilization, and environmental health (American Nurses Association, 2010). All of these standards play an essential role in forming the quality of the nursing profession.
The experience and qualifications of junior healthcare personnel are largely considered in the context of the aforementioned standards. As Melnyk, Gallagher-Ford, Long, and Fineout-Overholt (2014) note, competent specialists are aware of these norms and can distinguish cases where the search for evidence is not necessary, and where the rules of ethics mean much. Therefore, an ability to apply these standards in practice effectively proves the professionalism of nurses and gives an opportunity to demonstrate leadership skills.
Conclusion
Nursing leadership is the aspect of junior medical professionals’ practice, which is a dynamic phenomenon and may change under the influence of innovations in the field of healthcare and certain norms implementation. The quality of care largely depends on the rationality of the application of relevant knowledge, and employees’ activities imply following different standards, including moral and ethical aspects. The list of specific rules is quite large; however, their importance in nursing practice is significant.
References
American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: American Nurses Association.
Clarke, U., & Marks-Maran, D. (2014). Nurse leadership in sustaining programmes of change. British Journal of Nursing, 23(4), 219-224. Web.
Marquis, B., & Huston, C. (2011). Leadership roles and management functions in nursing: Theory and application (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing, 11(1), 5-15. Web.
Teixeira, C., Ribeiro, O., Fonseca, A. M., & Carvalho, A. S. (2014). Ethical decision making in intensive care units: A burnout risk factor? Results from a multicentre study conducted with physicians and nurses. Journal of Medical Ethics, 40(2), 97-103. Web.
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