Effective Approaches in Leadership and Management

The nursing profession is undoubtedly the most important in the health care sector in terms of patient satisfaction and the continuous enhancement of quality health services. Such significance is likely best highlighted by the 2010 adoption of the Affordable Care Act (ACA), sometimes known colloquially as Obamacare. The Affordable Care Act (ACA), perhaps the most groundbreaking act since the 1965 Medicare Act, was designed to reduce the financial hardship that lower-income patients face. Most of the time, the government pays the medical bills of people in this category. The pressure to conform to expeditious methods of delivering care while simultaneously operating within the confines of limited budgets has compromised quality and patient satisfaction. Several issues have hence emerged. However, the implementation of the ACA has inadvertently created other problems regarding magnet designation which may be remediated through nursing management and leadership.

Issues in Continuous Quality Improvement and Magnet Designation

The implementation of the ACA has compelled nurses to frequently readjust to a constantly changing operating environment. According to Laschinger and Fida (2014), such changes inconvenience nurses to with the effect being that they become fatigued, suffer burnouts, and eventually become less satisfied with their profession. These experiences then have a negative domino effect on patient satisfaction as well so long as patients feel nurses are not providing optimal care (Laschinger and Fida, 2014). Medical facilities have hence strived to improve the quality of nursing services to achieve the magnet status designation. Notably, the magnet status is issued to medical facilities that promote the nursing culture in such manner that attracts and retains nurses. The magnet designation is of particular importance as studies have demonstrated that in Magnet hospitals, patients report better satisfaction and safety, are less likely to be readmitted in the same facility and would recommend the patient management they received. The achievement of the magnet designation has hence necessitated the application of various leadership and managerial styles as demonstrated by nursing leaders and managers.

According to Abualrub and Alghamdi (2012), acquiring the magnet status is complicated by the stringent prerequisite that the hospital in question is a facility with a commendable nurse satisfaction rates. It is, therefore, crucial that nursing management and leadership roles complement each other to ensure the recognition, organization, and accomplishment of the tasks necessary for directing staff participation for nursing excellence. Despite this shared objective, nursing leadership and management differ in consideration of several factors. Foremost, the managerial approach involves the application of a strategic blurring to direct people’s efforts for the achievement of broader organizational goals. In a sense, administrative flexibility is limited since managers are likely to avoid too much risk. Comparatively, leadership is concerned with the adoption of new ideas to solve pressing problems. A leader will depend on their instincts to address challenges (Laschinger et al., 2014).

Nursing Management

In as far as nursing management is concerned, Laschinger et al. (2014) contend that nurse managers are best placed to comprehend the nature and extent of issues regarding the provision of quality health care and achievement of magnet status. For instance, nursing managers are capable of influencing the nurse-patient ratio with grave consequences on patient outcomes, satisfaction, and turnover. In fact, studies have demonstrated that with fewer patients per nurse, medical institutions are more likely to exhibit the above indicators of quality healthcare (Wong, Cummings and Ducharme, 2013). Nursing managers are hence expected to approach challenges through, for example, implementing a staffing policy for the recruitment of qualified and experienced nurses. Similarly, nursing managers are expected to design a staffing matrix that places nurses with particular skill sets in the areas where their experience would have optimal results.

According to (Wong, Cummings and Ducharme, 2013), the role of nursing managers also involves the daily provision of direction on day-to-day operations and acting as a resource to staff. Such typically includes observing and guiding the activities of floor nurses and dealing with any issues arising from patients or staff. Such challenges could cover a broad range of areas such as misunderstandings of policy or patient-nurse conflicts. Understandably, Wong, Cummings, and Ducharme (2013) also observe that managers may find it difficult to manage conflicts arising from the competing interest of ensuring the welfare of the medical facility vis-à-vis satisfying nurses and patients. More so, nursing management suffers from the fact that upper management may not always comprehend the reality of the nursing floor or what is takes to maintain patient satisfaction.

Nursing Leadership

According to Laschinger et al. (2014), nurse leadership is characterized by a desire to motivate fellow nurse practitioners and the entire medical staff to implement the goals, mission, and vision of a health care institution. Such leadership may be a delegated responsibility or could even occur as an informal role. As compared to nursing management, nursing leadership is defined by an overall visionary outlook on the broad nursing objectives. Such targets range from ensuring nurse and patient satisfaction as well as overseeing a medical institution’s fiscal responsibilities. Nursing leadership may also be more important than nursing management in particular contexts such as emergency situations or any other sensitive environment. Internally, the nursing leaders are expected to play an oversight role on the entire staff including nursing managers, evaluating the effectiveness of policies and provision of quality care. Lastly, nursing leaders are responsible for change management, specifically as relates to explaining why certain changes are necessary. For this approach, Mitchell (2013) recommends situational leadership style where leaders act and provide direction depending on new contingencies.

Personally Applicable Approach

In consideration of the dynamics of the healthcare environment and personal philosophy, a single method not sufficient. Instead, a combination of situational and participative leadership suffices. Foremost, situational leadership comes in highly recommended because of the dynamic nature of the healthcare environment. For example, the nursing floor is characterized by numerous emergencies which demand creative leadership for to achieve successful nursing outcomes. It hence becomes imperative that nursing leaders be prepared to adapt to whatever situation presents itself. Similarly, the external environment affects healthcare institutions in a variety of ways; government policy on health care, costs, economic performance, and decreased reimbursements. These factors may have grave consequences on the delivery of quality health care and achievement of magnet status. It hence becomes imperative that leaders conduct a cost-benefit analysis of any decisions they make that may be dependent on any of the above factors. However, less urgent circumstances require leaders only to follow standard procedure and compliance with the institutional policy.

Situational and participative leadership are suited to my personal pragmatic leadership style. Personally, I consider approaching from a practical standpoint since situations in the nursing environment differ in one way or another. For instance, a conflicts between nurses and patients may not always exhibit the same dynamics. It hence follows that the method involved in solving a particular conflict may not necessarily be applicable in future conflicts. To effectively redress potential issues, it is important that the nurse leader or manager evaluate the dynamics of unique cases. Arguably, the situational approach emerges as the most practicable strategy. Similarly, participative leadership would provide the best mechanism for understanding relevant details of any situation for effective resolution.

Conclusion

In summary, the need to comply with the 2010 implementation of the Affordable Care Act (ACA) pressured healthcare institutions with adverse consequences on their capacity to assure quality health care, patient and nurse satisfaction, and ability to attain the magnet status. This issues could be remediated through nursing management or leadership. Although both approaches could achieve the same results, personal philosophies necessitate the implementation of situational and participative leadership in a complementary combination. Situational leadership ensures adaptability to a changing external environment, whereas participative leadership goes a long way towards boosting staff morale to ensure their optimal output. Overall, no single approach is sufficient.

References

Abualrub, R. F., & Alghamdi, M. G. (2012). The impact of leadership styles on nurses’ satisfaction and intention to stay among Saudi nurses. Journal of nursing management, 20(5), 668-678.

Laschinger, H. K. S., & Fida, R. (2014). New nurses’ burnout and workplace well-being: The influence of authentic leadership and psychological capital. Burnout Research, 1(1), 19-28.

Laschinger, H. K. S., Wong, C. A., Cummings, G. G., & Grau, A. L. (2014). Resonant leadership and workplace empowerment: The value of positive organizational cultures in reducing workplace incivility. Nursing Economics, 32(1), 5.

Mitchell, G. (2013). Selecting the best theory to implement planned change: Improving the workplace requires staff to be involved and innovations to be maintained. Nursing Management, 20(1), 32-37.

Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: a systematic review update. Journal of nursing management, 21(5), 709-724.