Leadership Styles PDF

Leadership Styles Leadership Styles Students recognize the need to learn about leadership (Meakin, 2013). 1- Autocratic There is a discrepancy bet ween identity as a clinical professional and a leader (HEE, 2015). - Characteristics: Lack of consultation,...

Leadership Styles Leadership Styles Students recognize the need to learn about leadership (Meakin, 2013). 1- Autocratic There is a discrepancy bet ween identity as a clinical professional and a leader (HEE, 2015). - Characteristics: Lack of consultation, desire for control. Definitions of Leadership - Pros: Effective in crisis - Northouse (2016): Leadership is a process of influencing a group to achieve a common goal. situations. - Gardner (2011): A leader influences behaviors, thoughts, and feelings of others. - Cons: Long-term use leads to low - Drucker (1996): A leader is someone who has followers. morale and job satisfaction. - Maxwell (1998): Leadership is influence. 2- Bureaucratic - Characteristics: Ensures staff Clinical Leadership follow rules and procedures. - Provided by clinicians (Daly et al., 2014). - Pros: Maintains safety and - Involves influencing peers, supporting and motivating them, enacting organizational strategies, and standards. ensuring safety in healthcare (Garubba et al., 2011). - Cons: Stifles creativity and - Effective clinical leadership lacks a standard definition (Howieson, 2011; Mannix et al., 2011). autonomy. 3- Charismatic Leadership vs. Management - Characteristics: Inspires, sets - Management: Focuses on operational issues. high expectations, develops - Leadership: Provides vision and inspiration. collective identity. - Pros: Effective if followers' Formal and Informal Leader values align with the leader. - Trait Theories: Leaders are born with innate qualities (Northouse, 2015). - Cons: Can be negative if leader's - Trait Approach: Emphasizes personal qualities, physical abilities, and personality traits (Stogdill, 1948). motives are self-ser ving. 4- Democratic Situational Leadership (Hersey and Blanchard, 1969) - Characteristics: Promotes - No single best style; depends on the situation. responsibility sharing, - Leaders need self-awareness to let others lead. consultation, delegation, - Focuses on follower maturity and responsibility. feedback. - Pros: Enhances decision-making, New Leadership Era (1990s and 2000s) open communication, motivated 1- Transactional Leadership workforce. - Assumptions: People motivated by reward and punishment. - Cons: Lengthy decision-making - Characteristics: Clear structures, goals, and objectives. processes. - Cons: Overlooks complex social and emotional factors. 5- Laissez-faire 2- Transformational Leadership - Characteristics: Little direction, - Characteristics: Engages hearts and minds, inspires, develops vision, leads by example. ultimate freedom for employees. - Pros: Trust, concern, facilitation, empowerment, coaching. - Pros: Effective with experienced, - Cons: Requires more than just charisma. competent, and motivated staff. 3- Person-Centred Leadership - Cons: Can be over whelming and - Focus on high standards of patient care. unsafe without feedback. - Address issues like bullying, target-driven priorities, disengagement, and lack of feedback. 4- Collective Leadership Stages of Development - Emphasizes shared responsibility for organizational success. - Focus on self: Develop self- - Develops collective capabilities and continuous learning focused on patient care. awareness and leadership behaviors. NHS Leadership Framework - Working with others: Develop Personal Qualities: positive team working. - Self-awareness - Improving healthcare: Lead - Self-confidence teams to instigate positive - Self-control change. - Self-knowledge - Personal reflection - Resilience - Determination.  Consent and Capacity Key Points Consent - Consent must be informed, - Definition: Permission for something to happen or agreement to do something. voluntary, and given by someone - Types: Implied, expressed (oral/written), informed. with capacity. - Ethical principles guide the Requirements consent process. - Full and valid - Capacity involves - Freely given (voluntary & informed) understanding, retaining, and - Person must have capacity weighing information. - Continuous approach; can be withdrawn anytime - Children’s consent depends on - Proceeding without consent is trespass and actionable in law. age, maturity, and understanding. - Legal frameworks ensure respect Examples of Legal Cases for patient autonomy and - Williamson V East London and City HA 1998: Mastectomy instead of breast implant replacement. protection from harm. - Marshall v Curry: Testicle removed during hernia operation. - Murray v McMurchy: Caesarean section, fallopian tubes tied. Ethical Principles - Autonomy: Respect for patients as self-determining choosers. - Non-maleficence: Protect patients from harm, battery, trespass, exploitation. - Beneficence: Maximize patient well-being. - Justice: Fairness in the consent process. Decision Making Capacity - Autonomy: Ability to understand information to make decisions. - Test of understanding: Do not assume based on age, appearance, condition, or behavior. - Mental Capacity Act: Patients assumed to have capacity unless evidence suggests other wise. - Conditions of Capacity: Healthcare professional usually decides; courts involved if no agreement. Consent and Children 1- Developmental Stages: - Child of tender years - Gillick-competent child - Children 16 and 17 years old Children 16 & 17: Can consent to their own treatment unless significant evidence suggests other wise. Gillick-competent child: Under 16 can consent if they have enough intelligence, competence, and understanding. Parental Responsibility: One person with parental responsibility can give consent; courts can overrule if in the child's best interest. Mental Capacity Act (NI, 2016) -Applies to people over 16 years old. - Assumes capacity unless proven other wise. - Capacity determined by understanding, retaining, appreciating, and communicating information. Court Cases - Montgomery v Lanarkshire Health Board, March 2015: Informed consent rule reversed; closed gap bet ween legal consent, informed consent, and best interest of patients.  Understanding Ethics Key Takeaways Definition - Ethical Theory: Provides a - Ethics is a branch of philosophy that studies ideal human behavior and ways of being. framework for understanding and - Application: Ethics involves systematic approaches to understanding right and wrong, good and bad, as resolving problems. they relate to well-being and relationships. - Patient Advocacy: Essential for defending moral perspectives and Importance of Ethics in Nursing making informed decisions. - Accountability: Nurses are legally and professionally accountable for their actions. - NMC Code: Ethical principles underpin the Nursing and Midwifery Council (NMC) standards, ensuring Conclusion nurses act for the benefit of patients (beneficence), do no harm (non-maleficence), respect autonomy, and Ethics in Nursing: Integral to ensure justice. providing high-quality, patient- centered care and maintaining Professional, Legal, and Ethical Issues professional standards. - Duty of Care: Nurses must not harm patients, based on the law of negligence. - Consent: Lawful treatment requires informed and freely given patient consent. - Confidentiality: Legal principles regulate the nurse-patient relationship. - NMC Standards: Derived from ethical principles, these standards guide nurse conduct and performance. Law vs. Rules - Positive Rules: Legal obligations with sanctions for breaches. - Normative Rules: Guidelines based on values, without legal force. Relevance to Healthcare - Minimum Standards: Law sets minimum care standards; The Code (2018) requires higher standards. - Shared Values: The Code is underpinned by values common to UK healthcare regulatory bodies. Ethical Principles (Beauchamp & Childress) - Justice: Fair and equitable treatment. - Beneficence: Actions that contribute to others' welfare. - Non-maleficence: Avoidance of harm. - Autonomy: Respect for individual self-determination and informed choices. Ethical Decision-Making - Frameworks: Use frameworks like the ETHICS framework (Gallagher 2008) to guide decision-making. - Clinical Dilemmas: Address issues like truth-telling, informed consent, and patient welfare. Nursing Codes of Ethics - Purpose: Inform the public, outline ethical considerations, provide guidelines for behavior, and guide self- regulation. - NMC Code: Essential for sound ethical practice. Everyday and Clinical Dilemmas - Handling personal opinions - Witnessing unethical behaviour - Prioritising patient needs - Dealing with resource limitations. Developing Ethical Competence - Education: Continuous learning and critical thinking about ethics in practice. - Professional Values: Acquired through socialization, experiences, mentors, and peers.  Communication Summary Communication in Healthcare -Communication is fundamental in - 1 million patient-staff contacts every 36 hours in the NHS. healthcare. - Effective communication is crucial for patient safety and care quality. - NMC and NHS outline clear communication expectations. NMC Guidelines - Despite guidelines, communication - Prioritise people: Treat individuals with dignity, listen, respect privacy. issues are a leading cause of - Preser ve safety: Be open about care, raise concerns for vulnerable individuals. complaints. - Promote professionalism and trust: Uphold profession's reputation, respond to complaints professionally. - Understanding the communication process and EI is Patient Standards essential for effective - Patients expect respect, proper attitude, behavior, communication, and privacy. communication. Communication Failures - Leading cause of errors and patient harm. - Over 70% of Root Cause Analyses (RCA) cite communication issues. - Failures increase harm, length of stay, resource use, and reduce staff morale. Communication Process - Involves a message, sender, receiver, mode/medium, internal and external climates. - Effective communication requires sensitivity to these climates. Effective vs. Ine ffective Communication - Effective: Clear, accurate, meaningful information exchange. - Ineffective: Lack of precise, relevant information exchange. Communication in Nursing - Patient Interaction: Clear, empathetic communication, active listening. - Interdisciplinary Collaboration: Effective team communication, standardized protocols. - Documentation: Accurate, timely records. - Education: Clear patient/family education, use layman's terms. Cultural Competence - Respect cultural differences. - Non-verbal Communication: Awareness of body language, tone. - Use of Technology: Proper training for EHRs, telehealth. Emotional Intelligence (EI) - Recognise and manage own and others' emotions. - EI is crucial for interpersonal relationships, decision-making, and problem-solving. - High EI correlates with better clinical performance, patient care, and lower stress levels. Practical Tools for Communication - Standardised tools (e.g., SBARR). - Escalation processes. - Daily multidisciplinary rounds. - Team huddles. - Briefing and de-briefing sessions. Professional Development - Reflective practice, clinical super vision. - Training and education to build confidence. - Seek feedback, preceptorship. Communication Importance of Emotions in Healthcare - Emotions play a crucial role in healthcare, affecting decision-making, problem-solving, working relationships, and patient care decisions. - Emotional intelligence (EI) directly impacts nursing performance and is essential for effective communication. Effective vs. Ineffective Communication - Effective communication involves precise, accurate, meaningful, and relevant information exchange, while poor communication leads to misunderstandings and contrasts with effective communication. - The communication process involves a message, sender, receiver, mode, and internal and external climate. NMC Code Expectations - The NMC Code outlines expectations for healthcare professionals, emphasizing the importance of treating individuals with dignity, clear communication, cooperation, and safety preser vation. Key Aspects of Healthcare Communication - Education Nurses educate patients and families about health conditions using layman's terms and ensure understanding. - Cultural Competence Understanding and respecting cultural differences enhances communication and builds trust. - Non-verbal Communication Body language, facial expressions, and tone of voice significantly affect interactions. - Use of Technology Modern communication tools enhance information sharing but require proper training. Challenges Faced by Newly Qualified Nurses - Newly qualified nurses may struggle to speak up against unsafe practice and demonstrate moral courage due to lower confidence in assertive communication. Professional Development Tools for Communication - Reflective practice, clinical supervision, confidence cultivation, feedback seeking, and preceptorship are essential for improving communication skills. Role of Emotional Intelligence - Emotional intelligence is crucial for successful interpersonal relationships and professional success, emphasizing interpersonal awareness, empathy, and self-regulation. Impact of Poor Communication - Poor communication is a leading cause of complaints in healthcare and can lead to serious incidents, emphasizing the need to understand the communication process and different professional communication styles. Diversity in Communication Styles - Different professional groups have distinct communication styles, and understanding these differences is essential for effective interprofessional communication. Standards of Care and Expectations - Patients expect respect, attitude, behavior, clear and accurate information, and sensitivity from healthcare staff, highlighting the importance of upholding these standards. Practical Examples and Reflections Practical tools like standardized communication tools and escalation processes aid in timely and effective communication. Reflective examples of poor communication and its potential consequences underscore the critical role of effective communication in healthcare. Accountability Principles of Accountability -Emphasizes putting the interests of patients first. - Requires clear and accurate communication, record-keeping, and sharing of skills and knowledge. - Stresses the importance of patient and public safety. -Encourages reflection and acting on feedback to improve practice. Responsibility vs. Accountability - Responsibility can be delegated, but accountability cannot. - Accountability requires autonomous decision-making and answering for one's actions. - Legal arenas of accountability include public, patient, profession, and employer. Delegation - Definition The transfer of responsibility for an activity while retaining accountability for the outcome. - Importance Divides workload, promotes teamwork, fosters collaboration, and maximizes resources. - Challenges Need for careful decision-making, knowledge of team capabilities, and effective super vision. Legal Cases - Bolam Test Sets the standard of care and skill expected in medical practice. - Montgomery Case Emphasizes the importance of informed consent and patient disclosure. Challenges in Delegation - Different delegation styles "do-it-all," "justifier," "buddy," "role model," and "inspector." - Factors influencing delegation ward organization, culture, and staff levels. Professional Aspects - Pre-registration students' accountability to the university and the law for their actions or omissions. - The purpose of accountability protective, deterrent, regulatory, and educational aspects.  Record Keeping Key Takeaways Definition and Purpose Good record keeping is essential - Health Record: Any electronic or paper information about a person for managing their healthcare (Data for: Protection Act, 2018). Includes nursing records, X-rays, pathology reports, etc. (Griffith & Tengnah, 2008). - Legal and professional - Record Keeping: Integral to holistic practice; documents the care provided and reflects clinical care compliance. (Dimond, 2005; Prideux, 2013). - Continuity and quality of care. - Safeguarding patients and NMC Code and Standards healthcare providers. - The Code (2018): - Always adhere to ethical and - Presents professional standards for nursing practice. professional standards. - Section 10 emphasizes keeping clear and accurate records relevant to practice. - Key Requirements for Records: Case Study Example - A full account of assessments, planned and provided care. - A student midwife altered - Relevant information about patient conditions and responses. records to falsify experience, - Evidence of meeting duty of care and patient safety measures. resulting in a jail sentence (Griffith & Tengnah, 2008). Responsibilities and Accountability - Highlights the legal and ethical - Responsibility: Tasks demanded by employers, professional bodies, or courts. consequences of poor record - Accountability: Mechanism by which failures may result in sanctions (warnings, dismissal, criminal keeping. prosecution). - Key Principle: Responsibility and accountability must not be used interchangeably. Characteristics of Effective Record Keeping 1- Logical and methodical sequencing. 2- Clear milestones and goals. 3- Promotes high standards of care, continuity, and communication. 4- Facilitates early detection of risks or patient condition changes. 5- Maintains confidentiality. Common Errors in Record Keeping (Dimond, 2005) - Omitting times or signatures. - Illegible handwriting. - Mixing opinion with facts. - Using ambiguous abbreviations or unprofessional terminology. - Delaying completion or including inaccuracies. Technology and Data Protection - Digital Records: - Same principles as manual records; must identify the record’s author and show updates. - Access should be controlled and limited. - GDPR (2018): Protects personal information with 99 articles outlining individual rights and organisational obligations. Challenges in Record Keeping - Time constraints. - Lack of knowledge about terminology and reporting standards. - Theory-practice gaps. - Adapting to new systems. Enablers - Knowing the patient. - Using appropriate frameworks (e.g., PACE: Person-centred Assessment, Care planning, and Evaluation). - Factual, timely, and critical documentation. Transitioning Definition - Transition: The process of moving from one state to another, often associated with significant changes in roles, goals, and responsibilities (Azimian et al., 2014). Background - Global Nursing Shortage: - Nurses and midwives represent over 50% of the global health workforce shortage. - Estimated need: 9 million more nurses and midwives by 2030 (WHO, 2020). - UK Nursing Vacancies: - ~41,000 vacancies in the NHS (2018). - High attrition rates: More nurses leaving than joining (Buchan et al., 2019). - Retention Efforts: - Regional retention initiatives to address immediate workforce challenges (Robin Swan, 2021). Reality Shock Theory (Marlene Kramer, 1974) Phases of Reality Shock: 1- Honeymoon Phase: Excitement and optimism. - Tip: Build trust and respect with preceptors early. 2- Shock Phase: Realization of challenges; potential for burnout or quitting. - Tip: Seek mentorship, maintain self-care, and build a support net work. 3- Recovery Phase: Adjustment and acceptance of job realities.Tip: Provide constructive feedback and mentorship. 4- Resolution Phase: Full integration into the profession, typically after one year. - Tip: Focus on retaining job satisfaction for long-term success. Preceptorship Definition: - A structured transition period for newly qualified nurses, supported by experienced practitioners to build confidence and refine skills (NHS Employers, 2021). Benefits: - Enhanced patient care. - Improved recruitment and retention. - Reduced absenteeism. - Higher staff morale and satisfaction. Framework: - Guides the implementation, evaluation, and auditing of preceptorship programs. Focus: - Integration - Confidence-building - Fostering accountability - Independence. Resilience Tips 1- Self-awareness and compassion. 2- Inter ventions to address challenges. 3- Mindfulness for mental well-being. Using SWOT Analysis - Reflect on current status (e.g., Phase 7 Student Nurse) and plan steps to achieve goals (e.g., Newly Qualified Nurse).  Professionalism Key Takeaways Definition of Professionalism - Professionalism is critical for - Professionalism: Autonomous, evidence-based decision-making underpinned by shared values, education, trust, accountability, and high- and purposeful relationships (NMC, 2018). quality care. - Goal: Ensure safe, effective, and person-centered care for patients, families, and carers. - Uphold professional standards - Attributes: Accountability, competence, leadership, and patient-centered focus. both offline and online. - Be mindful of actions to Key Reports Highlighting Professionalism Failures safeguard career and public - Ockenden Review (2022): Maternity ser vices at Shrewsbury and Telford NHS Trust. confidence. - Francis Inquiry (2013): Failures in patient care at Mid Staffordshire NHS Foundation Trust. - Gosport Independent Panel Report (2018): Excessive opioid prescribing concerns. Guidelines (NMC, 2018) - Hyponatraemia Inquiry (2018): Avoidable child deaths in Northern Ireland. - Protect privacy and confidentiality. Professional Attributes and Values - Avoid inappropriate relationships 1- Professionalism requires candour, ethical behavior, and adherence to professional standards (NMC & with patients. GMC, 2015). - Maintain professional 2- Attributes (Cruess & Cruess, 2009): boundaries and communication - Integrity online. - Accountability - Respect NMC Code (2018) - Competence - “Treat people with kindness, respect, and compassion” Professionalism in Practice (Paragraph 1.1). - Importance of good care, accountability, and prioritizing the patient. - Maintain effective and - Early professionalism training essential: Evidence links undergraduate lapses to future practice issues professional communication with (Papadakis, 2004). colleagues (Paragraph 8.2). NMC investigates: - Misconduct - Lack of competence - Serious ill health - Criminal behavior e-Professionalism - Encompasses online behavior relating to the profession. Risks: - Breaching confidentiality. - Sharing inappropriate content or comments. - Engaging in unprofessional interactions on social media. Benefits - Build professional net works. - Enhance knowledge and peer support. Tips for Responsible Use - Be informed about platforms. - Think before posting; even strict privacy settings have limitations. - Protect your reputation and adhere to professional codes. Social Media Risks - Sharing confidential information. - Posting discriminatory or disrespectful content. - Inciting violence, discrimination, or self-harm.