This written assignment aims to identify a change that has taken place during a clinical placement. The document will explore a leadership style emp
Introduction
This written assignment aims to identify a change that has taken place during a clinical placement. The document will explore a leadership style employed in implementing this change, demonstrating a thoughtful understanding of key principles in effective leadership, organisational dynamics, and culture. It will also reflect on the change process using a recognised change management model, examining how the execution and outcomes of the transformation were influenced by organisational and team strategies. Additionally, the assignment will thoroughly investigate factors impacting quality, as well as the development of health policies at both local and national levels, with a specific focus on enhancing the overall patient experience. Furthermore, the assignment will delve into how stakeholders in healthcare processes, including professionals, patients, and their support networks, support these drivers. Moreover, it will analyse how this experienced change can serve as guidance for a Registered Nurse in leading and managing change, ultimately strengthening their role. Finally, the impact of the change on the patient experience will be evaluated.
Learning Outcome 10 - Demonstrate a critical understanding of the principles of effective leadership, management, group and organisational dynamics and culture
Main
The change that had been observed in a clinical placement is the compulsive wearing of face masks for hospital staff member, service users and visitors, unless you can provide prove that you exempt. Visitors, parents, guardians, and siblings may be required to wear a mask or face covering based on a local risk assessment when entering and navigating healthcare facilities, unless exempt for medical reasons, for which supporting evidence must be provided (NHS England, 2022). The change was witnessed by a student while on a paediatric clinical placement. This change was implemented due to the Covid 19 pandemic. COVID-19 is an infectious illness triggered by the SARS-CoV-2 virus. The virus can be transmitted through tiny liquid particles from the mouth or nose of an infected individual when they cough, sneeze, talk, sing, or breathe (World Health Organization, 2023). Both surgical and cloth masks aid in preventing the dispersal of droplets when individuals talk, cough, or sneeze, thereby decreasing the likelihood of COVID-19 transmission (Health direct, 2023). Wearing face masks also help with infection control because face masks play a crucial role in infection control. They act as a barrier to prevent the transmission of respiratory droplets that may contain viruses, including pathogens like the SARS-CoV-2 virus responsible for COVID-19. When worn properly, face masks help protect both the wearer and those around them. Respiratory infections are widespread and consistently pose a threat to society. The utilization of face masks has demonstrated effectiveness in preventing the airborne transmission of these diseases (Sim et al, 2014). According to the research carried out by the World Health Organization (2020) considering that individuals with no apparent symptoms can still spread the virus, it is advisable to promote the usage of cloth face masks in public settings experiencing community transmission, especially when implementing other preventive measures like maintaining physical distance is challenging. The utilization of face masks or other facial coverings that encompass the mouth and nose is among the most impactful measures in diminishing the transmission of the virus. These coverings serve to prevent the spread of the virus by intercepting respiratory droplets that carry viral particles (Covid Portal, 2023).
However, one could argue that while face masks are crucial for infection control in healthcare settings, it's important to recognize and actively manage the communication challenges they may introduce to ensure effective and compassionate care. Effective communication plays a pivotal role in establishing therapeutic relationships, and functional professional relationships are essential prerequisites for delivering high-quality care (Ha and Longnecker, 2010, as cited in Marler et al, 2021). At its fundamental level, the use of masks establishes a physical obstacle to communication effectiveness (Marler et al, 2021). This signifies a significant deterioration in the acoustic signal. When combined with the inherent difficulty of ambient noise levels commonly encountered in healthcare environments, it can lead to additional physiological and psychological stress directly linked to the listening environment (Marler et al, 2021). Concealing the mouth also eliminates the option of relying on lip-reading cues to enhance comprehension, a resource especially valuable in reinforcing the auditory signals necessary for understanding in patients facing communication challenges (Dupuis, 2011, as cited in Marler et al, 2021).
The World Health Organization defines health policy as the decisions, plans, and actions implemented to attain specific healthcare objectives within a given society (World Health Organization, 2021). The success of change in healthcare is crucial for improving patient outcomes, optimizing efficiency, staying abreast of advancements, fostering equity, and upholding public trust. This success enables healthcare systems to adapt and respond to the ever-evolving needs of individuals and communities. As responses continue to multiply, and governments deliberate on the balance between policy stringency and other considerations, there is an urgent demand for current policy information (Hale et al, 2020).
Furthermore, Health policies play a crucial role in the NHS by directing healthcare practices, ensuring patient safety, optimizing resource allocation, enforcing regulatory compliance, fostering quality improvement, steering public health initiatives, standardizing practices, advocating for equity, aiding strategic planning, and bolstering public trust in the healthcare system. Healthcare policy holds significance as it sets forth guidelines that are advantageous to patients, healthcare organizations, and the healthcare system at large (Mozafaripour, 2022).
Numerous policies were considered and incorporated during the process of implementing the change. This was also observed by the student nurse. The infection control policy is very significant for the change. Certainly, the use of masks is just one element of a comprehensive set of prevention and control measures aimed at restricting the transmission of COVID-19 (World Health Organization, 2022). Wearing a mask serves to diminish the transmission of respiratory illnesses in the community by decreasing the quantity of infectious particles that can be inhaled or exhaled. These particles may be disseminated when an infected individual engages in activities such as talking, singing, shouting, coughing, or sneezing, even in the absence of noticeable symptoms (World Health Organization, 2022). The Equality Act 2010 is also crucial for the change
Leadership
Leadership in nursing refers to the ability of a nurse to guide, influence, and inspire others within the healthcare setting to achieve common goals that enhance patient care, organizational effectiveness, and the overall well-being of the nursing team. Nursing leadership encompasses various roles and responsibilities, extending beyond traditional management tasks. According to Morganelli et al, (2021) Nurse leadership is the capacity to inspire, influence, and motivate healthcare professionals collaboratively as they strive to attain their objectives. Leadership involves the capability of an individual or a collective group to exert influence and provide guidance to followers or members within an organization, society, or team (Barney, 2023). According to NHS England (2018) The National Health Service (NHS) requires proficient leaders across all levels and domains to guarantee the delivery of compassionate and high-quality care to its beneficiaries. strong leadership is essential in the NHS to provide high-quality, compassionate care. Leaders need to focus on patient-centred care, strategic planning, operational efficiency, team collaboration, adaptability to change, employee engagement, ethical decision-making, and continuous improvement to ensure the success of the healthcare system (NHS England, 2018). The pandemic has necessitated swift and substantial adjustments across various facets of life. Leadership within organizations plays a crucial role in maintaining the organization's functionality amidst a crisis. In addressing crises, the primary responsibility of leadership is to guarantee the sustainability of the organization (Kezar et al., 2018 as cited in Almazrouei, 2023)
During this change the student nurse observed that effective leadership was needed for the change to be successful. The student nurse could appreciate that a particular leadership style was utilised, autocratic leadership was utilised in implementing the change. Autocratic leadership is a managerial approach characterized by a single leader unilaterally making decisions, typically without seeking input from others (By et al 2023 as cited in Nickerson, 2023). One could argue that this leadership style was most appropriate because autocratic leaders are known for making decisions swiftly, The pandemic brought a halt to all regular activities, leading to a rapid and significant shift in the operational dynamics of the organization (Midlands Partnership University, 2021). Although this leadership style may not seem ideal at first glance, autocratic leadership in nursing does offer certain advantages, particularly in emergency or high-stress situations commonly faced by nurses (James Cook University, 2022), the ability to make rapid decisions, a characteristic of this leadership style, can prove essential in such scenarios like the implementation of face mask policy. In addition, Autocratic leaders exert a strong sense of authority. In England, a political leader displayed authoritarian tendencies by disregarding evidence on how to address Covid-19 (Spyridonidis, D. et al, 2022). Mandating face masks could be presented as a clear directive from the top, emphasizing the importance of compliance to protect public health. It is crucial for the public to maintain their active role when visiting NHS and care settings, contributing to the safeguarding of our staff and patients, especially those who may be more susceptible to infections (NHS England, 2022) (EVIDENCE) This style of leadership often relies on the use of threats and punishments to assert authority and motivate employees to meet performance expectations (By et al, 2023 as cited in Nickerson, 2023). In the context of implementing face mask mandates, autocratic leadership often involves robust enforcement measures. This could mean imposing severe penalties for those who do not comply, aiming to guarantee widespread adherence to the newly established policy. Autocratic leadership is characterized by a command-and-control approach, where leaders rely on negative reinforcement and punishment to enforce adherence to rules (James Cook University, 2022). This style does not tolerate mistakes, and individuals are held accountable for any errors they commit (James Cook University, 2022). This was noticed by the student nurse when service users and visitors were informed that they could be fined if they dont comply with the face mask policy and staff nurses would also face some type of consequences if they dont wear a face mask. (EVIDENCE)?
In an autocratic leadership setting, the leader assumes a dominant and directive role, maintaining tight control over decision-making processes and exerting authority in a top-down fashion (By et al, 2023 as quoted in Nickerson, 2023). In the context of implementing face mask policy, this may mean that the decision is made without extensive input from the public or other stakeholders. The emphasis is on efficient implementation rather than seeking consensus (EVIDENCE)
Conversely, while autocratic leadership enables swift and decisive action, it comes with the drawback of potential exclusion and resistance. Achieving a balance between autocratic decision-making and taking into account public opinion and engaging stakeholders is essential for effectively managing crises, particularly in the context of a global health emergency like the COVID-19 pandemic. Although this leadership style is often negatively perceived, it has demonstrated effectiveness in situations of crisis or emergency, particularly when urgent decisions must be made ( Admin, iOH, 2023) EVIDENCE
Autocratic leadership, characterized by quick decision-making and centralized control, has certain advantages during the COVID-19 pandemic, especially in implement the face mask policy. In times of crisis, individual leadership is crucial as leaders must make decisions that foster collective commitment and engagement among the group (Spyridonidis, D. et al, 2022) The ability to make rapid decisions, provide clear communication, and efficiently allocate resources is beneficial in addressing the immediate challenges of the crisis. The student nurse noticed that the change adopted this very well as the nurses on the ward including the student nurse ensured that patient/visitors were aware of the face mask policy on the ward by explain the change to them when they are first admitted on the ward and patient/visitors were also often reminded of the change. The student nurse was given the responsible of putting posters up around the ward including patient cubicles/rooms which has all the relevant information about the face mask policy. The student nurse also ensured that disposable surgical face masks were always available for patients/visitors at the entrance of the ward and around the ward, e.g., at the nurses station. Moreover, followers may be more willing to embrace individual leadership during a crisis (Mabey and Morrell, 2011, as cited in Spyridonidis, D. et al, 2022). In times of crisis, leadership is often perceived symbolically, with the public anticipating a figure who is 'in charge' and accountable (Currie et al., 2009, as cited in Spyridonidis, D. et al, 2022).
However, a balanced approach that incorporates input from various sources is essential to mitigate the potential drawbacks of autocratic leadership, such as a lack of inclusivity and increased resistance. Striking the right balance is crucial for effective and sustainable crisis management. EVIDENCE
According to KingsFund (2019), leadership is a pivotal factor in influencing and moulding the culture within organizations. The manner in which leaders guide and conduct themselves has a profound impact on the values, beliefs, and behaviours that characterize the organizational environment (KingsFund, 2019). Effective leadership not only establishes a cultural foundation but also serves as a driving force behind the collective mindset and actions of individuals within the organization (NHS England, 2019). Leadership's role in shaping organizational culture extends beyond merely setting the tone; it involves fostering an environment where employees feel inspired, motivated, and aligned with the organization's mission and values (Cote, 2023). Leaders act as role models, embodying the desired cultural traits and instilling them throughout the organization. Their actions and decisions communicate the priorities and expectations that contribute to the overall ethos of the workplace (cote, 2023). Moreover, leadership plays a crucial part in promoting a culture of innovation, adaptability, and continuous improvement. Leaders who encourage open communication, value diverse perspectives, and embrace change contribute to the development of a dynamic and resilient organizational culture. By fostering a positive and inclusive atmosphere, leaders create conditions that empower employees to contribute their best efforts and ideas, ultimately enhancing the overall organizational culture.
Bibliography
Admin, iOH (2023) Leadership in occupational health nursing, iOH. Available at: https://ioh.org.uk/2023/02/leadership-in-occupational-health-nursing/ (Accessed: 18 December 2023).
AlMazrouei, H. (2023) The effect of covid-19 on managerial leadership style within Australian Public Sector Organizations, Journal of General Management. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9880144/#:~:text=Changes%20in%20leadership%20style%20to,employee%20support%20during%20the%20pandemic. (Accessed: 18 December 2023).
Barney, N. and Pratt, M.K. (2023) What is leadership?: Definition by TechTarget, CIO. Available at: https://www.techtarget.com/searchcio/definition/leadership#:~:text=Leadership%20is%20the%20ability%20of,or%20ranking%20in%20a%20hierarchy. (Accessed: 07 December 2023).
By et al. (2023) Autocratic leadership style: Definition, examples, pros & cons, Simply Psychology. Available at: https://www.simplypsychology.org/autocratic-leadership.html (Accessed: 17 December 2023).
Collins, A.S. (2008) Preventing health careassociated infections - patient safety and ..., National Library of Medicine. Available at: https://www.ncbi.nlm.nih.gov/books/NBK2683/ (Accessed: 07 December 2023).
Cote, C. (2023) How does leadership influence organizational culture?, Business Insights Blog. Available at: https://online.hbs.edu/blog/post/organizational-culture-and-leadership (Accessed: 17 December 2023).
Covid Portal (2023) What is the purpose of face masks and respirators? Covid Portal, Covid Portal. Available at: https://covid.gov.cz/en/situations/face-masks-and-respirators/what-purpose-face-masks-and-respirators#:~:text=Recommendations,droplets%20which%20contain%20viral%20particles. (Accessed: 07 December 2023).
Hale, T. et al. (2020) Variation in government responses to covid-19, ORA. Available at: https://ora.ox.ac.uk/objects/uuid:0ab73a02-ca18-4e1f-a41b-cfeea2d30e81 (Accessed: 14 December 2023).
Healthdirect (2023) How masks can help prevent covid-19, healthdirect. Available at: https://www.healthdirect.gov.au/covid-19/face-masks (Accessed: 07 December 2023).
James Cook University (2022) 10 nurse leadership styles for developing your team, James Cook University. Available at: https://online.jcu.edu.au/blog/leadership-styles-nursing (Accessed: 18 December 2023).
Marler, H. and Ditton, A. (2021) Im smiling back at you: Exploring the impact of mask wearing on communication in Healthcare, International journal of language & communication disorders. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675237/ (Accessed: 14 December 2023).
Midlands Partnership University, N.F.T. (2021) Leadership during a pandemic: Leadership, Complexity and Inclusion, NHS choices. Available at: https://www.mpft.nhs.uk/about-us/pep-talk-extra/leadership-during-pandemic-leadership-complexity-and-inclusion (Accessed: 18 December 2023).
Morganelli Jul 13, D.M. et al. (2021) What is nurse leadership?, Southern New Hampshire University. Available at: https://www.snhu.edu/about-us/newsroom/health/what-is-nurse-leadership (Accessed: 07 December 2023).
Mozafaripour, S. (2022) Healthcare policy: What is it and why is it important?: USAHS, University of St. Augustine for Health Sciences. Available at: https://www.usa.edu/blog/healthcare-policy/#:~:text=Healthcare%20policy%20is%20important%20because,poor%20communication%20around%20medical%20decisions. (Accessed: 14 December 2023).
NHS England (2018) Leadership development - NHS england, NHS England. Available at: https://www.england.nhs.uk/wp-content/uploads/2018/03/leadership-development.pdf (Accessed: 17 December 2023).
NHS England (2019) NHS leadership and culture, The Kings Fund. Available at: https://www.kingsfund.org.uk/projects/positions/NHS-leadership-culture (Accessed: 17 December 2023).
NHS England (2021) NHS Patients, staff and visitors must continue to wear face coverings in healthcare settings, NHS choices. Available at: https://www.england.nhs.uk/2021/07/nhs-patients-staff-and-visitors-must-continue-to-wear-face-coverings-in-healthcare-settings/ (Accessed: 18 December 2023).
NHS England (2022) Living with COVID-19: Visiting healthcare inpatient settings principles, NHS choices. Available at: https://www.england.nhs.uk/coronavirus/documents/c1606-living-with-covid-19-visiting-healthcare-inpatient-settings-principles/ (Accessed: 14 December 2023).
NHS England (no date) Rapid Clinical Policy Development: Covid 19, NHS choices. Available at: https://www.england.nhs.uk/coronavirus/clinical-policy/ (Accessed: 14 December 2023).
Sim, S.W., Moey, K.S.P. and Tan, N.C. (2014) The use of facemasks to prevent respiratory infection: A literature review in the context of the health belief model, Singapore medical journal. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293989/ (Accessed: 13 December 2023).
Spyridonidis, D. et al. (2022) Leadership configuration in crises: Lessons from the English response to covid-19, Leadership (London). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9483131/ (Accessed: 18 December 2023).
World Health Organization (2020) Transmission of SARS-COV-2: Implications for infection prevention precautions, World Health Organization. Available at: https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions (Accessed: 13 December 2023).
World Health Organization (2021) Academic guides: Health policy: Introduction: The policy process, Introduction: The Policy Process - Health Policy - Academic Guides at Walden University. Available at: https://academicguides.waldenu.edu/library/healthpolicy (Accessed: 14 December 2023).
World Health Organization (2023) Coronavirus disease (covid-19): Masks, World Health Organization. Available at: https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-covid-19-masks (Accessed: 14 December 2023).
World Health Organization (no date) Coronavirus, World Health Organization. Available at: https://www.who.int/health-topics/coronavirus#tab=tab_1 (Accessed: 07 December 2023).
