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NRS-451VN Benchmark – Effective Approaches in Leadership and Management

NRS-451VN Benchmark – Effective Approaches in Leadership and Management

NRS-451VN Benchmark – Effective Approaches in Leadership and Management

Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.
Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
Discuss what additional aspects mangers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.

Effective Approaches in Leadership and Management

Health care providers play a critical role in promoting population health and well-being, and they should always work to the best of their capacity. However, many workplace issues impede health care workers from delivering the desired levels of care. Such issues can stem from managerial policies, everyday interactions, and work-related elements, mainly dissatisfaction. Mostly, issues affecting health care professionals’ well-being affect the quality of care and patient safety adversely. Nurse leaders and nurse managers can use their skills and influence to address issues as they emerge. This paper describes bullying and its impacts, standards applied in rectifying the problem, roles of nursing leaders and managers, and the appropriate leadership style in addressing bullying.

Bullying and Impacts

Workplace bullying is among the widespread negative behaviors in health care organizations affecting workplace relationships and productivity adversely. Poor employee management, excessive workloads, stress, and lack of autonomy are leading causes of bullying in health care settings. According to Murphy (2021), bullying denotes repeated, emotionally or physically abusive, threatening behavior targeted to a specific person or a group. The targeted individuals or groups have vulnerabilities related to roles, influence in the organization, ability, or personal attributes. Bullies usually intend to control, undermine or harm their targets.

Like other uncivil behaviors, bullying affects the quality of care and patient safety profoundly. According to Al-Ghabeesh and Qattom (2019), bullying is common in emergency units since nurses in such settings are highly vulnerable because of job stressors and working in a demanding work environment. Bullying affects nurses’ mental, emotional, and physical well-being. Exemplifying the issue with hospitals in Amman, Jordan, Al-Ghabeesh and Qattom (2019) noted that bullying declines nurses’ productivity, emotional well-being, and the desire to work. Over time, they feel detached from the workplace as the desire to leave their jobs increases.

Regardless of the setting, the quality of care and patient safety depends on health care providers’ well-being. The discomfort that bullying brings reduces nurses’ concentration and commitment. Al Omar et al. (2019) accentuated that bullying decreases nurses’ ability to respond to cognitive demands and communicate since they work while worried. In such a state, nurses cannot make correct decisions and the probability of erring increases. They cannot also examine patients and address their problems holistically. Patients may be misdiagnosed and mistreated. Considering that bullied nurses rarely engage in self-care or collaborate interprofessionally, their motivation and competence level reduce progressively. The issue is not limited to the emergency setting. Other health care settings can experience the same, implying the need for evidence-based interventions.

Professional Standards of Practice to Maintain Professional Conduct

Bullying is a challenging issue to address since it can be directed to any person in the workplace. Rectifying the problem requires a multifaceted approach characterized by ethical conduct, engagement, and critical thinking. It is crucial for health care leaders and managers to lead by example. Here, the implication is that leaders and managers cannot promote the required practice without modeling acceptable behaviors. Engagement is also crucial in rectifying bullying. The victims should be actively engaged when assessing the root of the problem and everyday experiences. Favoritism should be discouraged, and leaders should be genuinely interested in assisting the victims of bullying and increasing their comfort in the workplace. All issues should be solved professionally while including all concerned parties.

Differing Roles of Nursing Leaders and Managers

Leadership and management are usually used interchangeably, but they have significant differences. Nursing leaders inspire employees to work towards a shared vision (Weiss et al., 2019). They ensure that things are done and targets met by motivating teams. Accordingly, nursing leaders address workplace bullying by engaging teams and inspiring them to change. It is an approach characterized by recognizing that everyone should be involved in driving organizational change. Conversely, nursing managers achieve their targets by directing (Weiss et al., 2019). They use their positions to give directions on what should be done. Unlike leadership, where employees act as partners in decision-making, employees serve as a separate unit in management that should work as directed. The top-down approach of guiding teams dominates management.

Nurse leaders and managers apply different approaches in addressing bullying to promote patient safety and quality of care. A common intervention is promoting acceptable behaviors. According to Al Omar e al. (2019), bullying is prevalent in settings without adequate anti-bullying policies or regulations to control uncivil behaviors. In promoting the desired behaviors, training employees on acceptable conduct is vital. From a leadership perspective, promoting the desired behaviors prevents the undesired behaviors from spreading. It coincides with the bio-behavioral theory of workplace incivility that suggests that minor insults and demeaning actions have profound impacts if not controlled, eventually undermining workforce well-being (Cortina et al., 2021). Besides behavioral approaches, nurse leaders address workplace bullying by increasing their commitment to minimize workplace aggression. Nursing managers solve issues by developing new workplace policies and instructing different teams to follow depending on how bullying affects them.

Additional Aspects Needed by Managers and Leaders

Nursing leaders and managers need other aspects besides the desire to promote acceptable behavior in the workplace. For instance, they need to initiate and support appropriate cultures. For instance, a reporting culture encourages bully victims to report issues instantly (Al-Surimi et al., 2020). Irrespective of their approach, nursing leaders and managers should address problems promptly. Besides initiating a culture of reporting, nursing leaders and managers should be present and supportive. Al-Surimi et al. (2020) found that a significant number of bullying cases are unreported due to the lack of reporting platforms. Nursing leaders and managers should be reachable and provide multiple reporting channels.

Leadership Style to Address Bullying

Bullying is not a one-sided problem. The victims should be heard and helped and the issues causing bullying should be examined in detail. The participative leadership style would be the best fit in such cases. Xu (2017) defined participative leadership as a democratic approach where group members participate in guiding decision-making. Dominant elements include respect, collaboration, and supporting innovation. Xu (2017) further noted that participative leadership is highly effective in building new relationships. Addressing bullying primarily involves building a new relationship between bullies and victims. Both sides should be involved in evaluating the issues causing bullying and develop creative and lasting interventions based on the feedback. The participative approach is the most effective since the leader engages in a shared leadership style.

Conclusion

Bullying is prevalent in health care settings and affects the quality of care and patient safety adversely. Bullied nurses are physically, emotionally, and mentally drained. Their desire to leave is also high due to discomfort and low satisfaction. To address bullying, nursing leaders and managers should promote acceptable conduct through training and serving as role models. A culture of reporting is vital too. Since bullying is not a one-sided issue, a participative leadership style would be the best in addressing bullying. Participation would ensure that issues causing bullying are known, and the problem can be fixed in a way that it cannot recur.

References

Al-Ghabeesh, S. H., & Qattom, H. (2019). Workplace bullying and its preventive measures and productivity among emergency department nurses. Israel Journal of Health Policy Research8(1), 1-9. https://doi.org/10.1186/s12913-019-4268-x

Al Omar, M., Salam, M., & Al-Surimi, K. (2019). Workplace bullying and its impact on the quality of healthcare and patient safety. Human Resources for Health17(1), 1-8. https://doi.org/10.1186/s12960-019-0433-x

Al-Surimi, K., Al Omar, M., Alahmary, K., & Salam, M. (2020). Prevalence of workplace bullying and its associated factors at a multi-regional Saudi Arabian hospital: a cross-sectional study. Risk Management and Healthcare Policy13, 1905-1914. https://doi.org/10.2147/RMHP.S265127

Cortina, L. M., Sandy Hershcovis, M., & Clancy, K. B. (2021). The embodiment of insult: A theory of biobehavioral response to workplace incivility. Journal of Management, 0149206321989798. https://doi.org/10.1177%2F0149206321989798

Murphy, B. (2021). Why bullying happens in health care and how to stop it. AMA. https://www.ama-assn.org/practice-management/physician-health/why-bullying-happens-health-care-and-how-stop-it

Weiss, S. A., Tappen, R. M., & Grimley, K. A. (2019). Essentials of nursing leadership and management. F.A. Davis Company.

Xu, J. H. (2017). Leadership theory in clinical practice. Chinese Nursing Research4(4), 155-157. https://doi.org/10.1016/j.cnre.2017.10.001

 

Nurse staffing ratio is one of the major issues in the healthcare system. Most healthcare institutions are always concerned with the number of healthcare professionals who can give adequate and quality services to the patients. Also, patients are always attracted to the healthcare settings where there are enough nurse-to-patient ratios. The more the number of nurses, the higher the likelihood of receiving effective and efficient care from a healthcare institution. One of the critical topics discussed in the field of nursing is the increase in nurse-to-patient ratios. Generally, for the most healthcare institutions, nurse are asked to care for more patients at a given time; this happens due to the lack of enough number of nurses as well as the high costs of employing more nurses for a given healthcare institution (Aiken et al., 2015). Also, a high number of patients for one nurse is attributed to the increase in the number of patients seeking medical services from various hospitals and healthcare institutions. When nurses are assigned to fewer patients to care for at a time, there is always higher level of job satisfaction.

Nurse staffing ratio often impacts the quality of care and patient safety. With the appropriate number of nurses, there is always higher likelihood of attaining effective patient care leading to quality outcome. Healthcare institutions that adhere to the correct nurse to patient rations often tend to achieve the highest quality healthcare outcome. On the other hand, clinical or healthcare settings with less nurse to patient ratio often deliver low quality healthcare, a scenario that negatively impacts the health and wellbeing of the people within the community. Where there is huge number of patients compared to the number of nurses or healthcare professionals, the treatment processes are often compromised as nurses become overwhelm leading to low quality health outcome. Also, with the few number of nurses, there is always high possibility of nurse burnout. All these factors interfere with effective health outcome.

How Professional Standards of Practice Should Be Demonstrated

In This Situation to Help Rectify the Issue

Professional standards should always be observed in every treatment process. In every healthcare institution, healthcare professionals are required adhere to the required professional standards. Even though some healthcare institutions have low nurse-to-patient ratios, healthcare professionals are required to adhere to the professional standards to ensures that they deliver quality healthcare. Nurses need to stick to their commitment to serve; this is one of the professional standards required that leads to problems with the nurse staffing ratios. Serving patients irrespective of their number will overcome the problems that often arise as a result of low nurse-to-patient ratios (Griffiths et al., 2018). For instance, adherence to the quality standards in healthcare provision will ensure that there are effective treatment outcomes. The professional standards of practice in nursing also stipulate that the right number of patients should be assigned to one nurse so as to ensure that there is delivery of the required services at the right time. Adherence to ethical practices will also ensure that nurses perform their roles as required amidst the problems associated with the nurse staffing ratios. One of the professional roles of a nurse is to ensure that patients get the right care and to ensure effective or quality health outcomes. The application of all the above professional standards of practice would help in rectifying the issues or problems associated with the nurse staffing ratios.

Roles of Nursing Leaders and Nursing Managers

Nurse leaders and nurse managers play critical roles in ensuring that nurses act professionally in line with healthcare’s required standards. Nurse leaders guides healthcare workers especially the nurses in undertaking their roles under different situations. Nurse managers are always responsible for supervising the nursing staff including nurses, clinical officers, doctors, physicians and other healthcare workers who ensure the safety and wellbeing of the patients (Branden & Sharts-Hopko, 2017). One of the principles that nursing leadership should portray in ensuring correct nurse staffing ratio is the commitment to excellence. To ensure excellence in the treatment process, nurse leaders ensure that nurses are committed to quality treatment processes irrespective of their numbers and the rate of flow of patients into the hospital. Adhering to the principle of excellence will ensure that nurses work to provide safety and quality care to all the patients.

Nurse leaders should also possess leadership skills to be able to influence the operational processes geared towards achieving effective outcomes irrespective of the problems associated with the nurse staffing ratios. Nurse managers are always responsible for supervising nurse staff in clinical setting and in hospitals. Nurse managers also take part in overseeing patient care, make budgetary and management decision, set work schedules, make decision about personnel and coordinate meetings where decisions are made about the roles of healthcare workers (Branden & Sharts-Hopko, 2017). The key principle of nurse managers is building of a strong culture around the healthcare provision services. The above principle can therefore enhance the solution towards the problems associated with the nurse staffing ratios.

Additional Aspects Managers and Leaders Would Need

Nursing managers and leaders would need to initiate different management or operational processes to ensure the provision of solution to the issues associated with the nurse staffing ratio. Some of the additional aspects or activities in the nursing practices that managers and leaders would need to initiate include regulation of the number of patients during admission; the practice will ensure that nurses and other healthcare professionals do not experience burnout or excessive work that may lead to low quality outcomes (Driscoll et al., 2018). Another aspect of treatment that managers and nurse leaders need to initiate include adherence to the evidence-based practices whereby nurses are able to work in line with the patient’s demands to ensure effective or quality healthcare outcome. To ensure high level of professionalism there is a need for the management and nurse leadership to ensure continuous training processes so as nurses can observe professional practices in taking care of patients.  The above will also reduce problems associated with low nurse-to-patient ratio (Driscoll et al., 2018). Finally, nurse managers and leaders need to ensure that all healthcare professionals adhere to the ethical requirements, which is one aspect of professionalism required in the healthcare practices.

Leadership Style That Would Best Address the Nurse Staffing Ratio

Democratic leadership style would best address the issue of nurse staffing ratio. With this form of leadership, there is a high possibility that all the staff members will contribute towards achieving best practices in ensuring that there is quality outcome in the healthcare delivery processes. Also, the democratic leadership style would ensure that the medical staff members including nurses adhere to high levels of professionalism when dealing with patients. With the democratic leadership style, finding a solution to the problems associated with the nurse staffing ratio is easier as each of the member will be able to communicate the challenges they face as a result of the increasing number of patients in the healthcare settings.

References

Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., … & McHugh, M. D. (2015). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The lancet383(9931), 1824-1830.

Branden, P. S., & Sharts-Hopko, N. C. (2017). Growing clinical and academic nursing leaders: Building the pipeline. Nursing Administration Quarterly, 41(3), 258-265.

Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., … & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European Journal of Cardiovascular Nursing17(1), 6-22.

Griffiths, P., Recio‐Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., Meredith, P., … & Missed Care Study Group. (2018). The association between nurse staffing and omissions in nursing care: a systematic review. Journal of advanced nursing74(7), 1474-1487.

 

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  Nurse leaders, as well as managers, are key to the efficacy of the operation of healthcare organizations, but they uphold varying roles for directing personnel, overseeing organization-based structures, and steering care teams for offering healthcare to patients. Changes within healthcare necessitate for nurse leaders and managers to evolve with the set changes through the application of effective measures, processes as well as conceptions. These aspects are inclusive of awareness, responsibility, accountability as well as the application of effective communication measures (Fernandes et al., 2018). They are also sensitive for the upholding of the consideration for the utilization of proactive as well as collaborative measures for attaining effective changes that ensure patient and staff centeredness for their set satisfactions. These facets impact how nurse leaders, as well as nurse managers’ different roles, envision the required changes for ensuring a balanced work setting that ensures inclusivity for patient and personnel satisfaction.

Practice Settings Bullying

            Bullying within practice settings is descriptive of the physical combined with emotional abuse that is detrimental towards set healthcare provision to patients (Omar et al., 2019). Within practice settings bullying is attributed to high-risk environmental settings for nurses, and negatively impacts the extent of productivity combined with concentrations that enhances the chances for the realization of errors. This may be due to elevated stress levels for the care providers on an individual basis, coupled with hampering of the provider-patient association. This harms the quality of care provided to patients as well as safety. Healthcare providers who are worried about these happening may in the process resort to fear as a result of the limited awareness regarding the aspects of thwarting, preventing, tackling as well as reporting the scenarios.

Showcasing Standards of Practice for Countering Issue while Upholding Professional Conduct

            This challenge within the practice settings should be countered by nurses working collaboratively and envisioning American Nurses Association’s (ANA) ethical codes that call for the development of ethical practice settings combined with culture linked to civility and compassion. Colleagues are required to be treated with dignity combined with esteem. Stern measures should be applied to aspects that inspire violence. Registered practice professionals together with nurses within practice settings, academia, as well as evidence-based studies are required to oversee a collaborative culture that upholds esteem, lack of incivility, bullying as well as work environment violence (Bambi et al., 2017). This is geared towards the inspiring of best health, safety, as well as the well-being of the care providers. This in turn helps boost the best care outcomes for patients within the continuum of care.

As per provision 1.5 that is based on the associations of care providers with others, there should be utmost adherence towards obligation for fair treatment that also provides consideration for compromise alongside conflict resolution. As per provision 2.3, the aspects of effective collaborations should be inclusive of effective information sharing combined with freedom for free participation within consensus decision-making. As per provision 3.5, there should be the upholding of the recognition as well as undertaking counteractive actions regarding any form of bullying occurrences that may be ascertained as “incompetent”, “unethical”, as well as impaired by the collaborative teams (Bambi et al., 2018). As per provision 3.6, the tackling of impaired practice should comprehensively ascertain work settings bullying that impacts the set work climate, outcomes, as well as satisfaction for every party that is affected by the given behavioral facets.

Differing Roles of Nurse Leaders and Nurse Managers

            In this scenario, the nurse managers will be tasked with overseeing decision-making for countering workplace bullying. They will be steadfast in the prolonged devising of effective strategies for directing the personnel and collaborating with the care team to coordinate the best-required actions that alleviate bullying (Edmonson & Zelonka, 2019). They can ensure the attainment of these set objectives by managing the personnel teams, offering training for increased awareness on bullying, conducting supervisions of the care team’s goal towards the removal of bullying situations, coordinating with other set managers for ensuring a continuum of the ideology and applying scientifically proven strategies for best results.

The nurse leaders will be fixated on the quality of patient care required for best outcomes together with the personnel’s satisfaction. They will be steadfast in advocating for the victims of bullying within all the given phases of the organizational set-up to help in their overall required functioning as per the needs of the organization. (Crawford et al., 2019) The duties that they oversee may include playing the role of strategic leadership for the personnel’s initiatives, directing the managers as per the bullying scenario, impacting other staff members via effective communication as well as interpersonal expertise, enacting scientifically proven practices, and overlaying them for other care teams and organizational staff to thwart bullying, and offering mentorship to others on how to avoid bullying.

Managerial and Leadership Aspects for Upholding Professionalism

            The first step would be for nurse leaders combined with managers to admit that there is the aspect of bullying within the work settings. They should then proceed to alleviate all the probable situational facets that may heighten the scenario at every organizational level, like work overload, stress alongside exhaustion. There should also be the application of zero tolerance towards work settings bullying that may be initiated by actions such as policies that deter the issues together with related punishments for non-adherence. There should also be the nurturing of work settings that uphold a comfortable outlook for reporting any incident of bullying to set leaders as well as managers. The reports made should also be seriously perceived and fast responses followed. Victims of bullying should be offered support that may be in the form of behavioral health services (Edmonson & Zelonka, 2019). There should also be the inclusion of incivility within social as well as online media policies that embrace nurses’ accountability of themselves.

Leadership Style for Tackling Work Settings Bullying

            The best leadership style to utilize in this scenario would be the democratic leadership style that encourages enhanced engagements within a set shared leadership framework. This utilizes the aspect of involvement together with contribution for the personnel alongside the leaders. The leaders in turn should be perceived as mutually non-deferential, humble, collaborative, motivating, as well as empowering for positive creativities (Xu, 2017). This helps ascertain the best counteractive plans as well as policies for reducing work-place bullying together with other probable challenges.

Conclusion

Workplace bullying within healthcare institutions affects the quality of healthcare provided to patients that may also be prolonged. Getting rid of such instances necessitates the upholding of high-end professional behaviors coupled with showcasing of professional principles of practice within the settings. Every member within the workforce should maintain ethical awareness in terms of actions as well as words conveyed. The leaders as well as the managers should also be steadfast in ensuring the use of their in-depth underlying competencies in addressing workplace bullying together with other probable issues within the work settings.

References

Bambi, S., Foa, C., Felippis, C. D., Lucchini, A., Guazzini, A., & Rasero, L. (2018). Workplace incivility, lateral violence and bullying among nurses. A review about their prevalence and related factors. Acta Biomedica, 89, 51–79. https://doi.org/10.23750/abm.v89i6-S.7461

Bambi, S., Guazzini, A., Felippis, C. D., Lucchini, A., & Rasero, L. (2017). Preventing workplace incivility, lateral violence and bullying between nurses. A narrative literature review. Acta Biomedica, 88, 39–47. https://doi.org/10.23750/abm.v88i5-S.6838

Crawford, C. L., Chu, F., Cuenca, E., Jadalla, A. A., & Tze-Polo, L. (2019). An Integrative Review of Nurse-to-Nurse Incivility, Hostility, and Workplace Violence A GPS for Nurse Leaders. Nursing Administration Quarterly , 43(2), 138–156. https://doi.org/10.1097/NAQ.0000000000000338

Edmonson, C., & Zelonka, C. (2019). Our Own Worst Enemies The Nurse Bullying Epidemic. Nursing Administration Quarterly, 43(3), 274–279. https://doi.org/10.1097/NAQ.0000000000000353

Fernandes, R., Araujo, B., & Pereira, F. (2018). Nursing management and leadership approaches from the perspective of registered nurses in Portugal. Journal of Hospital Administration, 7(3). https://doi.org/10.5430/jha.v7n3p1