NR 501 Discussion Application of Theory to Leadership and Management

A middle-range theory that could be applied by nurse leaders or nurse managers, to deal with administrative problems such as staffing, and staff performance challenges is the Peplau’s theory of interpersonal relations. Among Peplau’s theory concepts we can find assisting other to identify their difficulties, applying human relations to the difficulties others are facing, being a resource person, a counselor and educator. These principles are of paramount importance for nurse leaders to apply in their professional environment to achieve effective leadership.

According to Hurley & Hutchinson (2013). effective nurse leadership positively influences the quality of clinical care, as well as work settings where nursing care is taking place. One of Peplau’s theory comprise assisting individuals to identify their difficulties. It is very important, for nurse leaders to engender a working environment that makes nurses and other personnel have a sense of safety and feel valued while carrying out their duties in the working environment. Such environment positively influences nurses and other personnel working moral and as a consequence will benefit nurses and other personnel retention as well as create a safe environment for nurses. Another demonstration of the application of Peplau’s theory is when a nurse manager detects any type of issue with the staff performance or getting used to the work environment, the manager has the obligation as leader to assist that personnel in identifying and overcoming such difficulties in order to promote a healthy working environment that is under her supervision. When any issue in the working environment is recognized, the nurse manager through the use of appropriate management skills should be able to provide assistance and resolve the issues identified. Although some issues can be resolved by each individual; there are other problems that indeed require the involvement of the manager.

I was employed to a facility that had a high rate of turnover and low morale. Nursing staff were leaving shortly after being employed and oriented for the job. It was like a cycle of employment and resignation not long after the orientation period was finalized. There was a common denominator in this situation, when staff personnel identified a problem that affected them, whether directly or indirectly, the manager would not intervene in a timely manner or sometimes not at all to resolve the situation affecting this nursing personnel. Nurses with senior positions were very indifferent, not training the new recruits properly and making degrading and unprofessional comments towards their newly employed junior colleagues. Some senior nurses were employed to the institution prior to the manager and therefore felt they had the right to have an upper hand in the institution due to their seniority. Newly employed nurses felt mistreated and professionally disrespected and they had no one to support them, and as a result there was an increased number of nurses leaving the institution. This situation stopped when there was an investigation from upper management to detect the reason why nurses were leaving in such a short period of time from this particular unit. Once the problem was addressed, and disciplinary action and changes made to management and in the working environment, nurses started to work in harmony, treating each other with respect and addressing each other professionally. Turnover rate decreased tremendously, productivity and patient healthcare also improved.

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One of the main problem-solving avenues in management is communication. It is of paramount importance for a leader to be able to utilize leadership methods conducive to healthy communication, proper interpersonal and interprofessional relationships which will be able to develop a productive and healthy environment among nursing personnel, management and the institution. The application of Peplau’s theory of interpersonal relation may be of crucial value to nursing personnel with its implementation in their professional career.

References

Hurley, J & Hutchinson, M. (2013). Setting a course: A critical review of the literature on nurse leadership in Australia. Contemporary Nurse, 43(2), 178–182. Retrieved from https://search-proquest-com.chamberlainuniversity.idm.oclc.org/docview/1698634428/fulltextPDF/EC172494A2C84A47PQ/1?accountid=147674 (Links to an external site.)

Peplau’s nursing theory may assist in bringing cohesiveness among the health care team, as through its application, leadership skills might be improved, which could positively impact cohesiveness in the clinical practice. Peplau’s theory of interpersonal relations is an adequate nursing theory that specifically play an excellent role in resolution of administrative problems as well as issues affecting staffing and staff performance when applied by managers and nurse leaders

NR 501 Discussion Application of Theory to Leadership and Management

According to Kumar, Deshmukh, & Adhish (2014) the skills associated with handling self, such as emotional capabilities, time management and active listening are crucial characteristics for the foundation of managing and leadership teams to be able to function in a constructive manner. The implementation of team building exercises play an essential role in accomplishing the goals of the organization. These exercises are of paramount importance when referring and addressing the health care factor in both the clinical as well as public health settings. The main and distinctive quality of a cohesive team is a joint vision towards the achievement of goals.

As a leader, creating and supporting a strong and cohesive team, the nurse will also help the patients take on maximum responsibility for meeting his or her treatment goals, as this will take place in a healthy working environment conducive to productive nursing work. A nurse leader who intends to promote a healthy working environment will take on other roles such as technical expertise and tutor in which this leader makes herself or himself available to the junior nursing staff, providing technical support, also act as a safety agent, environment manager, mediator in any circumstance that mediation is required, administrator and researcher.

According to Kumar, Deshmukh, & Adhish (2014) the team is a cooperative relationship supplementing and supporting each other’s skills, interacting openly and clearly with one another and holding themselves mutually accountable.

According to Hurley, J & Hutchinson, M. (2013) leadership is about relationships. For a nurse leader, it is important to adapt to a leadership style that nurtures healthy relationships intra-professionally and inter-professionally,that is among nurses, nurse leaders and other leaders within the organizations. Applying Peplau’s theory of interpersonal relation can be useful for nurses to adopt in their professional career.

References

Kumar, S., Deshmukh, V., & Adhish, V. (2014). Building and Leading Teams. Indian J Community Med, 39(4), 208-213. doi: 10.4103/0970-0218.143020 (Links to an external site.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4215500/ (Links to an external site.)

References

Concerning the need for a nursing theory of transformational leadership, I do not see the need. The abundance of nursing literature translating the leadership style for use by nursing leadership is likely sufficient. Consolidating the information into a specific nursing theory seems redundant.

Transformational leadership has generally been acknowledged as the most effective leadership style. Unlike the quid-pro-quo style of transactional leaders, transformational leaders encourage followers to create a personalized vision of their role and the future of the organization (Jackson, Hutchinson & Jackson, 2013).

Shared governance would be maximally effective when used in conjunction with a transformational leadership style. The members from each unit that sit on the nursing practice counsel (NPC) can employ transformational leadership styles to encourage nurses on their units to identify deficiencies in practice and develop strategies to combat them. The CNO can act as the ultimate transformational leader in this model, as their approval is required for the development of new NPC bi-laws (Meyers, et al., 2014). Shared governance is a structure of leadership that necessitates follower engagement because leaders are identified throughout the organization and take suggestion from their peers and coworkers.

References

Jackson, D., Hutchinson, M., & Jackson, D. (2013). Transformational leadership in nursing: Towards a more critical interpretation. Nursing Inquiry, 20(1), 11-22.

Myers, M., Parchen, D., Geraci, M., Brenholtz, R., Knisely-Carrigan, D., & Hastings, C. (2013). Using a shared governance structure to evaluate the implementation of a new model of care: The shared experience of a performance improvement committee. The Journal of Nursing Administration, 43(10), 509-516. doi:10.1097/NNA.0b013e3182a3e7ff

Unfortunately, the nursing profession does not currently have a transformational leadership nursing theory and we continue to use borrowed theories from other disciplines. Most of the borrowed transformational leadership come from the business profession and lack the ability to deal with the nursing specific dilemmas such as maintaining unit performance measures, promoting effective interdisciplinary teamwork, recruiting and retaining experienced nurses and navigating increased consumer quality expectations with reduction organizational budgets. Although the nursing profession has no distinct nursing theory for transformational leadership we do have a structured model that is used as the framework for constructing and expressing professional practices, processes, and relationships (Porter-O’Grady, 2012), known as “shared governance”. Shared governance was originally developed by Virginia Cleland in the 1970’s to assist in the collective bargaining by nurses to provide a balance between the union, nursing profession and an organization. Today’s shared governance emphasizes that professional nurses should be accountable rather than responsible, that they should focus more on the relationship between the process and impact instead of just the function, and is more concerned with advancing, improving and achieving excellence in the practice of healthcare (Porter-O’Grady, 2010).

Reference

Porter-O’Grady, T. (2012). Reframing Knowledge Work: Shared Governance in the Postdigital Age. Creative Nursing, 18(4), 152-159.

Dr. Imogene King developed the Goal Attainment Theory to explain the interpersonal relationship systems in which people develop and progress through life to achieve personal life goals (Schub, 2016). King’s Theory of Goal Attainment is a dynamic notion that nursing interactions lead to actions that result in accomplishing a goal (Schub, 2016). According to King, goal attainment fosters successful nursing care as well as growth and development (Schub, 2016).

King’s Theory of Goal Attainment is used as a framework for nurse leadership and the director of nursing position. King’s theory is based on accomplishing goals, which is the duty of a director of nursing. As a director of nursing an issue that may arrive is staff performance issues. This could be due to many factors for nurses. Long hours and high acuity patients lead to unhappy nurses. They feel over worked and underappreciated. As a director of nursing, it is imperative to be aware of these issues and find ways to address them to improve nurse satisfaction and performance. King’s Theory of Goal Attainment is a method that directors of nursing can use to address these issues.

As a nurse leader, goal attainment is a necessary aspect of the job. A director of nursing is in charge of the nurses in a health care setting. Nurses who have an optimistic attitude in reaching work related goals show a stronger ability to acquire nursing competencies and skills (Korunsky & Wiemer, 2016). As a director of nursing, it is important to support nurses in continuing professional development and growth to increase performance in the workplace (Korunsky & Wiemer, 2016).

As an example, director’s use King’s Theory of Goal Attainment to assist nurses in accomplishing professional development by supporting beliefs, listening to fellow nurses, and organizing programs that support nurse’s skills. This could be by simply speaking with nurses and listening to their concerns, or by facilitating continuing education for nurses to expand their nursing knowledge to enhance nurse performance. By doing this, director of nursing and nurses alike, are able to accomplish goals, address performance issues, and provide competent care to patients through King’s theory.

Korunsky, J., & Wiemer, H., (2016). Goal attainment. CINAHL Nursing Guide. Schub, T. (2016). King’s theory of goal attainment. CINAHL Nursing Guide.

NR 501 Discussion Application of Theory to Leadership and Management