Critical Analysis of Articles
Contemporary hospital care is confronted by challenges in workforce, change in the expectations of the consumers, increase in demands of patient centred care and issues with the level of safety and quality in health care (Daly et al., 2014). Under this exhaustive requirement, effective governance is indispensible in order to maximise the effective management of the overall care under hospital or other healthcare settings. The importance of effective clinical leadership in nursing helps to ensure high quality health care system that provides safe and effective care and the same has been highlighted in numerous scientific papers and government reports (Daly et al., 2014). The following paper aims to analyse how clinical leadership helps in sharing up the overall quality of care how a nursing professional can execute the overall concept of clinical leadership. In order to discuss the main aim of the topic, the paper will critically analyse four literary articles which falls within the scope of clinical leadership and nursing. The articles selected include the studies conducted by Mannix, Wilkes and Daly (2013), Hutchinson and Jackson (2013), Martin et al. (2012) and Dignam et al. (2012). The analysis of the article will be based on the leadership theory highlighted in the article, relevance of the research findings, limitations of the research and additional recommendation. The overall analysis will help to highlight the traits and the leadership models that will help in the promotion of clinical leadership in nursing theory.
Mannix, Wilkes and Daly (2013) conducted an integrative review with 10 research papers with an aim to understand the defining factors of contemporary clinical leadership in nursing. The analysis of the papers identified that clinical leadership in nursing highlight the technical and the practical skills of the nursing professionals which help in the establishment of the clinical practice and leading a team from front. The practical skills in clinical leadership encompass effective communications which help in growing friendly relationship with both the patients and subordinate nursing professionals. This friendly relationship helps in building supporting and healthy workplace environment. The review mainly upheld the concept of clinical leadership in nursing as a positive and engaging leader who promotes wellbeing of staffs and thus helping to increase self-confidence and reducing stress. Thus the main leadership theory highlighted in the review is transformational leadership theory. According to Avolio and Yammarino (2013), a transformational leadership is a process by which a person interacts with other and is successful in generating solid relationship that result in increased level of trust. This trust results in increased level of motivation among both intrinsically and extrinsically and in between the leaders and their subordinates. Thus review article published by Mannix, Wilkes and Daly (2013) emphasized over effective communication under transformational leadership model for the promotion of healthy workplace environment in clinical nursing. In relation to this, Kourkouta and Papathanasiou (2014) stated that communication holds a significant part in nursing. It helps to promote therapeutic relationship with the patients along with increasing the scope of positive engagement of the team mates. This creates healthy workplace environment helping to cope up with job stress and burn-out. Positive environment also helps to reduce the chances of unwanted medication error. The main limitation of this review is restricted sample size and this restrict the ability to generalise the findings. At the end author recommended further review of the research articles in order to overcome the limitation of small sample size.
Attributes of Clinical Leadership in Contemporary Nursing: An Integrative Review
Hutchinson and Jackson (2013) also conducted a critical review of decade old nursing articles in order to analyse the empirical evidence of transformational leadership model in clinical leadership of nursing. Recruiting nursing articles which are decade old in the review can be considered both as the strength and limitation of the review. The strength is big sample size which helped to increase generalizability of data. This is also considered as the concept of nursing can changed a lot since past one decade and thus including decade old article might mislead the leadership concept in clinical nursing (Rezaei-Adaryani, Salsali & Mohammadi, 2012). The leadership theories critiqued in this review is transformational leadership. Hutchinson and Jackson (2013) highlighted that the effective clinical leadership in nursing is positioned as an important attribute in achieving optimal improvement in the health-related quality of life of the patient along with positive enhancement in the workplace. However, critical review of the articles conducted by Hutchinson and Jackson (2013) surfaced the robust debate which questions the merits of transformational leadership model in clinical nursing. Hutchinson and Jackson (2013) are of the opinion that uncritical adoption of the transformational leadership model has caused restricted interpretation of nursing leadership. Hutchinson and Jackson (2013) recommended new ways for embracing transformational nursing leadership. In relation to this concept, Ross et al. (2014) conducted an email surveys among 448 nurse leaders in professional nursing associations (PNAs) during 2013 through the application of Leadership Practices Inventory (LPI). The analysis of the review highlighted that the nurse leader with extensive leadership training are successful in embracing the actual ethos of transformational leadership in clinical practice. The main attributes of general leadership training important for successful implementation of transformational leadership include having shared values; direct associations with the members and ability of mobilize the objectives in order to reach the desired outcomes.
Martin et al. (2012) conducted a study in order to evaluate the impact of the clinical leadership program towards building the leadership competencies among the nursing leaders. Martin et al. (2012) mainly used mixed method study format for the analysis of quantitative data obtained from 42-self assessment questionnaire distributed among 420 participants. Another limitation of the study is, it is constructed on perspective of the health care set-up of Switzerland which restricted the generalizability of the results. The main leadership theory which was focused in the clinical leadership program is transformational leadership. Martin et al. (2012) stated that transformational leadership is important for delivering quality care within the healthcare organisation. The analysis of the survey revealed that leaders with inspiring shared vision are more nimble in getting adopted with the approach of transformational leadership. Martin et al. (2012) stated that the leaders who have shared vision have their beliefs and values parallel their interventions and actions. This help in offering highest level of clinical interaction. However, Stanley and Stanley (2018) recommended that highest management of clinical interaction is not comprehensive for highest level of management in the ward. For this an amalgamation of transactional and transformational leadership is important. This helps to correlate between the effectiveness and satisfaction. Moreover, the application of transformation and transactional leadership must be done with respect to the situation. This help in establishment of strict discipline within the hospital ward with proper allocation of work along with the prevalence of health relationship in the work environment (Dumdum, Lowe & Avolio, 2013).
Transformational Leadership in Nursing: Towards a More Critical Interpretation
Dignam et al. (2012) conducted a survey under Australian perspective in order highlight the issues influencing management and clinical leadership in nursing. Dignam et al. (2012) highlighted that highlighting these issues will help to nurse leaders and mangers to work effectively under high pressure, uncertainty and burnout while facing unprecedented challenges on daily basis. The paper is mainly based on the reflection of the nurse leaders and managers about the challenges they face daily in their work life. Via analyzing the self-reflection data, the authors came to conclusion that collaborative approaches between educational and clinical settings are important in order to ensure quality education and managerial support in the nurse leaders. This further helps in enhancing the curriculum integrity. At the end Dignam et al. (2012) recommended that there is a need for contemporaneous and relevant research in order to come up with innovative models for collaborative education. The study conducted by Dignam et al. (2012) surfaced the importance of collaborative leadership in nursing. According to Lawrence (2017), collaborative leadership upholds the concept of management practice which is focused on the leadership skills across the organizational and functional boundaries. This helped to effective partnership in the clinical environment and thereby facilitating effective learning and work. Galletta et al. (2013) stated that collaboration is an important aspect of clinical leadership as it helps to promote the concept of multidisciplinary team. One of the limitations of the study conducted by Dignam et al. (2012) is it is based on Australian educational perspective which restricted the generalizability of the data.
Conclusion
Thus from the above discussion, it can be concluded that clinical leadership is indispensible in the nursing profession for the promotion of quality care and healthy workplace environment. The main leadership theory that must be followed for clinical leadership model in nursing practice is transformational leadership theory. Transformational leadership theory helps in upholding positive workplace environment which helps the nursing professionals to cope up with job stress, work load and burn out and thereby helping to reduce medication or other errors and improving the quality of care. Other leadership theories which were identified from the analysis of four research papers include transactional leadership for establishment of discipline and management in the ward and collaboration leadership with promotes multidisciplinary team approach. However, the nursing professionals are required to work on their effective communication skills and must receive preliminary leadership training for inheriting optimal clinical leadership approach in nursing.
References
Avolio, B. J., & Yammarino, F. J. (Eds.). (2013). Introduction to, and overview of, transformational and charismatic leadership. In Transformational and Charismatic Leadership: The Road Ahead 10th Anniversary Edition (pp. xxvii-xxxiii). Emerald Group Publishing Limited.
Daly, J., Jackson, D., Mannix, J., Davidson, P. M., & Hutchinson, M. (2014). The importance of clinical leadership in the hospital setting. Journal of Healthcare Leadership, 6, 75-83.
Dignam, D., Duffield, C., Stasa, H., Gray, J., Jackson, D., & Daly, J. (2012). Management and leadership in nursing: an Australian educational perspective. Journal of Nursing Management, 20(1), 65-71.
Dumdum, U. R., Lowe, K. B., & Avolio, B. J. (2013). A meta-analysis of transformational and transactional leadership correlates of effectiveness and satisfaction: An update and extension. In Transformational and Charismatic Leadership: The Road Ahead 10th Anniversary Edition (pp. 39-70). Emerald Group Publishing Limited.
Galletta, M., Portoghese, I., Battistelli, A., & Leiter, M. P. (2013). The roles of unit leadership and nurse–physician collaboration on nursing turnover intention. Journal of Advanced Nursing, 69(8), 1771-1784.
Hutchinson, M., & Jackson, D. (2013). Transformational leadership in nursing: towards a more critical interpretation. Nursing inquiry, 20(1), 11-22.
Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in nursing practice. Materia socio-medica, 26(1), 65.
Lawrence, R. L. (2017). Understanding Collaborative Leadership in Theory and Practice. New Directions for Adult and Continuing Education, 2017(156), 89-96.
Mannix, J., Wilkes, L., & Daly, J. (2013). Attributes of clinical leadership in contemporary nursing: an integrative review. Contemporary Nurse, 45(1), 10-21.
Martin, J. S., McCormack, B., Fitzsimons, D., & Spirig, R. (2012). Evaluation of a clinical leadership programme for nurse leaders. Journal of Nursing Management, 20(1), 72-80.
Rezaei-Adaryani, M., Salsali, M., & Mohammadi, E. (2012). Nursing image: An evolutionary concept analysis. Contemporary nurse, 43(1), 81-89.
Ross, E. J., Fitzpatrick, J. J., Click, E. R., Krouse, H. J., & Clavelle, J. T. (2014). Transformational leadership practices of nurse leaders in professional nursing associations. Journal of Nursing Administration, 44(4), 201-206.
Stanley, D., & Stanley, K. (2018). Clinical leadership and nursing explored: A literature search. Journal of clinical nursing, 27(9-10), 1730-1743.
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