Answer

Leadership in Nursing Team

            The leadership concept is significant to the profession of nursing. It is fundamental that nurses should establish an effective leadership role focused on delivering quality care with an aim of engaging in vast leadership roles implemented daily in nursing practice. Over the past few decades, nurses have increasingly adopted bigger responsibilities in the nursing profession. As the nurses’ role transforms from that of a doctor’s assistant to a fundamental person within with life-saving team, the role of the nurse leader emerged. According to Choi, Kim and Kim (2018), it is the duty of the nurse leader to offer guidance to the nurses to ensure that they adhere to the increased safety and quality standards. The primary focus of this paper is to provide a critical analysis of the leadership role of the registered nurse within a nursing team. This analysis will be founded on a shift change case study involving several nurses nursing professionals with different experience in the clinical practice.

Analysis of the Clinical Scenario

Leadership Role of the Registered Nurse (RN)

            Little, Wagner and Boal (2018) show that nursing leadership plays a fundamental role in the immediate lives of the nurses and it has an effect of the whole health systems and the people.  An RN nurse leader has an effective role to play. For instance, the nurse leader is accountable and responsible for the daily operations of the healthcare facility. The role of the nurse leader can include aspects such as resource management and allocation, risk management, patient safety, financial accountability, and employee development among others (Little, Wagner and Boal, 2018). Nurse leaders are also expected to offer direction, guidance and inspiration to other nurses and health providers. Additionally, the nurse leaders influence and supervise the professional practice of the largest number of frontline managers and care providers within the nursing profession (Little, Wagner and Boal, 2018).

            Looking at the roles attached to nurse leaders, it is evident that this group of health professionals have a great opportunity of instilling the principles of professional nursing within the nursing workforce. Little, Wagner and Boal (2018) further provide that nurse leaders also act as expert knowledge brokers. The leaders translate the organizational policy directives into action at the forefront of the health care while also bringing the information about the health care delivery and practice requirements to the persons available at the senior management with an aim of informing the organisational policy (Anders & Hollister, 2017). In this role, the nurse managers serve as an essential intermediary. Without the nurse leaders, the knowledge transaction of the organisational directives would not take place (Little, Wagner and Boal, 2018).

            In the case study, it is evident that the team leader has an effective role to play in observing patient safety. This is reflected by the fact that Nickie took part in an investigative process after a loud bang was heard in one of the wards. After assessing the case of the patient fall, it is evident that the team leader advises that the patient should not be moved until when the doctor assesses her condition. This suggests that the nurse leader plays the fundamental role of offering guidance and direction to the other nurses with an aim of upholding the safety of the patient and inspiring the other members of the team.

Registered nurse leadership role & responsibilities of prioritising care, delegation and supervision in a nursing team

            The standards of practice provided for the registered nurses plays an effective role in outlining the duties and responsibilities of the nurses in prioritizing care. According to the “Royal College of Nursing” (2017), registered nurse leaders should have effective skills of thinking critically and analysing nursing practice to make a sound judgement of when and where care should be administered for an effective outcome. The RN leaders should also engage in therapeutic and professional association with the peers, patients and their families to ensure an effective care delivery. The RN standard also guides that the RN leaders have the role of maintaining the capability for practice. The nurse leaders should also strive to deliver quality care by engaging in comprehensive forms of assessment to diagnose the need and urgency of care for desirable patient outcomes. The nurse leaders also have a role to play in providing responsive and appropriate quality nursing practice. Moreover, the nurse leaders are also required to take part in evaluating patient outcomes with an aim of informing nursing practice (“Royal College of Nursing”, 2017).

            Registered Nurses have a legal liability and duty of care to the patient. Therefore, of the RN leader delegates an activity, he/she has a responsibility of ensuring that the activity is effectively delegated. Taking into consideration the provisions of The Nursing and Midwifery Council (NMC) Code (2015), the applicants are advised to ensure that they only delegate tasks and duties that fall within their scope of competence. As a result, they should ensure that they fully understand the instructions required before taking part in the process of delegation. Furthermore, the nurse leaders have a duty of ensuring that everyone in which they delegate the tasks to are supported and supervised. This is mainly focused on guaranteeing that the care provided by the nurses is not only compassionate but also safe to guarantee an effective outcome. The NMC code further guides that for an effective delegation process, registrants should confirm that the outcome of the delegated task meets the mandatory standard requirements as guided under the Code (NMS, 2015).

            During the process of delegation, the nurse leaders should consider several principles which guide the process of decision making. For instance, the delegation should always consider the patient’s best interest. Evidently, the acts of delegation should not be carried out with an aim of saving on time or money. Moreover, the principle also guides that the support worker should have the requisite skills needed to carry out the intervention. This is only ensured if the support worker is adequately trained to offer the recommended intervention. Moreover, other factors such as having clear protocols and guidelines in place which guides the process of delegation should also be considered before making a clinical judgement associated with the process of delegation (“Royal College of Nursing”, 2017).

When it comes to the delegation and supervision in the nursing team, the nurse leader should consider five fundamental factors. Barrow and Sharma (2020) state that delegation is associated with five fundamental components. Responsibility is the first component to be considered. Evidently, the RN leaders have a professional duty of performing the patient care tasks reliably and dependably. The second component is authority. Authority provides an insight into the fact that an individual should be able to complete the assigned duties within a specified role. The authority originates from the firm’s policies, job descriptions and nurse practice acts. Accountability is the final essential component to be considered. This element suggests that the RN leader should be legally liable for his/her actions associated with patient care and any form of task delegation.

The RN leader has a role of supervising the nursing staff within a clinical setting. Lockwood (2019) shows that while supervising other staff, the RN leader should focus on implementing an effective style of leadership which matches the team requirement. For instance, being an autocratic leader will enable the RN leader to maintain the control of the process of decision making by limiting the delegation process or events of consultations with other team members.

NMBA Registered Nurse Standards Application

            Different NMBA Registered Nurse Standards are applicable to the clinical scenario presented in the case study. For instance, the nurses should have a comprehensive approach in place focused on risk management into practice to ensure that the quality and safety of the patients is observed in the future (“The Nursing and Midwifery Board,” 2020). Evidently, different measures can be put in place to reduce instances of patient falls, especially during shift changes to promote patient outcomes. According to the eighth principle which guides the decision making process, it is evident that nurses should consider several factors when making decisions about practice change (“The Nursing and Midwifery Board,” 2020). For instance, contextual support for practice is an aspect that should be considered and evidence for the change implementation. These factors will ensure that only favourable change processes are implemented within the clinical setting to promote patient safety and to reduce instances of patient falls.

Conclusion

            To conclude, nurse leaders have an effective role to play in a clinical setting. Over the year, the nursing role is continually gaining prominence as a result of the importance of the efforts of the professionals in saving lives. Evidently, it is the duty of the RN leader to ensure that the high standards of safety and quality as guided by the RN Code of practice. Not only do the nurse leaders have a responsibility of safeguarding the safety of the patients but also ensuring that they familiarize themselves with the standards and protocols guiding their efforts in the delivery of safe care. Evidently, through shift changes, instances of patient falls appear to be a course of concern in the case study suggesting the need for change. As guided by the NMBA Registered Nurse Standards, the RN leader should ensure that the change process matches the individual needs and the professional standards of practice.