This assignment will focus on a degree level student nurse’s experience of leadership and mentorship, whilst in practice, in the adult field of nursing. The importance of these skills is highlighted by the professional bodies that govern the nursing profession, The Nursing and Midwifery Council’s (NMC) Standards for competence (2004) states that nurses must provide leadership to develop quality services to enhance patients wellbeing and experiences within healthcare settings, while The Royal College of Nursing [RCN] states that a fundamental role of the nurse is to provide both leadership and mentorship (Scrivener, 2014).
Within this assignment I will relate these qualities to my own experiences in practice, I will examine the how learning is facilitated in practice, discuss the effectiveness of the strategies implemented and identify any areas for my own personal development of leadership and mentorship skills. I will also look at professional accountability and its role in the education of nurses and the nursing profession as a whole.
Included as appendices is a personal development plan (PDP) which I have used to address areas for development in my practice and two reflective accounts of my personal experiences of leadership and mentorship during my programme. Throughout this assignment I have used pseudonyms and altered or omitted any identifiable information to protect the confidentiality of anyone mentioned this is in line with the NMC’s Code of Professional standards of practice and behaviour for nurses and midwives (2015).
I have used Gibbs’ (1998) model of reflection to guide the reflections included as appendices, I chose this model as it is one I am familiar using and feel it suits the task given more comfortably than other models available. In his 2008 report High Quality Care for All Lord Darzi wrote that effective leadership is a crucial skill needed to enable the changes necessary to secure the future of the National Health Service (NHS).
Following the public enquiry into issues at the Mid-Staffordshire trust, which cited poor leadership in all levels of the organisation as a major contributing factor in the failings, the RCN in agreement with the findings called for nurses to be placed in leadership roles in all levels of the NHS (2013). A 2012 report by the Kings Fund also recommends nursing staff become more involved in leadership, citing that nursing involvement has been shown to improve not only patient’s outcomes but also business outcomes.
The NHS has introduced a leadership academy to train staff to perform leadership roles within the organisation and also developed a healthcare leadership model to guide staff in leadership roles. There is no clear definition of leadership, as it means something slightly different to each individual (Sinha et al, 2015), many have attempted to define it however these are so varied that one single definition is difficult to pinpoint (Owens and Patton, 2003).
There are however common themes to be drawn out of the literature pertaining to leadership, Northouse (2013) writes that there are two types of leader, ‘assigned leaders and ’emergent’ leaders, assigned leaders being a person who is appointed leader due to their role or position whereas and emergent leader is a person who becomes or is perceived by others as a leader based on their behaviour and personality.
Leadership and management are often viewed as one and the same, however Northouse (2013) describes leadership as a continuous process developed by both leader and followers, whereas The Oxford English Dictionary (ND) defines management as ‘the process of dealing with or controlling things or people’ when applying this definition to management in nursing it could be argued that this perceived control could lead to a poor view of management within the workforce (SEE APPENDIX), whereas an emergent leader might be viewed in a ore favourable light, this is supported by Kotter (1990) who wrote that despite some concurring themes, there are major differences between leadership and management, as he argues the role of management is to give direction and order where leadership aims to bring about changes through partnership and inspiration, the NMC’s (2004) view on leadership seems to agree with this, as they call for all nurses to act as ‘agents of change’ working to bring about better outcomes for patients. There are several models of leadership.
Burns (2003) writes that more modern theories tend to have a greater focus on the ‘transformational model, where a partnership between leader and followers is created, this form of leadership is now being integrated into the NHS with the introduction of the NHS’S leadership academy, which has produced the Healthcare Leadership Model (2013) which sets out nine ‘dimensions’ of leadership behaviour for all NHS staff to improve the leadership skills of all and make others aware of what good leadership should be.
This was produced in response to a Kings Fund 2013 review of the Francis Report (Mid Staffordshire NHS Foundation Trust Public Inquiry, 2013), which found that the authoritarian leadership within the trust had created a ‘blame culture’ which left staff afraid of the consequences of reporting mistakes or whistleblowing.
The literature around leadership styles in nursing following the Francis Report is extensive and the is a general conclusion that nurses, whose leaders use empowerment strategies, are seen to be open and honest and engage their staff in decision making, perform better, deliver safer practice and bring improved patient outcomes (West, 2013, MacPhee, Skelton-Green, Bouthillette, & Suryaprakash, 2012, Laschinger, 2013).
There are many theories pertaining to leadership and management particularly leadership styles, seminal work in this field conducted by psychologist Kurt Lewin in 1939, highlighted three leadership styles, these are, authoritarian, democratic and laissez-faire, he found that an autocratic leader shows power over their staff taking all ecisions out of their hands, where a democratic leader will build partnerships with staff to make decisions and a laissezfaire leader leaves their staff to make their own decisions independently (Saarikoski et al, 2007), many studies have followed this work and built on the idea of these styles of leadership and it is the general consensus that the most effective style of leadership is very much dependent on the circumstance and leaders must be able to adapt their style to the task(Leyshon, 2005), as a leader can quickly alienate staff by becoming an ineffective leader, leading to poor outcomes for everyone involved(Bally, 2007).
Marquis & Huston (2009) write that one model of leadership will never be compatible with every personality or situation, leaders should be knowledgeable of models and theories so they are equipped to adapt to many leadership situations.
Certain personality traits have been identified as helping to make an effective leader, Northouse (2013) wrote that traits including self-confidence/belief, intelligence and integrity are present in many who a viewed as effective leaders, this is supported by Belbin (2010) who concluded that the presence of such traits can indicate how successful a person may be as a leader. However these studies pertain to the business world and although they are somewhat transferable, the main aim of the NHS is to deliver the best outcomes for patients (Department of Health, 2013).
There is an element of business management in the NHS as it is a large corporation which needs to use its funds wisely and in this current economic climate the pressure is higher than ever to save money where ever possible, for managers this means carefully looking at stock usage and encouraging staff to take an interest in the budget of the department and where the biggest expenses lie, I have seen this first hand in practice causing frustration as staff feel their job is stressful enough without worrying about how much is spent on the equipment they use.
When reflecting on my own experience of leadership and management it is quite daunting that in just a few months I will be expected to act as a leader and mentor, having started university straight from college with very little experience in healthcare, the past three years has been a huge learning curve and the experiences I have had have made me acutely aware of the importance of good leadership and management. I hope that going forward my theoretical knowledge and practical experience not only as a student nurse but also my part time roles will help me to become an effective leader as I progress through my career.