Respond on two different days by explaining how the leadership skills they described may impact your organization or your personal leadership, or by identifying challenges you see in applying the skills described.

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A healthy atmosphere and morale in the workplace are essential to provide the best possible experience for employees. Quality leadership is a result of the hard work an individual has done to establish personal and professional goals. They have a passion for leading people and helping the staff to grow.  In this post, I will discuss insights from transformational leadership and the role of emotional intelligence in the workplace.

Transformational Leadership and Emotional Intelligence

 The hallmark of transformational leadership is the ability of the leader to inspire workers by acknowledging the beliefs, values, attitudes, and motivations of their workers (Wang, Tao, Bowers, Brown & Zhang, 2018).  Transformational leadership is associated with a decrease in the number of nurse turnovers rates due to job satisfaction and healthy well-being (Wang, Tao, Bowers, Brown & Zhang, 2018). This type of leadership also improves patient satisfaction and reduction in nursing errors.  As a transformational leader with emotional intelligence, it is possible to engage staff by providing employee empowerment, strategy, innovation, and opportunity (Holmwood, 2019). What is the key to transformational leadership? Research is stating emotional intelligence.

 Emotional intelligence is “the ability to perceive, understand, manage, and use emotions in self and others, comprises a key factor in interpersonal relationships that are inherent in actualizing leadership, communication, and teamwork in healthcare” (Cox, 2018, p. 649).  Emotional intelligence is also a “measure of how we challenge ourselves to collaborate, how we employ our curiosity to dig into conversations, are centered and positively engaged in our world, and are accepting of our surroundings” (Holmwood, 2019). Transformational leadership, mixed with emotional intelligence establishes an understanding and awareness of how we influence our environment, which leads to a sense of well-being and positive growth.  Leaders are present and show up for their employees. They are authentic and have excellent communication skills (Marshall, 2011).

 In my last job, I had a leader who sought to include everyone and was present.  She planned events just for staff, took time to get to know each employee, and took into consideration employee’s goals and thoughts.  It was not without conflict, but when conflict arose, she would bring them to her office and talk it out. The employees knew she was their cheerleader and trusted her decisions.  The environment was positive, and the employees had friendships outside of work together.

Another example of emotional intelligence in leadership that I experienced was working for a nursing professor. This professor spent time with each student helping them to discover their passions and talents in order to apply them to their current work. She placed us on teams to collaborate and learn from one another. This work experience increased my self-confidence and helped me discover my passion for nursing. 

In contrast, a manager who leads by micro-managing, using punitive discipline, and lacks communication skills can deflate, and individuals purpose for their work. With transformational leadership, there is a sense of trust between the manager and employee, but with authoritarian leadership, the sense of trust is not present. As a leader, finding the balance between leading and serving is challenging, but worth the exploration.

Reference

Cox, K.M. (2018). Use of emotional intelligence to enhance advanced practice registered nursing competencies. Journal of Nursing Education, 57(11). 648-654. doi:/10.3928/01484834-20181022-04

Holmwood, T. (2019). Greater emotional intelligence is your key to superior team performance. Governance Directions, 71(4), 215-218. https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=bth&AN=136273758&site=eds=live&scope=site.

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert to clinician to influential leader (2nd ed.). New York, NY: Springer.

Wang, L., Tao, H., Bowers, B., Brown, R., & Zhang, Y. (2018). When nurse emotional intelligence matters: How transformational leadership influences intent to stay. Journal of Nurse Management, 57(11). 648-654. doi:/10.3928/01484834-20181022-04

 

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Excellent leadership in nursing is likely to pull from different theories according to the job at hand, the team’s needs and the local state of affairs.

There is no simple answer to the complex question of what makes exceptional leadership in nursing, despite the existence of evidence showing that it can have a positive impact on both patient experience and outcomes, and nurse satisfaction and retention. There is some suggestion that the latter then influences the former. However, establishing what makes good nursing leadership is challenging.

A number of leadership theories describe how they can be applied to nursing and how effective they are. What appears is that different approaches are needed according to the goals of the individual leader. One thing is clear: success hinges on good relationships between leaders and their teams.

In the face of ambiguity and complexity, it seems that good leadership is an anomaly and requires careful evaluation. Where there are contradictory findings, it is important to delve deeper to uncover what each different approach has in common.

Historically, leadership studies have been focused on the beliefs and actions of leaders, leaving followers with a passive role and at the of the mercy of those they follow. Recent studies have explored the roles of both leaders and followers, and suggest that it is the nature of the relationship between them, rather than any specific behavior of their leaders, that creates effective leadership.

Hersey and Blanchard (1969) observed that the leader’s actions should be determined by the experience of the team remembering that the behaviors of good leaders are circumstantial rather than permanent. In this model, leaders evaluate the needs of the followers and adjust their actions accordingly.

Haslam et al (2011) suggest that leaders must be an essential part of the team and that their primary role is to create a sense of group uniqueness. The leader must convey what the team dynamics are and why people would want to be part of it, and motivate followers to identify with the group, by fostering a true sense of loyalty.

Uhl-Bien et al (2014) go further, suggesting that the guidance of a team is co-produced with followers and that it depends on their actions toward the leader and the leader’s reaction towards them, in an open network. The idea is that you cannot force leadership and that it must be earned from followers. In this model, there is a distinction between people in positions of authority and leaders, and leadership has to be won rather than assumed.

Avolio, who had worked with Bass on transformational leadership, developed his thinking further into authentic leadership, which emphasizes the leader’s ethics and behavioral integrity (Avolio et al, 2004). This is reflected in Haslam’s model, which requires the leader to lead by example, displaying the team’s values and desired behaviors (Haslam et al, 2011). What these theories have in common is a focus on collegiate relationships that leaders form with, and promote between, other members of the team.

The best and most relative example of exceptional leadership that comes to mind is exemplified by my Walden professors.  The following key leadership skills are routinely exhibited by all of my professors:

· Monitoring and calibrating the team’s workload

· Upholding the Walden Code of Conduct

· Creating a work environment in which all staff feel they can contribute the maximum in a fulfilling way for them

· Creating relationships that build camaraderie

· Ensuring that the team delivers the best use of available resources (Maxwell, 2017)

· Every week each of my professors provides direction, critical updates and other additional tools provided via announcements, feedback is frequently offered on previously completed assignments and/or discussions, individual support is offered through e-mail or the blackboard. Each of us embarked on this course with virtually the same goal in mind, however, the outcome is dependent partially on personal performance, but also the leadership and expertise of those who educate us.

· Nurse leadership is in truth a pragmatic blend of theory and evidence, adapted to the local circumstances, flexible enough to respond to the reactions of the team, and agile enough to deal with the unexpected.

References

Maxwell E (2017) Good leadership in nursing: what is the most effective approach? Nursing Times [online]; 113: 8, 18-21.

Avolio BJ et al (2004) Unlocking the mask: a look at the process by which authentic leaders impact follower attitudes and behaviors. The Leadership Quarterly 15: 6, 801-823.

Haslam SA et al (2011) The New Psychology of Leadership – Identity, Influence and Power. Hove: Psychology Press.

Hersey P, Blanchard K (1969) Life cycle theory of leadership. Training & Development Journal 23(5) 26-34

Herzberg F et al (1959) The Motivation to Work. New York: Wiley. Gerontological Nursing; 1: 3, 217-228.

Laureate Education (Producer). (2014). Leadership [Video file]. Baltimore, MD: Author.

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

Uhl-Bien M et al (2014) Followership theory: a review and research agenda. The Leadership Quarterly; 25: 1, 83-104.

West MA et al (2014) Collective leadership for cultures of high-quality health care. Journal of Organizational Effectiveness: People and Performance; 1: 3, 240-260.

 

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The Assignment

Reflect on the TCN Self-Assessment you completed during Week 2, and determine if your score changed.

• Perform an Internet search, and locate one Global Nursing Opportunity sponsored by a professional organization that utilizes nurses as either paid employees or volunteers. Name the organization, and include a working link. In your own words, share the organization’s mission.
• Share two contributions you could make to the organization (patients served) based on your current experiences and future career aspirations based on your learning from this course.
• Identify personal opportunities for improvement in providing culturally competent care.

 

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Case Study 1 (Inflammatory Bowel Disease)

The patient is an 11-year-old girl who has been complaining of intermittent right lower quadrant pain and diarrhea for the past year. She is small for her age. Her physical examination indicates some mild right lower quadrant tenderness and fullness. 

Studies and Results:

 Hemoglobin (Hgb):  8.6 g/dL (normal: >12 g/dL)

 Hematocrit (Hct):  28% (normal: 31%-43%) 

Vitamin B12 level:  68 pg/mL (normal: 100-700 pg/mL) 

Meckel scan:  No evidence of Meckel diverticulum 

D-Xylose absorption:  60 min: 8 mg/dL (normal: >15-20 mg/dL) 

                                                 120 min: 6 mg/dL (normal: >20 mg/dL) 

Lactose tolerance: No change in glucose level (normal: >20 mg/dL rise in glucose) Small bowel series:  Constriction of multiple segments of the small intestine 

Diagnostic Analysis 

The child’s small bowel series is compatible with Crohn disease of the small intestine. Intestinal absorption is diminished, as indicated by the abnormal D-xylose and lactose tolerance tests. Absorption is so bad that she cannot absorb vitamin B12. As a result, she has vitamin B12 deficiency anemia. She was placed on an aggressive immunosuppressive regimen, and her condition improved significantly. Unfortunately, 2 years later she experienced unremitting obstructive symptoms and required surgery. One year after surgery, her gastrointestinal function was normal, and her anemia had resolved. Her growth status matched her age group. Her absorption tests were normal, as were her B12 levels. Her immunosuppressive drugs were discontinued, and she is doing well. 

Critical Thinking Questions:

1. Why was this patient placed on immunosuppressive therapy? 

2. Why was the Meckel scan ordered for this patient? 

3. What are the clinical differences and treatment options for Ulcerative Colitis and Crohn’s Disease? (always on boards) 

4. What is prognosis for patients with IBD and what are the follow up recommendations for managing disease?  

Case Studies 2  (Urinary Obstruction )

The 57-year-old patient noted urinary hesitancy and a decrease in the force of his urinary stream for several months. Both had progressively become worse. His physical examination was essentially negative except for an enlarged prostate, which was bulky and soft. 

Studies and Results 

Intravenous pyelogram (IVP): Mild indentation of the interior aspect of the bladder, indicating an enlarged prostate.

Uroflowmetry with total voided flow of 225 mL: 8 mL/sec (normal: >12 mL/sec) Cystometry: Resting bladder pressure: 35 cm H2O (normal: <40 cm H2O)  Peak bladder pressure: 50 cm H2O (normal: 40-90 cm H2O).

Electromyography of the pelvic sphincter muscle: Normal resting bladder with a positive tonus limb .

Cystoscopy: Benign prostatic hypertrophy (BPH) 

Prostatic acid phosphatase (PAP): 0.5 units/L (normal: 0.11-0.60 units/L) 

Prostate specific antigen (PSA): 1.0 ng/mL (normal: <4 ng/mL) 

Prostate ultrasound: Diffusely enlarged prostate; no localized tumor 

Diagnostic Analysis 

Because of the patient’s symptoms, bladder outlet obstruction was highly suspected. Physical examination indicated an enlarged prostate. IVP studies corroborated that finding. The reduced urine flow rate indicated an obstruction distal to the urinary bladder. Because the patient was found to have a normal total voided volume, one could not say that the reduced flow rate was the result of an inadequately distended bladder. Rather, the bladder was appropriately distended, yet the flow rate was decreased. This indicated outlet obstruction. The cystogram indicated that the bladder was capable of mounting an effective pressure and was not an atonic bladder compatible with neurologic disease. The tonus limb again indicated the bladder was able to contract. The peak bladder pressure of 50 cm H2O was normal, again indicating appropriate muscular function of the bladder. Based on these studies, the patient was diagnosed with a urinary outlet obstruction. The PAP and PSA indicated benign prostatic hypertrophy (BPH). The ultrasound supported that diagnosis. Cystoscopy documented that finding, and the patient was appropriately treated by transurethral resection of the prostate (TURP). This patient did well postoperatively and had no major problems.  

Critical Thinking Questions 

1. Does BPH predispose this patient to cancer? 

2. Why are patients with BPH at increased risk for urinary tract infections? 

3. What would you expect the patient’s PSA level to be after surgery? 

4. What is the recommended screening guidelines and treatment for BPH? 

5. What are some alternative treatments / natural homeopathic options for treatment?

 

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Key Assignment Final Presentation – Report of Findings to Mr. Magone, CEO, Healing Hands Hospital and the “Future of Healing Hands” Task Force

Continue to use the scenario to assist you with this assignment.    

For this assignment you will be putting together the components from each of the Unit Individual Projects into a presentation. Using your instructor’s feedback and suggestions from each week you will put together a presentation reporting on your findings titled “Future of Healing Hands Task Force Findings”. You will also include an introduction that shares information about Healing Hands and provides background information.  The presentation will be made up of the following 6 sections:

1. Introduction
2. Impact of CMS Regulations and Reimbursement Models
3. Comparison of Healing Hands Hospital to Competitor in the Community
4. The Role of Managed Care and Other Models for Reimbursement
5. Innovations in Healthcare Technology
6. Future of Healing Hands

The section titled “Future of Healing Hands” should include information on future opportunities for Healing Hands based on what you have learned in the previous assignments and will end with a conclusion.
 

For the final paper reference list, be sure to include all of the reference sources from the previous Unit assignments. Document your references using APA format.

 

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