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Reflection on leadership

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Reflection on leadership

 Reflection on leadership

Assessment 2: Reflection on leadership

I recently attended a clinical placement on a paediatric oncology ward. I was buddied with a Registered Nurse and together we were looking after a 10-year-old child with a relapsed neuroblastoma. The patients mother had asked me if the patient could have pain relief as the patient was experiencing severe pain throughout her legs and pelvic area. I immediately asked my Registered Nurse if we could administer PRN analgesia as this patient described her pain as 8/10. The Registered Nurse responded to me by saying “I have other things to do, the patient can wait. She is not in that much pain”. I questioned the Registered Nurse and alerted her that I had conducted a pain assessment and the patient was experiencing severe pain. However, the Registered Nurse continued to state,“The patient can wait- you can tell them that”. I then followed this up with the patient and her mother by apologising for the delay and informed that I will do my best to ensure the medication is administered shortly. Time passed and I repeated to the Registered Nurse that the patient was still in pain to which she raised her voice and replied, “Okay! I will get it now then”, angrily walking away. This was evidently a negative episode of leadership and mentorship, which was quite distressing for the patient, her mother and I.

During this episode Ifelt uncomfortable, distressed and anxious. I felt sadness for the patient and her mother as this was a very emotional and traumatic admission for them and it was distressing for them both that the patient was in pain. I felt stressed, as I did not know how I could approach the Registered Nurse, who made me feel inadequate and more so in the way. This was very disheartening, as I believe pain management should be prioritised and nursing staff should acknowledge requests of patients and their families. After this experience I felt unheard, ignored and discouraged due to the words and actions of the Registered Nurse.

Unfortunately, I can only identify negative aspects of this experience. I believe the Registered Nurse demonstrated poor communication skills, was discourteous and unprofessional in her approach to the situation. I felt that my attempt of advocating for my patient was ignored and discouraged. This was also negative for the patient who continued to experience pain and felt disregarded. Additionally, the Registered Nurses mentorship skills were negative in that she did not show active listening, respect or support towards me. To demonstrate good leadership skills is to listen to the team members, acknowledge concerns and problem-solve, which the Registered Nurse failed to do.

Poor leadership skills in nursing may have a detrimental effect on patient outcomes, evident in this case. This may involve poor communication and a culture of poor care (Daly et al 2013). In order for a leader to effectively demonstrate leadership skills, they must show support and acknowledgement to their team and listen to opinions and concerns. Interestingly, a recent Australian study found that student nurses seek support, approachability, motivation and effective communication skills from their buddied Registered Nurse, which unfortunately was not demonstrated in this case (Daly et al 2013). Evidence shows that poor leaders produce poor care-which can stem from burnout, job dissatisfaction, poor management and increased stress (Scully 2013). The Registered Nurse also demonstrated poor mentorship skills through discouragement, ignoring concerns, impolite communication and lack of support. This is evident among many student nurse experiences’ on clinical placements with a common theme evolving of being ‘just a student’ (Bickhoff et al 2014). Often, poor mentorship skills can be resultant from Registered Nurses experiencing insufficient time, lack of experience, pressure, lack of support from senior nursing staff and burnout. This could be due to the evidence that paediatric oncology nurses suffer high rates of anxiety, stress, emotional exhaustion and burnout, which may result in poor mentorship skills (Zander et al 2013). Although it was a negative experience, it is important to reflect and analyse the situation in order to understand, gain insight and learn valuable lessons for future nursing practice.

From this experience, I have been able to acknowledge positive and negative attributes and skills of leadership and mentorship. This has showed me that a good leader must be someone who acknowledges, listens to and works effectively with his or her team members. Good leadership skills prove to result in higher rates of job satisfaction and a more cooperative, effective and encouraging team (Middleton 2011). I have also acknowledged the importance of advocating for patients and standing up for what I believe is right and fair in order to prevent harm to my patients. There is an unfortunate common theme of student nurses viewing themselves as ‘just students’. This stigma has stemmed from poor mentors demonstrating discouragement, poor communicating skills and lack of effort in supporting students- this is another lesson I have learnt from this experience (Bickhoff et al 2014). These behaviours and actions that dishearten students is what I experienced on this clinical placement and hope to never have this negative impact on someone else. 

From this experience, I have learnt the importance of mentorship in nursing, and the impact it has on students and their confidence. 1. In future as a Registered Nurse, I will take the time to listen to my students concerns and questions and allow them to feel heard and acknowledged. It is important for students to feel able to voice their opinions and advocate for their patients. Studies show that student nurses have a strong sense of responsibility in advocating for their patient, therefore by allowing students the moral courage to challenge and question nursing care is an important attribute in nursing, that their mentors should encourage (Bickhoff et al 2014). 2. In future as a Registered Nurse, I will ensure that I demonstrate effective, professional and thoughtful communication skills to student nurses and staff members. Effective communication is imperative in patient care and can have a profound impact on job satisfaction, teamwork and confidence (Amos et al 2005). I will ensure that student nurses feel comfortable, encouraged and supported through my choice of words, tone and approach in communication- qualities that many student nurses seek and appreciate when being mentored (Bickhoff et al 2014).

References

Daly, J., Jackson, D., Manix, J., Davidson, P., Hutchinson, M., 2013, ‘The Importance of Clinical Leadership in the Hospital Setting’, Journal of Healthcare Leadership, vol. 2014, no. 6, pp. 75-83

Scully, N., 2013, ‘Leadership in Nursing: The importance of recognising inherent values and attributes to secure a positive future for the profession’, Elsevier, vol. 2015, no. 22, pp. 439-444

Bickhoff, L., Sinclair, P., Levett-Jones, T., 2014, ‘Moral courage in undergraduate nursing students: A literature review’, Elsevier, vol. 2017, no. 24, pp. 71-83

Zander, M., Hutton, A., King, L., 2013, ‘Exploring Resilience in Paediatric Oncology Staff’, National Library of Medicine, vol. 2013, no. 20, pp. 17-25



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