Clinical Leadership Journey... Destination Pat McCluskey Advanced Nurse Practitioner (Wound Care) Cork University Hospital Group
Clinical Leadership...Definition...one who possesses clinical expertise in a speciality practice area and who uses interpersonal skills to enable nurses and other healthcare providers to deliver quality patient care (Harper, 1995) Clinical leaders provide vision to their followers and empower others...is an expert nurse who leads their followers to better health and health care (Lett, 2002)...a nurse directly involved in providing clinical care that continuously improves care through influencing others (Cook, 2001b)...a clinician who is an expert in their field and who because they are approachable, effective communicators and empowered, are able to act as a role model, motivating others by matching their values and beliefs about nursing and care to their practice (Stanley, 2006)
Clinical Leadership Pilot Evaluation Report (NMPDU, 2008) The Clinical Leadership Programme provided an ability to work with clinicians in the development of skills and knowledge that enables Nurses and Midwives to be empowered and to contribute to improvements in patient or client outcomes. The theoretical framework (Cunningham and Kitson 2000) supporting the programme was focused on: Learning to self manage Developing effective relationships Patient focus Networking Political Awareness Action Learning...Patient /Client Focus
Clinical Leadership...The Literature Transformational Leadership (Bowles & Bowles, 2000, U.K.) This style of leadership has been commended as highly effective and suitable for nursing. Leadership is an interpersonal relationship of influence, the product of personal characteristics rather than mere occupation of managerial positions. It is these personal characteristics which attract, enthuse, motivate followers towards organisational goals, the main aim of nurse leaders is then to maintain and improve patient care via a cohesive workforce (Malby 1997) Interpersonal communication, mutuality, affiliation & empowerment... Australia ( Davidson et al, 2006) Transactional... Transformational Attributes: Expert clinical skills, patient-focus, vision, stamina, innovation, dynamism, confidence, selflessness, assertiveness and collaboration, political/organisational awareness Expert clinical practice remains the foundation of nursing professionally and philosophically and is the currency with which nurses negotiate and engage with other health professionals...clinical practice informed by nursing science is...foundation of clinical practice.
Clinical Leadership...The Literature Australia: The importance of effective clinical leadership in ensuring a high quality health care system that consistently provides safe and efficient care has been reiterated in the scholarly literature and in various government reports... (Daly, Jackson et al, 2014) Difficult to define, effective clinical leadership...easier to consider what constitutes ineffective clinical leadership... Avoidant (placating, equivocal, hostile) Characteristics/Qualities/Attributes: Advocacy skills, ability to affect change, credible, clinical competence, supportive, excellent communicators, positive attitude towards their own profession, courage and capacity to challenge the status quo, effectively address care quality issues and engage in reflective practice (Jackson et al, 2013) Expertise, direct involvement in patient care, high level of interpersonal and motivational skills, commitment to quality practice and empowerment of others (Stanley, 2006) Clinical credibility and the capacity for collaboration...
Clinical Leadership...The Literature Congruent Leadership (Stanley, 2006)...where the values and beliefs match the leader s actions, deeds and involvement in care. Congruent leaders, commonly fill no formal, structured leadership role. Characteristics: Motivational, Inspirational Approachable, Open Actions based on and match values & beliefs About where you stand (principles) Effective communicator Visible (vs. visionary) Empowerment
Clinical Leadership... (Daly et al, 2014) Barriers Fiscal efficiency Structural Cultural Lack of incentives Lack of confidence..etc... Clinical vs. Administrative...could lead to devolution of responsibility to clinicians who are unprepared & under resourced for their roles Facilitators Behaviours Altruism Courtesy Conscientiousness Civic virtue i.e. Helping those with a heavier workload, giving of one s time to help others...
Registered Nurse to Advanced Nurse Practitioner Leadership in Context Question: Am I a Clinical Nurse Leader? Reflections... The Swab story The Dressing Clinic in 1989...1990... Treating your place of work as your own kitchen...!
The Journey
The Philosophy...Personal...Work in Progress Altruism...(degrees of...) Resilience Persistence Collegiality Fun and Fate Work/Life Balance/Creativity Self awareness Honesty Healthy balance of Self Vs Other centeredness Responsibility and accountability Courage Work Ethic: Give it your best Love what you do Knowledge & sharing of... Emotional Intelligence Do no Harm Be the best you can be Professional & Personal Development Putting things down...and away...not lying in the long grass Don t take it personally...it usually isn t
Influences Values Beliefs Work hard...vs...entitlement Role Models Education...knowledge...application Mistakes or learning opportunities?
Recent Influence NMPDU conference on Clinical Decision Making Motivational Speaker: 3 Key Points: Spectator...Vs... Competitor Optimist...Vs...Realist (Hope & Acceptance) Collaborator...Vs...Soloist
The Journey... One step at a time Stop & Enjoy each mini ladder achievement. Practice & Application of each new learning, until it becomes second nature Snakes & Setbacks: Learning opportunities We don t always have to be going somewhere...
Staff Nurse... CNS... ANP Many of the same qualities/attributes/characteristics Patient Focus Patient care...wounds and holistic care Evidence based practice within the current organisational structures...making the most of what we have & using resources to maximise patient experiences and outcomes Additional Policy/Guidelines: Fight or Flight New initiatives Expert witness Education
The Bigger Question...is not am I a Clinical Nurse Leader but rather am I an effective Clinical Nurse Leader?...sometimes but not always Have I arrived at my destination?...the journey goes on and on and on...hopefully and does it really matter whether we arrive there in a short time or over many years?...i think not! It really is all about the quality of that journey, the people we meet, the care and compassion we deliver & receive in the circumstances we find ourselves in!
Enjoy the Journey, Risk being a Realistic competitor & collaborator!!! Thank you