This assignment is based on a critical incident experienced by a student nurse while working with a charge nurse in a surgical ward at a
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Title: Leading and Managing Nursing Care Introduction This assignment is based on a critical incident experienced by a student nurse while working with a charge nurse in a surgical ward at a London hospital. A detailed description of the incident is provided in appendix A. A critical incident can be described as an event that creates an emotional impact (Ghaye and Lillyman 1999). The incident took place in a 27 bedded surgical ward. The ward is staffed by a charge nurse, twelve nurses, four healthcare assistants, a ward clerk and three domestics. In writing up this assignment I will use both the first person and third person in the pursuit of reflexivity (Webb 1992). The reflective cycle (Gibbs 1988). Pseudonyms will be used to maintain anonymity and confidentiality in accordance with clause five of the nursing and midwifery council (NMC) Code of Professional Conduct (NMC 2002). I will also explore leadership and management concepts relating to the critical incident and an action plan to facilitate and change will be presented. My rationale for choosing this incident is because it involves interpersonal skills and management style. Interpersonal skills include leadership, motivation, problem solving, managing change, negotiation skills and communication and listening skills (McCall and Cousins 1990; Hargie et al 1994; Elllis and Hartly 2005). Furthermore, communicating effectively is essential to nursing practice.
In providing hands on nursing care Edward will have a detailed knowledge of all the patients in the ward and this could make him a more effective ward manager (Douglass 1992; Iles 1997). Another explanation could be that as a registered nurse Edward needed to maintain his professional knowledge and competence by providing nursing care to patients. This is in accordance with clause 6 of the Nursing and Midwifery Council Code of Professional Conduct (NMC 2002). Edward accepted constructive criticism from the ward's matron. Being able to accept constructive criticism is one of the characteristics of a good manager (Sullivan and Decker 1997). The importance of the topic in question (communication and record keeping) could have also contributed to Edwards's acceptance of the Matron's criticisms. The standard of nurse's record keeping now has a direct effect on the star ratings awarded to NHS hospital trusts (Cooper 2003). Edward demonstrated democratic leadership quality by encouraging maximum participation and discussion within the ward staff (O'Connor 1994; Tomey 2000). Research studies have concluded that allowing staff to participate in decision making increases job satisfaction and productivity (Lucas 1991; Volk and Lucas 1991; Morey 1996; Comack et al 1991). Edward did not plan a teaching session for this shift but was able to quickly organise one. This emphasises what Ellis and Hartley (2005)
was poor in the ward and that this was unacceptable. Edward acknowledged the criticisms and promised immediate action to improve record keeping and communication in the ward. Edward later spoke to the entire ward's staff in turns asking for their opinions on how to improve the ward's record keeping and communication. In addition Edward also gave a lecture to students on good record keeping and communications in the ward environment and then went to the canteen for lunch. On my return to the ward after the lecture on communication there was an argument going on between an elderly patient (Mrs Johnson) and Lucy (an adaptation nurse). Other patients also appeared to be listening. Mrs Johnson complained that Lucy did not explain to her what the injection was about. She also wanted to know the possible side effects. According to Mrs Johnson Lucy gave her the injection without any explanation. She was also not happy with the way the injection was administered. She appeared angry and agitated. I stood there looking at them arguing until Edward came back from lunch. Edward called Lucy to the other side of the bay away from the patient, praised her overall past nursing performance and then suggested that she attend a communication study day to which she agreed. Edward then went ton to see Mrs Johnson and keenly listened to all she had to say. He then promised her that he will observe and supervise Lucy during the administration of her next injection. Mrs Johnson smiled and thanked Edward.
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