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This essay explores how the nursing profession has evolved since Florence Nightingale and how any change in the direction of n

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This essay explores how the nursing profession has evolved since Nightingale and to understand how quality patient care today, requires effective leadership rather than autocratic management. Nurse managers still perform a valuable function; however, management activities are thought to compliment rather than replace the leadership role. As the nursing profession has evolved, nurses have adapted and developed skills that are complimentary for the society and times they are functioning in. One example of this has been the development of competency standards for the registered nurse [Australian Nursing Council (ANC) 2002]. Modern health care settings are complex and the registered nurse's ability to perform a multitude of roles and responsibilities requires highly developed skills in decision making, critical thinking, and adherence to professional, ethical, moral and legal standards. In addition to these skills, leadership and management abilities are considered essential for professional practice; all are included in the ANC National Competency Standards (ANC 2002) and are required for competent practice. The ability of registered nurses to be effective leaders will impact on staff, resources, and the setting and achieving of goals. This will, in turn, have implications for the quality of patient care. I examined the role of the registered nurse to understand how practise and client safety can be maintained by adhering to competency standards. In addition, transformational leadership was examined to understand how this style of leadership functions and to determine how it could benefit the nursing profession. Professional competencies and transformational leadership theories were then combined to reflect on a scenario to see how, when used together, an improved outcome could be achieved for all involved, especially the client. . Transformational Leadership could be one answer to the question; How do you transform organisations or the staff within them to work in a more effective or efficient fashion? Those who support transformational leadership believe it to be much more than a passing fad. ...read more.


As a student registered nurse we are taught that with a positive attitude we can see ourselves as part of the solution to making the workplace one in which the experiences for staff and patients are positive ones. This appears to be a very tall order! Transformational leadership offers us some strategies in the hope that we will be able to achieve this goal. Reflections on a practice situation: What might have been different if a 'transformational' leadership style could have been accessed? I will be looking at my first and only clinical experience thus far to reflect on a time when I believe the qualities and theories of transformational leadership may have proved valuable. This my first I wanted to explore how transformational leadership skills could enhance life in a real clinical setting. I will identify the registered nurse I spoke to as A.C. A.C had been a registered nurse for 3 years working in a busy public hospital in many different wards including, A&E, gerontic, medical and surgical. She decided to further enhance her skills by undertaking a post-graduate course in mental health nursing (psychiatric in those days). This was undertaken at another large public hospital that provided care solely for mental health clients. The course involved 18 months of clinical practice interspaced with study blocks. The particular episode we discussed and that A.C. remembers clearly due to its less than satisfactory outcome for her and the patient, involved an elderly man in his 80's whom we will call Mr J. He had had been admitted to a very busy acute admissions ward in the hospital. He was diagnosed with dementia and A.C had been given the responsibility of his admission. This involved a nursing assessment and routine observations. During this time his wife with whom he lived with at home and usually managed his behaviour well (even though she herself was in her 70's) ...read more.


2002 National Nursing Competency Standards for the Registered Nurse and Enrolled Nurse, 3rd edn. 2000 (online accessed October 5th 2003) URL: http://www.anci.org.au/competencystandards.htm Chambers N 2002 Nursing leadership: the time has come to just do it. Journal of Nursing Management 10: 127 -128 Cook MJ 2001 The renaissance of clinical leadership. International Nursing Review 48:38-46 Dingwell R Allen D 2001 The Implications of Health Care Reform for the Profession of Nursing. Nursing Enquiry 8(2): 64-74 Faugier J & Woolnough H 2002 Valuing 'voices from below '. Journal of Nursing Management 10: 315-320 Fedoruk M, & Pincombe J 2000 The nurse executive: challenges for the 21st century, Journal of Nursing Management, Vol. 8:13-20 Huber D 2000 Leadership and Nursing Care Management, 2nd edn, WB Saunders, Philadelphia: ch 5 Inouye SK, & Charpentier PA 1996 Precipitating factors for delirium in hospitalized elderly persons: Predictive model and interrelationship with baseline vulnerability. Journal of American Medical Association 275(11), March 20: 852-857 Mair J 2000 An introduction to legal aspects of nursing practice. In: Daly J, Speedy S, & Jackson D (eds) Contexts of nursing: An introduction, MacLennan and Petty, Eastgardens: Ch 10 McCallin A 2003 Interdisciplinary team leadership: a revisionist approach for an old problem? Journal of Nursing Management 11:364 -370 Olofsson B, Bengtsson C, & Brinke E 2003 Absence of response: a study of nurses' experience of stress in the workplace. Journal of Nursing Management 11, 351-358 Sofarelli & Brown 1998 The need for nursing leadership in uncertain times. Journal of Nursing Management 6( 4): 201-207 Stordeur S, D'hoore W, & Vandenberghe C 2001 Leadership, organizational stress, and emotional exhaustion among hospital nursing staff. Journal of Advanced Nursing 35(4): 533-542 Thyer GL 2003 Dare to be different: transformational leadership may hold the key to reducing the nursing shortage. Journal of Nursing Management 11, 73-79 Wieck KL & Evans ML 2003 Developing the role of leader. In: Yoder-Wise Patricia S (eds) Leading and Managing in Nursing. 3rd edn, St. Louis, Mosby: ch. 2 ?? ?? ?? ?? 1 ...read more.

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