Clinical Leadership In Nursing: A Literature Review

Clinical leadership theory and nursing

The report brings about the discussion on the nursing assignment, which includes the description of the leadership in clinical settings and the related aspects. It has been understood that the health care is delivered by the complex systems, and the processes to any patient in the health care or hospitals, thus it is essential for a clinician to perform their role or function effectively leading to the positive health outcomes. Thus, it defines about the clinician leader who contributes to the effective healthcare system in the economy. Thus, the report in the later part, will include a literature review on the clinical leadership, and the issues identified, and the appropriate recommendations to improve them ensuring patient’s health and wellbeing (Wong, 2015).

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Nursing is a dynamic and the challenging profession that requires the contribution of efforts and higher commitment of the health professionals or doctors in the hospitals. Due to the emergence of the increased complexity, chaos, high rates of change, safety, and quality health issues, and the shortage of the workforce, it has been analysed that the clinical leadership play an effective role in the healthcare settings (Démeh & Rosengren, 2015).

Daly et al., (2014) was of the view, that clinical leadership is important in the healthcare settings to ensure effective treatment and care of the patient. It is significant as it is considered as the important foundation for the good-quality and well-run healthcare services and the systems. It can be described through an example of the New Zealand, which is in a strong position, and exercise effective clinical leadership in their healthcare settings. The authors has described well that clinical leadership is not a single activity, rather it has been linked to a wide range of functions in the healthcare. Firstly, it has been considered as the important requirement of hospital care, including the performance of their systems and processes (Lindenauer et al., 2014). 

Some other functions include the health reform objectives, delivering timely care to the patients, system integrity and efficiency are the vital components of the healthcare system. Nursing is considered as both explicit and implicit to the leaders or leadership in the healthcare settings. One of the major drawback or issue which has been highlighted by the authors in context to the clinical leadership includes that role or function of clinical leadership is considered important only on the part of some health professional groups. Rather it is the combined efforts of all the members of the healthcare team in any hospital. Each and every member in the healthcare team is considered as potential leaders. Thus, for all the clinical leaders, must have all the competence and skills required to attain positive health outcomes (Curtis, Sheerin & de Vries, 2011).

Importance of Clinical leadership in the hospital settings

Mannix, Wilkes & Daily, (2013) was of the view that the clinical nurse leader in an emerging role in the health care settings, which aim to deliver effective care coordination to the patients. The key to healthy, functional, and supportive work environment is effective clinical leadership, for the nurses working in the hospitals, motivating them towards delivering services with their full potential. The authors aim to cover the unexplored attributes or characteristics of the clinical leadership and the issues found throughout their research. They have stated different positive perspectives of the leadership in the clinical scenarios; leadership in the healthcare acts as the catalyst for overcoming the problems in the healthcare. The study was conducted in the hospitals of England or Canada, which revealed about the importance of the clinical leadership, and the implications on the practice of health professionals (Moorley & Chinn, 2016). They identified certain issues, such as workforce shortage, and the incapability of the nurses or professionals in the healthcare; multi-generational workforce issues in the healthcare.  Other issues were also identified amongst the major health-cares in the Canada, included violence in the workplace, that stated about 24-hour nursing care indicates about impatient care in the hospitals. It requires that the hospitals needs to be restructured and redesigned to improve patient health and safety while giving them treatment. Thus, it has been analysed from the research conducted that leaders in a healthcare are crucial to enhance the patient care outcomes, in the healthcare practices (Cherry & Jacob, 2016).

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According to Joseph &Huber, (2015), clinical leadership in healthcare is termed as the process of influencing the innovation, in medical practice and the improvement in both, procedures of healthcare and the practices adopted for the individual care, to achieve safety and quality of the health service. The researchers have stated that clinical leadership encounters a major challenge, of structuring, the knowledge, skills, and abilities of the nurses in the healthcare so that become able to handle or deal with their roles in the health cares. The term clinical leadership has not been defined yet, but it, is used to describe doctors as leaders, within the health service. The leadership of the doctors, in the healthcare settings is driven by the skills, knowledge, abilities, and the advocacy of the patient interests. Nursing requires numerous skills, and abilities in different situations, some of the skills, such as integrity, emotional intelligence, respect, mentorship, advocacy skills, interpersonal and motivational skills, are necessary while delivering care to the patient (Busse, Aboneh & Tefera, 2014).

Attributes to Clinical Leadership in Contemporary Nursing: An integrative review

To discuss the relevance of the research findings, from the above description in the mentioned articles, it has been understood that nursing is a practice discipline, and the scholarships, must be predominantly based on clinical scholarships. Husebo & Akerjordet, (2016), was of the view that nursing development, can be enhanced through improved education and training facilities to the people/staff in the healthcare organisations. Thus, an affordable care act has been introduced which has elevated the roles of nurse or clinical nurse leaders in the healthcare, leading to increased patient safety during their treatment. Relevance of the research from the perspectives of different authors, and articles has well stated about the emerging nurses in the healthcare, stating that clinical leadership ensures patient safety, health, improves communication, and brings clarity in the roles of nurses, in the hospitals (Stanley & Stanley, 2018). As the change has been so rapid in the healthcare systems, and treatment of the patients, therefore matching development and education is necessary for the nurses and other staff working in the hospitals. Innovation and interdependency has been found as the core concepts providing an opportunity that encourages health professionals to develop the clinical leadership and provide education, which will foster student nurses to become future registered nurses or senior nurses in the health-care in an appropriate manner (Mianda & Voce, 2017).

After discussing about the meaning, attributes, and importance of clinical leadership in context to the healthcare settings in different regions or countries, a number of has been identified as the major contributors. Workplace environment, competency of the nurse leader, and the other staff, complexity of the job, which leads to the increasing turnover in the health practices, describes about the nursing problems. The limitations of the study included, that the qualitative research on the study of the hospitals in different regions, was done on a small number of patients, which would help the practitioners or the government institutions to take any steps towards ensuring improvement in healthcare practices. The other limitation was the absence of the system in the healthcare which would assess the competence of the nurses or health profession to introduce new methods or trends of ensuring effective patient care in the hospitals (Mannix, Wilkes & Jackson, 2013).

From the discussion of the clinical leadership in nursing or healthcare practices, described in the above articles it has been recommended that the nurse leaders in the healthcare must become aware of the nurse’s concerns related to wrongdoing, or any issues in their practices. In addition, they must create a mechanism to ensure that the feedback is taken from them timely. In healthcare settings, there must be studies conducted to analyse the impact or influence of clinical leadership, on the nurse’s job-satisfaction and their commitment towards achieving health outcomes. A study must be made on a wider population, in all the hospitals, regarding the positive role of leaders or leadership, and health professionals must practice considering the equality, and for the sound health of their patient, maintaining a healthy work-environment, and sound relationship with nurses or nurse leaders in the hospitals (Brown, Crookes & Dewing, 2016).  

Clinical leadership development and education for nurses: prospects and opportunities

Conclusion

To conclude the above discussion, on the nursing assignment it has been analysed that nursing involves complex duties, roles, and responsibilities to enhance patient care and safety in the healthcare. The above report discussed the meaning, significance of the clinical leadership in healthcare or nursing practices. Clinical leadership defined and structured the roles of clinical nurses in the healthcare, and ensures attainment of the goals and objectives in the healthcare. Hence, the report stated the aspect of leadership in clinical settings, and the issues and recommendations for the learning, education and the opportunities for the nurse leaders in the future.

References

Brown, A., Crookes, P. & Dewing, J. (2016). Clinical leadership development in a pre-registration nursing curriculum: what the profession has to say about it. Nurse-education today, 36, 105-111.

Busse, H., Aboneh, E. A. & Tefera, G. (2014). Learning from developing countries in strengthening health systems: an evaluation of personal and professional impact among global health volunteers at Addis Ababa University’s Tikur Anbessa Specialized Hospital (Ethiopia). Globalization and health, 10(1), 64.

Cherry, B. & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. United States: Elsevier Health Sciences.

Curtis, E. A., Sheerin, F. K. & de Vries, J. (2011). Developing leadership in nursing: the impact of education and training. British Journal of Nursing, 20(6), 344-352.

Daly, J., Jackson, D., Mannix, J., Davidson, P. M. & Hutchinson, M. (2014). The importance of clinical leadership in the hospital setting. Journal of Healthcare Leadership, 6, 75-83.

Démeh, W. & Rosengren, K. (2015). The visualisation of clinical leadership in the content of nursing education—a qualitative study of nursing students’ experiences. Nurse education today, 35(7), 888-893.

Husebø, S. E. & Akerjordet, K. (2016). Quantitative systematic review of multi?professional teamwork and leadership training to optimize patient outcomes in acute hospital settings. Journal of advanced nursing,  72(12), 2980-3000.

Joseph, M. L. & Huber, D. L. (2015). Clinical leadership development and education for nurses: prospects and opportunities. Journal of healthcare leadership, 7, 55, 55-64.

Lindenauer, P. K., Lagu, T., Ross, J. S., Pekow, P. S., Shatz, A., Hannon, N. & Benjamin, E. M. (2014). Attitudes of hospital leaders toward publicly reported measures of health care quality. JAMA internal medicine, 174(12), 1904-1911.

Mannix, J., Wilkes, L. & Daly, J. (2013). Attributes of clinical leadership in contemporary nursing: an integrative review. Contemporary Nurse, 45(1), 10-21.

Mannix, J., Wilkes, L. & Jackson, D. (2013). Marking out the clinical expert/clinical leader/clinical scholar: perspectives from nurses in the clinical arena. BMC nursing,  12(1), 12.

Mianda, S.  & Voce, A. S. (2017). Conceptualizations of clinical leadership: a review of the literature. Journal of healthcare leadership, 9, 79.

Moorley, C. &  Chinn, T. (2016). Developing nursing leadership in social media. Journal of advanced nursing, 72(3),  514-520.

Stanley, D.  & Stanley, K. (2018). Clinical leadership and nursing explored: A literature search. Journal of clinical nursing, 27(9-10), 1730-1743.

Wong, C. A. (2015). Connecting nursing leadership and patient outcomes: state of the science. Journal of Nursing Management, 23(3), 275-278.

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