Leadership and Management in Nursing

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Leadership and responsive care: Principle of Nursing Practice H McKenzie C, Manley K (2011) Leadership and responsive care: Principle of Nursing Practice H. Nursing Standard. 25, 35, 35-37. Date of acceptance: February 23 2011.

Summary
This is the final article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare professionals. This article discusses Principle H, the need for leadership among staff and the provision of care that is responsive to individuals’ needs.

Authors
Christine McKenzie, learning and development facilitator, and Kim Manley, formerly lead, Quality, Standards and Innovation Unit, RCN, London. Email: christine.mckenzie@rcn.org.uk

Keywords
Leadership, Principles of Nursing Practice, professional development, quality assurance These keywords are based on subject headings from the British Nursing Index. For author and research article guidelines visit the Nursing Standard home page at www.nursing-standard.co.uk. For related articles visit our online archive and search using the keywords.

THE EIGHTH Principle of Nursing Practice, Principle H, reads: ‘Nurses and nursing staff lead by example develop themselves and other staff, and influence the way care is given in a manner that is open and responds to individual needs.’ Principle H explores the themes of leadership and responsive care in all care settings. This Principle is essential to enable nursing teams to provide care that consistently reflects all of the other Principles of Nursing Practice. Workplace culture and context is established through leadership and this in turn affects patient outcomes and staff wellbeing. NURSING STANDARD

With the major national and local reforms in health and social care currently being implemented, there has never been a better time for nursing to demonstrate its leadership capabilities. The proposals for restructuring health care in England (Department of Health (DH) 2010), and the health directives in Wales, Scotland and Northern Ireland (DH 2009, Scottish Government 2010, Northern Ireland Department of Health, Social Services and Public Safety 2011, Welsh Assembly Government 2011), have the potential to transform the NHS during a climate of economic recession and significant policy change. Organisations need to continue to deliver quality care, nurture innovation and improve productivity. The lynchpin for implementing and sustaining these changes is the quality of leadership in practice. Leadership often has different meanings and there is no single definition. However, there is some consensus that leadership encompasses vision, passion and the desire to meet challenges (Bishop 2009). Rosemary Kennedy, former chief nursing officer for Wales, suggested that leadership is about getting the best from others – not ‘simply telling staff you are their leader’ (Frampton 2009). Leaders should demonstrate good decision making, problem solving and critical thinking skills. ‘Leaders must challenge the processes, inspire a shared vision, enable others to act, model the way forward, and encourage the heart... There is a need for strong, courageous leaders… and everyone has leadership potential if they want it’ (Frampton 2009). The Royal College of Nursing (RCN) (2009) identifies clinical leadership as one of the requirements vital for assuring and sustaining quality care through the supervisory role of the ward sister or team leader and the creation of an effective workplace culture. There are two may 4 :: vol 25 no 35 :: 2011 35

art & science principle series: 9...
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