Effective leadership is critical to organizational success in the 21st century (Marquis and Huston 2009). In Hong Kong Special Administrative Region, most health care organizations are contemplating health care reform and work redesign at the start of a new decade (as in the early 1990’s). Reform of health care delivery in Hong Kong is unquestionably one of the most challenging issue facing nurses and putting unreasonable workloads on nurses (Hedley 2001). Speaking at the annual Hospital Authority Convention 2008, Mr. Wu said the Hospital Authority must train and retain staff, so there are more reasonable workloads and create more opportunity for nurses to be a nursing leader, both in direct patient care roles and in formal management positions. As a result, the career progression model for nurses was implemented in 2008 in order to help retain nurses, guide and improve nursing staff’s competency and career development. The Human Resources Committee and the Hospital Authority have supported a new three-tier career profession model for nurses. The three tier progression structure is as follows: Registered Nurse is tier 1, Advanced Practice Nurse is Tier 2 and Department Operations Manager is Tier 3. I have been working in Intensive Care Unit for about 10 years. As there is a need to develop more clinical leaders with up-to-date knowledge on clinical practice development and innovation to improve the quality of patient care, I was promoted to be an advanced practice nurse since this new three-tier career profession model commenced. As an advanced practice nurse, I used to make the transition from a staff role to a formal leadership position. I am confidence that I am able to influence change rather than wait for the next change to occur as planned by others. The ability to view one as being successful was the most important predictor of future leadership achievement. Many of the leaders had displayed innate leader tendencies. With the emergence of self-governed work teams and more emphasis on decisions being made at the “point of care,” such as at the patient’s bedside, there are increased expectations and opportunities for professional nurses to influence the healthcare delivery system. Nurses have more opportunities for leadership, for example, when they plan and execute a clinical pathway, lead an organizational quality improvement team or play a role in restructuring projects. Opportunities for leadership abound in healthcare organizations that have implemented shared governance (a form of responsibility shared between staff and management). In the following paragraphs, the characteristics of successful leadership and the challenges or difficulties that affect the development of leadership will clearly describe by reflecting on my role to be an advanced practice nurse. Leadership Characteristics
Due to the emerging importance of clinical leadership, the issue of transformational leadership in the nursing field has become a very important issue. Cook (2004) identified five attributes are creativity, highlighting, influencing, respecting, and supporting. Creativity is required to generate new ways of working. It results from engaging actively with the surroundings to seek new possibilities. Like me, I rarely sit on the sidelines; I usually involved in working with groups of nurses in an active way. Once in position of advanced practice nurse, I displayed a high level of motivation and a strong desire to influence change that would improve patient care e.g. introduce ventilator association pneumonia (VAP) bundle of care, nurse control sedation protocol etc. Highlighting gives one the ability to point out new ways of care delivery, based on engaging actively with the care environment. According to Cook (2004), the effective clinical nurse leaders were willing to look for new ways of doing things. On a regular basis questions were asked to clarify and enhance understanding. The status quo, were...
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