The aim of this assignment is to describe and discuss a management activity and the issues that emerged from it in relation to the delivery of patient care in my practice area. This management issue was about a change in ordering menus for patients and how it affected the dynamics of the ward. The proposal was that menus were to be ordered electronically and emailed to the kitchen. For purposes of confidentiality, and to comply with Part 5 of the Nursing and Midwifery’s Code of Conduct (2004), the name of my practice area has been omitted and subsequently any other names or places have been changed/ omitted. I will explore areas of development and then make recommendations for future practice.
My practice area is a forensic inpatient low enhanced secure unit with ages ranging from 21 to 65 years. It is evident that nutrition is important for the recovery of patient’s physical and mental states. Within the staff team, there is mix of skill on the ward, which made this proposal difficult because most of the staff are not computer literate and they would find it difficult to use the computer. The patient’s food is meant to be ordered 48 hours prior to delivery. For example, menus for Friday were to be done before 1600 hours on Wednesday. This posed a difficult task for three elderly women whom do find arduous to remember what they had ordered in the last two days. It was evident that this proposal was not inline with the Department of Health’s (DOH, 2009) initiative that nutrition of the elderly should be seen as priority by care providers. O’Regan (2009) echoes the same notion, stating that ensuring patients had adequate nutritional intake is part of the nurse’s role and it is supposed to be an important part of holistic care. The NMC (2008) also gives clear advice of the necessity of working with others to protect and promote the health and well being of patients. The proposed changes towards plan of care with regard to ordering of food emerged numerous issues as a result of the change.
Most staff on the ward reported that they were not computer literate which meant that training had to be commenced as soon as possible, this led to issues of cost/fund to train staff members and it was not clear as how this was going to be possible. Time was also a factor due to staffing issues of flu outbreak. The matter was made worse for the reason that anyone with flu like symptoms were asked to stay at home, which left the ward struggling to cover shifts. Staff felt that the sudden change would affect the quality of time spent with patients will be compromised by spending time on the computer. The issues of change regarding the menus increased the risk of being left out; creating a limitation to the elderly patient’s nutritional intakes on the ward because most of them were either asthmatic, diabetic or they were mentally unwell and adequate nutrition is essential for their well being.
Leadership in Healthcare
Developing future nurse leaders is one of the greatest challenges faced by the nursing profession (Mahoney, 2001). Mahoney (2001) asserted that powerful leadership skills are required by nurses, from those providing direct care to those in top management positions. Anyone who is perceived as an authoritative figure (e.g. a nurse taking care of a patient) or who is responsible for giving assistance to others is considered a leader. A clinical nursing leader is a professional who is involved in direct patient care and whom continuously improves care by influencing others (Cook, 2001). An important leadership role in my practice area is that all nurses are responsible for enabling o to provide good nutritional care. Leadership is not merely a series of skills or tasks, rather; it is an attitude that informs behavior (Cook, 2001). In addition to this, good leadership is consistent to superior performance with long term benefit to all involved. Leaders are not merely those who control others, but...
References: Alexis,O. (2002) Securing the future of the NHS. Developing and supporting the staff nurses. Nursing Management 9 (2) 15 -17.
Allan,E. (2007) Change management for school nurses in Scotland. Nursing Standard 21(42) 35 – 39.
Bacall,H. (2000) The importance of Leadership in Managing Change. Bacall and Associates, Ontario, Canada.
Bennert,M. (2003) Implementing new clinical guidelines: The manager as agent of change. Nursing management 10(7) 20 – 23.
Bert,S. (2007) Implementing organizational change. Theory and practice. Why employees resist change. Pearson Education Inc. New Jersey.
Cook, MJ. (2001) The renaissance of clinical leadership. International Nursing Review 48(1): 38-46.
Department of Health (2009) Choosing Health: helping people choose a better diet [online] available at www.dh.gov.uk accessed 28/11/2010.
Faugier, J. and Woolnough, H. (2002). National nursing leadership programme. Mental Health Practice, 6 (3): 28-34.
Graetz, F. & Smith, A. (2005) ‘Organizing forms in change management: the role of structures, processes and boundaries in a longitudinal case analysis’. Journal of Change Management 5 (3) 311 – 328.
Hodges, B. (2008) Change management: setting up an asthma camp for children. Nursing standard 23 (15) 35 – 38.
Holbeche, L. (2006) Understanding change: Theory, implementation and success. The impact of change in people. Butterworth – Heinemann, London.
Hyett, E. (2003). What blocks health visitors from taking on a leadership role? Journal of Nursing Management, 11: 229-33.
Jooste, K. (2004) Leadership: A new perspective. Journal of Nursing Management. 12:242-245.
Kessler EH and Bailey JR (2007) Handbook of organizational and managerial wisdom. London: SAGE.
Lewin, K. (1951) Field Theory in Social science: Selected Theoretical Papers. Harper & Row, New York.
Mahoney, J. (2001) Leadership skills for the 21st century. Journal of nursing Management. 9: 269-271.
Moiden, N. (2003). A framework for leadership. Nursing Management, 9: 19-23.
Murphy, L.(2005) Transformational Leadership: a cascading chain reaction. Journal of Nursing Management 13(2) 128 – 136.
Nursing and Midwifery Council (2008) Code of Professional Conduct: Standards of Conduct, Performance and Ethics [online] available at www.nmc-uk.org accessed 15/11/2010
Outhwaite, S. (2003). The importance of leadership in the development of an integrated team. Journal of Nursing Management, 11: 371-76.
Pearce, C. (2007) Ten steps to improving team leadership. Nursing Management 14 (4) 25
Robert, A. Paton,J. & James, M. (2008) Change management: a Guide to effective implementation. 3rd ed. Sage Publication Ltd. London.
Scott, L. and Caress, A-L. (2005). Shared governance and shared leadership: Meeting the challenges of implementation. Journal of Nursing Management, 13: 4-12.
Wang CL and Ahmed PK (2003) Organisational learning; a critical review. The Learning Organissation. 10(1) 8-17.
Welford, C. (2002) Transformational leadership in nursing: matching theory to practice. Nursing Management 9 (4) 7 – 11.
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