Introduction
Clinical leadership in nursing has enhanced good patient care and the development of a safe
healthcare. Clinical leadership is a concept where clinical healthcare staff undertakes the role
of leadership. Involves providing a sense of support and direction to other members of
healthcare team and also clients to ensure patient care. Clinical leadership involves
influencing, promoting and the improvement in the processes of the organization and also
individual care practices to enhance quality and safe outcomes (Gauld, 2017).
Attributes and importance of clinical leadership in nursing
Clinical leadership in nursing attributes to the efficiency and production of nursing
services. It has also enhanced cost-effectiveness in nursing. Clinical leadership skills also
empower nurses. Clinical leadership in nursing helps in providing good patient care,
adversity of nursing practice, and the creation of a work environment that is productive (Xu,
J. H. (2017).
Clinical leadership has also helped in the improvement of the care delivered to the
patients. This, therefore, improves the outcomes of patients. Additionally, it impacts the
quality and safety of the care provided. Patients safety is considered a priority while
performing nursing care. Good leadership in nursing also helps in reduced medical errors and
also helps in improved staff retention, therefore benefiting the healthcare workplace.
Moral courage and clinical leadership
In clinical leadership, moral courage requires a nurse to stand up for what is right
and should be done despite the potential risks and consequences that may arise. Moral
courage in nursing is where one is willing to speak out and do the right thing even in the face
of forces that would lead a person to act in some other way (Numminen, Repo, & Leino-
Kilpi, 2017). According to the American nurses association 2015 code of ethics, the
CODE acronym helps nurses actualize moral courage. The ‘’C’’ represents courage. This is
CLINICAL LEADERSHIP IN NURSING 3
the ability to have the willingness to overcome fear and stand up to the values you think are
right. ‘’ O‘’ reminds them of their obligation as nurses to adhere to the code of ethics of
nurses. ‘’D’’ represents danger management. It involves the development of cognitive
strategies to deal with danger. ‘’E’’ represents expressions American nurses association
2015.
Challenges of moral courage
Most undergraduate students and also new nurses lack the moral courage and are
unable to speak up when they are confronted with situations that are of poor practice, despite
having felt a moral obligation (Beckhoff and colleagues 2017). When a nurse engages is
actions of moral courage he/she is likely to experience the following challenges:
Stress and anxiety. Practicing moral courage in nursing causes many discomforts since you
do what is right, making other colleges always question your integrity—secondly, Isolation
from colleges. Colleges and senior managers will always see your ways of doing things
irrelevant and will not engage with you. Finally, Threats of employment termination.
Practicing moral courage against requirements and policies set to follow as a nurse means
you have violated what you are wanted to do, and this can lead to employment termination
(Lachman, Murray, Iseminger, & Ganske, 2012).
Emotional intelligence and reflection in clinical leadership
Emotional intelligence is the ability of a nurse to understand, have control, and monitor
his/her emotions and others' emotions. Having emotional intelligence in nursing involves
having the ability to recognize feelings, having awareness, and knowing how emotions
impact relationships and how they are managed. Emotional intelligence is extremely
important in the nursing field because you work with patients all day, and this can cause a lot
of stress, sadness, exhaustion, joy all at the same time.
Importance to clinical leadership
CLINICAL LEADERSHIP IN NURSING 4
When clinical leaders have a high level of emotional intelligence, they adapt better and
are able to understand their patients' needs better. They cope with stress and anxiety better
and improve their social skills enhancing long-term benefits (Park, & Park, 2018). This
enhances a better patient's outcome and also improved care quality to patients. Nurses with
high emotional intelligence are usually happier and also successful. It also helps a nurse
know when a patient is in pain, angry or happy.
What can you do to develop clinical leadership?
DEVELOPMENT OF CLINICAL LEADERSHIP
1. Recognizing and developing required skills
2. Developing healthcare management skills
3. Implementation succession plan
4. Investing in leadership development
5. Becoming an influencer
6. Preparing for new clinical leadership roles
7. Promoting close clinical- administrative collaboration
8. Pushing for board membership
What can you do to demonstrate clinical leadership in nursing?
CLINICAL LEADERSHIP IN NURSING 5
Tactful communication
As a nurse, you are dealing with a variety of different people in different hierarchy
levels- technicians, paramedics, paramedics, physicians, other nurses, patients- and all of
them require effective and clear communication from you. Honesty is key with your patients,
and you need to effectively communicate the condition of your patient so that the doctor
prescribes proper treatment and medication. In case of conflict with a colleague or patient
resolutions that support resolution and collaboration should be used rather than using ways
that can cause friction in the future ( Kunju, & Ahmad, 2020).
Skill-based delegation
Nurses in the position of clinical leadership are usually in charge of scheduling and
allocating the nurses. To delegate responsibilities perfectly, you have to be able to recognize
and identify skills in nurses and utilize them accordingly. One should learn nurses and
recognize their potential skills and delegate to help them attain their whole potential. One
must develop the skills you are overseeing.
Informed administration
Consistent mentorship
Skill-based delegation
Tactical
communication Informed
administration
CLINICAL LEADERSHIP IN NURSING 6
Nurses work in different work environments such as clinics, hospitals, rehabilitation
centers, and other healthcare establishments. Each work environment has varying specialties
policies, laws, and budgets. You should be aware of the limitations and freedom of an
organization and know-how to work well with others and within given limits. For Eg, when a
hospital has experienced budget cuts, fewer nurses will be left working, which will require
you to manage schedules, and patient care with minimum loss is quality.
Consistent mentorship
Ensure to encourage and support other nurses when you all face difficult issues and
challenges to achieve a common goal of providing optimum patient care. Getting desensitized
to the patient’s pain is very easy if one sees it happen repeatedly. As a leader, you should
always ensure your commitment to patient care does not wave, no matter the situation, and
this will make nurses who look up to you also become more focused. Have a mentor who you
visit so as to guide you since a nurse experiences mental exhaustion, frustration, long hours
of work, and fatigue. This will help your mental health stay on track. One should also aim to
be a leader among your colleges and be a role model and help during their best and worst
times.
What makes a good mentor?
A good mentor acts as a role model and treating nurses they would want to be treated.
He helps identify areas of growth in the new nurses, educates new nurses on the culture of a
company, help nurses network with other professionals in healthcare, give praise where it
deserves, share’s their own experiences and mistakes to help others, Are trustworthy, and
makes new nurses feel comfortable when they come with their own problems; They are open
to feedback – from new nurses, They offer criticism that is constructive and sensible.
NURSING LEADERSHIP STYLES
CLINICAL LEADERSHIP IN NURSING 7
VISIONARY.
It involves emphasizing on visions and the
goals for the development needs in the
nursing practice. Clear rules are set to
develop a geed nursing practice
AFFILIATE
Acceptance of differences and harmony is
emphasized. The values of employees is
valued and their best interest also recognized
and valued.
DEMOCRATIC
Teamwork and commitment to work is
emphasized. Employee’s opinions are valued.
Decisions are discussed with nurse managers.
ISOLATING
Works alone, communication with other
employees are minimal. When situations that
are problematic arise are difficult to handle.
LAISSEZ-FAIRE
Some tasks are delegated and decisions are
made by employees although the leaders are
still responsible.
COMMANDING
Employees are expected to follow clear
directions. The decisions are made by the
nurse managers and are not changed based on
employees opinions.
COACHING
Tasks are delegated to employees since they are seen as experts in their fields and they can
work independently
Goal setting and surviving placement
CLINICAL LEADERSHIP IN NURSING 8
Goals setting are important and these strategies help nurses identify the development needs
and are explained into the SMART goals. (Stonehouse, 2017).
Feedback – what it is and what it isn't
Feedback in nursing helps provide reassurance and support. Positive feedback been
given on a regular basis to the nurses helps enhance motivation and helps in effective
deliverance of services. When nurses effectively participate in feedback, it helps them know
how their career is progressing.
Managing the poorly performing students
CLINICAL LEADERSHIP IN NURSING 9
There is a need to early identification, and intervention of underperforming provides a
potential for improvement (Oducado, 2019). The early stage's missed opportunities to correct
reflect to underperformance long after the issue have been identified (Elliott, 2016).
Through open and honest communication between the students and mentor.
Communication is vital to help underperforming students since they are able to express their
troubles in a fair and open way.
By enabling mentors to fail underperforming students so as to protect the future of
nursing and healthcare. Some mentors are failing to fail nursing who underperform, and yet
they did not meet the assessment standards (North, Kennedy, & Wray, 2019).
Underperforming students manipulate and use strategies that are coercive to influence the
practical decision of mentors (Hunt, McGee, Gutteridge, & Hughes, 2016).
The student-mentor relationship should be good, which will help reduce students' poor
performance since when a mentor is close to the student, he can correct errors a student
makes. A student is also able to learn from his mentor and adjust his poor performance
(Olander, Rayment, Bryar, & Brook, 2018).
Do’s and don’ts for mentors and mentees
Mentor
Don’t s Do’s
Condemn: should not condemn mentees Listen: to problems and ideas from mentees.
force Criticize constructively: point areas that need
improving.
Use undue influence. Encourage and motivate
Loose critical oversight. Promote balance
CLINICAL LEADERSHIP IN NURSING 10
Mentees
Don’t s Do’s
Stay in your comfort zone: learn new
experiences
Work hard
Avoid difficulties: mentor should not solve
all your problems
Support your peers
Take advantage: don’t use your friendship to
avoid work
Maintain balance
Sidestep: mentors should not do your work Take the initiative
Conclusion
Clinical leadership in nursing helps to improve patients care. Clinical leadership in
nursing attributes to the efficiency and production of nursing services. It has also enhanced
cost-effectiveness in nursing.
References
Epstein, B., & Turner, M. (2015). The nursing code of ethics: Its value, its history. OJIN: The
Online Journal of Issues in Nursing,
Bickhoff L., Sinclair P. M., & Levett-Jones T. (2017). Moral courage in undergraduate
nursing students: A literature review. Collegian, 24, 71-83
CLINICAL LEADERSHIP IN NURSING 11
Lachman V. D., Murray J. S., Iseminger K., & Ganske K. M. (2012). Doing the right thing:
Pathways to moral courage. American Nurse Today.
Stonehouse, D. (2017). Understanding the nursing process. British Journal of Healthcare
Assistants, 11(8), 388-391.
Elliott, C. (2016). Identifying and managing underperformance in nursing students. British
Journal of nursing, 25(5).
Gauld, R. (2017). Clinical leadership: what is it and how do we facilitate it?. Journal of
primary health care, 9(1).
Olander, E. K., Rayment, J., Bryar, R., & Brook, J. (2018). Midwifery students in health
visitor placements: the importance of student-mentor relationships. Midwifery, 62, 49-
51.
Park, S. H., & Park, M. J. (2018). The effects of emotional intelligence, nursing work
environment on nursing work performance in clinical nurses. Journal of Digital
Convergence, 16(4).
Oducado, R. M. (2019). Are Nursing Students’ Early Course and Perceived Performance
Related to Their Final and Actual Course Performance?. Nurse Media Journal of
Nursing .
Numminen, O., Repo, H., & Leino-Kilpi, H. (2017). Moral courage in nursing: A concept
analysis. Nursing ethics, 24(8).
Xu, J. H. (2017). Leadership theory in clinical practice. Chinese Nursing Research, 4(4).
CLINICAL LEADERSHIP IN NURSING 12
Kunju, A., & Ahmad, A. (2020). Being Tactful: Communication Skill Training in Managing
Challenging Situations for Novice Pediatric Nurses. In Challenges