Nurse's Watch: Conversations on contemporary nursing,
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~Start date February 2010~

Sunday, October 30, 2011

Leading by example...

                 Leadership in Clinical Education and Leadership Growth

                                             Creative Clinical Leadership

Jones (2005) proposes that senior nursing students can practice leadership by delegating responsibilities to novice nursing students. She outlines how they must gather patient information and give report to the junior students, as well as, inform them of the  time they are expected to arrive, while also providing directions to the medical facility (Jones, 2005). Most importantly, they must evaluate the patient and student to determine which duties can be delegated safely and within the student’s scope of practice (Jones, 2005). This takes quite a bit of preparatory planning and organization.

Further, Jones (2005) notes that Bos (1998) identified five benefits of this type of delegation; students receive practice in prioritization, critical thinking, technical skills, use of peers as resources, and management. Other authors also relate that this type of peer tutoring increases confidence, personal leadership and personal relationships between students (Jones, 2005).

Kling (2010) had two classes of senior students lead sophomore students on their first and second days of clinical. The purpose of this endeavor was to allow the senior students to be able to participate in an active leadership position (Kling, 2010). This also allowed the students to experience life as an educator and mentor (Kling, 2010). Additionally, numerous other benefits became apparent after the implementation of this project. Friendships and support groups between the students that were initiated during this time period continued (Kling, 2010). Most notably, however, several students reflected that they might consider the possibility of someday aspiring to be nurse educators (Kling, 2010). Lastly, this leadership class took place before the NCLEX exam; this allowed the senior students time to review skills and processes as they explained these to the younger students (Kling, 2010).

In order for this scenario to be successful, students must be prepared, have a good understanding of the expectations and they must be familiar with their state’s Nurse Practice Act (Jones, 2005). If the student does not understand or is not prepared, this learning experience can fail to produce the expected outcomes.

In conclusion, this is an excellent way to introduce leadership with senior level nurses and this could be expanded upon in a number of ways. What if these senior students were assigned a sophomore or junior level student at the first of the year? They could be responsible for many aspects of the student nurse experience. Perhaps they could call a couple of times each month to see how the student is doing and if the student has any needs for tutoring or support. Not only does this provide extra direction and understanding for the novice but it could also increase the empathy level of the senior nurses toward the junior students. Is it possible this type of peer support could eventually impact lateral violence by increasing this sense of caring, collaboration and camaraderie toward other nurses early in the educational experience?

It is possible that this type of activity could be associated with the nursing honor society or the student nurse association where it could be voluntary or it could flow from one class to another. The students that feel comfortable with this experience may desire to continue to mentor the novice students after the year is over. In conclusion, this method of leadership training has tremendous potential beyond the activity itself.

       Final Thoughts on Personal Growth

 Fights (2011) suggests that nurses from the floor to the boardroom need to assess where they wish to be in 5 years, set career goals, discern how to accomplish them, commit to lifelong learning and get involved in policymaking, data collection and planning. She poignantly states, “As nurses, we must measure the value of what we do. Nurses are counted upon; yet if we don’t count what nurses do, nurses don’t count” (Fight, 2011, p. 59). This is very prophetic; nurses must cease to be invisible. How can this be accomplished?

This course has increased my appreciation and understanding for who I am so that I too can effectively lend my voice, vision and energy to the profession I love in an educated and intelligent manner. As Fights (2011) suggested I have been encouraged to set career goals and determine what I must do to accomplish them. This is vital to the growth, empowerment and consequent visibility of all nurses.

As I look back over this last year and a half, my growth as a professional has been incredible. This course and program of study has helped me define leadership and followership; it has helped me identify my personal leadership potential and creativity (Grossman & Valiga, 2009). Further, this course has helped me identify my personal role as a visionary, expert, achiever, critical thinker, communicator and mentor (Feldman & Greenberg, 2005). Additionally, as an educator, it has provided instruction on compelling ways to integrate and teach leadership (Feldman & Greenberg, 2005). This transformation has been subtle, continuous and at times unperceivable, yet as I look back from where I came, I am in awe.

Just a year ago, when we were instructed to write our personal philosophy; I wrote that the development of a philosophy is a process. I reflected, “Someday, I will more intimately know and understand my own personal philosophy. It will move beyond a way of doing and being to a personal philosophy of knowing. The journey has just begun” (Hiott, 2010). This has been accomplished! This class has expanded upon my “ways of knowing” (Jackson, Clements, Averill, & Zimbro, 2009, p.152). I know myself much more fully and have an appreciation for my strengths, my weaknesses, gifts, and passions all the better for participating in this program. I have been equipped, not only to teach, but also to dream and serve! Personal and professional exploration and education has increased my knowledge and confidence. Empirical knowledge helps me define the vision and set goals, while confidence from my personal, aesthetic and ethical knowing supplies the creative energy to embark upon the first step. Tyrrell (1994) shares, “Facilitation of student leadership development is an act of empowerment and an expression of caring” (Aroian, 2005, p.22). Thank you very much, Dr. Kling.
Feldman, H. R., & Greenberg, M. J. (2005). Educating nurses for leadership. New York, NY: Springer Publishing Company, Inc.
Fights, S. D. (2011). Future of nursing initiative: Nurses are the key. MEDSURG Nursing, 20(2), 58-59.
Grossman, S. C., & Valiga, T. M. (2009). The new leadership challenge: Creating the future of nursing (3rd ed.). Philadelphia, PA: F.A. Davis Company.
Hiott, D. B. (2010, October). Towards a personal philosophy of nursing education.
Jackson, J. P., Clements, P. T., Averill, J. B., & Zimbro, K. (2009). Patterns of knowing: Proposing a theory for nursing leadership. Nursing Economic$, 27(3), 149-159.
Jones, J. M. (2005). Chapter 26: Practicing delegation skills. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 279-287). New York, NY: Springer Publishing Company.
Kling, V. G. (2010). Clinical leadership project. Journal of Nursing Education, 49(11), 640-643. doi:10.3928/01484834-20100831-02


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