Leadership Journal: Purpose

Leadership Journal: Purpose

Grand Canyon University

NUR 670

Leadership Journal: Purpose

During this week’s activities with the clinical director of perioperative services, I was given the opportunity to present an evidence based practice model for implementing a sharps safety initiative for the operating room. I presented the project to the staff and in a separate meeting to surgeons. The presentation began with a short four-minute animated video that described the findings from the resources and summarized the evidence from the research as well as demonstration of the practice change. A slide show of the data and implementation plan followed the video. Questions, feedback and concerns from the attendees followed the presentation. The response from staff was supportive with little resistance to the proposed practice change. Following the meeting, I began to observe various surgical cases for the implementation of the practice change.

As the new perioperative services clinical director, just barely six months into her position, the observation of the staff in the surgical department is receptive and supportive to her leadership but seem hesitant to step forward to voice their concerns. An example of the hesitation is observed during the meeting as a topic in the agenda covered concerns with documenting, tracking and the communication specimens in the operating room. The issue caused the miscommunication of margins from the pathologist to the surgeon in the operating room and the patient having to return for an additional procedure. My preceptor determined to resolve the situation with the pathologist directly speaking with the surgeon over the phone to communicate the results of the margins. A few staff members voiced their opinions regarding the issue labeling the cause as a breakdown in the communication of the results rather than a lack of communication and the relay of the information given from the pathologist to the nurse then to the surgeon.

In observance of the leadership style or styles that my preceptor utilizes and expresses, there are at least two that come to mind. The first is that because she has formal authority her staff follow her management decisions. An example of this is when she spoke about clocking in and out, she explained to the staff who float between different departments (ambulatory surgical unit and main operating room) to clock in and out using the correct department code because it affects the budgeting of man hours for each department. The current practice for staff was to just punch in and go to the department that you were assigned to do cases. With the new time clock procedure, staff will need to adjust their clocking in and out and when switching intra-day. Staff expressed their issues with getting used to different department codes and the additional time it takes to switch departments during the day between cases. My preceptor utilized her authority to change the habits of her staff to lighten the load of manually changing the department codes every pay period for all the staff that float between departments.

Another is regarding the use of double gloves for all scrubbed staff. As part of the sharps safety initiative, implementing methods to reduce sharps injury is one of the priorities. The double glove method has been studied to decrease contamination from blood borne pathogens as well as an added protection from a sharps related injury (Daley, 2014). With evidence based research as well as my preceptors’ direct authority, she determined the use of this method as a cost-effective strategy to reduce sharps related injuries as well as the many other savings with an occupational related incidence like follow-up appointment and missed hours to do so. She also reminded the many new nurses that this is the beginning of their healthcare career, they shouldn’t have to manage any form hepatitis for the rest of their lives from an injury that could have possibly been prevented.

With reflection of the video and the explanation on the issue of rule, I learned about how God is asking his followers to act, “on earth as it is in heaven.” I perceive the translation of this rule as God’s desire for us here on earth to be an example of what heaven. Heaven is God’s kingdom and the vision of living there in peace is how we should be living here, “on earth as it is in heaven” (Matthew 6:10). Another takeaway from the video expressed on how we need to release and purge our power to rule over others as servant leaders. This is a very interesting concept to grasp. It is on the same level as one of the primary principles regarding servant leadership, to serve others first. I often see managers function in their roles conservatively by expressing their formal authority within their departments. I rarely experience a servant leader, one who is out of the floor serving the staff in their department. I can attest to this concept of releasing or purging your power and becoming a successful servant leader. Working as a traveler in the operating room, I have experienced many hospitals with managers that do not even wear scrubs and go into operating rooms to see how things are going with not just your current case but with the rest of your days’ schedule. Even some charge nurses just sit at the front desk for the entire shift not checking on staff. The rare successful leaders wear scrubs, round in all rooms and assist with needs, in other words they serve others. The executive functions with these servant leaders tend to positively work themselves out and the managers who never step in the operating rooms seem to struggle with meetings or management of their department (Fong, Smith & Langerman, 2016). This may be a cause as to necessitating extra staff such as a traveler like myself.

Overall the previous clinical experience with my preceptor has allowed me to learn how others react to her leadership style. I can assume or even conclude that different facilities have different reactions to management decisions as evidenced by my travels. Each facility is unique and the culture follows suit to the uniqueness that is expressed from the staff and leaders in each department. This facility in particular, is under new leadership and the staff has been able to adapt to the leadership style with little resistance. At times, there is an autocratic expression with her management and there are many moments of the laissez-faire style because the staff function independently to complete the daily list of cases with very little supervision from managers. From the studies within this program and current course, the leadership abilities from my preceptor and the other managers here have yet to be displayed. The manager and director are fairly new to the organization busy learning the systems within the facility and very little transformational leadership is being displayed. They have been great at sharing with me the experience of managing a department that has been absent of a manager and a director for many months. In observance of the culture in this department, the staff work well with each other creating a great visible team environment and a primary reason for its viability.

References

Daley, K. A. (2014). The ANA and AORN: An Enduring Partnership for Safety. AORN Journal, 100(3), 328. doi:10.1016/j.aorn.2014.06.007

Fong, A. J., Smith, M., & Langerman, A. (2016). Delivery of Care: Efficiency improvement in the operating room. Journal Of Surgical Research, 204371-383. doi:10.1016/j.jss.2016.04.054