Effective Leadership and Teamwork in Nursing

Effective Leadership and Teamwork in Nursing Effective leadership and teamwork in nursing, with particular reference to psychiatric (mental health) nursing, within the context of professional practice and client (patient) perspectives As part of the campaign to deliver effective health and social care, the Government’s modernisation agenda focuses on strengthening nursing leadership and developing inter-professional teamwork. It is proposed that having good quality clinical leadership skills among all health professionals is perceived as vital to the provision of high-quality, effective patient-centred care, as well as for the development and future of the National Health Service (NHS) (Department of Health (DOH), 2000, pp59-71). Nurse leadership has developed significantly over the past decade and now nurses can become nurse consultants, nurse practitioners, and modern matrons or run nurse-led units. It is debated that high calibre nurse leadership can produce more motivated and effectual staff, reduce the risk of errors in drug management, decrease staff turnover and rates of sickness, result in fewer patient complaints and most importantly improve patient care (Williams et al, 2001, pp1-3). This essay wi ll critically analyse effective leadership and teamwork in nursing, especially within a mental health nursing context, with respect to professional practice and patient perspectives. As mentioned leadership skills have for a long time been acknowledged as a solution to the provision of good health care. In order to achieve first-rate health care, healthcare personnel especially senior nurses must be able to effectively lead teams, particularly across professional, clinical and organisational boundaries (Taylor, 2007, p30). Two of the key roles of a lead nurse or senior nurse manager are that of supporting staff and overseeing nursing in the provision of patient care (Castledine, 2004, p119). It is proposed that meeting staff needs improves satisfaction, productivity and efficiency and it is debated that productivity is now an important concept within health and social care sectors. It is suggested that productivity within the healthcare industry is defined by the quality of patient care. Arguably, productivity is not exclusively dependent upon how hard and well individuals work, but about meeting staff needs and support from leaders and colleagues (Moiden, 2003, p19). Debatably, where team leaders or managers are concerned about the needs and objectives of their staff, and are aware of the social and physical conditions that affect their working environments, productivity and efficiency will improve. It is possibly that a lack of working environments that support staff affects the quality of care for patients. It is suggested that it is vital that the nurse manager has leadership skills that allow a team to work together effectively (Moiden, 2003, p19). Nurse leaders sho uld be seen frequently by those they lead as high visibility could ensure that support is obtainable when most needed. Similarly, nurse leaders must ensure that staff skills are used in such a way that patients’ obtain the greatest benefit from their abilities. This can be achieved by the nurse leaders enabling others to act and giving positive responses to work-related performance. This will facilitate motivation, increasing job satisfaction and promoting better patient care (Clegg, 2000), p44). Within a psychiatric nursing environment whether it is in the community or in a mental health unit teamwork is imperative for both the staff and the service users. In the field of psychiatric nursing, nurses work as a team with other professionals such as psychiatrists, clinical psychologists, occupational therapists and social workers. Therefore, responsibility for the service users is shared across the whole multi-disciplinary team and each service user relates to several team members (Williams, 2005, p39). Arguably, the team approach to patient care within mental health nursing has advantages in terms of reducing dependency on team members, and reducing levels of burnout. It is debated that teamwork is vital in order to provide a safe and therapeutic environment that respects the service user’s dignity while promoting independence and preparation for life in society. The team approach can be supportive and creative but it is not without its problems (Machin, 1998, p17). Onyett et al (1997) studied a sample of four hundred and forty-five team members across various disciplines working in fifty-seven Community Mental Health Teams (CMHTs). Emotional exhaustion, low personal accomplishment, depersonalisation, job satisfaction and sick leave was examined in relation to the perceived clarity of the role of the team, personal role clarity, identification with ones profession and the team, caseload size, composition and the frequency with which users were seen. Excessive emotional exhaustion was reported, predominantly among consultant psychiatrists, social workers, nurses and psychologists. High job satisfaction, high individual achievement and â€Å"low depersonalisation† were also found. Job satisfaction was associated with â€Å"team role clarity† and identification with the team. Caseload size, assemblage and the frequency with which service users were seen were not associated with job satisfaction or burnout. Important disparities were f ound between disciplines on all variables except sick leave. Therefore, on the evidence presented it could be argued that team membership has different implications for different disciplines. Debatably, greater attention is needed to the composition, training and leadership of CMHTs rather than hope that the disciplines will spontaneously work effectively together. It is important to note that the research used here of evidence of effectiveness of teamwork has various limitations. Firstly, the small sample size makes it not viable to relate the findings to all CMHTs in the United Kingdom. Secondly, the questions asked in the study might be seen to be leading questions and this makes the study unreliable. Thirdly, this study does not take into account the personal views of the members of the team. The individual views on the effectiveness of multi-disciplinary teamwork from the nurses, occupational therapists and social workers could make this research more valid as relationships and issues of skill mix between the disciplines could have been explored within the context of patient care. Teamwork appears to be more effective in enabling first-class patient care within hospital based mental health units. Flockhart and Moore (2002, p96) assessed the effectiveness of teamwork on patient care at the psychiatric intensive care unit that is part of the Maudsley NHS Trust in South London. The unit admits some of the most challenging patients who cannot be safely managed on general wards. Many patients suffer from paranoid schizophrenia or bipolar affective disorder and can be violent or aggressive, suicidal, harming themselves or be abusing various substances. Patients are only admitted on the unit for clinical reasons, not for safety. The main ethos of the unit is to help the service users achieve their maximum level of functioning so that they can be cared for with the fewest possible restrictions. It is important therefore that in this unit and in others like it in the United Kingdom the nurses need to be good team workers and be able to deal with issues calmly. Patient involvement and collaborative working has been addressed by joint care planning with the family and other key disciplines such as social workers, probation officers and various psychiatric and psychology therapists and this had led to rapid improvements in patients’ mental state and behaviour. The collaborative teamwork that focuses on the patients’ safety has improved team communication and effectiveness. Arguably, this particular unit has an efficient team that has empowered and enabled the staff to provide the best and most effective care for the service users. This is because the team is organised, supported and valued by each of the other members and the skill mix is ideal for improving patients’ mental health. It is also important to note that this unit has one dedicated team leader or co-ordinator that provides a consistent approach that meets all the needs of the service users and staff. Routine physical proximity appears to contribute to constructive working relationships and this has been illustrated by the effective interprofessional working relationships observed in this unit. Debatably, in contrast, within a community setting each discipline will have its own team leader or manager and this might lead to inconsistencies, differences and confusion in policy and decision making. In reviewing the literature for this essay the author would like to propose the following recommendations. Debatably, more evidence based research is needed on how effective leadership leads to enhanced practice and improved patient care, especially within mental health nursing. There appears to be some literature on the effectiveness of teamwork within the mental nursing profession. Arguably, this is because the provisions needed by mental health service users are wide and varied and historically multi-disciplinary teams have always been the solution to providing care and support for service users whether that care was deemed to be of good quality or of inferior quality. However, there is room for more evidence-based literature on the effectiveness of teamwork within mental health nursing. Similarly, it is suggested that there is a need for more evidence-based literature on the effectiveness of teamwork in nursing in general. Correspondingly, there is little or no evidence-based lit erature that expounds service user’s perspectives about how efficient teamwork improves their care. From the evidence presented it can be said that many factors lead to better team performance and arguably, one of the most significant is that of team leadership. Good quality leadership skills are the solution to enabling teams to provide high quality effective patient care. Effective team leadership improves satisfaction among team members and patients and improves productivity. In order to be effective as a leader the team leader must be visible and approachable. Team working within a hospital setting is generally more effective in delivering good quality patient care than that often achieved within a community setting where multi-disciplinary teams are involved. The stress on team members in CMHTs is related to the standard of leadership as well as the composition and training of the team. Experience in the Maudsley NHS Trust illustrates the importance of good team working and leadership in determining the quality of outcomes for patients. Evidence in the literature studied is pr esented from the perspective of staff in healthcare teams while there is little or no evidence of the views of service users on the subjects of leadership and teamwork. References Castledine, G (2004) Nursing leadership must keep its roots in nursing, British Journal of Nursing, 12, 2, 119. Clegg, A (2000) Leadership: improving the quality of patient care, Nursing Standard, 14, 30, 43-45. Department of Health (2000) The NHS Plan. A Plan for Investment. A Plan for Reform. London, HMSO. Flockhart, G and Moore, S (2002) Teamwork is the key, Nursing Standard, 17, 3, 96. Machin, T (1998) Teamwork in community mental health, British Journal of Community Nursing, 3, 1, 17-24. Moiden, N (2003) A framework for leadership, Nursing Management, 9, 10, 19-23. Onyett, S, Pillinger, T and Muijen, M (1997) Job satisfaction and burnout among members of community mental health teams, Journal of Mental Health, 6, 1, 56-66. Taylor, V (2007) Leadership for service improvement, Nursing Management, 13, 9, 30-35. Williams, T, Taylor, S and Petts, S (2001) Assessing leadership development training, Nursing Times, 97, 42, 1-3, www.nursingtimes.net, date accessed 11/02/2007. Williams, C (2005) Assertive outreach: the team approach, Mental Health Practice, 9, 2, 38-40.

A Civil Action Review

A Civil Action Essay Jay Lee 9-8-09 In the movie â€Å"A Civil Action†, the environmental problem was that trichloroethylene and silicone was placed into the water in the town of Woburn. It happened through a tanning company pouring chemicals on the hides of animals and it seeping out. The company also placed a lot of barrels with the dangerous chemicals into the ground and it seeped out into the wells of the town. The damage it caused to the environment and to the people was a huge amount. It poisoned the town and children were killed because of it. The chemicals caused the children to get Leukemia and they died. The people blamed the companies Beatrice Foods and W. R. Grace & Co for neglecting proper cleaning habits. This movie showed that humans really need to practice good habits or humans will not be able to survive. One tanning company poisoned an entire town. If everyone was like the tanning company, everyone would be dead by now. People really need to practice good habits because we cannot live in a world that is polluted by dangerous chemicals. The earth cannot become like the town of Woburn. We cannot continue to pollute the earth or we will harm ourselves and each other. People also need to know what they are dumping into the earth. People have to continually study what they are dumping into the earth or they may end up getting sued and hurting people. Jan Schlichtmann found out a lot about what happens to people and the earth after studying the harmful effects of the chemicals that were being dumped into the town of Woburn. People need to study these things because the earth cannot take the harm from the chemicals nor can the people. The earth is all connected and it was shown in the movie. The chemicals from the plant were dumped into a ditch. The chemicals traveled through the soil into the groundwater. The chemicals then reached the wells of the community. From there the people drank the water. One action can affect everybody. The earth is all connected somehow and putting something harmful in it is just hurting everyone and everything. The earth does not take a problem and just magically make it disappear, it stays within the earth and people need to find a way to do something better or everyone suffers. People alter the planet a lot. In the movie, just a tanning company polluted the ground water and killed people because of it. â€Å"A Civil Action† showed a lot of things that dealt with people hurting the planet. People should have to pay because they are responsible for more than just hurting people. The environment is important to people along with animals. It affects everything people do. In the movie people were forced to come together to do something about it. The people were sick of facing trials and watching the deaths of children because of the chemicals in the water. It really makes people do things about them and environmental problems are serious. They have to be dealt with quickly or it may hurt current generations and future generations. People may not be able to fix the problems we make today in the future. Environmental problems are serious and need to be dealt with quickly.

Influence of Religion on the Civil Rights Movement

Religion has had a profound effect on numerous events throughout the course of American history. The Civil Rights Movement was not withheld from the influence of religion, particularly Christianity and Islam. Many of the key players such as Martin Luther King, Jr. and Malcolm X, who were devoted to the cause of justice and equality for African Americans, gained their passion from their spiritual roots. Through these religious leaders organizations were established to fight for civil rights. It was through these religious men and the religion of blacks that the fight for equality gained enthusiasm and courage to fight oppression and discrimination. Opposition also came from religion, however. Reverend Jerry Falwell and the white supremacists of the Ku Klux Klan, who fought against the Civil Rights Movement, based their justification for an inferior black race on their religious beliefs. The Civil Rights Movement, by the people and parties involved, was in itself a battle of beliefs. How is religion involved in the progression and initiation of the fight for equality for African Americans? Christianity, being the a religion active in the Civil Rights Movement, has aspects within its doctrine that encourages equality. It contributed in giving African Americans the passion and the support to continue on in the struggle despite its hardships. â€Å"‘I come to preach, to liberate them’†¦. The thrust of the Civil Rights Movement†¦was that God was on the side of the oppressed, the poor, the downtrodden, the outcast, the persecuted, the exploited. God is on the side of justice† (Williams 119). Those that believed in God also believed that this divine, powerful being was behind their every effort and would grant them victory in the battle for civil rights. They saw themselves as the persecuted and knew that their God would have compassion on them through their difficulty. Moreover, the Christian faith brought unity among African American because they saw others turning to faith for hope to gain equality and so they followed suit. â€Å"According to several respondents, religion engendered in them collective identities and meanings that imbued a sense of purpose† (Williams 113). It â€Å"inspired the construction of perspectives proclaiming, ‘people who were products of segregation must be viewed theologically as the poor, the handicapped, the downtrodden. And theologically we have a responsibility to use our faith—to not be afraid to confront the oppressor’† (Williams 113). Many Christians believed it was their duty and their way of showing obedience to God by fighting those who discriminated against them. Christianity was certainly a motivator and contributor to the Civil Rights Movement. It caused African Americans to not limit their movement to the potential of a human being. Instead, they gained hope in believing that something more powerful than them was working to give them equality. Despite the unity and empowerment that blacks received from their churches, white churches mostly existed in the background and never really urged their members to partake in the Civil Rights Movement. Rather, they sat back in a more comfortable position and consented to the Supreme Court’s decision to segregate. Integration, although it did occur, had a very slow progression in Caucasian churches and schools. Roman Catholicism was the first Christian sect to completely integrate their parochial schools (Mathisen 575). With Catholics and most other sects of Christianity, preachers gave sermons to white folks, many of whom favored segregation. If a pastor spoke out about the injustices of discrimination and encouraged civil rights, they might be removed from their position as a clergyman. Moreover, Ku Klux Klan members were mixed in their churches as well. â€Å"Much of the minister’s ardor is dampened when he returns to his flock though this is not to say that he bends completely to their will. It is not without significance that some fairly strong announcements have been made on the local level† (Mathisen 574,575). Based on their audience, white pastors had to weaken their sermons so that people would continue to attend their church and so they could maintain their job. Clearly, white Americans were not all opposed to integration. Rather, many of them just did not desire to sacrifice their lifestyle to help African Americans in their struggle for equality. Yet, this is not to say all Caucasians did not fight for civil rights, but the majority of them were not an active part of the movement. Such a religious force in America that did not partake in the struggle for civil rights held back some of the potential of the movement. The Ku Klux Klan, notorious for their brutality towards others, fought against the efforts of Civil Rights activists. Despite their ruthless behavior, the Ku Klux Klan had members in law enforcement and within the church. Members of this organization believed that only white Christian people should exist within America and that other races should be honored to be controlled by Caucasian Christians. If others, such as the African Americans in their fight for civil rights, tried to gain an equal status, then the KKK would use ruthless tactics to suppress them. They defended their violent acts against African Americans by referencing their faith. A member of the KKK was asked in an interview, â€Å"What is your explanation of why there have been so many National Police Agents [F. B. I.? ] involved in the case of the ‘missing civil rights workers’† (Mathisen 576)? The Ku Klux Klan member, knowing that the National Police Agents involved were in cooperation with the KKK, responded, â€Å"First I must correct you on your terms. Schwerner, Chaney and Goodman were not civil rights workers. They were Communist Revolutionaries, actively working to undermine and destroy Christian Civilization† (Mathisen 576). Later on in the interview the KKK affiliate declared that Lyndon B. Johnson, a president known for his support of the Civil Rights Movement, â€Å"is a communist sympathizer† (Mathisen 576). This member was clearly discussing the Civil Rights activists. He proclaims that they were tainting the Christian religion, which is why they were killed and are â€Å"missing. This notion brings up religion as a contributor to their own views against African Americans. â€Å"The KKK uses words from the Holy Bible and teachings from Protestant Reverends to support its cause and justify its actions† (Fisher 1). They truly rationalize their superiority complex and their brutality to blacks by the Christian faith. By using Christianity, they too obtained unity against the Civil Rights Movement. The Ku Klux Klan was not the only notorious adversary of civil rights. A prominent opponent of the fight for African American equality and was the Baptist minister, Jerry Falwell. Falwell was a strong supporter of segregation and believed that based on the bible, â€Å"Africans were the cursed descendants of Ham, and worthy only of subservience to white people† (Kimberley 1). In Genesis of the bible Ham was cursed by his father, Noah, for disrespecting him. Through this, Reverend Falwell believes that African Americans should not gain any standing in society. To him it is the natural place of blacks to be below the status of whites due to the actions of their ancestors (Kimberley 1). Due to this, his position on civil rights legislation is very ardently against it. He has been reported to have said that the Civil Right Movement is a ‘civil wrong’ (Kimberley 1). Clearly, religion was used on both sides of the spectrum as a means to rally for a cause. While it was used by blacks for their crusade, some whites relied on it as tool to keep segregation and maintain discrimination. Martin Luther King, Jr. is one of the most famous leaders of the Civil Rights Movement. It is through him and others like him that African Americans gained justice and equality. One of the motivators of this intelligent, talented orator is most certainly his faith. Before ever becoming a part of the battle for civil rights, King was a devoted Christian and minister of Dexter Avenue Baptist Church (King 47). He, then, carried these beliefs into the Civil Rights Movement. â€Å"There comes a time when people get tired of being trampled over by the iron feet of oppression† (Kelley 463). King continues on in a freedom sermon, â€Å"I want say that we’re not here advocating violence†¦We have never done that†¦I want it to be known throughout Montgomery and throughout this nation that we are a Christian people†¦We believe in the Christian religion. We believe in the teachings of Jesus. The only weapon we have this evening is the weapon of protest† (Kelley 463). The reactions to these words were astounding. People identified with this idea and it gave them passion and courage to pursue equality. â€Å"All through that statement of religious identity the people shouted and applauded, moved with King, pressed him forward even as he urged them toward their own best possibilities† (Kelley 463,464). By their religious unity the Civil Rights Movement becomes undeniably contagious. As faith is mentioned, everyone joins in the excitement of the crowd and begin to trust that with numbers they can protest and achieve equality. Martin Luther King, Jr. ’s most famous speech â€Å"I Have a Dream† contains within it references to religion, faith, and hope. â€Å"And when we allow freedom to ring, when we let it ring from every village and every hamlet, from every state and city, we will be able to speed up the day when all of God’s children—black men and white men, Jews and Gentiles, Catholics and Protestants —will be able to join hands and sing the words of the old negro spiritual, â€Å"Free at last, free at last; thank God Almighty, we are free at last† (Finkenbine 190). This speech, like many of his others, held within it the idea of nonviolence. King looked to an Indian leader named Mahatma Gandhi as a guide to his desire to resist violence in the Civil Rights Movement. Despite this, he always turned to the Bible as a source to defend this action. King puts it best when he said, ‘The spirit of passive resistance came to me from the Bible, from the teachings of Jesus. The technique came from Gandhi† (Kelley 468). Religion was certainly Martin Luther King, Jr. ’s driving force as he became a prominent leader of the movement. He used Christianity as a means to support his every action and without its inspiration he would not have had nearly as great an effect on the Civil Rights Movement. Through him, African Americans came together inspired to make a change to society and not stand for injustice. Another contributor to the Civil Rights Movement was a man known as Malcolm X. He, like numerous other African Americans, took to practicing the religion of Islam. Elijah Muhammad, a member of the Nation of Islam (NOI), influenced Malcolm X and many others into pursuing these beliefs (Kelley 478). Black Muslims viewed themselves in American society as â€Å"an isolated and unappreciated appendage† (Mathisen 576). Muhammad saw the black race as not wanted and believed that the only way to achieve peace in such a circumstance is to remove those that do not desire them. Moreover, he taught that white people belong in Europe and that, â€Å"there will be no peace until every man is in his own country† (Mathisen 576). Black Muslims stressed their own identity and black racial supremacy. They had little desire to integrate and would have rather made America their own Islamic nation. With such a heavy goal, they decided to become a part of the Civil Rights Movement and obtain the rights that they believed were due to them. Malcolm X was brought into the Nation of Islam and it became his inspiration to gain equal rights for African Americans. He actually, despite Elijah Muhammad’s influence, was the leader who made the Nation of Islam a prominent and powerful force in the United States. Unlike Martin Luther King, Jr. , Malcolm X believed in violence as a means for blacks to gain better standing in society. People looked to him as the militant, uncompromising man who would use violence when needed to scare whites into accepting their conditions. He too believed, as many black Muslims, that building black institutions and defending blacks was far more important than integrating into society. Through men like Malcolm X and Elijah Muhammad, â€Å"the Nation of Islam attracted thousands of urban blacks to the disciplined life of abstinence, prayer, and black self-determination† (Kelley 478). Although their techniques were different in achieving civil rights for African Americans, this religion of Islam motivated people just like Christianity to fight for equality and justice. As religious leaders began to speak up and stand up against the prejudices that African Americans faced, organizations began to form to further the effectiveness of the struggle for civil rights. One such organization is Congress for Racial Equality, or CORE. This group, which organized direct nonviolent protests, branched off of the Fellowship of Reconciliation. The Fellowship of Reconciliation was a Christian pacifist group formed during World War I. They, like Martin Luther King, Jr. , believed in the ideas of Mahatma Gandhi and implemented Christian values into their approach (Kelley 450). The Christian Movement for Human Rights (ACMHR) focused on destroying legalized segregation, particularly on downtown stores and municipal facilities. Another association that sprung up out of religious roots is the Southern Christian Leadership Conference (SCLC). By 1957, Martin Luther King, Jr. and several black ministers from the South came together to form this organization which was based on the â€Å"Montgomery experience† (Kelley 470). One of their major accomplishments during this time was that they held conferences and organized people, such as when a group of some twenty thousand people came together in Washington, D. C. to pray for civil rights legislation. The fact that a mass amount of people came to pray that day gave others in the church the inspiration to look beyond their own means and to see things occurring which have never before. This gave African Americans hope and led more of them to these gatherings since they know that their desire for justice can be heard. Religion had a major effect on the Civil Rights Movement. Even when it was on an individual level such as with Martin Luther King, Jr. and Malcolm X, the effects of religion trickle down into the masses. Speech after speech, African Americans became inspired and empowered by them and began to believe in things beyond their own human capacity. Blacks turned to divine beings as a means to achieve equality and justice. Religion helped teach them to ignore the years of discrimination and damage to their self-esteem. It gave them the power to stand strong in the face of hurt and in the face of humiliation. Without religion, the Civil Rights Movement would not have had the unity, and hope that allowed it to continue on. At the same time, however, the enemies of the movement found their muse to keep segregation and discrimination. Religion was then used by them too as a means to protect their way of life and maintain the status over blacks that they had ingrained in them since the time of slavery. Religion had a mixed influence over the movement, but in the end African Americans would see the day when they gained those civil rights. They would see the day when blacks have equality under the law in America.

The Horrifying Steps Of The Final Solution - 1581 Words

The Horrifying Steps of the ‘Final Solution’ Beginning in the year 1933, life became difficult for all non-Aryans living in Europe. That was the year Adolf Hitler became the chancellor of Germany. His anti-Semitic principles served as the basis of the Nazi party and its supporters. Although their ideas were opposed by many, the Nazis managed to carry out The Final Solution with the goal of ridding Europe of Jews, gypsies, Soviets, and homosexuals. One prominent figure was Heinrich Himmler who constructed the â€Å"Final Solution†: a written document that stated the steps needed to be taken in order to establish a pure Aryan race. This â€Å"solution† consisted of isolating Jews in ghettos, sending non-Aryans to concentration and extermination camps, and forcing them to undergo starvation, thirst, shootings, and extended suffering. The various steps within this document each served a different purpose and implemented a new kind of suffering upon the prisoner s. New family roles were established and new outlooks on life and religion were brought about due to the scares they experienced. The Holocaust transformed the lives of many through the daily hardships in its ghettos, concentration and extermination camps, and demolished post-war Europe. The first place the Jews were sent, as stated by the Nazi’s â€Å"Final Solution†, were the ghettos. Ghettos during the Holocaust were located in small German cities. Jews were isolated from the rest of society as they spent endless daysShow MoreRelatedEssay on Ending Of Apartheid In South Africa627 Words   |  3 Pagesfirst speech announced plans to legalise the ANC, PAC and SACP and also that political prisoners would be released. He said he wanted to work with political groups to form a new constitution for South Africa. Although De Klerk’s decision was a great step forward for blacks, there were many possible reasons for his drastic change in government. 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