The absence of a sufficient leadership pipeline has been one of the most significant challenges facing contemporary nursing. In about eighteen years to come, more than three million baby boomers will be on their retirement, and there will be an increased need for nursing services and leadership in nursing; this would demand extensive quality healthcare. Currently, the quality of healthcare offered at my workplace has been greatly undermined by the treatment approach, which the majority of practitioners have resolved to use. My workplaces majorly rely on Eminence based medicine (EMD) as the fundamental approach for treatment. According to analysis, this has limited the performance in terms of quality delivery and nursing knowledge development. For this reason, as a leader, I have opted to guide the workplace towards the wide-range use of an Evidence-Based Practice (EBP) and EMD concurrently; in this change, Eminence Based approach will be given lesser concentration lest it is a situation which demands its applicability. This work aims to review the problem faced at my working environment and how I will use strong leadership skills to drive the organization into a successful change.
A brief summary of the current situation at my workplace
Despite the prevalence of evidence-based practice (EBP) in the healthcare setting, my workplace has not yet standardly embraced it and transitioned to its applicability because many practitioners still believe on the effectiveness of the eminence-based medicine (EBM) for almost every ailment. However, from my research, I have found that Eminence based practice is very limited, and it is very flawed in spite of its values. Clinical experience was once described as “making the same mistakes with increasing confidence over an impressive number of years,” and this is what practitioners are always subjected to by EBM (Michard & Biais 369). So due to the many advantages associated with the EBP, I would champion for its increased adaptability in our nursing environment and ensure that it is sufficiently promoted and embraced together with the current EBM which will be then used on a limited scale.
The inclusion of Evidence-Based Practice will provide nurses with the knowledge to develop tactically founded decisions. Besides, EBP enables health practitioners to asses researches, and in so doing, they understand the effectiveness and risks associated with certain diagnostics. According to Eastern Illinois University, the application of Evidence-based practice is directly associated with the better treatment outcome; it can also lead to the decrease in the demand for certain healthcare resources and as a private clinic. On this ground, we would be able to save some expenses because practices such as EBM may entail the use of certain supplies or equipment which might be no longer useful for some procedures. Therefore, for better quality healthcare and profit maximization, the organization need to emphasize on the use of Evidence-based practice, and that is why I would spearhead a change.
Barriers to change
Inadequate management support is one of the key barriers that always cripple change initiative in any organization. According to Rapport et al., it is very easy to implement a change if there is management support because the top managers would epitomize the change itself and by doing so the subordinates would be convinced to embrace the change (2). An instance where change became unsuccessful due to ineffective management support was during the introduction and delivery of endoscopy services in Wales in which management showed little support for the program and this is also likely to affect my change(Rapport et al. 3). Another barrier is the inadequate knowledge by the nurses regarding the research methods, negative nurses attitudes towards the change, and poor awareness of a medical research finding. This knowledge barrier is considered as one of the major challenges that are always affecting the transition of outdated practices to the evidence-based practice. According to research by Shifaza et al., one of the main obstructs towards the adoption of the EBPs was related to the nurse’s characteristics and competencies (3). The nurses either had a bad attitude the practice or lacked required knowledge.
Adopting the newly proposed EBP requires the presence of certain resources within an organization because it is accompanied by training and a lot of research. The program would force the organization to initiate training programs which involve paid experts. The need for research would also demand that the clinic build a library fitted with many computers for efficient medical research. However, the clinic may fail to obtain the finances needed to facilitate these mentorship, training, and technological programs, and this may be a key obstacle for the change process. Moreover, people always conduct an interesting appraisal during the change process, in the event that they find changes to be against their interest, they would always resolve to resistance to develop protection against the change. And for this reason, those against change may get into a conflict with an intention to block the process, and this is one of the major barriers that may also affect the EBP change process. However, the conflict during change can also be contributed by lack of proper communication, and this makes poor communication one of the major barriers to effective change implementation. Haslam and Pennington have suggested that for a change to be effective, it should always be accompanied by risk-free open communication where employees or other related stakeholders can ask questions and get answers for their concerns (8). Therefore, in an organization like where I am working where employees voice has not been a concern for long; I might experience resistance due to minimized communication, which also shows restricted participation in the change process.
Leadership attributes and skills for an effective change process
Excellent communication skills
A change leader should always have variable communication skills; this skill should range from verbal to non-verbal communication competence. Communication skills enable a leader to establish a mutual understanding of the purpose of the imitated change and its effect; this communication competence is one of the basic success factors for a change leader. According to Miller, a leader’s communication ability during change management is determined by the leader’s ability to sufficiently articulate visions (360). Communication enables the leader to effectively engage the change stakeholders, outsource their opinion, and integrate their concerns during the change process. Therefore, it would be efficient to adopt superior communication skills during this process of change management in order to avoid any conflicts that might arise due to miscommunication. According to Haslam and Pennington, there are two key messages that a leader should sufficiently consider when managing change(9). The first message is the message about issues, and this includes communicating about the current situation and the reason for the change, the change expectation, and the basic of the things that would change. The second message should concentrate on the effect of a change on the daily activities of the employees. Good communication would also enable me to give clear directions to other staffs involved during the change process.
A successful change leader is always a person who demonstrates a high level of flexibility in terms of approaches. A leader should be someone who can effortlessly deviate from the natural orientation to assume a style of leadership that best fits the situation in question or the situation they are facing. For example, in situations where there is conflict due to the resistance of the EBP elements, it should be effective for me as a change leader to shift from a task-oriented leadership to relation-oriented leadership. In so doing, I would be able to calm the resistance. According to the situational leadership theory, there is no single style that is perfect for every situation (St. Thomas University Online). Therefore, it is important for change leaders to demonstrate a high level of flexibility.
Effective change management must be accompanied by the leader’s capacity to assume the ownership of the change process. When a leader assumes ownership for the change process and takes the responsibility of governing the well-being of the affected employees, the risks of losing talents from the organization is minimized. Attrition is always accompanied by change, and the employees may feel that their jobs are unsafe during the change process. If those feelings are combined with little or no people management, the employees, and the leader’s relationship in the change process may worsen, thus jeopardizing the success of the process (Miller 365). So, it is the responsibility of the leader to assume the complete ownership and convince the employees that the change is aimed towards improving their wellbeing. Naturally, such responsibility gives a leader a sense of ownership to the change process, and a change leader should be able to assume all the change responsibilities in order to indicate ownership (Queens University). Ownership is also determined by the leadership ability to assess change failure and success. Therefore, I would take full responsibilities of the change process by conducting all that relates to it.
Motivational and inspirational (influence)
Influencing skills enables a leader to articulate the vision of the change, align other stakeholders’ efforts, and build strong commitment from the stakeholders at all level of the change process. Change process involves processes and activities; therefore, an influence allows a leader to get things done in a manner that stimulates a positive outcome. Each stakeholder always has different concerns regarding the change; the stakeholders may include the peers, clients, management, or employees. Hence, it is necessary for a leader to devise different influencing skills in order to inspire every necessary audience in the change process (Centre for Creative Leadership). Motivation can be done through encouragements, leading by examples, creating a changing culture, and rewarding those who exert more effort towards the change process. Considering that shifting to an EBP is a complex process, I would motivate the employees by owning the process, rewarding their efforts, and presenting logical and compelling arguments which would aim towards positively engaging the stakeholders.
During transformation to a new process, there is a high likelihood that conflicts will emerge due to contradictory interests in the change process. Due to such a situation, a leader must be in a position to have strong problem-solving skills to ensure that such challenges do not affect the overall performance of the change process. A leader must know how to approach criticisms to the advantage of the change initiatives and come out with the most informed decisions that may likely calm the situation. It is important to learn the basic problem-solving strategies and how they can be applied in the health setting as this would help in enhancing the change success. According to the Southern University online leadership program, conflict resolution skills enables a leader to provide constructive disapproval to nurses while still keeping respect for their concern. Problem solving also enables a leader to correct mistakes identified in the evaluated change results.
Emotional intelligence is a key leadership attribute that enables leaders to comprehend the significance and power of their feelings and their stakeholders’ emotions. Understanding of the subordinate’s emotions would enable a leader to get the best out of them by positively influencing them. Such leaders develop self-awareness and are capable of formulating approaches to regulating every staff emotion in the process. According to Karkada and Sonia, such leaders have unique social skills and charm, which makes them be highly trustable and admired by the subordinates (60). Getting the subordinates trusts is important as it will minimize doubts on the process, which Is a key inhibitor of success. It would, therefore, be important in this may change course to give more concern to emotional intelligence. Emotional intelligence also helps in assessing the results of every situation.
There are five basic analytical skills that every leader demand for evaluating the outcome of change. These skills include critical thinking, data analysis skills, communication skill, problem-solving skills, and research competence. These skills are important because, in a health setting, they will enable me as a leader to find solutions, make decisions relating to the outcome, understand and analyze the results through critical thinking, detect patterns using my data analysis competence, integrate new information in the change process, and theorize phenomenon to get solutions. This means that results evaluations would require me a combination of different skills.
EBP is a nursing practice which is preferred because of its numberless advantages. Due to its benefits, I am to lead nurses in our work towards its adoption. But during the change process, it is possible that I may face challenges related to conflicts, resources, and lack of skills, most of which I will use leadership skills to overcome. Leadership task during change management should provide an efficient balance of creating a road map for the desired change while keeping the team members concern in mind. Well empowered nurses who work in a stress-free environment would confidently do better than others and render quality healthcare services. Therefore, as an effective leader, it is important to show a high level of resilience in responding to change. Besides, when leading change, it is important to reframe the thinking of the subordinates to fit in the change process. During the change leadership, a leader can use problem-solving skills to limit the effects of different challenges on the change process and minimize conflict. Also, leaders must demonstrate excellent communication skills in order to clearly articulate the vision and give a sense of direction while also evaluating results.
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