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Leadership Reflection Essay: Healthcare Issues & Gibbs Model

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Reflection and Issues of Leadership
Students Name
Course Name
Professors Name
Institutional Name
City and State
Date
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Reflection and Issues of Leadership
Introduction
Healthcare practitioners have a role as professionals to reflect on their practice and
determine domains for improvement. Reflection includes reviewing a clinical experience by
critically describing the elements, analyzing the experience and giving a professional evaluation
to foster practice. Therefore, reflection is reasoning out an experience and thoughts to give a
viable conclusion before giving an action plan (Delany and Watkin, 2008). Healthcare
practitioners can assess themselves through reasoning and point out areas that need tailoring
through change. Reflection offers a platform for a healthcare practitioner to self-evaluate and
learn from the described and analyzed experience hence attaining competence (Mann, Gordon
and MacLeod, 2007). From 2010 to the present, I have practised in different fields, which I will
offer a critical reflection while assessing the events.
Professional History
In 2010, after completing my studies, I graduated and attained my degree as a midwife.
After that, I applied for a job in three vacancies announced by three renowned healthcare
organizations. I was fortunate enough not to have waited long since I secured the position a
month after graduation. I was enrolled as a staff midwife and charge nurse in the labour and
delivery department in a local maternity hospital in Saudi Arabia. Following that, I completed
my training in the operations department and worked there for approximately one year. Then, I
completed my bachelor's degree in nursing in 2018 and began working in a kidney and dialysis
centre shortly after graduation. At work, I collaborated with health care professionals from
various specialities, including paediatricians, dietitians, anaesthetists, nephrologists, and
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students, in addition to other professionals. Additionally, I held leadership positions, which
helped me exercise my skills and steer the team forward to accomplish tasks.
Critical Reflection on Self
Purpose and Characteristics of Reflective Practice
Reflection happens when a healthcare practitioner undergoes an experience personally
examines it critically and professionally to expose a gap that could have been filled through
acting differently. Also, reflection gives a chance of evaluating what was done right throughout
the experience so that it may be repeated in the future to yield satisfactory results. Past decisions
offer a platform for demonstrating the strengths and weaknesses of actions, giving room to
eliminate the negatives and foster the positives. Theorist John Dewey examined the concept of
reflection and regarded it as being learning through experience by participation and relevant
experimentation (Ferreira, Prado, Heimann and Oliveira, 2013). The person should experience a
certain reflection scenario since it will form the foundation for observation. There is no reflection
without experiencing an event or situation. Secondly, the person will have to observe the
scenario he underwent and then reflect on it as it occurred, analyzing salient tenets to which it
relates. Analyzing the situation's specifics helps understand its components and how they led to
each other. Finally, knowledge develops after understanding the situation fully, which offers the
person a chance to execute an action plan.
Reflective practice has salient characteristics which make it an important and
professional field for healthcare practitioners. Reflective practice needs a combination of skills to
work effectively and produce constructive results. Critical thinking skills help a healthcare
practitioner to identify and separate the strengths from the weaknesses that occurred in the
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situation being reflected upon (Patel and Metersky, 2021). Without critical thinking skills and
being open-minded, it will be problematic to evaluate the areas that will need to be eliminated
and which ones to focus on (Bulman and Schutz, 2022). Additionally, reflective practice calls for
a commitment since the practitioner will need to continuously monitor the event and practice to
ensure that the changes made are accurate.
Reflection on Self
Having worked as a charge nurse in the labour and delivery department in a local
maternity hospital, I had qualities and skills that were instrumental and critical in helping me
accomplish my tasks and missions as a leader. The qualities which I have that have been
beneficial to the organization include; good communication skills, the ability to make a solid and
executable decision through decision making, the ability to resolve conflicts when they arise and
motivation ability. These leadership traits relate to transformational leaders who prefer to
transform current situations into better ones for future planning and orientation (Doody and
Doody, 2012). Motivation, a key element in transformative leaders like me, helps the team work
more efficiently with morale, hence yielding results beyond the scope of the organization's
expectation (Renjith, George and Renu, 2015). I cultivated a positive environment within which
the other midwives and patients thrived.
My motivation ability inspires, raising spirit in the entire workforce of nurses and
midwives to perform their duties and offer quality care. Through decision making, I have helped
the organization escape barriers which could otherwise derail the significant operations
(Nibbelink and Brewer, 2018).
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Furthermore, conflict resolution has been among my best abilities as a leader who
witnesses many cases of healthcare workers getting into conflict. Conflict causes job
dissatisfaction for the parties involved and may necessitate turnover (Almost, 2006).
Significantly, solving disputes has helped tailor a healthy and conducive environment for every
worker hence higher productivity and reducing turnover (Lahana et al., 2017).
Example for Reflection
I was given a rare opportunity of being a nurse leader in the labour and delivery
department after working as a staff midwife for a short period. One experience which I
remember well happened in the second month after I was assigned the role of a charge nurse. A
heavily pregnant lady whom I chose to call Esther for the sake of confidentiality arrived before 9
p.m., accompanied by her husband, and she seemed to be in so much pain. Confidentiality is a
professional requirement for the nurse to safeguard a patient’s right’s (Abiola and Ataiyero,
2015). I was together with my assistant that night, and although many more patients were
waiting to be attended to, we decided to give Esther more attention as she was about to give
birth. Esther and her husband were Indians, barely understanding the English language.
Gibbs Model of Reflection
Gibbs Model of reflection comprises six phases collectively called the "Reflective cycle."
The first phase is the description of the experience; the individual tries as much as possible to
recall the scenario and get enough tenets for analyzing it critically (Wain, 2017). After describing
the incident, the feelings phase begin. The individual takes time to evaluate and discuss the
underlying emotions regarding what he thought and felt when the scene occurred. Next, the
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individual explores the positives from that experience and the negatives, including events
contrary to the expectations. After analysis, the person discovers the domains that will need
improvement through skill interventions, hence offering time for learning. A conclusion follows
the analysis, and the person is free to develop a judgement based on the information evaluated.
The positives and negatives are used in the conclusion phase to tailor an action plan. The action
plan sums up as the final phase of the Gibbs model of reflection.
Gibbs model is straightforward, which makes its applicability and use feasible.
Additionally, it offers a clear description of the feeling analysis, the scenario, and the
experience's analysis to infer tangible conclusions. Also, it paves the way for the individual to
develop a course of action to avoid the weaknesses from recurring while fostering the strengths.
However, the model has a major drawback; it is not majorly and strictly introspective, a primary
requirement of reflection.
Using Gibbs Model to Present the Example
Description of the Event
My enrollment as a charge nurse necessitated my presence for the majority of the shifts in
the organization. The goal was to ensure that things were going on as planned. On the material
day when the event happened, I was together with my assistant ensuring that the nurses were
performing their tasks as planned and we were ready to address any arising issue. While we were
in the night shift before 9p.m a heavily expectant Esther dashed in with the help of her husband.
They were Indians, and they did not master the English language well, which posed a problem in
communication. Esther was in much pain, and because she could barely understand any of the
Basic English words, we requested the husband, who knew few words, to allow us to call a
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translator to help in the communication. They turned down our request, and I had to use sign
language to request Esther's husband take a seat as we took care of the situation. Esther was in
her late thirties, and this was the sixth pregnancy having had two miscarriages and three live
births, of which were girls. The husband hoped that the baby she would give birth to was a boy,
as we heard him praying in low tones. Esther insisted that she wanted to be attended by females
only, citing her religious needs.
Before taking her to the delivery room, my assistant explained the major details to
Esther's husband. Even though he did not understand as fast as needed, the latter grasped the
directions. After outlining the procedure, we brought papers for them to sign. Soon afterwards,
the anaesthetist came and offered Esther the epidural. The husband refused to leave the room and
let us continue with the procedure. He put his hand around Esther's head while touching his
shoulder periodically, which was annoying for the staff. The epidural procedure is expected to be
sterile to reduce the chances of infection. I had to intervene and struggled to tell him that bacteria
could cause infection, which could be problematic. After stepping out, the baby was delivered
but floppy, and he didn't seem alive. Esther got more worried when she saw meconium gushing
and started crying. I explained that we could do our best to offer extra attention until things were
okay. After one hour, the doctors managed to extract the meconium while rubbing him, after
which he cried, relieving our worries. After some hours, we transferred Esther to the postnatal
ward.
Feelings
I was empathic each time I saw how worried Esther was during the delivery procedure.
Empathy is an emotional connection to the state of another person (Terezam, Reis-Queiroz and
Hoga, 2017). She wanted the baby boy to survive, together with the husband. Additionally, I
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empathized with them for losing two pregnancies to miscarriage, which triggered more worry
during this procedure. Being Indians and unable to properly comprehend instructions given out
in English, it was irritating for the majority of the healthcare practitioners present. However,
being in charge and a leader, I tried to mend this bridge of misunderstanding to tailor a good
relationship. When I saw Esther in pain, I used hand gestures and expressions which she could
understand to ease her pain, and after smiling, I felt she was getting better (Gultekin et al., 2016).
Body gestures are non-verbal communication skills that can facilitate communication (Akoja,
Abolarin and Ogunlalu, 2019). After the procedure, I kept eye contact with Esther to showcase
my interest in helping if she needed some more interventions.
Evaluation
I feel it was right to engage with Esther and her husband when they visited the centre. My
approach was good when I tried to understand their worries and what they wished to be done
regarding giving Esther quality care as she sired. Explaining to them the benefits of having to be
attended by male practitioners instead of being exclusive was understanding the patient's needs
and ensuring they are satisfied with the best options available.
Cultural diversity requires that healthcare practitioners exercise professionalism to be
culturally sensitive for patients with diverse beliefs (Ekman and Emami, 2007). Fostering
cultural awareness improves understanding and confidence, a recipe for holistic care for
individuals with diverse cultural backgrounds (Prosen and Bošković, 2020).
Analysis
My good communication skills were instrumental and beneficial in providing quality care
to Esther. The clients being Indian, my non-verbal communication skills rescued the situation,
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and even though the husband knew a few English words, it was problematic to respond hence
hindering communication.
In the Indian sphere, which exercise Hinduism and the majority are Hindus, it is
fundamental and almost undisputed that a patient should be attended by a healthcare practitioner
bearing the same sex. Additionally, it is required that minimum exposure of the patient's body is
tolerated. Miscommunication is a problem that should not be a basis for unnecessary rifts, and
interventions should be done to help the situation.
Conclusion
Exploring this reflection has opened my thoughts on how important it is to accommodate
patients with language uncertainties and diverse cultural backgrounds. The reflection has helped
to pinpoint the effectiveness of my approach to this category of clients. Esther needed support
and personalized attention, and quality care.
Religious stands of different populations impact how people perceive healthcare
approaches and strategies. Hindu patients have a different view of how healthcare should be
undertaken compared to other religions in the case mentioned. Some healthcare providers may
find this absurd and get irritated with these individuals' demands. Intercultural
misunderstandings have detrimental effects in the long run. Therefore, healthcare providers must
be sufficiently equipped to satisfy patient needs, including an interpreter.
Action Plan
As a healthcare practitioner and not just a practising midwife, having worked in other
departments such as kidney and dialysis sections, I plan to evaluate the best ways to deal with
diverse clients. When engaging with a patient from another cultural background, I would strive
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to master basic words and research the culture to help grasp the expectations. I will continue
employing my communication skills to help understand the patient's needs and give them the
instructions I will deem necessary. Communication is an essential tool in giving quality care and
attaining positive clinical outcomes.
Furthermore, I will never prejudge my patient based on first impressions, but I will
engage with them to understand their stand and make possible changes if I feel something is
wrong. Having learned the importance of listening, I will continue to listen and set my eyes on
the client's gestures to create trust and showcase commitment (Jahromi, Tabatabaee, Esmaeili
Abdar and Rajabi, 2016). Additionally, I should respect people's fundamental beliefs and
principles as I attend to their needs.
Leadership
Key Characteristics of an Effective Leader
Leading a nursing team is not an easy task if a leader lacks “emotional intelligence,
integrity, critical thinking, good communication and skills.”Emotional intelligence in the clinical
setting is an essential feature that effective leaders possess. As a team leader who has been in a
team where the leader had emotional intelligence, it was established that help develop emotional
intelligence to the team members helps them cope with stress when challenges knock in their
routine (Regis College, 2021). Emotional intelligence helps the effective nurse to train the team
members of possible interventions and strategies that can be employed to counter negative
influences.
Secondly, integrity is a key characteristic for nursing team leaders. My leaders in the
teams I have been in and my personal experience integrity was instrumental in making the right
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choices by evaluating moral principles and ethical codes (Regis College, 2021). Clinical practice
is met with difficult situations that need a leader to tailor acceptable and right choices to
eliminate the problem and address difficult junctures in the treatment plans. Ethically viable
practices help in making safe and effective healthcare decisions.
Furthermore, critical thinking makes effective leaders make polished decisions
concerning a complex array of influencing elements in practice. Effective leaders should be able
to think critically, weigh on the options available and choose those which have a beneficial
influence on the team (Cherian and Karkada, 2017). Multidisciplinary collaboration calls for
critical thinking leaders to solve puzzles and attain better outcomes.
Also, an effective team leader should have good communication skills as they deal with a
collaborative set of individuals. Collaboration only materializes through the correct laying of
information and specifics to the other team members.
The Dynamics of Teams and Building teams.
Team members often have distinct roles they play, which can be influenced by
behaviours that impact other group members. Building and developing teams involves four
major phases; forming, storming, norming and performing. The leader offers a high degree of
guidance in the forming phase since the individual roles are not defined. This phase is less
established. Next in storming, there is the development of an understanding regarding how team
decisions are tailored. Additionally, the purpose is clear during storming, but the relationships
are not salient nor clear but blurry. During norming, the team understand the relationships and
commits to achieving team goals. Lastly, there is a “high-level commitment” for good
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performance in the performing phase of building the team. The workers focus on being strategic
together with the leader, helping in the smooth running of the team without much oversight.
There are five dynamics of teams: “psychological safety, dependability, structure and
clarity, meaning, and impact.” In psychological safety, the team members should feel safe in
engaging in risky ventures, making them seem vulnerable to others. Dependability dictates that
all the team members should perform the tasks promptly, meeting the objectives collectively.
Furthermore, structure and clarity need that team members to have defined and clear roles and
plans to accomplish tasks. Having clear roles helps create clarity, and hence everyone is
accountable for their portions. Meaning as a dynamic asserts that work is individually critical to
the entire team hence should be performed based on importance. Lastly, impact forced team
members to reflect on how and why their work matters, put more effort, and tailors change.
The Position of My Team
My team sits in the kidney and dialysis department and centre in the organization.
Additionally, we are contacted to offer training sessions to new employees and offer educative
services. Furthermore, the team liaises with the physicians in other departments to ensure goals
are achieved. My team strategizes on plans that will help train new nurses and get them absorbed
quickly in the system.
Common Leadership Problems
The common leadership problems which nursing leaders face include; staffing,
budgeting, burnout problems, and retaining nurses. Staffing problem is common for nursing
leaders as they have to create additional time as it eats much of the available time. Creating extra
time is to solve staffing problems that ensure that ratios are maintained to provide quality care to
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the clients (Ofei, Paarima, Barnes and Kwashie, 2021). Scheduling shifts without compromising
safe staffing can be problematic as the nurse leader should account for costly overtime.
Secondly, budgeting is a major problem that nurse leaders face. There are bulk nursing budgets
as influenced by the payroll and purchasing of supplies to ensure quality and efficient care
(Prempeh et al., 2021). These components eat up on the budget allocated, and the nursing leader
is left to battle financial constraints should the expenses exceed the budgeted amount.
During scheduling, the ratio of the nurses to patients may be beyond the required, and
workable scope required causing burnout. Burnout is a problem for leaders since it has
detrimental effects on workers' morale (Western Governors University, 2019). Low morale leads
to poor quality patient care being offered and may lead to good workers resigning. Furthermore,
retaining the nursing staff is a problem that the nursing leaders face. High demands for care
against staffing limitations long shifts causing burnout all affect the stands of nurses; hence may
opt to leave the job (Dall’Ora, Ball, Reinius and Griffiths, 2020).
Interventions to Leadership Problems
Increasing the number of nurses through recruitment helps attain the required ratio of
patients to physicians hence eliminating burnout. Additionally, nurse leaders should liaise with
nursing financial analysts to evaluate possible unsuitability in the proposed allotments. Financial
analysts will help examine monetary information and tailor strategic budget recommendations,
which helps draft finite budgets. Also, nurse leaders should boost team morale through forging
healthy relationships acknowledging concerns and rewards each time the nurses succeeds
(Stapleton et al., 2007). Rewarding helps the nurses to feel appreciated hence boosting morale
and avoiding burnout.
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Issue of Concern
An issue of concern is workplace violence. Workplace violence may not be physical, and
it takes the form of verbal assault and abuse (American Nurses Association, 2021). I had
encountered one issue of workplace violence when a nurse came and reported to me that she was
subjected to physical violence by a patient and incivility by a team member. A coworker was
constantly being rude to her and gossiping lies about her to other members. Two days before this
escalated, she was punched by a patient while requesting him to take medication, and she did not
report to me immediately but chose to keep quiet. I called the perpetrator, warned her about the
said behaviour, and asked her to verbally apologize to the nurse and write a formal apology letter
to management.
Addressing Workplace Violence
To address this workplace issue, I have developed and enforced a "zero-tolerance policy"
for the perpetrators of violence of any form of incivility. There are hefty fines imposed on those
who will be found guilty of such uncouth behaviour. A zero-tolerance policy helps the staff
members to fear losing their jobs or facing even serious cases in court if they perform actions
that may harm their coworkers. Secondly, I have tailored training programs that will help nurses
counter violent incidents in the workplace. Educating nurses on violence management policies
helps to know the right channel to follow when such incidents happen (Al‐Qadi, 2021). Selfdefence programs initiated helps the nurses to be mentally and physically prepared for physical
violence.
What to Change in Future
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Suppose such an incident of workplace violence occurs again. In that case, I will call the
perpetrator to a crisis meeting and request the executives to suspend him or her to be a lesson for
such uncouth behaviour. The zero-tolerance rule will apply, and the nurse will pay a hefty
penalty after the four-month unpaid suspension is over. Suspending a violent worker will act as a
warning to others of similar behaviour.
Conclusion
The paper has critically addressed my reflection of key experiences as a practising nurse.
Using the Gibbs cycle model, I have reflected on my experience case while working as a
midwife. Reflection happens when a healthcare practitioner undergoes an experience personally
examines it critically and professionally to expose a gap that could have been filled through
acting differently. Theorist John Dewey examined the concept of reflection and regarded it as
being learning through experience by participation and relevant experimentation. Reflective
practice needs a combination of skills to work effectively and produce constructive results. Gibbs
Model of reflection comprises six phases collectively called the "Reflective cycle." These phases
include; "description, feelings, evaluation, analysis, conclusion and action plan". Gibbs model is
straightforward, offers a platform for making a course of action, and is clear. However, the
model is not majorly introspective. Reflection gives a chance of evaluating what was done right
throughout the experience so that it may be repeated in the future to yield satisfactory results
while eliminating the bad.
Reflection on Module
This module was not only interesting, but it was thought-provoking, having given me a
platform to reflect on my experience as a practising nurse. This has been a good experience to
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open my mind and demonstrate my ability to outline my experience using the Gibbs cycle model.
I never cherished nursing experiences as a trendsetter until I encountered this module. Through
critical thinking, which is among the secretive tenets of this reflective module, I have learnt of
my past weaknesses, which I will eliminate in my practice as I work on bettering my strengths.
This module is constructive and educating at the same time through the elements it teaches about
critically examining scenarios that have happened in the past and how they influence a nurse's
future practice. I would change in the future concerning this module to take note of diverse times
and places, that is, more opportunities to explore multiple experiences using one model
simultaneously to engage the mind.
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