Leadership is defined as act uponing people to accomplish a intent or set of ends, but distinguishing it from direction causes confusion in many cases ( Tappen, Weiss and Whitehead, 2004 ; Senior and Fleming, 2006 ; Robbins, Judge and Sanghi, 2009 ) . Leaderships can be directors but non all directors can be effectual leaders, doing leading an of import facet of effectual direction ( Tappen, Weiss and Whitehead, 2004 ) .
Several efforts have been made over the old ages to explicate the features of an effectual leader. Trait, behavioural/style, situational-contingency and transformational theories are some of the theories that have been proposed to explicate these features ( Yoder-Wise, 2003 ; Tappen, Weiss and Whitehead, 2004 ; Senior and Fleming, 2006 ) . Goleman ( 2000 ) besides used competences of emotional intelligence ( self-awareness, self-management, societal consciousness and societal accomplishments ) to explicate these features. Nevertheless, none of these theories seem to adequately explicate the features that make an person an effectual leader. Yoder-Wise ( 2003 ) recognises followership as attitudes exhibited by persons that the leader comes into contact with and explains that followings collaborate and act with the leader.
Mahoney ( 2001 ) states that all nurses must get leading accomplishments since nursing leading ranges from the staff nurse lovingness for a patient to a nurse in charge of a infirmary. Nurses in clinical leading places collaborate with other leaders in the health care system to advance positive alteration ( Touati et al. , 2006 ) . However, Antrobus and Kitson ( 1999 ) criticise nursing leading for its deficiency of external focal point ( socio-political impact on wellness policies ) . They recommend that, in add-on to the cognition on issues related to nursing pattern, possible leaders of nursing should familiarize themselves with societal and wellness policies, direction and research. Sutherland and Dodd ( 2008 ) place that a batch of alterations are happening within the health care system, driving the demand for leading development.
As a clinical leader in the devising, a sound apprehension of schemes for alteration direction would fix me as an effectual leader. This is a brooding essay on how I set up a personal development program to derive much penetration on schemes for alteration direction. The contemplation is guided by Gibbs ‘s brooding rhythm ( 1988 cited by Jasper, 2003 ) . Although Cotton ( 2001 ) sees brooding pattern in nursing as a job, Durgahee ( 1996 ) identifies that nurses are able to hone their actions when they examine their experiences through contemplation and, accordingly, become witting of how different elements of attention inform entire professional nursing pattern.
The essay begins with a brief debut of my background, and a description of issues that led me to concentrate on alteration direction schemes in my personal development program. It, so, follows with a contemplation on strengths, failings, chances and menaces that I have and how these would act upon my calling in the hereafter.
The program is presented, get downing with my larning nonsubjective and actions that I hope to take to run into my larning nonsubjective. The literature is so reviewed, followed by an assessment of my administration and how I plan to implement alteration. The last subdivision describes my advancement.
Professional Background
I graduated with a BSc. Nursing grade from the Kwame Nkrumah University of Science and Technology ( KNUST ) in Ghana in 2008. I practised at the Komfo Anokye Teaching Hospital ( KATH ) , besides in Ghana, as a general nurse for one twelvemonth before inscribing at the University of Nottingham for MSc. Advanced Nursing. My duties, as stated by the Ghana Health Service ( 2005 ) , are to:
Assess attention demands of patients, develop and implement programs of nursing attention consequently
Formulate, novice and revise patient attention as status warrants
Participate in ward unit of ammunitions
Allocate undertakings based on accomplishment of staff
Supervise staff and pupils in the ward
Evaluate nursing attention and guarantee continuity of attention
In the 3rd twelvemonth of my undergraduate class, I was one of three pupils selected for a twelve-week exchange programme in the United States of America. The end was for us to see health care system and nursing pattern in the USA and consequence positive alterations in nursing and health care at KATH. Generally, pupils who participate in such plans develop themselves, larn differences between civilizations, and are able to compare healthcare systems and nursing in the several states ( Scholes and Moore, 2000 ; Button, Green, Tengnah et Al, 2005 ) .
Judging from the exposure I had in the USA, I felt I could do a major impact on my co-workers upon my return. Exchange pupils, whether short-run ( 1 – 4 hebdomads ) or long-run ( more than 4 hebdomads ) , expect to hold a positive influence upon their return to their place states ( Button et al, 2005 ; Carty et Al, 2002 ) . I developed myself, to an extent, as a consequence of take parting in the exchange programme. This was confirmed by some of my co-workers. I, besides, learnt some of the similarities and differences in civilization, nursing pattern and health care between the USA and Ghana. Notwithstanding, the overall intent of holding positive impact on my co-workers was non realised. I believe that deficiency of a scheme to consequence the proposed alterations every bit good as failure to join forces with the other exchange pupils were the major grounds for the failure.
I expect to develop a instruction bundle to detain the patterned advance of chronic kidney disease among patients with diabetes as my Advanced Nursing Practice faculty undertaking and implement it at KATH. I, besides, hope to derive new thoughts on patient attention while I am in the United Kingdom. Upon my return to Ghana, I aspire to presume a nurse-educator function. This occupation would give me some influence over the preparation of nurses at KNUST and KATH. All these have led me to concentrate on alteration direction in my personal development program so as to do positive alterations in nursing at KATH.
I should be able to reflect on my strengths, failings, any chances and menaces that may act upon my aspiration to consequence some alterations at KATH and Pearce ( 2007 ) suggests that utilizing SWOT model is a good manner to make this. Therefore, utilizing the SWOT analysis model, I identified the followers:
Strengths
I am committed to what I do
I am good at actuating others
I have good interpersonal accomplishments
I have good presentation accomplishments
Failings
I attempt to delight everybody
I am excessively indulgent
Opportunities
I am analyzing with co-workers from different parts of the universe
I have other experience from abroad
I am likely to go a nurse-educator at KNUST
Menace
Majority of the staff may see me as immature and inexperient to take them
Pearce ( 2007 ) suggests that one time menaces have been identified, there should be a manner to manage them. By confidently showing the experience gained, developing good interpersonal relationships and clearly showing shared visions, bulk of the staff are likely to join forces with me ( Martin, 2006 ) .
THE Plan
Learning Objective
Needs appraisal assists persons to put clear larning aims for their personal development program ( Holloway, 2000 ) . Contemplation on the exchange plan reveals that I lack thoughts on schemes and accomplishments required to take alteration within an administration. Therefore, it is my primary aim to utilize this personal development program to larn and develop schemes to take alteration in the establishment that I work in.
Actions to Meet the Objective
The Management Standards Centre ( 2004a ) suggests that leaders must possess three sorts of cognition and apprehension to be able to take alteration successfully. These are general cognition and apprehension ( illustration is knowledge on theoretical accounts and methods for taking organizational alteration, their strengths every bit good as their failings ) , sector-specific cognition and apprehension ( illustration is knowledge on emerging developments in the wellness sector ) and context-specific cognition and apprehension ( illustration is knowledge on countries within the administration that need alteration, with grounds and precedences ) . To take alteration successfully, leaders must, besides, be able to depict the alteration procedure within the administration and how it affects the people within ( Mott, 1996 ) . Sing these, actions that I consider as appropriate for me to run into my aim are as follows ;
Review literature on alteration direction within administrations ;
Perform an assessment of the administration that I work in ; and
Plan the execution of the alteration.
Main resources that are needed to set about these actions are clip and literature on leading and alteration direction within administrations. I should be able to accomplish my aim within seven months and the result step for me would be my ability to place change direction schemes that would outdo fit my organizational context.
LITERATURE REVIEW
Change Management within Organisations
Change in administrations is inevitable ( reactive ) and desirable but, normally, complex and hard to convey about ( Sturdy and Grey, 2003 ; Bellman, 2003 ; Boshoff, 2005 ; Dzik-Jurasz, 2006 ) . Yet, there are many a clip when alteration is proactive ( planned ) – administrations make alterations due to chances that they have to better the workplace or their end product ( Dzik-Jurasz, 2006 ) , and is besides described as invention. Change is really critical for health care establishments that seek to present quality and patient-centred attention to its patronage, and nursing leading is regarded as a anchor for such alterations to be successful ( Dzik-Jurasz, 2006 ; Sutherland and Dodd, 2008 ) . As a nurse aspiring to be a clinical leader, understanding the procedures of alteration is, hence, indispensable.
Pettigrew, McKee and Ferlie ( 1988 ) province that leaders of alteration should concentrate on the content, the procedure, the context of the alteration every bit good as the successful ordinance of the relationship between the three. They explain content as the specific countries where the alteration is expected to happen, and processes as the activities, expected reactions and interactions between the groups that seek to convey about the alteration. Context, as they explain, refer to internal and external factors that have influence over activities within the administration.
Lewin ( 1951 cited by Senior and Fleming, 2006 ) identifies three phases ; dissolving, traveling and refreezing. At the phase of unfreezing, jobs, demands or chances for alteration are identified, and the phase where new schemes or thoughts are implemented causes persons within the administration to see the alteration ( traveling ) . Finally, the phase of refreezing is reached when the alteration has been good integrated into the administration ( Yoder-Wise, 2003 ; Boshoff, 2005 ) . Tappen, Weiss and Whitehead ( 2004 ) , besides, place that alteration procedure is in four stages ; description of the alteration, be aftering the execution of the alteration, implementing the alteration, and incorporating the alteration. Change starts when consciousness of the demand for it is created and ends when a complete rating of its expected effects has been done after the execution ( ibid ) .
Lewin ( 1951 cited by Baulcomb, 2003 ) states that alteration is associated with certain forces that either facilitate or defy it ; success would ensue when the forces easing the alteration exceed those that are defying it within the context. Forces within the administration may be one of such forces. Peoples resist alteration on the evidences of their psychosocial demands, the rightness of the alteration and, besides, how the alteration affects their place and power ( Tappen, Weiss and Whitehead, 2004 ) . Therefore, they should be taken into consideration and be actively involved in the alteration procedure ( Boshoff, 2005 ) .
Bennis et Al. ( 1985 cited by Bellman, 2003 ) place three schemes of alteration and these are rational-empirical, power-coercive and normative-re-educative schemes. Rational-empirical and power-coercive schemes both use top-down attacks while normative-re-educative attack employs a bottom-up attack. Top-down attack involves senior direction bring forthing the thought, planning and straight implementing the alteration while the bottom-up attack straight indulges the employees in the alteration procedure ( Ryan, 2008 ) . However, Ryan ( 2008 ) adds that top-down scheme entirely is non effectual for pull offing alteration at all times although it is really common under transformational leading. Other schemes are instruction and communicating ; engagement and engagement ; facilitation and support ; dialogue and understanding ; and use, cooptation, and coercion ; and, dependant on the state of affairs, these schemes may be used entirely or in combination ( Kotter and Schlesinger, 1979 cited by Yoder-Wise, 2003 ) . It appears that the sort of scheme used would act upon how the content of the alteration would be communicated to the parties involved.
Action research is another alteration scheme and the procedure is said to get down when alteration is considered necessary ( Bellman, 2003 ) . Relevant information is collected consistently and reported to persons who must move on it, after which programs are collaboratively formulated and the necessary actions undertaken – research and action combined ( Senior and Fleming, 2006 ) . The procedure is in five phases ( diagnosing, analysis, feedback, action and rating ) and is described as problem-focussed, and able to cut down staff opposition because of their active engagement in the procedure ( Robbins, Judge and Sanghi, 2009 ) .
Organizational Appraisal
Komfo Anokye Teaching Hospital ( KATH ) is the 2nd largest learning infirmary in Ghana, developing many physicians, nurses and other paramedics in the Ashanti Region of Ghana. It is an independent service bringing agent under the Ministry of Health of Ghana ( MOH, 2009a ) . In add-on to developing many of the wellness forces in the Ashanti Region, many people within and outside the Ashanti Region seek health care at that place. As a consequence, proviso of quality health care has ever been the focal point. An administration that recognises the demand for alteration, weighs costs and benefits, and programs for the alteration when the benefits outweigh the costs is ready for a alteration ( Dalton and Gottlieb, 2003 ) . KATH is, hence, ready for alteration because some of its employees are sent overseas or to other parts of the state, whenever there is the demand for a new accomplishment or cognition to be gained, to convey about a positive alteration within the infirmary. This may be a factor that would ease my docket to implement lead alteration within the establishment upon my return.
However, Ghana, as a state is developing ( CIA, 2008 ) . Therefore, fiscal support, many a clip, becomes a trouble. Another challenge may be the fewer nursing staff. The Ministry of Health ( 2009b ) estimates that there was a nurse-to-population ratio of 1:2024 in Ashanti Region and 1:1451 for the full state in twelvemonth 2007.
Planing the Execution of the Change
This is the 2nd phase of the alteration procedure, as was identified by Tappen, Weiss and Whitehead ( 2004 ) , and it involves placing possible immune forces to the proposed alteration and placing schemes to forestall or get the better of them. The alteration schemes to follow every bit good as how to pass on the demand for alteration are considered at this phase ( Management Standards Centre, 2004b ) . Bellman ( 2003 ) suggests that the normative-re-educative ( bottom-up ) scheme is suited for altering pattern within nursing. As it appears in my instance, the demand for alteration would be driven from underside ( an employee ) to exceed ( direction ) and is likely to be supported by the nurses since it is coming from their co-worker. Nevertheless, others may defy the alteration because they might non see the demand for it ( Baulcomb, 2003 ) . But Martin ( 2006 ) suggests that a clear presentation of the vision and demand for alteration may do a bulk of the staff to back up it.
Flower and Guillaume ( 2002 ) suggest that dissolving stakeholders of health care is a necessity to dissolving the establishment. Stakeholders at KATH for my undertaking include the Director of Nursing Services ( DNS ) , the Deputy Director of Nursing Services ( DDNS ) for the medical board of directors, and the caput of the diabetic clinic. When these cardinal people are made to recognize the demand for a alteration, so hospital direction is likely to back up the proposed alteration.
In times like these when evidence-based pattern is being advocated for ( McEwen, 2007 ) , I should be able to utilize grounds to warrant the demand for a alteration. I, hence, program to set about a survey that would compare the instruction bundle that I hope to present with the current attack used at KATH. If the new instruction bundle proves to be comparatively successful, so bulk of the staff are likely to appreciate the demand for it.
Advancement
Reflecting on the exchange plan, I realise that the thought of conveying about alteration in pattern was non clearly communicated. None of the procedures of alteration, as has been identified now, were known at that clip neither was there a scheme or a program for the alteration. Some alterations are unsuccessful because they are non clearly defined ( Tappen, Weiss and Whitehead, 2004 ) and that is precisely what happened. Although I am still working on developing the instruction bundle that may be different from what is already present at KATH, I now realise that its intent and effectivity should be good communicated to other co-workers and direction before the thought would be supported. I have discussed my thoughts with the Director of Nursing Service of KATH and the Deputy Director of Nursing Services for the medical board of directors and both of them seem excited about my thought.
However, I have come to understand that all sorts of alteration are likely to confront some signifier of opposition from the people ( Baulcomb, 2003 ; Tappen, Weiss and Whitehead, 2004 ) . I hence, hope to use the normative-re-educative ( bottom-up ) scheme because it has been identified as suited for altering pattern within nursing ( Bellman2003 ) . I besides believe that such a scheme would allow my co-workers feel actively involved in the alteration procedure and, therefore, support it.
Furthermore, I hope to derive new penetrations from my visits to some infirmaries and my interactions with some specializer nurses while developing the undertaking. I, hence, hope to modify my programs and schemes, when the demand arises, in order to go an effectual alteration agent within my administration.
Decision
Personal development programs assist persons to concentrate on specific demands and stairss to take to accomplish their aims ( Floodgate and Nixon, 1994 ) . This essay has assisted me to reflect on my pattern and functions as a leader. Whenever there is contemplation, there must be a alteration in position ( Atkins and Murphy, 1993 ) . Development of alteration direction schemes was identified as my larning nonsubjective. Actions to run into this aim were identified and pursued. Gibbs ‘s brooding rhythm ( 1988 ) was used as a usher. Consequently, I have become familiar with different schemes that could be employed to consequence and lead alteration successfully, and programs to implement these in my establishment have been proposed, although they are capable to alter when new penetrations are gained.