NUR 4280 Module 1 Leadership Style Self-Assessment Example

Leading People Who Will Be Gone by Tomorrow: Leadership, Management and a Charge Nurse's Self-Assessment on an Observation Unit

Student Name

Bachelor of Science in Nursing, Thomas Edison State University

NUR-4280: Leadership and Management In Nursing

Mentor Name

Month Day, Year

Leading People Who Will Be Gone by Tomorrow: Leadership, Management and a Charge Nurse's Self-Assessment on an Observation Unit

I have worked for three years on a 22-bed observation unit attached to the emergency department of a suburban hospital, and for the last year I have been one of its regular charge nurses. Most of our patients are placed in observation for chest pain, syncope, transient neurological symptoms or dehydration, and most leave within twenty-four to thirty-six hours. The unit runs on protocols and on the clock. A chest pain patient who arrives at midnight may have a second troponin at 0300, a stress test at 0900 and a discharge by noon, and every hour lost between those steps is an hour a bed stays closed to the emergency department. Charge nurses on this unit spend much of their time watching that clock, and the role has taught me as much about coordination as about bedside care. This paper explains the difference between leadership and management as I now understand it, assesses my own leadership style honestly, and identifies what I need to develop during this course.

Two Functions, One Shift

Management and leadership are often used as if they meant the same thing, but the distinction matters in practice. Management is the work of planning, organizing, staffing, directing and controlling resources so that the unit's work gets done reliably. Leadership is the work of influencing people toward a shared goal, often when no rule tells them what to do. Marquis and Huston (2021) describe the two as overlapping roles that the best nurse managers integrate, noting that a manager holds formal authority from a position while a leader's influence may come from anywhere on the team. On my unit the difference is visible within a single shift.

At 0700 I am a manager. I take report, check the census against the staffing grid, assign patients by acuity and expected discharge time, and confirm which stress tests and imaging studies are scheduled. By 1100 I may need to be a leader. Last month a nurse with eight years of experience disagreed with a new protocol that allowed nurses to discontinue telemetry on low-risk chest pain patients after a second negative troponin. Nothing in my job description told me how to respond. I could have restated the protocol, which would have been management. Instead I asked the nurse to walk me through a case that caused worry, and we took the question to the unit's medical director together. The protocol did not change, but the nurse began using it and now explains to new staff why it is safe.

Assessing My Own Style

To assess my style I used two lenses: the full-range leadership model described by Bass and Riggio (2006), which places transformational, transactional and laissez-faire behaviors on a continuum, and feedback I asked for from four colleagues, two staff nurses, a patient care technician and the day nurse manager. The transformational end of that range is built from four behaviors: being a role model others want to follow, offering a vision that motivates, challenging people to think about how work is done, and attending to each person's development. Transactional leaders rely on contingent reward and on monitoring for exceptions. Laissez-faire leadership is the absence of leadership when it is needed.

The feedback was more useful than my own guesses. All four colleagues described me as dependable and organized, which are strengths of transactional management: I make assignments that make sense, I notice when tasks are missed, and I follow up. Two described me as approachable when they bring a problem. Only one described me as someone who explains why we do things or who asks for ideas. The technician said, kindly, that I am at my best in a crisis and least visible on a calm afternoon, when I tend to catch up on charting rather than talk with staff. That is a description of management by exception, and it is accurate.

Why It Matters for Patients

The style a charge nurse uses is not only a matter of personality. Wong et al. (2013) pooled the findings of twenty studies and reported that units led in relational ways, with transformational leadership among them, tended to report happier patients alongside lower counts of four harms, namely infections picked up during the stay, restraint use, medication mistakes and deaths. None of the included studies could prove cause, because none assigned leaders at random, and most looked at nurse managers rather than at charge nurses. Even so, they suggest that the behaviors my colleagues found missing, explaining the reasons for practice and inviting ideas, are linked to outcomes that matter on any unit.

On an observation unit those behaviors may matter more than usual. Our patients move fast, and our protocols change often as evidence on chest pain and syncope evolves. Ross et al. (2013) found that dedicated observation units with defined protocols had shorter stays and lower admission rates than observation care delivered elsewhere in the hospital, but protocols only work when nurses understand and trust them. A charge nurse who manages the protocol well but never explains it leaves staff following rules they do not believe, and that is how workarounds begin.

Development Goals for the Course

I have set two goals. The first is to spend fifteen minutes of every calm afternoon shift talking with staff about a protocol, a recent case or a change coming to the unit, and to record what I learn. This targets intellectual stimulation and individualized consideration, the two transformational behaviors my colleagues saw least. The second is to lead one small change on the unit during this course, using a change model from the readings, so that I practice influencing without relying on my position. I will ask the same four colleagues for feedback again at the end of the course and compare their descriptions with the ones in this paper.

These goals are modest on purpose. A larger goal, such as changing the unit's culture, would be impossible to measure in one term and easy to abandon after a hard week. Leadership habits are built through repetition on ordinary shifts, and I would rather change one afternoon routine than promise a new leadership philosophy. If the feedback at the end of the course describes me as someone who explains as well as organizes, the course will have done what I need it to do.

References

Bass, B. M., & Riggio, R. E. (2006). Transformational leadership (2nd ed.). Lawrence Erlbaum Associates.

Marquis, B. L., & Huston, C. J. (2021). Leadership roles and management functions in nursing: Theory and application (10th ed.). Wolters Kluwer.

Ross, M. A., Hockenberry, J. M., Mutter, R., Barrett, M., Wheatley, M., & Pitts, S. R. (2013). Protocol-driven emergency department observation units offer savings, shorter stays, and reduced admissions. Health Affairs, 32(12), 2149-2156. https://doi.org/10.1377/hlthaff.2013.0662

Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of Nursing Management, 21(5), 709-724. https://doi.org/10.1111/jonm.12116