Critical Reasoning: Leadership
1. Why do you think Antonio is feeling stressed?
Stress does not exist as an isolated event, but rather as a result of the interaction between the person and his environment. Antonio’s general source of stress could include: conflict with competing roles; complexity of the work; lack of control over work schedule, which prevents time for planning, and accomplishing the job, or developing professional relationships; value conflicts; and an excessive workload. More specifically, Antonio is feeling stressed because he is new at the job and he is already in danger of failing to meet two very important responsibilities that would reflect on his leadership and managerial skills (Leary & Allen, 2006). First, he is behind on his staff evaluations and he knows that periodic evaluation of the staff under his care is critical to ensuring that the health needs of the patients in his unit are being met (Leary & Allen, 2006). Failure to meet this responsibility means that he is letting his patients down. His staff evaluation also helps the cardiac step-down unit he leads determine whether the unit has the right number of people, with the right skills, available at the right time, to care for all the patients in the unit. The smooth operation of his unit and the allocation of financial resources to his unit depend on this assessment and failing to meet to this responsibility will let the unit down. The scenario also suggests that Antonio is failing in his balancing act of meeting the needs of the patients under his direct care and the needs of the patients under the care of his staff. It also suggests that Antonio has problems with communication and delegation, issues that can lead to stress (Hansten, 2008, McInnis & Parsons, 2009). In resolving his time management problem, Antonio should focus on ways to improve communication with his staff and learn to delegate some of his responsibilities to improve his management of the unit (Hansten, 2008, McInnis & Parsons, 2009). Both these approaches would serve to improve Antonio’s leadership skills and as these improve his confidence would improve and his stress would diminish (Leary & Allen, 2006).
2. Make a to-do list for Antonio.
Prepare patient case load data
Compile list of tasks accomplished and tasks in progress
Prepare an assessment questionnaire for his staff
Forward the questionnaire vie email with instructions for immediate response
Schedule meetings with each staff member for a brief discussion of the questionnaire
Provide feedback
Schedule a meeting with the staff member responsible for the documentation of patients who exceeded their stay
Prepare a short questionnaire to help document the reasons for the extended patient stays
3. Develop a time log for Antonio to use to analyze his activities.
Antonio should design a Gantt chart to manage and track the progress of his tasks. A Gantt chart is flexible, allowing the addition and removal of tasks as necessary, and can help Antonio evaluate each project individually. A sample Gantt chart is shown below. Figure 1 is the Gantt chart before any tasks have been completed. Figure 2 is a sample Gant chart after the completion of some of the tasks, given in percentages.
Figure 1: Gantt chart at start of tracking period, 0% accomplishment of tasks
Figure 2: Gantt chart during course of tracking, 38% accomplishment of tasks
4. How can Antonio organize and streamline his work?
Antonio needs to formulate a long-term plan that organizes the issues into broad categories and helps him prioritize the different requirements of his job. To accomplish this, Antonio has to address the following questions:
Table 1: Long-term management plan according to categories
Assessment and Planning
What steps must be taken to ensure the needs of the patients are being met?
Which tasks need daily/weekly/monthly attention?
Which tasks can be delegated?
Communication
What information does the team leader have to provide to his staff?
What information from the staff does the leader need to collect?
How do other team leaders manage to fulfill their own responsibilities?
Problem Identification and Solution Implementation
Which procedures may be instituted to facilitate staff assessment?
Are there ways in which staff members can help with their own personal assessments?
Can patient data be streamlined to facilitate evaluation?
Delegation
Which tasks and responsibilities may be delegated?
Which staff members have the right skills, experience, and training to take over the task or responsibility?
References
Hansten, R.I. (2008). Why nurses still must learn to delegate. Nurse Leader, 6(5), 19-25.
Leary, C. & Allen, S.J. (2006). Navigating the path of leadership: 12 qualities of an
effective charge nurse. Nurse Leader, 4(6), 22-23.
McInnis LA, & Parsons LC (2009). Thoughtful nursing practice: reflections on nurse
delegation decision-making. Nurs Clin North Am., 44(4):461-70.
