Nursing Leadership Assignment- Preparation Of Mothers During Postnatal Hospital Stay

Question

Task: How to prepare mothers for postnatal hospital stay through nursing leadership assignment reporting?

Answer

Introduction
This Nursing leadership assignment explores how Midwifery practice is underpinned by values that support the way in which midwives offer adequate care and service to attend women during pregnancy, post-natal period, labour, and birth while collaborating with other health care providers when needed. However, due to increasing paper workload and complying with mothers’ individual specific needs, it has been identified that the morale and satisfaction of midwives are sinking lower which requires immediate attention. Other than that, during the postnatal period, the pressure towards the midwives significantly increases as the mothers are not capable to care for themselves or newborns despite antenatal classes. This in turn critically impacts the working culture as well as care for women and their babies in terms of the highest quality standards. Based on such context, identified on this Nursing leadership assignment, I have put forwarded the significance and feasibility of adopting a 3-days hands-on intensive course for mothers during the postnatal hospital stay in my workplace Hong Kong Sanatorium & Hospital for ensuring the highest quality of care for women and their babies as well as increases morale, self-confidence, and nursing quality care among midwives. In addition, the challenges and opportunitiesassociated with the introduction of this intervention at the healthcare institution have been further indicated along with a significant plan to accomplish my end goal to introducea 3-days hands-on intensive course for mothers during the postnatal hospital stay. Lastly, the evaluation of the change in order to measure success at the end of one-year activity has been highlighted in this Nursing leadership assignment.

My leadership style and qualities
As put forward by Kumar et al. (2018), transformational leadership is a significant leadership style that can inspire and motivate positive changes in those who follow. In addition, this Nursing leadership assignment also explores how transformational leaders focus on empowerment and vision which in turn lowers turnover costs, improves communication, increases staff engagement, solves problems, as well as drives, change positively. Based on the research performed on this Nursing leadership assignment, I believe that these characteristics are my major competencies and qualities which can make me a great leader in the present and future terms. I always believe that fostering change requires an effective commitment by leaders and team members which makes my capabilities more intense and significant. On the other hand, I primitively emphasize gaining trust, loyalty, respect, and appreciation of the people in order to drive changes within people’s behaviour. As stated by Lowe et al. (2018), transactional style of leadership is based on motivating people to work harder by offering regards or punishment for good or poor behaviour. As a result, it leads to the fallback position for many leaders affecting business growth and success.

Fig: 1 (Components of transformational leadership style)
Source: (Malik et al. 2017)

Based on such context, I am completely against the transactional leadership style as in order to influence positive behaviour among people, the need for motivation and inspiration is relatively high compared to offering rewards and punishments for behaviors as identified on this Nursing leadership assignment. In addition, one of my major qualities in terms of transformational leadership is I am intrinsically motivated which assists others to follow my lead by creating an inspiring vision of the future that compels others to follow. Likewise, McInnes et al. (2020) indicated four components or behaviours of a transformational leader including individualised consideration, intellectual stimulation, inspirational motivation, and idealized influence. Based on individualised consideration, I attend to the needs of my team members by reflecting empathy, support and keeping communication open by considering the contributions of each member. In terms of intellectual stimulation, I always encourage creativity by taking risks, challenging assumptions, and brainstorming ideas that assist to perform tasks adequately. As per inspirational motivation, I articulate an inspiring vision that drives the team members forward and communicatesoptimism which motivates others to work harder for accomplishing the vision of the future. However, based on idealized influence, I believe that I need to work hard on becoming a role model for ethical behaviour as it can assist me to gain respect, trust and instill pride among my team members and followers. This is the particular area I believe requires significant improvement in terms of my leadership style.

Areas that require improvement identified on this Nursing leadership assignment
After analysing my qualities and competencies in terms of transformational leadership style, I comprehended that the qualities and competencies required for becoming an effective transformational leader are well integrated within me. However, one of the major areas in transformational leadership style is the idealized influence component,Darling et al. (2021) suggested that idealized influence is the degree to which the leader offers a role for ethical behaviour in terms of the followers. Based on such context, I believe that this particular component needs to be improved in terms of my leadership style for successfully initiating the new change and accomplishing my end goal to enhance the highest standards of care for both women and their newborns. On the contrary, in order to develop idealized influence component within me, I need to enhance the traits of a role model for gaining trust and respect from others and instilling pride.

It has been well suggested by Van Hecke et al. (2019), for becoming an idealized influence, the need to develop the traits of a role model is highly essential for positively influencing others and to accomplish both organisational and personal goals. Based on such context, I intend to demonstrate confidence, uniqueness, communicate and interact with others, show concern and respect for others, have willingness and humility to admit mistakes as well as focus on doing good things outside the job. Other than that, I am focusing on opening up all communication channels for gaining honest suggestions, feedback, and criticism from my team members while keeping each individual involved in the change or introduction of the new strategy. In addition, I will delegatetasks to staff nurses in their work aspects and encourage others to accomplish the end goal and drive positive change which is beneficial for midwives, staff, women, and their newborns.

Climate/culture of the workplace at Hong Kong Sanatorium &Hospital
At the Hong Kong Sanatorium & Hospital, there are 56 maternity beds which are distributed on 3 floors with around 35 postnatal ward nurses or midwives. The vision and focus of the hospital are to provide the highest quality of care to mothers and newborns. As per Lumbers (2018), the human relation theory indicates the need for fostering an encouraging and cooperative culture at the workplace for delivering quality service and care while considering the needs and morale of staff. Likewise, this Nursing leadership assignment emphasizes customer satisfaction and service while building a collaborative relationship with the staff. However, despite such vision and focus, there are potential problems in the workplace culture in terms of the postnatal ward of HKSH which is affecting the care for mothers and their newborns as well as the morale of midwives. For instance, mothers or clients are highly passive and reluctant in learning postnatal or baby care despite attending antenatal classes or going through pamphlets or videos. This indicates they have no hands-on practice and are highly resistant to getting off the bed. Results generated from this Nursing leadership assignment show, it entirely put pressure on midwives in terms of changing their pads, cleaning wounds, giving bedpans, sending their babies to and from the nursery.

Other than that, mothers’ complete dependency on midwives to position their babies for breastfeeding, changing babies’ diapers, bottle feeding, baby baths, and other specific needs of mothers indicates a lack of confidence or learning. In addition, on the day of discharge, only 5-10 mins information sessions are provided to mothers which are insufficient, and brief those results in problems when they go home. Also, complying with paperwork and meeting the mother’s individual specific needs makes it highly complex and difficult for midwives or staff nurses which lowers their morale and satisfaction as well. As stated by Cummins et al. (2018), in order to enhance standards of quality care, the need for increasing satisfaction and morale among workers is highly essential. Hence, the need for change is highly required specifically in this particular area for delivering quality care and services for mothers and their newborns as well as increasing the satisfaction and morale of midwives in the HKSH.

Nursing leadership assignment: Strategies for implementing changes
In order to enhance productivity, performance, and quality of care within the healthcare industry, the need to develop effective strategies and initiatives for managing complexities and issues surrounding the midwifery profession has become highly essential in this present covid-19 crisis, Hewitt et al. (2021). Based on such context, I believe that at the HKSH, the need for considering strategic changes to educate mothers, families and to boost the morale, recognition, and self-confidence of midwives is essential to enhance workplace culture and deliver high-quality care to both mothers and their newborns. Likewise, I am planning to propose a 3-days hands-on intensive course for mothers and their family members by re-demonstrating with their own newborns. On the 1st day, complete focus and education will be provided for baby care including holding, breastfeeding technique, positions, diaper change, baby vaccine program, bottle feeding technique, bath, sleeping pattern, and umbilical cord management of the baby. On the 2nd day, the complete focus and education will be provided for mother care which will include wound care, management of breastfeeding problems, postnatal nutrition, exercise, and other relevant aspects. On the 3rd day, complete focus and education will be provided for family relationship and emotional care that will integrate awareness of postnatal depression and blues, inviting husband to attend and support, and communication skills to cope with dissension.

Other than that, around 60-90 mins will be provided for each session per day but mothers are free to choose whether they want to participate in this postnatal education and learning or not. Also, compliance with HKD200 per session will be considered for ensuring the quality of the communication. As put forward by Fry & Attawet (2018), successful initiation and adoption of change require the active participation of the members who are highly influenced by the change. Likewise, this Nursing leadership assignment also explores active participation of all midwives in the postnatal ward is compulsory for initiating the new change as they will provide short lectures, hands-on workshops, and role-play. The course will be conducted in a group of 5 mothers or couples where they can actively engage and participate in team learning. Furthermore, upon completion of the course, evaluation forms and a follow-up program will be significantly provided to mothers after discharge for gaining feedback about the course as well as to support them as needed. As a result, not only the quality of care will be at a premium level but also midwives can feel encouraged and motivated to become highly productive due to supportive and collaborative relationships with clients while increasing their sense of accomplishment. In addition, it is expected that this change or the introduction of the new course can further increase commitment and collaboration among midwives which can ensure satisfaction and strengthen their skills and competencies accordingly.

Theoretical and practical issues that need to be considered in facing challenges in achieving change
As indicated by Russell (2018), every organisation faces significant challenges in terms of both practical and theoretical aspects for driving or initiating a change. Likewise, my plan to introduce the 3-days hands-on intensive course for mothers and their family members is a significant change at HKSH for staff, midwives, management as well as clients. However, the major influence of this change is expected to be relatively high on midwives and management. One of the major theoretical issues that need to be considered is the introduction of this new course will directly increase the workload of midwives as well as increase demand for manpower. As delivering adequate information to the mothers about child care and self-care postnatal period is highly intense and requires in-depth knowledge by midwives to demonstrate appropriately, it can increase the workload for midwives as well as require extensive training for increasing their competencies. Hence, this is one of the theoretical issues that may be encountered in achieving change as per findings on this Nursing leadership assignment.

On the other hand, Javanparast et al. (2018) argued that to successfully implement a change in the organisation, the need for effective participation of senior management is highly essential. Likewise, at HKSH, driving this change can also create a practical issue as every supervisor or senior management may not support the change which can further delay the implementation due to repeat clarification and meetings. As a result, it can directly affect the significance and purpose of this new change in the organisation. Other than that, the other practical issue that may be encountered is the resistive behaviour of mothers or family members to undertake the course as it has been already identified that there are clients who are passive and reluctant to learn postnatal care and baby care.As per the findings from this Nursing leadership assignment, it can directly impact the benefits and appropriateness of the new change in the organisation affecting the quality of care and service. Hence, the need to comprehend and eliminate these issues by training, education, actively involving relevant stakeholders, and boosting the confidence of both mothers and midwives is highly essential for the initiative of this positive change and behaviour in the organisation.

Nursing leadership assignment; effective implementation plan
Based on the above nursing leadership assignment analysis, I have comprehended that the need for initiating the new course is essential at HKSH but there are potential practical and theoretical issues that have to be well considered and mitigated by the organisation in order to successfully accomplish the change and enhance the quality of care. Therefore, I propose Bridge’s model of managing change or transitions at HKSH for managing emotional response and to mitigate the issues in response to the transition, (Refer to the below figure).The Bridge’s Transition model assists individuals and organisations to comprehend and more efficiently manage and work through the human and personal side of change.

Fig 2: (Bridges Transition Model)
Source: (Wmbridges.com, 2022)

Based on the above Nursing leadership assignmentmodel, the following are the phases that are highly required to be integrated at HKSH to accomplish the end goal and drive positive change.

Managing endings:It is essential for the organisation to provide explicit information about the need and significance of the change in order to increase midwives’ awareness level such as training needs, additional meetings, workload, and work overtime while fulfilling their needs and demands in terms of compensation and rewards management. As a result, their resistance and reluctance can be mitigated which can boost their motivation and performance level at a significant level.

Managing in the neutral zone: In this phase, it is essential to recognize and acknowledge the issues faced by the midwives during the process of change by assisting and guiding them. In addition, resolving conflicts when arises and eliminating confusion is significant in this phase, Kumar et al. (2018). Other than that, continuous review and refinement is required for analysing the delivery of the intensive course while emphasizing the common goal to educate and equip mothers with better skills and knowledge of postnatal care after discharge.

Managing new beginnings: This is the last phase of transition identified on this Nursing leadership assignmentwhere the midwives are well aware of their roles and responsibilities with clarity for sustaining the change. In addition, the need to celebrate the hard work and efficiency of midwives is significant for offering them a sense of belongingness and identity at the organisation including promotion or recognition. As a result, these can boost their morale and empower them explicitly which can positively influence their performance leasing to a high standard of care, Bianchi et al. (2018).

Evaluation of the change
It has been well suggested by Walker & Spendlove (2018), evaluation of the change can shed light on failure and success which in turn can assist to make effective decisions about what should be avoided or replicated for achieving desired goals and better results. Likewise, I believe that the need to evaluate the introduced change is significant at HKSH for analysing the effectiveness of the new course as well as the work culture. Based on such context, the following are the steps that are required to comply with evaluating the effectiveness of the new change at HKSH in terms of one year activity.

• Fostering a top-down and bottom-top communication approach for encouraging team members to share their feedback or ideas in terms of the course. This can assist to enhance the scope and significance of the Nursing leadership assignment course.
• As it has been identified that the need for appropriate training is essential for delivering quality care and successful implementation of the course, the need to ensure that the midwives are offered with required mentoring, coaching, and training is significant for accomplishing the end goal, Curtis et al. (2018).
• The need to regularly monitor and evaluate the progress at every stage of the transition including evaluation of the course by team members and clients, training of the new team members, quality of planning as well as the gradual development of skills and competencies among the midwives is highly significant for reaping out the potential benefits associated with the change.
• Incase of any deviation or new challenges, the need to adjust and manage the change anywhere and anytime is significant for eliminating any negative impact on the desired goal or outcomes, Sadowskiet al. (2018).

Conclusion
To conclude this Nursing leadership assignment, it can be stated that the introduction of a 3-days hands-on intensive course for mothers during the postnatal hospital stayis essential at HKSH in terms of midwifery practice for enhancing workplace culture, quality of care for women, and their newborns as well as boosting morale and confidence of midwives. In addition, I believe that the piratical and theoretical issues can be certainly eliminated with the active involvement of midwives, clients, staff, senior management, and other relevant stakeholders while complying with the transition stages as the impact on midwives is relatively high compared to others in the implementation of this change. Lastly, being a transformational leader, I intend to focus on developing my idealized influence component for growth and development as per models identified on this Nursing leadership assignment.

References
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Wmbridges.com. (2022). Bridges Transition Model - William Bridges Associates.Nursing leadership assignment. Retrieved 10 January 2022, from https://wmbridges.com/about/what-is-transition/