Nursing Leadership Assignment
Daisy and Kevin who are nursing students are faced with a complex scenario after the
taking of Mr Smith’s vital signs. This is because while Mr Smith’s vital signs are normal, he says
that he feels unwell and this could be a cause for concern. Daisy and Kevin however still need to
obey Mr Henry’s directions and they are in a dilemma on whether to leave the patient and check
on him later. This scenario not only tests Daisy and Kevin’s leadership skills but it could also
determine whether they possess the right decision-making traits to successfully perform during
complex situations in the nursing profession.
Factors influencing Daisy and Kevin’s decision making
Daisy and Kevin’s decisions after taking Mr Smith’s vital signs are influenced by various
factors. The first factor their individual attributes. This means that they are making their
judgment based on a low professional base and personal considerations such as beliefs, values
and attitudes (Thompson, 2013). Daisy and Kevin are nursing students whose experience in
nursing is minimal and their ability to make a viable decision in the complex situation may be
limited. It is also clear that Daisy and Kevin’s judgment is bound by the existence of rules, in this
case the requirement to take a break on time and to follow Mr Henry’s guidelines. This explains
why they ask Mr Smith if they can come back later to avoid trouble with Mr Henry.
The second influencing factor is the task attributes. Attributes that may influence decision
consist of certainty, familiarity, stability, urgency, relevance, conflict and risk (Kelly, 2011). As
first year students, Daisy and Kevin may not be familiar with such a situation, such that they may
not understand its urgency, relevance or risk involved when they do not attend to the patient.
There is also a conflict between attending to the patient and their fear of Mr Henry in case they
do not break at the right time.
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The third influencing factor is the nature of the decision undertaking. This encompasses
how the decision to be made is conceptualized and the outcome that is sought by the decision
maker (Noorie, 2012). In this regard, the objective of a nurse would be to make a decision that
optimizes patient outcomes. Daisy and Kevin seem concerned about Mr Smith and hence ask
him whether he will be okay if they check on him after the break. A different answer may have
provoked a different reaction from Daisy and Kevin in a bid to ensure the patient’s welfare.
Their judgment and intuition is shaped by the complex situation at hand. Kelly (2011) notes that
even in complex situations, intuition and judgment play an imperative role in the decision
Advise to Daisy and Kevin
I would advise Daisy and Kevin to consider the needs of the patient first before their own
needs and that of the supervisor; and therefore postpone their break until they are sure that Mr
Smith is okay. Nurses should be in a position to make exceptional decisions when the patient’s
life is at stake and in this scenario, going for a break is not as urgent as determining whether Mr
Smith is alright. They can explain to the supervisor that they need more time to attend to the
patient and will therefore be late for their break. In this regard, Daisy and Kevin ought to use
their leadership skills in making decisions in order to ensure that they enhance client outcomes.
The justification for the above advice is that in nursing, the ability to make effective
decisions that promote the patient’s life is imperative. This can be related to leadership theories,
with contingency theories taking a forefront place. Contingency theories postulate that in
leadership, there is need for leaders to act based on different situations. This means that for every
situation, the leader should be guided by relevant traits that ensure that the best outcomes are
achieved. In their research, Carragher & Gormley (2016) discuss the concept of emotional
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intelligence and note that nurses and midwives should possess a range of traits that determine
how effectively they relate with others in the presence of everyday pressures and demands. In
this case, Daisy and Kevin must understand that taking a break is not as important as the
patient’s concerns, such that their willingness to understand Mr Smith’s condition before taking
the break can be considered emotional intelligence. By taking their time to assess the situation,
they are assured that they will not compromise the health of the patient, which addresses the
third issue of nature of decision making (Rankin, 2013). The objective is to make a decision that
provides the best patient outcome based on the circumstances.
Behavioral theories are concerned with human behavior or leaders as opposed to their
physical, mental and social characteristics (Nongard, 2014). In this relation, leaders are
categorized as either being concerned about task or focusing on people. A focus on people is
highly preferred because this then ensures that they are capable of minding the welfare of others
(2012). Daisy and Kevin could learn from behavioral theories to exercise people skills and thus
concern themselves more with people and the impact that they have on them. Paley (2014)
emphasizes the importance of compassion in nursing practice, which the two students can apply
in the process of taking care of patients.
Transformational theory is considered an important theory in nursing practice because it
promises to promote performance while putting into consideration the needs of others (Bradley
University, 2016). Through transformational leadership, people skills are enhanced and this
ensures that a leader can create relationships that are strong and based on trust (Grants, 2016).
Relating this to the case, Daisy and Kevin need to develop transformational leadership that will
ensure that they can influence others at the Hospital. For example, they could influence Mr
Henry to be more concerned about the health of individuals as opposed to task completion in
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order to enhance outcomes. This could address the second issue by ensuring there is no conflict
between their decision making process and fear of their supervisor.
Strategies for improving leadership abilities
In order to effectively perform as a leader during placement and their careers, Daisy and
Kevin should employ the following three strategies.
Set goals and develop action plans: This provides a definite map of what the individual seeks
to achieve in terms of improving leadership skills and their plan to achieve it (Lussier & Achua,
Mentorship: Having a mentor ensures that an individual can gain leadership skills and
knowledge from a more experienced leader; thus improving their opportunities of becoming an
effective leader (Lussier & Achua, 2015).
Continuous education and improvement: Leadership is about continually improving one’s
skills and capabilities. This includes learning new aspects of leadership and learning from past
mistakes, strengths and weaknesses (David, 2011).
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Bradley University (2016). How Nursing Leadership Styles Can Impact Patient Outcomes and
Williams, L & Brown, H. (2014). Factors influencing decisions of value in health care: a review
of the literature.
Grant, R. M. (2016). Contemporary Strategy Analysis: text and cases, 9th edn. Chichester, Wiley
David, F. (2011). Strategic Management: Concepts and Cases (13th ed.). Upper Saddle River,
Nongard, R. (2014). Transformational Leadership How To Lead From Your Strengths And
Maximize Your Impact. North Carolina: Lulu.com
Carragher, J. & Gormley, K. (2016). Leadership and emotional intelligence in nursing and
midwifery education and practice: a discussion paper. New York: John Wiley and Sons.
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Rankin B. (2013) Emotional intelligence: enhancing values-based practice and compassionate
care in nursing. Journal of Advanced Nursing, 69(12), 2717–2725.
Thompson, V.L. (2013). Making decisions in a complex information environment: evidential
preference and information we trust. BMC Med Inform Decis Mak, 13(Suppl 3):S7. DOI:
Noorie, M. (2012). Factors Influencing Strategic Decision-Making Processes. International
Journal of Academic Research in Business and Social Sciences, 2(7). 405-429
Paley J. (2014) Cognition and the compassion deficit: the social psychology of helping behaviour
in nursing. Nursing Philosophy, 15(4), 274–287.
Lussier, R. N & Achua, C. F. (2015). Leadership: Theory, Application, & Skill Development.
Boston, MA: Cengage Learning.
Kelly, P. (2011). Nursing Leadership & Management. Boston, MA: Cengage Learning.