Leading in a Complex, Evolving Environment NUR 514 ESSAY

Leading in a Complex, Evolving Environment NUR 514

Leading in a Complex, Evolving Environment NUR 514 ESSAY

The nursing landscape has changed over the last couple of years with the introduction of both evidence-based practice and technological advances as well as the increasing demand for nurses. As such, nursing leaders have had to content with a myriad of issues in order to ensure that their practice conforms to the widely expected improvement in the delivery of care. Thus, these leaders have had to address issues such as conflict amongst their workers and the manner in which to resolve them. The present paper will thus examine the conflict among workers as a nursing leadership issue in the contemporary health care setting and the available alternatives for addressing it from a systems perspectives. In order to successfully resolve these issues, nurse leaders also need to have certain traits whose import in improving the quality of care after resolution cannot be overstated.

The Selected Issue

In the delivery of health care services, nursing leaders who exercise servant leadership grapple with conflicts among health care workers and then struggle when it comes to resolving them. According to Yang (2017), conflicts commonly occur among nurses across various health care settings but the dynamics of contemporary care has exacerbated them. A quintessential example of such a conflict involves feuding between day shift nurses and night time nurses as it relates to the allocation of duties as well as absence of communication from the relevant parties. As a consequence, the nursing field is also afflicted with shortage of staff, which has resulted in pressure for nursing employees, who are overwhelmed as they work for extended shifts. A majority of day time nurses thus feel aggrieved that they handle multifarious patient cases and conduct a lot of rounds, consultations, and transportation of patients from one section to another in comparison to their night shift colleagues (Streepada, 2017). Similarly, night shift nurses also have their own grievances as they complain of being assigned uncompleted work by their day time colleagues, which they consider as unfair.

By examining the matter, nursing leaders are faced with the challenge of establishing an understanding between the two sets of nurses. The most appealing solution to this situation would entail hiring more nurses, yet this is impossible as nursing shortage is now a global phenomenon (Lahana et al., 2019). For this reason, the conflict between the two groups of nurses will continue to be experienced by servant leadership nurses. As a result, appropriate handing of tasks appears as the only solution to mitigating the negative effects of such conflicts on both the nurses and their patients.

Leading in a Complex, Evolving Environment NUR 514 ESSAY

Leading in a Complex, Evolving Environment DETAILS

Leading in a Complex, Evolving Environment NURS 514 Details: The purpose of this assignment is to examine the impact of contemporary challenges in care delivery facing nursing leadership. Select and research a major issue in the delivery of care facing nurse leaders today and write a 1,250-1,500 word paper addressing the following:

  • Explain the issue(s) you have selected. Why is it a problem? What fuels the issue? Who does it impact and what specific impact does it have on patient care?
  • Describe an option for addressing the issue from a systems perspective. What entities/interests (stakeholders, organizations, operational systems, political, economic, public, private, patient) must be taken into account and how are they impacted? Be sure to highlight the direct impact the option has on patient care.
  • Discuss the qualities and traits needed of nurse leaders to effectively tackle this issue through the proposed option. Incorporate a leadership theory and AONE Nurse Executive or Manager Competencies in your response.
  • Finally, discuss the impact not successfully resolving the issue could have on the future of health care delivery.

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NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions

  1. Describe a scenario in which there was a conflict between nurses working in your current or previous work environment. What was the primary cause of the conflict? What conflict resolution strategies would you employ to manage this conflict and promote civility in the workplace and why?
  2. Compare and contrast servant leadership with another leadership style or theory such as transformational leadership. What are the primary characteristics of each? What appeals to you about them and what strengths and drawbacks do you see with each in terms of influencing organizational culture as a nurse leader? NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions
  3. Discuss organizational factors that can drive the change within a health care organization. Also, discuss the ethical, social, legal, economic, or political implication of the change within an organization and on the profession of nursing. Integrate a specific example of organizational change you have witnessed in your response.


  1. You have been selected to serve on a community outreach committee within your state’s nursing organization. The committee includes registered nurses of different specialties. At your first meeting, it becomes evident that not everyone is in agreement with a recent position statement about the role of spiritual care, with some members arguing they will no longer support the committee if the position statement is not revised or reversed. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions. As a nurse leader, how could you draw from change theory to address these concerns and encourage collaboration on the committee?


  1. Imagine you are working in an outpatient specialty office. Your nursing director has informed you that due to “accountable care” your office might be penalized by having too many diabetic patients that are above the hemoglobin A1C (HBA1C) goal of 8. The national benchmark is that only 20% of your population should be above 8 and your office shows 40%. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions. Your physicians have also been informed by their management of the same issue.

Develop a plan using enhanced communications with patients to reach the benchmark goal. What might you do if you had the resources to accomplish this? You should consider all the technology you might be able to use such as a patient portal, wireless home monitor, texting, and secure messaging for example. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions.

  1. What challenges do current reimbursement models pose for nurse leaders in their obligations to promote quality, cost effective patient What strategies can effective nurse leaders use to overcome those challenges? Discuss any specific examples you may have witnessed a leader implement in the practice environment in your response.


  1. Review the Graduate QSEN Competencies. Focusing on the areas of Quality Improvement (QI), Safety, and Informatics, summarize the essential knowledge, skills and attitudes that an advanced registered nurse should possess to competently promote the use of health care data and information to improve care in the clinical setting. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions. Discuss two specific ways information and technology can improve clinical practice, administration, education, or research in your response.
  2. Discuss a key event in the evolution of nursing informatics and the characteristics of nursing informatics as a specialty. In what ways do the roles of informatics nurses and nurse leaders intersect?


  1. What are the primary challenges related to interoperability and the exchange of health information in the practice environment and how might these impact patients’ access to the best care? NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions. Discuss a particular challenge with clinical provide order entry (CPOE) in your response.


  1. Discuss the benefits and drawback of clinical decision support systems, including the challenges of avoiding alert fatigue. Considering your interactions with patients and systems in the clinical environment, what best practices related to human factors and user-centered design would you recommend to designers of such systems?


  1. Discuss an example of a personal health, mobile heath, or telehealth-related application that you think can improve patient care. What are some of the primary challenges with integrating data from a mobile device or application with data within an EHR? Do you think most patients are comfortable with sharing their personal data in the clinical environment? Supposing the sharing of such information is beneficial for their health, what can be done to help patients overcome their reticence?


  1. Review HIPAA, protected health information (PHI), and requirements for privacy and confidentiality in EHRs. Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice. Discuss possible consequences for compromising patient data and measures you can implement in your own practice to protect patient privacy and confidentiality. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions.


  1. What quality standards or performance measures guide your role or specialty as an advanced registered nurse? Using these standards, discuss how informatics can be used to improve quality of care. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions. Make sure to discuss meaningful use and incorporate the topic materials, such as the American Health Information Management Association (AHIMA) and Information Governance websites in your response.


  1. There are several project management methodologies available to nurse leaders for supporting the implementation of quality and performance improvement initiatives in the practice environment. Two well-known ones are Lean and Six Sigma. Compare and contrast two project management methodologies you think are promising in the health care environment. Discuss their relative benefits and drawbacks and discuss why you think they can be successful for implementing quality improvement initiatives. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions.

Impacts of Contemporary Challenges in Care Delivery Facing Nursing Leadership

Currently, healthcare services are organized around healthcare professionals such as nurses, rather than the patient. For effective achievement of excellent outcome, the current healthcare organizational structures need to be changed. For instance, nurse care managers, intensive care unit registered nurses and operating room nurses, among others are required to deliver team-based care to promote care delivery. This change requires high organizational determination which can only be attained by a high-caliber leader. A leader who can comprehensively articulate the need and goals for change, present a vibrant vision of how to implement the change and motivate other nurses to participate in the needed change. However, nursing leaders are nowadays faced with several challenges such: How can I improve the quality of health delivery to the community? How can I balance investments in staffing and resources to promote patient’s health? How do I come up with the best health system to enhance effective and improved community health care? (Clark et al., 2015). Despite the above challenges, a great nursing leader with adequate leadership qualities will be able to overcome these challenges and prevent their negative impact to care delivery.

Nursing leaders in academic health centers are not just equipped to lead but are also in a better position to prepare the leaders of tomorrow. As a long-term measure, it is important that new nursing leaders must be adequately prepared to prevent such challenges from negatively impacting care delivery in the future. As at now, most nursing leaders who are 50 years or older, mainly gained their leadership position as a result of their public research, or productivity, or solid medical skills or just because they were excellent educators (Westra et al., 2015). Sadly enough, most of them never received any official leadership training. They learned leadership skills by observing the way that their role models, who were nursing educators or clinicians, perform their leadership tasks. However, the new system offers leadership training which is usually limited to the healthcare context.

Up to date, any leadership within the healthcare profession is based on conferred authority, as one being given the power to perform a particular service. This idea needs to change. The new structure needs to put the patient at the center of healthcare delivery. Implementation of the new change will enhance the delivery of patients care, promoting their health and reducing the number of chronic conditions. In a more in-depth perspective, most of these challenges being faced by nursing leaders while trying to change the system of care delivery need an adaptive response (Melnyk et al., 2014). They require the nursing leader to outline the challenge clearly, find an answer and permanently implement the solution, which is directed towards increasing the value, regarding quality and cost of care delivered. Increasing the value of care can only be achieved internally, by altering the mode of practice of nurses among other healthcare practitioners.

Nursing schools majorly produce solo nurses; however, the modern care delivery system requires teams. The main reason behind teamwork in care delivery is that an individual nurse cannot be able to produce a vast knowledge of disease management which they gained through their years in college and training. For this reason, they need one another to expand on the souse of information. According to Wong (2015), nurses are required to read up to 19 peer-reviewed articles in their line of practice every day all through the year to be able to keep up current information. However, working in teams reduces the pressure, while enhancing the improved quality of care delivery. Teamwork can be implemented and enhanced by a good leader.

According to Jones et al., (2016) individual who usually present with the highest urge to achieve, never produce the best leaders. Especially in the nursing field, successful care delivery depends on responsibility and control at a team level, which requires a broader spread of responsibility and control that might not be deployed by a higher achiever. A good leader might have the need for power but must base their thinking regarding group work and views responsibility for what it is. A good nursing leader must understand the importance of motivating other nurses to work in teams to be able to offer high quality and efficient care delivery services. Nursing educators have the mandate of producing qualified leaders with the required skills to overcome the current healthcare challenges and improve the quality of care delivery.

For new nursing leaders, some characteristics will be able to differentiate good leaders from the rest. For instance, all leaders are expected to be forward-looking, competent, inspirational and honest. Honesty requires the leader to be able, to tell the truth, and abide by the ethical principles and standards of practice. By forward-looking, the leader must be able to have a sense of direction and concerned about the future of the nursing profession and the healthcare system as a whole (Wong, 2015). They must also be inspiring in the sense that they can be able to share genuine excitement, enthusiasm, and energy in working toward future goals. Lastly, competence requires the leader to be able to keep track of the healthcare records and being able to complete the assigned tasks.

Five senior leaders of the American Association of Colleges of Nursing suggested that future nursing leaders should be professional willing to serve other nurses and patients, with a high state of mindfulness. It is crucial for a leader to be mindful to others to reduce misrepresentation and be able to correctly interpret perspectives and thoughts to be able to overcome the challenges faced by the current leaders. The future leaders must be able to understand their emotional state maturely and always be self-motivated. Finally, the five senior leaders also reiterated on the importance of emotional empathy as a quality for future leaders (Jones et al., 2016). With this trait, they will be able to generate reasonable and innovative ideas, while being able to understand what an individual at the third level is doing. Leaders with all the above traits will be able to effectively overcome the current challenges faced by nursing leaders and even come up with new healthcare systems which are patient-centered and not based on the healthcare provider.

However, failing to overcome the challenges discussed above successfully might deteriorate the quality of care delivery and hence increase the number of chronic illness. Future leaders will lack role models and end up repeating the same mistakes, prolonging the same challenges. For instance, failing to adopt teamwork in care delivery will increase the number of medical errors, in terms or patient record keeping and misdiagnosis. Nurses will lack someone whom they can be accountable to or consult in case they doubt the care plan of a patient with a chronic health complication. Additionally, lack of formal training for future nursing leader will groom leaders who will not be sure of their roles as leader, and even lack competency (Jones et al., 2016). Generally, the only way to overcome healthcare challenges is dealing with them at the right time within the shortest time possible. Failing to handle healthcare issues will undermine the health of the patient and the community at large.

In conclusion, there is urgent need to train and come up with a proper teaching curriculum for future leaders, with adequate skills so that they can be able to create and sustain significant changes in the health care delivery system. The curriculum should focus on creating leaders who can organize individuals into highly functional teams, making it easy to resolve future healthcare challenges. The new leaders will be able to hold every nurse responsible for the health of the patient and the community. To attain a harmonious working environment, the dysfunctional idiosyncratic culture dominating health care system must disappear.





Clark, M., Julmisse, M., Marcelin, N., Merry, L., Tuck, J., & Gagnon, A. J. (March 01, 2015). Strengthening healthcare delivery in Haiti through nursing continuing education: Nursing continuing education in Haiti. International Nursing Review, 62, 1, 54-63

Jones, J., Winch, S., Strube, P., Mitchell, M., & Henderson, A. (January 01, 2016). Delivering compassionate care in intensive care units: nurses’ perceptions of enablers and barriers. Journal of Advanced Nursing.

Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (January 01, 2014). The Establishment of Evidence-Based Practice Competencies for Practicing Registered Nurses and Advanced Practice Nurses in Real-World Clinical Settings: Proficiencies to Improve Healthcare Quality, Reliability, Patient Outcomes, and Costs. Worldviews on Evidence Based Nursing, 11, 1, 5-15.

Westra, B. L., Clancy, T. R., Weaver, C., Delaney, C. W., Sensmeier, J., Warren, J. J., & Warren, J. J. (September 25, 2015). Nursing Knowledge: Big Data Science-Implications for Nurse Leaders. Nursing Administration Quarterly, 39, 4, 304-310.

Wong, C. A. (January 01, 2015). Connecting nursing leadership and patient outcomes: state of the science. Journal of Nursing Management.