Clinical leadership of Registered Nurses working in an Emergency Department

Abstract

Aim To examine clinical leadership of registered nurses (RN) in an Adult Emergency Department (AED), based on the evidence that it is important for nurses to feel psychologically and structurally empowered in order to be able to act as clinical leaders (Laschinger, Gilbert, Smith & Leslie, 2010). Background Every registered nurse is a clinical leader (Patrick, Laschinger, Wong & Finegan, 2011). Clinical leadership is defined as staff nurse behaviours that provide direction and support to patients and the healthcare team in the delivery of patient care (Patrick et al., 2011). Clinical leadership is important for patient safety and improves patient outcomes (DeVivo, Quinn Griffin, Donahue & Fitzpatrick, 2013). The Emergency Department (ED) is an ever-changing criticalcare environment that requires every nurse directly caring for patients to be empowered to act as a leader (Raup, 2008). However, research on leadership in nursing mostly focuses on delegated leader roles, with some focus on all nurses as leaders, but little on clinical leadership by nurses in ED. Methods A non-experimental survey design was used to examine the psychological empowerment, structural empowerment and clinical leadership of RN’s working in an AED in a large tertiary hospital in Auckland City. Qualitative questions relating to factors that support and inhibit their clinical leadership abilities were also included. Results The response rate was low at 33%. However the ED nurses that responded felt as though they showed clinical leadership behaviours most of the time, even though their sense of being psychologically empowered was only moderate, with improvements possible in structural empowerment. Conclusion This research portfolio highlights the need for further research on the phenomenon of clinical leadership at the point of care (Patrick, 2010). The overall results, albeit not statistically significant, showed that staff nurses feel they perform clinical leadership behaviours, but that structural and psychological empowerment have an impact on their ability to act as clinical leaders. Implications for Nursing Management Ways in which management within the hospital can support clinical leadership behaviours by nurses in ED have been identified in this research. The results support the literature that states management must create empowering environments for nurses to be able to provide clinical leadership to their patients and colleagues. Other research identifies that providing an empowering environment will improve patient outcomes and quality of care (Patrick, 2010). Keywords: clinical leadership, psychological empowerment, structural empowerment.