Running head: BSN STUDENT LEARNING OUTCOME 6

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BSN Student Learning Outcome 6:
Apply Leadership Concepts, Skills, and Decision Making in Order to Provide Oversight and
Accountability for the Delivery of Safe, Quality Care in a Variety of Healthcare Settings
Megan J. Stucki
Dixie State University

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Abstract
What does it take to fulfill a leadership position? Despite the popular belief that leaders
are born and not made, I would argue that anyone may develop leadership skills if they choose to
apply themselves to the task. With leadership comes responsibility--a responsibility to provide
quality patient care, delegate or provide oversight to others and do so by analyzing decisions that
must be made each day.

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BSN Student Learning Outcome 6:

Apply Leadership Concepts, Skills, and Decision Making in Order to Provide Oversight and
Accountability for the Delivery of Safe, Quality Care in a Variety of Healthcare Settings
What does it take to fulfill a leadership position? Despite the popular belief that leaders
are born and not made, I would argue that anyone may develop leadership skills if they choose to
apply themselves to the task. Throughout life we are exposed to good leaders as well as bad
leaders. Each one, good and bad, provide us with the opportunity to learn and to grow
professionally, and sometimes personally. As I have grown in my professional career I have
chosen to adopt certain qualities of leadership. With that leadership comes responsibility--a
responsibility to provide quality patient care, delegate or provide oversight to others and do so by
analyzing decisions that must be made each day.
Attributes of a Leader
"The greatest leader is not necessarily the one who does the greatest things.
He is the one that gets the people to do the greatest things."
--Ronald Reagan
The history of the word leadership is a relatively recent concept. Marath (2012) states
that the word leadership did not enter into the English language until the first half of the 19th
century. With its recent history in mind, it comes as no surprise that experts and researchers are
still studying this concept and dont agree on the exact meaning of leadership or what constitutes
a great leader. Marath quotes a definition of nursing leadership from Yoderwise, which is as
follows, the use of personal traits and personal power to constructively and ethically influence
patients, family and other toward an end point vision or goal.

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Commonly accepted features of leadership have been identified: a dynamic exchange that
involves a leader and the followers, effective communication skills, accountability, goal-oriented
and inspiring, as well as influential (Marath, 2012). A dynamic exchange denotes the process of
constant change and with a positive attitude, leads to progress. Effective communication skills
are vital when speaking with interdisciplinary care teams, as well as patients and families from
varying backgrounds. As the leader, the nurse is accountable to the healthcare organization, in
addition to the public they serve (Marath, 2012). Leadership signifies the ability to motivate a
team in order to achieve a common purpose.
Personal Experience with Nursing Leadership
I have personally based some of my philosophies of leadership on a manual called
Principles of Leadership: Teachers Manual (CES Editing, 2011). Concepts learned within,
when applied to the world of nursing are invaluable. Some concepts of note are: leaders should
honor and respect the agency of those they lead; when appropriate leaders should both give
direction and allow others to share in decisions; leaders should develop attributes and display
characteristics they wish to inspire in their followers; leaders are more effective when they
understand the duties of their position; leaders should serve those who look up to them, and
finally leadership comes more naturally when a leader understands the needs of the people they
serve.
While I am not a manager and dont hold any other traditional position of leadership at
this time, I can and should display these attributes. As I labor alongside my coworkers I treat
them as individuals with their own unique identity. This is also the case as I implement nursing
care with the patients in my charge. I collaborate with coworkers as we work together to
determine the best way to treat difficult patients and various conditions. This is done in an effort

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to ensure best practices are followed, thus ensuring safe care. Finally, I continue to strive to
develop the qualities of an excellent nurse leader and encourage excellent nursing care from my
coworkers. In essence, I endeavor to practice what I preach.
Decision Making and Oversight
With leadership comes the responsibility of making decisions. This is true of individual
and group decision making. Individually, professional autonomy entails exercising judgement
of ones own work using professional values and standards. Professional autonomy and
competency are important as ethical decision-making requires independent reasoning and
accountability (Cerit & Dinc, 2013). Those individual decisions are often then relayed to a
team, who have the responsibility to evaluate and collaborate on appropriate actions. This
provides oversight.
A system of checks and balances is crucial to guarantee ethical and fiscally conservative
organizations. Oversight committees are needed in cases of ethical dilemmas, budgets, allocation
of resources, review of operations, etc. As such they provide a maximum benefit and better
ensure that the desired outcome is achieved for both patient and organization.
Personal Experience with Oversight
My personal experience with oversight is somewhat limited to collaboration with fellow
nurses and medical staff regarding patient care. This is done on formal occasions, such as staff
meetings, as well as informally during a work day. Another instance in which I provide
supervisory or oversight action is for the med technicians that pass medication at the facility I am
currently employed at. This seemingly small act of delegation has serious implications for nurse
and med tech, if due diligence is not practiced, because liability lies with both in cases of error.
In addition to liability issues, I rely on reports I receive from the med tech regarding patients

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conditions. Although the MAT [medication assistant technician] is in direct contact with the
patient, he or she lacks the clinical and educational background that the nurse possesses from
years of education and practice to determine and report changes in the patients' status (Barra,
2011). With this factor in mind, I review and reassess patients on a case-by-case basis as needed.
Although my experience with oversight and delegation is somewhat limited, it does not
limit my desire or accountability in providing nursing care of the highest caliber.
Conclusion and Future Nursing Practice
"A leader is best when people barely know he exists.
When his work is done, his aim fulfilled, they will say: we did it ourselves."
--Lao Tzu
Leadership, decision making and oversight are vital components in the field of nursing,
as very often peoples lives are at stake. It has been said that with power comes great
responsibility. Power is generally associated with leadership positions, but it is my opinion that
every nurse must demonstrate the power of responsibility in their professional choices and
actions. That being said, when a team is headed by someone who embodies the characteristics of
a great leader, then that team excels--each member playing their role to help the team reach its
common goals.
Compulsion leads to mediocre nursing care, while inspirational or motivational
leadership can be compared to a hospital code team, in which every person performs their duty
without being forced. Each person knows their role and as a whole the team responds like a welloiled machine. This team stays cool under pressure and does everything possible to guarantee a
positive outcome. Like a code team, a nursing leader should only be relied upon in challenging
circumstances. An extraordinary leader will provide direction, observe and facilitate the

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achievement of common goals. An exceptional leader leads by example and is willing to perform
the duties they request of their subordinates. These actions, in turn, inspire confidence and
increase job satisfaction, which inevitably increase positive patient outcomes.

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References
Barra, M. (2011). Nurse delegation of medication pass in assisted living facilities: Not all
medication assistant technicians are equal. Journal of Nursing Law, 14(1), 3-10.
Retrieved March 16, 2016 from
http://search.proquest.com/docview/867911841?accountid=27045
Cerit, B., & Din, L. (2013). Ethical decision-making and professional behaviour among nurses:
A correlational study. Nursing Ethics, 20(2), 200-12.
doi:http://dx.doi.org/10.1177/0969733012455562
CES Editing. (2001). Principles of leadership: Teacher manual: Religion 108r. Salt Lake City:
UT.
Marath, U., & Ramachandra, A. (2012). Concepts and characteristics of nursing leadership.
Nursing Journal of India, 103(1), 9. Retrieved March 15, 2016 from
http://search.proquest.com/docview/1536918429?accountid=27045