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LEADERSHIP THEORIES Nursing homework help

LEADERSHIP THEORIES Nursing homework help

I attached assignment task description

And module 1
Rest module 2-8 I will combine and send you 1 file.
As there is 4 part of assignment to reflect which student have to pick from module. It will be good if you pick Mildred video to reflect on it in module 6 I have put link in document.
For the 1 st critical reflection is from module 1 personal leadership philosophy.
For the 2nd it is related to standard
For the 3 reflection it is good to pick Mildred video module 6
For the 4th, you can pick any reading in the modules which you feel good to do critical reflection as a nurse leader not as organisation leader.
  • Welcome to Module 1. In this module we will address the following unit learning outcomes:
  1. Critically reflect upon the role of the registered nurse as a leader in a health care team in varying health contexts
  2. Critically analyse concepts of management and leadership in nursing and health services. LEADERSHIP THEORIES Nursing homework help

What is leadership?

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This is your first activity. Spend some time thinking about leadership and what it means to you. There’s not necessarily a correct or incorrect answer. What is important that you consider what are the behaviours that you might observe in someone who is leading others, for example, leading a team of nurses to adopt a new practice in a clinical work area.

What is your experience of leadership?

Think about occasions when you have been led by someone else. What was the context and how did the leader make you feel? Was the outcome achieved or could things have been done differently? Consider also your own leadership roles. What behaviours did you consider to be important and why?

We will discuss these issues in further detail during our tutorial.

  • Why do nurses need to understand leadership?


Leadership in nursing is critical for the safe delivery of quality person centered care. Leaders in nursing enable adaptation to challenges inherent in the dynamic healthcare and clinical environment, while at the same time advancing the practice of nursing through innovative, evidence informed guidance of teams toward shared aims.

The Nursing and Midwifery Board of Australia (2016) Registered Nurse Standards for Practice refers to leadership practice, specifically, in the following standard:

Standard 2: Engages in therapeutic and professional relationships: RN practice is based on purposefully engaging in effective therapeutic and professional relationships. This includes collegial generosity in the context of mutual trust and respect in professional relationships.

Criterion: 2.8 Participates in and/or leads collaborative practice

However, across the standards, criterion that refer to inter-professional practice, collaboration and communication have clear implications for leadership practice.

The following reading introduces the rationale for nurses, especially newly qualified nurses, to understand and develop knowledge and skills in leadership work. The authors are explicit in their view that leadership can occur in nurses at any level and is not a factor of seniority or position. The sections on leadership theory can be skimmed over as we explore these ideas in more detail in the following section.

Kirkham, L. (2020). Understanding leadership for newly qualified nurses. Nursing Standard, 35(12). 

  • Leadership and management 


In this section you will explore and differentiate meanings of leadership and management as a basis for understanding models of leadership, and the roles of leaders and managers in healthcare practice.

Leadership and management are commonly used terms in healthcare, sometimes interchangeably. t is essential that you are able to differentiate between these two terms. Adding to your response to the previous activity:


What is management?

Now, spend some time thinking about management and what it means to you. There’s not necessarily a correct or incorrect answer. What is important that you consider the behaviours that you might observe in someone who is managing others, for example, managing the implementation of a new practice in a clinical work area.

As I am sure you are aware, these terms (leadership and management) are used frequently and often interchangeably in health care workplaces. The term ‘leadership’ has replaced ‘management’ in the language of many organisations. Management is sometimes considered to be a less favourable term than leadership, and sometimes associated with rational approaches, bureaucratic profiteering and impersonal human interactions. In many workplaces, language privileges ‘leadership’ i.e., employees don’t ‘manage’ a task or a project, they ‘lead’ it. Perhaps the term is overused or perhaps, by using the term ‘leading’ we can influence our practice and that of others. What do you think? It’s important to be clear about our use of language, what it means and to avoid making assumptions. If we overuse the term ‘leadership’ we run the risk of overlooking the key behaviours that are central to leadership practice. We can also subordinate the important role of management in health care workplaces.

In contemporary organisations, there is an expectation that those appointed to management positions have well developed leadership skills (Yukl, 2014). Indeed, theories of management throughout history identify leadership as a vital component of management work. Henri Fayol (1949) defined management functions as planning, organising, coordinating (later redefined as leading), commanding and controlling. Henry Mintzberg (2009) identified leadership as a central manager activity, and advocates of contingency management theory (Robbins et al, 2018) position manager choice of leadership style as central to effective adaptation to changing situations. The vital place of leadership within management practice in healthcare is well recognised (Maddern et al, 2016), as managers in health care cannot achieve their aims without people, and effective management of people involves leadership (Griffin & Moorhead, 2012).

Kotter (1999), a seminal author on leadership and change, summarises the relationship between leadership and management.

Kotter, J (1999). Change leadership. Leadership excellence, 16(4), 16.

From this discussion, we can question whether management without leadership is in fact ‘effective’ management. However, the converse is well accepted. Leadership can exist outside of management roles. Informal leadership practices performed by those who are not working in designated management roles are well known and encouraged in health care organisations (Sullivan & Garland, 2013). It is this form of leadership that we are mostly concerned with in this unit of study.

What is leadership?

In this section we will examine this term more closely, as it is central to nursing work. Your task is to develop an understanding of leadership, and to develop a working definition or model that suits your preferences. There are many different perspectives on leadership, what it is and how it relates to management. Time does not allow us to look at all of these. You are encouraged to examine the following definitions, compare and consider their strengths, weaknesses and main messages, and work toward developing a definition, that resonates with you.

“Leadership is the process of influencing others to understand and agree about what needs to be done and how to do it, and the process of facilitating individual and collective efforts to accomplish shared objectives” (Yukl, 2014, p.7).

“Leadership is the intention to set direction, align efforts, and motivate people to achieve results which might involve managing change” (Sullivan & Garland, 2013, p. 36)

From your previous reading, Kotter (1999, para 9), one of the classic leadership theorists, offers the following definition:

“Leadership is about establishing direction, developing a vision of the future, often the distant future, and setting strategies for making the changes needed to achieve that vision. Leadership is about aligning people, communicating the direction by words and deeds to all those whose cooperation may be needed, influencing the creation of teams and coalitions who understand the vision and accept their roles in the implementation of strategy. Leadership is about motivating, inspiring, and energizing people to overcome major political, bureaucratic, and resource barriers to change by satisfying basic but unfulfilled needs. Leadership produces change, often dramatic change, and may produce extremely useful change (new products that customers want, new approaches to labor relations that help make a firm more competitive).”

Developing a vision, inspiring people through language and actions to follow, and importantly, the leader removes barriers to change are key messages in Kotter’s (1999) definition.

The Australian College of Nursing defines clinical leadership:

“At the unit level, nurse leaders focus on clinical leadership through the integration of clinical expertise and leadership practices. Clinical leadership involves delivering and monitoring evidence-based practice, evaluating outcomes within a continuous improvement framework, assessing and mitigating risks to individual patients, improving efficiency and coordination at the point of care and advocating for patients (Jukkala et al. 2013; Ott et al. 2009). Clinical leaders are able to engage with patients in the context of the care and take account of the patient’s social, cultural and economic environment. They also facilitate strong communication and collaboration with patients and within the multidisciplinary team. As a result, they are able to recognise and address gaps in patients’ care as well as systemic issues of concern. The clinical leadership of nurse unit managers and nursing teams is critical for identifying issues and implementing the necessary solutions in collaboration with management and other health care professionals (Begun et al., 2006; Tornabeni & Miller, 2008).” (Australian College of Nursing, 2015, p. 7)

The ACN’s (2015) definition focuses on leadership at the point of care delivery. This definition extends Kotter’s definition by including the context of leadership, and the influence of the leader on team communication and collaboration.

What criticisms can you make of the definitions offered above? How well do they reflect the nature of nursing work and the context in which it is practiced? Share your ideas on our Module Discussion Area

Start working on your own definition or personal philosophy of leadership. Read the following article especially from the section ‘on p. 65 that poses a series of questions that guide this process. Your leadership philosophy will be included in your Third Assessment: Critical Reflection.

Benson. (2015). Creating your personal leadership philosophy. Physician Leadership Journal, 2(6), 64–66.


That concludes Module 1. The nature of leadership and management, the relevance to nursing practice and the concept of a leadership philosophy have been introduced in this topic and I hope you feel ready to dive into some of the specific theories of leadership in more detail in Module 2.

  • References


Australian College of Nursing (ACN). (2015) Nurse leadership.

Avolio, B. J. & Gardner, W. L. (2005). Authentic leadership development: Getting to the root of positive

forms of leadership’, Leadership Quarterly, 16, (3), 315–38.

Bamford, M., Wong, C. A., & Laschinger, H. (2013). The influence of authentic leadership and areas of worklife on work engagement of registered nurses. J Nurs Manag, 21(3), 529-540.

EPM (2020, April 4) Leadership styles explained (Kurt Lewin) [Video] YouTube.

Fischer, S. A. (2016). Transformational leadership in nursing: a concept analysis. Journal of Advanced Nursing, 72(11), 2644-2653.

Greenleaf, R. (1991). The servant as leader. Robert K Greenleaf Centre.

Gregg Learning (2018, Jan 30) Contingency approaches to leadership [Video]. YouTube.

Gregg Learning (2018, December 12).Trait approaches to leadership. [Video] YouTube

Grint, K. (2005) Leadership: The heterarchy principle. Palgrave.

Kirkham, L. (2020). Understanding leadership for newly qualified nurses. Nursing Standard, 35(12).

Kotter, J (1999). Change leadership. Leadership excellence, 16(4), 16.

Mortier, A. V., Vlerick, P., & Clays, E. (2016). Authentic leadership and thriving among nurses: the mediating role of empathy. Journal of Nursing Management, 24(3), 357-365.

Robbins, S. P., Bergman, R., & Coulter, M. K. (2018). Management (8th ed.). Pearson. LEADERSHIP THEORIES Nursing homework help

ShiftWizard Inc. (2019, March 5). Transformational leadership at the bedside. [Video].YouTube.

Stanley, D. (2016). Clinical leadership in nursing and healthcare: Values into action. John Wiley & Sons, Incorporated.

Sullivan, E., & Galrand, G. (2013). Practical leadership and management in healthcare (2nd ed.). Pearson.

Swanwick, T. (2017). ABC of clinical leadership (2nd. ed.). Wiley-Blackwell.

The Nursing and Midwifery Board of Australia (2016) Registered Nurse Standards for Practice.

Thusini, S. T., & Mingay, J. (2019). Models of leadership and their implications for nursing practice. Br J Nurs, 28(6), 356-360.

University of Wollongong Australia ( 2001). Effective studying: Concept mapping.

Yukl, G. (2014). Leadership in organizations (8th ed.). Pearson.



  • Introduction

In this module we will explore and critique traditional and contemporary theories of leadership. Some of these will be familiar to you. Each theory offers a perspective that contributes to our understanding of leadership.

This module addresses the following learning outcomes

2.Critically analyse concepts of management and leadership in nursing and health services


Core readings for this Module are available in the following online texts:

Stanley, D. (2016). Clinical leadership in nursing and healthcare: Values into action. John Wiley & Sons, Incorporated. Chapter 2

Download part 1 Chapter 2: Leadership theories and styles.

Swanwick, T. (2017). ABC of clinical leadership (2nd ed.). Wiley-Blackwell.

Download Chapter 3: Leadership theories and concepts. 

The commentary presented within the unit module will guide you to the relevant sections of these text to read.

What is theory?

Before we start, lets take a look at what theory is and why it is valuable to your learning and professional practice.

Theory offers a lens that enables you to learn more about the properties of your ‘phenomenon’, e.g., leadership practice, than you would know otherwise. Acceptance or rejection of theory is also valuable to your learning, and your reasoning behind your position is an important part of being a critical learner. Furthermore, sometimes the limitations of one theory are addressed by another. There are a number of theories that we can draw from to understand leadership as the context of our learning. (Do not be put off by the prospect or working with theory- it can actually be quite interesting!).

As scholars of nursing leadership, it is vital that you develop a depth of understanding of leadership theory. Leadership theory forms the basis of arguments presented in published journal articles, and your baseline understanding is essential to your understanding of these resources. Leadership theory also informs models of leadership that you will come across in your practice, some of which you will study in this subject. Furthermore, the theory of leadership is reflected in the language of leadership that is embedded in professional practice, with obvious implications for your learning and transition to professional practice.

In this section you will examine the following leadership theories:

Conventional leadership theories
  • Trait
  • Behavioural (leadership styles)
  • Contingency
Contemporary leadership theories
  • Transformational and transactional leadership
  • Authentic leadership
  • Servant leadership
  • Dispersed leadership

As a preliminary activity, describe a scenario that comes to mind from your past experience (not necessarily clinical) where you observed what you consider to be effective leadership. (You may refer to your response to the previous week’s activity). It could be in relation to a change, or resolution of a workplace problem. Include the situation, the actions taken by the leader and the reasons for your judgement. What personal attributes and behaviours were evident? How did the leader make you or others feel? You could write your response as a paragraph in a case format, for reference. You will refer back to your ‘case’ as a learning experience, throughout this module.

To gain the most from your study of these theories, I suggest you make a list of the key concepts or features of each theory as you read, and comment on your view of their strengths, weaknesses and practice implications, and how each theory relates to the collection. Your overall understanding of leadership should reflect a synthesis of these ideas. Developing your synthesis incrementally as you study these topics is an efficient way to learn. You might find a concept map (refer to the Introduction) or the following note making table to be useful.

Conventional Leadership theories

Conventional leadership theories sought to identify characteristics associated with effective leadership and the achievement of organisational outcomes. These theories were largely contextualised within hierarchical organisations.

Trait theory

Trait theory of leadership reflects the perspective that leaders are born with particular attributes, and that leaders can’t be ‘made’. You may be familiar with the term: “he/she is a born leader”.

Stanley, D. (2016). Clinical Leadership in Nursing and Healthcare: Values into Action. Hoboken: John Wiley & Sons, Incorporated. Chapter 2 Pages 30-32 Trait theory: The man not the game

Consider your ‘case’- did you identify any particular traits in your appraisal of leader effectiveness?

Gregg Learning (2018, December 12). Trait approaches to leadership. [Video]. YouTube.



Note that the presentation refers to renewed interest in desirable leader traits. Emotional intelligence is one such trait that is widely researched in the nursing literature. You can undertake a library search to find studies that reflect this topic if you are interested.

Behavioural theory (leadership styles)

Behavioural theory, as the name suggests, examines leader actions and behaviours rather personal characteristics. Unlike trait theory, which assumes leaders are born and not made, behavioural theory suggests leadership skills and behaviours can be ‘learned’.

Stanley, D. (2016). Clinical Leadership in Nursing and Healthcare: Values into Action. Hoboken: John Wiley & Sons, Incorporated. Chapter 2 : Style theory: It’s how you play the game. pp. 32-34

Swanwick, T. (2017). ABC of clinical leadership (Second ed.). Wiley-Blackwell. Leadership styles pp. 4-8

Consider your case activity. Did you identify particular behaviours among the attributes of the effective leader?

Note Figure 3.1 in your second reading (Swanwick, 2017). The author refers to Tannenbaum and Schmidt’s (1958) continuum of leader behaviour that is proportional to ‘subordinates’ level of freedom. Their perspective reflects leader styles in relation to decision making situations, and is somewhat applicable to situational leadership.

Consider situations where an autocratic style of leadership is appropriate, and situations where an abdicatory or ‘ands off’ approach is appropriate. What are the implications of an inappropriate use of leader style?

Leadership styles can be given many different labels, and you will see a selection in Table 3.1. (Swanwick, 2017). The following video presents an excellent explanation of four leader styles that reflect the work of Kurt Lewin, a change leadership theorist (Robbins, 2018). The framework that is explained at the end of the presentation demonstrates the relationship between leader styles (Autocratic, democratic, transformational & Laissez-faire) and the nature of the practice situation.

EPM (2020, April 4). Leadership styles explained (Kurt Lewin) [Video]. YouTube.




Take time to study the framework. You may use it to analyse the case you developed in your earlier activity.

Contingency leadership theory

We have touched on contingency theories in our above discussion as leader behaviours and styles have been demonstrated within their context. Your reading below (Swanwick, 2016) presents quite a good example of the leadership styles of directing, coaching, supporting, and delegating during the period of new staff induction.

Stanley, D. (2016). Clinical Leadership in nursing and healthcare: Values into action. John Wiley & Sons, Incorporated. Chapter 2 Situational or contingency theory: It’s about relationships pp. 34-35

Swanwick, T. (2017). ABC of clinical leadership (2nd. ed.). Wiley-Blackwell. Contingency theories p. 8.

The following video underscores these ideas and introduces the need for leaders to achieve a balance between task and relationship oriented approaches.

Gregg Learning (2018, Jan 30). Contingency approaches to leadership [Video]. YouTube.



Return to your case. Did your leader achieve a balance between task and relationship oriented behaviours?

In this module you have explored some of the conventional theories of leadership. As a final activity, return to your case and engage in some analysis based on each of the theories you have studied. did you find these theories useful tools for viewing your case? What did you learn? You are encouraged to develop your answer in a journal in preparation for assessment 3. We will discuss further during our tutorial.


You have completed the first of two modules on leadership theory. In Module 3 we will explore contemporary theories of leadership. Note that the development of theory is an ongoing and incremental process: Earlier theories are explored and critiqued and tested and newer theories emerge. Each contributes to our understanding of this complex area of practice.

Conventional leadership theories

·         Introduction

The theories you have studied so far, have emerged from studies conducted in organisational hierarchies where leadership was enacted usually within a position of authority, such as a designated management or leader role. This remains a relevant context for the study of nursing leadership as nurses are often delegated to positions of authority such as team leader roles, or project leadership roles. However, as you are aware from your initial study, leadership also occurs irrespective of designated position, and involves collaborative team based interractions that are not well articulated in earlier theories. Contemporary leadership theories help us to understand this aspect of leader practice in further detail, and. In this section we will study:

  • Transformational and transactional leadership
  • Authentic leadership
  • Servant leadership
  • Dispersed leadership


This module addresses the following learning outcome:

1.Critically reflect upon the role of the registered nurse as a leader in a health care team in varying health contexts

2.Critically analyse concepts of management and leadership in nursing and health services

Transactional and transformational leadership

Transactional leadership focuses on the maintenance of equilibrium in a workplace, where work is done, standards are met and staff are given the support to compete their jobs and are paid for it. Transactional leadership is appropriate in many situations where stability is the aim and there is no need to adapt to or prepare for change or advancement (Sullivan & Garland, 2013). There are areas of activity throughout healthcare where transactional leadership is the norm and is appropriate for the circumstance. Transactional leadership clearly co-exists with transformational and other forms of leadership, depending on the situation or task to be performed.

Transformational leadership is of particular relevance to healthcare and nursing as the emphasis on empowerment of individuals, collaborative team work and the development of effective relationships is embedded in nursing work (Sullivan & Garland, 2013). Transformational leadership is also relevant to the management of change in dynamic contexts (Swanwick, 2019), such as healthcare. LEADERSHIP THEORIES Nursing homework help

Stanley, D. (2016). Clinical leadership in nursing and healthcare: Values into action. John Wiley & Sons, Incorporated. Chapter 2

Transformational theory: Making change happen pp. 35-37

Transactional theory: Running a tight ship p. 37

The following video has been selected for the presenter’s clear explanation of transformational leadership, and the relevance of its examples to the practice of nursing. The main presentation takes 30 minutes followed by an interesting discussion.

ShiftWizard Inc. (2019, March 5). Transformational leadership at the bedside. [Video]. YouTube.




From the video, which aspects resonated with you? Did you agree with the perspectives presented? From your practice experiences, what challenges and foreseeable changes would be amenable to a transformational leadership approach? Share your thoughts on the Module discussion board.

Refer back to your case and consider whether transformational leadership was demonstrated by the leader.

The following reading presents a concept analysis- a critique of transformational leadership (TFL). The article explains key dimensions of TFL, and applies these to a plausible case scenario. The author contrasts TFL to other perspectives that you will be familiar with, providing an opportunity for synthesis of your prior learning . This is a very good example of critical writing.

Fischer, S. A. (2016). Transformational leadership in nursing: A concept analysis. Journal of Advanced Nursing, 72(11), 2644-2653.

Authentic leadership

Authentic leadership includes four characteristics: self- awareness, an internal moral perspective, balanced processing and relational transparency (Avolio & Gardener, 2005).

Mortier et al. (2016, p. 358) explain these concepts: “Self‐awareness demonstrates how the leaders perceive themselves in comparison with the world and with their understanding of their own strengths and weaknesses…internalised moral perspective refers to an internalised and integrated form of self‐regulation…. balanced processing, refers to their decision‐making, which is based on the analyses of all relevant data, being positive or confirming information or negative clues… relational transparency, reflects how openly the leader presents her/himself to others. Encompassing all four components, authentic leadership provides a healthier, more ethical work environment.” Authentic leadership has been associated with enhanced work engagement in nursing (Bamford et al. 2012): a salient issue in today’s health care environment that is challenged by issues of staff retention.

Stanley, D. (2016). Clinical leadership in nursing and healthcare: Values into action. John Wiley & Sons, Incorporated. Chapter 2 Authentic/breakthrough leadership: True to your values pp. 37-38

Servant leadership

Servant leadership understandably, is based on he notion of leaders ‘serving’ their work teams. “Servant leadership occurs when other people’s needs take priority, when those being served ‘become healthier, wiser, freer, more autonomous, and more likely themselves to become servants” (Greenleaf, 1991, p. 7).

Health professionals’ focus on caring and providing service to others may be a factor in the attraction of this model of leadership (Sullivan & Garland, 2013). Of course, nurses are not bound to following any particular leadership approach, as contingency models would suggest, and servant style leadership accompany other approaches to individual leadership.

Stanley, D. (2016). Clinical leadership in nursing and healthcare: Values into action. John Wiley & Sons, Incorporated. Chapter 2 Servant leadership: A follower at the front pp. 38-39.

Dispersed leadership

Dispersed leadership is interesting as it challenges perspectives of leadership as an individual practice. Empowerment across the workplace or organisation, and the assumption that the workforce consists of many well informed and motivated leaders are features of dispersed leadership. Examples of dispersed leadership in action include shared governance, self- directed work teams and co leadership (Sullivan & Garland, 2013).

Swanwick, T. (2017). ABC of clinical leadership (2nd. ed.). Wiley-Blackwell. Distributed, shared and collaborative leadership, p.11

The final section of the text reading presents and synthesis and summary of the theories you have studied.

Stanley, D. (2016). Clinical leadership in nursing and healthcare: Values into action. John Wiley & Sons, Incorporated. Chapter 2 The right leader at the right time, and summary pp. 39-41.


There are many different perspectives on leadership, what it means, how it is enacted and the qualities and behaviours of an effective leader. Followership is another dimension of leadership that is relevant to your understanding. Grint (2005) argues that leadership is “in the eye of the beholders” that is, leadership cannot exist without followers, and any claims of leadership need to be based on evidence, which includes observation of leadership enactment and its outcomes. Thusini and Mingay (2019) emphasise the significant role of followers in sustaining leadership. Followers can accept the decisions of leaders and support the problem solving process by raising appropriate critical challenges and making an informed and participative contribution. Being an informed and supportive follower is an important role for team members, who themselves are well positioned to take on a leadership role.

Please complete the attached quiz to test your knowledge of Leadership theory. Answers will be posted to the unit Discussion board.

NUR543 Quiz.pdf


Summary and synthesis

Review your notes or concept map on leadership theory, being sure that you have captured key characteristics and interrelationships between the topics and ideas. Refer to your case to consider practice applications.

Review your initial definition of leadership.

As a final activity, what aspects of leadership interest you? If you were to investigate leadership theory further, what questions would guide your search? Post your responses to the Module Discussion Area.



In this module you have been introduced to the nature of leadership in nursing. You have built on your knowledge of management and leadership and have explored relevant theories of leadership, undertaken a critique and considered their application to nursing work. It is important to recognise that leadership is an elusive concept- that there is no one explanation of what it is, and no singe theory that can be deemed correct. However, theory enables us to gain some deeper insight and by now it is expected that you will be able to return to your original definition and expand in some detail, your own explanation of what leadership is. You can also develop your leadership philosophy. Your knowledge of leadership theory in this section will enable you to learn more meaningfully from the topics that follow.



  • In this section we narrow our focus down to the specific practice of nursing leadership at the unit level, and our learning turns to key aspects of the process of leadership in clinical environments.

This module will build on previous modules and will address the following learning outcomes:

    1. Critically reflect upon the role of the registered nurse as a leader in the health care team in varying health contexts.
    2. Critically analyse concepts of management and leadership in nursing and health services.
    3. Critically examine the role of the nurse leader in quality improvement and change management practices.

·         The practice of nursing leadership


In this module, you will engage with the following processes that characterise effective leadership in clinical workplaces:

  • developing teams
  • nurturing positive workplace cultures
  • motivating team members
  • empowering team members
  • developing emotional intelligence
  • enabling effective change

Your study so far has been focused largely on the theoretical aspects of leadership. From this topic onwards, you will be introduced to a range of relevant practice applications. I suggest you develop a tool box of ideas and strategies that resonate with you and that you feel you could apply to your practice.


Developing teams as the context of nursing leadership


Teams are defined by the mutually agreeable efforts of its members towards achieving a common goal. Members are accountable to each other, and the achievements are a product of their interactions. Individual knowledge and skills and ideas are exchanged and harnessed in achieving outcomes. An important aspect of team behaviour is that of collaboration, which includes members knowledge of and respect for each others roles and backgrounds and capacity to contribute (Sullivan & Garland, 2013).

Reflect on a work or other experience where you worked alongside other people. Did you (a) all have the same goal, and work collaboratively to achieve that goal? Or were you (b) co located, working at the same time and in the same space, but with different goals? In a ‘nutshell’, (a) represents the nature of a team and (b) represents the nature of a group.


Leadership is considered vital for effective teamwork (Rosengarten, 2019). A leader enables optimum team function and progress toward goals. However, despite the ‘rosy glow’ that might be inferred from teamwork and team leadership, the task of developing an effective team, often from a ‘group’ can be challenging. Rosengarten (2019 ,p. 38) identifies the following characteristics of effective team leaders.


Team leaders:

  • Think critically
  • Solve problems
  • Respect people
  • Communicate skillfully
  • Set goals
  • Share visions
  • Develop themselves and others
  • Appreciate team members’ skills
  • Understand team members’ knowledge
  • Engage all team members
  • Appreciate when another individual is better able to lead the team


Teams form the immediate context of leadership in nursing. Your studies of culture, motivation, empowerment and change management will extend your understanding of effective team leadership in clinical care.


Nurturing positive workplace cultures


We will now turn to culture as a key concern of nurse leader work. Team culture can enable or constrain positive change in healthcare.


Organisational culture has been described as “the shared values, principles, traditions and ways of doing things that influence the way organisational members act” (Robbins et. al., 2018, p. 83). In general terms, it is often referred to as ‘the way we do things around here’. The meaning of culture is complex, and defining culture in any given workplace is often a matter of perspective. However, for leaders to affect change, to motivate staff and to support forward progress of their work unit, an understanding of culture is imperative. Culture is manifested through values, behaviours and the use of artefacts.


To deepen your understanding of culture, the following presentation of Shein’s (2017) ‘Model of Culture’ is recommended for viewing. Note the way the presenter demonstrates use of the model to analyse the culture of an organisation. While the examples given are not in healthcare, I recommend you draw links to your own practice area as you follow the analysis. (2019, November 14). Edgar Schein’s culture model. [Video] YouTube.

Schein’s model was also illustrated in this presentation by an analogy of an iceberg that places explicit evidence of culture (artefacts) at the topic of the iceberg (the visible part), but the bulk of the culture (values and assumptions) like an iceberg, hidden from sight. The implicit nature of culture that is depicted in this model suggests gaining familiarity with values and assumptions (hidden) may be something of a challenge, especially for outsiders, new workers or consumers. LEADERSHIP THEORIES Nursing homework help


If you would like to read more about this model see:

Schein, E. H., & Schein, P. (2017). Organizational culture and leadership (5th ed.). Hoboken: Wiley.


The nature of organistional culture can have a profound influence on the capacity of the organisation or workplace to accept change. Leaders can develop workplace cultures that are more innovative and receptive to change (Yukl, 2019), although, this is not a simple process.

Stanley (2016) lists key strategies used by clinical leaders to affect cultural change. These ideas are based on the author’s view of congruent leadership, where leader influence is based on follower perception of the congruence between leader values and actions. These ideas could be added to your toolbox.

Stanley, D. (2016). Clinical leadership in nursing and healthcare: Values into action. John Wiley & Sons, Incorporated. pp. 116-117


Motivating team members


Inherent in the leadership definition above is the leader’s influence on the team and its members. A brief explanation of motivation theory is helpful in understanding the dynamics of this influence. There are many theories of motivation in the literature, and no doubt you are familiar with Maslow’s (1943) ‘Hierarchy of Needs’, or Hertzberg’s (1964) ‘Two Factor’ theory. These theories present different perspectives on what motivates people especially in their work. The one that we will consider in further detail is Vroom’s (1964) ‘Expectancy’ theory which has continued to contribute to research about motivation at work.


The following summary of key motivation theories outlines theories based inn meeting needs, and on the way that people are motivated. Do not be concerned with memorising these theories- this video really is a ‘crash course’! But try to identify some of the key ideas in motivation theory that are relevant to leadership work. For example, setting goals, ensuring team members have a sense of equity in terms of reward and opportunity, or that their needs for self esteem are being met. Consider what motivates you, and what opportunities are available for you to motivate others. Remember that these are theories or ways of looking at work, and are not intended to be prescriptive.

EPM (2020, October, 23).Motivation theories explained in ten minutes [Video] YouTube.



What rewards can nurse leaders use to motivate other staff? Think back to the case that you described in Module 1. What strategies did the leader use to motivate team members? What motivates you?

Understanding motivation is essential for leadership, as leaders are tasked with the job of influencing the collective effort to achieve patient- centred care.

Empowering team members


Associated with motivation, is empowerment of team members. An extensive body of research has emerged over recent years in relation to empowerment. This is a far cry from the early part of last century when worker welfare was largely ignored or related primarily to payment of wages. Empowerment is also ‘missing’ from some of the theories we have explored in this unit. Staff empowerment has been associated with retention in particular in relation to nursing work (Read & Laschinger, 2015).


Empowerment is generally considered a positive attribute of a team or workplace. Two forms of empowerment are commonly referred to in the nursing literature. Structural empowerment views practices, policies and structures that are inherent in organisational hierarchies as disempowering, as they support power in a small group at the top. Empowerment involves changing these arrangements so that power can be more evenly spread (Kanter, 1977).


Psychological empowerment refers to individual perceptions or beliefs about power, and to their intrinsic motivation and sense of self determination. Psychological empowerment in nursing is the perception that the work undertaken is valued. This precipitates a sense of autonomy and efficacy in influencing workplace activities (Knol & Van Linge, 2009).


Critics argue that structural and psychological power concepts positions individuals as recipients of power, that is, the organisation or leader acts to give them power, and the individual a passive recipient.


An alternative view has been articulated by Woodward (2019) who defines an empowered nurse as “one who has the ability to choose and perform allowable actions and direct his/her own growth in the desired manner” .(p. 142) and recommends; “we can work as a profession to ensure that the educational preparation, on‐the‐job training, and ongoing mentorship and support are focused on providing individual nurses the tools to set their own goals, practice with autonomy, remain engaged with the aspect of nursing they feel most passionate about, and exert influence on their colleagues, organizations, and communities.”(p. 142) Implications for team leaders then include, rather than handing out power through team roles, supporting team members to become autonomous in their own engagement and efficacious in their capabilities and ability to make change.

The following paper presents an in depth discussion on empowerment in nursing. This is an important concept that has implications for nursing, nursing leadership and professionalism.

Woodward, K. F. (2020). Individual nurse empowerment: A concept analysis. Nurs Forum, 55(2), pp. 136-143. 


What experiences have you had where you either felt empowered, empowered someone else, or felt disempowered? Share your views on the Module discussion area.


Developing emotional intelligence


The concept of Emotional Intelligence (EI) has also been given emphasis as vital characteristic of effective workplace relationships, and has particular relevance to leadership in nursing. Emotional intelligence has been defined as:


“the ability to monitor one’s own and other’s feelings and emotions, to discriminate among them and to use this information to guide one’s thinking and actions” (Salovey & Mayer 1990, p. 190).


Wang et al. (2018) report an association between transformational leadership in nursing and the development of emotional intelligence, as a precursor for nurse retention. This reading is comprehensive in its explanation of the relationship between EI and nursing leadership. You will be familiar with the theoretical ideas that support the author’s arguments.

Wang, L., Tao, H., Bowers, B. J., Brown, R., & Zhang, Y. (2018). When nurse emotional intelligence matters: How transformational leadership influences intent to stay. Journal of Nursing Management, 26(4), 358-365. 


In this section you have explored a number of characteristics of leadership practice. There are other factors that characterise good leadership practice including use of evidence, collaborative decision making, effective communication and stimulating intellectual engagement and learning. You have engaged with these topics in previous subjects and so they will not be repeated here. However, you may research these ideas out of interest or as part of your preparation for your assessments.



In this topic you have studied leadership in nursing practice. You have considered the concept of innovation as an opportunity to influence change within the ordinary routines of clinical work. Theories of motivation and culture can be added to your leadership tool box and your leadership philosophy. Embedded in nursing leadership are concepts of teamwork, empowerment, motivation and culture. In the following module you will apply your understanding of change leadership to matters concerning quality and safety on healthcare.

·         References



Beauvais, A.M. & Spahn, K. (2019). Innovation and change. In A.M. Beauvais (ed.) Leadership and management competence in nursing practice: Competencies, skills, decision making. Springer Publishing Company.

EPM (2020, October, 23).Motivation theories explained in ten minutes [Video] YouTube.

EPM (2020, October, 23). Motivation theories explained in ten minutes [Video] YouTube.

Flixabout (2018, July 16) Kotter’s 8 step leading change. [Video] YouTube (2019, November 14). Edgar Schein’s culture model. [Video] YouTube.

Kanter, R. M. (1977). Men and women of the corporation. Basic Books.

Knol, J., & Van Linge, R. (2009). Innovative behaviour: the effect of structural and psychological empowerment on nurses. J Adv Nurs, 65(2), 359-370.

National Institute for Health and Clinical Excellence (2007) How to change practice. National Health Service.

Read, E. A., & Laschinger, H. K. S. (2015). The influence of authentic leadership and empowerment on nurses’ relational social capital, mental health and job satisfaction over the first year of practice. Journal of Advanced Nursing, 71(7), 1611-1623.

Robbins, S. P., Bergman, R., & Coulter, M. K. (2018). Management (8th ed.). Pearson.

Rosengarten, L. (2019). Teamwork in nursing: essential elements for practice. Nurs Manag (Harrow), 26(4), 36-43.

Salovey P & Mayer J (1990) Emotional intelligence. Imagination, Cognition and Personality 9, 185–211.

Schein, E. H., & Schein, P. (2017). Organizational culture and leadership (5th ed.). Wiley.

Schermerhorn, J. R. (2020). Management (7th Asia-Pacific ed.). Wiley

Stanley, D. (2016). Clinical leadership in nursing and healthcare: Values into action. John Wiley & Sons, Incorporated. pp. 116-117

Sullivan, E., & Galrand, G. (2013). Practical leadership and management in healthcare (2nd ed.). Pearson.

Teaching (2014, April 28). Lewin, stage model of change unfreezing changing refreezing animated Part 5 [Video] YouTube

Tutor2u ( 2018, March 1) Kotter and Schlesinger 4 causes of resistance to change [Video] YouTube

Tutor2u (2018, March 1) Kotter and Schlesinger: Six methods of overcoming resistance to change [Video] YouTube

Wang, L., Tao, H., Bowers, B. J., Brown, R., & Zhang, Y. (2018). When nurse emotional intelligence matters: How transformational leadership influences intent to stay. Journal of Nursing Management, 26(4), 358-365.

Woodward, K. F. (2020). Individual nurse empowerment: A concept analysis. Nurs Forum, 55(2), 136-143.

Yukl, G. (2012). Effective leadership behavior: What we know and what questions need more

attention. Academy of Management Perspectives, 26(4), 66-85. LEADERSHIP THEORIES Nursing homework help



The context of nursing leadership

In this Module nursing leadership will be situated within its organisational, national and global contexts. This is important as the nature and effectiveness of nursing leadership and the opportunities and constraints that shape leadership practice, are influenced by its context.

This Module develops the content addressed by the following learning outcomes:

    1. Critically reflect upon the role of the registered nurse as a leader in the health care team in varying health contexts.
    2. Critically analyse concepts of management and leadership in nursing and health services.

·         The context of nursing leadership


The idea of the contextual nature of a practice is not new. As nurses engage in person- centred care, their assessment of influences beyond the physical, to the social, cultural and environmental context of individual health is a well recognised practice foundation. Similarly, the practice of nursing leadership is shaped by a complex and dynamic healthcare environment. Health professionals and services are challenged by a multiplicity of factors including rapidly changing technology, policy, regulations, political, economic and sociocultural factors, the health of Indigenous popuations, funding and resourcing arrangements, quality and safety concerns, population health issues (such as the Covid-19 pandemic and chronic illness), demands of health care professions and consumer expectations. The impact of competing interests between stakeholders adds to the complexity of the environment. The challenge of leading in this environment is the focus of this module.

Key issues in the context of nursing leadership


In this section we will work through a number of key issues in the environment of healthcare that shape nursing practice and leadership: the health of Indigenous Australians, chronic illness, safety and quality of healthcare, technology, consumer expectations, the Covid-19 pandemic, and nursing retention. This list is not exhaustive but gives emphasis to a selection of the most immediate contextual issues that influence healthcare today.

As a starting point, you might develop a table or a concept map to record, summarise and integrate key points from your readings on this topic. Seek to identify the main contextual factors that impact on nursing with implications for leadership, and especially leadership of change. Some of these factors may create opportunities, challenges or barriers to leadership work. These categories might assist in your note-making. Consider also some of the key factors that you feel are important in shaping your own leadership practice and include in your leadership philosophy.


The health of Indigenous Australians


A significant disparity exists between the health status of Indigenous Australians compared to non-Indigenous Australians. The reasons for this disparity include, but are not limited to, access to services and the quality of the care provided (AIHW, 2020). Policy level responses that may be familiar to you include: Coalition of Aboriginal and Torres Strait Islander Peak Organisations and Australian Governments (2020) National Agreement on closing the gap. As leaders, it is important that you are aware of these policy documents that guide the range of actions, including those directly related to health care, that seek to ‘close the gap’.

An in- depth discussion on this issue is beyond the scope of this subject. However, the capacity of nurses as leaders to make a difference to the recognised disparity in health outcomes is well recognised (Darvin, et al. 2018; Fedele, 2017): an important consideration for your leadership practice deliberations throughout this unit. Of note, an important theme to emerge from recent policy developments, that has implications for nursing leadership, is that of cultural safety. You are referred to the following readings as key resources on this topic:

The Australian Institute of Health and Welfare (2022). Australia’s health 2022: Australia’s health snapshots. Indigenous health. Culturally safe health care for Indigenous Australians.

Note the comprehensive list of topics and data that has been included on this webpage. I suggest you read further to address any shortfalls on your understanding of this important topic.

The following statement from The Nursing and Midwifery Board of Australia (2018) is essential reading for nurses.

Nursing and Midwifery Board of Australia (2018) Joint statement- Cultural safety: Nurses and midwives leading the way for safer healthcare.


Chronic disease


While the status of population health in Australia is positive in terms of life expectancy, years free of disability, falling rates of premature death, and reduction in the burden of disease (AIHW, 2016), an increasing life span has been accompanied by an increase in chronic disease including diabetes, cancer and heart disease as well as multiple morbidities (AIHW, 2016). Policy responses to the challenge of chronic illness include reduction of risk, coordinated care and an emphasis on self-management, with a greater emphasis on out-of-hospital care, including primary and community care (Duckett & Willcox, 2015).

The increase in chronic disease has implications for nursing. In Australian hospitals, nurses encounter an increasing number of older people admitted with complex combinations of chronic conditions, with higher levels of acuity, in need of more technically advanced care, and who stay in hospital for relatively short periods of time (Duckett & Willcox, 2015). This impacts on the skill sets of nurses, workloads and workflow processes, and models of care (Needleman, 2013). In response to this complexity, nurses play an active role in interdisciplinary care where health professionals from a range of disciplines work together to manage patients’ healthcare problems (Chang & Johnson, 2014). Nurses are well positioned to lead the development of systems, models of care and innovative care practices to enhance the care of those who are older and have chronic diseases.


Safety and quality of care


Achieving safety and quality in healthcare is a global concern. Across the world, approximately 1 in 10 patients receive an iatrogenic or unintended negative consequence from healthcare (Slawomirski et al., 2017). For users of healthcare services, a 1 in 10 chance of an unintended negative consequence is of great concern. It is estimated that many of these ‘adverse events’ can be prevented, fueling concerns about healthcare quality worldwide (Slawomirski et al., 2017). Adverse events are costly to patients, and to the healthcare system.

In Australia, the statistics are slightly lower, with approximately 6.7 patients per 100 hospitalisations experiencing adverse events, the most common being abnormal reactions to procedures, treatments or medications (AIHW, 2018a). Examples of adverse events include administration of wrong medication, or unanticipated but preventable reaction to a surgical procedure, which can lead to injury or death (Duckett, Jorm, Danks & Moran, 2018). Errors and adverse events in healthcare generally result from an interplay between a range of factors including the complex nature of care, systems and processes, as well as human relationships and behaviours and other contextual factors (Yates, Lewis, & Iedema, 2012).

Safety and quality of healthcare has become a focal point in healthcare, and has particular significance in the public hospital sector where the risks of injury to patients are high (AIHW, 2018a). Achieving safe, quality care, by working to prevent adverse events and by ensuring the outcomes of care are consistent with the intentions of that care, underpins nursing work. Nurses are well positioned to identify opportunities to advance safety and quality in healthcare through effective leadership and are expected to contribute to the system wide mandate to reduce incidents of unsafe care. This topic is discussed in further detail in a following module.




Over the past 30 years, a proliferation of medical technology in healthcare has improved diagnosis and treatment, and has decreased patients’ length of stay in hospital (Palmer & Short, 2014). Technology refers to the entire range of activities involving personnel, processes, and procedures and equipment that are involved in new approaches to treatment or diagnosis (Palmer & Short, 2014). Viewed this way, technology encompasses not only equipment and procedures, but the systems, skills and other human factors that influence its use.

Alongside potential health outcome benefits, advances in technology can also increase the complexity of care and risk of harm to patients, either directly during the process of care, or indirectly, by producing incorrect information (Healy & Sampford, 2011). For example, invasive surgery carries a high risk of harm, and diagnostic procedures such as pathology tests can produce incorrect results.

Technological advancements including the EMR, telehealth and mobile health have significant implications for the work of nurses. Nurses need to not only learn to use technology and adapt their practice in response to its changing demands, but as leaders, seek opportunities to ensure technology is used to advance person-centred care, including safety and quality.


Nurse retention


Registered nursing shortages are looming as a worldwide problem as populations age, nurses from the ‘baby boomer’ period retire and the current decline in nursing retention rates continues (WHO, 2016). In Australia, it is predicted that there will be a shortfall of 123,000 nurses nationally by 2030 (Health Workforce Australia, 2014). From an operational level, staff shortages present an unrelenting tension for nurses, whose focus on maintaining high standards of care in a dynamic and changing environment already poses challenges. LEADERSHIP THEORIES Nursing homework help

The impact of nursing staff turnover on clinical care has become a significant issue in the Australian healthcare system. Issues associated with staff turnover, including safety and quality of care, morale, job satisfaction and financial costs (Roche et al. 2015), pose a significant challenges for nurses, nursing leaders, health care organisations and consumers. Effective leadership is known to create an environment in which nurses are more likely to stay (Wang et al. 2018). Nurses at all levels have an opportunity to develop leadership strategies that achieve this important outcome.


The Covid-19 Pandemic


Possibly the most significant current environmental influence on nursing leadership, our health system and health care practice that many of us have ever experienced, is the Covid-19 pandemic. Nurses have been at the front line of care during the pandemic and their innovative leadership practices have facilitated exemplary care and outcomes for communities in many contexts. The following video presents opportunities created by the pandemic, for future health services delivery. The implications for nurse leadership in the post Covid-19 era are significant.

Stephen Duckett’s webinar presents future implications for services in response to the pandemic.

Grattan institute (2020 June 11). How our health system can be better after the pandemic.[Video] YouTube.




From the discussion, what do you see as they key opportunities for nurse leadership in the future? What changes can be made, where are the opportunities for nursing innovation and what do you see as the main challenges? Post your responses to the Module Discussion Area

The following chapter extract presents an in-depth discussion about the Australian health services environment. The discussion is not specifically focused on nursing leadership, however as nurses are a part of the health care system the reading is clearly relevant. You can skip the section on ‘systems’ if you like, although we will be coming back to that later. Read to the end of socio-political environment.

Duckett, S. J., & Willcox, S. (2015). The Australian health care system (5th ed.). Oxford University Press. Chapter 1 the changing healthcare environment pp. 4-8. 

The following comprehensive text emphasises the opportunities for nursing leadership that are emerging from the health care context. Read from the introduction, health care context and opportunities for clinical leaders- to page 240. to end of changing models of care delivery. You can add to your notes that list significant opportunities for nursing leadership in today’s healthcare context.

Davidson, P., & Sindhu, S. Becoming a nurse leader. In J. Daly, S. Speedy, & D. Jackson (Eds.), Contexts of nursing. Elsevier. pp. 233-240.

Refer back to our definitions of leadership from Module 1. How well do these definitions and theories address the relationship of leadership to its context? Now is a good time to review and revise your initial definition of leadership, and your leadership philosophy.

Chambers (2011) argues that, of all the theories, situational leadership is of greatest value in advancing the concept of context. They suggest that leaders can develop an approach that meets the circumstances. But not only do situational leaders seek to meet the needs of a changing context, they also navigate context to develop networks and to seek opportunities to access knowledge that informs leader decision making.


Understanding the context of nursing leadership work is vital if we are to respond to and anticipate change, and draw from the opportunities that are presented to advance patient care.


As explained in preceding topics, the context of nursing practice and nursing leadership is complex and dynamic. Systems thinking is a useful way to develop meaning from this context, and to shape decisions that impact on care. The following You Tube video touches on the central meaning of systems thinking. The emphasis is on interconnectedness, questioning key assumptions and removing barriers: key leadership activities. Systems thinking provides a way of thinking about individuals, organisations and their environment as an integrated system rather than as a collection of independently functioning parts. Take note of the questions that are asked at the end of the video. These ideas are central to effective leadership practice.

ST4CHealth (2015, March 11). Systems thinking and complexity in health [Video]YouTube







Health care organisations, including hospitals, community health centres, aged care facilities and public health services, as the context of nursing leadership are complex entities. The work is often uncertain and unpredictable, and leadership, especially leadership of change within this complex arrangement is challenging. It is relevant therefore to consider the network of relationships, processes, resources, policies, technologies, activities, barriers and constraints that occur within and between these organisations from a systems perspective.

The following brief animated video gives additional emphasis to these points.

Jeffrey Braithwaite (2017, November 21). The leader as systems thinker [Video]. YouTube.





Leading in response to challenges in the healthcare context has significant implications for nursing whose roles at the point of service delivery includes balancing inputs and outcomes to achieve desirable outcomes for patient care. Meeting the needs of a population that is aging, experiencing more chronic conditions, and is better informed about healthcare, in a context characterised by ongoing demands for safe, efficient and effective care, amidst a stream of costly diagnostic and treatment technologies, and issues of nursing retention, demands constant adjustment. Nurses are well positioned to seek opportunities for innovation and change, and to exercise leadership in advancing patient care. Systems thinking presents a useful framework for leadership in the complex and dynamic environment of contemporary health care.


·         References

Australian Institute of Health & Welfare. (2016). Australian burden of disease study: Impact and causes of illness and death in Australia 2011. AIHW.

Australian Institute of Health & Welfare. (2018)a. Australia’s Health 2018. (Cat No. AUS 199). AIHW.

Chambers, N. (2011). Leadership and governance. In K. Walshe & J. Smith (Eds.), Healthcare Management (2nd ed.). McGraw-Hill Education.

Chang, E., & Johnson, A. (2014). Chronic illness and disability: Principles for nursing practice. Elsevier Australia.


Coulter, A. (2011). Engaging patients in healthcare. Open University Press.

Deravin, L., Francis, K., & Anderson, J. (2018). Closing the gap in Indigenous health inequity – Is it making a difference? International Nursing Review, 65(4), 477-483.

Davidson, P., & Sindhu, S. Becoming a nurse leader. In J. Daly, S. Speedy, & D. Jackson (Eds.), Contexts of nursing. Elsevier.


Duckett, S. J., & Willcox, S. (2015). The Australian health care system (5th ed.). Oxford University Press.

Duckett, S. J., Jorm, C., Danks, L., & Moran, G. (2018). All complications should count: Using our data to make hospitals safer. Grattan Institute.

Duckett, S. J., & Willcox, S. (2015). The Australian health care system (5th ed.). Oxford University Press.

Fedele, R. (2017). Beating the odds: How indigenous nurses and midwives are closing the health gap. Australian nursing & midwifery journal, 24(11), 20-25.

Grattan institute (2020 June 11). How our health system can be better after the pandemic.[Video] YouTube.

Health Workforce Australia. (2014). Australia’s Future Health Workforce – Nurses Overview. Commonwealth of Australia.

Healy, J., & Sampford, P. C. (2011). Improving health care safety and quality: Reluctant regulators. Taylor & Francis Group.

Jeffrey Braithwaite (2017, November 21). The leader as systems thinker [Video]. YouTube.


Needleman, J. (2013). Increasing acuity, increasing technology, and the changing demands on nurses. Nursing Economics, 31(4), 200-202

Roche, M. A., Duffield, C. M., Homer, C., Buchan, J., & Dimitrelis, S. (2015). The rate and cost of nurse turnover in Australia. Collegian, 22(4), 353-358.



Slawomirski, L., Auraaen, A., & Klazinga, N. (2017). The economics of patient safety: Strengthening a value based approach to reducing patient harm at national level.

ST4CHealth (2015, March 11). Systems thinking and complexity in health [Video]YouTube

World Health Organisation. (2016). Global strategic directions for strengthening nursing and midwifery 2016-2020. World Health Organization.


Yates, C., Lewis, J. W., & Iedema, R. (2012). Quality and safety in the context of the Australian health care system. In E. Willis, L. Reynolds, & H. Kelleher (Eds.), Understanding the Australian health care system (2nd ed.). Elsevier.

Palmer, G. R., & Short, S. D. (2014). Health care and public policy: An Australian analysis (5th ed.). Palgrave Macmillan.

MODULE 5: Leading change in nursing

·         Leading effective change 


We now turn to change management and leadership, building on your previous learning. It’s important to understand the meaning of change and how it can be enacted in healthcare workplaces, so that aims are achieved and are able to be sustained. In Module 2 you were introduced to the nature of the health care environment, and of the factors that influenced change in clinical workplaces. Adaptation to new technologies and policies as well internal unit arrangements is part of the change equation. The other part is the planned change that nurses initiate and lead to advance nursing care and patient health. This type of change is dependent on innovation, creativity and critical and original thought.

To begin your study of this important topic, please download the following chapter. This reading has been chosen for its currency and excellent use of case studies to support your understanding of relevant theoretical concepts.

Beauvais, A.M. & Spahn, K. (2019). Innovation and change. In A.M. Beauvais (Ed.) Leadership and management competence in nursing practice: Competencies, skills, decision making. Springer Publishing Company. Chapter 13 pp. 245-256.

Read the first section of Beauvais and Spahn (2019) under ‘innovation’ and complete the quiz. Note the examples of innovation provided are simple examples of changes that are embedded in everyday practice.

Be sure to develop definitions for the following key concepts: innovation, creativity and critical thinking.

Post your responses to the following discussion activity (p. 249) to the Module Discussion Area.

Have you ever had (or do you have) an innovative idea? What factors promote the success of your idea? What factors inhibit the success of your idea? Does your innovation possess characteristics that would foster its implementation (provides a benefit, simple, easy, inexpensive, etc.)?

Continue reading through the different types of change (planned and unplanned change), then work through the section on change theories. There are many theories of change management, and some are based on the concept of health services as complex adaptive systems. However, the traditional theories created by Leuwin (as cited in Beauvais & Spahn, 2019, pp. 252-254) and Kotter (1996) are useful frameworks for planning and evaluating change management and leadership, even though they have been criticised for being simplistic, rational and insensitive to cultural and contextual variations. Note that Kotter’s change process addresses and extends that described by Leuwin. Apply your understanding of each model to the case studies included in the chapter.

The following video presents an informative summary of Leuwin’s change theory.

Teaching (2014, April 28). Lewin, stage model of change unfreezing changing refreezing animated Part 5 [Video] YouTube



Rogers (2003, as cited in Beauvais & Spahn, 2019, pp. 257-258) diffusion of innovations presents clues for leaders on how team members might respond to change. Note table 13.3 ‘Change strategies’ addresses different approaches to change leadership, that resonate with the situational theories of leadership included in your earlier module.

The final sections of this chapter refer to how you as a leader can support others through change, and how leaders can use modelling, engagement with teams and culture to enable and support effective change in clinical workplaces.

Work through the remaining activities and links to self evaluation included in the concluding pages of the chapter.

Add relevant ideas to your leadership tool box for future reference.

The following video presents Kotter’s (1996) 8 step leading change process. You will be able to see the similarities between Kotter’s model and Leuwin’s (as cited in Beauvais & Spahn, 2019, pp. 252-254) theory of change explained in the previous reading. This is a useful framework for planning change and for evaluating change. You could use the model to reflect on change that you experienced or witnessed in the past.

Flixabout (16 July, 2018) Kotter’s 8 Step Leading Change. [YouTube video]






Dealing with resistance to change


As Beauvais and Spahn (2019) conclude, change is not always welcome. Managing conflict, and resistance to change are essential skills for team leaders. In this section, you can take a detailed look at leaders in clinical workplaces can respond to resistance to change.

Schermerhorn, J. R. (2020). Management (Seventh Asia-Pacific ed.). Wiley. Chapter 8 (from previous Module) Read pp. 473-474

Schermerhorn presents resistance to change as a form of feedback rather than something to be managed and refers to the fit between the change and those affected by it and the context. Note the list of reasons for resistance and the discussion that follows about organisational silence and cynicism. Can you relate to these behaviours?

Finally refer to the discussion on managing resistance to change. The three approaches:

  • education and communication,
  • participation and involvement and
  • facilitation and support

are clearly evident in the change management models we looked at:

  • Leuwin’s three phases of planned organisational change: unfreezing, changing and refreezing not only guides the process of change but seeks to alleviate resistance (Schermerhorn, 2020)
  • Kotter’s (1995) 8 Step process of leading change: establish a sense of urgency; form a powerful guiding coalition; create a vision; communicate the vision; empower others to act on the vision; plan for and create short term wins; consolidate improvements; institutionalise new approaches; includes specifically steps that seek to reduce resistance by attending to the anticipated human responses to change.


The following two video resources summarise some of the key concepts that we have explored in this topic.

Tutor2u ( 2018, March 1) Kotter and Schlesinger 4 causes of resistance to change [Video] YouTube





Tutor2u (2018, March 1) Kotter and Schlesinger: Six methods of overcoming resistance to change [Video] YouTube





As a final reading, Yukl’s (2012) taxonomy presents effective leader behaviours that have been sourced from research conducted since the 1950’s. These leader behaviours, many of which will be familiar to you from your study so far, are explained in detail in this article.

Yukl, G. (2012). Effective leadership behavior: What we know and what questions need more attention. Academy of Management Perspectives, 26(4), 66-85.


ND Centre for nursing (April 3, 2020) Leading Change You Tube [Video]

This is an optional but highly recommended resource that takes you through the main elements of change leadership and includes some relevant examples a nd analysis. Note that this is an American video and some of the contextual content is not relevant, so you can skip through those sections. The theories featured ae different to those we have studied, but you will be able to see the similarities.



In this topic you have studied change leadership in nursing practice. You have considered the concept of innovation as an opportunity to influence change within the ordinary routines of clinical work. Theories of change management can be added to your tool box to guide planned change, and to evaluate and reflect on change you have experienced. Embedded in theories of change leadership are concepts of teamwork, empowerment, motivation and culture. In the following module you will apply your understanding of change leadership to matters concerning quality and safety on healthcare.


Clinical leadership and risk management in practice


In this section, you will focus on practice aspects of clinical leadership, in relation to risks to patient safety. The readings and activities in this section provides an opportunity for you to apply the knowledge and understanding you have acquired throughout the previous modules.

Download the following document and read ‘Clinical leadership’ (page 7). Then read from page 8 ‘The impact of nurse leadership’ with a focus on patient outcomes. While this document has a focus on leadership within formal leadership positions, these particular discussions support practice based knowledge for informal clinical leadership practice.

Australian College of Nursing (ACN) (2015). Nurse leadership: A white paper.

Your next activity involves engagement with two clinical risk scenarios that have implications for leadership of clinical risk. Your task is to critique the encounters within each scenario.

The source website is:

Levett-Jones, T. (2017). Patient safety for nursing students (2017) Teamwork and collaborative practice resources

Scenario 1:Incident in the waiting room

(You can download the facilitator resource if you choose).

Scenario 2 Mildred’s story- recognising risks and improving patient safety

Drawing on your knowledge of leadership theory, and patient centred care undertake a critique of each video. The following questions will assist you:

  • What were the risks posed to the patients?
  • What was the leadership style/behaviour that was presented in each scene?
  • Was the leader behaviour appropriate for the situation?
  • What were the outcomes of the leader behaviour?
  • What leadership approaches could achieve a more positive and sustainable change for the patients, with respect to person-centred care, and for the staff? This question has particular relevance to Scenario 2 which does not offer a revised presentation. Share your responses to the Module 4 Discussion board.


You will observe many other nursing care issues in these scenarios. Our focus here however is on leadership and clinical risk. Note also that these scenarios were produced in 2010 and clinical practices may be not be current.

You may like to explore this excellent resource and complete the quizzes and modules. You may need to ‘sign-in’ to access these other resources.




In this module you have explored the role of nurses as leaders in influencing quality and safety in healthcare. Clinical governance has been presented as a frame for considering the activities undertaken across healthcare contexts to achieve safe quality care. Nurses as leaders have a responsibility to advance safe, quality person- centred care, and to understand the nature of their workplaces, seek to remove barriers and identify opportunities to affect practice change through innovative leadership practice. In the following Module you will explore avenues for professional practice development, to enhance your leadership skills, as a conclusion to the unit.


Leadership, person- centred care and clinical governance


In this module, you will focus on nurse leadership in achieving safe quality person- centred care. Concerns over the quality and safety of care was among the key contextual influences on healthcare and nursing leadership studied previously. Safety and quality of care is a global issue, and despite efforts to improve safety, the incidence of adverse events in health care has not changed. As the health profession with the largest number of members working at the front line of health care, and in varying contexts, nurses are in a prime position to influence, through effective leadership practices, the quality and safety of care.

This Module addresses the following learning outcome:

4.Investigate clinical risk management and the registered nurse’s leadership responsibilities for quality and safety in health care.


Patient safety modulle


Person- centred care


At the forefront of nursing practice is a focus on patient- centred care, with which you are no doubt familiar. As a refresher, Levitt-Jones et al (2017, p. 3) offer the following definition:

“Person-centred care is the central tenet underpinning the delivery of safe and effective nursing care. It is a holistic approach that is grounded in a philosophy of personhood [7]. Person-centred care means treating each person as an individual, protecting their dignity, respecting their rights and preferences, and developing a therapeutic relationship that is built on mutual trust and empathic understandings [8]”

One of the primary aims of nursing leadership is to promote person- centered care. This involves leading teams to advance the care of individuals, groups, or to influence the processes and systems that impact on the delivery of person- centred care. In the following section you will explore clinical governance: the framework that guides quality and safety activities in healthcare organisations. In the final section, you will explore leadership of clinical risk which unites your leadership knowledge to the clinical practice context. LEADERSHIP THEORIES Nursing homework help

Clinical Governance

Clinical governance is an ‘umbrella’ term for the relationships, responsibilities, systems, policies and processes that exist throughout the health sector and individual healthcare organisations, that seek to advance the safety and quality of care. Clinical risk management is one of a number of activities that are included within the frame of clinical governance.

The Australian Commission on Safety and Quality in Health Care (ACSQHC) (2017a, p. 2) defines clinical governance as:

“the set of relationships and responsibilities established by a health service organisation between its state or territory department of health (for the public sector), governing body, executive, clinicians, patients, consumers and other stakeholders to ensure good clinical outcomes. It ensures that the community and health service organisations can be confident that systems are in place to deliver safe and high-quality health care, and continuously improve services.

Clinical governance is an integrated component of corporate governance of health service organisations. It ensures that everyone – from frontline clinicians to managers and members of governing bodies, such as boards – is accountable to patients and the community for assuring the delivery of health services that are safe, effective, integrated, high quality and continuously improving.”

There are a couple of points to consider when learning about clinical governance:


  • Clinical governance systems are not prescriptive- every organisation may develop different strategies for addressing quality and safety within their clinical governance systems, depending on their values, nature of the work or specialisation and the context in which it operates. Activities that are performed within the frame of clinical governance include, but are not limited to: quality improvement and measurement, clinical risk management, incident management, open disclosure, feedback and complaints management; compliance with professional regulatory requirements; credentialing and defining scope of clinical practice; clinical education and training; performance monitoring and management; clinical and safety and quality education and training (ACSQHC, 2017b);
  • Clinical governance is a part of corporate governance;
  • A system for clinical governance is a requirement for accreditation in Australia (ACSQHC, 2017b);
  • “Fulfilling a role in clinical governance aligns with the obligations of nurses and midwives under their code of conduct.” (ACSQHCa, 2017, p.1)


Nurses at all levels have a leadership role in influencing the context, relationships and activities that impact on the quality and safety of care as determined by the clinical governance framework.

You are referred to the key source document:

Australian Commission on Safety and Quality in Health Care (2017b). National model clinical governance framework

Read the introduction, and then the explanation of the framework if you choose. Of importance, the five components of clinical governance on p. 6 should be read (also represented in Figure 3). The section that follows: ‘Importance of culture in clinical governance’ (p. 8) emphasises the role of leadership in shaping a safety culture. You will no doubt recognise many of these strategies from your previous studies.

How can nurses as leaders contribute to clinical governance?

From your studies in previous modules, you have considered nurse leadership in relation to unit culture, empowerment, team work, motivation and change. The following document lists roles and responsibilities of nurses and midwives in relation to clinical governance. Select from this list particular strategies that can be enacted through effective leadership at the clinical level. The case studies you have engaged with in previous topics will assist you to identify likely leadership actions that can be carried out during the ordinary routines of care by nurses who are not necessarily in formal leader positions.

The Australian Commission on Safety and Quality in Health Care (2017a) Clinical governance for nurses and midwives

Which strategies did you identify? Share your ideas in the module discussion area

Disch, J. (2017). Leadership to create change (2017) In G. Sherwood & J. Barnsteiner (eds). Quality and safety in nursing: A competency approach to improving outcomes (2nd. ed.). John Wiley & Sons, Incorporated.

Read the entire chapter (16). (p308-312) Although published in the USA and somewhat reflective of that context, most of the content is applicable to other contexts. Many of the concepts you have studied in the previous units have been applied to the leader-safety mandate. Note that culture, change Box 16.1 includes some excellent example of nurses working in non management roles, engaging in leadership of safety practices. Note the use of Kotter’s change leadership process in the presentation of a comprehensive pathway for leading change.

Murray, M., Sundin, D., & Cope, V. (2018). The nexus of nursing leadership and a culture of safer patient care. Journal of Clinical Nursing, 27(5-6), 1287-1293. 

This article presents another comprehensive discussion on nurse leadership and safety. Note the inclusion of a discussion on barriers and constraints to effective leadership.

From your readings in this section, identify some of the key factors that enable and constrain leadership of safety and quality in clinical workplaces. Which factors resonate most with you?

The following reading explores the impact of leadership on patient safety. The findings suggest that leadership has a mediating effect in shaping the environment in which safe person- centred care can be delivered. Effective teamwork, collaboration and a sense of belonging among staff were among the mediating factors for quality and safety associated with good leadership. As you read, consider other positive outcomes that can arise from these mediating actions.

Wang, M., & Dewing, J. Exploring mediating effects between nursing leadership and patient safety from a person-centred perspective: A literature review. Journal of Nursing Management,

Extension Activity



Patient safety has been studied for many years and as you are aware, patient safety is much more than the actions of a particular clinician. In this presentation, patient safety is explained by Professor Jeffrey Braithwaite who has been researching patient safety for many years. The difference between work as imagined and work as done is an important extension topic to consider.

·  References


Australian College of Nursing (ACN) (2015). Nurse leadership: A white paper.

Australian Commission on Safety and Quality in Health Care (2017a) Clinical governance for nurses and midwives

Australian Commission on Safety and Quality in Health Care (2017b). National model clinical governance framework.

Disch, J. (2017). Leadership to create change (2017) In G. Sherwood & J. Barnsteiner (eds). Quality and safety in nursing: A competency approach to improving outcomes (2nd. ed.). John Wiley & Sons, Incorporated.

International Council of Nurses (2012) Patient safety.

Levett-Jones, T. Dwyer, T., Reid-Searl, K., Heaton, L., Flenady, T., Applegarth, J., Guinea, S., Andersen, P. (2017). Patient Safety Competency Framework (PSCF) for Nursing Students Sydney, NSW.

Murray, M., Sundin, D., & Cope, V. (2018). The nexus of nursing leadership and a culture of safer patient care. Journal of Clinical Nursing, 27(5-6), 1287-1293.

Wang, M., & Dewing, J. Exploring mediating effects between nursing leadership and patient safety from a person-centred perspective: A literature review. Journal of Nursing Management,

MODULE 8: Nursing leadership in practice: Accountability and responsibility

This module will draw on knowledge gained in previous units in your nursing degree regarding professional nursing practice, with a particular focus on accountability and responsibility in clinical nursing leadership.

“Professional nursing practice is a commitment to compassion, caring and strong ethical values; continuous development of self and others; accountability and responsibility for insightful practice; demonstrating a spirit of collaboration and flexibility” (Francine Girard & Jeanne, 2005, p.3)

Nursing is a very autonomous profession and it requires nurses to make decisions and take responsibility for their actions. Nurses are accountable for their patients, so it is crucial for nurses to provide constant observation and assessment of patients, to set priorities, work effectively, and efficiently to recognize critical situations, which may necessitate the nurse to monitor the patient closely. Nurses must also make clinical decisions about a required intervention; or, if needed, communicate with other healthcare team members for assistance, support, or guidance; or call the primary healthcare provider. Hence, it is essential that bedside nurses acquire leadership skills to improve patient outcomes and safety through the care provided (AL-Dossary, 2017).

Furthermore, it is crucial that nurses develop an effective leadership role to deliver high‐quality care and ensure patient safety while engaging in numerous daily leadership roles by practicing in accordance with the standards and codes that guide nursing practice in Australia

Please take the time to refresh your knowledge in relation to our guiding practice standards and codes.

Later in this module you will examine and apply the international code of ethics, code of conduct and the nursing practice standards to professional nursing practice and begin to reflect on your own professional practice in terms of leadership and continuous professional development.


The Regulatory Framework

The Nursing & Midwifery Board of Australia defines the requirements that applicants, registrants or students need to meet to be registered. Please explore the following registration standards.

Criminal history registration standard

English language skills registration standard

Registration standard: Continuing professional development 

Registration standard: Recency of practice 

Registration standard: Professional indemnity insurance arrangements 

 Please watch the following Youtube video. Play time one minute 30 seconds.

If as nurses we adhere to and meet the standards and codes of ethics and conduct set out by the ANMC we should be viewed as competent, professional and ethical in our practice, It is therefore our duty to influence and encourage other registered nurses to do the same. We should lead by example.

The International Code of Ethics has four principal elements that outline the standards of ethical conduct:

    1. Nurses and people
    2. Nurses and practice
    3. Nurses and the profession
    4. Nurses and co-workers


The Code of Professional Conduct sets out the legal requirements, professional behaviour and conduct expectations for all nurses, in all practice settings.


The Registered Nurse Standards for Practice consist of the following seven standards:

    1. Thinks critically and analyses nursing practice.
    2. Engages in therapeutic and professional relationships.
    3. Maintains the capability for practice.
    4. Comprehensively conducts assessments.
    5. Develops a plan for nursing practice.
    6. Provides safe, appropriate and responsive quality nursing practice.
    7. Evaluates outcomes to inform nursing practice.

Each standard has criteria that specify how that standard is demonstrated. The criter ia are to be inte2016_Registered-nurse-standards-for-practice for RN.pdf

Decision making framework

Nursing-and-Midwifery-Board—Codes-and-Guidelines—Nursing-practice-decision-flowchart-2013 (2).PDF


hang, Daly, J., & Adrian, A. (2016). Transitions in nursing : preparing for professional practice (Chang & J. Daly, Eds.; Fourth edition.). Elsevier. Chapter 2. Becoming a competent, confident, professional registered nurse

Chang, Daly, J., & Adrian, A. (2016). Transitions in nursing : preparing for professional practice (Chang & J. Daly, Eds.; Fourth edition.). Elsevier. . Chapter 21 Transition into practice: the regulatory framework for nursing,

Berman. (2021). Kozier and Erb’s fundamentals of nursing : concepts, processes and practice (Fifth Australian edition.). Pearson Australia. Chapter 5: Values, ethics and advocacy











  • Leadership at the bedside

Clinical Nursing Leaders 

It cannot be over emphasised the important role clinical nursing leaders play as an advocate for patients by providing and promoting best possible available care. The effective leader will act as a liaision between patients and healthcare teams in advocating for the rights and welfare of patients and by emphasizing the importance of a safe health setting for providing care. The nurse clinical leader will also challenge poor practices and assist patients access to appropriate healthcare information and allow them to be engaged in decision making of their care (AL-Dossary, 2017). Furthermore Nurses are required by law to report nursing colleagues or other health professionals for practices that endanger the health and safety of people in their care.


Case Study 1 Mark Green

This activity was adapted from an actual clinical case in which a serious clinical error occurred and this resulted in a person’s death. The coroner’s report following the inquest identified communication between staff and during handover, documentation and clear identification of decisions, and use of appropriate guidelines and protocols as key areas for improvement.

Levett-Jones, (2017).


  1. critically analyse what has occurred in the case study provided from a professional nursing perspective in relation to:
  • applicable Nursing and Midwifery Board AHPRA (NMBA) nursing practice standards,
  • principles of the NMBA Code of Conduct
  • elements of the International Council of Nurses (ICN) code of ethics

You can use the links above to access the relevant standards and codes you will need to apply to the case.

2.Using the questions that appear throughout the video as a guide. What have you learned from this case study from a leadership perspective that you can apply to your practice to prevent the type of errors highlighted in this case from reoccurring. You can post your answers to our module discussion board.


Case Study 2 Sarah Orange

Sarah Orange is a registered nurse. She has been registered after graduating from a Bachelor of Nursing course in 2010.

Sarah has been employed in aged care, surgical and rehabilitation services in different health care settings over the period since registration. She was working on a general medical ward in a regional hospital at the time when the following incidents occurred, which led to a series of incident reports being made by a nurse unit manager (NUM), and an enrolled nurse (EN). The reports led to complaints being made to the Australian Health Practitioner Regulation Agency (AHPRA).

The allegations against Sarah Orange were that:

  • She had accessed healthcare records for patients whom she had no role in providing care
  • When the NUM was not on the shift, Sarah spent her time on the computer, leaving the EN to manage the patients

During the course of the investigation and tribunal hearing, the NUM commented favourably on Sarah’s clinical skills and experience. She also stated that she was aware that Sarah was ‘under a lot of stress because (she) came to us with some difficulties from another hospital that were unresolved at the time”


Using the relevant codes, standards and guidelines that are part of the regulatory framework for registered nurses in Australia, identify potential breaches of these instruments that may lead to a finding of unsatisfactory professional conduct or professional misconduct being made against Sarah Orange

Was the leader (NUM) behaviour appropriate for the situation?

What were the outcomes of the leader behaviour?

What leadership approaches could achieve a more positive and sustainable change for Sarah Orange?

What leadership approaches could achieve a more positive work place environment?

You can post your answers to our module discussion board.

Engaging in Lifelong Learning 

Leadership in healthcare is a fundemental skill that enables healthcare providers to navigate the complex and everchanging healthcare system effectively in solving problems and making decisions related to issues from cost to quality healthcare services and access. Therefore it is essential that leaders are well equipped and trained to make the appropriate decisions at the right time. Continuing professional development (CPD) can also enhance a nurse’s leadership skills. CPD can include attending local or national study days, self-directed learning or online learning. Social media can also be used as a leadership development tool for newly qualified nurses. social media can connect nurse leaders from around the world, patients and carers. These connections can enable nurses to explore the opinions and experiences of others and develop their leadership characteristics (AL-Dossary, 2017).



Continuing Professional Development (CPD)

The NMBA requires all registered and enrolled nurses and midwives to complete a minimum of 20 hours of CPD per year. CPD must be relevant to the nurse or midwife’s context of practice a

The knowledge needed to function effectively as a professional nurse or midwife continues to expand and change, while consumer demand and expectations continue to increase (NMBA, 2016). 


CPD ensures all members of the nursing and midwifery professions are able to deliver high quality nursing and midwifery care and services, and keep pace with health care developments affecting their practice




In the previous module we watched Incident in the waiting room. This video highlights the importance of CPD and staying up to date with latest evidence based practice guidelines

Acknowledgment: Cobie Rudd (and team), Edith Cowan University. Funded by Health Workforce Australia.


“Observation tells us the fact, reflection the meaning of the fact”-Florence Nightingale-social reformer and nurse ( in Baly 1991)

An onglong process of critical reflection is key to learning to lead. Whilst leadership can be learned, truly ethical leadership requires internal reflection and personal commitment to a coherent set of core values (Swanwick & McKimm, 2017)

This week, you’ll concentrate on your own leadership learning and development, reflecting on what you’ve learned from this course and setting some goals for your own career progression and leadership development.

Leadership expert, Professor Jean Hartley is very clear on the benefits of taking a reflective approach. She offers her advice here:


Leadership skills can be developed in practice by observing experienced colleagues or by the reflecting on practice by taking notes on tasks they have undertaken effectively, and those which they could have undertaken differently. Reflection can support the newly qualified nurse to integrate theory and practice, develop self-awareness and understand clinical situations (Jones and Bennett 2018)

A case study that comes to mind and instills the importance of some core nursing leadership values is the case of Vanessa Anderson. What are some of your core leadership values? How do they influence your practice? Whilst you may think cases like Vanessa Anderson are rare, unfortunately they are not, and it is now more than ever that the new era of registered nurses continue to lead from the bedside up.

Medication safety for nursing students (2017) Medication safety resources: Vanessa’s story

Vanessa’s story

Reflective cycles can be used to link previous leadership experiences to new experiences and promote development and action planning. Strengths and opportunities could also be explored in the form of a SWOT (strengths, weaknesses, opportunities and threats) analysis or a SOAR (strengths, opportunities, aspirations, results) analysis, followed by an action plan (Jones and Bennett 2018).

The work of Platzer et al.( 1997) identified that learning through reflection is more potent if there is an understanding of frameworks that encourage a structural process to guide the act of refection. There is no right reflective framework.

One model of reflection you may be familiar with and you can use it in Assessment 4 is the Gibbs Model of reflection









CLINICAL REASONING Clinical reasoning is an essential component of competence. The NMBA National competency standards for the registered nurse (2016) refer to the importance of clinical reasoning. LEADERSHIP THEORIES Nursing homework help

„ Conducting a comprehensive and systematic nursing assessment

„ Planning nursing care in consultation with individual/groups, significant others and the interdisciplinary healthcare team

„ Providing comprehensive , safe and effective evidence based nursing care to achieve identified individual/group health outcomes

„ Evaluating progress towards expected individual/group health outcomes in consultation with individuals/groups, significant others and the interdisiplinary healthcare team

Clinical reasoning requires a structured educational model and active engagement in deliberate practice , as well as reflection on activities designed to improve performance. Therefore, in preparation for clinical reasoning it is important to reflect on practice; failure to do so may negatively impact on your clinical reasoning ability and, consequently, patient outcomes (Levett-Jones 2018)

Importance of clinical reasoning

A case study

This case study highlights the importance of all aspects explored in module 5.

Whilst you watch the four videos reflect on the importance of the nurse as leader in relation to safe quality person centred care. Additionally, reflect on the accountability and responsibility of professional nursing practice and the importance of continuous professional development through critical self reflection.

Click the link

Acknowledgment: Edith Cowan University.










This reflects the critical importance of collective and innovative approaches to leadership so health care organisations can rise to the complex challenges they face over the next ten years.

The collaborative leadership approach emphasises that leadership can be exercised anywhere in a health service organisation;it is not solely the responsibility of positional leaders.

Collaborative leadership is critical in fostering the inter-professional teamwork between clinicians and non-clinical managers to ensure excellence in delivering care centred on the patient or health consumer.



  • This tool is designed to enable you to manage your learning and development and to help you reflect on which domains of the leadership framework you’d like develop further




You can complete it online by entering your details below. If you enter your email address you will receive a report with your results. You’ll also receive an access cde so you can return to the Self Assessment Tool and your content will be reloaded. Your email address will only be used to send you the email with your report and access code and will not be stored on our database.

Click here to access the self assessment:


After completing the Self Assessment Tool you can go on to complete your personal action plan (Assessment 4)

  • Conclusion

In this module you have explored accountability and responsibility of registered nurses with regards to the practice standards and codes that mandate professional nursing practice. You will have applied these standards and codes to scenerios and gained further insight into the importance of best practive standards and leading by example in order to influence and encourage other registered nurses to be competent, professional and ethical in their practice. Furthermore, you will have reflected on your own experience with regards to leadership in professional nursing practice and identified areas for development. You will have learned that professional nursing practice takes a life long learning approach and the many benefits of reflection such as setting and achieving goals in your career as a registered nurse.

This module draws an end to NUR367 LEADERSHIP FOR NURSING PRACTICE. Module 6 has been provided to assist you with your revision.

  • References

AL-Dossary, R.N (2017). Leadership in Nursing. In A. Alvinius, (Ed), Contemporary Leadership Challenges (chapter 3). IntechOpen. DOI: 10.5772/65308

Australian Health Practitioner Regulation Agency (2015, December 22).APHRA National Scheme. [Video] YouTube.

Atkins, K. (2011). Ethics and law for Australian nurses. Cambridge Port Melbourne : Cambridge University Press.

Francine Girard, N. L., & Jeanne, B. (2005). Professional Practice in Nursing: A Framework. Nursing Leadership, 18(2), 0-0.

Health Education & Training NSW. (n.d).The leadership and management framework self-assessment tool. Health Education & Training NSW. (n.d).The leadership and management framework self-assessment tool.

International Council of Nurses. (2012). The ICN Code of Ethics for Nurses.

Jones L, Bennett C (2018) Leadership: For Nursing, Health and Social Care Students. Lantern Publishing, Cheltenham.

Kirkham, L. (2020). Understanding leadership for newly qualified nurses. Nursing Standard, 35(12).

Levett-Jones, T. (2017). Patient safety for nursing students (2017) Medication Safety

Levett-Jones, T. (2018). Clinical Placement: An Essential Guide for Nursing Students. Elsevier – Health Sciences Division.

Platzer, H., Snelling, J., & Blake, D. (1997, 1997/06/01). Promoting Reflective Practitioners in Nursing: a review of theoretical models and research into the use of diaries and journals to facilitate reflection. Teaching in Higher Education, 2(2), 103-121.

SkillsTeamHullUni (2014, March 3). Reflective writing. [Video] Youtube.

Swanwick, T. (2017). ABC of clinical leadership (Second edition.. ed.). Hoboken, New Jersey : Wiley-Blackwell.

The Open University (n.d) Professor Jean Hartley-Leadership and a reflective approach. [Video] Openlearn.§ion=1

The Nursing and Midwifery Board of Australia. (2018). Code of conduct for nurses.

sThe Nursing and Midwifery Board of Australia (2016) Registered Nurse Standards for Practice.

Willis, A. ( 2016). AHPRA’s requirements for CPD – A CPD Coffee Break for Nurses and Midwives. [Video] Youtube.

Assessment 3 Task Instructions

  • Task Description: Critical reflection

Value: 35%

Due Date: Friday, September 30, 2023


This assessment task presents an opportunity for you to extend and integrate your understanding of leadership in nursing through critical reflection on the learning experiences that you have encountered during the semester. Your analysis also establishes a basis for considering professional practice implications.


During your study of this unit, you have engaged with a wide range of learning experiences, including readings, commentary, discussion points, module reflective activities, assessment tasks, as well as practice and other experiences that relate to unit topics. These experiences serve as valuable stimuli for reflection.

It is recommended that you record your responses to these stimuli as you progress through the semester. A journal can be useful for this purpose. (Your journal is not submitted for assessment.)

For this task you are required to submit four reflective written pieces, using Gibbs cycle of reflection for each, that reflect your learning of leadership during this semester.

You must include:

-a reflection on your leadership philosophy, that you began during Module 1.

-a reflection on how your leadership practice can address the following domain within the Code of Conduct for Nurses: Practise safely, effectively and collaboratively (Nursing and Midwifery Board of Australia,2018)

-two reflections on other learning experiences that you have encountered during your study of this unit such as a tutorial discussion or a reading from one of the unit modules.

Your journal entries must demonstrate engagement with leadership, and there is a requirements to use the academic leadership literature to support your reflections.

Each extract must include reflective analysis that demonstrates how your thinking or assumptions have been challenged, what deeper insights you have gained, and what questions have emerged from your reflections, and how you will apply this thinking to future professional and leadership roles. It is essential that your analysis reflects engagement with the academic literature from this unit of study. Please refer to Module 6 to inform your understanding of this reflective task.

The following structure is recommended:

1.Introduction (200 words)

2.Reflective analysis (1600 words)

3.Conclusion (200 words)



Note that you will be assessed on the nature of your reflective writing, the depth of your thinking, and critical analysis (drawing from relevant academic research), of your learning experiences and knowledge as related to this unit of study. Your personal opinions and accounts of experiences are your own and will not be assessed.



Word Limit: 2,000 words*

Font: Calibri 11, Times New Roman 12, Arial 10

Line spacing: Double

Referencing Style: APA 7 or latest edition

Header: Student ID (digits) no name, unit code

Footer: Total word count, page number

File format: .doc or .docx.



Knowledge: The paper convincingly demonstrates knowledge of reflective practice and writing, and of topics studied within unit modules.

Critical Analysis: The writing demonstrates critical reflection arising from learning experiences encountered during the semester. Analysis of reflective extracts developed over the semester demonstrates a deepening spiral of learning and critical enquiry.

Argument: Relevant academic research supports the critical reflection/analysis.

Communication: The paper is articulate, ideas are presented logically and coherently. Applies rules of grammar, spelling and punctuation accurately. Accurately uses discipline-specific language.

Academic convention: APA 7th referencing conventions in both in-text referencing and reference list have been applied accurately and consistently. Use of first person is permitted.

*A word count that is outside the +/- 10% range will lead to a reduction of 10% of the total mark available for the assessment.


Learning Outcomes


This task addresses the following learning outcomes:

  1. Critically reflect upon the role of the registered nurse as a leader in a health care team in varying health contexts.
  2. Critically analyse concepts of management and leadership in nursing and health services.
  3. Critically examine the role of the nurse leader in quality improvement and change management practices.
  4. Investigate clinical risk management and the registered nurse’s leadership responsibilities for quality and safety in health care.








As healthcare professionals’ nurses need to be aware of the future innovations that are occurring and to open their mind to embracing new approaches to leadership.

Essential to the process of shaping practice in response our changing context, Registered Nurses are expected to reflect critically on their practice and to invite and explore emerging challenges. In this topic you will refresh your understanding of critical reflection. Your knowledge and understanding of this concept will be used to coalesce your learning in this unit of study, and to assist you to prepare for your final assessment.

This module addresses the following unit outcome:

  1. Critically reflect upon the role of the registered nurse as a leader in a health care team in varying health contexts.


Learning outcomes:


By the end of this module you will be better able to:

  • Explain the meaning of critical reflection;
  • Critique two models of critical reflection with reference to critical/practice dimensions;
  • Analyse reflective writing in relation to the three levels of reflection;
  • Reflect critically on practice implications of unit content;
  • Develop a plan for your final assessment task.


Why critically reflect?

·         What is critical reflection?


Sometimes we hear people say ‘I reflect all the time’. Thinking about what we are doing, pondering on the consequences and what we could be do better next time is a fairly routine behaviour that most of us engage in during the routines of daily life. However, critical reflection as a deliberate and structured act enables us in our professional practice, to gain the greatest learning potential from our experiences. LEADERSHIP THEORIES Nursing homework help

Some of the key tenets of critical reflection are structure, purpose, and enquiry (Cottrell, 2017, p. 188; Nicoll & Dosser, 2016, p. 35). Cottrell (2017, p. 188) presents a more detailed explanation of the characteristics of critical reflection:


These key characteristics of critical reflection, are common to many models of critical reflection and can be grouped under selection and description of an experience, an expression of individual responses to the experience, interpretation, analysis, planning for future practice and re analysis. A cyclical representation in most theories gives emphasis to the ongoing process of reflection on the experience, in the light of new knowledge or other experiences. A reflective ‘spiral’ of learning and understanding is perhaps a more useful analogy.

Note that

  • the key to critical reflection is the use of theory and literature as ‘lenses’ with which to interpret the experience;
  • learning from the reflective activity does not stop with development of the plan for future practice. The subject of the reflection can be explored more deeply over time and in relation to the emergence of new experiences and research etc.


Activity: Assessment 3

Your final assessment task requires you to develop a critically reflective essay. Be sure to reflect on the extent to which your written reflections address these characteristics.

The following reading explains in detail how theory can be related to the process of critical reflection.

Cottrell, S. (2017) Critical thinking skills. Chapter 12 critical reflection. Relating theory and practice p. 194.


As you view the following videos that explain three different models of reflection, you should aim to understand the cycle or spiral of reflective learning, and where in the models the experience is critically examined in relation to theory and new knowledge such as academic research. These presentations vary in terms of their emphasis on these characteristics.

The first presentation is of Gibbs reflective cycle with which you are no doubt familiar. Please review with the above characteristics in mind.

EPM (2019, May 3) Gibbs reflective cycle [Video].You Tube.




We now view Kolb’s model that contains similar features to Gibbs. Note that the phase of ‘active experimentation’ foregrounds ongoing analysis of the experience.

Preceptor Education Program (2015, September 9) M5 Kolb’s experiential learning cycle [Video]. You Tube.



Reflection often involves challenging our core assumptions and behaviours. This can be a daunting experience especially if it makes us question deeply held beliefs or perceive weaknesses in previous practice. In the following short video, Mezirow’s theory of transformative learning focuses our attention on this process. While it is beyond the scope of this module to explore Mezirow to any depth, it’s important to be aware of the ‘disorienting dilemmas’ that we encounter, that serve as important rigger points for reflection. These events can be quite powerful.

Jarvis, C. (2015, August 11). Introducing transformative learning theory. [Video]. YouTube.


As a final recap, the following reading is recommended. You may find it useful to download the chapter, as we refer to it in later sections. The reading also includes a range of engaging activities that you may find useful.

Cottrell, S. (2017) Critical thinking skills. Chapter 12 critical reflection. pp. 188-189.

Why critically reflect?


Critical reflection enables us to use our own experiences as an essential resource for learning. It is a process that invites an openness to challenges to our assumptions, from theoretical, experiential and other sources, so that we can learn and grow in our professional work (Cottrell, 2017). Reflection takes some practice, however the depth of understanding and personal and professional growth that can emerge from critical reflection can be surprising, illuminating and transformative.

Note the purpose of the reflective task you are required to undertake in Assessment 3

“This assessment task presents an opportunity for you to extend and integrate your understanding of leadership in nursing through critical reflection on the learning experiences that you have encountered during the semester. Your analysis also establishes a basis for considering professional practice implications.”

The task is both analytical and forward looking, with professional practice implications a key outcome.


1.Knowledge and reflection


In this unit, learning is presented as an active process that seeks to establish relationships between your existing understanding of communication, health informatics and technology and the new knowledge that forms the unit content. Knowledge development is a complex process, and time does not permit us to deal with that here. It’s sufficient to say that knowledge can sometimes be tacit, that is, some of our knowledge is hidden away, for example the knowledge that enables us to respond or make judgements while we are interacting with a patient, – or driving a car. Some knowledge is formed from the learning that occurs alongside formal instruction (Eraut, 2004) i.e. through studying course readings and material, preparing assignments, which can then be personalised by thinking about your work and applying it to practice. By making this ‘personalised’ knowledge explicit, we extend the operating knowledge that we have to work with moving forward, including being able to share it with others, build and deliberate on its meaning (Eraut, 2000).

Critical reflection, and writing, is one way that we can enable the transformation of tacit knowledge to explicit knowledge. It is recommended that you record your reflections throughout the semester, to aid your learning and to establish a basis for the development of Assessment 3.

2.Competency Standards 

Critical reflection is also a key dimension of the Nursing and Midwifery Board of Australia (2016). National Competency Standards for the Registered Nurse (p. 3).




As you can see from Figure 1, Standard 1 ‘Thinks critically and analyses nursing practice’ as a key Standard is clarified:

“RNs use a variety of thinking strategies and the best available evidence in making decisions and providing safe quality nursing practice within person-centered and evidence- based frameworks”

Note that this standard is related to Standards 2 and 3, and is common to the remaining dimensions 4,5,6,&7. Critical practice is therefore clearly embedded in all areas of the nursing standards, and is therefore expected in the conduct of professional nursing practice.

Criterion 1.2 is more specific to reflection:

1.2 develops practice through reflection on experiences, knowledge, actions, feelings and beliefs to identify how these shape practice.

There are other reasons why critical reflection offers a valuable foundation for professional practice, as the following reading explains.

Cottrell, S. (2017) Critical thinking skills. Chapter 12 critical reflection. p. 190

Critical writing

Presentations in the previous section summarise the meaning and purpose of reflection. In the following section we will explore how to record your reflections in a manner that is useful for you, and to aid your preparation of Assessment 3.

As you are aware there are many models of reflection. Gibb’s (1988) model offers the following structure:


  • Describe the situation
  • What were you thinking and feeling?
  • Initial evaluation: What was good and bad about the situation?
  • Analysis of the situation: What sense can you make of the situation?
  • Conclusion what else could you have done?
  • Action plan: If it happened again what would you do? (and once you have enacted your plan you can return to ‘describe the situation’.


Which ever model you use, or if you choose to develop your own, I suggest that you refer to the ‘characteristics of critical reflection’ presented in an earlier section to ensure your choice of structure addresses these elements.

Where to record your reflections

Choose a place to record your critical reflections. You may choose a diary or journal in hard copy or an online space. Your journal can include drawings, photographs, diagrams and need not be confined to writing. The practice of writing your reflections has the following benefits:

  • Writing can be therapeutic;
  • Writing can help to analyse or ‘unpack’ the experience, even before you have engaged in the structured process a of analysis;
  • By writing your reflections, you have a record that you can use for ongoing reflection on the experience, including reflection on earlier reflections, which gives insights into how your thinking has changed.

(Nicoll & Dossier, 2016)

Do you recall the ‘pensive’ in the Harry Potter series? In this magical story it was possible to store memories in glass bottles, for later viewing and consideration, as well as for sharing with others, through the ‘pensive’. Unfortunately we are confined to the less sophisticated paper journal, but the point of reflection and analysis on experience and sharing it with others is poignant in this short extract from Harry Potter and the Half Blood Prince. You need only watch the first 30- 40 seconds.

Stefan Dajiba (2009, June 26) Harry Potter and the half blood prince: pensive scene.








Critically reflective writing

The following video presents an excellent framework for writing critically. The examples of critical writing, while drawn from outside of the nursing field, exemplify the type of analysis that needs to be reflected in your critically reflective writing, with implications for your preparation of Assessment 3.




Academic skills The University of Melbourne (June 2 2017) Reflective writing,


The following extract from Cottrell (2017) presents further examples of critically reflective writing in relation to the core phases of reflection.

Cottrell, S. (2017) Critical thinking skills. Chapter 12: Critical reflection, pp. 198-200

Bringing it all together: Using reflection to integrate your learning in NUR543

As healthcare professionals, nurses need to be aware of the future innovations that are occurring and to open their mind to embracing new approaches to care, of which leadership is a central part. Our understanding of leadership a growing field that brings many opportunities for improved patient outcomes.

In this topic, reflective activities are presented to support your integrated engagement with these knowledge areas, to provoke critical thinking, challenge of existing assumptions and to facilitate the transformation of tacit knowledge to a more explicit form that can be used for analysis and sharing (Eraut, 2004). These reflective activities present further opportunities for you to identify themes to work with in Assessment 3. 


Activity 1

Return to the unit modules and reflect on or revise your responses to the unit reflective activities. Do you agree with your initial responses? Draw on the prompts in various activities to reflect on any changes.

Activity 2

Review your learning across the semester, noting that the emphasis on leadership for nurses at all levels.

Activity 3

As a simple task reflect on the knowledge you have gained in relation to the unit learning outcomes:

Learning Outcomes:

  1. Critically reflect upon the role of the registered nurse as a leader in a health care team in varying health contexts.
  2. Critically analyse concepts of management and leadership in nursing and health services.
  3. Critically examine the role of the nurse leader in quality improvement and change management practices.
  4. Investigate clinical risk management and the registered nurse’s leadership responsibilities for quality and safety in health care.


Activity 4


Reflect on your learning in relation to the following prompts:

You might consider:

  • What do I know now that I didn’t before?
  • What surprised me or worries me about the topics I studied?
  • What behaviours or attitudes have I changed?
  • Which topics should I take particular note of, and be sure to investigate further?
  • How will I apply my new knowledge to future practice?
  • What novel connections did I make between these topics and the readings that underpinned them?


Source: Adapted from Cottrell, S.(2013) The study skills hand book. Palgrave.

(Evaluating achievement, p. 386)


Activity 5


Identify the relationships between the knowledge areas covered in this subject and represent in a concept map. A concept map (see example below) connects key ideas in a meaningful way, using arrows and sometimes comments between different ideas to explain the relationships. This aids knowledge development. By reversing the arrows you can develop critical questions around the concepts represented in your map. (Generally, the process of creating the map has more value than the product, which can become unwieldy!) This is also a valuable strategy to use for further study, including mapping findings from the literature and planning essays etc. You can find free concept mapping software if you are interested. Pen, coloured pencils and paper work well too!



Chavan R.L. & Khandagale V.S. (2013) Human digestive system-conceptmap. CC4



By now you should have a good idea of the themes from the unit that have particular significance for you. These themes form the basis of your writing for Assessment 3. Please refer to the task detail before constructing your final paper, and see advice from the unit coordinator if you require clarification. LEADERSHIP THEORIES Nursing homework help








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