Running head: NURSING LEADERSHIP JOURNEY

Nursing Leadership Journey

Shawnee Cuthbert
Cedar Crest College

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Abstract

This paper explains the several clinical experiences the senior nursing student participated in as a
requirement of the curriculum for the Nursing Leadership class. This paper also examines how
the student nurse achieved both clinical objectives presented for this course, and personal
objectives identified for each individual clinical experience. This goal of this paper is to identify
the students journey of growth and development that was experienced throughout the semester.

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Nursing Leadership Journey

This senior student nurse had the opportunity to explore a variety of clinical settings over
the course of the spring semester in Nursing Leadership. This students leadership skills were
enhanced and the concepts of leadership were reinforced through each clinical opportunity
presented in this course. The clinical opportunities also helped the student nurse to obtain both
course and personal objectives for the clinical component of Nursing Leadership.
Utilizing previous knowledge of the sciences, liberal arts, information technologies, and
nursing to develop skills as a nurse leader
To fulfill the community leadership component of this course, I chose to participate in a
few blood pressure clinics, within different populations, such as at Casa Guadalupe and the Arab
American Association. I was able to utilize my previously learned knowledge from the nursing
courses, 311 Nursing Assessment, and 321 Health Promotion II, as well as the knowledge I am
gaining weekly in NUR330, pediatrics. Knowledge of measuring and assessing blood pressures
was first learned in 311 Nursing Assessment. I was able to provide information regarding good
and less-than-desired blood pressure numbers to the volunteers that were assessed. Health
Promotion II, which focused on the geriatric population, provided me with the knowledge of
informing my volunteers of issues that can arise from having a high body mass index and high
levels of cholesterol. All participants that had higher blood pressures and/or high body mass
index levels were informed of appropriate recommendations and health-care professionals that
they could follow up with. My previously learned skills helped me to become a nurse leader
among the volunteers through the use of assessment, providing knowledge relating to healthy
lifestyle habits and referral to the appropriate healthcare services.

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Applying the basic principles of ethics and management to meet the challenge of an everchanging healthcare environment
I had the opportunity to observe Lisa Baga, RN, BSN, Director of Research and
Innovation, at Lehigh Valley Health Network. Ms Bagas (Lisas) office is in Lehigh Valley
Hospital Cedar Crest, and this is where the observation day took place. I have always been
interested in research and chose to follow Lisa for the Advanced Practice nursing role. The
research and innovation department is comprised of two units oncology research and
everything else. The department is contracted by outside parties to conduct research. These
sponsors establish strict guidelines for participating in the trials, and the department must follow
the guidelines exactly, collect all data, then submit all results to the appropriate parties. The
Research and Innovation department conducts testing at all three LVHN hospital Cedar Crest,
Muhlenburg, and Sacred Heart. Each unit at the different facilities offers different services
depending on what is able to be tested at each site. For example, Cedar Crest is a Level 1 trauma
hospital and some of the current research projects require patients that are specific to trauma for
testing. Though there are three locations, I visited just one but was able to observe Lisas method
of instituting consistent ethical management among all of them.
The three units include many trials, over 60 at the day of observation, as well as staff.
Lisa has nurses assigned to be group leaders for each trial. Some of these nurse leaders are in
charge of a few different trials at one time, and most of these leaders assist each other when
needed. They are a very cohesive group and work well together. Lisa utilized the democratic
leadership style in the management of this large number of staff. The democratic leader displays
less control among the group and involves all members of the team in determining an outcome,
rather than the leader (Marquis and Houston, 2012). This style of leadership influences positive

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outcomes with respect to a positive work environment that it creates. Multiple staff members
within each unit attended weekly staff meetings and were encouraged to verbalize any ideas or
concerns. Staff members in all departments were reluctant to do so and congregated as teams
instead of as individuals. I was able to meet this objective by understanding that incorporating a
positive leadership style does influence staff and patients alike in an effective and positive
manner. To me, Lisa is a strong leader who is able to direct many people and coordinate many
tasks with little problems, and is a person I would like to emulate in my nursing career.
Demonstrating leadership skills through effective use of communication by representing
self, the college, and nursing in a professional manner
The first experience attended for leadership clinical was the 31st Annual SkillsUSA
Council PA District 11 Championships. Every year this is held at the Agriplex at the Allentown
Market where students can demonstrate their skills in front of parents, teachers, and future
employers. High school students from the entire 11th district, including the Lehigh Valley,
Bucks, Berks, and Montgomery Counties, who attend a technical school, are invited to
demonstrate their skills different categories. They are then judged and the best on this day move
on to the state finals in Hershey. The skills range from automotive care, building houses,
cooking, to nursing and EMT abilities, as well as many, many more areas.
Fellow students and I arrived at Agriplex where the nursing assessment area was already
set up into five different skill areas. Student groups were assigned each area in a rotation and
their nursing skills were tested. At the end of the competition, scores were tallied and a dinner
was held to award the groups. Unfortunately, since we were judging the students, we were not
allowed to interact with any of them. I personally would have loved to have sat down and answer
concerns and fears that are often associated with following a career and entering nursing school.

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I found this experience to be very rewarding in a personal way. It allowed me to display a

positive image of the senior nursing student that I have worked so hard to become. In choosing to
attend Cedar Crest College and obtaining a Baccalaureate degree prior to licensure, I feel that
Im getting the best education possible in representing nursing as highly regarded profession. I
was not able to pass this idea on, verbally, to perspective students if they had asked, Why Cedar
Crest?; however, I feel maintaining a professional appearance and demeanor while wearing the
Cedar Crest uniform projected a positive image of our program to these students.
Function as a competent patient advocate, nurse advocate, and change agent, and recognize
the role of the nurse in policymaking related to healthcare services at local, state, national,
and global levels
The nursing department coordinated a day trip to Harrisburg at the State Capitol building.
This experience helped me to achieve the following objective: to function as a competent patient
advocate, nurse advocate, and change agent and to recognize the role of the nurse in
policymaking related to health care services at local, state, national, and global levels. The visit
to the Capitol provided me with insight into the legislative process and the influence it has on the
nursing profession. This visit was also an excellent opportunity for me to observe first hand
where government officials for Pennsylvania meet and create bills and laws that affect the
nursing profession.
At the Capitol, two speakers came to give us information on the legislative process, as it
relates to nursing. Kevin Busher, the Director of Government Affairs for the Penn State Nursing
Association (PSNA), and Steve DeFrank, Chief of Staff for the Hon. Lisa Boscola, Lehigh
Valley. Each gave different perspectives of the process but both related to us as future nurses. Mr.
DeFrank explained how making a law works; from an idea, through to the house, committees,

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the senate, more committees, and then possibly back through each step, until hopefully, onto the
governor. The process can take many, many years so it is important for nurses to continue to
advocate and stay informed of the status of special interest legislation. Mr. Busher works as a
lobbyist for the PSNA and works hard to make sure the voice of the nurse is heard. Both
speakers emphasized the importance of belonging to a professional organization that advocates
for the profession of nursing. It was also greatly expressed that nurses have the ability to
implement change into the healthcare that they deliver and should strive to become patient
advocates by participating in the making of laws that have the ability to affect patient outcomes.
Since I am from a different district than most, if not all of the other nursing students, I
searched for my own representatives office, Chuck McIlhinney. I was able to speak with his
executive assistant, Monica Riddle, and express my opinions on one of the bills that was coming
up for vote, that would help nursing Registered Nurse Delegation, SB 853. This bill, if
approved, would allow RNs to legally delegate some responsibilities to other hospital personnel,
such as LPN/CNA/techs. Right now in Pennsylvania, while nurses delegate tasks daily, it is not
technically legal to do so. This bill would eliminate confusion and establish proper guidelines for
delegating to support personnel.
After attending the Legislative day, I know that I want to be a part of the American
Nurses Association so that I can have a voice in my profession. I also recognize the impact that I
can have as an individual within the hospital to advocate for patients and nursing.
Formulate plans for continued personal leadership growth and development as in
independent practitioner of nursing and contributing member of society
One winter day, during the semester, I attended the Burn, Trauma, and Neuro Conference
hosted by Lehigh Valley Health Network at Lehigh Valley Hospital Cedar Crest. During the

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seminar that I had the opportunity to listen to various respected healthcare professionals speak
about topics such case management, trauma accreditation, and child abuse head trauma. With
regards to child abuse in particular, I am currently attending my pediatric rotation and have
learned of some factors that are present in child abuse cases. However, I was able to learn so
much more newly discovered information that displays characteristics of abuse among children.
After listening to the lecture on abusive head trauma, I realized just how valuable continuing
education is. On my own, I would not have picked up on some of these traits because I never
learned of them in school and possibly mistakenly overlooked a case of abuse due to my own
knowledge deficit. I have met this objective in understanding the importance of making a
commitment to lifelong learning to better our education for the benefit ourselves as
professionals, our community, and our patients.
Predict and describe potential ethical dilemmas within clinical, organizational, and
professional nursing practice
For the role of Nursing Supervisor, I had chosen to schedule this observation at Lehigh
Valley Health Network at Cedar Crest during the 1100-1900 shift. I was able to follow three
nursing supervisors Roxy, Tina, and Eric. I was able to explore all of the critical care areas within
the hospital including, MICU/SICU, NSICU, TNICU, PICU, CICU and the burn unit. I observed
all three supervisors interact with nurse managers within each unit. The first task I observed was
going to each med-surg unit and getting an idea of staffing needs for the 1900 shift times. Also,
information about total one-on-ones was collected for each unit. Secondly, the supervisors asked
if there were any issues and addressed them accordingly.
At the beginning of the shift, Roxy was called to the emergency room, with an issue.
There was a 60+ car accident on Rt 78 and Cedar Crest was not informed of how many more

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patients would be sent. Six patients had already arrived and were placed in the PICU due to filled
beds. In the ED, 14 beds were filled already, the hospital was on divert, and more than thirty
Penn State basketball players, who were in the accident, unexpectedly arrived for care. The
players were lined up in the crowded waiting room. The medivac chopper was sent out but Cedar
Crest was not told if it would be coming there with patients or going to Hershey (the closer
hospital). Without information, the staff was preparing for the worst and trying to organize
patients as best as possible. According to the charge nurse, a young female patient with
abdominal pain had experienced a ruptured ectopic pregnancy while waiting in the waiting room
for almost five hours during the initial chaos. The charge had explained that this patient was
triaged appropriately but had no way of knowing how to correct or prevent the mistake from
happening again. This type of incidence falls under the category of Patient Protection and
Impaired Practice, in the American Nurses Association's Code of Ethics. The American Nurses
Association (2015) states, "Nurses must protect the patient, the public, and the profession from
potential harm when practice appears to be impaired" (p. 13). In not providing timely care, or
reassessment through triage, the patient had suffered serious consequences resulting from not
receiving medical intervention in time.
Reflections on personal growth
Personal objectives
Before each experience, I created two personal objectives indicating ideas and concepts
that I had wished to achieve during each experience. The majority of my personal objectives
were met and influenced by growth in utilizing and obtaining values related to my own
professional leadership growth. In the beginning of this semester, I had the expectation that this
clinical would involve a lot of observation in forming an understanding of leadership. I am

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pleased to say that it was so much more than just an observational rotation. I was able to not only
observe, but also become involved and form a deeper meaning of what a professional nursing
leader really means. The various roles of nursing practice incorporated into this clinical provided
me with a holistic idea of all of the qualities that should be possessed by nurses, not only to the
profession but to the nurse as an individual.
Time and organizational skills
This clinical experience places a high demand of hours required by the student. In the
beginning, it was suggested to keep a calendar updated with all appointments and experiences
organized. I took this tip and ran out and bought a large calendar planner and made sure it was
constantly kept up to date and viewed on a daily basis. I also printed out each experiences times,
locations, and dress codes. I organized this information according to dates and utilized it before
each experience and discarding it after each. These two methods had proven to keep me
organized, on-time, and responsible in attending and completing all requirements within each
experience. For future practice, I plan on continuing to keep a well-organized calendar in hopes
of continuing my success in managing and organizing my time both as a student and as a nurse.
Understanding of nursing leadership
My understanding of nursing leadership has developed and flourished during this clinical.
To be a successful leader in nursing, nurses need to be advocates for patients and to the nursing
profession. A successful nursing leader takes an active approach into expanding their education,
and through providing education to others. Nurses also develop leadership by becoming
politically active and involved in decision and law-making practices. Many of my experiences in
this clinical have been consistent with this understanding. I have had the opportunity to observe
nurses continuing their education through the LVHNs Trauma, Burn, and Neuro Conference and

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by furthering their education by pursuing a baccalaureate degree in nursing. I have also observed
nurses taking an active approach into benefitting their community through volunteering at a local
outreach programs for those who are less fortunate in the Lehigh Valley.
Expectations of the clinical experience
During this clinical experience, I really wasnt sure on what to expect. I had expected
from the first day of orientation that this rotation would prove to be busy and challenging with
maintaining expectations and completing all of the involved paperwork. My expectations of this
clinical experience being both busy and challenging were correct. However, I feel that the high
demands imposed of me actually helped to keep me motivated and efficient. For the first time in
my nursing career, I took the free time that was offered by spring break and utilized it to get
papers and projects started. I am currently in the end of this semester and am thankful now that I
used my expectations from this class to keep me motivated, which has definitely increased the
outcome of my work and my grades.
Growth as a potential nursing leader
This clinical rotation has proven to teach me the important qualities that all leaders,
especially in nursing, need to possess in order to be successful leaders. The education provided to
me during this semester has influenced my growth a potential nursing leader in my future
nursing career. I have grown to learn the understanding of different styles of nursing leadership
and was able to observe them first hand in many of the experiences provided in this clinical
rotation. I have gained personal growth from the knowledge and first-hand observation of what
qualities a successful leader has and the benefit it places on their workplace and the patients they
care for. I wish to someday have the opportunity to implement these practices learned in this
course into my nursing profession in displaying leadership qualities.

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Views of nursing leadership

My view of nursing leadership has not changed after completing this clinical rotation.
However, my view of nursing leadership has definitely proven to have grown and flourished. I
have developed a higher regard and respect of the position of a nursing leader. Almost every
experience in this rotation, especially the nursing supervisor role, advanced practice nursing role,
and the political day, provided me with the concept of implementing consistent and effective
leadership among nurses to incorporate positive change for their patients and their community.
Conclusion
Each clinical experience encountered throughout the course of the spring semester proved
valuable in achieving the different course objectives. The clinical experiences allowed the
student to incorporate leadership skills and concepts learned in the classroom into the clinical
setting. The senior student nurse is able to identify how to incorporate leadership concepts into
her professional development and practice as a nurse. The senior nursing student also recognizes
the need to advocate for patients and the profession of nursing by participating in organizations
that reflect these values.

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References

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements.
Retrieved from
http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNur
ses/Code-of-Ethics-For-Nurses.html
Marquis, B. L., & Huston, C. J. (2012). Leadership roles and management functions in Nursing.
(7th ed.). Philadelphia, PA: Lippincott
Tyczkowski, B., Vandenhouten, C., Reilly, J., Bansal, G., Kubsch, S. M., & Jakkola, R. (2015).
Emotional intelligence (EI) and nursing leadership styles among nurse managers.
Nursing administration quarterly, 39(2), 172-180.