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The policy in practice

To this end I plan to use the relatives monthly meetings, social worker/care manager/named nurse 6 monthly review, the consultant psychiatrist/GP regular review as forums to practice influencing languages inspiring those whose support and assistance I need as well as sharing my vision. In order to involve the staff in the objective and apply their motivation to achieve it, I intend to use my position power (Bento, 1999) to delegate each staff to write a care plan for a resident on need for provision for normal activity. I will give them guidance that they should know how active a resident normally is, what form that activity normally takes and what time of the day is the resident most active. This is to ensure that special individual care is delivered without compromising individual freedom of choice and life style.

By this activity staff would be motivated to work towards objective they have set. Their personal commitment will help in making the desired change. I intend to identify a motivator to observe him/her perform certain activities and to discuss with the person from experience what he/she has found out that motivates others. My next task is to lobby the relatives, care managers and

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others within the multidisciplinary team through face to face contact or by telephone, for the need of the residents to be physically active and visiting places of interest. The people who have contact with the client group will have in depth understanding of pertinent issue. Davidhizar (1993) found that charisma is an important characteristic that can be useful for leaders who want to motivate by interpersonal means, which involves communicating positive self-esteem.

It also appears to link in with my need to be more charismatic in my leadership in order to be able to tap into things I am emotional about. I plan to visit the sport injury club at my former gym centre to observer a session on how the clients are motivated as well as observe application of simple music and movement sessions with less mobile people. I intend to make contact with Health Education Authority and Alzheimer Society to inquire if they have any initiative to improve mental health in older people. My next task is to discuss with my manager about the unit networking with Scotland’s Physical Activity Task Force, which runs five days in-house course for volunteers and staff on exercise movement for people working with frail and less mobile older people. Etnier (1997) argue that exercise programme can reduce mental health problem, promote well being and improve quality of life. I intend to find opportunity to talk to my manager about translating research findings and polices into practice for the benefit of the clients.

The second goal I have chosen to focus on is to develop my decision making skills. The residents’ charter states that nursing records are confidential and shall be made available to residents, nursing staff, general practitioner and care staff. I tend to respond to this charter in a democratic or participate leadership style (Study Guide pg 32). I direct the experience staff and give them guidance in knowing who and when to give out residents records without my permission.

In accordance to this charter, one or two of the clients’ families take advantage and over step the boundary. I would feel a struggle within me to manage my feeling as well as deciding on the best way to handle the situation in order to maintain a good relationship. I would need to decide how to take control over the older trained staff that are sceptical about the change stating that in their good old days clients were not allowed to handle case file. I plan to discuss and to work closely with my manager as my mentor to enable me observe and listen to how she makes decisions on vital issues. As a leader and being my mentor she will help me in my future leadership.

I need to be aware that since I have adopted democratic style of leadership, decision making may not be rapid when issues arise (Study Guide pg 32). I therefore have to control my feelings and stop being uncomfortable. However I am also aware there are occasions when as a leader, for example in crisis or negative change, I should make rapid decision and tell the staff what to do. I intend to read and be conversant with situational/transformational leadership and stage of staff development (Study Guide pg 38). There is need to educate the old practicing staff on changes and seek their suggestions. I plan to use part of our regular meetings as teaching sessions when I must have discussed with the manager. By teaching the staff I will continue to learn and sustain my morale in the changes. I intend to discuss with my critical friend and my mentor to evaluate my performance.

We do have little absenteeism especially at weekends necessitating the need for decision on what to do to balance their work and their life needs. I am not very effective in making decisions especially when surrounded by newly employed staff, overseas nurses and NVQ candidates who may be thinking differently and have individual needs. I have the tendency of wanting to provide the answers to each person’s question instead of sharing responsibility for decision making. Manthey (1994, cited in the Nursing Leadership Study Guide pg 38) concept on situational leadership appeals to me as solution for decision making.

Reflecting on the concept I have reached the conclusion that making decision for people can decrease their sense of responsibility. I intend to apply the concept regularly during decision making in order to be skilled in its use. I also plan to look at the shift patterns at the weekend. It may be staff doing own off duty will help them share responsibility. In addition I will consult with staff on how to balance their work and life needs.

I intend to learn properly about shared governance which has shown to lower sickness and absence rate, high quality client care and better staff morale (Munro, 1999; Smith, 1998; Study Guide pg 90). Presently the standard of care for providing active life in older people with mental health appears inadequate. Smith (1998) points to clinical governance as a means of improving standards of patient care and promoting quality assurance. I intend to talk to my manager about care and the need to apply the policy in practice.

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