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This paper is a reflection about leadership/followership in my practice in the rehab unit located in a hospital setting. The importance of reflection for me lies in the opportunity this gives me to critically examine my nursing practice so that I can identify my strengths and weaknesses.

The literature reveals a number of positive outcomes, specifically, reflection provides the opportunity to “…applying theory into nursing practice … view the clinical situation from different angles, identifying … learning style[s] … [improving]…decision making … [developing] a greater sense of responsibility and accountability” (Caldwell & Grobbel, 2013, p. 320) in nursing practice. Caldwell & Grobbel also reference key findings that I think are applicable to how I approach reflection. Reflection helps me problem solve; allows me to become more engaged in my practice; helps me in identifying areas where I can strengthen my practice; and, gives me a focal point for identifying the emotions I experience in my practice.

Leadership & Followership Attributes


On a personal level, I communicate very well with the healthcare teams that I work with. This is important because of the multidisciplinary nature of patient care delivery. Without this skill or ability, it would difficult to work in a healthcare environment because patient care would be negatively impacted.  Also, communicating well allows me to learn from the other healthcare professionals. Each brings something to the table and I find the insight and lessons invaluable.

Literature: Best Practice, Necessary or Ideal Strategies for Effective Leadership

The Registered Nurses Association of Ontario (2013) outlines a number of best practices for a healthy work environment. Specifically, these are collaborative practice; developing and sustaining both effective staffing and workloads; the development and sustaining of nursing leadership; cultural competence; professionalism; all aspects of health and safety in the workplace; being aware of and managing violence that takes place against nurses; paying attention to nurse fatigue; and, the mitigation and management of conflict that can crop up in healthcare teams (RNAO, 2013, p. 7). Nurses, in their everyday practice, are leaders in their own learning and in their practice. When nurses assume a nursing leadership position, this self-leadership takes on broader implications, as staff and patients are affected. Nursing leaders should have the following attributes: a sense of a mission; be engaging; be able to encourage people to put aside their differences and work together for the good of the patient; have the ability to make decisive decisions; and, is creative in approaching problems (WHO, n.d., p. 265). I have also observed and the literature shows, that leaders should have exceptional organizational skills, have a very clear understanding of their purpose and the tasks for which they are responsible; have the ability to communicate effectively; is a negotiator; and, importantly, must have the ability to delegate effectively (WHO, n.d., p. 265).


In my practice, I believe that my strengths are the following: developing therapeutic relationships with my clients; communicating well with the healthcare team; and, I always strive to provide safe and competent care for all of my clients.

Areas of Discomfort

Areas of discomfort in my practice relate to the preparation of specialized types of medication. One example is the delivery of insulin. This is because I do not have a lot of practice with this medication. It is important that I understand my areas of discomfort because this means that I can actively identify and find ways to transform these discomforts into competencies.

Areas Requiring Development

The areas of my practice that require development are the following: being able to bring all of the clinical pieces together; and, building my critical thinking skills. The importance of the former means that I can help deliver good, effective and safe health care to clients. The importance of the latter is that I will be able to evaluate multiple factors and variables in order to make the best possible decisions with the information that I have at any given time.

Leadership Learning Plan: Clinical Management

            I had the opportunity to be in charge of planning the work and program assignments for my colleagues when I was on rotations in a mental health setting. From this experience, the following are leadership development goals that I would like to include in my learning plan.

Learning Goal 1

Learning objective: Developing effective communication skills. Communications skills represent a key to creating a better work environment and reducing misunderstandings among colleagues. Resources/strategies: Some of the resources and strategies that would facilitate this goal would be attending a public speaking course; remaining current in terms of the latest policies and policy changes in the healthcare environment; and, keeping abreast of peer-reviewed research articles in my field of study. Success indicators: In terms of public speaking, when I can begin to feel comfortable when giving presentations, this would be a success indicator. Understanding policies and policy changes success indicators would be my ability to participate more knowledgeably in staff discussions in these areas. I could also volunteer to be on committees for my subject area knowledge. Success in terms of reading more peer-reviewed journal articles would be volunteering, in staff meetings, to share what I have learned when there is a round-robin check-in of staff. Target date: Within the next 10-12 months.

Learning Goal 2

Learning objective: To help develop a culture of shared service so that all staff understand that everyone contributes a particular skill for the greater good. Resources/strategies: I would volunteer to work on cross-functional teams and encourage other staff members to do so. I would also ask that for staff meetings to include an agenda item focused on service each week, so that staff would be encouraged to actively think about service to each other, as well as to clients. Success indicators: I would measure success of this goal by the number of staff who volunteered to do something outside of their comfort zone in order to provide a service to a colleague and/or a client. Target date: Within the next 10-12 months.

Post-Graduation Leadership/Followership Intensions

After graduation, I intend to find a nurse leader mentor so that I can observe and learn about leadership in real terms. This will also allow me to understand different leadership styles and to learn about how policy decisions are made and why these decisions are made.

How My Learning Plan will Meet Career Goals

My learning plan will meet my career goals when I am able to understand the value and uses of effective communication from my mentor. As well, by cultivating a spirit of service, I will develop a broader understanding from my volunteer experiences. Both goals can be placed on my performance objectives so that the goals will become measurable and my supervisor will become aware of them.


Key Findings

The key findings in my reflection are centered around the importance of actively engaging in learning, whether from texts or from other professionals. As well, I have gained a better understanding of the role of communication in the healthcare environment and, moreover, the importance of effective communication.

Critical Thinking Statements

The following are two critical thinking statements relevant to my practice. First, it is necessary to analyze and evaluate the policies and processes that are the backbone of healthcare administration and, therefore, leadership in a healthcare environment. Without this, I would be unable to make appropriate decisions. Secondly, healthcare is about caring and, as such, teams that express a sense of consistent service delivery to clients will have contributed well to better client care.


To conclude, this reflection has made me even more aware of the importance of actively setting goals and working towards these goals. Providing nursing leadership is an important element in effective healthcare delivery, and nursing leaders have many opportunities to do so.







Caldwell, L., & Grobbel, C. (2013). The Importance of Reflective Practice in Nursing. International Journal of Caring Sciences , 6 (3), 319-326.

RNAO. (2013). Developing and Sustaining Nursing Leadership Best Practice Guideline. Registered Nurses’ Association of Ontario. Toronto: Registered Nurses’ Association of Ontario.

WHO. (n.d.). Leadership and Management. Geneva: WHO.



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