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A leader can be defined as someone who can influence others to perform beyond the actions dictated by authority (Robbins, Bergmann, Stagg & Coulter, 2005). These people may either be appointed or they can emerge from a group. Bureaucratic leaders work by following rules and regulations to ensure that procedures are followed exactly (Lega & DePietro, 2005). Bureaucratic style leadership is best suited to situations where there are serious safety risks and where following specific guidelines and adhering to lines of authority is extremely important (Palombara, 2006).

By designating roles for my fellow nurses to carry out, I was decreasing the risk of further injury to the patient and possible injury to themselves. By instructing them to get help before handling the current situation I was following a characteristic of bureaucratic leadership which is to follow formal rules and regulations, which ensures uniformity and regulation of workers (Johnson, 2003). Before handling the patient on the floor, I instructed the nurses to collect towels to wipe the blood which had spilled on the floor. I instructed them to bend their knees as they released the locked bed rail to free her leg and kneel on the floor.

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I then told one nurse to lower the lifter while the other three nurses and I assisted the patient off the sling completely. One nurse was instructed to support and bandage the bleeding leg until the ambulance arrived. These instructions were given by me to prevent any further harm coming to myself, the nurses and the patient. By following strict guidelines as characterised by bureaucratic leadership, further injury was avoided as well as any safety hazards removed (Draper, 2002). Division of labour, which is another characteristic of bureaucratic leader, was also shown in the way jobs were given to each nurse to divide up the tasks equally to handle the situation (Bowornwathana, 2006). The ambulance eventually arrived to pick up the patient and she was taken to hospital.

My future goals would be to equip the nursing staff with the knowledge that is necessary in handling such incidents in work place, this can be achieved if the staff are encouraged and willing to update their require skills. Evidence 4:4 of the ANMC competency, uses appropriate strategies to manages own responses to the professional work environment. This includes identification and use of support networks and sharing the experiences related to professional issues mutually with colleagues. This shows that if there is shared knowledge and support networks among the nursing staff such incident could be avoided. In other words, in service programmes such as use of lifter, manual handling and prevention of falls will help to prepare the staff in case of future occurrence.

Conclusion

Bureaucratic leadership is an effective style of leadership in handling situations like the critical incident described in this reflective report. By following specific guidelines and rules and designating jobs as characterised by bureaucratic leadership, the critical incident was handled well and successfully. I learnt from taking a leadership role that I was able to remain calm, think logically in an emergency situation and will hopefully carry this attitude forward throughout my future nursing career.

References:

Alphonso, C. D. (2007). Reflection on a critical incident. Contemporary Nurse, 24, 89-92. Australian Nursing and Midwifery Council [ANMC] (2005). National Competency Standards for the Registered Nurse, Dickson ACT:Australian Nursing Council. Bowornwathana, B. (2006). Transforming Bureaucracies for the 21st Century: The New Democratic Governance Paradigm. Research in Public Policy Analysis and Management, 15, 667-679.

Draper, P. (2002). Change in nursing and the introduction of the support worker. Nurse Education Today, 10, 5, 360-365. Johnson, M. (2003). Research, teaching or bureaucracy? On the preparation of mentors and lecturers in nursing and midwifery. Nurse Education in Practice, 1, 4, 171-174. Lega, F., & DePietro, C. (2005). Converging patterns in hospital organization: beyond the professional bureaucracy. Health Policy, 74, 3, 261-281. Palombara, J. L. (2006). An Overview of Bureaucracy and Political Development. Research in Public Policy Analysis and Management, 15, 193-220. Robbins, S., Bergman, R., Stagg, I., & Coulter, M. (2005). Foundations of Management. Sydney, Australia: Pearson Education. Written by Darawatta Alexander Student ID: 13258489

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