Introduction
This essay critically analyses my leadership and management roles in relation to the implementation of patient-centered care within my nursing practice. Patient-centered care, a cornerstone of modern healthcare, prioritises individual patient needs, preferences, and values in clinical decision-making (Epstein and Street, 2011). As a nursing student, my emerging roles as a leader and manager have been particularly tested in this area, especially during clinical placements where I have been tasked with coordinating care and advocating for patients. This essay explores how leadership and management intersect in my practice, focusing on communication as a critical aspect of patient-centered care. The discussion is structured into three key sections: defining leadership and management in nursing, examining my role in fostering effective communication, and reflecting on challenges and areas for improvement. By critically engaging with these themes, supported by academic literature and practical examples, this essay aims to illuminate the complexities of balancing leadership and management in delivering high-quality care within the UK healthcare context.
Defining Leadership and Management in Nursing
Leadership and management are distinct yet complementary roles in nursing, both essential for effective healthcare delivery. Leadership is often described as the ability to inspire, influence, and guide others towards a shared goal, focusing on vision and motivation (Northouse, 2018). In contrast, management involves planning, organising, and coordinating resources—including time, staff, and equipment—to achieve specific objectives (Marquis and Huston, 2017). Within nursing, these roles frequently overlap; for instance, a nurse may lead a team through effective communication while simultaneously managing shift rotas to ensure adequate staffing.
In the context of patient-centered care, my leadership role involves advocating for patients’ needs and fostering a collaborative environment where their voices are heard. Meanwhile, my management responsibilities include ensuring that care plans are implemented efficiently and that resources are allocated appropriately. As Sullivan (2017) argues, effective nursing leaders must also be competent managers to translate patient-centered principles into actionable outcomes. This dual responsibility is particularly evident in the area of communication, where I must balance leading interdisciplinary discussions with managing documentation and information flow. Understanding these roles provides a foundation for critically examining how I apply them in practice.
Fostering Effective Communication as a Leadership and Management Role
Communication is a pivotal element of patient-centered care, as it underpins trust, shared decision-making, and therapeutic relationships (Bramhall, 2014). As a nursing student, I have recognised that my leadership role in this aspect involves actively listening to patients and acting as their advocate during multidisciplinary team (MDT) meetings. For example, during a recent placement in an acute ward, I encountered a patient with limited English proficiency who struggled to express concerns about their treatment plan. By taking the initiative to arrange an interpreter and ensuring their preferences were communicated to the team, I demonstrated leadership by prioritising the patient’s needs over procedural convenience. This aligns with the Nursing and Midwifery Council (NMC) Code (2018), which emphasises the importance of clear communication in upholding patient dignity.
From a management perspective, I am responsible for ensuring that communication is systematic and documented accurately to maintain continuity of care. This includes updating patient records, sharing information during handovers, and coordinating with other healthcare professionals. During the same placement, I managed the timely documentation of the patient’s concerns in their care plan, which facilitated a smoother transition during shift changes. However, I recognise that my management skills in this area are still developing, particularly in prioritising tasks under time constraints—a challenge I discuss further in the next section. As Kitson et al. (2013) note, effective management of communication processes is crucial for embedding patient-centered care into routine practice. Therefore, both leading by example and managing logistical aspects are integral to my role in this domain.
Challenges and Areas for Improvement
Despite the successes described, I face notable challenges in balancing leadership and management roles, particularly in high-pressure environments. One key limitation is my tendency to focus excessively on leadership aspects, such as patient advocacy, at the expense of managerial duties like time management. For instance, during a busy shift, I spent considerable time addressing a patient’s emotional concerns, which delayed the completion of necessary documentation. While this reflects a strength in empathetic leadership, it highlights a gap in my ability to delegate or prioritise tasks effectively—a core management skill (Marquis and Huston, 2017). This experience underscores the need for better integration of both roles to avoid compromising overall care delivery.
Furthermore, my limited experience as a student nurse means I sometimes lack the confidence to assert my leadership during MDT discussions, especially when interacting with more experienced professionals. This hesitancy can hinder my ability to advocate effectively for patients, a critical leadership component in patient-centered care. Reflecting on this, I have identified the need to develop assertiveness through targeted training and mentorship, as recommended by Sullivan (2017). Indeed, addressing these weaknesses requires a proactive approach to professional development, including seeking feedback from supervisors and engaging with evidence-based resources to refine my skills.
Another area for improvement lies in managing team dynamics, a managerial responsibility that impacts communication flow. While I strive to ensure information is shared accurately, I have occasionally struggled to address conflicts or misunderstandings within the team, which can disrupt patient care. Research by West et al. (2015) highlights that effective team management is essential for maintaining a cohesive working environment, suggesting I must focus on conflict resolution as a priority. By acknowledging these limitations and committing to continuous learning, I aim to enhance both my leadership presence and managerial competence in future practice.
Conclusion
In conclusion, this critical analysis has explored my leadership and management roles in relation to communication within patient-centered care as part of my nursing practice. Leadership in this context involves advocating for patients and fostering trust through empathetic interaction, while management encompasses the organisation and documentation of communication processes to ensure continuity of care. Although I have demonstrated strengths in patient advocacy and systematic record-keeping, challenges such as time management, assertiveness, and team coordination reveal areas for improvement. These reflections underscore the importance of integrating leadership and management skills to deliver high-quality, patient-focused care, as supported by existing literature and professional standards like the NMC Code (2018). The implications of this analysis are clear: ongoing professional development and reflective practice are essential to address my limitations and enhance my effectiveness as a future nurse. By committing to these strategies, I aim to contribute more robustly to the NHS’s goal of prioritising patient-centered care in all aspects of healthcare delivery.
References
- Bramhall, E. (2014) Effective communication skills in nursing practice. Nursing Standard, 29(14), 53-59.
- Epstein, R.M. and Street, R.L. (2011) The values and value of patient-centered care. The Annals of Family Medicine, 9(2), 100-103.
- Kitson, A., Marshall, A., Bassett, K. and Zeitz, K. (2013) What are the core elements of patient-centered care? A narrative review and synthesis of the literature from health policy, medicine and nursing. Journal of Advanced Nursing, 69(1), 4-15.
- Marquis, B.L. and Huston, C.J. (2017) Leadership Roles and Management Functions in Nursing: Theory and Application. 9th ed. Philadelphia: Wolters Kluwer.
- Northouse, P.G. (2018) Leadership: Theory and Practice. 8th ed. Thousand Oaks: SAGE Publications.
- Nursing and Midwifery Council (2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. London: NMC.
- Sullivan, E.J. (2017) Effective Leadership and Management in Nursing. 9th ed. Boston: Pearson.
- West, M.A., Eckert, R., Steward, K. and Pasmore, B. (2015) Developing collective leadership for health care. The King’s Fund, London.
