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Journal of Nursing Research and Practice

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Clinical reflection and leadership in efficient management of patients in the Intensive Care Unit

Author(s): Nawaf Alharthi*

Reflection is made on the strengths and limitations of a transformational leadership style in the context of providing care to patients in critical care units, collaborating with other healthcare practitioners and the patient’s family. This involves a case study of a 49-year old patient admitted to an intensive care unit (ICU) due to severe chest pain; later transferred to cardiac catheter laboratory is presented. As part of reflective practice, the author’s role in the team is explored using Belbin’s 9 team roles as a guide. ICU is seen to be a complex, dynamic setting with healthcare practitioners fulfilling highly specialized roles. Conflicts in the team were avoided since all team members respected the roles of each team member. A discussion on how hierarchies in the team could possibly result in poor teamwork was also explored against what the author was experiencing in the ICU. A discussion follows how transformational leadership developed the author’s emotional intelligence and improved team members’ satisfaction with the quality teamwork. A critique is put forward on the importance of effective communication. Both verbal and nonverbal messages are critical in conveying and receiving important information in an ICU team. Although positive communication skills are defined, there are still some gaps in practice such as a need to develop therapeutic communication skills for positive health outcomes in patients. An evaluation of power in the team and an imbalance in power was observed. Power in a team is seen as critical in determining if resources in ICU were sufficiently used and that patients received quality, timely care and the dynamic nature of an ICU environment is examined. Patient’s needs, interventions can change quickly in an ICU environment which leads to complexities especially if a patient is clinically deteriorating. Recommendations are made on the importance of developing inter professional collaborations, effective leadership and communication among team members.

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