Reflection in Nursing Leadership Roles



Reflection in Nursing Leadership Roles

Tammy A. Garcia

Ferris State University

Abstract

Teenage pregnancy prevention in Kent County, MI was the focus of the group community assessment project completed this semester. The focus of this paper is a reflection on the nursing leadership roles for the direct care nurse and nurse manager involved in the pregnancy prevention project. The leadership skills needed for both roles are linked to the American Nurses Association (ANA) Standards of Professional Performance. The health disparities of the target population, teens age 14-19, are examined along with Title X and emergency contraception.

Reflection in Nursing Leadership Roles

Teen pregnancy in Kent County MI was the topic of the community assessment project that I was a part of. Even though the national teen pregnancy rate has declined over the past 10 years, the State of Michigan and Kent County have teen pregnancy rates well above the national average.

The teen pregnancy rate for females age 15-19 in Kent County, Michigan is 61.5 per 1000. Compare that rate to the State of Michigan average of 53.6 per 1000 and the national average of 39.1 per 1000 teens, and it is apparent that intervention is needed (Kent County 2011 Health Needs Assessment, p. 23).

Applying Neuman’s Systems Model, which suggests that individuals interact with their environment and the variables of the environment, several risk factors were, identified (Nursing Theory, 2011). Those risk factors include teen alcohol and drug use, D/F grades, living in poverty, single parent household, and child abuse. The snow ball effects of the risk factors cause them to perpetuate and magnify.

Harkness & DeMarco, (2012) state, “Successful strategies for preventing adolescent pregnancy vary from responsible sexual behavior education, which includes abstinence education, to improved contraceptive counseling and confidential reproductive services” (p. 441). We chose a multifaceted approach to educate both males and females in the 15-19 age groups,

Health Disparities of Target Population

The health disparities of the target population include socioeconomics, living in poverty, single parent household, and child abuse. Those disparities increase the risk factors of alcohol consumption, drug use, and D/F grades. The downward spiral continues.

Policies Contributing Positively or Negatively to Disparities

Both on the national and state levels there are policies and programs in place that effect the target population. Title X and emergency contraception are two examples.

Title X. Title X is a federal grant program for family planning and reproductive health. Title X funds are distributed to clinics that provide family planning services to low income patients. In recent years there have been proposals to decrease funding of Title X programs for political reasons. Title X funds, even when given to a clinic that does perform abortions, cannot be used for abortions, yet abortion is the most common reason given by politicians for wanting to decrease funding. Title X money is for family planning, STD testing, pregnancy testing and counseling and affordable birth control. Since its start in 1970, it has helped low income patients by providing family planning services. A cut in funding for Title X will lead to an increase in teen age and unplanned pregnancies due to a decrease in services provided (HHS).

Emergency contraception. Emergency contraception is also known as Plan B or the morning after pill. It is available without a prescription for women 17 and older; however, teens under the age of 17 need a prescription. Advocates of emergency contraception believe it should be available without a prescription for all women of child bearing age. The way it stands now makes it difficult for a population at risk to have easy access to the medication, which means it is not being used in that age group consistently. This leads to an increase in teen pregnancy (Guttmacher Institute, 2012).

Underlying Beliefs and Disparities

Pregnancy prevention is a topic that inspires passionate reactions; reactions that maybe due to underlying religious beliefs or political affiliation. Some religions believe that using birth control is against God’s will. Some believe abstinence only education should be taught to teens. I feel this is not enough. Will lack of knowledge in regards to pregnancy prevention stop a teen from having sex? Most likely it will not. If the teen that was taught abstinence only has sex, they may not be equipped with the knowledge needed to prevent pregnancy and STDs.

When does life begin? Beliefs, views and opinions differ on when life begins. Those beliefs also influence the views on birth control, emergency contraception, and abortion. One could argue that politically conservative views are counterproductive to pregnancy prevention programs as it leaves a narrow view of what is acceptable and can be taught and what isn’t. On the flip side it could be argued that liberal views lead to increased teen pregnancy. Is educating our teens on sex education that includes more than abstinence and providing them with access to birth control if it is needed, increasing the teen pregnancy rate?

Nursing Roles

Nurses play a significant role in reducing the rate of teen age pregnancy. We, as nurses, are the largest occupation in the United States and if our energy is concentrated, we can encourage a culture change. A focused program on prevention will provide awareness to an ongoing problem.

Role of Direct Care Nurse

There are several roles for a direct care nurse in a teen pregnancy prevention program. Providing direct care to teens in health care clinics, pregnancy care clinics, battered women’s shelters, or in other health care setting where the direct care nurse would come in contact with the target population. The direct care nurse could also come in contact with teens at risk by providing pregnancy prevention information in a teaching environment such as in the research based Reducing the Risk program. The nurse working in this setting needs the following leadership skills to be successful: motivating, managing, achieving workable unity, and explaining (Kearney-Nunnery, 2008, p.195, para.6). The nurse will need to collaborate with not only the teens, but also other health care providers and other professional disciplines, including social workers and teachers. The nurse working in this role demonstrate competency in the 13th Standard of Professional Performance, collaboration. This standard states, “The registered nurse collaborates with healthcare consumer, family, and others in the conduct of nursing practice” (ANA, 2010, p. 11).

Role of Leader/Manager Nurse

One of the roles for a nurse leader or manager is community liaison nurse. The community liaison nurse works with multiple entities to coordinate the efforts of the individual entities in a pregnancy prevention program. The nurse liaison may organize health fairs, educational programs for the target population, community education programs for the population at risk and their parents, and may serve as a resource for advisory boards (ASTDN, 2008). The nurse working in this leadership role will require the following skills: envision goals, affirming values, motivating, managing, achieving workable unity, explaining, and representing the group (Kearney-Nunnery, 2008, p. 195). Standard 12 of the Standards of Professional Performance is leadership. The nurse in this role meets this performance standard by demonstrating “leadership in the professional practice setting and the profession” (ANA, 2010, p. 11).

Analysis of Roles

There are a lot of leadership skills that are needed by both the direct care nurse and the nurse leader. Both roles require the nurse to be able to motivate, manage (patients, employees, time), explain and be able to achieve a workable unity. The additional leadership skills needed by the nurse leader are the ability to envision goals, affirm values, and represent the group.

Reflection

Looking back on the project and related nursing roles, I would be competent in either the direct care nurse role or the community nurse liaison role. I would be best suited for the community nurse liaison role. My current position has similarities to that role as I envision goals with the patient (regain strength and health); I represent the group (Trinity Corporation) and affirm the values of that group (Catholic). I have a workable unity with co-workers and hospital case managers. I motivate, explain the rehab process to the patient, and answer any additional questions the patient or family may have. In addition, I like to be on the front end of projects and I am an organized person by nature.

Kearney-Nunnery, (2008) state “leadership is not limited to those in positions of authority. Each of us has the potential to exhibit leadership at various points in our professional careers, regardless of our title, position, or academic credentials” (p. 202, para. 7). By the nature of nursing as a profession, nurses at all levels need strong leadership skills.

References

American Nurses Association (ANA), (2010). Nursing scope and standards of practice (2nd ed).

Silver Springs, MD: .

Association of State and Territorial Directors of Nursing (ASTDN), (2008). Providing a peer

and collegial for public health nursing leadership. Retrieved from

Guttmacher Institute. (2012). State policies in brief: Emergency contraception. Retrieved

from pubs/spib_EC.pdf

Harkness, G. A. & DeMarco, R. F. (2012). Community and Public health nursing practice:

Evidence for Practice. Wolters Kluwer/Lippincott, Williams & Wilkins: Philadelphia

Kearney-Nunnery, R., (2008). Advancing your career: Concepts of professional nursing (4th ed.)

Philadelphia, PA: F.A. Davis Company.

Kent County 2011 Health Needs Assessment. (2011). Retrieved from

pdfs/KentCoCHNA_Final.pdf

Nursing Theory. (2011). Nursing Theory: Neuman’s systems model. Retrieved from



U.S. Department of Health and Human Services (HHS). (n.d.) Title X family planning. Retrieved

from

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