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This essay discusses the leadership and ethical skills in the nursing field exemplified through Ms. Ann Makena, a nurse in charge of the Neonatal Section at the Southern-State Hospital. She was recently awarded a Community Service Medal as an appreciation of her dedication to her profession. This spurred me to interview a lady in the limelight, a leader, in order to understand further on the challenges facing leadership, appropriate professional ethics and the responsibilities that come with nursing.

In my personal interview, I decided to learn further on the skills she employed to ensure effectiveness in leadership and the challenges she encountered. I therefore decided to phrase the following questions: How did you prepare yourself for this role and what particularly influenced you to join nursing?, How do you co-ordinate staff, delegate duties and manage your work environment?, What are the particular challenges that you face in your current position as the section's boss and in nursing as a whole?, what are the professional and personal ethics that you highly uphold at the workstation? and What do you envision as the future of nursing?

In the interview, I learnt that Ms. Makena was a Registered nurse and held a Bachelor of Science degree in nursing. She had decided to study nursing since her childhood since she felt that she had a noble and divine cause to pursue in an effort to offer care to the needy masses in order to alleviate human suffering. She also found it sufficiently challenging and rewarding having been brought up by her mother who was also a nurse and was very influential when it came to her choice of career.

The Neonatal department has 16 registered nurses under its supervision. These nurses work in 12-hour shifts, 7 nurses at one particular time of day, while two are on rest. Each nurse is entitled to a one-day leave in every week though emergency cases at times necessitate a recall. It is therefore challenging to lay down strategies and a working criterion to be followed by staff and at the same time ensure required standards of professionalism are adhered. It is in this view that Ms. Makena upholds two leadership skills that have not only kept her at the top but also endeared her to the staff and patients. She employs the skills of motivation and also innovation to set an example to her staff. In particular, problems such as drug shortages like anesthetics are easily covered by administering other methods of pain relief and birth induction process in the case of a highly distressed mother. She highly motivates her staff through the particular successful innovations that set an example.

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From this interview, I was able to infer two major challenges that Ms. Makena felt needed to be addressed. First and foremost, there is an acute shortage of qualified nurses in the health care industry. Pressure has therefore been exerted on the available nurses in an effort to stretch the available labor resource. This, however, comes with lower service standards since the few nurses cannot adequately offer completely personalized service as the case should be in the medical profession. Secondly, she felt that the cost of accessing services was quite high for the average citizen. This had led to inaccessibility of midwife services to these citizens leading to at times critical and disastrous cases being reported after delivery took place elsewhere. This ends up costing these patients more than they would have had to pay for the services.

Ms. Makena insists that proper professional standards and ethics must be followed. She insists that due theatre procedure must be followed no matter the amount of experience acquired unless in the case of a special delivery case. Before delivery, the nurses must first check the blood pressure and pressure which if assumed, could be fatal to the mother. The nurse must then determine the true onset of labor whereby the cervix has started to contract. During birth, the nurse must monitor the mother's heartbeat and check the baby's condition through the Doppler on position and oxygen supply. This due process stages should not be skipped be it either before birth or after which involves cleaning and weighing the baby and monitoring the mother's condition. Nurses should further extend on their professionalism to offer breastfeeding instructions, signing of paternity papers and the birth certificate.

Ms. Makena also enlightened me on various trends to watch out for in nursing. Of concern is the rapid impact of technology on Neonatal services. Nurses can obtain material on how to use new methodologies and machines. We nurses cannot afford to be left behind by technology such as telehealth whereby clients can be administered to without physical proximity. This will go a long way in saving lives that succumb during delivery which is in line with the nursing vision. Also, state and federal regulation on healthcare will increase in an effort to control costs and encourage a shift into a less expensive industry. This shift into managed healthcare will increase the state's oversight role such as defining standards and assess quality while ensuring accountability of these organizations. Ethical issues in an integrated system constrained by economic incentives are being addressed by policy makers instead of health care professionals. Nursing leaders should therefore contribute to this issue since they are the professionals in this field even if it means political campaigning.

It is therefore imperative for me to come up with appropriate leadership skills, key among them, innovation as I begin practicing. As a leader, I should ensure that the working environment is not dictatorial but rather consultative. I shall endeavor to uphold my professional ethics and morality in this field. I shall also keep abreast of technological advances by researching to ensure effectiveness. I shall also uphold customer relations in order to inspire confidence through offering free advice pre and post birth. This will ensure a good interactive field between clients and the health industry which will further encourage the average citizen to use professional help rather than other means in child delivery. (Tschudin, 1992)  (Wilkes, 2005) (Rothwell, 2003)

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