In this final section you are invited to reflect on:
‘Ethical leadership’ can be understood as leading in a way that promotes good outcomes while respecting people’s dignity and rights and providing leadership for others to do the same. As a nurse working in a care home you have leadership responsibilities and can influence dignity in care (see for example ‘Small changes make a big difference: how you can influence to deliver dignified care’ http://www.rcn.org.uk/__data/assets/pdf_file/0008/191735/003285.pdf)
Write down your answers to the following questions and then discuss with colleagues:
When we talked to registered nurses in care homes, they told us about leadership responsibilities ranging from supervising care staff to leading a unit. The ways in which they provided leadership on dignity included:
In order to provide leadership, or to be able to influence we need to be empowered – to have the power – to do so. Power might be formal (for example, it is part of your role as manager of a unit), or it might be informal (for example, your colleagues listen to your advice because they recognise and respect your knowledge and experience). As before, write down your answers to the following questions and then discuss with colleagues:
The things that empower you might include the support of your managers; things that disempower you might include a lack of staff time to spend with residents.
Think about ways in which you might become more empowered to provide ethical leadership and the people who might help you to do this.
When you think about how you can build on and develop as an ethical leader, including providing leadership on dignity in care, you might think about the areas where you have, or would like to have influence.
Discuss your responses with a trusted colleague.
The RCN Defending Dignity – Challenges and Opportunities for nursing report identified 3 ‘levels’ at which individual nurses can have influence and provide leadership on dignity:
Micro-level – this is the level of the individual, and includes role-modelling and challenging the behaviour and attitudes of others.
Meso-level – this is the level of the organisation, and includes providing staff with training and developing policies and practices to support dignified care
Macro-level – this is the level of government, and includes the impact of policies and resourcing on the ability to deliver dignified care
In Section 1 of the Toolkit you were invited to think about and note down your answer, as a registered nurse, to the following questions:
Find your answer now and consider if you have progressed towards influencing change. Discuss your responses with a trusted colleague or mentor and agree what will help you in the future to engage with dignity in relation to the levels above.