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P-248  Harmonising the working structure of an in-patient unit embedding a culture shift
  1. Jacquie Pamphilon and
  2. Karen Causton
  1. St Helena Hospice, Colchester, UK


Introduction Hospice nurse leaders need to promote a safe effective environment for patients requiring end-of-life care, whilst being a mentor for less experienced palliative nurses. The hospice inpatient unit manager observed a disparity in roles when registered nurses work as shift leaders. Some shift leaders have not had leadership skills training and do not always have the skills to create process and offer clear direction. Nurse leaders need to achieve good outcomes for all not just a few, to achieve this they need to reflect on and question leadership and management practices (Ellis and Bach 2015)

Aim and objectives

  • Coaching RNs to understand leadership practices as shift leaders and the importance of their role in influencing the development of new nurses

  • Encourage a culture change for shift leaders to realise the potential of being stong leaders focusing on patient wellbeing.

Approach used – work in progress The unit manager and learning and development officer working in partnership on a joint project investigated reasons for the disparity. Shift leaders spent time reflecting on their approach to leadership, outcomes provided a base of their then situation. Observation allowed for deeper understanding of the nurse’s practice (Keatinge 2002). Discussion of the observations included; could understanding and implementing leadership styles harmonise the team, reflection on management theories such as Belbin’s team roles (Belbin 2004)

Evaluation RNs recognising their responsibilities as leaders and seeing a growth in project work and knowledge sharing that will educate new nurses.

Conclusion This culture shift is important to bridge gaps in leadership as effective leadership is critical in delivering high quality care and ensuring patient safety and facilitating positive staff development (Frankel 2008). Sharing an approach that looks at leadership styles and what they mean on IPU might offer alternative methods for solutions in other hospices.

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