Introduction
The aims and intentions of this essay are to reflect on a case which I attended. I will reflect on how LMC is used in the work place using evidence based practice. I will critically compare and contract clinical LMC. I have looked at different reflective cycles, I have chosen to use Gibbs (1988) as it allows me to link LMC theory and practice and also helps me to identify positives and negatives, which I can reflect on and change for future cases as I can see what went wrong and what needs to be improved.
Description
I attended an elderly female patient who was experiencing difficulty in breathing. The patient had a recent urinary tract infection. Upon completing a history take, observations and assessment. I soon realised that the patient was in septic shock. I then administered the appropriate treatment and transfer the patient to the nearest accident and emergency. Throughout the case I alternated between autocratic and democratic leadership, and my mentor alternated in-between Laissez-faire and democratic.
Feelings and emotion
I was in my second year of my course when I attended this case, so I felt remotely comfortable and knew that if I was unsure I had the safety net of my mentor.
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Evaluation, Analysis and Conclusion
Reflecting back on this case there was three different leadership styles used by me and my mentor, the three leadership styles were Autocratic, Democratic and Laissez-Faire (Lewin et al 1939).
I originally adapted an autocratic leadership role however did alternate to democratic leadership as well. I chose this type of leadership as it benefitted me the most, as I am a student and I am in the final months at university I want as much practice leading a case as possible. But I did consider observing my mentor as an autocratic leader as I can see first-hand how my mentor works, which would mean I can learn from her, to apply it to my future leadership skills.
I decided that I wanted to be an autocratic leader for this case because I believe that case who are run by one person work better. Cherry (2018) believes that group projects usually work better where one person is the leader.
Another reason I decided to be an autocratic leader was because the patient was in septic shock which is a medical emergency (Daviaud Et Al 2015). Dahlkemper (2017) states autocratic leadership is the best suited leadership style when there is an emergency.
However Cherry (2018) states that an autocratic leader is usually the most knowledgeable of the group, And I am not the most knowledgeable due to my mentor having more experience and higher qualifications than me. But due to me coming to the final months of my course, I decided that I need experience leading cases without the input from others.
I acted as an autocratic leader by cannulating the patient in order to commence treatment without my mentor asking me to gain intravenous access. However after the cannulation process I changed to a democratic leader as I wanted to make sure that I was correct in what drugs we would be administering to the patient.
Middleton (2011) state that democratic model of leadership is where there is consideration for the opinions of those who are also in the group. So I asked my mentor and the technician if they both agreed which they did and then my mentor administered them through the cannula. By asking for my mentors opinion on what drug to administer has given me experience and has also allow me to develop in my treatment (Northhouse 2012)
I considered that if I was a democratic leader for the case there would be positives as I would be able to listen to my colleagues inputs to the patients treatment and also help me on my decision making (Cherry 2017). Which would benefit me as I would still be leading the case and I would be benefitted by communicating with my mentor about our decisions but I would make the final decisions upon my mentors ideas and contributions (Cherry 2018).
Being a democratic leader can be time consuming and not appropriate especially in a time critical situation states Miller (2010), which therefore democratic leadership was not the appropriate in the case which I attended.
However I will consider democratic leaderships in future cases where the patient is not time critical. As using the democratic approach can provide me with support from my colleagues and can also improve my knowledge from my colleagues input, especially on cases where I have little knowledge or exposure.
Throughout this case my mentor adapted the Laissez-faire leadership approach which was appropriate for the case. Cherry (2017) explains that Laissez-faire leaders incline to leave the decision to group members; which was beneficial to myself.
Due to my mentor allowing me to “lead” the case my mentor has allowed me to work with minimal supervision and empowers myself to make decisions (Steinhauer 2016). My mentor let me use my knowledge to make decisions, as laissez-faire leaders let things happen rather than make things happen states Pullen and Richard (2016).
As my mentor was being a Laissez-faire leader, it shows that my mentor has trust in me and my abilities to lead a case (Cherry 2017). Reflecting on this case, it shows how easily a leader can change their leadership style, as I change my leadership approach from autocratic to democratic. Northhouse (2012) suggest that one leadership style is not always appropriate in some situation therefore the leader may change their approach.
Clutterbuck (1998) describes a mentor as someone who helps another person to become what the person aspires to be. The Royal College of Nursing (2008) state that a mentor should be willing to help a student develop through clinical competence through support, reflective practice, communication and honesty appraisal.
Throughout my time as a student my mentor has used two different mentoring models being Hay’s (1995) ‘Mentoring Life Cycle’ and Klasen and Clutterbuck’s (2002) ‘Model of Business Mentoring’. Hay’s (1995) model being the long term mentoring model and Klasen and Clutterbuck’s (2002) model being the short term mentoring model.
Hay’s (1995) model suits me as I am being mentored for a period of two years, the model has four different stages. The stages are ‘initiation’, ‘getting established’, ‘developing independence or autonomy stage’ and ‘ending’. As I am in the final chapter of my training I am currently in between stage three and stage four. My mentor is currently developing me as an autonomous clinician by letting lead case such as the one in the scenario however she is also preparing me for stage four which is where I will be finished me degree.
In order for my mentor to mentor me effectively we have had to build a rapport and relationship (Hay 1995), this has benefitted me. As If I had conflict or negative experiences with my mentor then it would restrict more opportunities to learn and could affect my confidences states Mamchur and Myrick (2003).
During the case I used Klasen and Clutterbuck’s (2002) model, this model consists of four stages. The first stage is where I and my mentor established my learning needs and we set up a personal development plan, this plan consisted of me leading the case, I focused on the treatment and history take (Klasen and Clutterbuck 2002).
The second stage is where the mentee is to be encouraged to carry out my personal development plan independently, so I can become self-reliant (Klasen and Clutterbuck 2002). Therefore my mentor encouraged me by informing me that I am able to do achieve my goal and I need to be confident when attending the case.
The third stage is where the mentor facilitates the achievement of the learning objectives (Klasen and Clutterbuck 2002). Therefore my mentor offered me guidance and advice on how I can achieve my goal, such as concentrating on what the patient is saying and be confident with your treatment pathway.
The final stage is evaluating the success of my personal development plan (Klasen and Clutterbuck 2002). I and my mentor reflected on the case so we could identify my strengths and weakness. We then communicated my weakness during the case so I could develop and improve.
Overall I personally think that Klasen and Clutterbuck’s (2002) mentoring model was effective for me. As the model can focused on my weaknesses and ultimately allowing me to improve and develop. Klasen and Clutterbuck (2002) state that mentoring model can be modelled to fit a student’s learning needs.
Prior to using Klasen and Clutterbuck’s (2002) mentoring model I considered Pegg’s (1998) ‘The Five C’s Model of Mentoring’. When I and my mentor were assigned the case, we were 5 miles away from scene therefore we had limited time to review Pegg’s (1998) model. I had no knowledge on Pegg’s (1988) model, so the benefit of my learning we used Klasen and Clutterbuck’s (2002) mentoring model.
Coaching is instructing an individual, focusing on certain tasks so the individual can have feedback which will therefore help the individual improve and develop states Webster (2013).
Parsloe and Leedham (2016) developed a coaching model called the ‘Professional and Business Coaching’ which consists of four different stages. Parsloe and Leedham (2016) stages are ‘Analysing for awareness of need, desire and self’, ‘Planning for self-responsibility’, ‘Implementing using style, techniques and skills’ and ‘Evaluating for success and learning’. I considered using Parsloe and Leedham (2016) coaching model however I personally preferred Whitmore’s (2010) ‘G.R.O.W’ model, as it is more simplistic and easy to understand plus I have experience using this model prior to the case I attended. Klob (2014) suggests that individuals can learn and develop from experience.
During this case I and my mentor set myself a goal, setting an individual a goal is part of the coaching side of being a mentor (Whitmore 2010). I used Whitmore’s (2010) ‘G.R.O.W model.’ This model consists of ‘Goals’, ‘Reality’, ‘Options’ and’ What will you do’. Using Whitmore’s (2010) coaching model allowed my mentor to allow me to unlock my potential to maximise my own performance and has allowed me to learn rather than me being taught (Whitmore 2002); which benefited me.
Whitmore’s (2010) model is ‘Goals’; therefore I and my mentor set myself a goal, my goal was to be able to successfully lead the case myself with minimal input from others. By setting this goal helps prepare for the future for when I don’t have my mentor as a safety net. I believed that my goal was achievable and SMART (specific, measurable, attainable, realistic and time-bound) (Whitmore 2010).
The second phase of Whitemore’s (2010) coaching model is Reality. I decided that my goal was realistic with the stage I am in my course, as I have led cases before however I sometimes rely on my mentor if it is a case I have not had much exposure to.
The third stage of Whitemore’s (2010) coaching model is Options, therefore I and my mentor discussed options. We came to an agreement with an option which was if I get confused during the case, my mentor will step in and take lead to help me get back on track. Whitmore’s (2010) options phase is to encourage the brainstorming of individuals without judgement and to eliminate assumptions that stop the individual from achieving their goal (Stout-Rostron 2013).
The fourth stage of Whitmore’s (2010) stage is What will you do; therefore I and my mentor discussed a brief action plan on how I will achieve my goal on route to the case, we both agreed that my mentor and the technician should ‘take a step back’ and only put their input in if I ask for it.
Reflecting back on the case Whitmore’s (2010) G.R.O.W model allowed me to reach my goal, it allowed me to turn my weaknesses into strengths. This model worked well for this case as it is a simple model which helped me set and achieve a goal (Coaching for Performance, 2014). Stout-Rostron (2013) states many master executive coaches think the GROW model is very simplistic, however it is very useful for setting goals and developing an understanding of the fundamental structure of a coaching question framework. My mentor coached me well as she focussed on my development and my issues I had with placement (National College for Training & Leadership).
