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NURSING LEADERSHIP ROLES & ITS IMPACT OVER NURSING PRACTICE SOLOMON ISLANDS EXPERIENCES SOUTH PACIFIC NURSES FORUM 2012 Leonda by The Yarra, Melbourne, Australia.

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Presentation Outline Introduction /Background Nursing Demand /Nursing Numbers Nursing Leaders Roles Influence over Leadership roles Why Nursing needs a strong leadership Significant Leadership Issues Predisposing factors for leaders Strategies to support leaders roles Expected Outcome/Conclusion

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Introduction Nursing in the Solomon Islands is faced with deferent leadership challenges as a result of Constant Changes Increase Demand Complex Health system Deferent HR issues and demands Cultural influences Low economical status.

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A call for Nurse leaders .. Not only competent but Strong & Influential Innovative and creative Immune and manage through realities Strategize/Outcome focus Leader Man of all Trade & Master of all. In order to influence changes and developments that drives the nursing practices forward to improve the patient care and health outcome.

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Initial response............. Call for Reform Could be an answers to some of our leadership challenges . 2003 (9yrs ago) a reform was done realignment of nursing positions, upgrading of clinical leadership positions, This has create demand for senior nurses to fill these positions. The Nursing Division has no option but to fill all these position with senior nurses. Challenges : Senior Nurses are given these leadership roles without being trained, hence it has impact on how clinical nurse leaders taking on the leadership roles from there on.

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Despite such training and capacity limitation, the caring passion of the nursing profession, has very instrumental in ensuring that nurse leaders are doing the right thing and leading the team through,to reach this far................ The Principle of caring for the sick, caring for your self and caring for the profession......

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What are Nurses .. Most Important workforce Back- bone of the Health Services Front-liners Almost of MHMS workforce Nurse are present in all the Shifts/Health facilities (NRH/Remote RHC) The image of the SI Health Sector

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NURSES ARE THE BACKBONE & FRONTLINERS OF THE SI HEALTH SERVICES DELIVERY

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NURSING NUMBERS

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Where 50 % Nurses Live & Work Inland Coast Scattered Islands Universal Access

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LEVELS OF NURSE LEADERS DONS DIRECTORS OF NURSING- 10 NM/NE NURSE MANAGERS - NURSE EDUCATORS CNC CHNC CLINICAL NURSE CONSULTANT COMMUNITY HEALTH NURSE CONSULTANT CN CLINICAL NURSES - SPECIALIST RN SENIOR RN- HOSPITALS SENIOR RN- PHC. of the Leaders Clinical leaders Team leaders

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Roles of Nursing Leaders Clinical Leaders Task Supervision /Coordination Team leader Training/Coaching/Mentoring Initiating care & treatment Clinical Duties Management/Administration Executive representative HR Recruitment /Repositioning /annual Leave Designing regulatory and performance policies Planning and Budgeting Training & Development

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Complimentary Roles Provincial Directors(CEO) -Administrators Clinical Expertise/Managers Financial Managers Focal Person/ Mediator Statistician

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Why Does Nursing required strong Leadership team. Health Sector is complex and challenging Nursing is faced with constant changes and new demands. Nurses are required to be prepare for new situations Nursing is begin to faced with deferent Human resources challenges

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Significant Leadership Issues Limited drive to perform better Low performance and staff productivity Staff Under utilization Un clear Communication process

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Findings underperformance are not manage effectively Nurse Leaders do not necessarily deal with underperformance appropriately Nurses do not feel satisfied with the level of recognition they are provided or feel valued Nurse Managers do not necessarily draw the best out of their nurses.

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Level of Workplace Engagement 20

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21 D OMAINS OF R ELATIONSHIPS AND INFLUENCE IN THE S OLOMON I SLANDS Domain 1 Tribe or Wantok Domain 2 Church Domain 3 Public Institutions Waiting for Time Communal Abundance Relationship Tolerance Obligation to the Tribe Making Time Scarce or Finite Resources Task Accountability Individual Freedom

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TRIANGULAR HYRACHY SYSTEM Strategic Level Management Division Individual Operational Level Policy /Strategic Visions Program People Focus must link with the vision/ Strategies Nurse Leaders

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Underpinning issues MDGs count down Health Priority issues- NHSP 2012/2015 Parliamentary Enquiries/Media release. Nursing Priorities

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Predisposing Factors Resources issues Infrastructure/equipments Unclear Organization policies/Directions Work under Pressure- shortage of doctors, Nurses Lack/Low Capacity -Forces to uphold leadership position Performance management / regulatory /Support issues

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A Call for Reform Practice PHp Practice PHp Management/leadership Education /Research Regulate Standards Regulate Standards NURSES TIME

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Responses to leadership Issues. Establishment of the Nursing Strategic Direction Priority Areas Nursing Leadership/Management Nursing Education /Research Nursing Regulation/Standards Nursing Practices/Public Health

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Nursing Strategic Directions, 2010 to 2014 Key Strategic Areas 1.Nursing Management/Leadership and Administration. 2.Nursing Education, Development and Research 3. Nursing Regulation/Standards 4. Nursing Practice (including Public Health

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Nursing Management & Leadership Organization Reforms Strengthening capacity through -Supervision -Regular Conferences /Seminars -Upgrading leadership post National/Provincial -Training locally/Abroad.

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Nursing Education, Development & Research Midwifery School(WB/MOH/SICHE) Review of Nursing Curriculum- Certificate/Dip (AUT) Introduction of Bachelor of Nursing(AUT) Introduction to Nursing Research Symposium/Training (JCU) Align Nurses Training with Doctors Specialist fields.Attachment /FT.

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External Exposer for leaders Locally IPAM Institution of Public Administration & management Abroad JICA Nursing management ALA Leadership PACE- Leadership

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2012 High Lights- International Nurses Day

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Nursing Regulation/Standards Review of Nursing Regulation Features Competency Standard Registration/Licensing process Training/course Accreditation

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Nursing Practices /Public Health Re-redevelopment of Nursing Procedure books Re-introduction of NCP in Hospital Regular reviews & support for Clinical leaders. Motivated to be Leading Role in the Introduction and implementation of PH interventions/approaches Mother/ Baby Friendly Hospital/Clinics- MAPISRH/FHC

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Conclusion Strive for better outcome. Continue Planning Implementing Evaluating Deferent levels of improvement process Organization expectation Vision/Goals Skilled HR Effective Regulatory Policies/Standards

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Special Acknowledge WHO-Collaborating Centre UTS/JCU Under the ALA Scholarship AUT- Zealand JICA International cooperation urgencies UPNG FNU- FSM For others organization and individuals Tagio Tumas for your help

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So, who are you called to Be? Be the change you wish to see in this world. Mahatma Gandhi

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We come a long way & there still a long way to go a head of us TAGIO TUMAS.