HRM 674 Practicum Journal: Power

Practicum Activities Reflection:

During Weeks 1 and 2 of my practicum in the labor and delivery unit, I spent most of my time actively learning alongside my preceptor while becoming familiar with unit workflow and expectations. My preceptor guided me through patient admissions, ongoing labor assessments, and prioritization of care in real time. I observed how experienced nurses quickly gathered patient histories, interpreted fetal monitoring, and responded to changing conditions. I was also gradually involved in supporting basic tasks such as preparing rooms. These experiences helped me understand how structured knowledge is applied in a high-pressure environment. My preceptor consistently emphasized safety, teamwork, and situational awareness during all patient interactions.

A key focus of my early practicum experience has been identifying a potential quality improvement project related to documentation variability among nurses. While all staff follow standard charting guidelines, I observed differences in detail, clarity, and consistency of nursing notes between shifts. My preceptor encouraged me to explore how these variations might affect continuity of care and communication among healthcare providers. At this stage, I am in the early assessment phase, gathering observations and considering how documentation practices influence patient outcomes and workflow efficiency. This project connects to broader quality improvement principles in nursing practice, emphasizing communication, patient safety, and interdisciplinary coordination in clinical environments (Tajari et al., 2024).

Throughout these two weeks, I observed multiple examples of both formal and informal leadership within the labor and delivery unit. The charge nurse provided structured direction during shift huddles, ensuring priorities were clearly communicated. However, I also noticed that experienced staff nurses frequently demonstrated leadership through mentoring, quick decision-making, and supporting colleagues during high-acuity situations. My preceptor modeled calm, confident leadership when managing anxious patients and coordinating care during busy periods. These observations helped me understand that leadership is not limited to authority roles but is demonstrated through communication, accountability, and clinical judgment. Effective leadership also contributed to smoother workflow and improved team coordination during unpredictable clinical events.

My practicum experiences closely connect with concepts I have learned in my coursework, particularly regarding prioritization, communication, and leadership in nursing practice. In class, I learned that effective clinical decision-making requires systematic assessment and evidence-based reasoning, which I observed in real-time during patient care. However, in practice, decisions were often made more rapidly and intuitively due to time constraints and patient acuity. Communication theories emphasizing clarity and empathy were also evident in patient education, where nurses adapted explanations based on the patient’s emotional state. This experience reinforced theoretical knowledge, which provides a foundation; clinical environments require flexibility, adaptability, and interpersonal skills for safe, effective patient outcomes.

Application of Leadership:

Leadership is strongly influenced by how power is understood and exercised in real clinical situations. My preceptor demonstrated that power in nursing is not about authority alone, but about the ability to influence care, support colleagues, and maintain patient safety under pressure. In high-acuity moments, such as when multiple patients were in active labor, she coordinated care without dominating others, instead guiding the team through calm direction and shared decision-making. This coordination reflected a form of professional power rooted in competence and trust rather than control. I observed that staff naturally responded to her guidance because she consistently demonstrated reliability, clinical expertise, and fairness in her interactions.

Authenticity was evident in how my preceptor communicated with both staff and patients. She remained consistent in tone and behavior, regardless of workload intensity. When situations became stressful, she did not project frustration but instead acknowledged challenges openly while maintaining composure. This composure created psychological safety within the team, allowing nurses to ask questions and seek clarification without fear of judgment. I also observed that authenticity strengthened patient trust, as she explained procedures honestly while remaining reassuring. In practice, this demonstrated that authentic leadership is closely tied to transparency and consistency, which helps stabilize both team performance and patient experience in unpredictable environments (Sinnott et al., 2026).

Integrity was another strong leadership element I consistently observed. My preceptor ensured that clinical decisions and documentation were accurate, even when the unit was extremely busy. She emphasized adherence to protocols and environmental awareness, especially during fetal monitoring and medication administration, reinforcing that shortcuts could compromise patient safety. I noticed that she corrected documentation inconsistencies professionally and privately, without undermining staff members. This approach reinforced accountability while preserving respect within the team. Integrity was also reflected in how patient advocacy was prioritized; she ensured that patient concerns were escalated appropriately and that clinical decisions aligned with ethical nursing standards rather than convenience or time pressure.

Emotional intelligence was especially visible in how she managed both patient and staff interactions. During emotionally charged situations, such as anxious first-time mothers or emergency interventions, she remained calm and attentive to emotional cues. She adjusted her communication style based on the emotional state of patients and family members, using reassurance when needed and direct clarity when urgency was required. With staff, she demonstrated empathy by recognizing fatigue and workload stress while still maintaining expectations for safe care delivery. This balance helped sustain team morale in a demanding environment. I observed that emotional intelligence was essential in preventing conflict and maintaining cooperation during high-pressure situations.

Overall, my observations demonstrated that power in leadership within the labor and delivery unit is relational rather than hierarchical. My preceptor’s ability to integrate authenticity, integrity, and emotional intelligence allowed her to influence care delivery effectively without relying on authority alone. Leadership was expressed through presence, communication, and consistent decision-making that prioritized both patient outcomes and team cohesion. This experience helped me understand that effective nursing leadership requires more than clinical expertise. It also depends on the responsible use of power to support others, build trust, and maintain safe, coordinated care in complex clinical environments. Ultimately, it contributes to professional growth and confidence over time.

Practicum Project Preparation:

My practicum project focuses on documentation variability across nursing staff within and between units in the labor and delivery setting. During my initial weeks of observation, I noticed that although nurses follow standardized charting guidelines, there are differences in how assessments, interventions, and patient responses are documented in daily practice. Some entries are detailed and structured, while others are brief depending on workload and individual style. This variation raised concerns about consistency in communication during shift handovers, especially in high acuity situations. Even small gaps in documentation may affect continuity of care and patient safety outcomes across shifts and interdisciplinary teams (Saporito & Mrad, 2025).

The purpose of this project is to examine how documentation practices vary and how these differences influence communication among healthcare providers. I aim to identify patterns in completeness, clarity, and structure of nursing notes across different shifts and staff members. This topic aligns closely with patient safety and quality improvement principles because accurate documentation is essential for safe, coordinated care. My preceptor supported this idea and emphasized that documentation serves as both a legal requirement and a communication tool. Understanding these variations will help identify areas where standardization or additional training may improve consistency, reduce errors, and strengthen overall clinical communication across the unit environment.

This project will also help me develop essential professional skills that are directly relevant to my long-term career goals in nursing leadership. In analyzing documentation practices, I will strengthen my ability to observe system-level issues, evaluate workflow processes, and apply critical thinking to clinical environments. These skills are important for advanced practice and leadership roles where nurses are expected to identify gaps in care and contribute to evidence-based improvements. Additionally, I will improve my communication and analytical abilities by reviewing documentation trends and interpreting their impact on interdisciplinary collaboration, continuity of care, and patient outcomes within the labor and delivery unit setting.

In relation to my career goals, this project supports my interest in becoming a nurse leader who contributes to improving care quality and patient safety. Understanding documentation variability will help me recognize how small inconsistencies can contribute to larger communication challenges within healthcare teams. It will also prepare me to participate in initiatives that promote standardization, accountability, and staff education in clinical documentation practices. Ultimately, this experience will strengthen my ability to support safe, efficient, and evidence-based nursing care across different healthcare settings. I am currently gathering observations and comparing documentation practices across shifts to ensure accurate, consistent analysis and meaningful interpretation of findings for improvement.

Leadership Video Reflection:

The servant leadership video emphasized that effective leadership begins with serving others rather than exercising authority over them. It highlighted that leadership power is most effective when it is shared and used to empower team members instead of controlling them. In my practicum experience, I observed this principle when nurses responded more positively to leaders who were supportive, approachable, and present during high acuity situations. My preceptor demonstrated servant leadership by guiding staff calmly while prioritizing patient safety and providing emotional support to laboring mothers throughout care delivery. This experience reinforced that shared leadership fosters trust, teamwork, and safe patient-centered care in high-pressure clinical environments consistently and effectively in practice.

The second key insight from the video is that servant leaders build trust by consistently prioritizing the needs of patients and staff. This approach strengthens teamwork, improves morale, and enhances overall patient care outcomes within healthcare environments. In my practicum setting, I observed that when leaders demonstrated humility and emotional intelligence, staff became more confident and communicated more openly. This openness reduced errors and improved coordination during busy shifts in the labor and delivery unit. Overall, servant leadership reframes leadership as influence grounded in service, respect, and commitment to patient and team well-being. Kang et al. (2023) support this perspective in nursing leadership practice and professional healthcare environments today overall.

References

Kang, J. Y., Lee, M. K., Fairchild, E. M., Caubet, S. L., Peters, D. E., Matti, L., & Howell Jr, T. G. (2023). Do organizational values and leadership impact staff engagement, wellbeing, and patient satisfaction?. Journal of Healthcare Leadership, 209–219. https://doi.org/10.2147/JHL.S421692

Saporito, A., & Mrad Georgis, B. (2025). Enhancing patient safety through effective communication in healthcare. In Healthcare Services Management (pp. 107–112). Springer, Cham. https://doi.org/10.1007/978-3-032-12602-3_11

Sinnott, C., Campbell, K. H., & Pettker, C. M. (2026). Communication, teamwork, and culture: Creating winning teams to support optimal childbirth outcomes. Obstetrics and Gynecology Clinics, 53(1), 173–185. https://doi.org/10.1016/j.ogc.2025.11.002

Tajari, M., Ashktorab, T., & Ebadi, A. (2024). Components of safe nursing care in the intensive care units: a qualitative study. BMC Nursing, 23(1), 613. https://doi.org/10.1186/s12912-024-02281-5

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Assessment Traits
Requires Lopeswrite
Assessment Description
Journaling provides a valuable tool for recording, reflecting on, and reviewing your learning. This approach provides an opportunity for you to “connect the dots” and observe the relationships between and among activities, interactions, and outcomes.

Unlike a personal journal of thoughts and feelings, this leadership journal is a record of your activities, assessments, and learning related to this academic experience.

Journal entries should include a record of the number of hours spent with your nurse leader each week.

Write a journal entry of 750-1,500 words on the subject of power, including the following:

Practicum Activities Reflection: Provide observations and thoughts on the activities in your practicum setting during Weeks 1 and 2.

Application of Leadership: Professional responsibility and power, authenticity, integrity, and emotional intelligence are key factors of multiple leadership styles. Discuss how you have observed your preceptor or nurse leader in your professional setting integrate these elements into leadership styles.

Practicum Project Preparation: What are your ideas for your practicum project? How does this project refine and build skills related to your career goals?

Leadership Video Reflection: Reflect on at least two things you learned from the “Servant Leadership – Issue of Power” video.

Use the “Leadership Journal Template,” located in Class Resources, to complete this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.