Article Appraisal

It is essential to remain calm and confident in times of uncertainty or crisis in the nursing practice. This set mindset helps nurses to approach stressful conditions of dealing with patients more appropriately. The article critiqued identifies the calmness and confidence of clinical leaders in practice. The article, “Clinical leadership in mental health nursing: The importance of a calm and confident approach,” was conducted in a mental health service where most participant nurses worked in inpatient units, mental health triage, and community teams (Ennis, Happell & Reid‐Searl, 2015). The purpose of the study was to explore nurses’ perceptions in promoting mental health for clinical leadership. The abstract summarized the design and methods used, the study’s findings, and the practice implications in influencing patient outcomes.

Literature Review

In the introduction section, the author has evaluated literature from different sources relevant to the research’s purpose. This literature has demonstrated significant evidence to show the unpredictability of nursing units. It also presents the intensive work that nurses do, their challenges, and their mental health conditions due to their jobs. One source describes clinical leadership as an emerging characteristic of nursing, and most health organizations are adopting models and theories to improve it (Stanley & Stanley, 2018). Most of the literature sources were qualitative. The research used a comparative analysis of data and categorization.

            According to Hamaldeh & Ammourt (2011), the nursing profession may be stressful due to the conditions nurses are exposed to and the timelines they are supposed to be of assistance to a patient. Cleary, Hunt, Horsfall, & Deacon (2011) recognizes it as the only profession that has hands-on care on patients 24 hr in a day and seven days a week. Using this information, the author has developed different connotations about the topic, such as confidence among nurses, consciousness, and mental health environment issues. The literature guides some of the factors that lead to aggression, mental disorders, and quitting from the profession (Dickinson et al., 2009). The stated aim of this study is to explore the perceptions of nurses working in mental health on the realm of its leaders’ characteristics. Furthermore, the focus was on the ability of clinical leaders to portray confidence and calmness in their practice.



Considering the concept of exploring clinical leadership in nursing health, the author adopted a grounded theory, a qualitative approach to research. The theory allowed the author to generate a substantive explanation about the subject by evaluating the experiences of the participants (Ennis, Happell & Reid‐Searl, 2015). As detailed above about the setting of the study, the author has detailed it. From the author’s perspective, the setting would be a sample for a wide range of applications. The participants selected were registered nurses and had worked in practice for 12 months (Ennis, Happell & Reid‐Searl, 2015). Through assumption and the help of different tools, the author believed that this group would provide significant insights for the study. This is because they were most likely to be aware of the formal and informal roles within the nursing service.

            The study used semi-structured interviews, audio-recordings, and other forms of information from individual participants. These individuals provided their characteristics of their clinical leaders that made them practical for the practice. These views would be used in exploring the attributes of a significant mental health nursing leader (Ennis, Happell & Reid‐Searl, 2015). They would be asked questions about the leader’s suitability in the position and how this influenced their performance. When the leader demonstrated calmness and confidence, they described how that affected their emotions in practice. Among the shortlisted nurses, based on the criteria, 12 participants were recruited for the study (Ennis, Happell & Reid‐Searl, 2015). This number was small due to the setting of the study. However, the author details that they were sufficient to provide the required information to establish the expected findings.

Ethical Considerations

The illustration of ethical research practice is included in the paper. The ethical approvals were obtained both from the mental health service and the university human research ethics committee. Also, the nurses that participated in the study did so voluntarily, and all the procedures recommended by the National Health and Medical Research Council were followed (Ennis, Happell & Reid‐Searl, 2015). Both physical and online communication channels were used to describe the study’s aim and purpose before they agreed to participate. This would ensure that the nurses’ participants were not put at risk of any kind ((1) Ennis, Happell & Reid‐Searl, 2015). According to the author, this method would preserve the emotional and mental state of the participant. Furthermore, these procedures exposed the nurses to brainstorming and constructing expressions about what they felt based on clinical leadership (Ennis, Happell & Reid‐Searl, 2015). According to the author, the ethical approvals were necessary for verifying that the study followed all the set laws and policies of research.

Significant Results

The author used grounded theory to analyze the information collected from 12 eligible participants. The recruitment for participants focused on registered nurses, without other clustering factors such as gender. The sample was very narrow but adequate to make significant conclusions. The information collected contains most of the words spoken by the participants. The questions asked to guide the findings were well analyzed, which formed the basis for data collection. In a theoretical sampling model, the participants’ views were compared. Subcategories of calmness and confidence were ensured to be consistent with the information that participants availed. A theoretical saturation method was used to classify the results, as McCann & Clark (2003) suggested.

            The value of the participants’ perceptions of their leaders was embedded when they could relate to how attributes help them remain calm and confident in the nursing practice (McNamara et al., 2011). The author found that the participants attached value on leaders that would help them address mental health clients when they were acutely unwell, and when the situation was severe. They also attached importance to the leaders that would remain calm and confident in the middle of a crisis (Stanley & Stanley, 2019). Some reported this when the health service received an extensive number of patients with severe problems ((2) Ennis, Happell & Reid‐Searl, 2015). Therefore, they described effective leadership as associated with the leaders who would calm them down even when such situations were stressful.

            After analysis, the author found three findings put into three themes and presented in prose. First, the ability to remain calm was linked with clinical competence. The ability to manage unpredictable conditions in the nursing practice, mostly when they were unexpected. These findings are critical in nursing practitioners as they are demeanors of understanding confidence and calmness among the nursing practice (Ennis, Happell & Reid‐Searl, 2015). They help to describe the essence of clinical leadership and its relationship with the characteristics of the leaders (Mannix, Wilkes & Daly, 2015). However, some of the limitations were that the participants’ perceptions and the findings could not be generalized across all settings.

The study results are clear and easy for nurses to understand. The author has not used complex analytical methods to analyze and present the data. In that regard, a nurse can straightforwardly understand the implications of the study, that leaders are essential in directing nurses and be aware of the actions that would lead them to increased competency.

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The author supports the findings adequately in the discussion section. Some of the literature that was evaluated have been used to draw some findings. Each attribute of the assertions made by the participants is connected to the relationship with the confidence and calmness findings. These are presented in an evidence-based manner (Ennis, Happell & Reid‐Searl, 2015). The author discusses the importance of clinical leaders to remain confident and calm as a component of clinical leadership. Some of the areas that the author identified to depend on confidence and calmness are in the engagements that were directed towards a positive outcome for the mental health clients (Ennis, Happell & Reid‐Searl, 2015). For the nurses to establish a rapport with the clients, the author found that a significant therapeutic relationship was required.

            The author described different skills that a calm and confident leader should portray and how they can motivate their employees. The author noticed that most of these skills are not obtained from schools (Ennis, Happell & Reid‐Searl, 2015). In an emergency, the leaders were required to offer a different form of organized mechanism to create intervention measures. The reliability of findings was enhanced through teams that were used. Reliability instruments are used to determine the reliability of information collected (Jeon et al., 2015). The nurses that were consulted were allowed to give their views from their experiences. In that regard, the author did not have the tools to verify whether the information provided was accurate or not. The author recorded this as a limitation to the study. Another limitation of the study was that the study population was small, and due to resource constraints, the study setting would not cover a broader community of nurses. However, due to the registered nurses’ experiences, the information was sufficient to guide the conclusions and the findings.


The conclusion stated different attributes of the standard leadership roles preferential for enhancing performance in the nursing practice. According to the author, this ability requires mental health and a high level of confidence and calmness within a nurse. In a mental health setting, nurses should address the most urgent cases of a crisis. When they are calm and collected, they can calm the patients and stabilize their emotions. Unpredictable situations such as depressive and mental disorders require a nurse who can articulate the client’s challenges, connect with them, and have a moment of closure with them.


The author details some of the insights that were collected from the views and perceptions of nurses. From the findings, it was clear to the author that most nurses used calmness and confidence to address most clients’ problems they encounter daily (Stanley & Stanley, 2018). The implications for the practice section majored on how learning these skills could impact the practice positively. Based on the findings, most nursing schools may not offer these skills, and nurses have to gain them practically (Ennis, Happell & Reid‐Searl, 2015). In that regard, a suggestive process of influencing nursing schools to train their nurses on these skills is essential. However, according to the author, further research is required to ensure that a clear foundation is set on the specific type of gifts to feed them (Ennis, Happell & Reid‐Searl, 2015). Therefore, future studies can focus on further findings of skill application in the profession and some other alternative ways in which confidence and calmness can be developed.


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