PART 3 – PLACEMENT 1 – 2024 SEPT – Leadership and Autonomy in Primary Care
NMC Reflective Account Form
Reflective account:
What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
During my GP placement (October 2024), I was given increasing responsibilities in managing my workload independently. While still under supervision, I was expected to prioritise tasks, make clinical decisions within my scope, and support the wider team. This included assisting with patient assessments, preparing vaccinations, and responding to queries efficiently.
What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
I learned that leadership in primary care involves both clinical decision-making and effective time management. Applying Hersey and Blanchard’s Situational Leadership Model (1969), I adapted my approach depending on the complexity of tasks and the level of supervision required. I also recognised that autonomy comes with accountability, and decision-making must align with evidence-based practice and patient safety principles.
How did you change or improve your practice as a result?
Following this experience, I became more confident in handling low-risk clinical tasks independently, while also knowing when to escalate concerns. I refined my prioritisation skills and learned to manage competing demands effectively. Moving forward, I plan to develop my leadership further by engaging in structured mentorship and management training programmes.
How is this relevant to the Code?
- Practise effectively: Managing tasks autonomously while ensuring high standards of patient care.
- Preserve safety: Recognising the limits of my competence and escalating appropriately when needed.
- Promote professionalism and trust: Developing leadership skills that contribute to a well-functioning, patient-centred healthcare environment.
This reflection highlights the importance of leadership, autonomy, and decision-making in nursing practice within a primary care setting.
SOURCES USED:
- Leadership and Supervision in Nursing – A Reflective Analysis.pdf
- Decision-Making Under Pressure: The Clinical Decision-Making Model (Tanner, 2006) suggests that clinical judgement is enhanced through reflective practice, situational awareness, and pattern recognition. This was applied during the placement experience in primary care, where leadership decisions were required in fast-paced settings.
- Balancing Responsibilities: Managing workload and prioritising tasks were key aspects of the GP placement, aligning with Covey’s Time Management Matrix (1989) for structured prioritisation.
- Aligning Future Leadership Goals with Career Progression: The guidance provided on career planning (qualifying, gaining high-acuity experience, and enrolling in GPN courses) was a major component of leadership development.
- PART 3 – PLACEMENT 1 – 2024 SEPT – Reflection on Meeting Professional Values.pdf
- Autonomy in Clinical Practice: Decision-making autonomy was exercised during the placement, including vaccine administration choices and handling patient concerns in a way that ensured safe and effective patient care.
- PART 3 – PLACEMENT 1 – 2024 SEPT – Mid-point Interview.pdf
- Situational Leadership in Nursing: Developing autonomy and prioritising tasks in a primary care setting was discussed in the student self-assessment and learning objectives.