10 Common Mistakes that Nurse Leaders Make

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Nurse Leaders It is always interesting to ask nurse leaders about the mistakes that they have made in their roles.  Most leadership mistakes are not big failures, but smaller mistakes that they often repeated early in their careers.  Experience is a good teacher but as one seasoned leader laughingly told me, “to be honest, I was not a quick learner early in my career….it seemed that I had to learn everything the hard way.  I still make mistakes today, but not the same ones that I used to make”. 

Making mistakes is part of being a leader according to Richard Hader, the editor of Nursing Management.  He points out that leadership is a daunting task, and the behavior of leaders is closely scrutinized.  We should not only learn from our own mistakes but can also learn from the experiences of other nurse leaders.  I have compiled ten of the most common mistakes that nurse managers have discussed with me.

The Top Ten List

1.  Failing to deal with performance problems early enough

This is probably the single most common mistake that nurse leaders make especially early in their career.  They wait too long to take action on poor performers, and fail to hold them accountable for their behavior.  Often, poor performers are difficult to deal with.  The leader does not want to face the confrontation that a counseling will bring or keeps hoping the employee will change.

2.  Avoiding a conflict that later escalated

Conflict management is a big challenge for many nurse leaders.  They often avoid the conflict, hoping it will just go away.  That rarely happens and the conflicts escalates out of control.  In an earlier post, I discussed carefronting as a different way to think about and approach these conflicts.

3.  Selecting a staff member that was not a good fit for the unit out of desperation

In today’s healthcare workplace, nurse leaders are usually able to be more selective about the staff who offered positions on a unit.  During times of nursing shortages (and we will have another by the end of the decade), this dynamic changes, and nurse leaders are often confronted with too few applicants for their positions.  Often against their better judgement and in desperation, the leader will select an applicant despite serious misgivings about a goodness of fit for the unit.  These selections rarely work out, and nurse leaders come to regret their mistake.

4.  Trying to be liked by everyone   

As a nurse leader, your relationship with your staff changes.  You can’t be their best friend.  It is important to strike the right balance but to also realize that leading change usually means ruffling someone’s feathers. Being a leader means requires that you need to develop a thick skin, and be able to take the heat without taking it personally.  This does get easier with time.

5.  Taking action without knowing the whole story

New leader often want to be seen as being action oriented in their positions.  You can pay a heavy price in leadership if you act too quickly on limited information.  Hearing all sides to the story is important.  When staff come in to present problems with another staff member or department, it is important to carefully listen.  But before you formulate an opinion about what happened and who may be at fault – get all sides to the story.  You may end up being quite surprised as situations usually end up being much more complex and nuanced, than the picture painted when they are first presented.

6.  Losing an excellent staff member without really finding out why

It can be very difficult to lose valued staff members.  Nurse leaders often attribute the loss to the individual moving on to other career opportunities.  That may be true but maybe not.  There may be problems or challenges on the unit that would be valuable feedback.  As an example, the research literature on bullying tells us that environments where this occurs have retention problems. Most nurses report that they did not discuss the situation with their manager.

7.  Acting in anger over a situation and later regretting it

Anger is a powerful emotion and a career derailer as I discussed in a previous blog.   A leader’s immediate reaction to an explosive situation is usually emotion laden.  As a wise mentor once told me, “when I feel this way – I tell myself to calm down – go home and think about it carefully before saying anything.”  This is when a trusted mentor to talk through the situation with can be very helpful.

8.  Failing to spend enough time developing relationships with staff and colleagues

Nurse leaders have very busy roles.  It is easy to get so wrapped up in your own workload that you don’t make yourself available to your team or establish relationships with colleagues.  Make it a priority to get out of your office each day to make rounds, talk with staff and meet with colleagues.  Leadership can be very isolating, but often leaders isolate themselves.

9.  Being misunderstood because communication was not carefully worded

Words have power and in leadership, people do listen carefully to the words that we use.  A careless response to a question can easily circulate quickly among staff, and not convey the meaning that the leader intended.  In difficult situations, it is even more important to carefully think through the language that you are using.

10. Not being open to feedback

Effective nurse leaders make sure they listen actively to their employees and their peers.  This means being open to feedback that may not always be positive.  You may not always agree with the perspective offered, but you need to respect that it is how others may view you.  If you are open to feedback, your staff will be more honest and open with you to help you succeed.

As a nurse leader, you will make mistakes.  In research that I have conducted with leaders, they indicate that the key is having the insight to be able to look at your mistakes, acknowledge them and learn from them.  There is nothing that nursing staff appreciate more than a leader who is able to confidently say “I was wrong.”   

 

Are Nurse Leaders Responsible for their Staff’s Happiness at Work?

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Nurse Leader Several years ago, I had a conversation with two nurse managers regarding the challenge of keeping their staff happy.  The novice manager in her first year of leadership practice, lamented that she was unsure if she could ever do enough to keep some of her staff happy.  The more experienced nurse manager, beloved by her staff for her superb leadership, sharp wit and candor, replied that she no longer spends much time worrying about this.  She described how in her early days of leading, some staff frequently came into her office to give her updates on how “everyone was feeling“.  They would tell me that the staff on the unit were not happy.   It did not seem to matter what I did – I still received this feedback.  So when I felt that I had done all that I could, I changed my response and began saying “then you just need to get happy”.  She raised a very important point in telling her story.  Happiness at work is not just the nurse leader’s responsibility.

Why Happiness at Work does Matter

Diane Scott has written a Center for American Nurses Association whitepaper on Happiness at Work.  She has written that not only is there a positive correlation between happiness at work and the individual nurse’s life and professional satisfaction, but there is also a strong business case.  Employee happiness increases productivity, improves retention.  It has also has been demonstrated to improve patient outcomes.  Being happy at work is important to life satisfaction, because so much of our time is spent in the work settting.  There is no one size fits all for staff happiness.

The Nurse Leader’s Responsibility

While nurse leaders cannot make staff happy, they can establish workplace cultures that engage and empower staff – two key components to work happiness.  Building a sense of community among staff is very important, because personal relationships with others at work do impact workplace happiness.  It is also important to staff that the leader demonstrate that they are happy in their own roles. Some key evidence-based leadership strategies that have been demonstrated to increase staff happiness include the following:

  • Provide a clear vision about the work and goals of the organization
  • Value the importance of everyone’s contribution to the work of the unit
  • Listen to staff and make them feel like their opinions matter
  • Give staff autonomy in their work
  • Communicate honestly even during tough economic times
  • Ensure that no-one is working in isolation
  • Establish a culture of celebration of everyone’s successes
  • Don’t tolerate bullying and discourage cliques
  • Treat all team members with the same respect

The Individual’s Responsibility

Srikumar Rao, a Columbia University Professor and author of Happiness at Work, proposes from his research that when we create our own experiences on the job.  Happiness at work is a very individual thing.  Two employees can have very different experiences within the same organization.  Happiness ultimately comes from within, and how we view our circumstances.  If you wait for your manager, your colleagues or your organization to make you happy, nothing will happen.  It is important for the individual to have a clear sense of what makes them happy or unhappy at work, and what actions they can take to change their own situation.

All of us have a strong need to be respected, recognized for our talents, feel a sense of belonging and do work that we feel is essential.  Only an individual staff member can truly know whether they are happy at work and if not, does something need to change.  Nurse leaders can create the environment for staff happiness but may find that some staff are still unhappy.  That is not the nurse leaders responsibility, and it never can be.

 

Are You a Good Follower?

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Follower To be selected for leadership, you must demonstrate that you are also a good follower.  This is a topic that rarely receives attention when we discuss professional development in nursing.  We hear a great deal about developing our leadership abilities, but little about follower-ship.  Great leadership is only possible when the leader surrounds him or herself with followers who will be inspired to do great work.  I remember once interviewing a nurse for a staff nurse position and I asked her about her leadership goals.  She responded that she really was not interested in seeking any higher level of leadership, but she told me that she was a great follower.  As I worked with her over a number of years, I found that to be very true and what a remarkable gift it was.  Some key traits of good followers include the following:

1.  Frequent Communication with the Leader

Leaders count on followers who will be self-starters in their work but who keep them informed about what they are doing, and any challenges they may be experiencing.  Leaders need good communication from their followers to help them make the right decisions.  Most leaders have preferred methods of communication such as a weekly briefing, email, frequent huddles or text messages.  Find out what the leader’s preferred communication style is and use it.  You will also want to know if there are specific types of things that the leader does want to be informed about – ex. medication errors, family complaints, supply issues, areas of staff dissatisfaction.  Health Care is a 24/7 business so learn the types of issues that a leader may want to be called about in their non-work hours.  Leaders become frustrated when they hear that a problem has gone on for weeks and they were never informed about it.

2.  Trustworthiness

Even great leaders can be undermined by followers who criticize decisions, are passive-aggressive, look to find fault or use their influence to erode the support of others.  Good followers need to be trustworthy and transparent in their actions.  There may be times in your career when you work for a leader that does not earn your trust but this should not change how you behave.

3.  Accountability for Commitments

I once asked a nurse ,who has had remarkable achievements in his career, about the secrets to his success.  He told me that the foundation of his success was that he always follows through on what he had committed to do.  So few people do, he observed, that it will always make you stand out.  Leaders depend on followers who will follow through on their assignments and can be counted on to do their work.  When nurse leaders look at their staff to identify their emerging leaders, this is a key trait that is considered.

4.  Support for Decisions Made

The health care environment today is in a state of constant change.  Even nurse leaders at the most senior level of the organization find themselves making decisions that may impact the work of staff in ways that will be perceived negatively.  There is often no choice but to make these tough decisions and policy changes.  Followers can and should share their concerns with leaders. Once a final decision is made, it needs to be supported.  Don’t blame the leader for unpopular organizational decisions that they may have no control over.

5.  Encouragement of Leadership Efforts

It is often said that it is lonely at the top, and many nurse leaders would agree with this assessment.   Good followers recognize this and find ways to encourage the leader on their journey.  There is nothing that leaders value more than authentic praise from those that they lead.

In her work on follower-ship, Barbara Kellerman identifies five types of followers based on their level of commitment:  Isolates, Bystanders, Participants, Activists and Diehards.  She contends that the ideal follower is the Activist.  The activist is passionate about their leader and/or organizations and demonstrates that enthusiasm. They are energetic, eager and engaged.  It is from this group that future leaders emerge.

As you begin thinking about your future career as a nurse leader, don’t forget to ask yourself first whether you are a good follower.

 

Building More Collaborative Relationships between Clinical Nurses and Nurse Managers

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Nurse In my discussions and research with nurse managers, I have found that one of their most significant challenges in today’s environment is building close collaborative, working relationships with the nurses that they lead.  Nurse managers today supervise an average of 65 nursing FTE, but spans of control up to 100 are not unusual.  With 12 hour tours, some of these staff interact infrequently with their manager.  Communication with staff and the development of personal relationships takes very intentional work on the part of the manager.

The American Organization of Nurse Executives (AONE) and the American Nurses Association (ANA) recently issued some guiding principles to assist nurse managers in building more collaborative relationships with clinical nurses.   To develop the guidelines, the organizations selected three nurse managers and three clinical nurses to ensure a balanced perspective from each side. The group worked together to determine the principles and guidelines to effective working relationships.  The Principles are divided into three main themes—effective communication, authentic relationships, and learning environment and culture.  The recommendations for clinical staff and nurse managers to build more collaborative relationships include the following:

  1. Maintain Effective Communication through active listening to fully understand what is being said.  Remember that context is important in communication as is tone, emotions and the accuracy of the information that is being discussed.  Both managers and staff should be more intentional in their communication, and understand the purpose and expectations of messages that are conveyed.  To be effective, communication must be open, accurate and the right people need to be involved in the discussion.
  2. Build Authentic Relationships through the type of caring for each other that nurses are so easily able to cultivate when caring for patients.  Being authentic means that you are true to yourself, and present your true self in interactions with others.  It means being honest but respecting the personalities, needs and wants of others.  It also means believing the best of others, and assuming good intent from their words and actions.  In authentic relationships, both staff and leaders are empowered to do their best work.
  3. Establish Learning Environments and Cultures through the recognition that a learning environment supports great nursing care while giving nurses the satisfaction of knowing that their work is valuable and meaningful.  A learning environment allows nurses and leaders to thrive because they are not afraid to fail.  In order to establish this type of environment, innovative and creative thinking must be valued.  Successes should be celebrated and mistakes should be recognized as an opportunity to learn and grow.  Asking “what if” should be the cultural norm versus “no way” in response to suggestions for change.

You may view the above recommendations and wonder why it took a panel to develop principles that seem to be such obvious building blocks of a healthy work environment.  If strong collaborative relationships existed in all our work environments between nurse managers and their clinical staff, there might not have been the need to develop these guiding principles.  But the sad reality today is that many of our nursing environments are not healthy, and change is needed.   This change is a joint responsibility between managers and their clinical staff.  What is also true is that changes in attitude, behavior and work environment can be simple, sustained and virtually costless when there is a commitment to have more collaborative relationships.

 

Imposter Syndrome in Nursing Leadership

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imposter syndrome Nurse leaders often tell me that during their first year in a new role, they feel like an imposter.  One young new manager captured these thoughts so well when she said,“I just keep thinking that someone will figure out how much I really don’t know and question whether I should have been given the position.  I sometimes feel like an imposter.  My mentor tells me to fake it until you make it but I am not so sure about that.”  Imposter Syndrome has been found to be more common among women leaders who may feel that they don’t deserve the success that they have achieved despite external evidence of their competence.

Imposter Syndrome Defined

The term imposter syndrome was originally coined by two researchers, Dr. Pauline Chance and Dr. Suzanne Imes, at the Georgia State University in 1978.  These psychologists observed that there are high achieving individuals who have a secret sense, that they may not be able to live up to the expectations that others have for them. They may even think that their success is based on luck versus their own positive qualities.  In small doses, this may not be a bad thing because it reminds us to work on building our competency.  But some individuals with imposter syndrome feel a level of self-doubt that can lead to overwork and a paralyzing fear of failure.  Many nurse leaders who experience imposter syndrome have unrealistic expectations of themselves in their first year in a new role that compromise their success.

Overcoming Imposter Syndrome

A wise mentor once told me that we can easily overestimate how much time other people spend thinking about us and our behaviors.  Most people, she observed, are pretty self-absorbed.  This is important to consider because it is likely that the idea of the leader being an imposter probably never crosses the mind of his/her followers.

Learning to better manage your feelings about imposter syndrome is important.  Cathy Robinson-Walker who coaches nurse leaders provides some good advice to mitigate imposter syndrome.  Her action steps include the following:

  1. Enlist the help of a trusted mentor to discuss your feelings about imposter syndrome.
  2. Pay attention to your own self-talk and consider whether your thoughts are empowering or disabling.
  3. Make of list of the strengths you bring to the role and what you contribute.  Ask others for their input, and refer to the list when you have feelings of self-doubt.
  4. Accept that perfection and the need to “know it all” is both unrealistic and can be personally costly.
  5. Recognize that there are times when you will be on a steep learning curve in a role and need to further develop your competencies.  Be honest about what you know and what you don’t know and utilize the experts on your unit or in your organization.
  6. Be willing to be uncomfortable and move through your fear.

Most nurse leaders will grow out of feeling like imposters as they build their competency and become more comfortable in their roles.  Biographers of Eleanor Roosevelt have talked about her initial feelings of inadequacy being first lady.  In reflecting on her experience, she noted that “I believe that anyone can conquer fear by doing the things he fears to do, provided he keeps doing them until he gets a record of successful experience behind him.”

 

5 Tips for Success in Interviewing for a Nursing Leadership Position

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Nursing I served as the director of nurse recruitment at two hospitals during my nursing leadership career.  It often surprised me how little preparation some candidates did for their interview, even when interviewing for leadership positions.  Well prepared candidates really stand out.  As you seek to advance to a leadership position either within or outside your organizations, here are five tips for success:

1.  Learn as much about the health care agency and department of nursing as you can.

Prior to your interview, it is important to take the time to learn as much as possible about the organization and nursing department.  Carefully study the website so you know the mission, vision and range of services provided by the health care agency.  If the hospital or agency is part of a larger system, go to the systems website as well.  Review any publicly reported data available about the agency such as what is on the hospital compare care site in the United States.  Many nursing services today use specific theoretical frameworks such as Watson’s Caring theory to guide care – be familiar with it.  If the hospital is Magnet designated and you have not worked in a Magnet hospital, review the forces of magnetism. You will be expected to be prepared to speak to the role of leadership in promoting a healthy work environment.

2.  Request a copy of the position description, the organizational chart and information about how the interview will be structured in advance.

You should know in advance what the position expectations are and information about the reporting structure in the organization.  This will allow you to carefully consider whether this position is a good fit for your current skill set and what competencies you may need to develop.  It is important that you also know how the interview will be conducted and who will be involved.  Many leadership interviews are conducted by panels.  Ask if staff are involved in the interview and whether a tour of the department will be part of your interview agenda.  Seeing the level of involvement of staff, the physical layout of unit and how you are greeted during a tour of the area will help you to better understand the unit culture.

3.  Anticipate what types of questions you will asked.

Leadership interviews are different than interviews for staff level positions.  You can expect to be asked questions directly related to leadership competencies so it is important to know what those competencies might include.  The NMLCInventory is a good document to review to better understand leadership competencies.  Many organizations today use performance-based or behavioral interviewing techniques.  In this type of interview, you will be asked very pointed questions  and given leadership scenarios related to the knowledge, skills and abilities related to the position.  You could be given a scenario that involved a conflict situation and asked the steps that you would use to resolve it.  You may be asked to describe a situation where you did not use effective communication and how you would do it differently if it occurred again.  You might asked how you manage your stress or to identify your leadership weaknesses.  You will be asked about your own leadership style so carefully think about how you will respond to this.  You should be prepared to give honest, authentic answers to a wide range of questions.  Asking someone in a leadership role to do a trial run interview with you would be excellent preparation.

4.  Develop your own list of questions to ask about the position and organization.

Come to the interview with your own list of questions about the position.  If this is your first leadership role, ask about what type of leadership development and mentoring is offered, and what the leadership challenges are in the organization.  Prepare questions to determine information about the budget, staffing, current performance on customer satisfaction surveys and other indicators. Ask questions about the patient population served, their needs and their health problems.  Ask about the unit culture, what is important to staff and any specific areas where improvement is needed.  Always have at least one or two questions when you are asked about questions that you have even if the interview has been thorough.

5.  Ask about the timeline for selection and the follow-up process.

Prior to leaving the interview, you will want to know what the follow-up process will be.  You may be asked to come back for a second interview so don’t be surprised if this happens.  Ask when a decision will be made about the position, and who you can contact if you have questions.  Get business cards from everyone that you meet with during the interview process so you can send follow-up thank you notes or emails.

Candidates who are interviewing in their own organizations sometimes make the mistake of not preparing for the interview.  Approach every interview in the same way whether you are an inside or outside candidate.  Don’t schedule an interview to follow a 12 hour night tour and don’t wear scrubs to a leadership interview.  Schedule the interview on your day off when you are rested and dressed for success.  After the interview, think carefully about the job that you interviewed for and whether it is a good fit with your strengths, weaknesses and career plans.  I recommend making a list of the pros and the cons.  You may be offered a position that you decide is not the right one for you.  That is fine but be gracious and professional in how you handle a situation when you turn a position down.  You may not be selected for a position that you really wanted.  All of us have this experienced this at some point in our career.  Let the recruiter know that you were impressed and hope there may be other opportunities in the future.  You will learn and sharpen your skills just by the act of interviewing. Take the risk of applying for positions that interest you.  You just never know where it could lead you.

 

An Attitude of Gratitude

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Gratitude There is great uncertainty in health care today about what will happen in the future.  Many nurse leaders tell me that work environments are very stressful as organizations try to plan their strategic direction.  It is clear that there probably will be less reimbursement and a greater emphasis on controlling costs.  We can’t change the reality of this situation but we do have control over how we think about it.

Peter Drucker, whom many consider to be one of the greatest thought leaders on management, observed that the job of leaders is to interpret reality even in the toughest of circumstances.  At the same time, he believed that leader have a responsibility to keep hope alive and focus on what is working well.   Having an attitude of gratitude can help to balance out the negative effects of the challenges and stresses.  The benefits of gratitude for both leaders and followers include include reduced stress, optimism, better cognition and improved health.  So here are 5 ways that nurses can develop an attitude of gratitude mindset:

  1. Keep a Gratitude Journal

Dr. Robert Emmons in his work on gratitude found that keeping a gratitude journal resulted in better sleep and more energy.  Each day, take the time to consider 3-5 things that you feel grateful for.  These could be simple magic moments like a smile from a baby or a call from a close friend or perhaps bigger achievements like acceptance to graduate school or getting a new job.  The point of the journal is develop a conscious mindset to focus on the positive things that happen in life.

  1. Stop Complaining

Have you ever noticed how whining can be contagious.  There are problems in every work environment and people who spend most of their time focused on the negative.  Commit yourself to think and speak positively.  If you are very upset about a situation, give yourself a time limit to vent your concerns and then move on to more positive thoughts.  Be grateful for the tough times because it will teach you to deal with adversity and there are always some positive outcomes from even the most negative experience.  In most situations, it is important to consider that things could be worse than what you are experiencing,

  1. Show Appreciation

If you actively look for things to be grateful for, you may be surprised at how much good there is in your life.  Your appreciation of others can have a very powerful impact on their life and also make you feel better.  Great nursing leaders know that it is important to begin with praise and honest appreciation of their staff.  During tough times, this can mean much more than a raise that you are unable to give.  A culture of appreciation and gratitude is very powerful and benefits everyone on the team.

  1. Write Thank You Notes and Emails

Take the time to send a note or email of appreciation to that person that you may take for granted but deserves your thanks.  People will never really know the positive impact that they have unless you tell them.  You will brighten someone’s day and it will make you feel better as well.

  1. Visit a Patient with a Terminal Illness

We sometimes fail to put our lives and problems in perspective.  Spending time with a patient who has a terminal illness can help us reflect on adversity and what is really important in life.  Not only will you feel good for taking the time to do this but you may also find that the patient is quite a source of inspiration for you.

When you feel stressed at work, stop yourself, reflect and just begin to notice others and what they do for you.  Gratitude is a way of investing in both ourselves and others.  So begin today with a mindset of gratitude and thank those who make a difference in your life and work.

 

Becoming a Transformational Nurse Leader

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Nurse Leader All of us have probably had a leader or coach who was able to bring out the very best of everyone on their team and achieve results that seemed impossible.  If you have had this experience, you were probably witnessing transformational leadership.  It is one of the key characteristics of Magnet designated organizations and is considered essential to solve some of the complex problems that we see in health care today.  But the truth is, many current nurse leaders are not transformational leaders.  They may not even be sure what a transformational leader does or how to develop their skills to become one.

Key Attributes of Transformational Leaders

Transformational leadership theory was first introduced in 1978 by James McGregor Burns.  He described it as leadership that occurs when the leader engages with followers in a way that raises their level of performance and motivation.  Those influenced by transformational leaders find meaning and value in their work, are able to make significant contributions to their organizations and are more likely to become leaders themselves.  There are four key attributes of transformational nurse leaders:

  1. The leader serves as a role model and “walks the talks”.
  2. They inspire motivation in their followers by having a strong vision about their work.
  3. They are concerned about the individual and demonstrate genuine concern for their needs and feelings.
  4. The leader challenges and develops the followers to be innovative and creative nurturing independent thinking.

Transformational Leadership Skill Development

Nurse researchers who study transformational leadership have found that nurse leaders who use transformational leadership principles create environments that promote higher levels of job satisfaction, well being and organizational commitment.  Wong & Cummings (2009) also found in their work that there were significant associations between transformational leadership practices, increased patient satisfaction and reduced adverse events.

Developing transformational leadership skills requires that nurse leaders be honest and reflective about their current practices.  Dr. Ronald Riggio, an expert in leadership development, advises leaders to ask themselves the following key questions to determine whether they demonstrate transformational leader qualities:  (Agree or Disagree)

  1. I would never require a follower to do something that I would not do myself.
  2. My followers would say they know what I stand for.
  3. Inspiring others has always come easy to me.
  4. My followers would say that I am attentive to their needs and concerns.
  5. My followers have told me that my enthusiasm and positive energy is infectious.
  6. Even though I could easily do a task myself, I delegate it to expand my followers skills.
  7. Team creativity and innovation are the keys to success.
  8. I encourage my followers to question their most basic way of thinking.

Your Leadership Journey

You probably were not able to answer yes to each of the above questions.  Leadership is a journey of self-development.  It is important to turn your areas of weakness around using these statements in situations to ask yourself for example – am I being attentive to the needs and concerns of my team members?  An even stronger test would be to ask members of your team how they would rate you on each of the eight statements.

Every nurse who assumes leadership (CNO, nurse manager, charge nurse, preceptor) can and should practice transformational leadership.  You will find that most of your followers are visionary, passionate and committed.  They have great innovative ideas about how to transform health care that need to be unleashed through transformational leadership.

 

Getting Noticed in Your Organization

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Organization I am often asked by young nurses with plans and hopes for their future – how can  I really stand out and get noticed in my organization?  This is a very good question to consider especially in large health systems with many employees or if you regularly work a night tour.  When opportunities become available for advancement, you want to be someone that the nurse leaders in your organization think about as a great candidate.  Getting noticed is not about self-promotion.  It is recognition for the work that you do, for being a team player, for your professionalism and for going that extra mile.

10 Tips to Get Noticed at Work

1.  Look Professional

First impressions do count if you want to get noticed.  Professional dress and being well groomed matter in creating a good image.  When nurse leaders see nurses with wrinkled scrubs and dirty shoes, the impression is generally not favorable.  You want to remembered as someone who will be a good candidate to represent the organization.

2.  Stay Updated

It is important to stay updated by reading professional journals and attending educational programs.  Be a “go to person” for new information in your specialty area.  In addition to staying updated clinically, pay attention to the news and what is happening with health policy.  Think about how proposed changes in health reforem could impact your organization and share your knowledge with other staff.  Recognize that health care is also a business and become knowledgeable about the business of caring.

3. Take Leadership Roles

Take leadership roles at the unit level.  They can be small but it is a great way to get started.  Volunteer to take a leadership role on a unit shared-governance committee.  Take charge when you have the opportunity.  This is an excellent way to connect with other staff and leaders in your organization.

4. Volunteer for Task Forces and Committees

Volunteer for organizational committees and taskforces even if it does mean coming in on your day off to participate.  Leaders do notice when a staff member is committed enough to an organization that they are willing to give back some of their personal time to be involved in activities.

5. Participate in Organization Sponsored Community Activities

Join the heart walk team, the breast cancer walk, the march of dimes or other teams your organization may put together to support the community.  Get others on your unit to join you.  You will find that organizational leaders participate in these activities and it can be a great way to introduce yourself in an informal setting and meet many new people.

6.  Attend Staff Town Hall Meetings

Go to meetings that senior leadership hold for staff and carefully listen to what is being said.  Represent your unit and manager in a very positive light by asking good questions.  Very often, these meetings are held and few staff attend unless there are major announcements.

7.  Be Professionally Involved

Join a professional nursing association and attend the local meeting.  You will probably meet staff and leaders from your organization that you might not interact with in other forums.  Local professional associations are always looking for members who are willing to assume some leadership responsibilities. This can be a good way to gain recognition by holding office in a local association.

8.  Introduce Yourself to Leaders Visiting your Area

So often when organizational leaders visit nursing units, staff avoid them.  There is nothing that makes a better impression than walking up with a smile on your face, introducing yourself and asking how you can help them.  Even on the busiest day, this will take very little time.  Senior nurse leaders enjoy being invited by staff to work a day with them on the unit if they ever have a chance

9.  Serve as a Preceptor and Cheerleader to other Staff

Be ready to share your skills and knowledge with others.  Sharing and volunteering to be a preceptor can be a great way to get noticed.  Your manager will appreciate your willingness to be a strong team player.  Be the first to congratulate others for their achievements and be the person who helps create a healthy work environment on your unit.

10. Keep your Commitments

I once asked a great nursing leader what he attributed his success to.  He told me that he did what he said he was going to do when he said he was going to do it.  This will get you noticed he assured me because so few people actually keep their commitments.  This is really great advice.  If you volunteer, be sure to follow through.

Will others feel jealous or threatened if you do get noticed in your organization and are identified as an emerging leader?  This could happen despite your best efforts to be both a valued team member and supportive of others.   There is a great quote about leadership to keep in mind if this happens…..“if not you then who, if not now then when”.

 

Healthy Work Environments

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Work Environment A nursing student who is getting ready to graduate in May recently asked me what a healthy work environment should be like. She also wondered how she could tell if a unit environment was healthy when she was interviewing for a position.  These are interesting questions. Today in nursing, we frequently talk about healthy work environments and assume that we have a shared mental model of what that should be.

Key Components of a Healthy Work Environment

At the beginning of this decade, the American Association of Critical Care Nurses made a commitment as an organization to actively promote the creation of healthy work environments.  In their now widely used work, they identified 6 standards for establishing and sustaining healthy work environments.  These included:

  1. Skilled Communication – A nurse’s proficiency in communication is as important as clinical skills.
  2. True Collaboration – Nurses must be relentless in pursuing and fostering collaboration.
  3. Effective Decision Making – Nurses must be valued and committed partners in making policy, directing and evaluating care and leading organizational operations.
  4. Appropriate Staffing – Staffing must ensure the effective match between patient needs and nurse competencies.
  5. Meaningful Recognition – Nurses must be recognized and recognize others for the value that each brings to the work of the organization.
  6. Authentic Leadership – Nurse Leaders must full embrace the imperative of a healthy work environment, authentically live it and engage others in its achievement.

The Evidence about the Impact of a Healthy Work Environment

There is growing evidence in the nursing literature about the positive impact of healthy work environments on staff satisfaction, retention, improved patient outcomes and organizational performance.  Many organizations have launched efforts to improve their work environments. Achievement of Magnet designation is considered to be the gold standard for hospitals who seek to build professional practice environments that are healthy and support the work of nurses. Findings from a growing body of nursing research have provided evidence supporting that Magnet® hospitals have increased patient and nurse satisfaction, improved recruitment and retention of nurses, and improved patient outcomes.

The Role of Nurse Leaders in Building Healthy Work Environments

Although much work has been done to identify what needs to happen in practice environments to maximize the health and well being of nurses, the achievement of these standards has proved challenging for many organizations in the current turbulent health care environment.   The establishment of a healthy work environment requires strong nursing leadership at all levels of the organization but especially at the point of care or unit level where most front line staff work and patient care is delivered.  Nurse leaders can help create a deeply satisfying organizational culture at the unit level by engaging staff in the development of shared values in their work.  This entails a paradigm shift from a more traditional command and control style of staff supervision toward a more transformational and authentic style of leadership.

Signs of a Healthy Work Environment

So how can you tell if a nursing unit has a healthy work environment? Kramer and Schmalenberg made the important observation from their research that only staff nurses can confirm whether initiatives planned and designed to improve the health of a work environment are truly successful.  If you are interviewing or considering employment, some key questions to reflect on include the following:

  • Is the hospital or agency Magnet designated or on the Magnet journey?
  • How much time and energy does the nurse manager/director give to the selection of new staff members?
  • Are nursing staff involved and engaged in the selection process?
  • During unit tours, are you introduced to staff members and what is the response?
  • Are there visible signs of staff achievements/recognition such as postings of certification?
  • How much time is invested in staff orientation?
  • What are the opportunities for professional development?
  • Do staff appear to work well as a team and interact with each other?
  • What is the response to questions that you ask about staffing?
  • Do you have a sense that there is pride in nursing and professionalism in this organization?
  • How is the follow-up communication after your interview managed?

When I walk on units, I do an environmental scan that includes some of the above elements.  I have learned through experience that much can be learned by just observing. The advice that I gave to our student was to consider the above questions and to pay close attention to both the verbal and non-verbal ques in the environment.   Are first impressions sometimes wrong?  They can be but more often they turn out to be a very good indication of what you can expect if you are selected and accept positions.