Meeting Management Skills

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Management All of us have probably had the experience of attending a meeting where there were no outcomes, and the conversation drifted way off the subject of the original intent of the meeting.  Participants leave meetings like this feeling de-energized and perhaps even angry that their time has been wasted.  It can become difficult to maintain enthusiasm and engagement when this occurs.  Unproductive meetings are also costly to organizations in terms of staff time.  Meeting management skills are an important nursing leadership competency.  There is both an art and science to the effective management of team, task force or committee meetings.  Effective meeting management is a very visible way that one’s leadership skills are judged by both peer and supervisors.  Prior to leading any meeting, review the following checklist of questions:

1.  What is the objective or purpose of the meeting?

Effective meetings start with good planning.  Some meetings may be required monthly staff or committee meetings.  These meetings often have set agendas with specific topics/information that is discussed.  Other meetings have a specific purpose such as a review of a sentinel event or selection of a product vendor.  Prior to planning a meeting, you should have a very clear idea of the meeting focus.

2.  Do we need to have a meeting?

This is a critical question, that we often fail to ask.  Think about whether a meeting is the right vehicle to solve a problem, improve a process or establish an action plan.  Could this discussion happen through an email exchange?

3.  Who should be present to provide input?

Nothing is more frustrating than to attend a meeting, and find through discussion that a key player in the decision has not been invited to the meeting.  Carefully think through whose input and buy-in will be needed to move forward with a decision.  To avoid push-back at a later point in time, it is better to err on the side of being inclusive and inviting every stakeholder.

4.  How should the meeting be conducted?

Historically, most organizational meetings have been face to face meetings.  With the availability of technology, this is rapidly changing.  Many health care organizations are now part of larger systems and the meetings will include stakeholders from facilities outside your geographic area.  Meeting leaders need to make a decision about the right format for the meeting.   If video conferencing, telephone conferences or webinars are used,  these plans need to be made well in advance and may involve assistance from technology staff.  Meeting leaders should have some expertise with the technology that is being used to avoid wasting meeting time dealing with technical issues.

5.  What are the critical agenda items and meeting time frame?

Agendas should be established in advance of the meeting and sent to participants for review and comments.  Items to be discussed should be prioritized, and a specific time frame should be allotted for each item.  Think carefully about how much time should be allotted for the meeting.  It can be extremely difficult to maintain the engagement of participants when the meeting extends beyond 90 minutes so keep agendas short.  All material to be reviewed should be sent a week in advance.  A reminder message with the date/time/room number/call-in number with the agenda should be sent out again the day before the meeting.  At the beginning of the meeting, ask if there are any additional agenda items that members would like to add.

6.  What ground rules should be established?

When teams meet for the first time or if you are a new leader to a team, ground rules should be discussed.  Some basic meeting ground rules include the following:

  • Meetings begin and end on time.
  • The time frames on the agenda will be followed.
  • All members are expected to arrive on time so timely discussion can begin.
  • Only one team member should be talking at any given time.
  • All viewpoints should be honored.
  • Everyone needs to participate.
  • Participants should refrain from reading email and checking phone messages.
  • Confidentiality should be maintained depending on the topic of discussion.

7.  What outcomes are expected from the meeting?

It is important to be clear about the outcomes expected from the meeting.  The agenda and time-frames for discussion should be reviewed at the beginning of the meeting.  Good facilitation involves keeping everyone focused and productive.  You may have to stop discussion on an agenda item that has exceeded the time-frame.

8.  What follow-up may be needed?

A frequent problem after meetings is the lack of follow-up on agenda items.  Meeting leaders should wrap up each meeting with a clear statement of the next steps and responsibility for each action item.  Ask members if there are any questions or additional thoughts.  The need for a follow-up meeting with possible dates/times should be discussed.  The discussion during the meeting should be recorded, and a summary of the meeting should be sent to each participant shortly after the meeting.  As leader, your actions after the meeting are crucial to maintain the enthusiasm and energy of the group. Team leaders should attempt to follow-up with each participant who has an action item to check progress and provide help.

To improve your leadership of teams, consider asking your committee or team to debrief the meeting process.  Ask what was effective and ineffective about the meeting, and their thoughts about the progress of the team.  As the meeting leader, try to be inclusive of everyone on the team, and ask questions of those who might be attending by phone.  End all meetings on a positive note thanking everyone for their time and active participation.

Your ability to effectively manage meetings will develop over time.  New leaders sometimes do lose control over meetings.  If this happens to you, don’t become frustrated.  Take time to go back through these meeting management questions and reflect on how you will do it differently the next time.

 

Self-Care for Nurse Leaders – 5 Lessons Learned

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nurse leaders In today’s healthcare environment, it can be challenging for nurse leaders to maintain a healthy balance between the demands of their work and their own needs for rest and recharging.  During one of my research projects, I interviewed a new nurse manager who confessed to me that she was working 12-14 hours each day and sometimes slept in her office.  I stopped the interview. I talked with her about how she would not be able to maintain this pace of work, and would soon burn herself out.  This can be a difficult to convey to new leaders who are trying to make a great impression and meet all their role demands.  Here are 5 lessons that I have learned about self-care from my research and work with nurse leaders:

1.  Rest is an investment in yourself, your team and your future.

We know from work studies involving nurses that a lack of rest leads to fatigue, problems with concentration, difficulty controlling emotions and poor decision making.  Leaders too experience these problems when they work long hours and stimulate themselves with caffeine to keep going.  Caring for self is not selfish behavior on the part of leaders.  This investment in rest will actually make you feel better, be more alert and better able to process the many challenges that leaders confront today.

2.  Recharging your battery will make you a better leader.

Leaders sometimes worry about what will happen if they take time off.  The reality is that recharging your battery will both make you a better leader and reduce the likelihood of role burnout.  Taking periodic planned vacations is very important.  This recharging of your mind, body and emotions allows you to be at your best so you can be of service to others.  Over the course of their careers, nurse leaders learn that life and work moves on even in their absence.  Wise leaders know that often the strongest gauge of their leadership is how well they have developed others to function when they are not there.

3.  Find an activity outside of work that brings you self-renewal.

Leaders should take the time to find at least one activity outside of work that quiets your mind, soothes your soul and re-energizes you.  This activity could be meditation, yoga, walking, reading, cooking or prayer.  The choice of an activity is highly personal. It should be something that enhances your well-being and something you can commit to doing frequently.

4.  Make time to reflect on how you use your time and energy at work.

During a 2005 commencement address, Steve Jobs the now deceased CEO of Apple spoke about how remembering that he would soon be dead is the most important tool that he had encountered to help him make the big choices in life.  He told these graduating students that “all external expectations, all pride, all fear of embarrassment or failure – these things just fall away in the face of death, leaving only what is truly important.  Remembering that you are going to die is the best way I know to avoid the trap of thinking that you have something to lose.  You are already naked.  There is no reason not to follow your heart”.  This is good advice for nurse leaders who sometimes believe that their units or departments cannot function without them or are hesitant to change their work patterns.  Time in self-reflection is an important step in learning how to re-balance your work and life.

5.  Leaders set the example for self-care on their teams.

In talking with younger nurses, they will often tell me that they are concerned about taking leadership positions because they see the imbalance in the life of their own leader.  Leaders set the example for self-care.  If it appears to your staff that self-care and leadership are mutually exclusive from observing your behaviors, then this will be the impression that they have about leadership.  To achieve a healthy work environment, leaders need to promote the idea of self-care and role modeling is a powerful way to do this.  Attention to our own self-care will both keep us vibrant and establish it as a strong value in our work culture.

 

The Dilemma with the 12-Hour Nursing Shift

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12-hour In politics, the term third rail is a metaphor for any issue so controversial that it is considered to be highly”charged” and “untouchable”.  Social Security in the United States is an example of a political third rail.  Anyone who dares to discuss these third rail topics will receive enormous push back.   I believe that 12-hour nursing tours is a third rail issue in nursing today.  Nursing leaders have concerns about the widespread use of 12-hour tours and their impact on patient safety.  Today’s nursing workforce grew up with the work-life balance freedoms that the 12-hour tour provides.  Any discussion of their elimination or reduction evokes passionate arguments on both sides of the issue.

The Beginning of the 12 Hour Tour in Nursing

Nurses did not always work 12-hour tours.  They were introduced in the 1980s during a serious nursing shortage as a strategy for improving working conditions for nurses.  Initially, they were used only in specialty units such as critical care and the ER.  Over time, use of 12-hour tours spread to most units in acute care facilities. Schedules shifted from 5 days per week to 3 days per week followed by two to five days off.  Nurses quickly came to appreciate having more time off and the reduction in their commuting expenses.  Nurses were able to increase their income by working overtime or Per Diem on their days off.  Today in hospitals, 12-hour tour scheduling is the most common staffing pattern in use.  In some settings, there is no other option.  A significant percentage of the nursing workforce has never worked a schedule other than a 12-hour tour.

A troubling picture is emerging from the research on 12-hour tours that is becoming difficult to ignore.  Twelve-hour tours may be great for nurses, but it appears that they may not be in the best interest of patient care and outcomes.

The Evidence about 12-Hour Tours

The research question that drives most studies looking at 12-hours is whether nurses can work more consecutive hours without any adverse impact on productivity, quality and safety.  Geiger-Brown & Trinkoff (2010) are two faculty members at the University of Maryland who closely study these issues.  They have determined from their research and a review of the evidence globally that the answer is no.  Surprisingly, they found that nurses who worked 12-hour tours averaged only 5.5 hours of sleep between shifts and that sleep was fragmented.  They contend that there is research to support that the likelihood of a nurse making a mistake is 3 times greater for nurses who work 12 hour tours versus 8 hours.  Their recent research indicates that mortality for selected conditions like pneumonia were higher in hospitals where nurses reported longer shifts.

The complexity of acute care environments has significantly increased over the past decade resulting in ever increasing demands on direct care nurses.  On blogs where nurses discuss 12-hour shifts, many are acknowledging their fatigue and mental exhaustion during these shifts.  With an aging nursing workforce, these are important concerns.  Nurse leaders have expressed concern for years that the increased issues with communication and fragmentation of care in acute care environments are partially attributable to 12-hour tours.  Although their are fewer hand-offs on these tours, nurses rarely work with the same team members and often don’t take care of the same patients.  Nurse managers struggle to keep staff who work only a few days a week updated about changes in policies and procedures.

The Dilemma

For the 12th year in a row, nurses have been voted as the most trusted profession in Gallup’s ranking of professional groups on their honesty and ethical standard.  Patient’s and their families depend on nurses during life crises to care for them.  If a piece of medical equipment or a nursing procedure was known to endanger patient safety – we would quickly work to fix the problem.  The evidence is mounting that 12-hour tours need to be reconsidered or modified.  Nurse leaders have hesitated to act because of concerns about retention of staff and possible nurse staffing shortages from nurses who have second jobs on their days off.  Nurses themselves acknowledge that there are issues with the 12-hour shift but are reluctant to change their lifestyle.  So the dilemma is where do we go from here.  This can’t be nursing’s third rail.  It is really up to nurse leaders to talk with staff about the issues involved with 12-hour tours, nurse fatigue and patient safety.  There may no perfect solutions to this dilemma but the conversation needs to begin.

 

What Nurse Leaders Should Stop Doing

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Nurse Leaders Knowing what leadership behaviors to practice is important, but it is equally important to consider behaviors that you exhibit that are not helpful to your team.  I remember a number of years ago working with a leadership colleague who always wore a rubber band on her wrist.  She used the rubber band to remind herself to listen to the viewpoints of others at meetings versus jumping in with her ideas in an aggressive way.  She snapped herself with the rubber band when tempted.  It was a powerful reminder of a behavior that she needed to stop.

Here are 10 key things that Marshall Goldsmith, a well recognized leadership coach, urges leaders to stop doing:

1.  Adding too much value

Sometimes nurse leaders feel compelled to to comment on every situation, add their opinions to every conversation or wordsmith every document they are given to review.  We don’t need to do this.  Our co-workers and team find this behavior annoying.  My friend who wore the rubber band on her wrist recognized that she did have this problem.  The rubber band helped her to stop and ask the question as to whether the comment she was about to make would add some value to the conversation.  Learning when to say nothing and let others talk is a skill that many leaders need to develop.

2.  Passing judgement

Many good ideas are never implemented because nurse leaders are too quick to pass judgement on the idea or the person.  Staff will stop offering suggestions if they feel that their leader will shut down the discussion.  In today’s environment, some nurse leaders pass judgement on the values, beliefs and attitudes of their diverse workforce without trying to understand the viewpoints of others.

3.  Passing the buck

Some nurse leaders present changes in policies or procedures as decisions that are entirely outside of their control that have been imposed by out of touch administrators.  Often there are good rationale for changes that staff are not educated about.  Interestingly leaders who do this are viewed as being powerless in the eyes of their staff.

4.  Starting with “No”, “But”, or “However”

Some leaders shut down discussion with the use of words like no, but or however.  The message to the other person is not that they have a different opinion but rather that they are wrong.  Marshall urges leaders to monitor their own conversations to see how often they use these words and advises that it can be real eye opener.

5.  Speaking when angry

Emotional volatility is not a good management tool.  Nurse leaders must learn to control their anger even in very difficult conversations.  Leadership reputations can be severely damaged when leaders have an angry emotional response to a situation.  It is far better to say nothing or walk away from the other person with the words that you need time to think about what has happened.

6.  Withholding information

Some nurse leaders falsely believe that information is power.  This can work in the short run to maintain an advantage over someone else but it rarely works in the long run.  Withholding information breeds distrust.  In today’s environment, our younger generations of nurses look for transparency and want information shared with them.  Sharing information will in fact make you a more powerful leader.

7.  Failing to give proper recognition

All staff want to be valued for their contributions to the work of the team.  When leaders fail to say thank you or take the recognition for themselves, staff feel devalued.  Marshall observes that successful people become great leaders when they shift the focus from themselves to others.

8.  Playing favorites

It is natural that nurse leaders may feel closer to some staff than others.  What is important as a leader is to be fair and to discourage behaviors that appear to others as “fawning over you” to engender favoritism.  Sometimes nurse leaders play favorites with staff that are not their top performers, and this tilts the field against honest, principled employees who won’t play along.

9.  Multitasking instead of listening

Nurse leaders have extremely challenging and busy roles.  The most passive-aggressive form of disrespect for a staff member is to continue multitasking (reading email, answering phone calls) when they try to have an important conversation with you.  An interesting thing about listening is that people don’t notice when you do it, but are certainly aware when you are not listening.

10. Failing to express gratitude

Thank you is a magical gesture that some nurse leaders don’t use enough.  There is nothing more disheartening to staff than to be short-staffed, work hard and hear nothing from their leader.  An attitude of gratitude is important in leadership.

As leaders, all of us have things that we do well.  Most of us also have annoying habits that we need to stop doing.  It is these behaviors that hold us back from being even greater leaders.  Take time to review the list above, and honestly ask yourself if there is anything on this list that you need to stop doing.  Marshall Goldsmith advises that if there is, start working on it and hold yourself accountable to change.

 

Your First 100 Days in a Nursing Leadership Position

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100 days When you are selected for a leadership position that you really want, it is very exciting.  While celebrating career success is important, many leaders don’t give enough thought to how to manage their own transition to the role.  How you spend your first 100 days in a leadership position can help set the stage for the rest of your tenure in the role.  Those you lead closely watch how you orient yourself to the organization, how you spend your time and what relationships you begin to build.  Five key activities that you will want to build into your action plan include the following:

1.  Learn as much as you can about the department and organization prior to your first day

Carefully study the website of the organization 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 know the role of leadership in promoting a healthy work environment.

2.  Meet with all your direct reports

Whenever there is a change in leadership, nursing staff will worry about how a new manager will affect them.  A key success factor for the new nurse leader is to be proactive in alleviating this concern by scheduling a meeting with each staff member during your first 100 days.  These meetings will provide you with an opportunity to build a relationship with each staff member, find out about their concerns and seek support from them.  Some good questions to ask during these meetings include the following:

  • What are three things that you are proud of about this unit/department/organization?
  • What are three things that we need to change?
  • What do you most need me to do as your leader?
  • What are you most concerned about that I’ll do?
  • What advice do you have for me?

3.  Gain trust by listening and observing

To gain the trust of staff, you need to avoid rushing to judgement about “what is wrong”  based on your observations.  At the same time, you do need to take note of what you see.  Listen during your conversations with staff and carefully observe what happens on the unit when you make rounds.  During the first 100 days, new leaders should also reach out to stakeholders including patients, interdisciplinary team members and other department leaders.  They will provide you with important insights into your work setting, and you will want to build strong working relationships with them.

4.  Learn the culture and politics of the organization

Every organization has a unique culture and organizational politics.  New leaders can damage their credibility by being insensitive to the politics of the unit and organization.  You may have grown up in another organizational culture that has become so familiar to you that it is like the air that you breathe.  When you come into a new culture with different norms, the differences can be profound.  Take time to learn the norms.  A good example of this involves meetings.  Meeting norms, behaviors and standards vary widely across organizations.  In some organizations, meetings are very formal while in others, they are casual and informal.  Take time to observe, adapt and learn.  New leaders can alienate members of their organizations by talking excessively about how things were done on their previous units, so avoid doing this.

5.  Find a Mentor

You will want to build strong relationships with your staff but remember that they are not your leadership peers.  You should not use members of your staff as sounding boards particularly when the topic is confidential.  Look for an experienced leader in your organization who can help mentor you during your transition.

6.  Avoid Acting too Quickly

Wise nurse leaders don’t announce huge changes during their first 100 days and don’t turn their departments upside down.  It is important to let staff know that you have high standards and expect their best work.  You can lower the level of what you expect if it turns out the demands are too high but it is almost impossible to raise it if you have started too low.

For many new leaders, the first 100 days will be challenging but exhilarating.  What if your feel during this first 100 days that you have made a mistake accepting the leadership role?  This is a difficult question to answer because you may feel overwhelmed during these first 100 days, but it may not be a good indication of how you will feel in six months.  If you feel you have made a mistake, it is important to have the courage to discuss the situation with your supervisor.  It is often said that success is becoming who you already are.  Using this first 100 days to build this success will set the stage for a great leadership career.

 

5 Steps to Finding a Nurse Leader Mentor

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Nurse Leader You may know that you want to be a nurse leader but are unsure about your next career step.  A good mentor can open doors to new learning and help you grow as an emerging nurse leader.  Unlike the preceptor relationship which you may be familiar with in the clinical setting, a mentor provides career guidance and help you become more aware of your strengths and areas where you need development.  Mentoring is an important career strategy.  An ideal mentor for an emerging nurse leader is someone who is knowledgeable, has leadership experience and is interested in helping you to grow.

Finding the right mentor can be challenging.  Although some organizations have formal mentoring programs and assign mentors, research shows that you may receive the best mentoring experience if you find your own mentor.  As you begin the process of trying to identify who might be the best mentor for you, use the following 5 steps:

1.  Ask yourself what you want from a mentor and the mentoring experience.

Before you approach anyone to mentor you, it is important to think about what you want from the mentor.  Are you looking for career guidance, personal development, a shadowing experience, networking opportunities or guidance on how to handle a difficult professional situation?

2.  Reflect on your own preferences

It is important to choose a mentor that you will find easy to talk to and be with so think about what personality type complements your own.  Identify your own strengths and weakness and look for a mentor who has traits that you would like to develop in yourself.

3.  Decide what qualities you want in a mentor

A nurse leader mentor should be someone that you admire and feel is an excellent role model for professional behavior.  He or she should be an excellent listener and someone who will be honest with you.   Although your mentor can be of any age, someone who is 5 to 10 years ahead of you in their nursing leadership journey can provide the best guidance.

4.  Consider availability

Although you may be tempted to choose a nationally known leader to mentor you, it is important to consider geographic proximity.  Think about the ease of getting together to talk.  You will also want to think about whether you want a mentor from within the organization where you currently work.

5.  Make a list of potential mentors

As a last step, identify potential mentors who match the requirements that you have identified above.  Think about nurse leaders you have worked with or nurse leaders that you have met in professional organizations.  Ask others for suggestions.   Learn as much as you can about the mentors that you are considering.  Don’t assume because they are nationally known that they wouldn’t be interested in mentoring you.  It never hurts to ask.

Following Up

Once you have identified a possible mentor, ask him or her to lunch to discuss the idea of mentoring.  The personal approach is always best but if they don’t live geographically close, you can make your request by email, letter or telephone.

Prepare good questions to ask during your initial meeting.  Explain why you have chosen them and what type of support you need.  Remember that mentoring is a two-way street so talk about what you will bring to the mentoring relationship.

If the mentor turns you down, don’t take it personally.  This happen to me early in my career and initially, I felt hurt by the response.  I later realized that this mentor had many responsibilities that would have prevented her from being a good mentor.  Be sure to say thank you for considering it and ask for other suggestions for mentors.  Managing awkward situations well will make a good impression on the nurse leader even if he or she does not mentor you.

Following Through

It is important to respect your mentor’s time.  Set an agenda for each followup meeting and set a timeline for the goals that you mutually establish.  If the mentor offers suggestions, be sure to follow through on them.  Be willing to do some stretch assignments that demonstrate that you are committed to the mentoring experience.

A good mentor will push you out of your comfort zone and help you achieve bigger things than you ever imagined for yourself.  Be sure to show appreciation.

During the course of your career, your mentoring needs will change and you may find yourself changing mentors several times.  At some point in your career, it will be your turn to give back.  Mentoring is a gift and one that hopefully you can eventually pass on by mentoring others.

 

Courage in Nursing Leadership

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Leadership In the past, courage has not been recognized as an important attribute for nurse leaders.  This is changing.  In my recent conversations with current nurse leaders about what our future nurse leaders will need, the ability to act courageously is increasingly part of the discussion.  Without question, innovation is needed in health care  systems globally.  It is courage that makes change possible.  Rosabeth Moss Kantor in a recent Harvard Business Review article wrote that ” moral courage enables people to stand up for principle rather than stand on the sidelines”.  Consider in your own work all the times that staff may know something is wrong but don’t speak up.  In this month’s Hospitals and Health Network magazine, Mark Classen the President of the Joint Commission Accrediting Organization in the United States estimated that there are still 40 wrong site surgeries a week being reported.  This is in spite of numerous safety initiatives put in place throughout the country.  In some of these situations, the surgical checklist was not followed or other shortcuts occurred  and the nurses involved did not speak up.  Truth-telling is an important part of patient safety that we often don’t discuss.

What is Courage in Leadership

Courage in leadership is doing what is right, despite being afraid or risking negative repercussions.  Fear is the most common common reason that people give when they avoid being courageous.  Think about how you feel when you watch a leader who demonstrates personal courage.  Most likely, you will trust that leader more.  Courage comes from feeling very deeply about important values and working to achieve goals that are consistent with those values.  Although sticking to the status quo may be tempting, this is not how change occurs.  Every leader ultimately has the choice to either lead with courage or lead without it.  Taking a risk in situations where you feel passionately or a deep sense of purpose does not guarantee a successful outcome.  But many leaders over the course of their careers have situations where they did not speak up and later deeply regret it.

Examples of Courageous Leadership Behaviors

  1. Providing honest feedback in conversations and discussions.
  2. Sharing alternative viewpoints to the rest of the team.
  3. Speaking up rather than being compliant in silence.
  4. Not settling for “we have always done it this way”.
  5. Making decisions when you are in uncharted territory and the safe path is to do nothing.

Developing Courage

The first step to becoming a more courageous leader is to be very clear about your own vision and values.  When you choose to be courageous, it is important to know what your goals are in the situation and what you hope to achieve.   Scripting in advance what you are about to say can be helpful and anticipate the  people who will disagree with your message most.  To be courageous, you must also have the honesty to admit when you have made a mistake or took a wrong path.  Telling staff that you were wrong in a situation is a powerful act of leadership courage as is the willingness to entertain new ideas and change your assumptions.  Courage is a learned skill and all of us have the capacity to be courageous.  To be courageous means stepping our of your comfort zone and taking the risk.  As we move into the future, we will need innovation in nursing and health care that is both ground-breaking and tradition defying. Keep in mind, most great ideas begin in situations where there are naysayers who believe that it cannot be done until it happens.

 

Do You have what it takes to be a Nurse Leader?

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Nurse You may be wondering if you have what others look for in their leaders.  If we look at the research that has been done both in nursing and the business world, followers do look for certain attributes in their leaders that help inspire confidence.  So ask yourself these 10 questions.

1.  Am I seen by co-workers as someone who has integrity?

Integrity is a fundamental leadership attribute.  Nurses expect to be able to trust their leaders.  Followers become very insecure when trust breaks down in the work environment.  When leaders are inconsistent in their expectations or if they don’t role model the behaviors that they expect of their staff, trust is compromised.

2.  Am I empathetic towards others on my team?

Empathy is defined as the ability to be sensitive to the needs of others.  Most nurses have no difficulty being empathetic with patients but may behave very differently with their team members.  Combined with integrity, empathy helps to drive trust.  It gives followers a sense that their interests are being looked after, and this helps to create positive energy.  Followers who sense that a leader appreciates them are motivated to carry out their responsibilities in a more committed way.  Nurse leaders must show that they care for their staff if they expect staff to care for patients.

3.  Do I have the respect of my peers?

It is often said that the essence of leadership is the ability to influence the thoughts and behaviors of others.  To achieve influence, leaders must be respected.  Respect by one’s peers is something that needs to be earned.  In a leadership role, you will be given formal authority but will need respect to win the hearts and souls of your followers.

4.  Do I demonstrate emotional intelligence?

While it has always been important for leaders to be knowledgeable about their work, the importance of emotional intelligence in leadership is now considered to be equally important.  Emotional intelligence (EQ) can be described as self-mastery or the ability to understand and control what we feel (our emotions) and the way we act (our response to these emotions).  It is about self-awareness, self-management, social-awareness and relationship management.  It is also about maintaining a keen sense of awareness of the emotions of others.  This is not always easy to do in high stress environments but leaders with a high EQ are more effective.

5.  Can I create a vision that lends direction to the work of the team?

Members of high performance teams want to be led by leaders who have a clear sense of direction in their work.  Cohn and Moran describe visionary leaders as “good storytellers who are capable of weaving together interesting connections”.  In nursing, this vision should include the ability to see the connections in the system of care rather than simply focusing on the impact on one unit or department.

6.  Do I have good judgement?

Good judgement means that leaders are able to make good decisions.  We know how important critical thinking and the ability to respond rapidly to crisis situations are in clinical settings.  These same traits are important when making leadership decisions.  Although good decision making may sound simple enough, the origins of how and why people make the decisions that they do is often very complex.  For nurse leaders, good decision making is the ability to zero in on what is important in a situation and take decisive action in a timely manner.

7.  Do I have the courage to face conflict?

Conflict is an inevitable part of work-life and this is especially true in health care settings where the level of stress can be very high.  Being a leader means being on the frontline of those conflicts.  If you are like many nurses, you may tend to avoid conflict.  Avoiding conflict can lead to the escalation of problems.  Leaders need to learn to confront conflict directly and develop strategies to effectively mediate conflict.

8.  Am I a Self-Starter?

In a staff nurse role, your day is often drive by the many tasks that need to be done to care for patients.  Nurse leaders have considerable responsibility and accountability but their time is not structured in the same way as it is in a staff position.  For many new nurse leaders, this is one of the most difficult parts of the transition to a leadership role.  To accomplish your goals, you must not only be organized but you will also need to be a self-starter who tackles the issues that are presented.  You cannot expect to always wait for direction from those higher in authority.

9.  Can I stay positive and resilient in a changing environment?

Health care today is in a constant state of change.  This is a global phenomena and is unlikely to change.  Nurse leaders must be able to live with the ambiguity that inevitably occurs when there are rapid changes in the environment.  There are often not clear cut answers to questions that staff and patients may have about the future.  The ability to remain positive and keep your team focused on the mission and goals of the organization are critical skills.

10.  Do I have a passion for nursing and can I inspire that passion in others?

A leader’s passion or drive is important because it creates positive energy.  Nurse leaders should be professional advocates.  They also need to look for ways to inspire their team.  Marcus Buckingham in his well-respected book ,First Break all the Rules: What the World’s Greatest Managers do Differently, outlining research with 80,000 managers observed that great leaders are able to find what is unique in each of their employees and help them to use their gifts to do great things.

 

Does Clinical Experience Matter in Nursing Leadership?

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Nursing How many years of clinical experience should I have before I seek a leadership position?  This is a question that I am frequently asked by novice nurses who are considering a career as a nurse leader.  My response is that there is no one right answer to this.  It would be easy to make a recommendation if a certain amount of time spent in clinical practice easily translated into superior performance as a leader but this is not true.  While it is true that clinical experience is important for leadership credibility in a practice discipline like nursing, it cannot be viewed in isolation without considering the ability and temperament of the individual.

Paying Your Dues – An Old Leadership Paradigm

Historically, clinical experience has always been an important criteria in the selection and career progression of nurse leaders.  Many current nurse leaders were selected for their positions based on their technical expertise.  Experience has generally been measured in terms of “years of experience”.  While at one level, it might seem logical that a nurse with five years of experience is a better candidate for a leadership position than a nurse with three years of experience, this is not always the case.  What a nurse really does within that time frame is often much more important.  In addition to working clinically, the nurse with three years of experience may have returned to school and begun graduate coursework, achieved certification or perhaps became a member of a key nursing committee.  The nurse with five years of experience may be just “doing the job” without any other professional enhancement or leadership development.  I have recently spoken with a number of nurse leaders on this topic to find out how they handling the issue of clinical experience in selection for leadership positions.  Most have told me that they use Patricia Benner’s Novice to Expert Framework to guide their decision making.  In this framework, nurses move along a continuum of practice from novice to advanced beginner to competent to proficient and some go on to become experts.  Progression to the competent stage which generally takes about three years but can happen sooner was felt to be essential for movement into a leadership position.

Leadership Aptitude and Interest – The New Leadership Paradigm

Beyond clinical experience, nurse leaders today look for candidates with leadership aptitude based on experience as a charge nurse or other unique experiences.  With the increase in second degree programs in nursing, some nurses today with relatively few years in nursing bring rich leadership experiences and skill sets from previous careers.  Looking for candidates who have a genuine interest in leadership is now crucial for organizational leadership succession planning.  Generally, nurse leaders seek positions in their own areas of clinical specialty expertise.  As their leadership careers progress, they may think about applying for leadership vacancies outside their traditional clinical comfort zone.  With the financial challenges in health care today, some organizations are merging clinical areas and the leader’s span of control may include specialty areas where they have no experience.  Thinking about leadership as a specialty area may be a way to frame your decision making on this topic.  With beginning leadership roles, it is probably wisest to stay in your clinical area of expertise.  As you develop competency and confidence as a leadership, you can consider and may be asked to take on new challenges where you need to build some clinical competency in the areas that you supervise.

If you are just beginning your nursing career and are considering applying for a leadership role but worry about whether you have enough clinical experience, ask yourself the following questions:

Key Questions

  • Am I confident about my clinical skills?
  • Do I have the respect of my peers?
  • Am I comfortable asking questions when I don’t know something?
  • What are unique leadership strengths and talents do I have?

 

Five Great New Year Resolution Ideas for Emerging Nurse Leaders

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Nurse Leaders It is not unusual to establish goals for ourselves both personally and professionally that we hope to achieve during the year.  There is good research to support the fact that the act of writing down goals is the first step to the successful achievement of those goals.  You may have a goal to return to school for a bachelors or master’s degree, achieve specialty certification or update your resume to make yourself more competitive when interesting positions become available.  For many of us, we never move past the phase of thinking about what we would like to achieve in the future.  Here are five New Year’s resolution suggestions for emerging nurse leaders:

1.  Challenge yourself to make at least one personal sacrifice this year for your long-term career success.

The idea of giving something up especially personal time, to achieve something better at an undetermined time in the future can seem very unappealing.  One truth about leadership is that it does not come without personal sacrifice.  This year, think about doing at least one thing that will advance your professional career but will require an investment of your personal time.  If you have avoided advancing your education to achieve long-term professional goals, this is the year to stop being defensive about what you have not done and to focus on what you will gain by beginning the journey.  If you are interested in nursing leadership but have resisted taking a charge nurse role, this is the year to say yes.  If you have thought about taking a certification exam in your nursing specialty but never began the process, this is the year to do just do it.  Begin to see success as something that you need to incorporate into your life.  You may not always be successful in achieving your goals even when you sacrifice but even these failures can provide tremendous growth.

2.  Commit yourself to become a continuous learner.

It is often said that the best leaders are the best learners.  This is especially true for nurse leaders who work in a health care environment that is rapidly changing in unexpected ways.  We know as a professional discipline that our practices should be based on the best current evidence available but often they are not because we don’t commit ourselves to reading journals, doing internet searches or attending professional programs.  Challenging yourself to grow and learn is a professional and a personal responsibility.  Many health care organizations today provide great learning opportunities but what is often disappointing is how few staff take advantage of those opportunities.  Outstanding leaders commit themselves to learning whether or not their organizations are paying for it or providing them with paid time off to do it.   What works for one person may not work as well for another.  The key is to find the way that you learn best and commit yourself to engage in learning on a continuing basis.

3.  Find a mentor.

You may know that you want to be a nurse leader but are unsure about your next career step.  A good mentor can open doors to new learning and help you grow as an emerging nurse leader.  Unlike the preceptor relationship which you may be familiar with in the clinical setting, a mentor provides career guidance and help you become more aware of your strengths and areas where you need development.  Mentoring is an important career strategy.  This is the year to look for that person.  Use the strategies provided in an earlier blog – Five Steps to Finding a Mentor

4.  Help to build a healthy work environment in your work setting.

Mahatma Gandhi is often quoted as saying “be the change that you want to see in the world”.  Building a healthy work environment is not only an organizational responsibility but also the responsibility of every staff member that works in the setting.  Great leaders work hard to build strong, positive cultures.  Even if you are not currently in a leadership role, you have the choice whether to engage in negative discussions and behavior in your environment.  What is true is that the more that we focus on the positive aspects of our environment, the more we will notice them and start experiencing them in our work life.

5.   Volunteer to coach a new graduate in their professional transition.

Every year thousands of new nurses enter practice with enthusiasm and passion for the profession that they have chosen.  They are the future of nursing and may someday take care of you or one of your family members.  All of us were once novice nurses.  We would not be where we are today without having experienced the challenges of being a novice. New graduates often become frustrated and disillusioned as they experience the real world of health care.  Good coaching can make a significant difference in both reducing the frustration often felt by new graduates and retaining them in their initial work settings.  Coaching our novice nurses is a responsibility that all professionals in nursing share although many nurses today feel burned out and are unwilling to make this commitment.  This year commit yourself to volunteering if asked and remember that your contribution to coaching future generations of nursing may have a much longer and more profound effect than anything else that you do as a professional.