Mary Carter, on leading through change

December 5, 2003

Why did you become a nurse?

I originally wanted to pursue acting, but my mother (who was a nurse at the Henry Ford Health System) convinced me that becoming a nurse would make me more marketable. Thanks to help from my mother, I was able to conduct my internship on the neurosurgery general practice unit at Henry Ford Hospital and then, after graduating, I went right into ICU-one of the first new grads ever to start in ICU at this hospital.

What has been the greatest challenge of your nursing career?

Recently, I helped bring together two separate eight-bed units (a neuro ICU and a neuro intermediate unit) and transform them into one 16-bed neuro ICU. Bringing these units together was a massive challenge because there was a culture clash in terms of supervision, education, training, authority and gender.

How did you go about the task?

With support from the institution, I hired a consultant and together we developed a series of weekend retreats. We selected 22 employees who were leaders (both formal and informal) and embarked on a comprehensive training and development program to coach them on areas such as conflict management, developing their own mission and learning how to run the unit more like a business. Physicians also participated in the retreats whenever possible.

We also initiated weekly rounds whereby a more novice nurse is paired with an experienced nurse to help assess for learning, discuss diagnoses, research family psychosocial history, etc., in order to create plans of care from the time a patient enters the unit until they leave. The more novice nurse is expected to come fully prepared and make a presentation to his or her peers-this fosters communication, learning and leadership. It's all about leading individuals through the change process and getting their feedback and buy-in along the way.

Have these efforts paid off?

Yes. Our customer (patient) satisfaction has increased remarkably. On this unit, we measure satisfaction weekly to capture as much feedback as possible (as opposed to waiting for the formal quarterly measurements conducted by the overall hospital). We also have developed a true collaborative practice with our physicians. I know you have probably heard those words before-but this is the real thing! Lastly, our unit has dropped from a 75 percent RN vacancy rate to 11 percent in a year and a half-thanks to getting the entire unit to participate in the recruitment process.

What final thoughts would you like to share?

If there is a dream that you are seeking within your career, don't ever feel that it's impossible-it is never too late to pursue your dream. With hard work and determination, you can achieve anything you want. If you love nursing, the sky is the limit.