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| Making
a difference |
| John
DeBoer, a Southern California nursing student,
knows he would like someday to work with
a nursing association and become a nurse
leader.
When he graduates in May, DeBoer plans to
work as a nurse in the Navy. After that,
he said, he isn’t sure what course
his nursing career will take. He has a minor
in business and might go into administration.
But he also is considering running for office
or working as a lobbyist.
“I want to give to nursing and to
raise the level of the nursing profession,”
said DeBoer, immediate past president of
the California Student Nurses Association
and a nursing student at Point Loma Nazarene
University in the San Diego area.
For DeBoer and a growing number of nurses,
that doesn’t necessarily mean going
into management.
“Leadership to us does not mean management
or administration,” said Linda Finke,
RN, PhD, director of the Professional Development
Center for the Sigma Theta Tau International
Honor Society of Nursing. “The most
important thing is promoting the idea that
you can be part of making a difference.
You can make things change for the better.”
Two Sigma Theta Tau leadership programs
focus on mentoring and on changing policy.
One pairs nurses now sitting on boards,
such as the American Heart Association and
the American Red Cross, with nurses who
are interested in becoming board members.
“Many of us who sit on boards are
sort of learning by the seat of our pants,”
Finke said. The year-old program lets seasoned
board members share their experiences with
newcomers.
A second program provides mentors and resources
for aspiring nurse leaders around the world.
Many times these leaders are staff nurses
who want to change or set new policies to
help their patients, Finke said. For instance,
a nurse in Greece used the program to help
establish visiting hours in a hospital that
didn’t have them. Staff nurses at
another hospital developed end-of-life guidelines
for people with lung disorders.
A few years ago, the American Organization
of Nurse Executives changed its bylaws to
create a membership category for “aspiring
nurse leaders” to attract nurses interested
in leadership, said Pamela Thompson, RN,
MS, chief executive officer of the organization.
Under this category, any nurse interested
in the concept of leadership can join the
organization, she said.
“You have to encourage people about
what they want to do with their future long
before they get into a leadership position,”
she said. The organization is working to
change its bylaws to include student memberships,
she said, and during the last year and a
half, it has been working closely with the
National Student Nurses’ Association.
Originally, DeBoer said, he had thought
of eventually becoming a nurse anesthetist
after his Navy service. But after becoming
president of the student nursing association
and working closely with the Association
of California Nurse Leaders, he became excited
about taking a leadership role. No matter
what happens in his career, he said, he
plans to keep working with nursing associations.
He has shared his enthusiasm with his fellow
students, he said, but “there are
only a few that really get involved. I try
to explain about the profession and giving
back to nursing, but I don’t know
if they see the big picture.”
Cathryn Domrose
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The workload has increased over the years, and
nurse leaders feel pressure from demands that
sometimes conflict. Young people may overlook
the rewards of the job and see only the pressure
and time demands, Thompson said. “This is
not a highly attractive job because of the stress.”
About 20 years ago, nurse managers had more time
to identify and mentor young nurses in part because
there were more managers to go around, said Frank
Shaffer, RN, EdD, FAAN, president of the education
and training division and chief education officer
of Cross Country University, which offers “boot
camp” training programs for new nurse managers.
Assistant manager positions allowed potential
leaders to try out a less stressful management
position under the guidance of an experienced
manager. “We didn’t call it succession
planning then because we didn’t know that’s
what it was,” he said.
But in the cost-cutting frenzy of the 1980s and
early 1990s, many hospitals eliminated middle
management positions and education programs for
them, Shaffer said.
At the same time, many nursing schools began
switching to advanced degree nurse practitioner
programs and eliminating their administrative
tracks. The managers who kept their jobs were
given more units and more responsibility, including
advanced financial planning—something they
hadn’t covered in nursing school.
Many became overwhelmed and frustrated, unable
to find time to do their own jobs let alone mentor
and groom someone else. An advisory board study
found that 61 percent of nurse managers considered
leaving their roles in the past 12 months and
less than one-third reported they were satisfied
with their jobs.
Jeanna Bozell, RN, a former nurse recruiter and
founder of NurseQuest and the author of A Nurse
Leader’s Little Instruction Book, said she
recently heard about a staff nurse who had been
put in charge of a unit after two weeks’
orientation.
“She just couldn’t handle it,”
Bozell said. The nurse returned to being a staff
nurse and didn’t go into management again.
“I know that happens quite frequently,”
said Bozell, who is based in Muncie, Ind. “They’ll
take these wonderful shooting stars that are RNs
with excellent clinical skills and put them in
a leadership role with little or no preparation.
They set them up to fail.”
Appetite for learning
Many of those who do manage to stick it out are
desperate for education, training and resources,
say those who educate and train nurse leaders.
Catherine Robinson-Walker, MBA, president of The
Leadership Studio in Oakland, Calif., has worked
with nurses in leadership development since 1980.
When she offers weeklong or weekend training
seminars for nurse leaders, she is always amazed
and gratified by the response. “People really
love it. It’s so great to teach them, they
really are hungry,” she said. “They’ve
been trained to be great clinicians, but almost
none of them have much leadership training.”
Nursing coalitions and some hospitals and health
care organizations are responding to the cry for
information and support from nurse leaders. Shaffer’s
Nurse Manager Boot Camp, based in Tennessee, is
an intensive five-day program that covers staff
management, leadership, financial management,
culture and organizations, and career and staff
development.
About two years ago, the Pacific Northwest Nursing
Leadership Institute, sponsored by a number of
nursing groups and medical facilities, began offering
a leadership program in Seattle. The program consists
of a two-day class followed by eight full-day
seminars once a month.
Students work on a project with a sponsor from
their organization, which they present at the
end of the session. Projects included creating
a falls prevention program, a process for purchasing
surgical supplies and a detailed orientation book
for RNs on the orthopedic floor.
All the projects address some challenge the managers
are facing in their workplaces, said Sally Watkins,
RN, MS, vice president and chief nurse executive
for Multicare Health System, administrator for
Tacoma General Hospital and president-elect of
the Northwest Organization of Nurse Executives.
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