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| Big
shoes to fill |
| Will
there be enough new nurse leaders to step
into the shoes of those who do the job now?
“That’s up to us,” said
Catherine Robinson-Walker, MBA, president
of The Leadership Studio in Oakland, Calif.
“If we do a good job, we could solve
this problem.”
Robinson-Walker, who has worked with nurses
in leadership development since 1980, helped
create the California Foundation for Leadership
Excellence program under the Association
of California Nurse Leaders and the California
Institute for Nursing and Healthcare.
Administrators of health care organizations
who want to attract and develop strong nurse
leaders and potential leaders should ask
themselves these questions, Robinson-Walker
suggested:
> Does
the culture of the health care organization
support nurse leaders and the decisions
they need to make as they balance clinical
and business objectives?
> Is the reputation
of the leadership team and the organization
a good one on the street? Magnet hospitals
are obvious examples of well-regarded institutions,
but non-Magnet hospitals can develop reputations
as places where patients receive excellent
care and employees are respected and involved
in decision-making.
> Does the organization
have a process to assess whether people
will fit into jobs and the culture, including
leadership roles? Not everybody will fit
into a leadership role in every position,
and people should not be plugged into jobs
just because they are available and the
jobs are open.
> Does the organization
allow leadership progression to develop
leadership at all levels, both formally
and informally? This would include mentoring
and coaching programs and ways of identifying
potential leaders, both among new staff
members and among more senior nurses as
they develop.
To keep nurse leaders in an organization,
she recommends:
> Offer them training,
education and development throughout their
time in the organization.
> Support them
with coaching and mentoring throughout their
lives as nurse leaders, but especially in
that first transitory year. Have a process
in place to help them assimilate into the
leadership culture, but also encourage informal
mentoring and learning.
> As nurses become
leaders, get them involved in mentoring
and coaching others on their staff and leaders
in other departments.
> Live the values
of the organization’s mission statement
and show respect for all employees, including
leaders, clinicians and support staff.
Cathryn Domrose
|
The students, almost all with less than three
years in management, may be capable of doing the
projects on their own, but usually don’t
know how to get started, Watkins said.
The class helps them focus, and gives them information
on subjects such as teamwork and staff development
to use in their work.
A number of hospitals are focusing on identifying,
educating and training potential leaders, then
supporting them throughout their careers.
Rosemary Luquire, RN, PhD, CNAA, senior vice
president, patient care and chief quality officer
at St. Luke’s Episcopal Health System, a
Magnet-designated hospital in Houston, said her
organization has found many leaders among through
its system of shared governance, which lets nurses
take part in making decisions.
“Many times, you’ll see through that
mechanism who is strong and who has the ability
to influence their peers,” she said.
Katherine Johnson, RN, BS, BSN, nurse manager
of transplant acute care at St. Luke’s,
said her experience on the staff nurse council
as a staff nurse helped her meet people and gave
her a taste for leadership.
Lisa Cushman, RN, MS, CNA, nurse manager of the
coronary care and cardiac observation units, said
when she and other interim nurse managers went
to their director and said they wanted to make
their jobs permanent, the director interviewed
them, then hired them.
A few years later, Cushman said, the hospital
offered to pay tuition for nurse managers who
wanted to earn their master’s degrees. The
nurses also received paid time off for their studies.
Most of them put in their regular hours anyway,
she said, “but just for [Luquire] to say
it’s OK to work on school stuff meant a
lot.”
Nurses also received support from supervisors
who asked how their classes were going and discussed
ways to apply what they were learning. Managers
in other departments broke away from their busy
schedules to answer their questions.
“This is something I’ve always wanted
to do, and I wanted to do it 15 years ago,”
Cushman said of her degree. “All I needed
was somebody to say, ‘Here is an opportunity.
You should take it and run.’ ”
Stretched thin
Much of nurse leadership begins that way, nurse
leaders say. Many say they got into leadership
because of someone who tapped them on the shoulder
and said, “You can do this.” But most
nurse managers don’t have time for anything
but day-to-day tasks.
“I think people are just so busy,”
Watkins said. “We as a profession don’t
have a real good history of mentoring each other,
coaching each other.”
Because current leaders are stretched so thin,
Bozell suggests bringing in retired leaders to
mentor for potential or hiring a nurse leadership
specialist—a sort of clinical nurse specialist
for leadership—who would provide education
and training, pair up mentors and research new
ideas about leadership and staff development.
Hospitals and other health care facilities need
to support the decisions of their nurse executives,
Robinson-Walker said, even in the face of opposition
from an upset physician. “It needs to be
OK for a leader to say something that is different
from the way the rest of the group thinks.”
Nurse leaders, with the support of their institutions,
should be assessing potential leaders when they
begin hiring, then working to develop those leaders
throughout their careers.
“We need to think across the lifespan,”
said Karen Haase-Herrick, RN, MN, executive director
of the Northwest Organization of Nurse Executives
in Seattle and president of the American Organization
of Nurse Executives. “Not all of them are
ready to move to the next level, but they would
like to become ready.”
Perhaps the most important thing nurse leaders
can do, say those who train them, is to provide
them with positive role models and show them how
the rewards far outweigh the frustrations of leadership.
People go into management because they want to
emulate people they like and because they want
to make a difference, Shaffer said.
Johnson, who applied for manager jobs with the
support of her director three times before she
landed her present position, said she came out
of school wanting only to do bedside nursing.
But as she grew in her position, she saw and
appreciated how her managers supported her, her
co-workers and the patients. “The other
managers are really good and really strong and
the structure is really good,” she said.
“They are very positive nurses. I wanted
to be like them.”
As a manager, Johnson said, she tries to encourage
and help other potential leaders whenever she
can. As her own mentors have done, she wants to
share her enthusiasm and show her staff she believes
in them.
“It really helps to have strong people
supporting you,” she said. “It really
helps to have them say, ‘I know you can
do this.’ ”
Contact
Cathryn Domrose at kaguilar@well.com.
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