Many companies have clear guidelines for onboarding a new hire; they often have formal training, manuals, and extra resources to help them adjust to their new responsibilities. However, many nurse leaders are promoted from within, and their training path is often less clear. As a new study suggests, the training process for internal promotions is often inadequate, and internal hires require just as much support as external ones.
Michael Watkins wrote in the Harvard Business Review about this issue, and coined the term “inboarding” to describe the process of training internal hires for their new position. About two thirds of the new hires in his study were internal; 70% of them said that their transition was as difficult as joining a new company, and 35% found the transition more difficult. This results in unnecessary failures and difficulties for the organization.
Watkins identifies the lack of support given to inboarding as one of the main reasons for this disparity. So how can an organization make inboarding easier? To start, leaders should adopt a common methodology when approaching new hires. This includes using the same framework and tools for all leadership transitions. Watkins also suggests performing a risk assessment for transitions: identify the potential difficulties (such as relocation, new business divisions, or shifts in work culture) and provide additional support for those risks. This might sound simple, but changing an organization’s culture can be difficult and the first step is identifying that internal hires need the same support as external hires.
Did you receive formal training when you got your first leadership position? Did you feel prepared for your new responsibilities? Let us know in the comments, or take our Strategies for Nurse Managers Poll.
The responsibilities of nurse leaders are changing rapidly and the role is more fluid than ever. We collected perspectives from several nurse leaders on how nurse leaders can stay effective in the ever-changing world of healthcare.
Jeanine Frumenti, RN, an expert in leadership consulting, posits that the most important aspect of nurse leadership is the ability to create a healthy work environment. “[Nurse Leaders are] always looking at what’s good for the organization, what’s good for their patients, their staff, their team — it’s not about them. And their focus stays on the goal… They’re transformational, giving those around them a voice, encouraging them to share in the decision-making, and owning their work and their practice.” This focus creates a healthy culture, that can allow their staff to flourish and take pride in their work.
Toby Cosgrove, CEO and President at Cleveland Clinic, writes that healthcare leaders need to embrace the quickly changing healthcare environment to remain effective. “Today’s leaders must have a clear vision of the future based on the most fundamental values of the organization. We need to communicate our strategies, achieve consensus, and move quickly to implement change. Innovation is essential, and so is the courage to fail. Most importantly, we must never give up.” Cosgrove agrees that leaders should rely on their staff and create an environment for them to grow: “A leader creates a learning environment that opens all caregivers to new skills and capabilities. Each of us needs to inspire and uplift our teams with a commitment to their professional growth and development.”
Claire Zangerlie, MSN, MBA, RN, president and CNO for the Visiting Nurse Association in Cleveland, Ohio, argues that this impetus to teach should be applied to patients as well through population health management. As nurse leaders take on more and more responsibility, they will be able to educate “entire populations of patients through workshops and printed materials.” According to Zangerlie and her team, competencies that nurse leaders will need for population health management include: “Effective communication, including excellent negotiation skills; relationship management, including asserting views in nonjudgmental, nonthreatening ways; [and] diversity, including creating an environment that recognizes and values differences in staff, patients, families and providers.”
Want to receive articles like this one in your inbox? Subscribe to Nurse Leader Insider!
Last week, we discussed some of the benefits of having nurses in executive positions. It is crucial to bring a myriad of perspectives to these positions, and nurses are significantly underrepresented in hospital leadership. This week, Becker’s Hospital Review has offered up some tips about how nurses can prepare for hospital board seats.
The first thing an aspiring nurse should consider is the core competencies of the hospital board. This can be a little different for each hospital, so having a specific facility or type of facility in mind would be helpful; if you can find a facility that matches your nursing specialty, even better. Often, boards have lists of competencies, so not having the right core skills can sink an application right away.
Once you establish the required skills would need, you can begin working towards that goal. Many nurses don’t have opportunities to develop governance skills on the job, so it might be helpful to look outside the hospital for that. Volunteer board positions in their community or at a nonprofit organization can be a great way to get experience in governance and make nurses more appealing candidates for board positions.
Connections are key in this process as well. Nurses should meet with board members and the chair if possible, to better understand the board’s mission and how they might align with it. These relationships can be crucial to obtaining a board position, but also to keep it. Board members can become mentors that can teach nurses how to navigate their new responsibilities and help them through the gauntlet of new board membership.
Recently I was faced with a decision to compromise my belief over yielding to conventional thinking that I now know is in question. For example, we now know that cholesterol is no longer the cause of heart disease. Inflammation is. But conventional thinkers may not have changed their thinking on this issue because new information takes time to catch up with everyone.
Because it is my job to educate on health issues and keep people informed with the latest scientific evidence, it is not always readily acceptable to the masses. So the challenge is – do you yield to the old paradigm or do you take the risk of telling the new truth and standing out on a limb?
I remember when I entered the field of wellness and when I tried to educate about it in the healthcare system one physician said to me “there is no such word as wellness.” But I of course forged ahead and now look where we are with wellness – front and center!
So how do you handle this? Please email me your comments to email@example.com.
In just about every field, there are discrepancies between leadership positions and the population they represent; health care is no different. The American Hospital Association’s Institute for Diversity conducted a national survey that found that minorities made up 31 percent of the patient population, but only 17 percent of first and mid-level management positions. There’s even less representation in upper management roles, with 14 percent of hospital board members and 12 percent of executive leadership roles filled by minorities.
As the hospitals’ population get more diverse, so should its leadership. This doesn’t just mean racial diversity, but gender, experience, and cultural diversity as well. Hospitals that have a multitude of perspectives will serve their population better and make the hospital more successful.
In terms of diversity of experience, nurses can bring a useful perspective to executive leadership. Many hospital executives come from a business background and don’t have the kind of on the ground experience nurses can bring to the table. Medical staff generally prefer leadership that is familiar with their experience, that can relate to how big-picture decisions can effect day-to-day practices in hospitals. Additionally, nurses have more racial diversity compared to executive leadership, so they would bring that experience to the table as well.
However, there are a lot of barriers to nurses trying to obtain leadership positions. As a nursing student, nurses are much more focused on learning patient care than management techniques. Nurses don’t get much formal training in finance or business, so staying competitive might mean seeking a time-consuming and expensive degree on the side. There is also a possible stigma against nurses from executives, so much so that the American Nursing Association reports that RNs seeking executive work often leave that off their resume. As one nurse told them: “Well, I don’t want to put RN after my name because some people might not think that I know as much about business, or that might be a detractor when I’m competing with others in the C-Suite, especially men in the C-Suite.”
While perspectives are slowly shifting, along with diversity numbers in hospital leadership, nurses taking on larger leadership roles can help hospitals and their patients.
Performance review time is never easy. Managers have the uncomfortable task of assessing their team, and the staff is uneasy about what a poor review could mean for their career; if a review goes poorly, it can lead to tension and dissatisfaction long after the review. A new study in The Nursing Management Journal proposes a new way of approaching performance reviews that could make the process a little easier on everyone.
A task force of nurse leaders from a Magnet® recognized hospital system sought to make their process more objective after receiving staff feedback that their performance reviews were too subjective. Previously, the nurse manager would evaluate staff based on the fulfillment of their job description, meeting performance outcomes, and following care commitment guidelines. The team revised the RN job description to better fit the staff’s responsibilities, then created performance metrics based around the revised job description. They hoped that this would provide the staff with measurable results for their performance review and tangible goals for improvement.
The staff responded to this new criteria-based model for reviews. The surveyed nurses said that the new system was more transparent and consistent, and they liked that the results were evidence-based and didn’t hinge on personal bias. Overall, 71.7% of the surveyed staff felt the new process accurately reflected their performance, versus the 37.8% under the previous method. So while performance reviews will always be a headache, perhaps moving to a criteria-based model will help ease the pain.
Want to receive articles like this one in your inbox? Subscribe to Nurse Leader Insider!
In 2015, the number of millennials in the workplace surpassed baby boomers as the largest segment of workers. This future generation of nurses has very different career expectations than the generations before them. Millennials expect more feedback, greater collaboration, interaction with nurse leaders, an 8-hour workday and better work-life balance. Unlike their parents, they rarely intend to stay with one employer for their entire career—or possibly even more than a few years.
The shift in attitude has many organizations struggling to retain millennials and learning to adjust management strategies to accommodate their unique style. Join Kathy Bonser, Vice President of Nursing and CNO at SSM Health DePaul as she discusses the importance of leveraging the differences to create a win-win environment for staff and frontline leaders.
Take part in this live 60-minute webcast to:
- Uncover how making changes in leadership behaviors can bridge the generation gap
- Discover new onboarding processes that support the growing millennial workforce
- Devise a structured approach to providing regular employee feedback
- Understand the importance and value of engaging millennials early and often
For more details or to register for the webcast, please visit The Health Leaders Media store.
Changing specialties has become an integral part of a nurse’s career growth. We spoke with Elaine Foster, Ph.D., MSN, RN, Associate Dean, Nursing Graduate Programs at American Sentinel University about this trend and what nurses should consider when making a change.
“Nurses have a powerful thirst for knowledge and a strong desire to learn and grow, and this often translates into motivation to make a career change. Many will reach a time when they would like to experience different professional opportunities,” says Foster. “In the nursing world, we need to actually help people plan out their career strategies, and it would help new nurses if they received more guidance; we don’t spend a lot of time painting the overall picture of healthcare.”
So where should a nurse considering a career change start? Foster advises that a nurse should start by researching their areas of interest and finding a specialty that fits them. “Read articles, talk to nurses in that field, assess the job market in your area, and learn everything you can about the specialty you are interested in.”
Another important factor to consider is education: does the specialty require more education or certification? Foster notes that in the past, it was more common for nurses to receive on-the-job training and end up in management positions without formal training, but in recent years, nurses require formal education and credentials to advance their careers.
After conducting your research, Foster suggests talking to people currently working in the field. Networking is crucial to making a career shift, and making a connection with an experienced nurse in your field provides plenty of benefits. Shadowing a nurse in your field gives you first-hand experience with the day-to-day demands of the position, and if you do end up pursuing the new specialty, your contact could provide job leads or even become a preceptor in the future.
Finally, before you make a career change, Foster advises that you reflect on the benefits and consider the costs. “Think about how this change will impact you in the future and what you might have to give up now to get that future five years down the road,” she says. “It took ten years to get my PhD; I had to give up a few things, but I’m grateful that I did.”
For more career-shift strategies, check out American Sentinel University’s guide.
It turns out nurses are good for the heart. Provided they aren’t overworked and underappreciated.
A study published in The Journal of Medical Care found that 85% of patients who suffer an in-hospital cardiac arrest (IHCA) die before being discharged. This is despite the fact that 80% of IHCA cases are witnessed and 88% of patients were on cardiac monitoring equipment when the attack happened.
Nurses are typically the first to witness and respond to IHCA cases, making them crucial in a patient’s survival. It was found that each additional patient per nurse decreased a patient’s chances of surviving an IHCA by 5% and that a poor work environment dropped a patient’s chances of survival by 16%.
Researchers suggest improving nurse staffing in general medical-surgical units to increase IHCA survival rates. Medical-surgical units have the most variable staffing levels and would benefit the most with more nurses. Improving staffing may be difficult for some hospitals because of costs, though some of the pressure can be alleviated by hiring temporary nurses.
What kind of manager are you? What do others say about you? Here’s a list of qualities that I like in a manager.
M - Meets employees where they are and accepts them.
A - Assesses their attitude daily and keeps a positive attitude.
N - Notices greatness and share with others.
A - Ask questions rather than giving advice.
G - Greets everyone they see with a smile.
E - Engages employees in the decision making process.
R - Recognizes achievements and celebrates regularly.