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Newly promoted leaders need support too

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.

Perspectives on nurse leadership

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.”

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Getting nurses from bedside to the boardroom

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.

Nurses bring layers of diversity to hospital leadership

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.

FREE White Paper: Preceptor competencies

Enjoy a FREE white paper on preceptor competency assessment and verification!

This white paper is compiled from the third edition of the groundbreaking book, downloadicon3
The Preceptor Program Builder
,
written by Diana Swihart, PhD, DMin, MSN, APN CS, RN-BC, and Solimar Figueroa, MHA, MSN, BSN, RN. It discusses and defines the competencies developed in preceptorships, explores the goals and essential elements of competency assessment and verification, and takes a close look at the categories of competencies and methods for assessing and verifying them within the context of the preceptor relationship.

Click here to download the white paper: Preceptor competency assessment and verification.


The Preceptor Program Builder provides professional development staff the keys to creating a successful preceptor program in the healthcare environment. Learn more here.

Click here to view our full range of nursing resources.

A Simple Interprofessional Accountability Technique

Listening, validating and asking for a commitment

From Team-Building Handbook: Accountability Strategies for Nurses, by Eileen Lavin Dohmann, RN, MBA, NEA-BC

accountability scenario

When working with a group, I assume that people are rational and logical.

So, if I want them to do something, I just need to explain it and they’ll do it. When I don’t get the results I am seeking, I tend to think “Oh, I must not be explaining it well. Let me try it again.”

It’s taken me a long time to realize that what I was hearing as “not understanding me” was often someone’s polite way of telling me no. So, now when I find myself explaining the same thing to someone for the third time, I stop and ask the person what he or she is hearing me request. If I can validate that the person is hearing me correctly, I ask for the commitment: yes or no.

Validating… and asking for a yes or no

We can hold ourselves accountable, but holding other people accountable can be much more difficult. Consider this nurse-physician scenario and ask yourself [more]

Join our nursing book review group

HCPro is seeking enthusiastic nurse managers, nurse leaders, and nurse educators to join an ad-hoc group interested in reading and reviewing prepublication drafts of books and training materials in your areas of interest and expertise.

Our editors will send you periodic emails listing upcoming projects available for outside review. If you’re interested, just let us know. We’ll send reviewing guidelines and give you an idea of our timeframe. If it works for you, we’ll send the draft chapters as they’re available, and a printed copy of the book when it’s complete. In addition, you will be recognized as a reviewer inside the printed book.

Please have a minimum of five years of nursing experience and be in an educational, supervisory, or leadership role within your organization.

For more information or to sign up as a reviewer, please send an email including your areas of interest and expertise to Rebecca Hendren at rhendren@hcpro.com.

Nursing research: Understanding whistleblowing

Last week I promised a downloadable version of the whistle imagewhistleblower flowchart. For those who are interested, you can access the file here.

When I read about the fallout on Kim Cheely, the nurse whistle-
blower I wrote about last week, I had to ask myself:
Why do nurses risk their jobs to blow the whistle? Why speak out, when there is danger of ostracism, marginalization, and damage to one’s career? I did a bit more research on the subject, and ran across a thought-provoking study published “down under” a few years ago in the Journal of Advanced Nursing. You may find it interesting also.

Using a qualitative narrative inquiry design, the Understanding whistleblowing: Qualitative insights from nurse whistleblowers study looked into the reasons nurses decided to become whistleblowers, and gathered insights into nurses’ experiences of being whistleblowers. I doubt any nurses reading this will be surprised to learn the primary reason behind the decision to blow the whistle.

It’s simple, nurses are patient advocates. Of course there’s much more to the study, and it makes interesting reading for many reasons, not the least of which is that it used face-to-face data collection methods, and based queries on real experiences and not hypothetical scenarios.

In other words, the questions didn’t ask “what would you do” if you faced with wrongdoing. The subjects of this study had worked through the tough decisions and lived through actual whistleblowing events. You can access the report on this study here.

 

Men earn more than women in nursing

Men typically earn around $5,000 more than women in the nursing profession, according to a recent study published in JAMA.

Even adjusting for factors such as experience, education, shift, or clinical specialty, the salary gap between men and women is around $5,000.

The Huffington Post quotes lead study author Ulrike Muench from the University of California, San Francisco: “Nursing is the largest female dominated profession so you would think that if any profession could have women achieve equal pay, it would be nursing.”

What do you think of this report? Share your comments below.

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