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Nursing Leadership: An Affair of the Heart

W I L L I A M DUF F Y M J, R N , C N O R , F A A N V I C E PR ES I DEN T PA TI EN T C A R E S ER V I C ES & C N O S T. JO S EPH H O S PI TA L C H I C A GO , I L PA UL A GR A L I N G DN P, R N , C N S , C N O R C L I N I C A L N UR S E S PEC I A L I S T I N O V A F A I R F A X H O S PI TA L , F A L L S C H UR C H , V A C H A R L O TTE GUGL I EL M I M A , B S N , R N , C N O R PER I O PER A TI V E N UR S E S PEC I A L I S T B ETH I S R A EL DEA C O N ES S M EDI C A L C EN TER , B O S TO N , M A

Disclosures

William Duffy None

Paula Graling

President, AORN Foundation

Charlotte Guglielmi AORN Works, Board of Directors

Safety/Risk Consultant: Sedgwick CMS

Objectives

1. Discuss the affairs in which nurse leaders must engage during their careers

2. Describe why nurse leaders must be able to articulate their value in the emerging healthcare system

3. Discuss the tools that nurse leaders/managers must possess to advocate and influence the care of patients, staff and themselves

The Road Not Taken

Two roads diverged in a yellow wood, And sorry I could not travel both And be one traveler, long I stood

And looked down one as far as I could To where it bent in the undergrowth;

Then took the other, as just as fair, And having perhaps the better claim,

Because it was grassy and wanted wear;

Though as for that the passing there Had worn them really about the

same,

And both that morning equally lay In leaves no step had trodden black. Oh, I kept the first for another day!

Yet knowing how way leads on to way, I doubted if I should ever come back.

I shall be telling this with a sigh Somewhere ages and ages hence:

Two roads diverged in a wood, and I- I took the one less traveled by, And that has made all the

difference. Robert Frost

No Steps Had Trodden Black

We entered into a special relationship and are now part of the less than 1% group

We have the honor of touching people in the most intimate way possible

We help people to continue to make their mark on the world

We have the ability to change the world of team members as well

Some say what a great gift but what about all the stuff we have to deal with – how can I stay committed?

Nursing Leadership: A Love Story

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Nursing Leadership: A Love Story

When we ask to be able to make a difference will we have smooth schedules, patients with insurance, vendors ready to compromise, easy to work with surgeon or will we have to use our talents to make a difference

Our world is changing and we have chance to build ark to help our team survive and thrive

But it is something we have to want to do

Leadership: You have to want to do it

Leadership: Journey to Success Leadership: Being Perfect in Your Practice

“Leadership  is  Influencing  Others”   (Bethel 1990)

All Nurses Must be

Exceptional Leaders

Authentic Leadership

People hunger for personalized leadership that speaks to their hearts and inspires them

Authentic leaders love challenging people to do  what  they  didn’t  think  was  possible

Authentic leaders generate energy to make the impossible possible by the passion for their people, their patients and for doing the right thing

Karlene Kerfoot, Nursing Economics, 2006

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The  5  A’s  of  Leadership

Approachable Accepting Acknowledging Accountable Adaptable

An Effective Leader is:

Self-aware Sets clear, achievable

expectations Navigates through

change Fosters engagement Promotes prospective

accountability Is sensitive to

diversity Acts as a mentor

More About Effective Leaders

Approachable role models

Understand the vision and goals of an organization

Able to channel the commitment of the followers

Knows how to listen

Four Obstacles to Effective Leaders

Climate in the

healthcare arena Losing the desire to

grow Self esteem Change Knowing ourselves

Why do some leaders survive while others flame out?

• The best leaders: • Inspire trust • Inspire loyalty • Inspire commitment • Inspire collegiality • Demonstrate courage • Surround themselves with

and recognize top performers

How to be an inspiration to those you want to lead?

• Plan well • Teach • Delegate • Do not dump! • Encourage independent thinking • Build a team • Set an example • Accept responsibility • Share the spotlight

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Lesson from Crayons

We could learn a lot from crayons. Some are sharp, some are pretty and some are dull. Some have weird names, and all are different colors, but they all have to live in the same box.

S. McNamara, 2005

Generational Differences

Is this something we must consider as we plan the interaction within our groups?

How do I relate to my colleagues on my team ? In my chapter? In my state?

Are you a 33, 45, a CD or MP3?

Historical Depictions

Nursing Role?

Historical Nursing Role Models

What and who do you think of ?

Can you identify with this individuals now?

First Role Models?

“Shot”  Lady School Nurse Somebody’s  Mom Neighbor Cartoons…..Movies

Question

Who was the Nurse in Harry Potter Story? Who identifies with her? What could she do? What  do  you  think  about  her  image……

Insert Madame Pomfrey

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Question

When you think of Nursing Role models who do you think of??

• Adventure • Autonomy • Authority

• Hot lips Houlihan - 4077

• Bobbie Spencer- General Hospital

• Recent • Grey’s  Anatomy • House • Private Practice, • ER

Male Role Models

Leadership Images Leadership Images

Opportunity

Can you relate your leadership to what we do everyday?

You are always on a stage!

Think  about  who  is  watching  ………..and  who  is  listening…………

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Word Association

Words and pictures can illicit emotion……..

Basis of: Advertising Marketing Film production

Messaging  must….

Genuinely express view of person Congruent with strategic plan Supportive of Mission

Creating your Message

Images Words Timing- calendars- events

Leadership Calendar

• Known events • October • November • June

What other important dates for you, your chapter, your year?

Follow the Leader

• Most  words  used… • Future • Nursing/nurse • Practice • Excellence • Challenge

AORN Theme 2006-2007

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2005-2006

Diversity: patient, practitioner, practice

2010 - 2011

• Freedom to Be • Image • Words • Color

• What is your purpose? • How will you use it?

Why would anyone want to be led by you?

• Vision • Energy • Authority • Strategic Direction

• Golfee and Jones, 2000

Do you demonstrate your Freedom to Be? Have you created your leadership message?

Leadership Attributes

• A leader should: • Provide continuity and momentum • Be flexible in allowing changes of direction • Inspire change

“a  leader  is  not  so  much  someone  who  assists  with  the  mission  ….a  good  leader  creates  it”

C. Spry, July 2004

What does this mean for us?

Operating Room practice is changing from a theater approach where focus was getting ready for entrance of  the  star  surgeon  …..

…..to  the  preparation  of  a  high  tech  suite  where  a  

multidisciplinary team of individuals collaborate to deliver  care  focusing  on  the  patient……..

Atul Gawande, 2010

Will this affect our messaging moving forward?

Follow the Leader

Be action oriented, Goal driven, Politically astute, Tenacious, Articulate, Scientific, Compassionate, Resourceful, Creative, Visionary, Heroic.

Roll up your sleeves and get the job done.

Challenge the status quo. Refuse to be intimidated. Dare to stand in the line

of fire. Boldly go where no nurse

has gone before Lead.

Courtesy of Melodie Chenevert R.N.

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Defining the Spirituality of Leadership

We speak of a spirituality of leadership in a broader rather than a religious sense

A spirituality of leadership requires us to an active opening  of  one’s  self  to: • Consideration of our values and beliefs • Naming our personal mission

We must understand our complex, fast paced world of work

We need to look into our hearts to be the nurses that we have been born to be

Anonymity

“As  perioperative  nurses  we  are  all too familiar with the double-edged sword of being anonymous in  our  success…Sadly,  as  much  as  we have advanced as a profession, we are still the forgotten heroes in our hospitals…Colleagues,  we  cannot  continue  to  be  anonymous.” Paula Graling 2006 – 2007 AORN President

“The  heart  of  leadership  is  in  the  hearts  of  leaders. You have to lead from something

deep  in  your  soul.”   Bowman & Deal

Compassionate caring,

Acknowledging our imperfections

The ability to act justly

Compassionate Caring

• Easily recognized are those sacred tasks • Our ability to allay

a  patient’s  fear • Hold a hand, • Recognize a

physical need

Compassionate Caring

• Not so easy is to recognize • The way that we interact, respect, and attempt to

understand each other and our patients • Embracing

• The colleague who learns slowly • The resident who wants it done now • The family that thinks we are not responsive enough

• Taking time at the end of the day to reflect and say to oneself, what could I have done to make things better today?

Befriending our Imperfections

Understanding our imperfections is difficult to acknowledge.

How often do any of us start the day do we declare to our colleagues situations that might influence our work?

Do we call out issues in a timely manner or does our pride that gets in our way?

Do we try to solve issues ourselves or seek help? Is  there  a  quality  that  is  inbred  in  us  that  says  we  can’t  

make a mistake?

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Acting Justly Means

Listening carefully when a staff member stops the line when we observe a safety flaw

Creating an environment in which a staff member will call out a colleague who may be impaired without regard with what does it he/she is wrong

Holding oneself to the highest of ethical standards Practicing in a manner that is fiscally responsible. Keeping  one’s  eye  on  our  three  customers,  patient,  

staff and physicians every minute of every day

Future of Nursing

Nurse ethicist Sara Frye contends: Requires that nurses possess strong skills in

negotiation, expert communication, assertiveness, persuasion, interdisciplinary collaboration, and the  technique  of  ‘ethical  compromise  

Act to protect, defend, and advocate for doing what is right in the best interest of meeting the patient’s  needs  and  affecting  quality  healthcare  outcomes while maintaining quality of life

La  Sala,  CA.,  “Moral  accountability  and  integrity  in  nursing  practice”  Nursing  Clinics of North America., 44(2009) 423 – 434, Elsevier Inc.

Accountability

La Sala synthesized the work of many nurse theorists on accountability

Accountability has been described as a basic moral value & a moral foundation for nursing practice

“In  choosing  one’s  profession,  individuals,  assume  responsibility for adhering to the standards and for  upholding  the  values  of  their  profession.”

We are ethically bound to be accountable for the care we deliver or that those who work for us deliver

Role Measurement

Are my expectations clear to the team? Do I provide my team what they need to do their

job? Are my team members doing what makes them

happy? Is my team committed to offering quality care? Do I offer praise? Do I listen?

Adapted from Sovereign Banks Organizational Leadership Development Process

The Power of Team work

• Shared Values • Center point for

teams • Required for peak

performance • Align around a

mission • Team first

Team Culture

• Commitment to teamwork • Mutual accountability • Acknowledgement &

recognition • Acknowledgement of human

fallibility • Professional respect

Teamwork Not a part-time activity; a 24/7 commitment Requires leadership by example Taps on the innate strengths of each person Requires effective communication

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6 Tips for Sustaining a Culture of Safety AORN Periop Insider, 9/5/2012

1. Be patient 2. Understand the system 3. Listen 4. Be preoccupied with failure 5. Be the change you want to see 6. Build your network and use it

“Embracing passionate leadership requires taking time to rest, reflect and recharge our batteries”

Now is the Time

Solidarity in nursing is essential The more nurses are engaged and speaking with a

united voice, the more influence nursing and its values will have on the health care system

Nurses know what their patients want and need, and historically always respond to both.

There in lies the power of nursing

A Call to Passionate Leaders

Nurses must fully embrace an even stronger level of leadership

Our leadership skills are demonstrated every time we manage the complexities of our daily practice

Nursing is about growing and adapting to meet the  public’s  needs

Nurses must partner with physicians, pharmacists, infection prevention practitioners and others to direct and manage care effectively

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Call to Action

Expect to lead Expect to be

different Demonstrate how to

bridge the generations

Demonstrate how to accelerate the change

Driving the Healthcare of the Future

We must manage more than the individual patient case

We must direct and reshape our environment to ensure the most effective use of nursing resources

We must be active partners in managing the tension between fiscal responsibility and clinical acceptability

We must continue to advance the initiatives that ensure patient safety

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Embracing Nursing Leadership: An Affair of the Heart

Experiencing the joy of being a nurse. Continually finding ways to reinvent our

passion for our profession, Rekindling our infatuation for who we are

and what we do. It is falling in love with nursing over and over

again

Questions