leadership – JRM Nurse Consultants

February 02 2020

Leadership Skills Mentoring and Coaching

When I was a manager of a team of nurses and social workers, collaboration existed in my direct report team, and as a team, we functioned using critical thinking, interdisciplinary team approach and collaboration on cases together. But in the big picture of corporate America under the manager that I reported to, this was not acceptable, it was more along the lines of a multidisciplinary team. In this type of team, you only have individual thinking in the group, meaning their way and no other opinions. The focus would be on tasks and check off systems regardless if it was feasible to do (Rubenfeld & Scheffer, 2014).

Nurses do have the ability to be leaders, educators and changers of a system, if assertive enough to make that change, but in order to do so, a good team of interprofessional people is needed (Denisco & Barker, 2012). Because at the end of the day, the patient is who counts and why changes are necessary. If more companies were focused on having a management style that was transformational vs transactional, this would alleviate the unnecessary resignation of employees, corrective action plans and disgruntled employees.

In my team, for instance, a good way that we incorporated learning was to have one person do a case study every week. They would team up with another person on the team to present the case study on a difficult patient. During this time the team had the ability to comment on the case, make suggestions and also refer to our medical director for review. This allowed me to mentor the nurses and social workers during our weekly meetings so that we could continue to go over any other cases that may have been difficult or of concern to them.

References

Denisco, S. M., & Barker, A. M. (2012). 25. Advanced practice nursing: Evolving rules for the transformation of the profession (2nd ed., pp. 547-567). [Vital Source Bookshelf] Retrieved from https://campus.capella.edu/web/library/home

Rubenfeld, M. G., & Scheffer, B. (2014). Critical thinking and patient-centered care. Critical thinking tactics for nurses: achieving the IOM competencies (3rd ed., pp. 155-180). [Vital Source Bookshelf]. Retrieved from https://campus.capella.edu/web/library/home

February 02 2020

Leadership Theories and Attributes

I had the opportunity to interview Mary Alice Cullen, a Director of Patient Care Services. She oversees the Neonatal Intensive Care Unit (NICU), labor and delivery, pediatrics, maternity ward, and the women’s clinic. Mary graduated in May, 2016 with her Doctorate of Nurse Practice. Mary has always wanted to get her MSN. As she started to study to get her MSN, it opened her eyes to endless possibilities of what she could do with her degree. When she graduated with her MSN, the position that she was in opened up for her and she took on the job. As she went through her role she wanted to make more of an impact on the role and the clients and staff she was supporting. Mary decided to continue school for her Doctorate in Nurse Practice (DNP) with a concentration on Executive Doctorate in Nurse Practice, and this degree is also approved by the American Nurses Credentialing Center (ANCC). Her attributes are that of a caring leader, one that will work with her staff to encourage and teach them and empower them to be the best that they can be, even when they do not see that they can.

Mary does not often do hands-on care she is in an executive role. However, she does round daily. She provides support to her managers that manage the staff, in order to provide better care for the patients. Her leadership model is Kouzes and Posner, but if she is scrubbed in for surgery in labor and delivery, her transactional model side comes out. Meaning this is a time as a transactional manager, where following directions the same way every day is crucial. Mary most recently participated in a study that involved strategic planning of having single-family NICU rooms for the parents. These were her visionary plans and the hospital agreed after the research was completed, that having individualized patient rooms in the NICU, would benefit the staff and the parents of the babies.

My leadership style is very similar to Mary’s in that I lead by example and I am not afraid to do the work that my staff does. This makes a strong leader because the people who follow you will know that although you are in a position of higher authority, you will still be humble enough to do the job your staff does and be able to explain it from their side and understand the position that they are in. Knowing your staff’s job by example, allows the manager to know the timeliness of things that need to be accomplished and the ability of each worker’s caseload and what they can manage. There are seven attributes to being a good leader and Mary possesses those in her character, her track record to be given assignments and projects that have been successful and in the skills that she shows handling her staff (Baer, 2012).

References

Baer, J. (2012). Theories of leadership. In Leadership in health care (2nd ed., pp. 45-69). [Vital Source Bookshelf]. Retrieved from https://campus.capella.edu/web/library/home

February 02 2017

Why is Leadership Important to Nursing

Nurses are not often recognized for their professional expertise. I know that when Florence Nightingale started the very first school of nursing her goal was to change how people viewed nurses by educating the nurses (DeNisco & Barker, 2013).

Leadership is important to nursing because without it, there is not going to be anyone to educate new nurses. The baby boomers are retiring and we will need new teachers that are prepared to teach new nursing students as well as students at the graduate level. Recent studies show that nurses that are prepared with their bachelor’s in nursing experienced less pressure ulcers, deep vein thrombosis and hospital acquired infections in their patients. It was noted that although an associate’s degree is less costly and provides the care needed to a patient; by the year 2020 the goals are 80% of nurses will have their BSN and doubling for nurses with their doctorate.

There are organizations that provide nurses of higher education grants to conduct research and be able to make difference. In order for these research projects to be done, it is required that the nurse be able to write a solid proposal request for the grant. This may require the skill of a grant writer, but the nurse must be knowledgeable in the project and what it entails in order to help the grant writer correctly write the grant to fund the project that the nurse wants to do (Laden, 2013).

In Orlando, we have the Florida Nurses Association. It is an organization that will support nurses from the student level through the advanced level. The organization is involved in many things especially any that are legislative where a nurse wants to make a difference. The Florida Nurse’s Association has subgroups called Special Interest Groups ( Sigs), these groups will benefit the members because they are formed to specialize in something that a particular group wants to see changed. For example there is a group called Nurse Entrepreneur Special Interest Group, this groups supports nurses that have an entrepreneur business that they want to start or have started. If there is a group that you want to start for a particular interest that you have and it is not a group already listed here, then after speaking with leadership in the group, if they approve it, then you could start it. The group is responsible for having ten members in it in order for the group to work. A master’s and beyond prepared nurse would be able to conduct research needed for any new programs that need to be implemented.

References

DeNisco, S. M., & Barker, A. M. (Eds.). (2013). The slow march to professional practice. Advanced Practice Nursing (2nd ed., pp. 6-17). [Vital Source Bookshelf].

Ladden, M. D. (2013). The Case for Academic Progression: Why Nurses Should Advance Their Education and the Strategies that Make this Feasible. Retrieved from http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf407597

January 01 2017

Working Your Staff Unsafely

This week has been the week of speaking with different professionals on training and how companies place employees in jobs that are not properly trained in their skill set to pay them less and get more out of them. I used to work for a large insurance company that employed over 80,000 people. I worked in the long-term care department which had about 400 staff from administrative assistants to presidents. I was the manager of case managers which consisted of RN’s, LPN’s and Social Workers. They all did the same job and got paid different salaries to do it, however the job description and responsibility was the same.

I felt that this policy of having nurses and social workers working on the same cases needed to be changed. Having all the staff doing the same exact work and paying them differently based on their degree and expecting the same level of skill, was inappropriate. Nurses have a different skill set than social workers. If a patient has a medical issue, the social worker that is visiting that member in the home completing an assessment may not be able to capture that the member has been retaining water in their ankles and think to ask if they are on a diuretic. Much like the nurse that goes in the home setting and sees a patient that has issues paying their light bill won’t know where to call to find a resource for them. The patient may be concerned because they are on oxygen at home; they wonder how they will pay their light bill and what they will do if the power is turned off. This can be a liability to any staff member but also a disservice to the patient.

In contrast, I worked for another company that did case management. I loved that job, until federal cutbacks came along for the program during the new Obama administration. The company employed RN’s, MSW’s, CHW’s, Nutritionists and Behavioral Health Specialists. The cases were assigned only to nurses and there were two tiers of nurses, regular case managers and those that were more experienced received complex care patients. The other staff MSW’s, CHW’s , Nutritionists and Behavioral Health Specialists were consulting on the files that the nurses referred to them. They would work as a team with the nurses. This team work gave the patient a more well-rounded form of care.

There are several leadership styles in companies, autocratic, democratic and laissez-faire. In the large insurance company that had all the workers regardless of skill set do the same job, the leadership was autocratic. The department maintained total control in all decisions and no opinions or suggestions were accepted from others. There was no opportunity to make a change due to the leadership style. In my prior job, where everyone worked on a tiered team, there was a democracy; decisions were made after consideration of input from the staff (Mitchell, 2013).

There are some days that as a professional you want to see changes implemented or at least considered, however the leadership does not support that. If you are the type of person that works for the better of seeing changes in a situation, get involved in the departments or committees that have a say in policy writing, this will be the only way to see changes that can be discussed for the betterment of the company.

References

Mitchell, G. (2013, April). Selecting the Best Theory to Implement Planned Change. Nursing Management, 20(1), 32-37. Retrieved from http://web.a.ebscohost.com.library.capella.edu/ehost/pdfviewer/pdfviewer?sid=4ba42c53-9a6d-4ec5-b6bb-2f078e04b7c7%40sessionmgr4001&vid=1&hid=4204

Years of experience in Work Comp, Case Management, Disease Management, Utilization Review and Prior Authorization.

Tag Archives: leadership

Leadership Skills Mentoring and Coaching

Leadership Theories and Attributes

Why is Leadership Important to Nursing