Creating a positive future

This blog was created as a component of a Nursing Leadership course I was in. Over the course of the past 11 weeks there have been many discussions, activities, and experiences with leadership. If there is anything thing I have gained from this course, and the experience of developing this blog, it is this:

Leadership is not a job title or having a position of authority. Leadership is a quality, one that each of us can possess. It takes a conscious effort to develop leadership skills. Most importantly, though, we each have the potential to be a leader in our current role!

Qualities of an Effective Leader:

• Honesty
• Commitment
• Drive
• Compassion
• Synergy
• Emotional Intelligence
• Courage

As I move into my final quarter of my nursing program, and brace to enter a field I have worked to prepare for, I am ready to take on the role of leadership in every area I work in. I am ready to be a nurse that help leader her profession to bigger and better places. I am ready to be a woman who challenges the barriers placed solely because of my gender!

I challenge you to examine your current situation, professional and personal, and determine how you can be a leader to enact greatness.

Where are all the women?

Take a second to think of a leader…

Who did you think of? What qualities did they possess? What was their gender?

I am willing to guess most people think of a male. The qualities that we associate with leadership are many of the same qualities we associate with men. Leadership has long been viewed as “masculine.” Women are making strides in their fields and fighting for equality, but there is still a hug gender divide in leadership. “Femaleness” in leadership is “typically associated with ideas that are not aligned with leadership, ideas such as compliance, dependence, emotionality, weakness, needing to be accepted, passivity, nurturance, and being ‘people oriented’” (Grossman, 2009).

Sheryl Sandberg, Facebook's Chief Operating Officer, discusses this topic in this thought provoking TEDTalk.

• Out of 190 heads of state in the world, only 9 are women
• Of all of the world’s parliaments, 13% are women
• Women comprise 15% of top jobs in corporations. This number has not changed since 2002
• Success and likability are positively correlated for men, but negatively correlated for women

So what can women do?

Sit at the table!  Don’t underestimate your abilities! Negotiate for yourself. Be an advocate! “Women need to view themselves as leaders with something to offer…when women ‘sit at the table’ the manner of discussion changes and different priorities are frequently set which enable the discussion to be more inclusive” (Grossman, 2013).

Keep your hand up! Women tend to “bow out” early, anticipating an outcome. It is time for women to keep themselves involved until the very end.

I challenge you to recognize the gender divide! Women, sit at the table! Be involved! Advocate for yourself and for fellow women! Men, encourage females to participate. Be supportive of their efforts to be strong, influential leaders. 

Grossman, S. & Valiga, T. (2009). The new leadership challenge: creating the furture of nursing. P.A. Dacis Company. Philadelphia, PA

Technology and Nursing

It is estimated that nearly 77 million of Americans own a tablet or ipad. That number is expected to double in the next year or two. So what’s the big deal? I read an article from Reflections on Nursing Leadership discussing a study being done on the use of tablets as a tool to identify domestic violence during prenatal home visits [read full article here].

Why use a tablet instead of having a conversation?

• Abuser is typically around during the home visit and monitoring the conversation
• Women are not comfortable talking with varied skills of health care workers that visit
• Nurses feel uncomfortable asking about domestic violence

In utilizing this technology the nurse can hand the women a tablet and headphones. The patient can then direct themselves through a series of question regarding domestic violence. There is also a “safety button” the woman can press should the abuser enter the room. This button would activate a cloaking video to secure the questionnaire.

Does it work? “Though it remains to be proven, Sharps and Bullock hypothesize that using mobile tablets will increase the number of women who identify themselves as victims of domestic abuse by as much as a third. And once they’re identified, women who are victims can be given appropriate interventions” (RNL, 2012). This can be having extra car keys, packed bags, development of a safety plan or help gain a protective order.

Technology is changing the face of health care. We are seeing greater access with electronic medical record systems to tele-health visits to online health resources.

So tell me, what do you think of tablet use in identifying domestic violence?

I also encourage you to visit the Reflections on Nursing Leadership webpage for some more great articles!

Reflections on Nursing Leadership. (2012). Tablet computers: a tool for identifying domestic violence? Sigma Theta Tau International. Retrieved from: http://www.reflectionsonnursingleadership.org/Pages/Vol38_2_RNews_tablet_computers.aspx 

Vision

I am sure somewhere in your professional or educational experiences you have heard the term vision. In fact, nearly all businesses, schools, and organizations have a vision statement to guide them. “Having a vision, as well as being able to energize followers to join in the effort for making that vision a reality, involves credibility, communication skills, and the ability to maintain momentum and creativity” (Grossman, 2009, p75).

…but what is a vision?

• A vision is an image of where an organization would like to be in the future.
• A vision is different than a goal in the fact that it is broader and does not focus on a greater return on assets.
• Personal visions provide purpose in one’s life, whereas a professional vision helps accomplish work ideas and the mission of an organization.
• Vision is a catalyst for change
• Vision unleashes energy
• A vision is the embodiment of core beliefs

”Vision without action is merely a dream. Action without vision passes the time. Vision and action can change the world.” –Joel Barker

Recently I read an article on the relationship between vision and strategy. In the article, Michael Hyatt describes vision as the “what” and strategy as the “how”. If we don’t first have the “what” (vision), then our “how” (strategy) is non-effective. In other words, it is important to first determine your vision for moving forward so that you can then effectively develop a strategy for actualizing that vision. 

Developing a vision does not only apply to leadership and management roles!  Creating a personal vision sets a framework for personal and professional development in all future roles, activities, and locations.

How to develop a vision:  

• Think first about your past
• Determine what you want
• Write an article about how you’ve made a difference
• Write a short vision statement
• Act on your intuition
• Test your assumptions
• Become a futurist
• Rehearse with visualizations and affirmations

I encourage you to take some time and develop a vision for yourself, your practice, and your field!

Grossman, S. & Valiga, T. (2009). The new leadership challenge: creating the future of nursing. F.A. Davis Company. Philadelphia, PA.

The Law of Replication

Today I stumbled upon a website called Michael Hyatt: Intentional Leadership. Michael Hyatt is an author and former chairman and CEO of Thomas Nelson Publishers. There is an interesting article on his website call “Leadership and the Law of Replication” [read full article here]. In this article he discusses the law of replication and how it applies to human nature.

Essentially, people will begin to act in much the same way you do. If you are consistently late, you will begin to see that in others. If you are disrespectful, angry or defensive then people will begin to react that way toward you. On the other hand if are humble, engaging, respectful, and even-tempered you will see those behaviors reflected back toward you.

“This law…applies to leadership. Like it or not, you will replicate yourself. Your followers will adopt your behaviors, habits, and—if you have a strong personality— even your mannerisms” (Hyatt, 2013).

This has HUGE implications for leadership! As leaders it is important to act in a manner than we would want reflected practice. Even if we do not hold a leadership or management role, we can begin to act as leader and evoke positive change in the working with us!

Do your actions reflect those of what you would expect from a leader? Would you be proud if your action were imitated by those around you?

Hyatt, M. (2013). Leadership and the law of replication. Michael Hyatt: Intentional Leadership. Retrieved from: http://michaelhyatt.com/leadership-and-replication.html

The Future of Mental Health Care

Imagine this…you are a nurse caring for a patient in their home....

 ...No big deal right? What if I told you though that your patient was diagnosed as having paranoid schizophrenia? Now what do you think?

It is estimated that approximately 57.7 million Americans experience a mental health disorder in any given year. 1-in-17 adults live with a serious mental illness such as schizophrenia or bipolar disorder (NAMI, 2013). Lack of access to mental health services and a shortage of inpatient beds is a huge problem in our country. The National Alliance on Mental Illness gave the United States and overall grade of a “D” for its mental health care in a 2009 report (USA Today, 2009). [click here to see how your state ranks]

I don’t know about you, but in my mind that is NOT a passing grade! So what can we do? It seems logical to me that a great way to go about treating mental illness is in the community. One type of community program is Assertive Community Treatment teams or ACT. ACT is a service-delivery model that provides comprehensive around the clock cares to patients with serious and persistent mental illness much like an inpatient hospital unit would. The difference, however, is that ACT provides care within the home of the patient. 

WHATS SO GREAT ABOUT COMMUNITY BASED PROGRAMS?

• Decreases hospital days by 85%
• Reduces jail days by 83%
• Creates patient and family centered care
• Patients are able to find and maintain employment longer
•  Decreases co-occurring substance abuse problems
• Creates greater compliance with medication and treatment plans (NAMI, 2013)

Health care is changing, and it is changing rapidly. Community based health care, especially in mental health hold the potential to change lives! Why not be a part of effective patient centered care? Are you ready to be part of the change?

The Basics of Financial Planning

 

I read an article recently discussing financial planning for nurses. Trust me, I understand that planning for retirement can seem daunting, especially with a MOUNTAIN of student debt staring at you! “A 2011 Fidelity Investments Nurses Study revealed that although 79% of nurses interviewed feel secure in their jobs and their financial futures, 71% do not think they are saving enough to fund their retirements”(Quinn-Szcesuil, 2013, p11). Anyone else see a problem with that?

Where do you start?

1.       Make a plan for loan repayment. This is the first priority, and possibly the most difficult, for new graduates. Pay more than the principle balance to help reduce interest and shorten the repayment period.

2.       Determine what you want from your future. It is important to determine if you want to return to school, travel, have children, or be mortgage free.

3.      Once you have indentified what your personal goals are, meet with a financial planner (or take a class). “A 2008 WISER survey revealed that only about 6% of nurses thought they had a strong grasp of financial planning issues, but nearly all thought it was important” (Quinn-Szcesuil, 2013, p12). It is important to choose somebody you trust. Examine all of your accounts, insurance plans and benefit packages to ensure that all data is up to date.

4.       Start slowly! While repaying loans it can be difficult to focus on saving money. By starting slow you begin to familiarize yourself with the retirement saving process. Even $10 per week into savings will add up to big results!

5.       Plan an emergency fund! Experts agree that an emergency fund is a necessity. Plann to save 3-6 months worth of income into an accessible fund to be prepared for financially difficult times.

6.       Save first! Saving for retirement should be a top priority! By saving now you can ensure stability and a quality of life for your future, and the future of your loved ones!

 

Quinn-Szcesuil, J. (2013). Financial planning 101: know your worth. Minority Nurse. Springer Publishing Company. Winter 2013.

Interdisciplinary Teams

The other day, at about four o’clock in the morning, I found myself sitting in the emergency room with a loved one. I would like to be able to say this is a rare occurrence, but in the past few years I have found myself in this situation many times. Each time I have experienced health care from the perspective of a family member. This time, however, I found myself being much more aware of the importance of interdisciplinary teams in health care. I am not sure if it is because of my nursing leadership course or if it is a result of something else, but this time I understood profound impact that a positive team can have on patient care.

According to Huber, interdisciplinary teams are “essential to an organization’s efficiency and effectiveness because collaboration and teamwork are essential to achieving high-quality work outcomes and cost control” (2010). Patient needs are increasingly complex and successful outcomes are dependent on interdisciplinary communication. Characteristics of a effective interdiscplinary team include:

• Communication Skills: both verbal and written
• Mutual Respect: between, and within, each discipline
• A common goal: patient centered care
• Effective conflict resolution
   

Nursing is in a unique position to provide profound leadership in this area. As the “eyes and ears” of the patient, we have the opportunity to communicate the needs of the patient and facilitate appropriate action.

“Nurse leaders need to learn how to manage in a team-centered environment; staff nurses must learn how to be effective team players” (Huber, 2010, p226)

After hours in the emergency room, my loved was admitted to a hospital unit. Our greatest needs were not what would have been expected. Our nurse was able to utilize her communication skills to not only hear our needs, but to facilitate an appropriate course of action from the interdisciplinary team, leaving a profound and lasting impact. This nurse understood the importance of communication, working as a team, and being a leader in her role. As I strive to become a leader in my role, and hone my communication skills, I CHALLENGE you to do the same!

Huber, D. (2010). Leadership and nursing care management (4th ed.). Philadelphia, PA: Saunders Elsevier
Mickan, S. (2000). Characteristics of effective teams: a literature review. Australian Health Review. 23:3. Retrived from: http://www.unc.edu/courses/2008fall/nurs/379/960/65_604078165817-effective_teams.pdf

The Blind Men and the Elephant

 

We have all been in groups where communication is almost non-existent and conflict is through the roof. Conflict is one of the most difficult challenges to over come in the team setting. But why is there conflict? Is it a clash of personalities? A difference of opinion? Or could it be boiled down to perception? Chris McGoff of the ThePrimes.com discusses conflict in terms of perspective. 

BLIND MEN AND THE ELEPHANT

What I found powerful about this video, was that McGoff key into the fact that each individual has their own perspective. On top of that, their perspective isn't wrong, because for every reason that is their reality.

Knowing this…how can WE apply it to leadership or managing a team?

- Objectively determine the perspective of each team member

- Ensure everyone has access to the same information

- Focus on rationalizing each perspective rather than being drawn into an argument

- Use shared information to solve conflict

- Take time to see the benefit in each perspective

The Primes. (2011). Blind men and the elephant. Retrieved from: http://theprimes.com/index.php?option=com_content&view=article&id=110&Itemid=55&prime=4

Appreciation - Influence - Control

This past week I had the opportunity to be involved in a round table discussion on leadership with Dr. Dan Pesut. Dan is the director of the Katharine J. Densford International Center for Nursing Leadership at the University of Minnesota. Our discussion centered on the AIC (Appreciation, Influence and Control) model of power.

What is AIC?

“Appreciation, Influence and Control are the names given to the three fields of power that we use to accomplish any of our purposes, however small or large. It helps us to look at ourselves, our organizations and our world in a profoundly new way. It reveals the true sources of our power and how we can use them for the good of ourselves, others and the common good” (Smith, 2009). The concept of this model is to provide individuals with awareness of their power sources. The most effective leaders are able to maintain balance between the three fields.

In order to understand your personal AIC model, you must first take a quick quiz based on colors. Doing so will provide an understanding of your balance in the three areas of power. Click here to take the quiz.

Appreciation

 The appreciative phase goes beyond our perceptions of a situation. This phase reveals your future orientation. It encourages an awareness of the “BIG PICTURE.” This field affects your purpose, but you have no influence or control over it. The appreciative method relies on our mental, spiritual, intuitive and sensing capacities. This is where our ideals are represented.

Represented by: beauty, enlightenment, love, social, appraisal, spirit, discovery, equanimity, and pragmatism

Influence

The influence phase focuses on collaboration and cooperation and is represented through our values. Your present is represented in this phase. Influence affects your purpose, which you can influence, but not control. Influence draws on our thoughts and emotions to balance any differing values.

Represented by: diplomacy, science, sociability, technology, negotiation, and reason

Control

The control phase allows us to shape our purpose through the development of goals, based on our past experiences. This is the phase that allows you to affect your purpose through control. 

Represented by: Diplomacy, discovery, negotiation, economics, omnipotence, and truth

My Results:

Control: 54%   Influence: 22%    Appreciation: 24%

I was initially surprised by my results to the AIC model. I had a negative connotation associated with the word “control.” It elicited an image of a very authoritative leader (not someone I want to be). However, the more I thought about it the more I realized the truth behind it. I strive for perfection, to be an individual, and enjoy a certain amount of predictability. As a nursing student my schedule is very important! Without it I would NEVER accomplish anything, or show up anywhere. I prefer my work to stand for itself in terms of my success, not my powers of persuasion. There is a lot to be said for this area power.

….however, there is also a lot to be said for appreciation and influence (which also had negative connotations for me) as well. The great thing about the AIC model is that it not only shows where you rank in each of the three powers, but also explains your strengths and weaknesses in each of these areas. It is through the examination of these strengths and weakness that we are able to utilize the knowledge behind the model in order to become great leaders.

What did you discover?

Smith, W. (2009). The meaning of the three circles. Retrieved from: www.oodi.com

Emotional Intellegence

If you were to ever Google what is needed to be an effective leader, many qualities and attributes would show up. Some of them would be humorous, some helpful, insightful, and others would not be helpful at all. According to Peter Borner, there are ten things that all outstanding leaders share:

1.     A clear vision

2.     A strong mission

3.     Expert communication skills

4.     SMART goals

5.     A high degree of competency

6.     Strong interpersonal skills

7.     A strong team

8.     A “can do” attitude

9.     A strong ability to inspire

10.             A driving ambition

All are important. All are important characteristics of a leader. However, The New Leadership Challenge suggests Emotional Intelligence is almost twice as important as any other leadership attribute. Emotional intelligence evokes a more productive and effective result from team members. It is recommended that leaders be self-aware, be able to self-regulate, be motivated, have empathy, and possess social skills. “Leaders can maximize their successes as well as facilitate others’ achievements by fostering and environment more conducive to using emotional intelligence…” (Grossman & Valiga, 2009, p.66). 

What is your opinion? What do you feel makes an effective leader?

Borner, P. (2012). What does it take to be an outstanding leader. Pete Boner: Thoughts from a Process Centric Leader. Retrieved from: http://www.peterborner.com/2012/05/13/what-does-it-take-to-be-an-outstanding-leader/

Grossman, S. & Valiga, T. (2009). The new leadership challenge: creating the future of nursing. F.A. Davis Company. Philadelphia, PA.

Effective Team Communication

To work in health care means to work as part of an interdisciplinary team. As I am sure we can all attest to, working as part of a team is not always an easy task. Personality and communication differences can lead to conflict, burn out, and hurt feelings. Nursing leaders act as a facilitator for many interdisciplinary groups. While it is important to highlight the positives in our behaviors when working as a group, sometimes it is equally important to highlight dysfunctional behaviors as well. Common types of dysfunctional behaviors:

Compulsive Talkers: these individuals are continuously giving their opinion and often end up guiding the conversation
How can the nurse leader deal with this situation? Thank them for their input and ask for input from other team members. Help guide the conversation so each member of the team feels heard and valued. Allow time for this individual to discuss the topic at hand in further detail later.

Non-Talkers: these individuals listen to the team discussion and often hesitate to give their opinion. How can the nurse leader deal with this situation? Ask them to write their opinions down. Specifically ask them questions to gain their insights. Allow them the opportunity to think and formulate their opinion.

Interrupters: these individuals are often seen as lacking self control. They can leave other team members feeling discourage, self conscious, and unappreciated.
How can the nurse manager deal with situation? control the situation by stopping the interrupter and asking the other team member to finish. Then ask for their opinion as soo as they are finished. Try saying “I like your thought process, but lets finish hearing what Jessica was saying.”

Squashers: these individuals will discount opinions and ideas before they have a chance to be entirely formulated. They are often seen as resistant to change or afraid to take a risk.
How can the nurse leader deal with the situation? State that the group will first hear all ideas before gaining pros and cons. In certain situations it may be important to allow them to express their reservations for a period of time before asking to move on. Ask them to determine positives as well as negatives to each situation

Busybodies: these individuals are often not entirely committed to the task at hand. They do not come prepared to group meetings, show up late, and leave early. They are meeting their own personal needs by attending the meeting.
How can the nurse leader deal with the situation? Find creative ways to engage the team member. Give them concrete assignments with a high level of accountability. If the team member is not able to commit, it may be necessary to consider disciplinary action. 

When it comes to working as a team, it is important to be aware of positive and negatives of human behavior. As a nurse leader, pay attention to the members of your team and how they respond to group task. 

I challenge you to contemplate which of these team members you are. How can you alter your behavior to be a better team player?