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Nursing Management:
doi: 10.1097/01.NUMA.0000428196.06765.f9
Department: Leadership Q&A

Know your value

Raso, Rosanne MS, RN, NEA-BC

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Senior Vice President of Patient Care Services and Chief Nursing Officer, Lutheran Medical Center, Brooklyn, N.Y.

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Q As a nurse manager, I often feel undervalued. Is it the position or my working environment?

My gut reaction is that feeling undervalued is most likely due to your work environment, but you may have to look to yourself for the answers because there are many factors involved. Sometimes we get into a slump and feel unhappy or deenergized, and it has more to do with our own feelings and expectations than job reality. There are always portions of the job we don't like, but most of the time we tolerate these because we get fulfillment from the enjoyable majority of the work.

What makes us feel valued is both internal and external. Are you recognized privately and publicly for your contributions? Just as our staff members need recognition and appreciation, so do we. Are you learning new skills and competencies? If not, you can work with your boss to create a development plan and volunteer for projects and activities out of your comfort zone. Do you feel included in decision making? If not, that can be the result of organizational culture, your nurse executive's leadership style, or even your own competence or engagement level. Do you enjoy working with your team? Sometimes a few “bad apples” on the team can ruin the work environment. Confront it and get help to manage any problems. Does the culture of your organization appreciate nursing's influence on success? If not, that's an impediment to feeling valued and not something you can change single-handedly.

Concentrate on what brings you joy and relish it. The position you hold is one of the most important leadership roles in the healthcare setting. You can contribute and facilitate improvements to unit culture, processes, and outcomes. You make or break the work environment for your staff and the interdisciplinary team. Your management and leadership make an enormous difference to patients and families. Staff members will grow and flourish as a result of your influence.

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Focus on what you can control. Some of my own sense of value comes from patients and staff at the point of care—listening, helping, appreciating, removing barriers, and engaging them. That's the point where you intersect every day. If there's no joy in your work despite addressing the issues you can identify and fix, then it's time to move on. The role is far too important, and so is your happiness.

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Q I just finished my master's degree in nursing administration. To remain current, do I need to go right back to school for a doctor of nursing practice (DNP) degree?

You're very ambitious! You don't necessarily need a DNP to stay current because there are other approaches to keeping abreast in nursing administration. Reading journals, attending conferences, joining collaboratives, and networking with fellow nurse leaders are just a few. However, you'll want to further your education if your career goals require a nursing doctorate, if you're committed to having the highest nursing academic credential, if you desire advanced leadership skills, or if you simply love the continuous pursuit of knowledge.

The DNP is a practice doctorate, distinct from a PhD or doctor of nursing science, which are research degrees. It's akin to any other practice doctorate in healthcare, such as medicine, physical therapy, or pharmacology. Check your state rules because not all states permit a nursing executive DNP. For example, my state (New York) only permits DNP programs in advanced clinical practice for NPs.

The DNP curriculum essentials include systems thinking, analytics, healthcare policy, interprofessional collaboration, population health, information technology, and more. These fundamentals of DNP education will, of course, make you a more forward-thinking nurse leader and prepare you to have greater impact in your current role and advanced roles in the future. You may be able to use a DNP to fulfill requirements in the faculty realm if you're teaching nursing practice in your specialty.

I admire your energy. At an overall level, the nursing profession continues to have limited academic credentialing; however, motivated leaders such as you will help push us into a new era.

© 2013 by Lippincott Williams & Wilkins, Inc.

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