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Think About It
A forum for discussion of the latest news and ideas in nursing management and healthcare.
Wednesday, July 23, 2014
Career advancement didn't weigh heavily on my mind when I first became a nurse. My primary career goal was to simply be a good nurse. Whatever your career path, being good at your job is essential. But advancing your career can also increase job satisfaction and enhance fulfillment. Throughout my career, in varied experiences as an employee, supervisor, mentor, and colleague, I've observed a number of key attributes that will make a career successful. See if you agree!
1. Leadership is my number one. Being a leader inspires confidence from those around you, whether it's your boss, an employee, or a peer. Leadership includes having the courage to say and do the right thing, and being able to instill those values in others.
2. Ethics are also essential. Applying rules consistently and following them yourself will earn you respect. You'll also gain status from being a trusted resource and ally--respect is an important underpinning for future advancement.
3. Knowledge serves as a necessary tool. Being inquisitive and taking the time to think about what it is you’re doing and why you’re doing it is extremely valuable. A good education provides a foundation, but learning from everyday experiences and keeping up with the latest research, technologies, and trends will position you as a savvy resource.
4. Collaboration is key! Building relationships and working as part of a team strengthens your ability to influence an agenda, discussion, project, or program. When others see you serving as a partner, they'll be more likely to help advance your goals, be they personal or professional.
5. Communication closes out the top five. Being able to communicate clearly, succinctly, and compellingly in both oral and written formats helps get your point across and helps you better engage others in your efforts.
While the ranking of these key attributes may fall in any order, making them a part of your career planning will definitely put you on a path to success!
Joyce Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, FAAN

Wednesday, July 16, 2014
I just saw the movie Frozen and can’t get that song out of my head. As I hum the chorus, "let it go," I’m thinking nurse managers should let some things go. Do you think you’re the only one who can do things right on your unit--let it go. Are you the sole decision maker in your area--let it go. Are you still developing the work schedule--let it go. You may need to work on these gradually, but you really can let them go.
Make a list of your staff members and give close consideration to strengths and skills demonstrated by each person. One might be great at writing policies, another may be a strong negotiator, and another might be excellent at working with groups to get tasks accomplished. As new initiatives arise, match your staff members and their strengths with rising challenges to ensure success. Provide clear expectations and make yourself available as needed.
If they come to you with questions, ask “What do you think is the best option?” and be ready to support their recommendation if it moves the group toward its goal. If not, redirect them by providing additional suggestions.
If your unit isn't using self-scheduling move forward toward developing a group to establish boundaries and discuss its implementation. Although initially, some staff members may be skeptical, nurses appreciate the autonomy and participation in shared governance.
If you’re not seeing the specific skills needed among your staff members, look for the potential to develop them. When listing staff members' strengths and their potential to develop value-added skills you determine that some of your staff have neither, you may need to take a note from Frozen and let them go.
Dennis R. Sherrod, EdD, RN

Monday, June 30, 2014
While the political machinations surrounding the Patient Protection and Affordable Care Act, 2010 continued to swirl in the public fora, translation and application of its requisites are now well into the fourth year of implementation. While there will likely be political and legislative adjustments along the way (this is America, after all), the strong likelihood is that most of its implications, which affect its implementation for providers will continue to steadily unfold over the next 6 or 7 years. Specifically, the elements and characteristics of accountability and the “triple aim” will continue to drive the design and construction of health services for the foreseeable future.
What’s important for nurse leaders is the recognition that much of the demand for value-based healthcare is a positive force and a strong influence for the future correct calibration of health services. Clearly, for far too long, the focus of health services has been strongly medical model delineated with primary emphasis on therapeutics, intervention, and treatment strategies. While there has been a huge effort to give what’s essentially lip service to creating a healthy society, most of the health resources of the United States have been directed to supporting the predominant part of the system, which is essentially late-stage, late-engagement, high-intensity intervention in the illness process. A microscopic amount of social and financial capital in the United States has ever really been devoted to producing a net aggregate level of health for the citizens of the wealthiest nation in the world.
Of course, the expectation is that leading the way for this transformation will be nurses whose key characteristic and social purpose has ostensibly been to manage and advance the healthcare continuum of those we serve. While the vast majority of our nurses have been co-opted historically into the illness model because of the structural, financial, and service predominance of it, establishing the highest level of health for persons is an historic centerpiece of nursing practice. Now the time has arrived where both the opportunity and obligation have converged under the auspices of health reform to actually initiate and sustain a system for health for the American people. Truly, a convergence for nursing between purpose and need now serves as a driver for the future of nursing practice.
It’s now incumbent upon nurse leaders to be able to alter the contextual and conceptual framework for nursing practice in significant and innovative ways. Nursing practice now must move out of compartmentalized, diagnostically identified, iterative, and functional delineations for care delivery into more linked, integrated, team-based, facilitated, continuum-driven care models. Creating a seamless interface between components of healthcare users’ personal health needs and the positioning, availability, and location of services to meet those needs now drives the design and construction of nursing care service models. This means altering care delivery standards, practices, scheduling, assignments, roles, competencies, and relationships with both populations and the network of providers that will be aligned to best serve them.
Nurse leaders at every place, especially at the service level, must now stop negotiating the potential for changes in nursing practice. The potential is now past. Much of the work of nurse leaders is helping the profession engage the realities of transforming practice, coping with the implications of personal change, helping staff surrender attachment to clinical sacred cows and past rituals and routines. All of this in an effort to lay the groundwork for a different conversation about just what the future of nursing practice is and how it plays out in the day-to-day role of the nurse. Nurse executive leadership must create the “burning platform,” which serves as a drive for strategically aligning practice priorities with shifting organizational service demands and the requisites of “the triple aim” of service excellence, consistent quality metrics, and service affordability. The emerging requisite for transparency in these arenas of performance now leave little option for failing to demonstrate both the relevance of nursing practice and its impact on the metrics of service excellence, quality, and affordability. Directors and unit managers must now do the heavy lifting of recalibrating practice around populations, episodes, and continua, in a horizontal relationship that favors highly interactive team decision making and collaborative practice and creates mobility in scheduling, assignments, and practice in the fluid and portable engagement of the user of health service where they live and within their lives.
There’s no doubt that this is a seminal moment in the longer life of the nursing profession. Certainly as Nightingale’s life indicated, nursing’s relevance is verified by the positive impact it demonstrates on the health circumstances and lives of those it serves. As the condition and circumstance’s shift and emerging opportunities provide a greater potential for impacting the health of our nation, nurses must continue to exemplify through their social compact and commitment that they’ll take on the challenge to do just such work. One hundred years hence from Florence Nightingale’s time, we’re challenged much as she was to raise the standard, write a better script, and push the walls of our profession’s commitment to health to the next level. That was the demand of nursing leadership then and remains the requisite of nursing leadership now.
Tim Porter-O’Grady, EdD, APRN, ScD, FAAN

Wednesday, June 11, 2014
Retention is your best recruitment strategy and it begins with developing healthy and engaging workplaces that retain staff. While ensuring safe and quality patient care is a priority for every healthcare system, it's also important to establish a culture that recognizes and values the staff members who provide that care.
Back injuries, workplace violence, needle hazards, chemical exposures, and work stress are just a few examples that may threaten you and your staff members' health. But, just as you’re developing quality improvement initiatives for improving patient care, you can also pilot strategies for improving workplace safety for you and your staff.
Let’s say, for example, one of your nurses asks to speak with you confidentially and tells you her ex-husband has been making threatening phone calls. He showed up last week unannounced at her home and threatened her with bodily harm. Does your human resources office have a counselor available to work with this issue? Is this a responsibility of the nurse manager or your organization?
This can be a gray area for some nurse managers as well as organizations and the best learning occurs from each other. Feel free to join this conversation by responding with what’s working or not working in your organization to develop a healthy workplace for you and your staff.
Dennis R. Sherrod, EdD, RN

Tuesday, June 03, 2014
Primary elections are being held across the country and it will be a mad dash until we reach the national election date of Tuesday, November 4, 2014. Currently, we have six nurses in the U.S. Congress, but we can use more. We can also use some “nurse thinking” in state legislatures, local municipalities, and on health system boards.
Healthcare continues to be a national issue and the public voices concerns regarding safety, quality, and costs. And most nurse managers I know are waiting to see how the Affordable Care Act dust will settle. Stop waiting--no one has a better understanding of healthcare delivery systems than nurse managers and clinical nurses, and we can begin now to increase nurse representation in policy-making arenas.
Consult your state nurse executive, nurse manager, or nurse associations to identify if nurses are competing in local, state, or national elections. Inform yourself about campaign issues. Discuss these issues with nurse colleagues to gather their thoughts and support. Support a candidate by sending a campaign contribution, attending a rally, or making phone calls to get out the vote.
Encourage fellow nurses to serve as a candidate in local elections or on community boards. If nursing is currently not represented on your health system Board of Trustees or Advisory Boards, you might want to write a letter or make a suggestion to board stakeholders and decision makers to add a nurse.
Let’s identify and create opportunities to get nurses to the policy-making table. The community and healthcare need our expertise.
Dennis R. Sherrod, EdD, RN
About the Author

Nursing Management
“Think About It” is an extension of Nursing Management. Here, you can read and discuss professional information geared toward helping nurses excel as leaders. This blog tackles important topics without the worry of print publication deadlines!

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