In 2019, American Organization for Nursing Leadership (AONL) held the inaugural cohort of its Nurse Executive Fellowship. The intent of the fellowship was to prepare a cohort of nurse leaders who demonstrate the AONL Executive Nurse Competencies in their 1st executive roles. As members of the inaugural class of the AONL Nurse Executive Fellowship, we have gained skills and insights. Through the fellowship, we learned about ourselves as leaders, identified leadership strengths and potential, were challenged to develop executive competencies, and developed bonds with a cohort of peers new in their executive journeys.
The fellowship consisted of 3 in-person gatherings as well as virtual small group meetings and webinars. It included insightful education and self-development sessions centered on the AONL nurse executive competencies. Learning occurred through multiple educational methods such as leadership simulation, self-assessment, didactic presentations with group discussion and small group activities. Participants connected and bonded through the various exercises that brought us together physically, mentally, and emotionally.
One practice that connected us was the use of circle principles, introduced to the fellowship in the 1st session and used during each of the sessions. Participants gathered together in a nonjudgmental circle that offered opportunity and time to share with others. We were welcome to check in and or pass, and as the circle progressed, many of us felt the support of our peers. Many of the fellowship participants found the circle time so simple, yet impactful, and incorporated this into their own leadership practice.
Another learning tool was the Hogan self-assessment, which provided awareness of personality and behavioral tendencies. The assessment generated a report, and the results were reviewed during one-on-one telephone calls with an experienced executive coach prior to the 1st session. During the initial session, Hogan experts explained how an enhanced self-awareness is the foundation for effective leadership. As one participant said, “When I am asked about what I gained from participating in the fellowship, I respond by highlighting the importance of self-reflection. The ability to complete the Hogan assessment and navigate how to build upon my personality strengths when connecting with my leadership team supported fostering relationships whereby initiatives could be achieved through mutual trust.”
Engaging With Thought Leaders
The fellowship provided opportunities to engage with thought leaders within nursing and external to the field. Several of the presenters were personal role models—leaders whom participants may hold in high regard, read about, and admire for their work, but would not have the opportunity to meet, let alone engage in deep discussion. It is a different experience to spend the day together with those speakers, discussing the future of nursing leadership and sharing ideas on how we will keep moving the needle in the right direction. The fellowship provided this unique opportunity to ask questions, down to a granular level, to probe role models' thoughts and establish deeper understanding. From journal editors and nurse innovators to specialty topic leaders and current and former chief nurse and healthcare executives, the fellowship provided a chance to interact with these leaders, with the potential for mentoring opportunities beyond the fellowship time.
Deepening Executive Competencies
The fellowship reinforced current executive competencies, expanded on areas where we were less experienced, and increased our knowledge base through exposure to entirely new information. It is challenging to summarize the fellowship experience given the robust curriculum and the significant impact it has had on how we view ourselves and our development as nurse executives. The following reflections from members of the cohort demonstrate how several of the goals of the fellowship were met.
From the beginning, we were challenged to be innovative thinkers. One of the 1st presentations was on the importance of appreciative inquiry and positive deviance. It set the tone for the entire fellowship as it challenged us be disruptive innovators, to question old ways of doing things, and examine how appreciative inquiry can be a valuable tool in problem solving. The presentation validated a core belief that in order to be successful in the rapidly changing healthcare environment, we need to think differently.
Communication was emphasized throughout the fellowship as foundational for deepening relationships and having influence. A variety of communication modes were introduced, such as storytelling. One participant identified that she brought forward to her senior leadership team the importance of storytelling to highlight quality and safety concerns. Another communication tool used in the fellowship was the salon. Salons are gatherings of people for the purpose of conversation around a topic or piece of literature with the intent to increase knowledge, allow for debate, encourage the exchange of ideas, and to inspire and stoke passion. One participant implemented salons in her organization as a method to solve complex organizational issues with the nurse executive team. By engaging nursing thought leaders in discussion around a broad question as opposed to attempting to solve a singular issue, the nurse executive team is honing its ability to engage in disruptive innovation.
The above activities helped meet the intended fellowship outcomes of shaping the culture through expert communication and influence; demonstrating skilled communication to build relationships with the medical staff, academic partners, and the community to achieve common patient care goals; and developing executive presence in both the C-suite and governing levels of an organization (Figure 1). As 1 participant noted, “My nursing dyad partnership is stronger after the fellowship. My voice will not be silenced, and I have gained knowledge, commitment, and understanding of my role at the executive table.”
Network of Peers
Networking with colleagues and connecting with others who may not have otherwise met were a joy. The fellowship's professional collegiality provided a readily available network for navigating operational issues and providing peer support. Ample networking time created a foundation to develop peer support where we could openly share with others in similar roles. Members of the inaugural fellowship were a diverse group of nurse executives with similar leadership roles, sharing parallel issues and challenges across vastly different healthcare settings. It has been said that it is “lonely at the top” and trust is rare. This fellowship shattered that concept by creating a space where an internal circle of trust was created. By crafting long-term collaborative relationships, it assisted us as leaders to be better equipped to be innovative and experts in our field. The fellowship encouraged different ways of thinking, supporting growth, and challenging the norm; the group created a bond.
Responding to a Need
Committed to the development of current and future trailblazers, AONL developed the Nurse Executive Fellowship with input from thought leaders from various sectors of the healthcare industry including established and seasoned nurse executives. Drs Kathleen Sanford and Michelle Janney,1 who served on the planning team for the fellowship, authored a JONA article last year in which they reviewed the future of workforce needs. Sanford and Janney1 noted the lack of professional development programs for the novice nurse executive and the need for such a program. We believe the fellowship meets the needs of new nurse executives, providing practical tools for problem solving and a peer network that might have taken years to build without this program. It also encouraged us to reflect and think differently.
Based on the feedback of the participants, AONL continues to refine the program, anticipating that the program's content will continue to morph in response to changing needs. However, the program's core will remain: connecting individuals in executive roles who aim to be influencers shaping health care. The confidence gained was a gift, and we are proud to be a part of the mission of AONL.
1. Sanford K, Janney M. Preparing the nurse executive of the future. J Nurs Adm