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Feature: Executive Extra series, part 3

The mindful nurse leader

Key take-away

Go slow before you go fast

Doucette, Jeffrey N. DNP, RN; Cotton, Amy MSN, RN; Arnow, Debra DNP, RN; Pipe, Teri PhD, RN; FitzPatrick, Kate DNP, RN

Author Information
doi: 10.1097/01.NUMA.0000502802.29800.61
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The primary objective of this project was for our team to focus on the process of learning and reflecting, with the project outcome as a secondary focus. For nurse leaders accustomed to emphasizing performance and measurable outcomes, the attention to individual and team learning presented a refreshing, but sometimes difficult, challenge. As a team, we found that the outcome was stronger because we concentrated on the process; this learning became the core of our ongoing work.

Creating the context for leadership development

Fortunately, we had a team coach who guided us in this endeavor, along with clear guidance from our fellowship program content. For example, we adopted the Inclusive Learning Environment Agreements:

  • speak your truth
  • lean into discomfort and lean into each other
  • commit to nonclosure
  • embrace paradox
  • seek intentionality, not perfection
  • the teacher and student create the learning community.2

As a team, we also adhered to the safe space norms adopted by our larger executive nurse fellow cohort. These ground rules provided behavioral parameters for our work and how it was accomplished. We agreed to:

  • be humble and authentic
  • accept/appreciate mistakes
  • actively listen to and solicit all opinions and input
  • have fun
  • define mutual goals for clarity of purpose
  • engage in respectful disagreement
  • create a gracious space
  • interact face-to-face
  • share expectations, goals, mission, and vision
  • maximize the creative talent of each team member
  • exhibit nonjudgmental behavior, mutual respect, and trust
  • rotate leader, chairperson, and facilitator roles
  • be intentional
  • leave it in the room (no meeting after the meeting).

Elements for expansive team growth

We took several concrete, intentional steps to propel our individual and team learning forward in ways that helped us focus on both the process and the product.

Our action learning team made the decision to hold our face-to-face meetings in environments that facilitated clarity of thinking. For this reason, we avoided typical meeting rooms and chose a nature retreat, a home setting, and a mountain retreat for our meeting locations. Important elements of the locations included quiet with minimal distractions, natural light, and access to outdoor space. Our team practiced principles of situation-behavior-impact (SBI) feedback during these powerful in-person meetings.3 SBI was a technique presented to us during one of our intensives as a tool for providing constructive feedback. As the months progressed, all team members developed the trust to freely share their individual and team learnings in a transparent and impactful manner.

At one point, the powerful importance of environment was tested when the team was forced to hold a meeting in a small conference room without windows. We all felt the team's energy shift, and progress during the meeting was impacted until we recognized that our environment was part of the issue. We then moved outdoors to engage in a brief group mindfulness activity to reset our energy.

We agreed early on that we would each rotate through specific roles, including leading a mindfulness activity, facilitating the meeting, scribing, time keeping, and reflecting on team learnings. Teleconference and face-to-face meetings were held regularly, with each member agreeing to prioritize participation. The clarity of action items and the practice of each team member stepping forward with their talents, expertise, and contacts were critical to accomplishing project completion. We used a template agenda that served to frame minutes; all documents were posted on a file sharing site for ease of distribution. We also used e-mail and social media to communicate with each other and our coach.

We decided to start every teleconference and face-to-face meeting with a centering mindfulness activity. We rotated the role of leading the activity to develop our individual skills of facilitating mindfulness exercises. This was a new experience for most of our team members. By practicing in a supportive environment and allowing all team members to utilize various methods and approaches, we grew in our familiarity with and openness to continued mindfulness practice. This shared accountability not only encouraged personal growth, but also helped with the creation of a mindfulness practices toolkit.

Our action learning team had an expert consultant to serve as a facilitator for group feedback and the leadership learning process. Her role was invaluable in reflecting on team effectiveness and our project's progress. We also brought in a communication expert once we determined that our project would be a video and an administrative expert to assist with the operational needs of the project such as budget.

Personal and organizational lessons

We're all expert nurse leaders within our respective fields. This diversity challenged us personally and offered an opportunity to expand our knowledge and passion in a much broader approach to influence nursing and healthcare. Providing constructive feedback, listening, and supporting each other became the backbone of success. Our rotation of meeting roles provided each of us with an opportunity to build our skills in leading, centering, and reflection, leveraging our personal strengths to improve the team's progress. Further, practicing mindfulness as a team and individually throughout the process added a level of richness to our group.

As individuals, we recognized the power of authenticity as a critical leadership skill. Mindfulness and centering were unfamiliar skills to most of us; we learned from each other about the impact mindfulness made in our personal and professional lives. Understanding our own strengths as individuals and the contribution that each of us made to our project's success had a tremendous impact. Several team members were strong in innovation and idea generation, whereas one member was particularly strong in operations. She brought a grounding influence to the group when accomplishing tasks and moving us toward our goal.

One key lesson is to go slow before you go fast. For example, what seemed to be a simple solution of acquiring nurses' mindfulness stories turned into a valuable lesson in understanding the impact of quick decisions. As individuals, we valued the importance of developing keen listening skills to gain the perspectives of fellow team members. Openness to different methods of communication and project leadership roles led to added effectiveness within a diverse team.

Future directions

Our goal of developing a tool to support a national-level campaign to inspire and engage nurses to enhance the human experience through stories of compassion, mindfulness, and presence was achieved with the production of our video vignettes. Although the project is national in nature, we believe there's applicability at all levels of practice, from the bedside and beyond. We not only succeeded in enhancing our understanding of mindfulness in nursing, we also developed a narrative method to remind nurses of the many ways to practice mindfulness in simple, practical, and meaningful ways.

A secondary benefit for team members was gaining mindfulness skills to use in our personal and professional lives. In addition to building resilience in nurses, mindfulness is an effective path for younger generations considering a career in health. The impact of mindfulness on the nurse offering compassionate presence to each individual patient and family during care delivery strongly supports current efforts to be person-centered in healthcare.

Within the current changing landscape of nursing practice and the stressful environments of healthcare provision, we hope this project will be one of many powerful tools for academic institutions, healthcare organizations, and professional nursing associations to communicate how to inspire, engage, teach, and celebrate the powerful impact of mindfulness, presence, and compassion in nursing practice.

REFERENCES

1. FitzPatrick K, Doucette JN, Cotton A, Arnow D, Pipe T. In the moment: stories of mindfulness in nursing. https://drive.google.com/file/d/0B4DSpdC0BRYEOUNETGpJQ0hod2M/view.
    2. OpenSource Leadership Strategies, Inc. www.opensourceleadership.com.
    3. Center for Creative Leadership. Situation-behavior-impact (SBI) feedback. www.ccl.org/leadership/pdf/community/SBIJOBAID.pdf.
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