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Feature: Richard Hader Visionary Leader Award

2019 Visionary Leader Iesha Bethley

Kelly, Leisa MS, APRN-CNS, CEN, CMSRN; Solomon, Sophia MSN

Nursing Management (Springhouse): January 2020 - Volume 51 - Issue 1 - p 13-15
doi: 10.1097/01.NUMA.0000617016.42696.2f
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Starting on a busy surgical unit as a clinical nurse, Iesha worked as an informal leader, which led to her becoming a supervisor and setting the professional goal of becoming a manager. After completing her master's degree in 2016, an opportunity arose to manage a 35-bed neurology unit. This was a challenging unit, with team member engagement, nursing initiatives, and staff satisfaction scores not meeting expectations. Iesha accepted the position, assuming responsible for over 40 employees.

Iesha's primary vision was to change the unit's philosophy from “my patient” to “our patient.” When she arrived on the unit, there was a tense relationship between nurses and ancillary staff, with clear divisions between what the nurses felt they should be doing and what the unlicensed assistive personnel felt they should do. Staff members often spoke “at” one another rather than “to” one another. Iesha changed the unit's culture by being a role model and mentoring nurses on how to effectively communicate, work as a team, and set expectations. She empowered both groups to speak to each other and work together, often serving as a sounding board and the mediator of problem-solving activities. Staff members slowly began to partner together rather than working separately. Both groups now work amazingly well together, resulting in better patient care and a more positive work environment.

Iesha believes that leadership is rooted in the team. One of her goals is to help make her unit a positive place to work. She wants her staff members to enjoy coming to work and delivering quality care. Under her leadership, the neurology unit has become a tier 1 unit for staff engagement and satisfaction, experiencing a reduction in nursing turnover.

Clinical practice

Iesha is a strong clinician and a certified medical-surgical nurse. She believes in supporting staff development, increasing knowledge, and utilizing evidence-based practice on her unit. She encourages clinical nurses to attend charge nurse and preceptor classes and offers unit educational opportunities. During Iesha's tenure, all clinical nurses on the unit have become National Institutes of Health stroke certified.

Iesha has remained involved with patient care, demonstrating compassion and concern. One example is her work with a 22-year-old patient who was paralyzed from the waist down. He was depressed, nonadherent, and angry after spending months in the hospital. Over time, Iesha learned his likes and dislikes and created a bond with him. She made a point of visiting him every day to sit and talk. He shared his goals, prayers, fears, and aspirations and how he believed that he would walk again. His anger gradually subsided and he became more active in his care. Even after he was discharged, he came back to visit with Iesha and share what was going on in his life. He was appreciative that she accepted him for the person he was and not just another sick patient. She also taught him that even against all odds, it's important to have faith in your ability to meet challenges. Every day you can observe Iesha talking to patients, families, and team members on the unit.

Iesha illustrates to our nurses that they're able to provide holistic care. Spending time with our patients can make a real difference in their hospitalizations. Listening or holding a hand sends a positive message to the patient, not just the tasks we complete. Recovery is often long and difficult for stroke patients, and having positive energy is extremely important in the healing process.

In her first year as manager, the unit achieved 1 year without central line-associated bloodstream infections. The unit has also had a significant reduction in falls, catheter-associated urinary tract infections, and pressure injuries. Iesha is involved in our facility's committees and strives to make a difference through activities such as stroke prevention and our annual American Hospital Association drive and by being a member of the American Nurses Association.

Iesha's staff members have also become involved in nursing committees and initiatives. Her unit served as a pilot unit for video monitoring of high-risk fall patients and presented a poster at the 2018 TRIP Conference in Baton Rouge, La. The unit also served as a pilot sitter reduction unit, which is projected to save our facility over $70,000. Her team's poster on sitter cost reduction was recognized at our facility's 2017 Quality and Safety Day. Iesha encourages her nurses to be involved in our clinical advancement and preceptor programs, and the unit now has an active shared governance council. Iesha truly believes in growing her nurses.

Transformational leadership

Transformational leaders are sometimes called quiet leaders, leading by example. Iesha inspired and developed a rapport with her team to change the things that weren't working on the unit. She solicited staff input on what needed to be changed to make the team exceptional. With this information, she developed short- and long-term goals for the unit. She created a supportive environment that was open to change and established expectations for the team.

Nursing administration challenged Iesha to make the unit a premier unit in our organization. She not only met the challenge of managing a busy neurology unit, but also successfully coordinated the unit's activities, juggling patient care while developing an engaged team. She prepared her team members to utilize critical thinking, increase their clinical knowledge, and deliver quality care. She worked closely with the stroke team educator to hold postevent huddles and individual educational sessions.

The patients on Iesha's unit require a high level of coordination between the nursing team and other disciplines from the time they arrive on the unit until discharge. Iesha has built and established mutual trust with not only her team, but also multidisciplinary team members. She worked with her nurses on developing rapport with the physicians who admit patients to the unit. And she helped establish interdisciplinary discharge rounds to better plan patients' hospital stays and discharge plans.

Iesha has given her team a voice, guiding them in developing an active unit-based council that reviews patient and nursing satisfaction and plans celebrations, recognition events, and nursing initiatives. Team members can give their opinions and learn about unit activities. They have a voice as to how assignments, projects, and schedules are implemented. Iesha also recognizes individuals and celebrates successes as a team. Her bulletin boards are visible for all team members to share accomplishments and track improvements.

A mentor and a role model

Iesha serves as a mentor and role model for her charge nurses and staff members. Under her guidance and with her support, charge nurses have the autonomy to make decisions and be a strong voice on the unit. She's a true role model in that she doesn't ask her team to do anything she wouldn't do. She also serves as a mentor for students from our local nursing schools.

Iesha leads by example, approaching problems as learning opportunities. She guides her staff members in decision-making and encourages them to speak up for their patients, as well as their fellow team members. She encourages independent thinking and provides support and the necessary resources for her team members to make a difference and change to occur.

Iesha is passionate about nursing and she translates this to her team. She communicates with optimism and confidence, inspiring her team by engaging their talents, igniting their spirits, and celebrating their successes.

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