• Describe transformational leadership qualities necessary
for creating and sustaining healthy work environments.
• Define...
• Effective communicator
• Charismatic
• Inspirational
• Individual consideration
• Intellectual stimulation
• Empower oth...
• Servant leader
• Humble
• Ethical
• Transparent
• Empathetic
• Compassionate/Caring
• Authentic
• Strategic
• Visionary
• Committed to
EXCELLENCE
• Passionate
• Trustworthy
•COACH
•MENTOR
Florence Nightingale –
Transformational Leader & Role Model
• Self-knowledge
• Authenticity
• Expertise
• Vision
• Flexibi...
Florence Nightingale –
• Innovator
• Change agent
• Advocate
• Reformer
Ildauro Murillo-Rohde, PhD,
RN, FAAN –
• Innovator
• Change agent
• Advocate
• Reformer
• Visionary
• Instrumental in
foun...
Henrieta Villaescusa,
MPH, RN, FAAN –
• Mentor
• Role Model
• Trailblazer
• Advocate for Social
Justice
Mary Lou de Leon Siantz,
PhD, RN, FAAN –
• Interdisciplinary,
Multicultural Educator
• Researcher &
Translationalist
• Leg...
• What do YOU
see in the
mirror?
• Skilled communication
• True collaboration
• Effective decision making
• Appropriate staffing
• Meaningful recognition
•...
http://ajcc.aacnjournals.org/content/14/3/187/F1.expansion
Interdependence
of healthy work
environment,
clinical
excellenc...
High-quality, patient-
centered health care for all
will require a
transformation of the
health care delivery
system
One o...
1) Remove scope-of-practice barriers
2) Expand opportunities for nurses to lead and diffuse
collaborative improvement effo...
Campaign for Action
Education Practice Collaboration Leadership Data
Diversity
Ergonomics and Safety
Intergenerational Workforce
Just Culture
Mind, Body, Spirit Healing
Moral Courage/Distress
Structural Empowerment
Evidence and Outcomes
Transformational Leadership
Modeling the Way
• Complexity of nursing work environments
• Workplace stressors – patient acuity, technology,
rapid cycle change, ethical ...
• Key to recruiting and retaining “best talent” and
providing care for patients
• “Feeling physically and emotionally safe...
• Critical Incident Stress Management
• Psychological Debriefing
• Peer Support
• Ethics Consultation
• Employee Assistanc...
• One Size Does
NOT Fit All!
Stabilization &
Acknowledgement of
Events & Reactions
(Everly, 2001)
Critical Incident
Impacting a Group
of RNs Initiate
C...
• Stress Support Work at UT
Southwestern
• Staff Survey and Involvement in the
Work
• EAP, Chaplain Support
• Lessons Lear...
• Ergonomics
• Quiet Environments
• Cultures of Safety
• “Zero Tolerance” Policies for Abusive
Behavior
• Healthy Work/Lif...
• Support for education
• Working with clinically competent
nurses
• Collegial and collaborative
interdisciplinary relatio...
• What will YOU
agree to DO?
GOALS
ACTIONS
OUTCOMES
HEALTH WHOLENESS
GOOD GREAT
MIND
BODY
SPIRIT
Mission
Vision
Values
• What brought you
to this work?
• What sustains your
commitment?
• What is your vision
for the future?
AACN (2005). AACN Standards for Establishing and Sustaining Healthy Work
Environments: A Journey to Excellence. Aliso Viej...
Everly, G.S., Flannery, R.B. & Mitchell, J.T. (2000). Critical incident stress
management: A review of the literature. Agg...
McDonald, L. (2001). Florence Nightingale and the early origins of evidence-based
nursing. Evidence Based Nursing, 4, 68-6...
Courage to Lead: Transformational Nurse Leadership for a Healthy Work Environment
Courage to Lead: Transformational Nurse Leadership for a Healthy Work Environment
Courage to Lead: Transformational Nurse Leadership for a Healthy Work Environment
Courage to Lead: Transformational Nurse Leadership for a Healthy Work Environment
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Courage to Lead: Transformational Nurse Leadership for a Healthy Work Environment

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Courage to Lead: Transformational Nurse Leadership for a Healthy Work Environment
June Marshall, DNP, RN, NEA-BC

Mano y Corazón Binational Conference of Multicultural Health Care Solutions, El Paso, Texas, September 27-28, 2013

Published in: Health & Medicine
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  • Courage to Lead: Transformational Nurse Leadership for a Healthy Work Environment

    1. 1. • Describe transformational leadership qualities necessary for creating and sustaining healthy work environments. • Define components and characteristics of healthy nursing work environments. • Identify strategies for mitigating nurses’ workplace stress.
    2. 2. • Effective communicator • Charismatic • Inspirational • Individual consideration • Intellectual stimulation • Empower others
    3. 3. • Servant leader • Humble • Ethical • Transparent • Empathetic • Compassionate/Caring • Authentic
    4. 4. • Strategic • Visionary • Committed to EXCELLENCE • Passionate • Trustworthy
    5. 5. •COACH •MENTOR
    6. 6. Florence Nightingale – Transformational Leader & Role Model • Self-knowledge • Authenticity • Expertise • Vision • Flexibility • Shared leadership • Influence • Inspiring others
    7. 7. Florence Nightingale – • Innovator • Change agent • Advocate • Reformer
    8. 8. Ildauro Murillo-Rohde, PhD, RN, FAAN – • Innovator • Change agent • Advocate • Reformer • Visionary • Instrumental in founding NAHN
    9. 9. Henrieta Villaescusa, MPH, RN, FAAN – • Mentor • Role Model • Trailblazer • Advocate for Social Justice
    10. 10. Mary Lou de Leon Siantz, PhD, RN, FAAN – • Interdisciplinary, Multicultural Educator • Researcher & Translationalist • Legislative Advocate
    11. 11. • What do YOU see in the mirror?
    12. 12. • Skilled communication • True collaboration • Effective decision making • Appropriate staffing • Meaningful recognition • Authentic leadership (AACN, 2005)
    13. 13. http://ajcc.aacnjournals.org/content/14/3/187/F1.expansion Interdependence of healthy work environment, clinical excellence, and optimal patient outcomes
    14. 14. High-quality, patient- centered health care for all will require a transformation of the health care delivery system One of the most-viewed online reports in IOM history AJN Book of the Year Award
    15. 15. 1) Remove scope-of-practice barriers 2) Expand opportunities for nurses to lead and diffuse collaborative improvement efforts 3) Implement nurse residency programs 4) Increase the proportion of nurses with a BSN degree to 80% by 2020 5) Double the number of nurses with a doctorates by 2020 6) Ensure that nurses engage in lifelong learning 7) Prepare and enable nurses to lead change to advance health 8) Build an infrastructure for the collection and analysis of interprofessional health care workforce data
    16. 16. Campaign for Action Education Practice Collaboration Leadership Data Diversity
    17. 17. Ergonomics and Safety Intergenerational Workforce Just Culture Mind, Body, Spirit Healing Moral Courage/Distress
    18. 18. Structural Empowerment Evidence and Outcomes Transformational Leadership Modeling the Way
    19. 19. • Complexity of nursing work environments • Workplace stressors – patient acuity, technology, rapid cycle change, ethical dilemmas and bullying/violence • Stress responses produce adverse physiologic, social, emotional, and behavioral reactions
    20. 20. • Key to recruiting and retaining “best talent” and providing care for patients • “Feeling physically and emotionally safe” • Culture with a sense of belonging and positive team relationships Shirey (2006)
    21. 21. • Critical Incident Stress Management • Psychological Debriefing • Peer Support • Ethics Consultation • Employee Assistance Programs • The Nurse Advocate Role
    22. 22. • One Size Does NOT Fit All!
    23. 23. Stabilization & Acknowledgement of Events & Reactions (Everly, 2001) Critical Incident Impacting a Group of RNs Initiate CISM Program Defusing in Small Groups – Including Introduction, Exploration, & Information (Mitchell, 2006) Successful Work Reentry Facilitation of Normal Recovery (Mitchell, 2006) If Stress Responses Unresolved, Refer to Formal Individual or Group CISM Program Stress Responses Completely Resolved Without Need for Ongoing Follow-up Professional Practice-related Critical Incident Initiates Referral to Nurse Advocate (TNA, 2010) Individual and Group Workplace Critical Incident Stress Management (CISM) for Registered Nurses (RNs) – Marshall (2010) Critical Incident Impacts Individual RN – Initiate CISM Program Assist RN to Understand & Normalize Events (Everly, 2001) Encourage Actions to Facilitate Effective Coping (Everly, 2001) If Stress Responses Resolve, Provide Periodic Follow-up as Needed for Problems If Stress Responses Continue, Refer for Follow-up Assessment & Interventions (Everly, 2001) Stressful Workplace Incident Occurs & Individual or Group Peer Support Session Initiated
    24. 24. • Stress Support Work at UT Southwestern • Staff Survey and Involvement in the Work • EAP, Chaplain Support • Lessons Learned • Accomplishments • Next Steps
    25. 25. • Ergonomics • Quiet Environments • Cultures of Safety • “Zero Tolerance” Policies for Abusive Behavior • Healthy Work/Life Balance
    26. 26. • Support for education • Working with clinically competent nurses • Collegial and collaborative interdisciplinary relationships • Autonomous nursing practice • Control over nursing practice • Supportive nurse managers • Perceived adequacy of staffing • Culture in which concern for the patient is paramount http://www.amsn.org/practice-resources/healthy-work-environment
    27. 27. • What will YOU agree to DO?
    28. 28. GOALS ACTIONS OUTCOMES
    29. 29. HEALTH WHOLENESS
    30. 30. GOOD GREAT
    31. 31. MIND BODY SPIRIT
    32. 32. Mission Vision Values
    33. 33. • What brought you to this work? • What sustains your commitment? • What is your vision for the future?
    34. 34. AACN (2005). AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence. Aliso Viejo, CA: American Association of Critical-Care Nurses. ANCC (2013). 2014 Magnet® Application Manual. Silver Spring, MD: American Nurses Credentialing Center. Bowles, A. & Bowles, N.B. (2000). A comparative study of transformational leadership in nursing development units and conventional clinical settings. Journal of Nursing Management, (8), 69-76. Clements, P.T. & Averill, J.B. (2006). Finding patterns of knowing in the work of Florence Nightingale. Nursing Outlook, 54, 268-274. http://dx.doi.org/10.1016/j.outlook.2006.06.003 Dossey, B.M., Selanders, L.C., Beck, D-M., Attewell, A. (2005). Florence Nightingale Today: Healing Leadership Global Action. Silver Spring, MD: American Nurses Association.
    35. 35. Everly, G.S., Flannery, R.B. & Mitchell, J.T. (2000). Critical incident stress management: A review of the literature. Aggression and Violent Behavior, 5(1), 23-40. Florence Nightingale. (2012). Biography.com. Retrieved 12:01, May 09, 2012 from http://www.biography.com/people/florence-nightingale-9423539 Govier, I. & Nash, S. (2009). Examining transformational approaches to effective leadership in healthcare settings. Nursing Times, (105), 18. Hutchison, M. & Jackson, D. (2013). Transformational leadership in nursing: Towards a more critical interpretation. Nursing Inquiry, 20(1), 11-22. Maloney, C. (2012). Critical incident stress debriefing and pediatric nurses. Pediatric Nursing, 38(2), 110-113. Marshall, J. & Zolnierek, C. (2012). Supporting nurses through critical practice incidents: The nurse advocate role. Nurse Leader, 10(2), 34-36,44.
    36. 36. McDonald, L. (2001). Florence Nightingale and the early origins of evidence-based nursing. Evidence Based Nursing, 4, 68-69. doi:10.1136/ebn.4.3.68 . Swanson, K.M. & Wojnar, D.M. (2004). Optimal healing environments in nursing. The Journal of Alternative and Complementary Medicine, 10(1), S-43-S-48. Sherman, R.O. (2012). What followers want in their nurse leaders. American Nurse Today, 7(9). Smith, M.A. (2011). Are you a transformational leader? Nursing Management, 26(8), 44-47.
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