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How Could Nursing Change in a post-COVID-19 World?

A new era of health care preparedness is upon us. For the healthcare industry in general, scaling up can happen when backs are against the wall. We know we can quickly add capacity, or have the ability to add capacity when care delivery needs are vast (ICU for ex.) With this new can-do spirit, we’ll see new approaches to how healthcare will be organized, delivered and distributed. And it can be led by nurses.  Here are a few hypotheses of what some of those changes could be:

 

Increased Talent Supply from Younger Clinicians

Even before the pandemic, many clinicians were frustrated by the limitations of overstretched health systems. Some of these clinicians will leave the profession for good, or scale back hours. This experience also will inspire many young adults to pursue a career in medicine. We surely need them. Besides recent optics showing how important this field is, young adults now see how large the demand is for nursing services, and how much job security they would have in an otherwise uncertain world. Expect more males to enter the nursing profession. There hasn’t been a “nursing profession surge” since the 1970’s, but expect one in 2021 and the immediate future.

Nurses are finally getting the credit they have deserved all along; the words “thank you for your service” have probably never been spoken more in history. We hope this positivity and compassion keeps nurses going, and inspires the next wave of talent.

 

Distance Work….. and Distance Learning

The pandemic showed that more nursing work experiences can be taught digitally, so more nursing schools are offering some online learning. And many believe a rise in digital nursing jobs will emerge from the pandemic, in telehealth and work-from-home settings. These roles could be aesthetics nursing, medical writing, home healthcare, legal nurse consultant, insurance case manager RN, for example.

Leadership development for bedside nurses will change too. Instead of classroom-based Charge Nurse or Nurse Manager development, much will move online and be available when nurses are not needed at work. NCharge: “Nurses Learning to Lead” for example is now offering fully digital nurse leadership development for Charge Nurses. Courses like Charge Nurse Fundamentals, Critical Thinking Skills for Charge Nurses, and Supervisory Skills for Positive Outcomes are fully available online.

 

Allowing Nonphysicians (Nurses, NP’s, PA’s) to Play a Larger Role

This pandemic put a large strain on emergency rooms and ICU’s. The non-physician support team has never been more important. But this situation only spotlights a problem that predates COVID-19 by decades. Many hospitals, particularly rural hospitals, are struggling to financially keep the doors open, and many could provide care at lower costs by leaning more heavily on non-physician practitioners. We may see Congress, state legislatures, and state medical boards start to ease restrictions, to allow these clinicians to provide more care. Needing nurses to be frontline leaders is more important than ever.

 

“Investigator-in-Chief” is officially added to the Nursing Job Description

Nurses have always worn many hats, some they haven’t always received proper credit for. But the pandemic, with a virus that sometimes has undetectable symptoms, has brought to light the new role of “investigator.” Nurses have had to play the role of screeners and contact-tracing investigators, enforcers of high-risk group prevention procedures, run surveillance on nosocomial infection prevention, and decoders on how to communicate to isolated/stressed patients through cultural differences.

 

Clinical Cross-Training, Especially for Critical Care Skills

As some health systems saw high quantities of COVID-19 patients, nurses of all specialties are turning into critical care nurses. Any nurse treating the virus needs to quickly cross-train in ICU procedures, especially being trained to care for patients with ventilators and other oxygen-delivery systems. While nurses from various units in some hospitals were floated to the ED to assist with patient volume during the outbreak, some will want to stay with that focus and appreciate working in an essential service.

Currently, of 4 million trained U.S. nurses, only 15% work in critical care units. Look for nursing schools to ramp up clinical experience curriculums in the near future.

 

Labor Supply Chain Shifts, and Scaling Up

The pandemic has shown that healthcare is in need of more reliable supply chains. You might think this trend will only affect pharma and device/equipment companies, but it will affect us all. In nursing, this could affect labor. Relying on international nurses for example may be relooked. And we’re already seeing travel nurses struggling to find contracts, as many hospitals cut much non-essential care. Many hospitals are re-looking at finances, cutting overtime, cutting per diem nurses and managing through hiring and wage freezes. Elective procedures are coming back, but will the international and travel nurse trend be the same? In the pandemic, we’ve seen that nurses can learn ICU skills quickly and with limited orientation. So health systems may think more about retraining of local full-time nurses to fill future labor gaps, instead of relying on a more uncertain supply chain of traveling/seasonal nurse labor.

Because of the pandemic, federal and state governments are shifting more government-aid to train new healthcare workers in late 2020 and 2021. As many people have been laid off during the pandemic, the federal government will roll out programs to train left out labor pools into higher demand healthcare roles. Some nursing school admissions may be waiving certain entrance requirements as well, including flexible start times. With standardized testing centers shut down, universities are reassessing testing requirements, which could help more students to be admitted to nursing programs.

As we witnessed society nearly close down this Spring, empty streets in our busiest cities, and desperate city officials begging people to stay home, there is no doubt that the world has changed.  While most of us were at home, nurses have been fighting on the front lines. Stories of heroism are almost too many to count. As we eek into a new reality, some changes will come to the nursing industry, affecting nursing perceptions, processes, skills needed, and talent pool. Nurses will be where they have been throughout the pandemic; caring, advocating, leading, adapting, and innovating.

 

“5 ways COVID-19 will change the future of work,” Cornerstone, Kris Dunn, July 20, 2020

“The backbone of healthcare: 3 CNOs on what COVID-19 has taught us about nursing,” Beckers Healthcare, Mackenzie Bean, May 11, 2020

“How will COVID-19 change the working lives of doctors and nurses? Philips, Jan Kimpen, April 14, 2020

“This is How COVID-19 is Changing The Future of Nursing for Students and Tenured Nurses,” Nurse.org, Kathleen Gaines, June 26 2020

“7 Ways COVID-19 Will Change the Future of Nursing for the Better,” Aspen University, Sarah Jividen, July 21, 2020

“Life after COVID-19: What Will Change?”, Medical Futurist, April 21, 2020

“How COVID-19 will impact the future of nurses,” Local 21 News Pittsburgh, Talia Kirkland, May 1, 2020

“9 ways COVID-19 may forever upend the U.S. health care industry,” Stat News, Lev Facher, May 19, 2020

“How Nurses are Keeping Up with Practice Agreement Changes During COVID-19,” Registered Nursing.org, April 17 2020

“What’s Changed in Nursing During the COVID-19 Pandemic,” Travel Nursing.com, Lee Soren, August 22 2020

“Nursing Perspectives on the Impacts of COVID-19,” The Journal of Nursing Research, Wolters Kluwer Health Inc. – Shu-Ching CHEN, June 2020

“Emergency Nursing, Post-Pandemic: What Changes Can We Expect,” American Mobile, Debra Wood RN

“How COVID-19 will impact the future of nurses,” Local 21 News in Harrisburg PA, news segment by Talia Kirkland and interview with Dr. Mary Glasgow, Dean of Nursing at Duquesne University

 

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Bristol Builds on Magnet Success – Develops Great Nurse Leaders

ANCC’s Magnet Recognition Program® recognizes hospital organizations for excellence in patient care and superior nursing processes. Bristol Hospital, a small community hospital in Connecticut, is extremely proud to be among the elite 7% of health care organizations with Magnet designation nationally. To uphold this high standard, Bristol has embraced dedication to one theme: developing great leaders at all levels of nursing, including charge and other first-level supervisory nurses.

Cultivating Greatness
For many organizations, leadership training is provided to management and executive level leaders only. Bristol acknowledged the need and benefit of including first-level supervisors in their training plan. Previously, charge nurse training at the hospital utilized the traditional shadowing approach in which current charge nurses train those who are new to the role. While this experience is of value, there is little emphasis on honing leadership skills outside of clinical situations. Bristol Hospital was searching for a way to invest more in nursing employees, and deploy training more quickly than they could by creating a program of their own. In the search for a program to fit their needs, and with the help of Capital Workforce Partners, Bristol discovered Catalyst Learning’s NCharge® “Nurses Learning to Lead” series. NCharge has the lessons and materials most important to creating strong supervisory and business skills.

Bristol chose three courses from the series with specific desires in mind. “Critical thinking, decision making, effective communication, and conflict resolution all help to advance our nurses’ practice,” stated Kerry Yeager, Clinical Informatics Specialist at Bristol. “The participants were most engaged in the communication and conflict style assessments. I believe it gave them a greater understanding of how effective communication and conflict resolution skills impact patient care. As the charge nurse, these skills are essential.”

Magnet Environment
The NCharge courses were directly in line with the overall goal to create a collaborative, innovative environment. The Magnet Model emphasizes not only exemplary professional practice among healthcare providers, but also an environment where nursing staff are encouraged to be strong leaders, make decisions and improvements for efficiency and effectiveness, and continually grow and evolve within the profession. In response to a post-training survey, managers at Bristol reported improvement in participants’ ability to make complex decisions, find collaborative approaches to managing conflict, and fostering team engagement.

Bristol has observed more engagement from nurses who participated in the NCharge courses. Charge Nurses can be concerned about speaking up when there is a potential to disrupt the process or one is unclear about expectations within a role. “You get used to doing things a certain way. Breaking out of the mold can be harder for employees in a smaller hospital,” stated Nancy LaMonica, Director of Clinical Excellence, Professional Practice and Magnet. The confidence charge nurses gain from NCharge assists in creating the collaborative, forward-thinking environment Bristol strives to uphold. “They seem to have an increased autonomy and appear confident in bringing up new ideas to improve patient care and nursing practice” added LaMonica.

Additional Benefits
For Bristol’s participants, the NCharge program also fueled increased interest in continuing education and specialty certification. LaMonica reported seeing a growth in nurse’s interest in attending specialty certification review and studying for exams, promoting excellence and professionalism, which is one of the key goals Bristol’s Nursing leadership team identified prior to participation in the program. With a desire to have 80% or more nurses achieving a BSN or higher by the year 2020, Bristol leadership plans to increase the elite status that the hospital has established by providing more nurses who are experts in their field.

Continuing education, professional growth, and certification are several ways Bristol instills value in the leadership team and their roles. By investing in the leadership training, charge nurses continue to grow and influence hospital standards, nursing autonomy, patient centered care and patient satisfaction. “You see a different light in them when they go back to school, almost like it’s a new day. It helps them realize that our nursing profession never stops growing,” added LaMonica.

With a high focus of growing charge nurse engagement, Bristol Hospital is not only striving to live and breathe their Magnet designation, but to keep a Magnet environment striving for nursing empowerment and excellence flowing through the hospital to ensure patients receive the best experience possible. The commitment to cultivating great nurses into becoming great leaders at Bristol Hospital is upholding a level of excellence for current and future patients which is second to none.

Nemours Children’s Hospital: Teaching Charge Nurses How To Understand And Communicate Financial Performance Indicators

Nemours Children’s Hospital (NCH) in Orlando, FL opened its doors in 2012 and has quickly become one of the premier children’s hospitals in the country, providing a full spectrum of pediatric care to its young patients. Nursing Director of Professional Excellence, Toni Christopherson, described the nursing team as exceptional, passionate and always willing to go the extra mile for the children and families entrusted in their care.

When Nemours leaders decided to add charge nurses to every shift on every unit, they sought out a training program that would give their emerging leaders the development needed to effectively manage a nursing team. With that in mind, NCH chose Catalyst Learning’s NCharge® curriculum. NCharge offered new nurse leaders evidenced-based professional development, and CLC provided a means to measure the effectiveness of the training.

NCH tapped into an initial cohort of 30 nurses to take NCharge courses. These nurses had been providing stellar direct patient care, but had no formal healthcare leadership training. While they are still early in the process, Christopherson pointed out that the organization is already seeing benefits from the training. Nemours is on a Magnet journey, and strives for a cultural transformation in nursing.

UNDERSTANDING FINANCIAL CONCEPTS
In addition to learning basic leadership skills like conflict resolution and meaningful communication, the instruction covers the financial implications of hospital value-based purchasing, which builds a common understanding Charge Nurses wouldn’t otherwise have, according to Christopherson. “When a Charge Nurse understands the basic concepts of financial management, they can see how their role affects financial performance,” said Christopherson. “The Charge Nurse can also articulate financial issues to the nursing unit they are leading and have more informed conversations with Nurse Managers and other leaders.”

Christopherson believes NCharge courses also help a Charge Nurse speak the same language as senior leaders. The learning and class discussions build an appreciation for what goes into making good business decisions that contribute directly to business outcomes and ultimately patient care. The courses Charge Nurse Fundamentals and Supervisory Skills for Positive Outcomes especially helped Nemours’ core group of first-level nurse supervisors to develop an understanding of how their roles impact financial stewardship and performance.

“Even more importantly, our Charge Nurse development initiative is helping these vital supervisors to promote continuous quality improvement, develop clinical leadership, manage team performance and contribute to delivering the organization’s objectives,” said Christopherson.

TRAINING WITH AN RETURN ON INVESTMENT (ROI)
In regards to ROI of leadership development, Christopherson added that CLC’s use of the Kirkpatrick Learning Evaluation Model allows Nemours to measure results and impact of the training. The model looks at satisfaction and participation; knowledge acquisition; behavioral application; measurable business improvement; and return on investment. Early in the process, both participants and managers who supervise them indicated increased knowledge.

NCH is now turning its attention to how well the new Charge Nurses apply the knowledge they gained, behavioral application. Charge Nurses meet monthly and discuss application of the learning such as the need for enhanced patient throughput structure and process to impact the safety and quality of care. The Charge Nurses decided to implement a night shift Charge Nurse huddle. “Charge Nurses meet at 2300 to conduct proactive staffing that has increased the visibility of the bed planning process and allowed for targeted staffing specific to patient needs,” said Sophy Rodriquez, Nemours Catalyst trainer. For example, they discuss pending surgical cases, anticipated time back from the OR, and then staff appropriately to meet the patient’s needs. Ultimately, NCH will evaluate how the training impacts turnover, retention, promotion and patient care, and calculate the cost savings and/or increased revenue that comes from these gains. Christopherson noted that this sort of evaluation helps leadership understand the value of professional development.

“We want the whole organization to understand the value of education and professional development because it does reduce costs and add up to better safety and care,” said Christopherson.

The NCharge training initiative is NCH’s first step in operationalizing its nursing succession plan. It wants to be proactive in identifying high potential nurses and needed role competencies, and formally develop the right future nurses to assume leadership roles. Developing nurse  leaders, building the leadership pipeline, and pursuing Magnet designation is Nemours’ focus in pursuing nursing excellence for the children it serves.

A Nurse Succession Plan at East Alabama Medical Center

East Alabama Medical Center has a strong mission statement – Deliver high quality, compassionate healthcare. EAMC knows that to do this, they need to keep a strong pipeline of nurses and first-level supervisory nurse leaders, a familiar concept to EAMC. Being a quality hospital in a smaller market, EAMC has a longstanding tradition of growing their own to carry out the organization’s mission statement. In fact, a V.P. started as an orderly 34 years ago, proof that senior leadership has walked the walk.

While several programs were in place to retain professional positions, growth opportunities were needed for nurses to continue growing internal talent. “There’s a lot of competition in this region for employees, so we started to look at how to better retain talent at EAMC,” said Karen Gresham, RN, Director of Education Services.

EAMC had offered Catalyst Learning’s School at Work since 2005, a career development program for entry-level healthcare associates, to help employees advance within the organization through clinical or administrative positions. Given their success with School at Work, EAMC turned to Catalyst Learning for a solution. EAMC adopted NCharge®: “Nurses Learning to Lead”, a program in line with its leadership development and succession planning goals.

“I just loved the program [NCharge] right away. It spoke to me as a nurse,” said Rosemary Cummings, Director of Medical Surgical Services. “When I started as a labor and delivery nurse, I was put in charge after being on the floor for three months or so. If I’d had some of this info, I could have done more with that position. So, I understood what we were lacking, not having anything for those supervisors.”

Recognizing the importance of having experience in a nurse leadership role, EAMC decided to have nurse managers like Cummings deliver the NCharge content. Each nurse manager is paired with an educator who can help deliver the curriculum. The feedback has been overwhelmingly  positive.

As with School at Work, the success of NCharge is dependent on buy-in from managers and their willingness to allow frontline staff time away from their regular duties to complete the program. Once managers learned the objectives and how a leadership program developed specifically for nurses could make a difference, they were on board. This year, EAMC will also offer NCharge to managers to give them a firsthand understanding of what NCharge participants are learning.

EAMC is focused on results and a return on their investment. Two groups of 20 nurses have gone through the program and checkpoints are now in place to see if the nurses are using the skills they are learning.

Managers are seeing improved engagement and confidence among nurses and a positive change in communication with physicians and other employees. One participant shared with Cummings that she uses different parts of NCharge every day, for example finance and value-based purchasing skills that are typically learned on the job. Two nurses who have completed the program have been promoted to managers.

EAMC’s long-term goal for its nurse leadership development program is sustainability. Cummings and other instructors are planning lunch-and-learns with the two groups who have gone through NCharge to discuss how they are leveraging their new skills and which tools are most effective. The lunches will also be an opportunity for participants who formed a bond completing the program together to reconnect.

“We are not part of a big organization, but we offer quality healthcare here. We take a lot of pride in how we do things from a quality and cost perspective,” said Cummings. “It helps our frontline supervisors to see we’re investing in them. Development at this organization is an important piece of who we are. I think that’s why people stay. This is in line with our leadership development goals, and NCharge is now in our hospital’s official succession plan.”

Saint Anthony Leaps to an “A” In Hospital Safety 

Saint Anthony Hospital staff worked hard to improve its Leapfrog Hospital Safety Grade from a D in 2014 to an A in October 2016. The nonprofit, community teaching hospital in Chicago found one key to success came in providing front-line nurse leadership with increased confidence and management tools that would help improve hospital standards and quality of care.

Finding the Right Curriculum

Saint Anthony’s development team was searching for a structured, in-depth learning program that would empower their nurses to take leadership to the next level. What they found was Catalyst Learning Company’s NCharge® Nurses Learning to Lead program. NCharge provided the detailed content and knowledge assessments they were looking for, with results that are measurable. By focusing on relevant leadership scenarios within the hospital, participants were able to easily relate and apply techniques to their everyday environment.

“Like most healthcare organizations, we are growing and changing. We were also in the process of reorganization. It was about sweeping clean on old ideas and looking for ways to be more efficient. Illinois is also tightening on funds and as a nonprofit hospital, we had to look at ways to be more efficient in how we were working and make our staff feel as if they have a way to advancement,” stated Jaqueline Napier, Manager of Talent and Development at Saint Anthony.

Leading with More Confidence

One important outcome noted by Saint Anthony management is the overall improved confidence among nursing leadership. Creating a more autonomous team has positively impacted the hospital environment and proven an effective influence regarding quality of care.

Sonia Haro, an ICU Staff Nurse and NCharge participant, committed her time to the NCharge series with specific objectives in mind. “I was looking for ways to communicate more effectively, especially when setting expectations for the team. Sometimes, not everyone feels like being a team player. I wanted to find a way to encourage my team but stay firm and reach expectations,” explained Haro. This was the type of leadership training that most staff nurses don’t get with shadowing or clinical training. Haro was pleased with NCharge, which provided her with a better understanding of communication styles and techniques to handle a variety of situations confidently in the unit.

Haro wasn’t the only person who noticed a need for better communication and confidence from front-line nursing leaders. When Catalyst Learning surveyed nurse managers at Saint Anthony before the NCharge courses were implemented, less than 20% strongly agreed that the Charge Nurses in their departments displayed confidence when leading their teams. In addition, less than 30% agreed that Charge Nurses were cognizant of the key drivers of a positive patient experience. A few months after the training was held, the same nurse managers were surveyed and reported dramatic improvement with over 65% saying Charge Nurses were more confident and over 70% recognized key drivers in positive patient experience.

Cultivating Team Dynamics

A more efficient, collaborative environment was formed as a result of the NCharge leadership training. The team who completed training worked stronger and smarter together when handling obstacles. “I really wanted to work with others in the hospital in the same position. It’s nice to have others to lean on and run questions by, and share experiences with. Networking with my own colleagues was a great bonus,” stated Haro.

Elizabeth Negrete, Director of Perinatal and Pediatric Services, had staff who completed NCharge training. Staffing in OB, having the right number of staff and the right combination, had been a continuous issue. NCharge class participants looked at staffing and created plans to put the right skills and experience in the best combinations. “Now the staff are the ones doing the schedule, entering it in to the system and balancing. When the census goes down, they adjust appropriately based on the patient grid. This shows how they have been working more autonomously and are able to make important decisions with less guidance,” explained Negrete. “The Charge Nurses are working more in collaboration with the house managers. Before, staff managers were just telling them what the need was, but now the Charge Nurses are more empowered to speak up about needs.”

Haro reported that the rounding process has also gone through changes, giving the NCharge participants an opportunity to observe with fresh eyes what happens within the unit when everyone is not on board with a change. “It takes some buy-in from everyone, and there were days when we were just being run ragged. You could easily see that on days when the new process wasn’t being used, feelings and tensions were high,” conveyed Haro.

By equipping front-line leaders with the skills to embrace change, NCharge prepares staff for reaction from team members and how to move forward as a unit. This can be vitally important and impactful when trying to deal with the constant updates within hospitals. “There is always more trust from staff when changes come from Charge Nurses. There is more peer influence and impact. The staff has more of a buy-in because they know the Charge Nurses truly understand what the impact will be since they are on the frontline with them,” described Negrete.

Quality Advancements

Made evident in the impressive move of their Leapfrog Safety grade from a D in 2014 to an A in October 2016, the hospital seems to have found the key to success in increasing quality standards. Napier credits the NCharge series with being a factor in that improvement after implementation in early 2016.

The combination of increased confidence, more efficient staffing and adaptability to change have helped Saint Anthony become a more progressive, efficient hospital when it comes to patient care and standards. “The nurses are more cohesive as a team and moving towards a group environment where the charge nurses really stand out as leaders. They are really keeping their team members engaged. All of that correlates to the patient experience and how everyone is measured,” stated Napier. “Our people were skilled but now they have more confidence in those skills and their ability to engage the nurses on their team. They now understand how this all comes together to enhance the patient experience.” By giving front-line leaders new techniques to handle their day-to-day situations and changes, an environment of new ideas and proactive enthusiasm has been cultivated.

By investing in the front-line nursing leadership at Saint Anthony, stronger teams were built and the confidence instilled in the newly trained charge nurses was of great value. The return on investment for the Chicago hospital is shown through the recognition of receiving its first A rating from Leapfrog Hospital Safety Grade and becoming a top-rated hospital.

UTMB Invests in Developing Patient Care Facilitators and Nurses

When the University of Texas Medical Branch (UTMB) assessed its training needs in late 2015, nursing leadership recognized a gap in charge nurse development. With no formal tools in place and a somewhat inconsistent structure to the Charge Nurse position, UTMB decided to take action. Catalyst Learning’s NCharge® courses were chosen to bring more commonality and consistency to this vital hospital role for both current and aspiring Charge Nurses. To date, 60 participants in three cohorts have completed all five NCharge courses: Charge Nurse Fundamentals; Critical Thinking; Leading Change in a Dynamic Climate; Supervisory Skills for Positive Outcomes; and Employee Engagement & The Patient Experience. Patient Care Facilitators (PCF), who have similar responsibilities to Certified Clinical Nurse Leaders, have also been included in this comprehensive professional development program. Because Charge Nurses often look to PCFs as experts on the patient care experience, UTMB determined that leadership training could equally benefit the PCF role, said Barbara Bonificio, Director of Nursing Excellence. Bonificio added that the NCharge program could become an important asset in a comprehensive health system initiative to increase employee engagement and patient satisfaction. In fact, UTMB leaders believed the program was valuable enough to include some of its relevant results at the unit level in UTMB’s recent reapplication for Magnet status.

Improving Outcomes

By putting in place formal training, UTMB hopes to make significant improvements not only in patient satisfaction, but also RN-to-RN communication, nurse sensitive indicators and workflow on the units. Comparisons of participant surveys conducted before classes began and after completion indicate positive movement in critical skills development across several of these areas.

Most notably, when asked if they were cognizant of the key drivers of positive patient experience, only about 65% of respondents strongly agreed when surveyed before taking classes. After completion of the program, more than 85% strongly agreed with that statement. When asked if they understood the linkage between employee engagement and the patient experience, nearly 90% strongly agreed after the course, up from less than 70% before entering the program.Also, only about 60% of respondents strongly agreed they were cognizant of key drivers of an engaged team prior to NCharge. That number jumped to close to 90% after completion.

A Timely Decision

When UTMB launched NCharge in December 2015, hospital staff was preparing to relocate to a new facility and would be faced with a new set of workflows. The program’s Leading Change module proved to be timely, as all participants in the class were involved in this major move. One especially valuable component of the Leading Change module educated students about the change curve, demonstrating that workers at different levels in an organization also are at different stages of the curve, said Sharon Hensley, Nursing Program Manager. Those in leadership roles may have already processed a change, while frontline workers may have just been introduced to it. “That was very impactful for them,” she said. Prior to taking the Leading Change class, only 55% of survey respondents strongly agreed they were cognizant of their role to assist the team with change management. After completion, nearly 90% strongly agreed. In terms of leadership, 100% of respondents reported strong agreement that they were cognizant of their influence on the attitude and tone of the unit, up from only 60% prior to the class.

Additional Benefits

Beyond these targeted outcomes, NCharge has been successful in helping to dispel some misconceptions and illuminate different perspectives. For example, before the courses, many participants believed value-based purchasing simply meant that if system departments bought in volume, UTMB got a discount.”The financial impact of value-based purchasing was a real eye-opener for everyone,” said Bonificio. “I don’t think they realized the significant dollar amounts attached to not being reimbursed, as well as the penalties for not reaching certain targets.”

Because each cohort comprised a mix of experienced Charge Nurses and those hoping to land the role, NCharge was beneficial to both groups because they were exposed to each other’s perspectives. In addition, the module on types of communication is already being put to use on the floor. “Participants learned the best way to talk to people whose communication styles are different than their own,” said Bonificio. Now, graduates are “excited to share the skills they have learned with their units.”

Looking to the Future

Reception to the NCharge program has been overwhelmingly positive overall, Hensley said. “There were significant dollars connected to the people being selected, and I think that was impressive to them – that we are investing in them.” UTMB nurse leaders are happy with the program response and results so far, and plan to continue offering it to PCFs and Charge Nurses. In fact, they envision further advantages across other nursing roles. “It would be beneficial if all nurses could understand challenges their charge nurse colleagues face,” according to Bonificio. “If everyone understood these challenges, it would make the units run much more smoothly.”