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Preparing Millennial Charge Nurses To Be Successful Leaders

In a busy and stressful nursing unit, the first-level supervisor nurse is very important. The Charge Nurse is responsible for care delivery and ensuring procedures are running smoothly. They look for outcomes, think about success indicators, and are responsible for a team. Clinical knowledge alone is not enough for a nurse to fulfill this role. Charge Nurses need to be prepared to lead teams and manage different viewpoints, personalities, and motivations.

As Baby Boomers retire and younger generations fill in more of these roles, there can be a talent crunch in many U.S. health systems. Older nurses leaving means years of insight and experience is lost, and this hurts an organization’s performance and efficiency. Talent loss is one of many barriers which young Charge Nurses need to overcome as they manage teams. For more information on this subject, see our article 9 Leadership Barriers Charge Nurses Face.

How can U.S. healthcare organizations set up the Millennials, our younger generation of nurses, for Charge Nurse success?

Prepare Young Charge Nurses! Provide Leadership Courses with Actionable Content Built Directly for that Role

The best way to set up millennial nurses for leadership success is to directly teach Charge Nurse situational leadership in your organization. Role uncertainty or ambiguous job responsibilities leads to confusion, so build defined job responsibilities for the first-level supervisory nurse and teach to it. Prepare Charge RN’s with the behavioral skills they will need, including communications, critical thinking, switching from peer to leader, supervisory skills, and financial awareness. Early preparation for the Charge RN role will also boost retention and encourage your next wave of leaders to apply for Nurse Manager roles in the future. If a nurse has a bad first leadership experience, they are often unlikely to pursue further management roles, or could even pursue other employment.

Consider a curriculum like NCharge®: “Nurses Learning to Lead” to prepare nurses with the leadership and behavioral skills they will need to be successful. Courses like Charge Nurse Fundamentals, Critical Thinking for Charge Nurses, and Supervisory Skills for Positive Outcomes will help boost behavioral skill learning. These courses also teach business objectives in nursing, like using critical thinking to make informed decisions, the financial implications of value-based purchasing, and implementing strategies to improve staff productivity. Another course, Managing Multigenerational Conflict, can help young Charge Nurses to understand other generations’ work tendencies, and how to apply a 3-step framework to communicate effectively and motivate high performance on work teams.

Teach Conflict Resolution and Communication

When Catalyst Learning surveys Nurse Directors and VPs about skills they need from a Charge Nurse, we see that dealing with conflict is usually top of list. Conflict is unavoidable and problematic, so nurses with strong conflict resolution skills are better able to deal with challenges quickly and reduce potential errors stemming from it. Teach young nurses how to gain trust before conflict arises, how to separate the person from the problem, and how to demonstrate empathetic listening. Conflict resolution will help young nurse leaders to be more successful. See our article, “Nurse Conflict Resolution Strategies.”

Also encourage (or teach) communication skills to new Charge RNs. This will help with decision-making and will help that nurse build trust with a team. Part of communication is delivery of information; delivering bad news to a team is part of the job, so doing so without ruining team morale is critical to the role. Plus, if the team leader can effectively communicate information, the team will follow her example. Teaching nurses how to communicate and resolve conflict is very important in setting up Millennial nurses for leadership success.

Ease Transitions to New Leadership Roles

The experience for a new nurse leader in past decades may have felt a little bit like a “sink or swim.” But with growing demands on Charge Nurses, plus with Millennials craving more feedback than prior generations did, health systems should find ways to ease the transition to leadership. One way to do that is help new Charge Nurses to find a mentor who can offer support and encouragement. The mentor can be another Charge Nurse or manager within the organization. They do not need to be in the same specialty, but should be someone who can provide support and help build leadership ability, emotional intelligence, and confidence.

Another way to ease transitions to leadership roles is a nursing residency program. This can help create the nursing workforce pipeline needed to provide experienced and quality care. These longer-term programs enable participants to hit-the-ground running, and build a solid foundation for future leadership roles.

Set up Realistic Expectations, and Plan for Success

A first time Charge Nurse can fail if an administration does not give clear goals and role expectations. Sit down with a first time nurse leader and discuss issues that can arise, ask what concerns a new Charge has about the role, and set up any applicable goals that are necessary. One part of setting up realistic expectations may just be talking about delegation and how a leader is not expected to take on all the work themselves. See our article, “Charge Nurses & Delegation.”

Make sure your new leader is comfortable with policies and procedures. Discuss with her how to communicate with Nurse Managers, and what success looks like from management’s eyes. Discuss with your new leader how her unit supports the larger goals of the organization, and what internal resources are available to her if needed.

“Charge nurse: What’s in a name?” Beckers Hospital Review, Nich Chmielewski and Larry Faulkner, May 17, 2018

“Staffing challenge: How to manage a new generation of nurses” Beckers Hospital review, Marcia Faller, June 2017

“The best strategies to engage millennial nurse leaders,” Beckers Hospital Review, Laura Dyrda, February 2016

Tips to BOOST your Nurses’ Confidence

No one said nursing was easy. There are days when your nurses will be stressed out and possibly feel hesitant about their own abilities. Nurses may ask themselves “Is this something I can handle?” or “Can I really do this my entire career?” New nurses straight out of school may acknowledge that they have the clinical know-how, but don’t feel ready to face real life challenges or high acuity patients.

While executives are working on higher-level system initiatives like nurse retention planning and staff development, are there simpler ways to keep nurses happy and engaged? Here are some tips to help boost your nurses’ confidence:

Teach Personal Boundaries

Encourage your nurses to have personal boundaries; this is code for you cannot please everyone. Teach nurses, especially young ones, to be selective about what personal information they share with other nurses and staff. Teach your nursing staff the fundamentals of Emotional Intelligence, most notably keeping emotions professional. Boundaries are important in successful nurse-patient relationships as well. Teach your nurses where their responsibilities begin and end and how to assert those boundaries when tested.

See our related article, “Emotional Intelligence in Nursing – Six Key Traits.”

Build Bully-Proof Nurses

Lateral violence is no longer the hidden secret of the profession, and being bully repellant is sadly necessary. Physicians can also bully nurses; nasty workplace behavioral practices exist. But if nurses have a strong sense of self and know what they stand for, they can make themselves less likely to be a target for a bully. Bullies are attracted to low self-confidence and nurses with timid communication styles, so teach nurses to be assertive. Also teach your nurses the more subtle forms of bullying to watch out for. While physical violence is an obvious form of workplace bullying, there are other bullying techniques: peers setting peers up for failure, sabotaging work, gossip, or giving misleading/false information. If your nurses know these patterns, they can better prepare themselves to deal with it and possibly even combat it.

See our related article, “The Nurse Bullying Phenomenon.”

Teach Nurses NOT to Compare Themselves to Others

Unfortunately, we live in a culture where everyone seems to care about what others are up to. But there is little that can shatter confidence faster than comparing oneself to others. It is good for young nurses to have senior nurses/administrators to serve as inspiration for a career path, but teach your staff not to look down on their own abilities by comparing to others. You can also teach senior nurses not to inflate their own ego just because they are superior in some competencies. Even very experienced nurses can see their confidence get shaken at times.

Set Your Nurses Up with a Mentor

A career mentor is important in any career, but especially in nursing. A mentor can encourage nurses when frustration sets in, and give new perspectives. Start a nurse mentor program at your facility, whether formal or informal. For nurses, knowing that they have someone in their corner can give confidence. If a mentor program isn’t possible, encourage your supervisors, instructors, and directors to build stronger relationships with nursing staff. Have these senior staff members take nurses out for coffee or get some 1×1 moments in a judgment free mindset.

If there is anyone who knows the ins and outs of a facility, it’s the people who have been there the longest. Teach your nurses to model their work ethic after someone who is excelling in their role.

Teach Nurses that Perfection Isn’t Real

When in small groups with nurse staff or at 1×1’s, remind your staff that no one is perfect. It is better to admit a mistake or flaw than it is to make an excuse for it. Confident nurses are able to admit when they are wrong. By acting defensively after a mistake, it hurts confidence instead of boosting it. Possibly share mistakes or flaws that you had as a bedside nurse, and assure staff that all great nurses had moments they wish could be taken back.

Let your nurses know they do not have to personally know everything. Giving great care doesn’t mean nurses are on an island; teach nurses to flip the script. For example, when they don’t know what to do with a patient in distress, teach them to leverage the collective knowledge of the nursing team around them. Let the group figure out next steps. Having the ability to gather information and consensus is more important than the personal clinical knowledge to figure it out solo.

Help Your Nursing Staff to Engage in Lifelong Learning

Learning new skills and acquiring new experience contributes to both confidence and competence. As your nurses learn and develop, they will become more effective nurses. They will also be more confident nurses and better leaders. While knowledge is power and well-educated nurses will naturally be more confident, tell your nurse staff not to limit education to just clinical learning. “Soft Skills” like communication, conflict resolution, and leadership can help nurses stand out on the team and boost confidence.

NCharge®: “Nurses Learning to Lead” is a set of leadership courses built for the first-level supervisory nurse, the Charge RN. NCharge is an evidence-based curriculum that gives nurses the insights, interpersonal skills, and business knowledge they need to more effectively manage, inspire, and lead. NCharge helps U.S. health systems to build a nurse leader pipeline, impact financial awareness and results, and increase nurse engagement and retention. For instance, the Supervisory Skills For Positive Outcomes course teaches communication strategies to confidently communicate practice concerns, conflict management, time management strategies, and appropriate delegation while maintaining accountability.

Click Here to have one of our team members reach out to you about NCharge. Give us the opportunity to hear your skill gaps in nurse confidence and allow us to make a course recommendation!

 

Sources

“4 Ways to Build Confidence as a Nurse,” AHS Nurse Stat, Cade Webb, January 24 2019

“Boost your confidence to reach the stars,” The Nursing Times

“7 Things Nurses Can Do to Feel More Confident at Work,” Nursing CE, Keith Carlson, RN, BSN, NC-BC, March 20, 2019

“How Nurses Can Build Their Confidence,” The Gypsy Nurse, February 20, 2018

“Tips Nurses Can Use To Build Confidence,” Diversity Nurse Blog, Erica Bettencourt, July 26 2019

3 Ways NCharge® Supports Magnet Applications

Transformational leadership is a key ingredient in establishing a nursing environment that achieves Magnet designation. Gradually, a transformational mindset should take root in the organization and become even stronger as other leaders adopt this way of thinking. Nurses in charge need to be developed, directed, and empowered to find the best way to accomplish the organizational goals and achieve desired outcomes. Where Transformational Leadership meets the Structural Empowerment domain is where Magnet nurses will shape dynamic change in healthcare and the nursing profession as a whole.

Magnet requires dedication of the entire nursing staff; it is almost 2020, and it is time to think about developing the first-level supervisory nurse, the nurse at the beginning of her career path. NCharge®: “Nurses Learning to Lead” can assist organizations either considering the Journey to Magnet Excellence, or in a re-application for Magnet status, within these application sections:

 

1) ADVOCACY AND INFLUENCE:
The CNO advocates for organizational support for ongoing leadership development for all nurses, with a focus on mentoring and succession planning. TL6 (pg. 32)

How does NCharge® support?

  • Partners with CNO to assure content delivery is aligned with priorities of the organization.
  • Introduces first-level nurse leaders to Value-Based Purchasing principles and financial implications of their work. It raises awareness of the importance of adopting evidence-based care standards, eliminating occurrences of untoward outcomes and adverse events, and improving patients’ experience of care. For a reference case study, read “Nemours Children’s Hospital Teaches Charge Nurses Financial Implications of Success.”
  • Supports the development of an adequate pipeline of future leaders who understand the CNO’s vision and how to drive to positive outcomes.
  • Demonstrates the organization’s investment in helping to assure that staff have a positive leadership experience, and pursue further leadership roles.

Provide an example, with supporting evidence, of mentoring or succession planning activities for clinical nurses.

How does NCharge® support?

  • Provides education on how to be a first-level nurse supervisor; it provides education to assist an organization’s future leaders to think critically, supervise, and lead change.
  • Assists with clinical nurses transitioning from a peer to leader.
  • Assists with creation of multiple Personal Action Plans and topics, to aid in creation of ways to use information learned when back in the unit.
  • Reinforces exercises like the 5 Rights of Delegation Model to help prepare first-level nurses for planning to lead a team, which is key for succession planning. Classes prepare leaders for qualities they will need, like teamwork and collaboration, ego management towards self/staff, innovative thinking, adapting to rapidly evolving roles, and confidence with compassion. For a reference case study, read “East Alabama Medical Center Develops a Nurse Succession Plan.”

 

2) STRUCTURAL EMPOWERMENT DOMAIN – Commitment to Professional Leaders
Structural Empowerment processes developed by influential leadership to create an environment where professional practice flourishes. Staff need to be developed and empowered to find the best way to accomplish goals, and reference the Forces of Magnetism for pillars like the image of nursing and professional development.

How does NCharge® support?

  • It includes the development of the trainers and builds the pipeline of future leaders. Professional development includes:
    • Transitioning from peer to leader
    • Leading quality initiatives
    • Critical thinking integrated with the Charge Nurse role in driving process improvement
    • Change leadership integrated with the Charge Nurse role in leading compliance and other quality initiatives
    • Confident communication, conflict management, and delegation
    • Employee engagement strategies, led by nurses, integrated with patients’ experience of care

 

3) ACCOUNTABILITY, COMPETENCE, AND AUTONOMY: • EP14 (pg. 47)
Resources, such as professional literature, are readily available to support decision-making in autonomous nursing practice. How does your organization provide a dynamic learning environment that enhances the professional practice environment skills to build confidence and competence to manage common challenges Charge Nurses encounter?

How does NCharge® support?

  • NCharge® teaches keys of critical thinking for Charge Nurses. Courses teach evaluation and building initial analysis of making decisions, determining merit of information, and placing a judgment. It teaches deductive reasoning, inductive reasoning, and using these tools to apply towards decision-making and critical thinking concepts. One course, Critical Thinking for Charge Nurses, teaches essential traits of critical thinkers with situations that Charge Nurses encounter.

 

For more information on how NCharge supports the Magnet Application or Reapplication, CLICK HERE.

Are you attending the Annual ANCC Conference in Orlando in October? CLICK HERE to set up a quick meet and greet with our team.

Charge Nurse Traits Which Clinical Nurses Value Most

Every nurse early in their career has had a Charge RN they did not want to work under on a shift. Ineffective shift leaders may lead “reactive” instead of proactive, be pessimistic, unpredictable, poor under stress, or may even find it challenging to relate to other nurses viewpoint. This is why nurse leaders with high tenants of Emotional Intelligence (EI) are effective, as they are able to consciously align their behaviors toward a desired outcome.

There have been many articles written about the relationship between high EI and effective leadership. Books like Emotional Intelligence 2.0 by Dr. Travis Bradbury and Dr. Jean Greaves gives a framework for why EI is especially important in healthcare. The more complex an organization is, the more it needs leaders who can navigate complex issues and work relationships. EI enables a nurse leader to gain trust and understand emotions. Cognitive skills are important too of course, but not as important as EI in complex healthcare systems.

While EI frameworks provide lists of skills and personality traits needed for effective leadership, what exactly are the top traits which clinical nurses cite looking for in their floor leader, the Charge Nurse? As Carol Holm identified in her presentation “Attributes in Leaders Most Desired by Clinical Nurses” at the AONE 2019 Annual Meeting, adaptability, stress management, empathy, and assertiveness are the EI attributes most desired by clinical nurses.

Adaptability
Adaptability is how a Charge Nurse shows potential for change management. It is the flexibility and willingness to adapt to new conditions. Here is a quick example: Recall a situation where bed capacity is an issue on the floor. A Charge is asked to put estimated discharge dates into records as well as likely beds to become available for patient placement. Charge Nurses may be asked to forecast throughput and document better practice. Charge RNs have to follow up with clinical nurses to be better at disclosing information for records. Some Charge RNs can engage clinical nurses to be better and get buy-in to processes, and some do not. Clinical nurses look for a leader to push towards doing their records better, and organizations rely on adaptable leaders to champion change and processes.

Stress Management
The next most important trait which clinical nurses desire for their Charge RN is the ability to handle stress. Clinical nurses have all been through situations where the team is short-staffed due to call-ins or other factors, and a floor leaders ability to rally a team is vital. Besides just morale, what about a stressed out patient or patient’s family member with unrealistic expectations for that shift? A Charge RNs ability to support co-workers during times of stress is critical and supports the entire team.

Empathy
Empathy in a first-level supervisory nurse is a top correlated trait with clinical nurse job satisfaction. It is the ability to stand in someone else’s shoes and see other viewpoints. When “life happens” to bedside nurses, they want to feel like the Charge Nurse is there for support. And when empathy is not demonstrated, it leads to low nurse job satisfaction. Especially during nursing shortages, this is a top personality trait, and is also a crutch pillar of high EI.

Assertiveness
This is the 4th highest rated trait which clinical nurses look for in a Charge RN. Nurses want a Charge RN who can stand up for the team and be forthright with leadership when appropriate to do so. This is the ability to say in a non-offensive way what needs to be said, and when to say it. For example, a Charge needs to be able to advocate for additional support in a particular shift, possibly due to the acuity on that shift. Having an assertive nurse leader is also linked with patient safety and quality of care.

While these are the top 4, other important traits which nurses look for in their first-level supervisory nurse are optimism, self-motivation, social awareness, and impulse control. In total, these eight traits are vital to having high EI and leading teams.

How can healthcare institutions encourage a culture of high EI?
• Promote nurses into leadership with identified traits of success – adaptability, stress management, empathy, and assertiveness.
• Use EI testing to screen nurse leader applications
• Encourage sharing of EI assessment scores among nurse co-workers. Have Charge Nurses find improvement areas by choosing a trait of impact focus based on their EI scores, and have them work with a colleague, mentor, or coach on that area of focus. There are many EI tests available for purchase.
• Purchase courses or libraries for EI education/training for Charge Nurses. Integrate Charge Nurse training into position descriptions, and use this nurse leadership development as a catalyst to start conversations on how to be an effective Charge RN.


Catalyst Learning offers its series NCharge®: “Nurses Learning to Lead.” Courses like Charge Nurse Fundamentals offer learning objectives like application of qualities for successful Charge Nurse leadership. It also teaches nurses to create an individual action plan to identify challenges and maximize opportunities faced in a complex hospital environment – a skill crucial to EI. A second NCharge course, Critical Thinking Skills For Charge Nurses, teaches nurses to apply critical-thinking skills to the decision-making process. Feel free to contact us to learn more.

“Attributes in Leaders Most Desired by Clinical Nurses”

Carol Holm at AONE 2019, Oregon Health & Science University and Academic Medical Center

How the CNO Drives Nurse Engagement

What is employee engagement? Gallup defines it as the level of commitment, passion and loyalty a worker has towards their work and their organization. CNOs can take action to drive nurse engagement; in fact Magnet hospitals are even graded on engagement metrics like leadership access/responsiveness and RN to RN teamwork and collaboration.

To help a nurse executive to be “visible” and lead organizations with dedicated nurses, here are a few tactics a CNO can use to drive nurse engagement:

Be Intentional About Nurse Recognition
One employment stat by Gallup shows that employees who receive senior-level recognition 3x or more in a quarter are twice as likely to stay with an organization. So recognize good work! Here are a few examples:
-Publish good works on the health system intranet, or even start a company/unit newsletter.
-Have contests tied to recognition received. Let the prize be “Be CNO for a Day!” Your nurses may even appreciate how hard it is to run a hospital.
-Celebrate your nurses’ certifications. Show that professional growth is noticed, valued, and contributes to long-term hospital success.

Enforce Patient Stories, Periods of Caring
Remind your nurses why they became a nurse, and give permission to spend time with patients, and collect stories from care and patient attention given. Let nurses know it is important to hold onto these moments and share if possible. A few examples:
-Redesign/Rethink the Care Delivery Model. In doing this, work in solutions to give nurses time at the bedside. Some nurse leaders adopt Swanson’s Caring Theory, which calls for nurses to take 5-minutes to get to know their patients. Ask nurses to share these stories from moments of caring.
-Give positive reinforcement to nurses for telling stories of caring. One CNO from Baystate Medical Center (MA) is so serious about enforcing stories of caring, that she passes out coffee shop gift cards at random intervals if a nurse can quickly tell her a unique patient story and how care delivered impacted the patient and nurse. This reinforces the importance of periods of caring, and shows nurses it is OK to spend a few moments just talking with patients and learning about them.

Increase Nurse Autonomy, and get Nurse Feedback
Think about a more collaborative shared governance model, and make sure your leaders buy-in. Shared governance will not work without the backing of managers and directors. Plus use a few of these tactics to show nurses you trust their judgment and ideas:
-Create nurse councils to address issues which leadership may not be noticing. For example, start a “night shift council” that meets monthly. Issues the night staff nurses face may be much different from other nurses. Night shift nurses may not deal with staffing issues for instance, they may have problems arising from Nutrition or Environmental Services which can more easily be fixed with attention and planning. And with a council, nurses will see that their input is being listened to.
-Increase the number and availability of nurse driven protocols.
-Use surveys to learn about nurse frustration points which may otherwise go unnoticed. You may not like what you hear, but you may also find out that untrue organization rumors are driving negative perceptions, giving you an opportunity to dispel rumors or false gossip. CNOs have enough on their plate without having to deal with issues that are imagined or perceived. And with surveys, don’t hand them out during busy periods and ask for them back in 5-minutes. Give your nurses a quiet moment to reflect off-the-floor, to help make answers meaningful.

Be Visible
Show your nurses that you are a part of the team and understand their issues:
-Consider doing a bi-weekly open coffee time, where nurses can come talk to you about issues they are facing.
-Be the first cheerleader when recognitions, certifications, or professional growth are achieved. Others will follow your lead and create a ripple effect.
-Since a CNO can’t be everywhere and cannot possibly “coach” every associate, assign a senior nurse resource for less experienced nurses. This will allow for discussions and mentoring without nurses feeling fear of retribution for speaking out or voicing concerns.

Organize a few “big deal” events
Plan fun outings or events to show nurse appreciation. Let nurses know that the organization doesn’t work without them! Feel free to tie “big deal” events to stories/periods of caring (previously mentioned):
-Don’t over think it here, have a “decorate an Easter basket contest,” a Yoga retreat, organize a dance class, go to a baseball game. Celebrate and recognize caring behavior as a group.
-Volunteer as an organization or get involved in the community somehow.
-Establish a few self-care practices or resources internally to help nurses build resiliency and work-life balance. Even if they do not participate it will show you value well-being.

Sources:
-AONE 2019 session, “Let’s Get Visible, and Drive Nurse Engagement;” Christine Klucznik, Baystate Medical Center
-“Tips from CNOs on Increasing Nurse Engagement in 2018;” Avant Health, Shari Costantini