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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