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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

6 Reasons to Budget for Charge Nurse Development in 2020

If 2020 has taught us anything about the nursing profession, it’s that nurses have to be leaders for our country to make it through a pandemic. While often called “soft skills” of leadership, the COVID-19 pandemic has shown us that the hardest skills for nurses to master are navigating conflict, promoting resilience, engaging a team, communicating, and reducing negativity. These skills are all crucial for the Charge RN. As the C-suite is now acknowledging the valuable role that first-level supervisory nurses play, nurse executives should put this thinking into action by budgeting for Charge RN development. More than ever, there should be intention around preparing less experienced nurses for future leadership roles.

The truth is, the Charge RN role is a position that many nurses may not proactively seek. Clinical nursing education typically does not prepare bedside nurses for supervisory responsibilities. Many hospitals still have no formal program to prepare nurses for this “promotion.” But now there is increased awareness within health systems that a lack of role clarity and management skill leads to inefficiency and job dissatisfaction. And when a nurse is frustrated with a first leadership experience, it is possible she stops pursuing those roles, at a time when we need nurse leaders more than ever.

Here are 6 reasons to budget for Charge Nurse development:

It will show Charge Nurses how their Leadership, Morale, and Team Communication Contribute to Organization Success – Especially During Times of COVID-19, and possibly a bad Flu Season

Obviously the COVID-19 pandemic has brought challenges and uncertainty. But it has also presented unexpected opportunities, showing nurses that they can and must lead, for our nation to heal. Charge RNs need to be taught to maintain leadership presence and communicate frequent, transparent, and informative messages to their bedside nursing teams. Leadership development is one way to prepare them for this. During these uncertain times, Charge RNs should have L&D that encourages suggesting new ideas, how to consider alternate plans of action, provide on-the-fly feedback on new work processes, and rapidly help their team adjust to new tactics.

Learning communication is especially key for frontline supervisory nurses right now, as large group in-person large team meetings are not happening because of COVID-19. Front-line supervisory nurses must decipher system-wide phone briefings for their teams, communicate policy updates, discuss COVID-19 topics with their team, communicate equipment and supply chain issues, and share staffing issues as they arise.

Dealing with nurse team morale, while not a new issue for Charge Nurses, is a tougher challenge than it has been in recent history. Morale is down because some younger nurses feel like “it will always be like this,” and some units experience PPE body heat and general fatigue with wearing it which contributes to low morale. There may be team incivility caused by news and events, plus a fear nurses have of taking the virus home, and a general feeling that the COVID-19 sprint has now become a marathon. Given all this, Charge RNs need preparation to deal with morale and negativity that creep into the workplace.

Leadership development is key for job morale. As a Charge Nurse serves as a resource to other nurses for clinical direction, preparing them helps job morale of the entire staff. Organizations need Charge RNs who can be calm in emergency situations, and can keep an eye on the entire unit. This winter may be a viral nightmare in the U.S. – so now is the best time for your Charge Nurse to feel prepared and excited to lead with Charge RN leadership development.

Make sure the role is clear, and has clear expectations

The initial step when preparing the first-level supervisory nurse is to define the role of the Charge RN inside the organization, then be consistent. Success is achieved when new Charge Nurses have a clear understanding of their goals and obligations. For example, determine whether the Charge Nurse will take on a full patient load. It should also be clear how the Charge Nurse should act in terms of delegating work to staff members and how he or she will be using computer systems and other technology. Development and planning for Charge Nurse leadership development helps establish expectations and gets nurses to buy in.

Retention

As the baby boom generation heads for the door and younger nurses take charge, preparing staff members for these open leadership roles is time consuming. But this step in succession planning is necessary and highly beneficial. Many larger systems have an official nurse succession plan in place and Charge Nurse development is starting to become a part of those plans at U.S. hospitals. East Alabama Medical Center (EAMC) has an official nurse succession plan which compliments its overall organization goals to develop employees from within. Read More – An Official Nurse Succession Plan at EAMC.

Alternative job perk

As the labor market is already near full employment and a nursing shortage looms, organizations are getting creative in offering non-traditional perks. Usually alternative perks are thought to just include lifestyle assistance programs/EAP’s, financial assistance programs, or free daycare, but investing in development of nurses shows how the hospital values their contributions and sees promise in potential, and becomes an alternative job perk. Be sure to communicate how Charge Nurse training shows organization excitement in the career path of its nurses.

More informed financial discussions with Nurse Managers and other Senior Leaders

Nursing executives generally agree that financial indicators of hospital success and reimbursement are often not understood by bedside nurses. This may be intentional, because nurse executives may not want to inundate nurses with too much information or bureaucracy. But there are several reasons to teach Charge RNs about financial issues they impact. It will prepare them for future leadership roles, allow them to have more informed conversations with Nurse Managers and other senior leaders, allows them to take an ownership stake in VBP, it improves nurse communication and can help save money. To learn more, refer to our related blog article, Why Teach Charge Nurses About Financial Success Indicators.

Positive first leadership experience produces a pipeline of future Nurse Managers

Setting expectations for the responsibilities and characteristics of a successful Charge Nurse by having an official orientation helps new nurse leaders embrace their role. Much research shows that nurses who have a bad experience in a first leadership role are more reluctant to pursue further leadership roles. If this promotion reluctance happens, filling Nurse Manager roles with qualified internal candidates becomes tougher than it already is. When a nurse is successful in leadership early, it is a benefit to your organization and fills the pipeline for future Nurse Managers.

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“When the Soft Skills Become the Hard Skills,” Emerging RN Leader, Rose O. Sherman, August 27 2020

“COVID-19: The Nurse Leader Perspective 6 Months Later (Thoughts from Cleveland Clinic’s Chief Caregiver Officer), Consult QD, K. Kelly Hancock, DNP, RN, NE-BC, FAAN, September 3, 2020

“Nursing leadership during COVID-19: Enhancing patient, family and workforce experience,” Patient Experience Journal, article 27;  Anne Aquilia (Yale New Haven Health), Karen Grimley (UCLA Health), Barbara Jacobs (Anne Arundel Medical Center), Maryellen Kosturko (Yale New Haven Health), Jerry Mansfield (Mount Carmel Health System/Trinity Health)

 

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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