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Nurse Leadership at ASCs: How to Grow a Great DON

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Jessica NantzPresident of Outpatient Healthcare Strategies Jessica Nantz discusses how ambulatory surgery center leaders can internally identify and grow outstanding nurse leaders and directors of nursing.
 
Q: What qualities are most important in a nurse leader?

Jessica Nantz:

•    Passion. Passion for providing exceptional care and taking care of patients as if they were family members.
•    Compassion. Compassion for patients as well as members of the staff.
•    Strong clinical skills. A nurse leader needs to be able to step into any care provision situation — routine or abnormal — and support efforts to deliver safe care and good outcomes.
•    Strong management skills. A nurse leader needs to know how to manage staff, and feel comfortable making decisions that may not always make everyone happy.
•    Strong communication skills. Effective management requires effective communication. The two go hand-in-hand.
•    Knowledgeable. A nurse leader needs to know his or her facility's policies and procedures, and the reasons (rules) they are in place. The leader also needs to follow those rules to a tee as clinical staff is likely to emulate good and bad practices.
 
Q: Is it possible to tell whether the nurse will be a potential leader during the hiring process? What do you look for in applicants?

JN: It is definitely possible. Look for previous leadership experience and speak with references who can discuss the individual's role as a leader.

A good exercise is to ask the applicant to discuss how he or she would handle scenarios where leadership skills are important. They can be clinical scenarios (what would you do if a patient started suffering from malignant hyperthermia?) to staff scenarios (what would you do if you heard one staff member badmouthing another?). The applicant's responses may shed some light into the type of leader the applicant has already or may become.

It's also worthwhile to look for signs of the qualities noted earlier. Good interview skills require good communication skills and confidence. Speaking with the applicant about why he or she wanted to become a nurse may help bring out evidence of the applicant's passion for providing exceptional care.
 
Q: How can you tell early on that a nurse might be a good fit for promoting to a leadership position?

JN: You're definitely looking for the qualities noted above. Is the nurse always working to provide passionate and compassionate care? Does the nurse know and follow the facility's policies and procedures? Does the nurse set a good example for others on the clinical staff in the manner he or she provides care and communicates with patients, family members, physicians and staff members? Is the nurse willing to step up and help with anything that needs to get done?

You're also looking for a nurse who is a good employee — someone who shows up on time, doesn't leave early, takes appropriate breaks, does not gossip or bring issues from home into the workplace.

A nurse leader also works to continuously improve his or her skills while staying atop of the newest regulations and best practices. This can be accomplished through reading, participating in webinars, attending conferences or simply asking questions of leaders within and outside the facility.

Good leaders are also usually liked by patients, physicians and staff. If any of these groups of people don't respond positively to a nurse, this may be a red flag for a possible leadership role.
 
Q: After identifying a great potential leader, what opportunities can the ASC offer to challenge and grow that person's role?

JN: It's a matter of finding opportunities that put the nurse in a leadership position. For example, a nurse can be tasked with taking the lead on a QAPI study or leading training sessions on new recommended practices or reviewing important rules. The nurse can also be tasked with providing some training to new nurses.

If a facility invests in growing the nurse's role by sending him or her to a conference or providing time (and sometimes money) for participation in a webinar or purchase of a publication, the nurse can be asked to provide a presentation on the information learned during these educational sessions. This gives the nurse another opportunity to take on a teaching role.

It's also worthwhile to ask a potential leader to spend some time coming up with suggestions for improvement for the facility — suggestions that can improve workflow, satisfaction, efficiency and even profitability/cost-effectiveness. If these suggestions are worth pursuing, the nurse can be tasked with leading the execution of them.

Q: When mentoring a future nurse leader, what are the most important values to instill in this person?

JN: A future nurse leader should already have most — if not all — of the values needed to succeed in a leadership rule, so it is important to emphasize that the nurse should continue to focus on maintaining and growing the qualities and skills that have made him or her an excellent nurse to begin with. Those values include honesty, integrity, passion and compassion, patience, open-mindedness; a willingness to listen and learn; a desire to become a better nurse and leader; and a never-wavering commitment to safe, high-quality patient care.

The best nurse leaders usually learn how to be a good leader from and through the mentorship of the leaders they have served under. Effective nurse leaders motivate the clinical teams under them to treat every day as an opportunity to provide even better care than the day before. Future nurse leaders should continuously reflect back on what made their mentors such successful leaders and attempt to emulate these qualities while adding a personal touch that strengthens these qualities.

A future nurse leader should also never hesitate to seek answers to questions they do not know the answer to. Just because a nurse becomes a leader doesn't mean the nurse will always know the answer to every question or how to most effectively and appropriately respond to every situation. Future nurse leaders should identify other nurse leaders — mentors or peers — they can turn to for insight and advice when necessary, and not hesitate to use these resources to make them better leaders.

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