How to Develop High Quality Nurse Leaders: Q&A With Candace Smith of Medline

Candace Smith on nurse leadershipCandace Smith, MPA, RN, NEA-BC, SVP, Chief Nursing Officer, Clinical Program Consultant for  Medline, talks about how healthcare organizations can build a quality nurse leadership program and why it's important to foster a culture of nurse leadership in the future.

Q: What is the value of growing nurse leaders within the organization?

Candace Smith:
The value of growing nurses to take on leadership roles is important. We want to strengthen nurse presence in the healthcare arena so they learn to collaborate with physicians and build relationships with other professionals in a continuous learning environment. Every nurse has the ability to change the environment. Every nurse should be thought of as a leader and enrich care delivery. Administrative leaders can help nurses speak up and feel like they are in a safe place to take on leadership rolls. Growing nurses as leaders will create a sense of accountability in your facility.

Q: How can an organization develop the kind of culture that values nurses as leaders?

Eliminate the "we" versus the "they" in the organization. You build trust and create a sense of "oneness" versus hierarchy of structure. That is the way to begin to foster a culture that values nurses as leaders. Think about developing an "Organization University" for education and put forth an education plan that really creates value. The chief medical officers and senior nursing leaders and administrators can become the faculty and teach nurses about their value and role in the organization.

Q: What tactics can organizations use to educate nurses?

There has to be a plan and commitment to educating nurses. It may be a weekly class or self-learning packets sent home with them. People are using social media and email to educate nurses as well. The education must be thoughtful and deliberate, as well as continuous. Most places have monthly sessions or roundtable discussions and take walking rounds of the facility to keep nurses engaged.

In the absence of a plan, chaos emerges. It's imperative, given the number of changes in the healthcare environment today, that nurse education is made a priority. I've always had the feeling that your front line is the bottom line, but particularly in healthcare where you have people dealing with patients all the time, they need continued education.

Q: How should an organization identify great fits for leaders within a nursing pool, assuming that not everyone will be appropriate for or interested in leadership roles?

You need a nurse that has good vision and demonstrates solid accountability. The nurse must understand the plan well and have good judgment, as well as team building skills to collaborate with others. Nursing never works in a silo, so you never work alone. You have interdependence on physicians and other disciplines, so nurse leaders must understand how to integrate all those roles into care.

Q: When a nurse leader is beginning to think about retirement, how can the organization develop a meaningful succession plan?

The overall key to good succession planning is to have the right person ready to take over that title as soon as the position opens. If you assess that well, you can build the attributes of that role in the next individual. Look to see where different people are within your organization and figure out how to give them new opportunities to lead. There are different initiatives throughout the organization that present opportunities for nurse leadership.

There are also things you can do with talent management to utilize strengths within the nursing staff. You have to have a relationship with those nurses and know your staff more intimately to find the right people to fit into leadership roles.

Q: What tools are available to help organizations develop nurse leaders?

CS: There are many professional organizations that have development programs in place. The American Association of Nurse Executives has a wonderful program called "Emerging Nurse Leader Institute" where they offer leadership modules and conferences as well as online training that can help with leadership development. You can also consider board certifications, such as the advanced nurse executive, to promote further education. It's self-directed and the course prepares nurses to take on top leadership roles.

The American College of Healthcare Executives also gives nurse leaders the opportunity to network with other healthcare leaders and grow with them.

Internally, the chief nursing officers can develop a boot camp for aspiring leaders. Different disciplines can teach the classes about leadership competencies, operations optimization, conflict management and conflict resolution. There is a nursing shortage, so in order to grow internally you have to support and invest in nurses.

Q: How can organizations encourage nurses who aren't being groomed for leadership roles to take on 'mini' leadership responsibilities to stay invested in the organization's success?

If we as a profession do this well, we can have nurses lead projects and take on assignments, but the culture has to foster staff engagement. Everyone should have the chance to take on mini leadership roles. Facilities like to put together responsibilities such as skin care and falls prevention champions, which allows nurses to develop and expand projects in these areas.

We have to support a program where we are helping nurses mobilize to act as liaisons between departments to strengthen their relationship. At large academic medical centers, they are liaisons between the medical students and residents. Who better to do that than the front line staff?

It's important for nurses to have the opportunity to lead. These projects don't require a lot of work, but we are able to give them to staff members who take on those roles. The opportunities are endless.

Q: What are the most important areas of focus for nurse leaders in the future?

I think it's important for nurse leaders, chief nursing officers and senior nursing leaders to have a good handle on making sure they address barriers to care and helping nurses in the workplace be successful. This is the role of the nurse leader. We can't continue to do the same things we've done for years; we have to figure out what's not working and how to help every staff member in their role be the champion of care delivery.

For example, I have a close friend who is a CNO and she decided she wanted to learn more about the emergency room staff. She stepped out of her role as CNO and worked with the staff on the ER for four weeks. She was able to find a different level of respect and understanding for ER nurses after the four weeks was over. To me, that's the sign of a great leader.

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