Nurses entering practice today need to be trained on how to become the next generation of nurse leaders. In order for that to happen, there are time-tested principles/practices that need to be observed, but the way in which those are delivered must evolve to reflect how this new class of "millennial" nurses absorbs and processes information.
"We need to teach these nurses to lead, mentor and coach," says Press Ganey CNO Christy Dempsey. "We have to do a better job at teaching them how to be leaders."
The key qualities of nurse leaders include the ability to:
1. Foster trust and teamwork
2. Model compassion and empathy
3. Provide support in the form of human, material and emotional resources
4. Communicate effectively with patients, physicians and other nurses
5. Be visible and accessible
6. Acknowledge the complexity and the gravity of the work nurses do
Education is also important and practicing to the top of their nurse licenses will allow nurses to continue growth.
"Healthcare is a team sport; it’s not something one person can do by themselves," says Ms. Dempsey. "Our patients want to see that the people who are taking care of them are talking to each other. Empathy is a cognitive attribute; it’s not emotional. You have to be able to understand what someone is going through and then communicate the understanding back to them. It’s really becoming a lost art."
There are some who argue empathy can’t be taught, but Ms. Dempsey isn’t one of those leaders. She firmly believes teaching nurse leaders empathy builds trust and allows them to lead with compassion but also based on data.
One of the most effective strategies for developing new nurse leader empathy is roll playing. Roll-playing has become an integral part of training at one Nevada hospital where nurses are asked to leave their belongings in the staff locker and then wait in the emergency room for hours. The trainers don’t tell them anything about the next stage of training, just to wait until they’re called.
When the nurse finally is called out of the ER, the trainers lead them to a room, pull the curtain closed and talk about the nurse from the other side of the curtain. The new nurse can hear everything going on the ED but they don't know what is happening.
"Then the preceptor comes in and says, 'This is what your patients go through every day; don’t forget it'," says Ms. Dempsey. "But the training isn’t a one-and-done. The patient experience in its totality isn't something that you can talk about one time at orientation and expect the lesson to stick for a 20-year career."
Ms. Dempsey suggests talking about empathy and compassion on an annual basis and training to make sure it’s second nature for the nurses. Formal ongoing education around the patient experience is crucial; this is different from patient satisfaction because the patient experience encompasses clinical, operational, cultural and behavioral aspects .
The work environment is also important for a successful organization. The nurse culture begins with leadership and can drive forward with the right attitude from the top down. Nurse leaders can practice "modeling behavior" to encourage others and drive up the standard of care.
"We talk about purposeful rounding in our organization and we want nurses to go in to the patient rooms every hour and have a purposeful connection with their patients," Ms. Dempsey says. "If nurse leaders want nurses to sit down and make a connection with patients, you have to do that too."
One of the best ways to connect with patients is discovering something about them outside of their reason for being in the hospital. The best nurse leaders apply the same principle to their nursing staff.
"If you’re a leader, it’s important to know something about the staff that isn’t work-related," says Ms. Dempsey. "I think it goes back to the theme of compassionate, connected caregivers. Nurse leaders acknowledge the work is difficult and foster team work to earn their employees’ trust."
Finally, active communication is a key component of leadership. But the type of communication is rapidly evolving as millennials enter the workspace and leadership roles. Millennials may have different values than older generations; work-life balance is very important and effective leaders understand how to pull excellence out of their team.
"There has to be the recognition that this job is hard and the nurses want a work-life balance," says Ms. Dempsey. "When we think about staffing and scheduling, we have to take that into account."
Millennials also prefer leaders not "manage" them. Instead, mentors can frame their role as helping younger nurses grow and prepare for the next stage in their careers. Developing expectations for empathy and teaching appropriate communication is necessary, especially when young nurses are treating patients in older generations.
"This is a very tech-savvy generation, but, we must teach them how to connect with other people," says Ms. Dempsey. "Thirty years ago when I went to nursing school, we practiced IVs on each other and did bath rubs on each other. We learned what was too rough, what worked and what didn’t. Nurses today are taught on simulators and simulators don’t usually talk, get angry or cry."
Young nurses need strong leaders who will work with them beyond just the preceptor orientation; they need mentors who will help make sure these new leaders understand their not only their job but also what effective nurse leadership looks like.
"Front line managers can make or break the experience of their staff and patients," says Ms. Dempsey. "We have to make sure they are well prepared to mentor and coach the people at the bedside."