Maria R. Shirey

Sleepless in America : Nurse Managers Cope With Stress and Complexity

Although nurse managers play a pivotal role in creating work environments for staff nurses, performance expectations for nurse managers practicing in acute care hospitals may be unrealistic. The authors discuss nurse manager interview data showing that these expectations are increasing nurse manager perceptions of stress, making coping more difficult, and potentially harming nurse manager and work environment well-being.

Ethical climate in nursing practice: the leader's role.

ABSTRACT Clarity in an organizations mission, vision, and values is key to effective management in todays complex healthcare work environment. To clearly articulate mission, vision, and values, employees must experience consistency between what is espoused and what is lived. The purpose of this article is to discuss the nurse leaders role in ensuring congruence between caring missions and caring practices. Ethical principles are discussed as the foundation necessary for creating an ethical climate for nursing practice. Components of ethical climate are presented and strategies to create a positive ethical climate for nursing practice are provided.

Stress and burnout in nursing faculty.

Nursing faculty are at risk for stress and burnout that threaten to worsen the current nursing faculty shortage. The author discusses the importance of preventing nursing faculty burnout and presents specific burnout prevention strategies.

Lewin's Theory of Planned Change as a strategic resource.

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author explores the use of the Lewin’s Theory of Planned Change as a strategic resource to mobilize the people side of change. An overview of the theory is provided along with a discussion of its strengths, limitations, and targeted application.

Competencies and tips for effective leadership: from novice to expert.

This ongoing department, sponsored by the American Organization of Nurse Executives, presents information to assist nurse leaders in shaping the future of healthcare through creative and innovative leadership. The strategic priorities of the American Organization of Nurse Executives anchor the editorial content. They reflect contemporary healthcare and nursing practice issues that challenge nurse executives as they strive to meet the needs of patients. To learn more about the American Organization of Nurse Executives, please visit the associations Web site at www.aone.org.

A nurse manager succession planning model with associated empirical outcomes.

OBJECTIVE: Perceptions of leadership and management competency after a formal nurse manager succession planning program were evaluated. BACKGROUND: A lack of strategic workforce planning and development of a leadership pipeline contributes to a predicted nurse manager shortage. To meet the anticipated needs for future leadership, evidence-based action is critical. METHODS: A quasi-experimental mixed-methods, 1-group pretest/posttest research design was used. Nurses working in an acute care hospital were recruited for the study and selected using an objective evaluative process. RESULTS: Participant perceptions regarding their leadership and management competencies significantly increased after the leadership program. Program evaluations confirmed that participants found the program beneficial. One year after program completion, 100% of the program participants have been retained at the organization and 73% had transitioned to leadership roles. CONCLUSION: Succession planning and leadership development serve as beneficial and strategic mechanisms for identifying and developing high-potential individuals for leadership positions, contributing toward the future nursing leadership pipeline.

Addressing strategy execution challenges to lead sustainable change.

This department highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author discusses strategy execution challenges that must be addressed to lead sustainable change.

Building the Leadership Development Pipeline: A 5-step Succession Planning Model

The demand for registered nurses, especially advanced practice nurses (APNs), will continue to grow over the next decades. This trend will coexist along with society’s increasing demand for healthcare services. As the US baby boomer population ages and lives longer, this will create a greater need for well-educated healthcare professionals such as APNs. Advanced practice nurses, especially clinical nurse specialists (CNSs), will continue to play an important role in providing care to the increasingly burgeoning US population well beyond 2020. Despite the increasing demand for nurses, a severe nursing and faculty shortage will continue to hamper the ability to meet society’s need for nursing services. Of paramount concern will be issues of care quality and safety, areas in which CNSs contribute significant expertise. Anticipating the growing need for CNSs in the future, the National Association of Clinical Nurse Specialists embarked on a campaign to increase the number of CNSs in the United States. Specifically, the Clinical Nurse Specialist Foundation (CNSF) determined its top priority for 2006-2008 to be increasing the number of nurses entering CNS graduate programs, including PhD programs. The CNSF identified 3 strategies to achieve this overarching objective: (1) promoting awareness of CNS practice to potential CNS students; (2) providing scholarships to CNS students in master’s and PhD programs; and (3) determining CNS workforce needs by specialty practice, practice setting, and geographic location. The 3 CNSF strategies focus primarily on the CNS workforce from the perspective of attracting individuals into CNS practice and then supporting them through their formal educational preparation. One strategy that bears concurrent pursuit, however, is the need to build succession planning programs that not only attract but also retain engaged CNSs and keep them reinvigorated throughout their professional careers. Because many CNSs work in hospital settings, this warrants the following question: What succession planning strategies can be instituted to create and sustain a high-performing cadre of CNSs in the hospital setting now and beyond 2020? The purpose of this article is to discuss the need for deliberate CNS succession planning in the hospital setting and to introduce a useful succession planning model that incorporates strategies to cultivate current and future CNS leaders.

Care coordination: a model for the acute care hospital setting.

OBJECTIVE: To evaluate a patient care delivery model (PCDM) that redefined roles for unit-based nurse case managers and RNs to streamline care coordination processes. BACKGROUND: Aligning care coordination in acute care is essential to meet constructs of accountable care. METHODS: A pre-post descriptive study design was applied to evaluate implementation of a PCDM in an acute care hospital setting. Regression and correlation analyses were used to compare length of stay (LOS), readmissions, patient satisfaction, quality measures, and cost of care. RESULTS: There was a significant decrease in LOS and negative patient responses related to nurse communication in the pilot PCDM unit as compared with the control unit. CONCLUSION: The model was supported as effective and will be implemented in other units in this hospital and across the healthcare system. A unit-based nurse care coordinator role is essential to facilitate interprofessional care coordination.

Building authentic leadership and enhancing entrepreneurial performance.

Entrepreneurs strive for success in their business ventures. Venture success is dependent on many factors, and one such factor is the entrepreneur’s leadership ability. An emerging body of literature in the business world is identifying the significant linkage between a distinct type of leadership known as authentic leadership and entrepreneurial performance. Authentic leadership is thought to create the positive conditions necessary for entrepreneurial performance and success. The purpose of this article is to provide an overview of authentic leadership and discuss the important role it plays in accelerating entrepreneurial performance. This article concludes with a brief discussion of authentic leadership development (ALD) geared to clinical nurse specialists (CNSs) interested in enhancing their entrepreneurial performance and success.