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Being a Manager Does Not Make You a Leader
Sage Advice Russell E. Tranbarger, EdD, RN, FAAN
Being a Manager Does Not Make You a Leader
I
entered a diploma nursing program on Labor Day, 1956. Almost everything was reused. Glass syringes were in use, needles were checked for clots and burrs and re-sharpened if needed. Surgical gloves were washed, checked for holes, turned, powdered, and re-sterilized. We were not allowed to tell patients what their medication was, and every patient got a complete bed-bath every day. Students provided the majority of care throughout the 24 hours. Throughout the 54 years of my nursing life, there have been several constants. With rare exceptions, we have had severe nursing shortages. Change has been amazing and occasionally overwhelming. We have gone from no orientation to extended orientation, internships, and residencies; no continuing education to mandatory education for licensure renewal, certifications, primary nursing, and advance practice. Managing in times of great change taught me a few principles for success. You are appointed to a management position but must earn followers to become a leader. Your vision for your organization must be articulated, shared, and give stakeholders belief that adopting the vision will be beneficial. A vision without follower buy-in is a hallucination. Staff need to understand your priorities. Patient welfare and preferred outcomes of care followed by supporting and promoting staff wellbeing and then organizational development lead to desired goals. Many in the organization protect the organization, and promoting patient outcomes is articulated often, but the nursing leader needs to actively demonstrate its priority. If you expect staff to care for clients, then you should demonstrate caring about and for them. An open-door policy has many benefits and should be available to staff. Observing staff in action, unscheduled and often, will reinforce vision and priorities and give the leader information not otherwise discovered. It also allows direct feedback to staff. Personally congratulating individuals on excellent performance appraisals, sharing positive patient feedback, and seeking suggestions for improvement give staff a sense of value that will improve practice and behavioral
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change of those surrounding the event. Corrective actions should be private, whereas positive reinforcement should be public. I was fortunate to acquire mentors before I knew what that meant. Helen Dulick, Esther Voorsanger, Dr. Grace Peterson, and Anne Zimmerman mentored me as an elected leader in the Student Nurse Association of Illinois. Later in my career, Dr. Eloise Lewis, Dr. Ed Halloran, and Dr. Luther Christman provided me with advice and connections. Every leader needs mentors and also needs to mentor others. Mentorship can be short term or lifelong, can include multiple individuals, and is invaluable. Leaders need someone who can share their highpoints and disappointments safely. Leaders also need someone to listen as they think through critical events and assess when career change is needed. Multidirectional mentorship is invaluable and growth-producing. The role of a nursing manager/leader is demanding and seldom easy. It provides many benefits including financial and status improvements. The real value for leaders comes from growth of staff, enhancement of patient outcomes, and organizational success. Russell E. Tranbarger, EdD, RN, FAAN, is professor emeritus at East Carolina University in Greenville, North Carolina, and continues his educator role as consultant. He can be reached at [email protected]. 1541-4612/2013/ $ See front matter Copyright 2013 by Mosby Inc. All rights reserved. http://dx.doi.org/10.1016/j.mnl.2013.09.010
December 2013
Being a Manager Does Not Make You a Leader
I
entered a diploma nursing program on Labor Day, 1956. Almost everything was reused. Glass syringes were in use, needles were checked for clots and burrs and re-sharpened if needed. Surgical gloves were washed, checked for holes, turned, powdered, and re-sterilized. We were not allowed to tell patients what their medication was, and every patient got a complete bed-bath every day. Students provided the majority of care throughout the 24 hours. Throughout the 54 years of my nursing life, there have been several constants. With rare exceptions, we have had severe nursing shortages. Change has been amazing and occasionally overwhelming. We have gone from no orientation to extended orientation, internships, and residencies; no continuing education to mandatory education for licensure renewal, certifications, primary nursing, and advance practice. Managing in times of great change taught me a few principles for success. You are appointed to a management position but must earn followers to become a leader. Your vision for your organization must be articulated, shared, and give stakeholders belief that adopting the vision will be beneficial. A vision without follower buy-in is a hallucination. Staff need to understand your priorities. Patient welfare and preferred outcomes of care followed by supporting and promoting staff wellbeing and then organizational development lead to desired goals. Many in the organization protect the organization, and promoting patient outcomes is articulated often, but the nursing leader needs to actively demonstrate its priority. If you expect staff to care for clients, then you should demonstrate caring about and for them. An open-door policy has many benefits and should be available to staff. Observing staff in action, unscheduled and often, will reinforce vision and priorities and give the leader information not otherwise discovered. It also allows direct feedback to staff. Personally congratulating individuals on excellent performance appraisals, sharing positive patient feedback, and seeking suggestions for improvement give staff a sense of value that will improve practice and behavioral
68
Nurse Leader
change of those surrounding the event. Corrective actions should be private, whereas positive reinforcement should be public. I was fortunate to acquire mentors before I knew what that meant. Helen Dulick, Esther Voorsanger, Dr. Grace Peterson, and Anne Zimmerman mentored me as an elected leader in the Student Nurse Association of Illinois. Later in my career, Dr. Eloise Lewis, Dr. Ed Halloran, and Dr. Luther Christman provided me with advice and connections. Every leader needs mentors and also needs to mentor others. Mentorship can be short term or lifelong, can include multiple individuals, and is invaluable. Leaders need someone who can share their highpoints and disappointments safely. Leaders also need someone to listen as they think through critical events and assess when career change is needed. Multidirectional mentorship is invaluable and growth-producing. The role of a nursing manager/leader is demanding and seldom easy. It provides many benefits including financial and status improvements. The real value for leaders comes from growth of staff, enhancement of patient outcomes, and organizational success. Russell E. Tranbarger, EdD, RN, FAAN, is professor emeritus at East Carolina University in Greenville, North Carolina, and continues his educator role as consultant. He can be reached at [email protected]. 1541-4612/2013/ $ See front matter Copyright 2013 by Mosby Inc. All rights reserved. http://dx.doi.org/10.1016/j.mnl.2013.09.010
December 2013