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Leadership From Within
Newborn & Infant Nursing Reviews 13 (2013) 104
Contents lists available at ScienceDirect
Newborn & Infant Nursing Reviews journal homepage: www.nainr.com
Guest Editorial
Leadership From Within
There isn't a day that goes by that the word “change” is not heard in the neonatal intensive care unit (NICU). The difficulty, however, is that the word invokes a variety of feelings such as fear, confusion, resentment, and the perception that the change is going to be difficult, impractical and irrelevant to the bedside clinician. Change may include alterations in our physical space, our team composition, and our communication patterns or how we provide care to the most vulnerable populations. Change management is defined as an approach to transitioning individuals, teams and organizations to a desired future state. Change can be a welcomed event, when perceived as a solution to an identified problem, or it can be seen as an additional task or burden that needs to be executed for some other purpose. Change is likely to invoke negative feelings when those involved lack understanding about the “why”, “how”, “when” and “what”. Change is likely to succeed if it is led by those skilled in its execution and passionate about its outcome. Leaders in health care are those who excel at interpersonal relationships and inspire others to follow or to change. Unlike managers who have legitimate control over decision making and direct both the willing and unwilling, leaders utilize their personal influence to empower others and challenge the status quo. Leaders in healthcare ask the questions “why” and are creative and innovative in solving dilemmas and moving ideas forward. Healthy work environments are those who have leadership at all levels of the organization, but especially at the point of care where care is delivered and patient voices are heard. Leaders are at the bedside. With our growing understanding and appreciation of leadership and its importance in creating a healthy environment for patients and staff, attention has turned to the leaders who lack true title. It is argued, that these leaders are in optimal positions to identify clinically relevant questions and have the knowledge and skills to determine the best approach to care. These leaders, who are the most intimately involved with patients and families, need to be recognized and promoted. This journal is dedicated to leadership at the bedside. Although change in healthcare is inevitable, it can be embraced with enthusiasm when leaders show us the way. Each paper focuses on a change in past practices and the importance of early engagement of key stakeholders, acceptance of novel ideas, careful planning,
identification of key outcomes and most importantly, the willingness to alter direction when required. Safe staffing is always a heated topic of bedside nurses, administration, and governmental bodies that is addressed. Ethics in the NICU requires leadership from a multidisciplinary interprofessional approach. Cultural competence is difficult to define and difficult to measure and thus, also difficult to teach and have good understanding. It is constantly evolving. Two foundational papers address the importance of cultivating frontline leaders in an ever-changing environment and the necessity of interprofessional collaboration to meet the complex needs of this decade. Formal training such as mentorship, expanded roles, practicing to full scope, and strategic leadership planning for the future as well as ongoing commitment and recognition to the development of our future frontline leaders are key strategies to sustaining change. These two papers form the basis for addressing change in our busy NICU environment. Whether the focus of the paper is the introduction of informatics, attainment of a baby friendly status, or developmental care approaches that may affect gene alteration in the developing preterm brain, the messages are consistent; change can be introduced and sustained with leaders at the bedside who inspire and guide. It is our hope that the enclosed papers provide neonatal nurses and allied health professionals with the courage to ask the difficult questions, challenge practices, engage others, inspire change and visualize a future that holds all leaders in awe for the work that they do in the lives of patients and families. We believe that it is the responsibility of all professionals who care for patients to be leaders in their field and manage change with dignity, pride and passion for excellence.
Sharyn Gibbins, NP, PhD Trillium Health Partners 2200 Eglington Ave. W, Mississauga Ontario L5M; 2N1; CA E-mail address: [email protected]
1527-3369/1303-0516$36.00/0 – see front matter. Crown Copyright © 2013 Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1053/j.nainr.2013.06.003
Contents lists available at ScienceDirect
Newborn & Infant Nursing Reviews journal homepage: www.nainr.com
Guest Editorial
Leadership From Within
There isn't a day that goes by that the word “change” is not heard in the neonatal intensive care unit (NICU). The difficulty, however, is that the word invokes a variety of feelings such as fear, confusion, resentment, and the perception that the change is going to be difficult, impractical and irrelevant to the bedside clinician. Change may include alterations in our physical space, our team composition, and our communication patterns or how we provide care to the most vulnerable populations. Change management is defined as an approach to transitioning individuals, teams and organizations to a desired future state. Change can be a welcomed event, when perceived as a solution to an identified problem, or it can be seen as an additional task or burden that needs to be executed for some other purpose. Change is likely to invoke negative feelings when those involved lack understanding about the “why”, “how”, “when” and “what”. Change is likely to succeed if it is led by those skilled in its execution and passionate about its outcome. Leaders in health care are those who excel at interpersonal relationships and inspire others to follow or to change. Unlike managers who have legitimate control over decision making and direct both the willing and unwilling, leaders utilize their personal influence to empower others and challenge the status quo. Leaders in healthcare ask the questions “why” and are creative and innovative in solving dilemmas and moving ideas forward. Healthy work environments are those who have leadership at all levels of the organization, but especially at the point of care where care is delivered and patient voices are heard. Leaders are at the bedside. With our growing understanding and appreciation of leadership and its importance in creating a healthy environment for patients and staff, attention has turned to the leaders who lack true title. It is argued, that these leaders are in optimal positions to identify clinically relevant questions and have the knowledge and skills to determine the best approach to care. These leaders, who are the most intimately involved with patients and families, need to be recognized and promoted. This journal is dedicated to leadership at the bedside. Although change in healthcare is inevitable, it can be embraced with enthusiasm when leaders show us the way. Each paper focuses on a change in past practices and the importance of early engagement of key stakeholders, acceptance of novel ideas, careful planning,
identification of key outcomes and most importantly, the willingness to alter direction when required. Safe staffing is always a heated topic of bedside nurses, administration, and governmental bodies that is addressed. Ethics in the NICU requires leadership from a multidisciplinary interprofessional approach. Cultural competence is difficult to define and difficult to measure and thus, also difficult to teach and have good understanding. It is constantly evolving. Two foundational papers address the importance of cultivating frontline leaders in an ever-changing environment and the necessity of interprofessional collaboration to meet the complex needs of this decade. Formal training such as mentorship, expanded roles, practicing to full scope, and strategic leadership planning for the future as well as ongoing commitment and recognition to the development of our future frontline leaders are key strategies to sustaining change. These two papers form the basis for addressing change in our busy NICU environment. Whether the focus of the paper is the introduction of informatics, attainment of a baby friendly status, or developmental care approaches that may affect gene alteration in the developing preterm brain, the messages are consistent; change can be introduced and sustained with leaders at the bedside who inspire and guide. It is our hope that the enclosed papers provide neonatal nurses and allied health professionals with the courage to ask the difficult questions, challenge practices, engage others, inspire change and visualize a future that holds all leaders in awe for the work that they do in the lives of patients and families. We believe that it is the responsibility of all professionals who care for patients to be leaders in their field and manage change with dignity, pride and passion for excellence.
Sharyn Gibbins, NP, PhD Trillium Health Partners 2200 Eglington Ave. W, Mississauga Ontario L5M; 2N1; CA E-mail address: [email protected]
1527-3369/1303-0516$36.00/0 – see front matter. Crown Copyright © 2013 Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1053/j.nainr.2013.06.003