Key Changes in How Nurses View Their Work
2024-04-25 01:00:34By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
This is the third blog summarizing research I presented at the AONL Research Foundation Keynote at the AONL meeting in New Orleans meeting. My topic was the Evolving Role of Nurse Managers in the New World of Work. To prepare for this presentation, we sought input from nurse managers through five focus groups conducted in February and March 2024. I promised the 141 managers who participated in this research that I would share their feedback in this blog, as many could not attend the conference. In previous blogs, I have written about the impact of staffing shortages on the nurse manager role and what recommendations nurse managers have to improve their roles.
Today, I will focus on seven fundamental changes that nurse managers now see in nurses’ views of their work. These changes include the following:
- Nursing staff today are more focused on their lives and less on their work – nurse managers see profound changes in how nurses view their work. Where once there was discussion about work-life balance, contemporary nurses seek ways to fit work into their lives. Some trends observed include working fewer hours, immediate use of paid time off, skyrocketing requests for FMLA, a decline in willingness to work nightshift, and a desire for weekends off.
- New staff accept positions and clarify that they don’t plan to stay on units beyond a year or two – nurse managers report that new nurses arrive with their career plans. They see jobs more as tours of duty on a longer career trajectory. Forming core teams has proved challenging in a one-and-done environment.
- Staff today are less committed to organizations and shared governance – nurse managers see a pronounced change in staff trust in organizations and a willingness to become involved in shared governance efforts. Many new staff won’t attend meetings on their day off even if compensated. Some report not understanding professional governance and whether these groups have any outcomes.
- Nurses will make job changes for pay increases or quickly leave positions if unhappy – many nurse managers report shock at how quickly contemporary nursing staff decide that “things are not working out” in a position. Staff leaving during orientation is not unusual.
- Nurses now demand answers when units are short-staffed and are less willing to accept professional accountability – nurse managers report that holding nurses accountable for their professional practice has become much more challenging. When managers try to discuss missed nursing care or missed documentation, nurses will often respond – you fix the staffing, and I will get everything done.
- Younger staff talk openly about exhaustion, burnout, and stress – nurses today talk more openly with their leaders about their mental health and well-being. Nurse managers worry about crossing the line between a leader coach and a therapist. Leaders report that emotional conversations are exhausting and they worry about their own compassion fatigue.
- Nurses now challenge leaders about decisions and are sometimes disrespectful – nurse managers report an uptick in disrespectful behavior toward leaders. Decisions made by the administration are openly discussed and criticized. Some social influencers encourage this behavior. One manager noted that, “Lashing out and disrespect to leaders seem to be an acceptable behavior for nursing staff now. As leaders, we need to pause and learn not to be reactive yet set boundaries. We must pull these nurses aside and inform them that their behavior is not okay.”
We are in a new world of work. Nurse managers report that not only has the work itself changed and become more complicated, but workplace norms and workforce views are changing. These changes impact the nurse manager’s role, activities, and coaching conversations. In our next blog, I will discuss what nurse managers want executives to know about their roles and how to better support them.
© emergingrnleader.com 2024
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Millennial Nurse Leaders Research Study
2024-04-19 01:00:34 Posted in: The Future of Healthcare Read more... 0 commentsNurse Manager Research Study Opportunity
2024-04-09 01:00:28If you are interested – contact the nurse researchers using this email address UCFTeam-Nursing-Manager-Research@groups.ucf.edu
Having Situational Humility
2024-04-08 01:00:44By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
A nurse leader told me about a recent conversation with staff on her unit. They were vocalizing concerns about their assignments and the volume of patients admitted to their unit. The conversation had taken a very negative turn when she backed off and said the following:
You may think I or any of us have all the answers to what is happening in healthcare today, but we don’t. We have never seen sustained volumes like this before. We can’t go on a diversion like before because every hospital in our community is experiencing the same thing. Then she flipped the question to the group and asked what we thought about pathways out. It led to some of the best conversations we have ever had as a team.
The manager in this story was practicing a powerful leadership strategy called situational humility. We all pride ourselves on our leadership expertise, but there are limits to what we can know, especially in situations like the present. Harvard Professor Amy Edmondson coined situational humility. She describes situational humility as a willingness to transparently acknowledge the gaps in our knowledge and remain relentlessly curious about the opinions of others. It leads to better outcomes in uncertain situations because the leader creates psychological safety for others to share their ideas. A leader who practices situational humility seeks to know what they don’t know about situations.
Edmondson observes that situational humility is strangely rare in organizations. Leaders believe they are paid for their expertise, so they sometimes err on the side of being overly certain about situations to the point of arrogance. Edmonson introduces what she describes as “the basic human problem: it’s hard to learn if you already know.”
I can’t think of a time in nursing when we need to maintain situational humility more than we do now. I have had discussions with some senior nursing leaders who describe what they see as another cyclical nursing shortage. The solution, they contend, is to pull together a commission or task force to make recommendations. That is what we have always done – bring together the “experts” and solve the problem. There is a lack of curiosity about what is happening at the frontline of care and how nurses today view their work and future. We think we know what is happening, but maybe we don’t.
Frontline nurse leaders are far more likely to admit they don’t know what to do because tried and true leadership strategies often don’t work today. They paint a much more nuanced picture of nursing, with many frequently telling me – I am seeing things today in my leadership career that I have never seen before, and I am not sure what these changes might mean in the long term.
Many leaders want to control everything. But some things can’t be known upfront or beforehand. You have to know when to take charge or let go and seek better information. This requires keeping an open mind and staying curious for a little longer by maintaining situational humility.
Read to Lead
Edmondson, A. (2018). The Fearless Organization: Creating Psychological Safety in the Workplace for Learning, Innovation, and Growth. Boston: Harvard Press.
© emergingrnleader.com 2024
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The Role of Nurse Recognition
2024-03-14 01:00:18By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
The topic of recognition is coming up more frequently today as I talk with nurse leaders. They see it as a double-edged sword. While most understand the importance of giving recognition, they now find many staff who want recognition for doing the bare minimum. One manager explained his dilemma in a recent coaching session:
“So we now have a growing number of staff who grew up in environments where everyone received a trophy and was given accolades for being present. Now, as adults, these nurses expect constant recognition and positive feedback for meeting the requirements of their role. I have had many conversations with our staff about what and beyond looks like because few seem to know. I recently talked with a nurse about why she was not advancing on the clinical ladder – she was talking about her excellent attendance record, and I was speaking about her lack of contributions to our professional governance activities. There was a definite disconnect.”
As leaders, we know that staff feels devalued when we fail to say thank you or recognize outstanding work. Nurses want to be valued for their contributions to the team’s work. Leadership experts Kouzes and Posner have called this Encouraging the Heart. It is one of the five exemplary practices of the world’s best leaders.
Leaders who encourage the heart bring others to life by recognizing their unique contributions. We all want to know that what we do matters and that our leaders will notice good work and be encouraging. Saying thank you may sound obvious, but it is often overlooked. You almost can’t do it enough.
And yet, to be authentic, the recognition also needs to be meaningful and call out contributions. So, the nurse manager in the situation above is not wrong in his concern or in setting a bar for what great work looks like. As we discussed the complexity of his situation (which other managers are also experiencing), the need to set clearer expectations about practice was established as very important.
When you give recognition to staff, ask yourself the following questions:
- Do I look for opportunities to celebrate achievements and be specific about what we celebrate?
- Do I give staff regular feedback about their work, focusing on what they need to start, stop, or continue doing in their practice?
- When staff volunteer to work overtime or float to another unit – do I recognize those efforts as going above and beyond?
- How often do I say thank you to staff, and am I clear what I am thanking them for?
- Do I look to create a community spirit and ask staff to nominate other staff for great teamwork efforts?
- When I have straight-talk conversations with staff about what warrants recognition and what does not – do I remain optimistic about their ability to meet higher expectations?
- Do I use feedback to encourage progress toward a goal?
In her book Dare to Lead, Brene Brown discusses the need to be clear when giving feedback and to view unclear or unwarranted recognition as unkind. Nurse Managers tell me that they want to create professional environments of excellence. To do this, they need to set the bar for what excellence looks like and celebrate staff who are meeting it.
© emergingrnleader.com 2024
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