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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Teaching Team Backup
2024-03-04 01:00:30By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
A nurse leader recently talked with me about comments several patients had made to her while she was leader rounding. They said they observed a lack of teamwork among the staff. One family member noted that she had seen one of our staff at the desk on her phone while the call lights were ringing throughout the unit. The leader was upset, but it did confirm some of what she had observed. The teamwork on her unit (once a source of great pride) had deteriorated and she needed to work to rebuild it.
Casey Stengel, the late and great coach of the Yankees, once noted that you could hire great players, but getting them to play together is another story. Most nurse leaders would agree with this assessment. Building effective teamwork and team backup has always been challenging in nursing, especially in the post-pandemic environment where turnover has skyrocketed to 22% yearly, and using travel nurses is still part of strategic staffing in many organizations.
Younger Generation Z nurses are more individualistic in their approach and may not have had exposure to strong teamwork during their clinical education. Answering a patient’s call light that is not part of their assignment may seem like a foreign concept. Recently, several managers have presented me with scenarios where their team members are not helping one another even when there is a clear need. One ED director told me that he reminds his young nurses at least five times daily that “nobody sits down until everyone can sit down.” Teamwork, he notes, is so critical in emergency departments. The need to help others should be obvious, but now needs to be reinforced.
Team backup is an essential concept in healthcare. In this era of short staffing, it has become even more critical. In reality, we can’t do primary nursing care as we have in the past. There are not enough RNs, and there won’t be for many years to come. By necessity, care needs to be delivered using a team approach. John Maxwell reminds us of this in his Law of Everest – “The Law of Everest: As the Challenges Escalate, the Need for Teamwork Elevates.”
Teaching Team Backup to Nurses
Strong team backup should be a core value in any organization that is emphasized to nursing staff from the initial interview. Ask potential candidates to give specific examples of how they have backed up other team members in prior jobs or while in school. In his book Give and Take, Adam Grant recommends that leaders look for signs that the person has a spirit of giving and is not a taker or a matcher. Leaders must be sure to role model this behavior when working with others.
Some key questions to ask team members to assess team backup include the following:
- Do you feel safe asking your team members for help when needed?
- Do you have a system on the team to let others know when you need help? (Some units use a traffic light system to signal a staff member is feeling overwhelmed).
- How do your team members respond when you ask for help?
- Is “it’s not my job” a phrase used on the unit?
- When patients ask for help on the unit, does the responding team member try to solve the problem?
- What happens when team members are late with their assignments during a shift?
Initiatives to Build a Team Back-up Culture
Some nurse leaders are already at work to emphasize the importance of teamwork and team backup. Examples of creative initiatives include the following:
- The Team Scavenger Hunt – every staff member on the unit is asked to come up with one question, usually something personal about themselves, for new team members to ask. During orientation, the new staff member goes on a scavenger hunt and must meet every team member, filling in the blanks on the questions.
- The Emergency Pit Crew – when complex patients are admitted on many units, the emergency pit crew approach is adopted to facilitate that patient’s timely admission and treatment. We drop everything and go in and help so no one gets behind or overwhelmed.
- A Buddy On Every Shift – to help build relationships and promote team backup, a backup buddy is now increasingly designated on assignment sheets.
- The Battle Buddy Program – is an initiative I wrote about in a blog to promote friendships on teams and a spirit of camaraderie.
- Fishbowl Fridays – A critical care director talked about her fishbowl Fridays, which she had initiated to promote team back up. Every week, staff nominate other staff who have helped them. On Fridays, they “go fishing” and choose the nominee who demonstrates a spirit of teamwork. That person gets a prize.
- No Nurse Left Behind – a nurse manager shared her initiative based on her experience as a Marine. We would never leave anyone behind on a mission, she observed – why do nursing teams think it is okay to leave nurses overwhelmed with things they have not completed at the end of their shift? This is not okay in my world, and I have told them we can accomplish much more together.
Building strong team backup is critical to staff retention. Team inclusion is a vital aspect of building psychological safety. Leaving a unit and never looking back is easy when no strong team culture exists. Committing to a culture of team backup is an inexpensive retention intervention and is vital to the future of nursing.
© emergingrnleader.com 2024
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Nurse Leader Coach Workshop March 28, 2024
2024-03-01 01:00:51Hi, Emerging RN Leader Blog Readers
I am pleased to announce that I am partnering with the New England ONL to offer our extremely popular Nurse Leader Coach Workshop on March 28th. You don’t have to be a member of ONL to enroll. You can register by clicking on this LINK.
What Nursing Workforce Models Tell Us and What They Don't
2024-02-22 01:00:36By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
Nurse leaders have voiced frustration over the past decade about nursing workforce models. Workforce researchers may reassuringly predict that the supply of nurses will meet the demand. When CEOs study the data, they have challenges understanding why it may not reflect their local workforce supply. Nurse leaders often find themselves on the defensive. Last week, JAMA released the latest nursing workforce supply derived from population census data. It comes at a time when nurse leaders in acute care settings in most of the US still see a significant shortage of nursing candidates.
The Findings
- The total number of RN FTE (including ARNPs) is 6% higher than in 2019, reaching 3.35 million.
- The 3.35 million RNs are all employed RN FTE, including ARNPs aged 29 to 69 in all settings.
- Based on historical trends, the RN workforce is projected to increase by roughly 1.2 million FTEs to 4.56 million by 2035, close to pre-pandemic forecasts.
- Future workforce growth will be primarily driven by nurses 35 to 49 years of age.
- Although there is an increase in RN FTE, there has been a significant drop in RNs choosing hospital employment from 60.3% to 57.8% from pre-pandemic levels.
- There has been a dip in enrollment in nursing programs since 2022.
- The forecasted growth will be significant enough to replace RNs who will retire and further expand the workforce by roughly 1.2 million RNs by 2035 to a total of 4.56 million nurses.
On the surface, these findings seem very optimistic. A challenge with workforce models is that they are built using historical data on how RNs have moved through their nursing careers and other societal trends. They often fail to consider many of the following factors:
- Current birthrate declines in the US population could lead to fewer students in nursing programs.
- Changes in societal attitudes about college education could lead to fewer enrollments in nursing programs.
- University and college financial issues could make nurse faculty salaries less appealing, exacerbating the faculty shortage.
- An aging US population is leading to increased utilization of healthcare services, especially hospital services.
- Changes in how generational cohorts view their professional work and may be able to apply their nursing skills in other occupations.
- The physician shortage is driving the need for more advanced practice nurses.
- Increased nurse employment in fields supporting healthcare services, such as insurance companies, technology, and medical supply firms.
- Changes in immigration policies and a drop in foreign-educated nurses who work longer in their careers and stay in acute care settings.
- The impact of societal violence, incivility, and bullying on career choice.
- Population migration due to economic reasons or climate impact.
Workforce studies provide essential data for nurse leaders to track, but they do not paint the full picture of what is happening with nursing employment. The drop in hospital employment at a time when volumes are surging is alarming. The authors acknowledge whether this forecasted growth will satisfy the needs for the types of healthcare services provided by RNs or match healthcare delivery organizations’ demand for RN labor remains to be seen.
Reference
Auerbach DI, Buerhaus PI, Donelan K, Staiger DO. Projecting the Future Registered Nurse Workforce After the COVID-19 Pandemic. JAMA Health Forum. 2024 Feb 2;5(2):e235389. doi: 10.1001/jamahealthforum.2023.5389. PMID: 38363560; PMCID: PMC10873770. Available at https://jamanetwork.com/journals/jama-health-forum/fullarticle/2815057
© emergingrnleader.com 2024
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Volunteers for Nurse Manager Focus Groups
2024-02-09 08:25:45Hi, Emerging RN Blog Readers – Thanks to Those of You Who Have Volunteered – I Still Have Slots in All Sessions
I need your help. I have been asked to give a research plenary at this year’s AONL conference. My presentation will be titled ” The Evolving Role of the Nurse Manager in the New World of Work. “
As part of this presentation, I would like to discuss nurse managers’ perspectives of those currently in the role. If you are in a nurse manager role or equivalent in any specialty setting, I would like to invite you to participate in one of five national one-hour focus groups that I am conducting on the dates/times listed below (all in Eastern Standard Time):
February 15th, 2024
11:00 AM – 12:15 PM EST
3:00 PM – 4:15 PM EST
February 20th, 2024
10:00 AM – 11:15 AM EST
March 14th, 2024
10:00 AM – 11:15 AM EST
March 20th, 2024
3:00 PM – 4:15 PM EST
Our conversation will be very interactive, and I promise to do my best to convey your ideas to the AONL audience. If you would like to participate or have colleagues who might, choose a date that works best for you, and I will send you the ZOOM meeting login information.
Email me at roseosherman@outlook.com
Thank you in advance for your help with this.
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