Courage to Lead: Transformational Nurse Leadership for a Healthy Work Environment
June Marshall, DNP, RN, NEA-BC
Mano y Corazón Binational Conference of Multicultural Health Care Solutions, El Paso, Texas, September 27-28, 2013
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Courage to Lead: Transformational Nurse Leadership for a Healthy Work Environment
1.
2. • Describe transformational leadership qualities necessary
for creating and sustaining healthy work environments.
• Define components and characteristics of healthy nursing
work environments.
• Identify strategies for mitigating nurses’ workplace stress.
15. High-quality, patient-
centered health care for all
will require a
transformation of the
health care delivery
system
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16. 1) Remove scope-of-practice barriers
2) Expand opportunities for nurses to lead and diffuse
collaborative improvement efforts
3) Implement nurse residency programs
4) Increase the proportion of nurses with a BSN degree to
80% by 2020
5) Double the number of nurses with a doctorates by 2020
6) Ensure that nurses engage in lifelong learning
7) Prepare and enable nurses to lead change to advance
health
8) Build an infrastructure for the collection and analysis of
interprofessional health care workforce data
21. • Complexity of nursing work environments
• Workplace stressors – patient acuity, technology,
rapid cycle change, ethical dilemmas and
bullying/violence
• Stress responses produce adverse physiologic,
social, emotional, and behavioral reactions
22. • Key to recruiting and retaining “best talent” and
providing care for patients
• “Feeling physically and emotionally safe”
• Culture with a sense of belonging and positive team
relationships
Shirey (2006)
23. • Critical Incident Stress Management
• Psychological Debriefing
• Peer Support
• Ethics Consultation
• Employee Assistance Programs
• The Nurse Advocate Role
25. Stabilization &
Acknowledgement of
Events & Reactions
(Everly, 2001)
Critical Incident
Impacting a Group
of RNs Initiate
CISM Program
Defusing in Small Groups –
Including Introduction,
Exploration, & Information
(Mitchell, 2006)
Successful
Work Reentry
Facilitation of
Normal
Recovery
(Mitchell, 2006)
If Stress Responses
Unresolved, Refer to
Formal Individual or
Group CISM Program
Stress Responses
Completely Resolved
Without Need for Ongoing
Follow-up
Professional
Practice-related
Critical Incident
Initiates Referral
to Nurse
Advocate (TNA,
2010)
Individual and Group Workplace Critical Incident Stress Management (CISM) for
Registered Nurses (RNs) – Marshall (2010)
Critical Incident
Impacts Individual RN
– Initiate CISM
Program
Assist RN to
Understand &
Normalize Events
(Everly, 2001)
Encourage
Actions to
Facilitate
Effective Coping
(Everly, 2001)
If Stress Responses
Resolve, Provide
Periodic Follow-up as
Needed for Problems
If Stress Responses
Continue, Refer for
Follow-up Assessment
& Interventions (Everly,
2001)
Stressful Workplace
Incident Occurs &
Individual or Group Peer
Support Session Initiated
26. • Stress Support Work at UT
Southwestern
• Staff Survey and Involvement in the
Work
• EAP, Chaplain Support
• Lessons Learned
• Accomplishments
• Next Steps
28. • Support for education
• Working with clinically competent
nurses
• Collegial and collaborative
interdisciplinary relationships
• Autonomous nursing practice
• Control over nursing practice
• Supportive nurse managers
• Perceived adequacy of staffing
• Culture in which concern for the
patient is paramount
http://www.amsn.org/practice-resources/healthy-work-environment
36. • What brought you
to this work?
• What sustains your
commitment?
• What is your vision
for the future?
37.
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Critical-Care Nurses.
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