1. Challenges in Developing Future Nursing Leaders Sally Dampier CASN, 2009

2. Investigator Team Patricia Sevean RN, MA (N) Susan Pilatzke RN, MPH Research Assistant Christine Zozula MPH (c)

4. Geographical Location

5. Session Plan Background (RNAO BPG, 2006) Key literature Methods Findings Next Steps

6. Background Without leadership that fosters and supports transformational change it is difficult to create work environments that maximize patient, nurse and system outcomes. ( The Office of Nursing Health Policy, 2006)

7. To conduct an environmental scan of an in-patient unit in a regional hospital based on Registered Nurses Association of Ontario: Healthy Work Environments Best Practice Guidelines: Developing and Sustaining Nursing Leadership. (RNAO, 2006) Purpose

8. Objectives Identify the organizational supports that enable nurses to develop effective leadership skills Evaluate the current leadership style in context to the ‘Healthy Work Environments Best Practice Guidelines: Developing and Sustaining Nursing Leadership’ (RNAO, 2006) Evaluate the educational supports for nurse leaders and aspiring nurse leaders

9. Conceptual Model for Developing & Sustaining Leadership (RNAO, 2006, pg. 22)

10. Contextual Factors Move to a new unit, new manager, 3 month review indicated: All staff were overwhelmed by the volume & acuity of the unit Sick time was increasing Overtime was on the rise Staff were very disgruntled &complaining of lack of support and high patient numbers Generalized discontent, negative feelings, feeding a negative atmosphere……….

11. Nursing Experience Number of Years ExperienceNumber of RNs % 20+ years12.4% 15+ years717.07% 10+ years37.31% 5+ years614.63% 1-5 years*2458.53% Of the 24 staff with < 5 years experience * 4 years28% *3 years833% *0-1.5 years1458%

12. Methods Phase I: Survey n=56 Based on the RNAO Best Practice Guidelines 14 Likert-scaled questions 4 open-ended questions Statistical software (SPSS) to analyze data Thematic analysis of open- ended questions

13. Demographics

14. Survey Questions: Range (1-5) Mean Std Deviation Variance 1) Does your unit have a vision, objectives and action plans for nursing practice? 2.91.1811.394 2) Are the vision, objectives and action plans for nursing practice implemented and evaluated? 2.581.1801.391 3) Does the leadership provide opportunities for continuing education for nurses? 3.63.937.878 4) Does the leadership create conditions for satisfaction and growth? 3.28.904.818 5) Is the leadership on your unit effective? 2.98.958.918 6) Does the leadership expect yourself and others to pursue excellence? 3.181.0141.028 7) Does the leadership build partnerships with unions, professional associations and other stakeholders to achieve the unit goals? 2.631.1131.238

15. Survey Questions: Range (1-5) Mean Std Deviation Variance 8) Does the leadership develop a supportive team by seeking and sharing information? 2.84.987.975 9) Does the leadership develop a supportive team by pursing joint problem-solving? 2.94.925.856 10) Does the leadership develop a supportive team by encouraging new ideas? 2.9.974.949 11) Does the leadership inspire trust by establishing open and candid relationships? 2.78.986.973 13) Does the leadership treat all individuals fairly and with respect? 2.78.907.824 14) Does the leadership practice in accordance with the standards and professional Codes of Conduct? 3.251.0171.034 15) Does the leadership maintain high standards of integrity?3.001.0391.080

16. Thematic Analysis: Open-ended Question 1) What are the best things about the leadership practices on your unit? Mentoring/Preceptorship for new nurses Visible, approachable leader Ongoing continuing education Support for evidence based practice Opportunities for professional growth

17. Thematic Analysis: Open-ended Question 2) Is there anything about the leadership practices on your unit that you particularly do not like? Inconsistency, lack of equality Not enough sharing of information Unclear vision, objectives and action plan for nursing practice Few opportunities to provide feedback on nursing practice Lack of empowerment to support a culture that values knowledge and builds trust

18. Thematic Analysis: Open-ended Question 3) If you could change one thing about the leadership practices on your unit what would it be? More effective team work Access to mentors, clinical experts Ongoing education opportunities to meet learning needs Improved communication Ongoing feedback on new initiatives

19. Thematic Analysis: Open-ended Question 4) Is there anything you would like to share that we have not asked? Improved access to resources More support for novice nurses Clearer lines of communication

20. “Leaders are those individuals in formal and informal leadership roles who are recognized by their peers and colleagues as experts in their practice, who consider patient care and nursing excellence as their priorities, who can be trusted and with whom it is easy to have an conversation about one’s dreams and vision for one’s career” Gail J. Donner, RN, PhD. & Mary M. Wheeler, RN, Med, PCC., from Donner G. J. & Wheeler, M. M. (2004). New Strategies for Developing Leadership. Journal of Nursing Leadership, 17(2),27-28.

21. Next Steps: Challenges in Developing Future Nurse Leaders Phase 11 Interviews: (n=6) Explored concepts related to transformational leadership practices, focusing on: Building relationships & trust Creating an empowering work environment Creating a culture that supports knowledge development & integration Leading & sustaining change Balancing competing values & priories (RNAO,2006 p 22)

22. Nursing Leadership Towards an Understanding….. “At one level it is, I’d say, quite simple. We remind ourselves what lies at the heart of our nursing practice. And then we begin to reshape our health care systems to ensure that the fundamental values and functions of nursing remain at their centre. To do this we need strong leadership of nursing – at all levels and in all sectors of the profession.” Alison Kitson BSc PhD RN FRCN Honorary Professor, Executive Director, Nursing, Royal College of Nursing, (2004).Drawing on Leadership.JAN. 48(3)pg211

23. Acknowledgments Project sponsored by: Registered Association of Ontario (RNAO) Nursing Leadership Network of Ontario (NLN.ON)

24. Contact Details Sally Dampier Faculty Confederation College Thunder Bay, Ontario P7C 4W1 sdampier@confederationc. on.ca Questions

25. References Donner G. J. & Wheeler, M. M. (2004).New Strategies for Developing Leadership. Journal of Nursing Leadership, 17(2),27,28. Kitson, A. (2004). Drawing on Leadership. Journal of Advanced Nursing. 48 (3) pg 211. Registered Nurses’ Association of Ontario: Nursing Best Practice Guidelines Program (June, 2006). Healthy Work Environments Best Practice Guidelines: Developing and Sustaining Nursing Leadership, Toronto, Ontario. http://www.rnao.org/projects/hwe.asp http://www.rnao.org/projects/hwe.asp The Office of Nursing Health Policy, 2006