Leadership and Management: How Well Can You Communicate?

Yesterday I witnessed a situation that I would like to talk about.  There were two people, a mother and a daughter at a table at the restaurant that my husband and I were visiting.  The mother, who was dressed as though she was in a professional, maybe managerial, postion, was on her phone talking to someone about a contract of some sort.  Her daughter, in her early twenties I would hazzard a guess, reminded me of my daughter, a college student, dressed in jeans and a pretty pink tee shirt.  Her hair was long and pulled up into a pony tail.  She was impatiently waiting for her mother to get off the phone.  As she was waiting, she was playing on her cell phone looking at Mom to "hurry up" the conversation.  Mom continued to talk until the food came.  At first, their conversation was blending in with the hum of the restaurant noise.  Soon, both my husband and I noticed voices becoming louder.  Mom was angry and the daughter was too.  Mom soon became verbally aggressive in an authoritative voice and refused to listen to the daughter.  The daughter, after responding defensively, clammed up and sat sullenly at the table while Mom either ignored her or spoke with harsh tones.  Shortly after the heated conversation erupted, Mom requested the bill and they both left.

I began to wonder how would I have handled that same scenario.  I also wondered how the mother would have responded to a coworker or an employee, if she was trully in a managerial situation.  Then I thought about how we communicate in general. What is communication?  We know that communication is when one person sends a message and the other, the receiver, receives the message.  The receiver then sends the message back to the send, and this of course is feedback.  Back and forth it goes, either until the conversation is ended or the communication fails.  As we know, there are two types of comunication, verbal and nonverbal.  In the scenario described, the two types were used as evidenced by the mother and daughter's words and behavior. The part of communication that tends to get lost is the active listening that should take place between the two individuals.  Most of the time we hear the words, but do we really listen to what is being said?  Listening is crucial to identify not only the information being received, but also the emotions of the other person so that the response is appropriate (Anderson, 2009). 

As the healthcare environment becomes more complex and diverse, communication becomes an essential skill for the nurse leader and the nurse manager. In addition, there will be a need to communicate effectively, not only with other healthcare members, but with patients and their families.  As a manager, or as a nurse leader, you have the responsibility of accomplishing work and goals through others, and part of how to make this happen in the clinical environment is through successful communication (Covey, 2004).

Please watch the video and take a few minutes to think about how we communicate when we are at work, in the classroom or with our family members.  Please see the next blog for the video.  Thank you.

References

Anderson, M. A. (2009). Nursing leadership, management, and professional practice for the LPN/LVN in nursing school and beyond, (4th ed.). Philadelphia, PA: F. A. Davis
Covey, S. R. (2004). The seven habits of hightly successful people. New York, NY: Simon & Schuster

Video posting "Why is Communication So Hard for Healthcare Professionals?"

Leadership and Critical Thinking: What does this mean to nurses?

Today I was thinking about critical thinking as I was preparing for a classroom activity.  We know critical thinking is important to nursing, but how important is it?  How does an instructor teach critical thinking, especially to those who have no concept of what it actually entails.  Do our leaders critically think?  Does someone in a leadership role critically think?  How do we get those in leadership to learn how to critically think?
 What exactly is critical thinking?  The term critical thinking is often used to mean problem solving, decision making and creative thinking in nursing, and yet there is no widely accepted definition of critical thinking. (Fero, Witsberger, Wesmiller, Zull, & Hoffman, 2009).  So with that as a basis for critical thinking, how then can we as educators teach the next generation of nurses to learn to "think out side the box" or "creatively think" when placed in leadership roles, if we can not teach them that skill to functiona as a nurse generalist?  In critically thinking, it helps one to understand that why solutions to particular issues have failed is part of the subset of these skills necessary to think in a critical manner (Fero, et al, 2008).  With the world of nursing changing almost everyday, and with patients becoming more complex, it is important for nurse eductors to to teach students to critically think and how to practice competently in a variety of situations in which there is no clear solutions to the problem presented (Kaddoura, 2011). 
 Nursing needs leaders that can critically think.  Nursing needs leaders to improve the nursing profession and become more forthright in the provision of patient care and safety. A study by Fero and team (2009) found that approximately 25%  new graduates were not meeting the expectation of having developed critical thinking skills, and these deficiencies included problem recognition, reporting of essential datat, initiating independent nursing interventions, anticipating relevant medical orders, and providing relevant rationale to support decisions.   It seems frightening that we are releasing graduate nurses to the world, and they have very little skills in critical thinking.  Nurse educators need to find ways of equiping the nursing skills that would promote critical thinking to solve complex problems (Kaddoura, 2011).  In order to do this, educators can promote active learning and a provide prudent preparation for clinical practice by useing case-based learning (Bradshaw & Lowensteing, 2011).
  Having students learn through case studies allows them to think about the big picture and to come up with all possible solutions to that particular issue.  They can brainstorm together and look at the solutions and put it into role playing practice.  They can also role play with the issue at hand to as to develop the critical thinking and problemsolving that wourl be a necessary skill when working with complex patients.
   How do you see critical thinking?  What does this term mean to you?  Do you think you have the skills of critical thinking and leadership?  Can one exist with out the other?
Judi
                                                                                           Reference
Bradshaw,  M.  J., & Lowenstein, A. J. (2011). Innovative teaching strategies in nursing and related health professions (5th ed.). Sudbury, MA: Jones and Bartlett.

Fero, L. J., Witsberger, C. M., Wesmiller, S. W., Zulio, T. G., & Hoffman, L. A. (2009). Critical thinking ability of new graduate and experienced nurses. Journal of Advanced Nursing, 65(1), 139-148. doi:10.1111/j.1365-2648.2008.04834.x.

Kaddoura, M.A. (2011). Critical thinking skills of nursing students in lecture-based teaching and case-based learning. International Journal for the Scholarship of Teaching and Learning, 5(2). Retrieved from http://www.georgiasouthern.edu/ijoti

Leadership

I would like you to take a few minutes to sit and think before you go too far into reading this post.  Think about the tape recordings that run through your mind on the different issues that you have come in contact and how you handled those issues.  In many instances our tape recordings in our mind play over and over again and they influence not only our reactions to situations, but how we are when we are faced with similar issues.  Think about  what your greatest fear about becoming a leader contains.  Do you have pictures of great managers and leaders that you have come in contact with?  I  know I do.  For all of us to understand and use management and leadership prinicples, we need to understand ourselves and what is improtant to us.  Leadership and management, two very distinct terms that are often blended in the minds of our students, colleagues and even ourselves, without a clear and defined picture of what either term means.  One of the more finite definition that I have learned of leadership is that leadership is a collection of personal traits that is present in order to establish a vision and goals for a particular group and implement them, whereas, management is more along the lines of organizing, motivating and making sure the plan of action is carried out.

So, what are you?  Are you a leader or are you a manager? What characteristics do you believe a person needs to be a leader? When do you think the roles of a manager and a leader could conflict?  Take a few moments and pause on these questions.  We may find our answers if we take a few moments and reflect on them.

"What lies behind us and what lies before us are tiny matters compared to what lies within us." Oliver Wendell Holmes.

Leadership and Professionalism

With the fast pace of healthcare and society, and the rapid growth of technology, professionalism and leadership skills are becoming a dying are in the nursing profession.  We need to bring both of these skill sets back to the forefront of our nursing education so that our upcoming nurse graduates could have the neccessary skills to become leaders and professionals in the nursing community.
With the rise in technology, many of our younger generation of nurses do not know how to communicate professionally, as they are used to texting, and thereby using abbreviated words, being unaware of the tone of voice nor understanding the impact of what and how words are said to the listener.  As a nurse educator, I have become appalled at the lack of professionalism and leadership skills that are exhibited, or not exhibited as I probably should say, among our colleagues.When one can say a person acts “professionally”, for example, we imply that the person is conscientious in actions, knowledgeable in the subject, and responsible to self and others, including civility. (AACN, 2008  ).  In addition a postive image is essential to be a nurse as we spend time with patients, familiesm managers, public officials and even administrators within the community (Larson, 2006).  As a nurse educator, how can I convey to students the importance of not wearing fake nails, dangling earings, thick necklaces, colorful but inappropriate shoes and color in the hair?  How do I as an older professional, keep reminding the next generation the importance of acting, and looking professional and becoming a leader for their generation of upcoming nurses?  Professionalism and leadership is a course that truly needs to be offered to all nurses of every discipline.

  In the upcoming weeks we will be discussing leadership and professionalism and how we can teach the next upcoming generation of nurses these much needed skills.  Please take the time to reflect and share your thoughts on what leadership means to you and also how you view professionalism, in a nurse, a nursing student or even a healthcare provider.  How does both of these skills affect the care of the patient?

American Association of Colleges of Nursing, (2010). The essentials of a baccalaureate education for professional nursing practice. Retrieved from http://www.aacn.nche.edu/education-resources/BaccEssentials08.pdf

Larson, S. E. (2006). Create a good impression; Professionalism in nursing. Retreived from http://www.nsna.org/Portals/0/Skins/NSNA/pdf/Imprint_NovDec06_Feat_Larson.pdf

Lessons learned from classmates and patients

I am enjoying my class this week with Teaching Strategies.  Usually I am a very creative person but my classmates have come up with a couple that I never even thought of.  One was using a snowflake analogy in which students are different but the same.  The other that I like is using fabric to bring back memories and what that piece of fabric reminds them of something from their past.  Sometimes I teach the senior class the last term of the program and I like to make it personal and reflective.  The biggest thing I came up with is having the students do a "Thank-you" T-shirt or hat for the patient they are caring for that last term.  I have them decorate it with ribbon, applique, fabric paint and buttons.  They also have to write a thankyou note saying thankyou to the patient for letting them (the student) for learning about nursing and caring for them.  I have had many students come back to me and say how much the patients truly loved their shirt or hat.  One student told me that her patient was one that never smiled the whole time she took care of him.  He was always short and seemed unappreciative.  The day she gave him a hat decorated with his favorite hobby, fishing, he grabbed her hand and had tears in his eyes as he thanked her for being there for him.  Every person, whether healthcare provider or visitor, he proudly showed off his hat and smiled frequently that day.  The student told me this, and as she did, she had tears in her eyes and said that for the first time in the 14 months of the program, she now understood the meaning of caring for someone.  I think we forget to thank our patients because we are too busy learning from them.  It is nice to thank them for teaching us.

Technology: Is it Progress or Not?

Educational Technology is taking over the nursing world.  Bradshaw and Lowenstein (2011)believe it is growing by leaps and bounds, and I would have to agree whole heartedly.  I, for one, would never have thought that I would be doing a Master's Program on line,especially at my age of 56,  I grew up in a whole different world of nursing.  We had no computers to chart on, no electronic beds or even digital thermometers.  The clinical areas I worked on were known as "wards" and rooms had 4 patients in one room with only a curtain dividing them.  School was an apprentice approach to learning with a little theory thrown in.  Nursing education was primarily done in a hospital based program.  Today, nursing education can be taught on line.  Who would have thought?  And here I am, not only doing it online, also teaching my students with computers and mobile phones, using e-mails, texting and facebook. Oh, and I must not forget my newest addition of blogging.  So I guess where I am going with this is, what happened to the good old classroom learning where I can see my classmates faces, talk to them and watch their expressions, enjoy my instructors presentation, and actually feel like I am in class?
 My children grew up with technology.  They text to each other instead of talking, they blog, they facebook and they are comfortable with the latest technological gadgets.  Yet I see a decline in accountability, communication skills and lack of respect as a result of technology.  Yes, they can learn from whereever they are, and do the learning all on line.  Yes, they can get all resources they need without having to step foot in a library, and pick up a book.  Communication skills are as brief as the texting and many have a new language because of it.  As an older nurse (am I really?) have I missed something that technology was meant to do?  Bradshaw & Lowenstein (2011) also believe that technology is great as to assist learning but it does not replace the instructor in the educational role.  Lol.  So I as I become a big part of the aging nurse educator population, and become immersed in the technology of simulation and pyxis, electronic charting and texting, I often wonder quite frequently, is it really progress or have we really regressed in life?

Bradshaw, M.J. & Lowenstein, A. J. (2011). Educational use of technology. Innovative Teaching Strategies in Nursing and Related Health Professions. Sudbury, MA. Jones and Barlett Publishers,