The last thing most hospitals want to do in a time of financial uncertainty is spend money on training and development. We know, however, that poor managers harm retention and productivity and we know that many nurse leaders feel unprepared to manage through the strategic change their organizations need.
Lillee Gelinas, vice president and chief nursing officer at VHA Inc., holds regular CNO group meetings for nurse executives across her health system. At the last one, Gelinas says the group of 100 CNOs decided to focus not on a single topic, such as value-based purchasing, but on innovation and leading change. The group felt they do not possess the skills and competencies to lead an organization through whole-scale transformation.
This is true for many healthcare executives, but the problem is particularly acute for nursing leaders who started out in clinical settings and rose through the ranks with fewer opportunities for formal business training.
Many choose to return to school for MBAs or other degrees that will hone their business acumen. Kim Sharkey, CNO/vice president of medicine at Saint Joseph's Hospital in Atlanta, already held an MBA when she decided to pursue a doctor of nursing practice degree.
"In my role, where I am VP for medicine, I work with doctoral-prepared medical practitioners," says Sharkey. She asked herself, "Do I really want to be the least educated person at the table?"
"I needed to find a program that would allow me to gain that skill and knowledge," she says. "It has really expanded my vision, scope of thinking, my ability to access and use evidence-based practice. It puts me at a more advantageous position at the table negotiating with other people."
Not everyone has the time or inclination to pursue advanced degrees. There are options such as the Robert Wood Johnson Foundation's Executive Nurse Fellows initiative or the American Organization of Nurse Executive's Nurse Manager Fellowship, but these are few and far between.
Some organizations create their own nurse leadership programs, which is what United Healthcare Group has done. The company employs more than 7,000 nurses in 43 states, making it one of the largest employers of nurses in the U.S.
The idea began a couple of years ago, says Dawn Bazarko, senior VP of UnitedHealth's Center for Nursing Advancement. "We observed there were needs around leadership development," she says. "There were not enough nurses at the table and their voices were not being heard. Given changing healthcare and the fact nurses make up the largest portion of it, we saw a missed opportunity and a chance for us to invest in nursing in a different kind of way, for us to prepare leaders to serve in larger roles."
The Center for Nursing Advancement focuses on nurse engagement strategies and training, development, and mentoring for nursing professionals within UnitedHealth. In conjunction with the University of St. Thomas, Bazarko created an executive development program specifically for nurse leaders.
"We could bring out untapped potential," says Bazarko. "Move our nurses into senior leadership roles. Many didn't have the skills and competencies to move into these roles."
"We designed a curriculum based on a number of needs assessments and put together a cohort-based intensive," she says. The program lasted just two weeks and offered a variety of executive leadership development competencies. It provided training about strategy, finances, change management, ethics, and business communication, all centered around the creation of a nurse leader profile.
The attendees were chief nursing officers, VPs and senior director levels, to ensure a peer environment where attendees were on similar levels. The program was so successful that UnitedHealth plans to offer it again.
What's important is that the program meets the unique needs and opportunities nurses face. "It's not a mini MBA, although some courses might resemble it," says Bazarko. "It's business education with a nursing perspective."
Bazarko believes the value to the organization will more than repay the expense of sending the nurse leaders for training. The nurses had to bring an idea for a leadership development project for their home organizations to work on during the course and then apply what they learned when they get home so they can drive a major change initiative.
"Despite pulling senior nursing leaders out of their jobs at very busy time in healthcare in our country, we wanted to provide them with lot of opportunity and enrichment in a short time," she says. "But we're always mindful of need for return. We're fairly confident that one year from now when we've implemented the projects, they will drive both quantitative and qualitative benefits."
Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits www.StrategiesForNurseManagers.com and manages The Leaders' Lounge blog for nurse managers. Email her at rhendren@hcpro.com.