Developing Nursing Leaders through Transformational Coaching

Developing Nursing Leaders through Transformational Coaching

Throughout my tenure for nearly 20 years as a nurse, nursing professor, and leader in higher education, I have learned a lot about the art of successful coaching. In both traditional, and non-traditional academic environments, no matter whether you connect physically in-person or virtually via video-conferencing, effective coaching can not only transform a nurse or student, but everyone they come in contact with, and ultimately an entire organization.

My proudest moments in leadership have been when I have helped my faculty have “light-bulb moments,” and deep moments of personal discovery. Discovering perceived versus actual obstacles in their teaching methodologies, and personal lives triggered powerful breakthroughs that left them forever changed. In a recent experience, it warmed my heart to have a team of faculty so passionate about student success and improved student outcomes, that they were willing to take a deep look at themselves and change anything that would hinder them from being the best professor that they could be. These faculty believed that transformed students started with transformed faculty. One particular cohort of nursing leaders I had the distinct pleasure of coaching were all geographically dispersed so we used a videoconferencing platform to meet as a group bi-weekly for 45-minutes, and one-on-one for 30 minutes for eight months.

During our meetings, I used evocative questioning and active listening to lead them on an individualized journey of discovery in personal and professional areas. The steps of the nursing process provided structure for our interactions. We started with the following:

  • Assessment: Defining where they are in their personal and professional lives, from a holistic perspective
  • Diagnosis: Identified area of opportunity for growth
  • Outcome Identification: SMART [specific, measurable, attainable, realistic, timebound] goal setting
  • Plan: Intentional action steps to achieve the goals
  • Implementation: Executing the plan
  • Evaluation: Reflecting on the journey, including personal and student outcomes

There were many lessons learned from this experience, but the greatest takeaway was that each faculty member personally experienced a fundamental internal shift and a personal transformation in their mindset and skillset and felt empowered to apply the lessons of their personal growth to student interactions and teaching methods. The application of the lessons they learned through my transformational coaching program not only enhanced their confidence in teaching, but also improved their coaching skills, student support, and student outcomes.

As an emerging nurse leader, I remember my mentor telling me that as I continued to teach nursing that my students would teach me more than I ever taught them. This was very true. The inspirational and empowering professional I desired to be for my students became an ever-evolving journey of self-discovery and becoming. I have been able to achieve extraordinary things throughout my nursing career because of mentors who allowed me to “borrow their belief” in me. Having someone to help you “unpack” personal and professional challenges, and change your perspective about adversity and obstacles has been priceless, totally life-changing, and essential for my growth. If nurse leaders seek to build more nurse leaders, mastering the art of effective coaching is critical.

Future of Nursing 2020-2030: Strengthening Nursing Education

Future of Nursing 2020-2030: Strengthening Nursing Education

This year, the National Academy of Medicine Committee on the Future of Nursing 2020-2030 issued The Future of Nursing 2020–2030 Charting a Path to Achieve Health Equity report. Sponsored by the Robert Wood Johnson Foundation, the report explored many areas critical to the future of the nursing industry–from education to disaster response.

Minority Nurse spoke with Marcus Henderson MSN, RN, lecturer at the University of Pennsylvania School of Nursing and a member of the Committee on the Future of Nursing 2020–2030 about the report’s findings on the future of nursing education.

Henderson, who specializes in psychiatric nursing and nursing in the community, says looking at nursing through the lens of community health competencies is a critical component of comprehensive nursing education.

Community Health in Nursing Education

Although Henderson says community health is covered in nursing education, the standards in place don’t reveal  how often or how well community  health and public health nursing competencies are covered in individual programs. Sometimes it’s just as one course or an elective course.

“We argue in the report that these areas of community health, public health, social determinants, and population health need to be comprehensively threaded throughout the curriculum,” Henderson says, “so it’s not an add-on. It’s baked in fundamentally into everything we do in our nursing practice.” As nursing education changes, schools and students will begin to collaborate more across disciplines.

Changing how nursing is taught and how students gain experience means more nursing students need to spend time working in various community settings. Nurses learn best through experiential learning, says Henderson, especially with community-based social issues. “Put students in the community and put students in settings where they are finding experts,” he says. And when students find the specialty that appeals to them, letting nurses deviate from the typical path will get them started quickly. “Telling nurses they need one to two years of med-surge under their belts is unnecessary,” says Henderson, “and we have to stop perpetuating that.”

Experience in the Right Settings

For nurses who know they aren’t interested in a med-surge path, those two years could be better spent gaining targeted skills. Immersing themselves with on-site community health work strengthens their commitment to the role.

“Without that kind of immersion, you are reinforcing stereotypes because what you read is not contextualized by what happens,” says Henderson. For instance, he says, nurses may read that “because you’re African American, you’re more at risk for ‘A'” or “because you live in this community, you’re more at risk for ‘Y.'” It’s not contextualized as to why any health impacts are happening, he says.

Nursing education depends on nurses understanding the socioeconomic influences of disease. Henderson says nurses who are immersed in a community may see that patients lack access to green spaces to exercise or may not feel safe in their neighborhood. They may see patients don’t have easy and affordable access to healthy foods.

“The context is the patients don’t live in a community that sets them up to eat healthy, exercise, and take care of themselves to reduce the risk for something like diabetes,” he says. “It has nothing to do with them being African American and has to do more with community conditions. You have to see that and experience it.” Henderson, whose own career was deeply influenced by his early work in community health, says nurses can’t address the health needs in a community without addressing the social needs. “The community is the teacher,” he says. “We go into a community with preconceived notions. But patient-centered care is community-centered care.”

Reading something in a book gives nursing students a theoretical background, but going out into the community, often sparks a passion about uncovering a solution to the root causes of some of the issues patients are facing. “There are downstream effects of that,” says Henderson.

Shift in Nursing Education

As nursing education changes to a community focus, nursing students will need faculty leaders who can talk to them about how to change approaches to tasks like screenings.

“One of the biggest hurdles is getting students out of the mindset of I have to get out to do a specific task,” he says. “It’s about what kinds of conversations are you having during the screening when you’re checking someone’s eyes. Are you learning about their home life? In community public health, you’re exploring the issues that are surrounding  their lives and the issues that impact their wellness so you can focus on intervention and prevention.” Nursing students have to be taught about it in their classroom work so they can merge their knowledge and hands-on experience to examine the root causes of illness differently.

Workforce Preparation and Qualification

People want to work in the settings they are exposed to, says Henderson, so nursing students should work in settings that let them see a nurse’s role in schools, correctional facilities, public libraries, preschools, community health centers, homeless shelters, and public housing, and learn from the experts who work in those settings.

Sometimes, says Henderson, the best professional to explain those topics are the ones on the front lines, like the social workers or school counselors who see people for issues that might not be related to an immediate health concern, but that most certainly impact health. With a chronic nursing faculty shortage, allowing educators who don’t have a nursing degree might help fill some gaps in staffing and course content, he says.

Henderson says the Future of Nursing Report calls for including curriculum topics around nursing policy, structural racism, and health equity to help nurses over their entire careers.

And, Henderson says, the report also advocates for nursing schools to address racism in society and within its own professional structures. “Nursing as a profession for a long time hasn’t addressed how racism has impacted our own profession,” says Henderson. “We say in this report we want to go out and do all this good and improve health equity, but we still have to clean our own house a little bit and examine how nurses of color are still discriminated against within our own schools and our own workplaces. And we talk about that in this report and that’s crucial.”

Higher education also must take a new look at its environment. “Schools of nursing need to acknowledge the impact of structural racism has within their own institution and how that disadvantages nursing students and faculty of color,” says Henderson. “That means critical examination of curriculum policy practices, curriculum strategies, and how they allocate resources. Who has the power and what do those dynamics look like?”

Diversity and Equity

A diverse, inclusive, and equitable nursing environment needs to be clearly defined. “Many people say diversity and think just by being diverse, we are equitable,” Henderson says. “But that’s not the case. You can be diverse but not equitable. You can have diverse people at the table, but it’s not equitable if they aren’t valued and their voices aren’t heard.” Lots of groups are recognizing that, says Henderson, but now they have to decide how to act on it and raise awareness about it.

Continually advocating for change in nursing and working to keep uncomfortable conversations ongoing and productive encompasses topics both new and historic, says Henderson, and is the focus of the next decades of nursing education. “It’s about who is having these conversations,” he says. “If we keep having the same people at the table, we won’t get far.”

Improve Your Written Communication

Improve Your Written Communication

The last year has given rise to a newfound reliance on Zoom and lots of virtual meetings, but excellent written communication is always needed.

If you’re not sure how your written business communication skills measure up, you can refresh your style with a few solid tips.

Whether you’re writing a quick follow-up note to a colleague, a department memo, or a message to a board of directors, your written communication needs to be polished. Like any other business skill, how well you master the art of professional communication is a reflection on you, so it’s worthwhile to take the time to do it right.

Before you write anything intended for work, think first and write second. It even helps to have an actual checklist in your head or on your desk. If you get into the habit of doing this, you’ll cut down on having to resend an email because you forgot an attachment or a link, sending communication that doesn’t answer the most important point or question, or even sending something with an unprofessional tone.

What should your checklist include? Keep these prompts in mind.

Who is this message intended for?

If it’s an informal note, you can have a more informal tone. But it’s still best to begin with a short salutation (“Hi,” is fine) and end with a thanks. If it’s a more formal communication or is in response to a larger project or initiative, make sure your tone matches that level.

What is the most important point I am trying to convey?

Readers have incredibly short attention spans and in the midst of a pandemic, these spans have become even shorter. Highlight the most important point right up front. You can even tease it a little with the subject line if you’re writing an email. Think about what you would say in person (sometimes this is referred to as the Guess What? step) and try to be that brief in your writing.

How will people find more information?

Are you referencing any kind of study, other communication, organization, or piece of essential information? If so, attach necessary files (Word docs, PDFs, slides, etc.), add hyperlinks, or note where readers can go if they need more information.

Do I have any implicit bias in this situation or with this topic?

If you’re writing about something that is controversial, that you have a differing opinion on, or where you need to really make a case for something, you’ll want to pay extra attention to the tone of your message. There’s nothing wrong with strong feelings, but written communication provides little context around what you are saying so it helps to be extra cautious.

Can anyone read this?

Anything you send creates a record, so take extra care to ensure a message that is direct, but not inflammatory. And don’t ever, no matter how tempting, say something about someone else in an email that you wouldn’t want that person to read. Aside from being exceedingly unprofessional, emails can be sent far and wide and you can’t be quite sure who will see them.

Do I have any mistakes?

Remember, spell check won’t catch improperly used words that are spelled correctly. Even if you’re in a rush, take one final look to make sure everything is accurate and that the right people are on the distribution (and their names are spelled correctly).

Send with Confidence

If you’re able to follow these steps, your written communication skills are bound to improve and will reflect positively on your professionalism. Eventually, this checklist will become a habit and will likely save you some big headaches over the years.

Common Barriers for Nursing Students & How to Overcome Them

Common Barriers for Nursing Students & How to Overcome Them

Nursing can be one of the most rewarding professions available to people today. Few other positions offer practitioners the ability to help people so directly and make such a large impact in their quality of life. It’s no wonder that nurses are some of the most trusted and highly thought-of professionals in our world today and have been for much of our lives.

Though nursing offers a lot of opportunity to help those in need, actually becoming a nurse can be challenging and filled with barriers that make entry into the profession quite difficult. Many aspiring nurses find themselves struggling with at least one of these barriers to entry.

Fortunately, there are ways to prepare, avoid, and fight these barriers at every curve in the road. It takes preparation and verve, but becoming a nurse is completely attainable for those with the drive to make it happen.

Financial Barriers

Perhaps one of the biggest challenges that many young aspiring nurses face is getting their finances in order. Student loan rates in the United States today are out of control, and nursing school is no exception. The average nurse will leave nursing school with upwards of $20,000 in debt. This amount doesn’t necessarily cover the debt acquired in any other associate’s or bachelor’s degree program prior to entering nursing school either.

Student loan debt is a significant challenge that a significant portion of the younger generation is facing. Few things can be done to resolve the larger issue without government regulation or debt relief programs, but there are some actions you can take individually. These include measures such as saving money before nursing school to avoid taking loans, working a part-time job, paying down interest while still in school, and refinancing loans for a lower interest rate.

Educational Barriers

Beyond financial barriers, there are still lingering educational barriers that could prevent aspiring nurses from attaining their goals. For instance, getting into a quality nursing school can be a real challenge. Even after getting into school, balancing rigorous coursework, homework, studying, and clinicals can be difficult, especially if you are already dealing with financial barriers that may require you to have a part-time job.

Time management is the best way to get around this barrier. Work on setting up your study schedule and sticking to it. Your days may feel full, but you should still build in time for breaks, exercise, and fun activities that will keep you from burning out. For better or worse, there still may be a time or two when you need to stay up all night — there are good (moderate doses of caffeine, exercise), and bad (energy drinks) ways to go about doing this, so be sure to take some steps to be successful.

Physical Barriers

Once you’re starting clinicals you may quickly realize that there is a lot more to helping people than originally advertised. There are long days, demanding patients, complicated treatments, and lots of stress. Many nurses will start to experience caregiver burnout, which is the feeling of being unable to care for yourself after caring for others all day.

Nursing is not an easy job and many people start to burn out relatively quickly if they don’t have a great work-life balance. Unfortunately, there are still plenty of workplace stressors that nurses bring home. This being the case, job stress leads to a high divorce rate for nurses.

The key here is to find some way to make time for yourself every day. Go for a walk on your breaks, exercise before work, read on the subway — do whatever it is that you need to do to relax and feel like you’ve had a little bit of “me” time. It goes a long way when the going gets tough.

Minority Barriers

Being a minority in the health care system isn’t necessarily easy either. Racism is still a lingering problem in health care in general. Though nursing as a profession has made many leaps and bounds, other specialties have not necessarily kept up. Chances are minority nurses will work in an environment where leadership isn’t necessarily representative of the country’s racial makeup.

Conquering these barriers takes organization and forcing greater attention to be brought to a lack of representation in the workplace. Policy change isn’t always easy to come by and many critiques have been made about policies that make it more challenging for minority students to succeed. Ultimately, greater pressure on leaders to implement reasonable changes is what is needed to continue to push the needle towards greater equality and representation in the workplace.

There are a lot of real barriers that work to prevent some aspiring nurses from achieving their goals. The barriers range from finance and education ones to physical workplace demands and social structure barriers. There is no easy way to solve all of these problems but making a plan, making time for yourself, and making people realize a need for a change is a good start.

9 Tips for Nursing Students Taking Online Classes

9 Tips for Nursing Students Taking Online Classes

Whether your classes were newly moved online due to coronavirus, or you’ve been enrolled in an online class from the get-go, nursing students all over the world have suddenly found themselves taking classes remotely. To help with the adjustment, here are our nine top tips for acing your online nursing classes.

1. Don’t assume online is easier.

Just because you can wear sweatpants, it doesn’t mean that online classes are a walk in the park. Plus, if you dress the part and wear your nursing scrubs, you’ll get into the nursing mindset. Some people make the mistake of assuming they can coast through an online class, believing that it will be easier than an in-person class. While online classes are certainly different from in-person ones, they’re not easier, just hard in a different way. Believing that you can slack off in your online classes purely because they are online will quickly lead to a failing grade. Taking it seriously from the beginning is the best recipe for success.

2. Get the equipment you need to succeed.

No, we’re not talking about clinical supplies. Take stock of what technology you currently have and what you might need to invest in. You’ll most likely need a reliable computer and other tools such as an external monitor, a mouse, and a keyboard as well. Test your internet connection and make sure that it can handle steaming lectures, video calls, and other high capacity tasks—the last thing you want is your internet cutting out in the middle of a quiz. If your internet isn’t up to the task, you might need to upgrade your plan or get a new router.

3. Embrace the possibilities of technology.

Online classes may be new and exciting territory for many people. They offer many fantastic possibilities for interactive learning that simply aren’t possible inside a physical classroom. In fact, many in-person classes still assign work that must be done online prior to class because the interactivity element of online programs can’t be reproduced. Online classes also allow you to connect with a much broader range of people from many different geographic areas, expanding your nursing network.

4. Participate digitally.

The words “class participation” probably conjure up images of raising your hand in class and speaking out loud to the group. While participation is definitely a part of online classes, it takes a different form. Usually, it means group forums where students host discussions on specific topics. It’s not the same as talking in person, but this format can actually be advantageous for quiet people who hate having to come up with comments on the fly. Due to the asynchronous nature of these message boards, you can read the discussion, take time to think it over, and post your comment when you’re ready.

5. Create a work from home space.

Even if you like to work from coffee shops or libraries, odds are that you’ll end up completing at least some of your classwork from home. If at all possible, try to create a work from home area outside your bedroom (you don’t want to associate schoolwork with your sleeping space). If that’s not possible, then at least set up a desk and chair so you’re not working from your bed. Try to place it near a window so you can take advantage of natural light. Be sure to set up some additional lamps, too, in case you end up working a lot at night.

6. Manage your time well.

Time management is one of the trickiest things for students to master during an online course, especially if the classes are pre-recorded and can be watched on-demand. Some people are distracted very easily, especially when working at home. They have every intention of watching that anatomy lecture and then end up spending an hour cleaning the house and folding laundry. Set aside blocks of time to work on your online classes and mark them off in your calendar, just like you would with an in-person class. Let your roommates or family know that you’re in school and ask them not to disturb you unless it’s an emergency.

7. Aim to turn your assignments in early.

Speaking of time management, turning in assignments early can help a lot with that. For in-person classes, you have to wait for the appointed day to turn in a physical paper. That’s not as much of a consideration for online classes. It’s a good idea to set a goal for yourself to turn in each assignment 1-2 days in advance. Even if you fall behind, which will happen eventually, you’ll still have that cushion built in so your assignment won’t truly be late.

8. Back up your work.

You should be doing this regardless of whether your nursing school classes are online or in person, but it’s doubly important for digital classes. Each week, if not each day, back up your work to an external hard drive as well as a cloud storage service such as Box, Dropbox, or Google Drive. If you must fill out quizzes or essays online, consider writing it in a separate document and then paste it into the field so you don’t lose your work if the submission doesn’t go through.

9. Ask for help.

Just because you’re physically alone in your house while you watch lectures doesn’t mean that you don’t have resources available to help. Your instructors should be able to help you via email, phone, or even video chat, and you also have your classmates to lean on. You might want to consider forming an online study group that meets regularly during Zoom calls to keep each other accountable. Don’t forget to explore any other resources offered for your classes, such as digital libraries.

Whether you’re taking online nursing classes by choice or not, digital courses are a new reality for today’s nursing students. Follow these nine strategies to knock your online nursing classes out of the park.

A Breast Cancer Diagnosis Brings a Nurse Closer to Her Patients

A Breast Cancer Diagnosis Brings a Nurse Closer to Her Patients

In 2014, Melisa Wilson, DNP, ARNP, ACNP-BC, the Clinical Operations Director and Pulmonary Hypertension Program Coordinator at AdventHealth Orlando, discovered a lump in her breast. Fearing a cancer diagnosis, her husband encouraged her to see her doctor immediately.

Wilson nearly didn’t. After all, she didn’t have a family history of breast cancer. She thought it was a mammary duct drying up as she was pumping breast milk less for their child.

Thankfully, she listened to her husband. An ultrasound led to a biopsy and then a diagnosis.

“I was taken entirely by surprise. The journey was swift from the time we felt the lump to diagnosis—just eight days. I did not expect to hear, ‘I am sorry, Mrs. Wilson, you have breast cancer,’” Wilson recalls.

Wilson’s diagnosis was Stage IIB HER2 positive, and for the next 18 months, her treatments included Herceptin, Perjeta, Carboplatin, Taxotere, and Neulasta. Her inspiration was her son, who had been born at 23-weeks. “He fought for his life, and in turn, it inspired me to fight for mine,” says Wilson. “My faith in God got me though.” She also had tremendous support from her family, work family, friends, and her oncology team, including her NP, MD, and LCSW.

The most challenging part of her journey, Wilson says, was financial. “The bills for oncology treatment came in quickly and were very high. I maintained my full-time job as a nurse practitioner, though, with some accommodations. I would work up to the day of chemo, take six days to recover, and then return to work for another two-week cycle,” she recalls. “It was hard, and the bills would be overwhelming to deal with at times. I remember being at chemotherapy and getting a call asking me to pay several thousand dollars to pay for a test I needed.”

Wilson beat the cancer, and she says that she now can more easily empathize with her patients because of what she’s experienced. “As an NP, I can relate to my patients on so many different levels. My patients have a rare cardiopulmonary disease—pulmonary hypertension. Most have no idea what pulmonary hypertension entails,” she says.

A few years ago, Wilson says, she had a patient who was scared about having a line placed in her chest. This needed to be done for infusion of pulmonary hypertension treatment. The patient experienced a lot of pain due to being on a subcutaneously infused machine. “One day I called her and asked for her to come in for an office visit with me. I explained that I had done as much as I could to manage her pain, and she needed to consider a different route of infusion. She was tearful and upset. She was concerned about her body image,” says Wilson. “I showed her my port, though it was different and showed her my head, which was hairless due to chemo. I told her, ‘I understand what it is like for your body to change in front of your eyes, but these are the things we do to survive.’ We cried together, and she went on to have the line placed.”

Just recently, Wilson says that her mother was diagnosed with breast cancer. Wilson believes that she went through her journey so that she can help others and that cancer taught her how to live and not be as fearful. “My tribulation shaped me, and now I help my Mom. I am happy to be her advocate,” says Wilson. “Being there for her and not feeling helpless is rewarding. I know it gives her comfort.”

Ad