Leadership

eriksoln, BSN, RN · Feb 6, 2009

Well, you may not like part of my answer, but here goes:

I think the biggest part of being a leader comes from experience. With experience, you learn to anticipate problems and extinguish them before they begin. You also can foresee problems and help your staff get set for them. For instance, say an 11PM-7AM night nurse calls off. There is little chance of getting a replacement. The nurses are going to work short. Myself, working under you, prefer to know this as soon as you do. I can then be prepared for it. Maybe cut down on the chat time with pt's, make sure I am as caught up as possible before the extra patient gets assigned to me. With the power of anticipation, problems cease to cause problems.

That is only one part of it though. I think equally important is general person to person skills. A good charge nurse/leader knows how to get the best out of the people around them. They bring out the good qualities in others. I guess I'm just talking about good old fashioned charisma. Making the people around you feel good about what they are doing, even if the situation is not ideal, is what separates the charge nurses who are just toting a title and the ones who define the position.

The one thing, more than anything else (at least to me) that will kill a leader is developing a delusion of grandiur. If you want to lead, dont take the "motherly" tone with people, dont get the "God speaks through me as I was destined for this position" complex and dont assume because you have the title you know better. A good example of this is a charge nurse we had when I worked in PA. She was a putz as a nurse, her work was fragmented and chaotic, nothing got done. Management liked her enough not to fire her, but they wanted to get her away from pt's. So they made her charge nurse (the called it "resource nurse" where I worked) thinking she could handle making assignments and helping with D/C's. Well, that was a mistake. She developed such an ego, thought she was picked for the position because she was the best RN on the floor. She'd follow people around, annoying the hell out of them, advising them on everything. And, not unlike when she was an RN, her duties never got done (assignment alwasy messed up, schedule was supposed to be posted 2 weeks before it started, she literally posted it THE NIGHT BEFORE IT STARTED. If you didnt work that day, you had to make a special trip in to see if you were working the next morning). The unit lost at least 3 good nurses that I know of because of her.

Lanessa Bah · Feb 6, 2009

Thank you so much for your advice. Now, the only problem is remembering it! Yes, your story definitely touches right where I wanted it to touch because even my boss at a nursing home doesn't even post our monthly schedule until the day before the new month. I understand now. Just stay on top of things, don't get too high up on your high horse, and anticipate problems before they occur. I will definitely need some experience before I can become a leader. Hopefully with time it will come. Thanks

diane227, LPN, RN · Feb 6, 2009

Have a good mentor. Get a few good management books and read them. A basic is Kenneth Blanchard. I also use a book called 1001 ways to document employee problems/ corrective action. Praise in public, critize in private. Be fair to everyone. Hold everyone to the same standard. Follow up, document everything. When an employee gives you a note asking a question or request, write a reply on the note, make a copy for their file and return the note to them with your response, especially if you work in a union environment. Know the nurse practice act for your state in detail. Know your HR policies in detail. When in doubt, take a few days to think it over. Don't gut react unless it is an absolute emergency. Keep your cool. Don't take 24 hour call unless you have to. Make sure your unit is staffed before you leave. Hire people for their character, you can train them after they get the job. Get to know your counterparts in other hospitals. This is useful if you have an employee who leaves a facility to come to you. You call call and get the real scoop from the former manager if you know him/her. Don't get in the middle of two employees fighting. Pull them together in a room and have them hash it out with you in attendance. When you get a complaint about a pt care related issue, INVESTIGATE FULLY before taking action unless the patient is in danger. Maintain positive relationships with your physicians. There are lots of other things also, hope this will help get you started.

eriksoln, BSN, RN · Feb 6, 2009

Have a good mentor. Get a few good management books and read them. A basic is Kenneth Blanchard. I also use a book called 1001 ways to document employee problems/ corrective action. Praise in public, critize in private. Be fair to everyone. Hold everyone to the same standard. Follow up, document everything. When an employee gives you a note asking a question or request, write a reply on the note, make a copy for their file and return the note to them with your response, especially if you work in a union environment. Know the nurse practice act for your state in detail. Know your HR policies in detail. When in doubt, take a few days to think it over. Don't gut react unless it is an absolute emergency. Keep your cool. Don't take 24 hour call unless you have to. Make sure your unit is staffed before you leave. Hire people for their character, you can train them after they get the job. Get to know your counterparts in other hospitals. This is useful if you have an employee who leaves a facility to come to you. You call call and get the real scoop from the former manager if you know him/her. Don't get in the middle of two employees fighting. Pull them together in a room and have them hash it out with you in attendance. When you get a complaint about a pt care related issue, INVESTIGATE FULLY before taking action unless the patient is in danger. Maintain positive relationships with your physicians. There are lots of other things also, hope this will help get you started.

I like these two the most. I knew the first one but didnt say it that way. The second, makes a lot of sense to me.

RNperdiem, RN · Feb 6, 2009

There are the official leaders and the unofficial leaders.

I once heard a nurse say "this is really JaneDoe's unit; she just lets Johndoe manage it". JaneDoe was not a manager, but she was a leader, and held a big influence.

eriksoln, BSN, RN · Feb 6, 2009

There are the official leaders and the unofficial leaders.
I once heard a nurse say "this is really JaneDoe's unit; she just lets Johndoe manage it". JaneDoe was not a manager, but she was a leader, and held a big influence.

You know, my first preceptor was like that in a lot of ways. Her name was Linda. She was not interested in management. She enjoyed coming in, taking care of pt's and going home. The hospital franchise (which had many branches) offered her managerial positions on a number of occasions but she turned them all down. She went to a lot of the same meetings they went to and was one of the first people the Director of Nursing went to when big decisions had to be made. But, she never took on the title of DON.

Still to this day, I sometimes think to myself "What would Linda say" when dealing with difficult people. When I talked about being able to remain positive outside of situations that are not ideal, I was actually thinking of her.

From her I got an understanding that people often take their emotional ques from you so maintaining control at all times, even when you think no one is watching, is essential.