A Nurse's Viewpoint
Changing directions: Preparing future nurse leaders
By Roberta B. Abrams, RNC, MA, LCCE, for HealthLeaders.com, Sept. 10, 2001
"Watch one, do one, teach one" is a time-honored tradition that describes the mode under which many generations of nurses and other healthcare providers developed their clinical skills. As a student, you were instructed to watch a skilled professional nurse demonstrate a psychomotor skill, such as a dressing change. The next time that dressing had to be done, you did it, and the following time, you might well be demonstrating your newly acquired skill to a peer or classmate.
If nursing were nothing more than a compilation of psychomotor skills, this might be sufficient preparation. Nursing, however, is far more than that. Nursing requires the development of assessment skills, the ability to plan, implement, and evaluate phenomena related to the care of the patient; and the ability to become adroit at critical thinking. "Watch one, do one, teach one" may enable the learner to acquire technical skills. It is, at best, poor preparation for today's professional nurse.
One need not be a rocket scientist to recognize that nursing today is in crisis. What was will not return. What will be is still clouded by the morass of issues currently confronting both healthcare providers and consumers. We need to attract and retain a cadre of strong nursing leaders who can guide nursing and nurses through the morass. We need to foster collaboration with other professional and community leaders to build a strong foundation for the emerging profession.
"Watch one, do one, teach one" will not result in the professional leaders who are needed. We need to develop a group of mentors - strong leaders who can clarify issues and influence others to become the leaders of tomorrow.
The mentors needed to guide the transition of nursing share several characteristics:
They are recognized as leaders in their profession and in their community. Whether emanating from academia, the clinical arena, or administration, their names and faces are familiar to both professional and community leaders. They are highly visible people and enjoy working in, and with, disparate groups in the community.
They demonstrate appropriate self-esteem and confidence in their abilities as leaders.
They are aware of their areas of needed growth and surround themselves with others who complement their abilities.
They have a commitment to the profession of nursing which they have demonstrated over time through a variety of academic, community, and/or clinical roles.
They have a clear vision of the future of nursing, and readily and cogently share it . They seek input from colleagues about their views and encourage differing viewpoints.
They genuinely like what they do in nursing, and engender the same spirit in the colleagues with whom they work.
They are active members of professional organizations and have built a network of colleagues who share similar goals and commitments. They are perceived by peers and followers as agents of positive change.
They are high-energy people who seem to easily manage to be involved in a variety of professional, community, and personal activities.
They are recognized in their professional community for their achievements in education, administration, or clinical work.
If the above description seems daunting, it is. These are not "average" folk. But they are real; they do exist. We need to provide them with a setting in which they can nurture and mentor colleagues. Nursing for tomorrow will be different from today. Failure to plan for this is to plan for failure. The plan revolves around our mentors in nursing.
We see these gifted professionals when they appear at nursing meetings and conferences. We walk away from their presentations feeling challenged and imbued with a spirit to go forth and emulate their actions. Then we return to our workaday world and get caught up with the everyday problems that consume our ambitions and energies. Like gerbils on a wheel, we run the familiar paths of our practice arena. We recognize the need for change, but lack the resources, and in some cases the will, to produce it.
If we are to use our mentors to develop tomorrow's leaders, we need to create a new mode in which that can happen. We should begin by establishing a new cadre of nursing leaders; a group of contemporary leaders representing nursing practice, nursing education, and nursing administration. This group would establish a plan for a mentorship program to develop new leaders in nursing. The action plan - with tight timelines - would define program characteristics, including:
Suggested content and teaching methods
Geographic distributions of mentors
Mentor and mentee qualifications
Costs and financing arrangements
Ongoing support for both mentor and mentee
Funding for the program could come from federal and state governments, from grant resources, from participating agencies, or some combination of those groups. The rationale for providing these funds is that our current path is leading swiftly to a national healthcare disaster. Our current care modes are expensive, and have failed to produce a reasonable quality of healthcare.
The selection of candidates for both mentors and mentees would be the province of the cadre of nursing leaders. The characteristics of the mentor have been described. Characteristics of mentees should be based on current roles and accomplishments and willingness to commit to preset goals allowing them to implement their new knowledge and skills to promote the future of nursing and healthcare.
The program content should revolve about development of qualities needed for leadership in the new age of nursing. Tomorrow's leaders will require the abilities to attract, retain, and inspire staff. Our future leaders in nursing will need skills in communication and collaboration facilitating their interactions with other nurses, other healthcare providers, and members of, and leaders in, their communities. They will require an understanding of healthcare finances, of methods of garnering and using increasingly scarce resources to provide for those in their care.
Tomorrow's leaders must understand the need for establishing and maintaining support groups within their communities and the community of nurses and other healthcare providers. In an era when change occurs at an ever-increasing pace, they will need to develop resources which will enable them to plan for and deal with change.
As part of the program's implementation, the mentor would encourage discussion about issues occurring in the mentees' practice arenas. The group, working with the mentor, could seek solutions to these issues, thus adding a pragmatic element and fostering intragroup collaboration.
In this age of telecommunication wizardry, travel to participate in the program can be limited by using chat rooms and interactive television devices. Some group gatherings are necessary to foster supportive relationships within a geographic group and among larger groups of participants.
Implementation of the mentor program will involve working with the organizations to which both mentor and mentee belong. Contracts will need to be established to deal with issues like providing temporary assistance for involved individuals in their usual responsibilities so they can participate in the program.
The nursing mentorship program is one vision, one attempt, to provide support and preparation for those who will lead nursing into the future. It is not an easy program; it is not a "quick fix." It is the product of many hours of discussion with the nurses and nursing leaders of today. It is, when all is said and done, A Nurse's Viewpoint.