The Experience of Being a Millennial Nurse Manager.

OBJECTIVE: The aim of this study was to explore the experience of being a Millennial nurse manager with a goal to better understand the influence of organizational factors on role expectations, satisfaction, support, development, and intent to stay. BACKGROUND: Research on Millennial nurse leaders is scarce. Understanding the perception of these young managers is needed to create succession and retention planning that meets the needs of this generation of leaders. METHOD: A national sample of 25 Millennial nurse managers participated in a qualitative interpretative phenomenological study. Audio-recorded telephone interviews were conducted and analyzed. RESULTS: Millennial leaders have a unique perspective on role expectations and support variables. Seven themes of experience emerged: coming into the role, learning as I go, having the support of my director, making an impact, helping staff succeed, and managing change. CONCLUSIONS: Opportunities to develop and retain Millennial leaders are shaped by understanding the support variables that are important to them.

Transitioning Emerging Leaders Into Nurse Leader Roles.

Millennials will soon comprise 50% of the nursing workforce. Leaders in organizations look to this generation to assume leadership roles. This is proving to be challenging in many settings. Learning how to more effectively recruit, transition, and retain these emerging nurse leaders will be critical to organizations and the future of nursing. This article presents academic and organizational practices in emerging leader transition tailored to the needs of the millennial generation.

Chief Nursing Officers' Experiences With Moral Distress.

OBJECTIVE: This study explores if moral distress and its lingering residue were experienced by chief nursing officers (CNOs). BACKGROUND: Chief nursing officers, by virtue of their position and experience, are expected to uphold their professional values and act for the benefit of others. Exploration is needed to determine if the inability to do so contributes to the moral distress of these leaders. METHODS: Twenty CNOs were interviewed to determine the lived experience related to moral distress and moral residue. An interpretive phenomenological analysis approach was used. RESULTS: Six themes emerged describing CNO experience of moral distress including lacking psychological safety, feeling a sense of powerlessness, seeking to maintain moral compass, drawing strength from networking, moral residue, and living with the consequences. CONCLUSION: Moral distress is a common experience for CNOs. Although CNOs act with moral courage, they still experience moral distress. Further research and professional discussion are needed to support nurse executive leaders.

Leading in the Healthcare Vortex.

The 2016 International Nursing Administration Research Conference, Leading in a Healthcare Vortex, was held in Orlando, Florida. The program drew 116 attendees with representation from Canada and Brazil. Participants from practice, education, and research discussed leadership in our turbulent healthcare climate, which are highlighted in this column. The conference was dedicated to the memory of Dr Heather S. Laschinger in recognition of her distinguished research legacy of empowering nursing work environments and mentorship of prominent nursing administration researchers.

Growing Nurse Leaders: Their Perspectives on Nursing Leadership and Today's Practice Environment

With the growing complexity of healthcare practice environments and pending nurse leader retirements, the development of future nurse leaders is increasingly important. This article reports on focus group research conducted with Generation Y nurses prior to their initiating coursework in a Master's Degree program designed to support development of future nurse leaders. Forty-four emerging nurse leaders across three program cohorts participated in this qualitative study conducted to capture perspectives about nursing leaders and leadership. Conventional content analysis was used to analyze and code the data into categories. We discuss the three major categories identified, including: idealistic expectations of leaders, leading in a challenging practice environment, and cautious but optimistic outlook about their own leadership and future, and study limitations. The conclusion offers implications for future nurse leader development. The findings provide important insight into the viewpoints of nurses today about leaders and leadership.

Florida Nurse Leader Survey Findings: Key Leadership Competencies, Barriers to Leadership, and Succession Planning Needs.

OBJECTIVE: This study examined barriers to nursing leadership and succession planning needs for nurse leaders in Florida. BACKGROUND: The Florida Action Coalition responded to the call to prepare and enable nurses to lead change to advance health, through a grant supported by the Robert Wood Johnson Foundation and Florida Blue Foundation. METHODS: This is a nurse leader subset of a 56-item statewide survey of actively licensed RNs and advanced RN practitioners in Florida conducted via a cross-sectional, exploratory descriptive research design. RESULTS: Key findings included a description of leadership competencies, barriers, and succession planning practices. Florida nurse leaders are aging and less diverse than the general population and report limited utilization of succession planning by their organizations. CONCLUSIONS: In Florida, attention must be directed to resources and strategies to develop skilled nurse leaders and plan succession.

Succession planning for the future through an academic-practice partnership: a nursing administration master's program for emerging nurse leaders.

A global nursing leadership shortage is projected by the end of this decade. There is an urgent need to begin developing emerging nurse leaders now. This article describes the work of an academic-practice partnership collaborative of nurse leaders. The goal of the partnership is to develop and promote an innovative enhanced nursing administration master's program targeted to young emerging nurse leaders, who have not yet moved into formal leadership roles. An action research design is being used in program development and evaluation. Qualities needed by emerging leaders identified through research included a need to be politically astute, competency with business skills required of nurse leaders today, comfort with ambiguity, use of a caring approach, and leadership from a posture of innovation. The current curriculum was revised to include clinical immersion with a nurse leader from the first semester in the program, a change from all online to online/hybrid courses, innovative assignments, and a strong mentorship component. Eighteen young emerging nurse leaders began the program in January 2012. Early outcomes are positive. The emerging nurse leaders may be uniquely positioned, given the right skills sets, to be nurse leaders in the new age.

Global nurse leader perspectives on health systems and workforce challenges.

AIM: As part of the 2011 annual American Organization of Nurse Executives conference held in San Diego, California, a session was presented that focused on nursing workforce and health systems challenges from a global perspective. This article includes content addressed during the session representing nurse leader perspectives from the UK, Singapore and the USA. BACKGROUND: Recent events in global economic markets have highlighted the interdependence of countries. There is now a global focus on health-care costs and quality as government leaders struggle to reduce budgets and remain solvent. EVALUATION: Finding solutions to these complex problems requires that nurse leaders adopt more of a world view and network with one another as they look for best practices and creative strategies. KEY ISSUES: Nursing leadership challenges such as staffing, competency development, ageing populations, reduced health-care funding and maintaining quality are now common global problems. CONCLUSION: There is a need for innovation in nursing practice to accommodate the enormous challenges facing nursing's future. IMPLICATIONS FOR NURSING MANAGEMENT: Opportunities on an international scale for nurse leaders to have dialogue and network, such as the conference presentation discussed in this article, will become increasingly more important to facilitate the development of innovative leadership strategies.

Taking charge: front-line nurse leadership development.

The recent Institute of Medicine (2010) report, The Future of Nursing: Leading Change, Advancing Health, included a recommendation that nurses at all levels should be prepared and enabled to lead change to advance health care in the United States. Historically, in most organizations, nursing leadership development programs have focused on nurses in management or executive roles rather than those working in front-line leadership roles. This article describes a front-line leadership development initiative developed by Tenet Healthcare Corporation and attended by 400 charge nurses. Program development, evaluation, and lessons learned that can be applied in other organizations are discussed.

Developing the leadership skills of new graduates to influence practice environments: a novice nurse leadership program.

The authors of the recently published Institute of Medicine on the Future of Nursing report emphasized the importance of preparing nurses to lead change to advance health care in the United States. Other scholars linked practice environments to safe quality care. In order for nurses to fully actualize this role in practice environments, they need to possess leadership skills sets that identify and respond to challenges faced. New nurses are no exception. This article presents a program with a 5-year track record that is designed to support transition and enhance the skill sets of leadership for new nurses in their first year of practice. Qualitative and quantitative evaluation measurements at baseline and postprogram provided data for evaluation of the first 4 cohorts in the program. Evaluative outcomes presented indicate that new nurses gained leadership and translational research skills that contributed to their ability to influence practice environments. Nonetheless, practice environments continue to need improvement and ongoing leadership from all levels of nursing must be upheld.

Lessons in innovation: role transition experiences of clinical nurse leaders.

OBJECTIVE: The purpose of this study was to describe the role transition experiences of 71 Clinical Nurse Leaders (CNLs) as they pioneered the role in practice settings. BACKGROUND: Although the impact of CNL practice is now being measured through a variety of evaluation projects, less is known about the role transition experiences of CNLs. METHODS: This was a qualitative study using an interpretative phenomenological analysis approach. Semistructured telephone interviews were conducted with 71 CNLs working in the role. RESULTS: The 5 major themes that emerged from the study included staying at the bedside, explaining who we are, keeping things from falling through the cracks, and proving our value and cautious about the future. CONCLUSION: The results of the study can both help to inform nurse leaders about introducing major changes in their organizations and guide future CNLs in their role transition.

Learn to Manage Yourself.

It's the first step in learning to manage others.

The first year of practice: new graduate nurses' transition and learning needs.

Although the phenomenon of reality shock has been acknowledged as part of the new graduate nurse transition for decades, there is evidence to suggest that the problems with the transition into practice are more serious today. This article presents findings about the new graduate nurse transition and learning needs from qualitative research conducted in a community-based novice nurse transition program. The new graduate nurse transition and learning needs are examined through the eyes of new graduates and the nursing leaders and preceptors who work with them. Recommendations are offered for continuing education initiatives that can be designed to meet these needs.

The Art of Giving Feedback.

For many leaders, giving positive feedback comes easily, but giving negative feedback can be more challenging. This article provides best-practice strategies for giving effective feedback-through building trust, promoting a growth mindset, and developing the courage to tackle difficult performance conversations.

Implementing the clinical nurse leader role in a for-profit environment: a case study.

The Clinical Nurse Leader project marks the first time in 35 years that nursing has introduced a new role to the profession. The project has evolved to include partnerships between more than 90 universities and 190 clinical sites. The authors present a case study of how a for-profit medical center created a sense of urgency for change, built a business case, and redesigned professional nursing practice to implement the Clinical Nurse Leader role.

Factors influencing organizational participation in the Clinical Nurse Leader project.

When the American Association of Colleges of Nursing introduced the Clinical Nurse Leader"s (CNL) pilot project in 2004, it was the first time in more than 40 years that an attempt was made to introduce a new role to the profession. This new role was designed to address many challenges related to patient care in the current health care delivery system including a need for more effective clinical problem solving, better coordination at the point of care, stronger interdisciplinary relationships, and more rapid implementation of evidenced-based practice findings at the patient-provider interface. Critics from both academic and practice settings have questioned the need and wisdom of introducing a new role to the profession at this time. The factors that led some nursing leaders in early stages of this project to be proactive and involve their organizations as early adopters of the CNL role were examined in this study. Five major factors were identified from the research to form a framework designed to explain organizational participation: organizational needs, a desire to improve patient care, an opportunity to redesign care delivery, the promotion of the professional development of nursing staff, and the potential to enhance physician-nurse relationships. The ability of academic and service partners to forge the types of relationships and promote best practices as is occurring in the CNL project may be a critical success factor in confronting the current and impending nursing shortage.

Transitioning internationally recruited nurses into clinical settings.

With a growing shortage of nurses, more health care organizations are turning to international nurse recruitment as part of their work force strategy. Although organizations that recruit internationally invest significant resources, there has been little research about the challenges of transitioning international nurses into practice environments outside their countries of origin. The purpose of the qualitative research presented in this article was to investigate the educational and support needs of international nurses from both their perspective and that of managers with experience in supervising internationally recruited nurses. The authors present educational recommendations and the implications for staff development.

The role of nurse educators in grooming future nurse leaders.

The authors have found in their research that too often our current nurse leaders have "fallen into" their positions, rather than choosing nursing leadership as a career path. With the impending retirements of so many nurse leaders, there is a need for a more proactive approach to ensure the next generation of nurse leaders is ready to assume the leadership of our profession. Guiding the development of a leadership mindset and promoting nursing leadership as a career choice are two important strategies. Nurse educators are in a key position to influence students and start grooming our future nurse leaders. There is no time to waste.