AACN News—November 1998—Opinions

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Vol. 15, No. 11, NOVEMBER 1998

The Power of Nursing: We Already Have the Tools and Skills to Realize Our Preferred Future

By Mary McKinley, RN, MSN, CCRN

This time of year, my thoughts turn to the beautiful fall colors of the scenic West Virginia hills and, of course, to football—in particular, West Virginia University football. I enjoy the excitement of a fall afternoon spent watching the Mountaineers play, listening to the WVU band, and just being a part of the 50,000 fans cheering on their team. To me, this is a perfect fall afternoon!

Now, I am not going to relate some story about how football is like nursing. Somehow, that just doesn’t work for me. However, I do think that there are lessons we can learn from football coaches, especially with respect to leadership in our profession.

The late Vince Lombardi, former coach of the Green Bay Packers, once said that his team’s practice games were 5 quarters instead of the standard 4 quarters. As a result, when his players took the field to begin the fourth quarter against an opponent, they weren’t even tired. In fact, they were ready to play on after the end of the game. By making practices longer, the coach helped to create a different reality.

I think this approach applies to leadership in nursing. We have said we have a leadership crisis in nursing for so long that we believe it.

Can we create a new reality of leadership in nursing? Can we create a new preferred future? I answer a resounding “yes!”

Rosabeth Kantzer, in her book World Class: Thriving Locally in the Global Economy (Simon and Schuster, New York 1995), believes that future leaders need 3 tangible assets—concepts, competence and connections. I believe we need 1 more—culture. Critical care nurses as individuals have all 4 of these important assets that enable them to create a new reality for leadership in nursing.

We have the concepts, a knowledge base of the latest and greatest. Nothing less than cutting-edge, science-based knowledge will do for critical care practitioners.

We have the competence, and we set our standards high. Our patients, who are at the most vulnerable time in their lives, deserve care that is based on these high standards.

We have the connections, the networking ability. We know the system and use that knowledge to help create safe passage for our patients and their families. Whether we work with a therapist or a specialist, we can help to make the linkages needed to achieve the most positive outcomes for our patients.

We have the culture. As nurses, we create the culture; we create a positive climate. For our patients, for our units, we help create a healing, humane environment.

Individually, we have what it takes, the tools that we need, to take the lead in creating a healthcare system driven by the needs of patients. AACN, as a collective voice for critical care, also has the tools that can help us to realize our preferred future.

AACN offers educational and practice resources including the National Teaching Institute™ and Advanced Practice Institute,™ Leadership Connections, and Fax on Demand to help keep you on the cutting edge of knowledge for critical care practice. In the area of competence, AACN is currently revising the practice standards for critical care. The standards, which are being revised in light of the recent changes in the American Nurses Association standards for nursing practice, will be in keeping with the Synergy Model, which matches nurse competencies to patients needs. When it comes to connections, AACN provides networking for critical care nurses on a local, regional, national, and international level. With respect to culture, AACN has always set a culture of excellence.

From the products AACN produces to the service given to you—its member customers—AACN strives for excellence. Whether individually or collectively within the association, the tools are available for effective leadership that can create our preferred future.

So, what is holding us back? What we must do is give life to those tools. Steps already have been taken in that direction. For example, AACN last year revised the Leadership Competencies into a Leadership Framework, which defines leadership as the ability to influence ourselves and others to interdependently accomplish work and reach defined outcomes.

This can be achieved if 2 skill sets—ambassador and intellectual skills—are in place. These skills incorporate the relational and analytical behaviors that facilitate the desired outcome. These skills aren’t employed separately. Instead, they are linked and interdependent.

The Leadership Framework is viewed as a way to assist in the identification of leaders for the Association, but it also has much broader implications. Although there is more work to be done to clarify and operationalize the framework, it nevertheless is an effective tool to help us create a new reality of nursing leadership.

In the meantime, it is a perfect fall afternoon and I am off to the football game! I hope my team has been busy creating its new reality and will win the game, but either way I will be there cheering them on!

My Turn: Apply the Rules of ‘People Ethics’

By Nancy Munro, RN, MS, CCRN

Ethics seems to be a vogue topic these days. The newspaper headlines are replete with the saga of our political leaders. I haven’t related much to these topics, because I consider myself an ethical person.

However, I recently read an article in Association Management, titled “The ‘I’ in Ethics,” which shook my complacency about my personal performance and opened my mind to the fact that “ethics” can be interpreted in different ways. I realized that ethics does not apply only to special situations but also to everyday interactions and decisions, especially in the workplace.

In the healthcare environment, ethics is automatically associated with end-of-life decisions about the course of care. However, there is a more common context that does not relate to moral ethics, or business ethics, or institutional ethics, but to “people” ethics—a subset of morality that exists among people, not systems or organizations. This code must be ingrained in each individual. James A. Autry, in Love and Profit: The Art of Caring Leadership, said that if people don’t behave ethically, no system in which they participate will.

As I read the article, I tried to apply some of the points of the Association Management article to my work. Because today’s economic environment continually distorts (how about impedes?) the pursuit of a fair and “ethical” system, working in any aspect of the healthcare industry is a staggering challenge. I frequently feel powerless when attempting to work within this system. But this article continues to challenge me with what I can accomplish each day.

In his book, The Ethics of Choice, David L. Thomas proposed building your own rules of engagement for any system you encounter. His premise is that it is ethical to serve, refine, and advance the organization you have chosen to join, but it is unethical to harm it. You can achieve this goal by integrating the following rules:
1) It is ethical to learn everything you can about the organization of which you are a part.
2) It is ethical to learn about the needs of those served by your organization.
3) It is ethical to perform your job to the best of your ability.

4) It is ethical to speak fairly and honestly or not at all about the other members of the organization.
5) It is ethical to follow the rules.
6) It is ethical to seek correction of rules, procedures, or practices that are inconsistent with the overall purpose of the organization.
7) It is ethical to create organizational improvement.
8) It is ethical to leave an organization whose purpose is in conflict with your own.

I can identify scenarios in my workplace that can benefit from the integration of these rules by the people involved. Although an extra expenditure of energy might be required, I have tried to use these principles daily to assist me in my professional endeavors. I can be particularly reassured of my power if I center discussion on the needs of my patients.

AACN is also encoding ethics in its performance as the world's largest specialty nursing organization. Our organizational values are really the “people ethics” of our membership. Our members
believe in:
1) being accountable
2) being an advocate

3) demonstrating good use of resources
4) embracing lifelong learning
5) acting with integrity
6) collaborating with others
7) committing to quality
8) promoting innovation
9) providing leadership
10) generating commitment

Without our members, we could not have evolved to where we are today.

I realize that this list of values is the reason I joined AACN. I hope the information provided will help you refocus your energy when the healthcare environment becomes distracting. Healthcare systems are made up of the people who make the systems work, by using their “people ethics” every day. Remember that you can and do make a difference.


German Chapter Looks to Future

Greetings from Germany! I want to thank AACN News for the wonderful article on the Landstuhl (Germany) Chapter of AACN.

I was amazed at how many people saw and read the article. Several even recognized me when I was on a recent trip to Texas. They all asked about our chapter.

We have elected new officers for our chapter. I am excited about this new group. All these officers are motivated, and I am optimistic that they will make our group bigger and better.

Thank you very much for all your support. We would have not done a good job without your help. I had a great time serving as this chapter’s president for 2 years.

Bob Gahol, RN, BSN, MBA, CPAN
Landstuhl, Germany

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