Leading With Brave Optimism

Oct 01, 2019

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Nurses in every unit and every type of employment have to identify as leaders. They have to want to sit at the table. They have to want to have an active voice.

Stephanie Meyer 

Stephanie Meyer, senior director of perioperative services at Children’s Mercy Hospital in Kansas City, Missouri, thinks empowerment and partnership are keys to leading teams successfully and creating a healthy work environment (HWE). She has spent her career focused on helping nurses find their voice and emerge as better leaders. “My passion is to improve accountability in healthcare by having candid conversations while working to level the hierarchy,” she says.

Beyond influencing at her hospital, she shares her expertise at AACN’s National Teaching Institute & Critical Care Exposition (NTI), where she leads sessions on topics affecting healthcare leaders today, including “Leading With Accountability: How to Be the Best Version of You,” “Support for Practice: How to Collaborate With Nurse Leaders” and “Recruiting and Hiring Humans, Not Refined Resumes.”

What’s the biggest change in technology that you’ve seen in healthcare during your career?

Out of all the technology changes we’ve seen, the biggest one for me in my career has been the electronic medical record. When I first started, and even when I was trained in nursing school, we were trained on paper. The patient’s paper chart was at the nurse’s station, and we would fight for access to look at it and to review orders. Everything was handwritten. And now, with the electronic medical record, everybody has access all the time. It’s the biggest change by far.

You lead a session at NTI called “Leading With Accountability.” Can you share how nurses at all levels lead with accountability?

I love that topic. First, we need every nurse to identify themselves as a leader. We struggle when nurses — in formal leadership positions or not — don’t think of themselves that way. If we are going to design healthcare as it should be, nurses in every unit and every type of employment have to identify as leaders. They have to want to sit at the table, they have to want to have an active voice, and they have to lead with brave optimism that they have the ability to change the future.

The latest HWE study indicates that establishing a healthy work environment and retention are linked. What advice would you give to nurse managers who want to implement the standards as part of their strategy to address turnover?

Nurse leaders have the ability to influence healthy work environments by sheer presence. Nurse managers need to be able to listen actively and intently to the staff’s needs to help remove barriers. Also, I think it’s important, as we bring on new nurse leaders into the role, that they understand there is good turnover and there is bad turnover, both of which are absolutely tied to the healthy work environment standards.

Nurses are leaving because the environment is toxic, because the environment doesn’t support practice and there are too many barriers. It’s important that we talk to nurse leaders about addressing those individually. Nurse leaders have to sit down and understand the barriers from the perspective of the staff nurse. The staff nurse can be their partner to make sure that we can move healthcare forward.

But all turnover isn’t bad. We also really need to discuss positive turnover. As we work to develop leaders in healthcare, and they move on to the next job and they move on to being leaders themselves, that’s good turnover. As they advance their education and they move on to be nurse practitioners or nurse educators, that’s good turnover.

What should be a priority for nurse managers establishing a healthy work environment?

Partnerships should be the priority. It can’t be the “staff nurse’s job” or the “nurse leader’s job.” We have to figure out how to do it together.

What kind of partnerships, such as with physicians, staff nurses and administration, do nurse managers need to implement?

To have an environment that people want to work in, the partnerships have to be strong and we have to work together to break down silos. The biggest way I absolutely believe we can do that is for everyone to lose the ego. Ego is killing healthcare. Hierarchy is killing healthcare. It’s killing patients. The reality is, administrators, physicians and nurses are all equally important. It takes all of us to make a system successful and to have good patient outcomes. And, we have to recognize that no one person in that trio is more important than the other. Lose the ego, and healthcare will absolutely go where it needs to.

What are some pitfalls or hazards for nurse managers to avoid in implementing the HWE standards?

The first one that comes to mind would be lack of visibility. While we have all of these extra things to do that are required by our position, it is important that nurses see us. They need to know that we care and understand their daily trials and tribulations. They have to know that we remember what it was like to be them.

What makes a healthy work environment (HWE)? AACN’s six HWE standards — skilled communication, authentic leadership, meaningful recognition, appropriate staffing and effective decision making — provide evidence-based guidelines for success. HWEs affect everything in your unit, from patient outcomes to nurses’ job satisfaction and intent to leave. The healthiest work environments integrate all six standards for positive outcomes. AACN has a free HWE assessment tool to measure the health of your work environment. Visit www.aacn.org/CreateHWE to take the survey and receive an analysis of the results.