TL10a

 

Visibility, Accessibility, and Communication TL10

 

Provide one example, with supporting evidence, of succession-planning activities for the Nurse Manager role.

 

 

Ambulatory Example a: Succession-Planning Activities for ED Nurse Manager Role

The nurse manager (NM) role at Catholic Health Initiatives (CHI) St. Vincent Hot Springs (SVHS) is an intricate position for each hospital unit. The duties include but are not limited to:

  • Twenty-four-hour accountability for the delivery of quality patient care that promotes safety and well-being
  • Planning, prioritizing, organizing, and directing/meeting the daily needs of the staff and unit
  • Communicating and managing the staff in a manner that promotes teamwork and enhanced work performance
  • Achieving and sustaining the assigned goals for budget accountability; productivity; and coworker, physician, and patient experience
  • Exceptional leadership abilities and the ability to manage complex, stressful, and critically ill environments while abiding by the core values set by CHI (Evidence TL10a-1, Nurse Manager Job Description)

 

In January 2023, the CHI SVHS nurse leadership team discussed how the hospital needed to have additional succession planning activities for the nurse manager role. At the time, succession planning for the nurse manager role included:

  • Advancing clinical nurses as preceptors, giving them more responsibility and learning when it comes to communicating with staff to promote teamwork and enhance work performance
  • Advance clinical nurses as charge nurses, giving them more responsibility and learning when it comes to communicating with staff to promote teamwork and enhance work performance, while meeting the daily needs of the staff and unit
  • Advance clinical nurses as unit nurse supervisors, giving them more responsibility and learning when it comes to communicating with staff to promote teamwork and enhance work performance, while meeting the daily needs of the staff and unit
  • Encourage clinical nurses to get involved in the Unit-Based Council (UBC) and hold a chair or co-chair role to enhance responsibilities, including planning, prioritizing, organizing, and directing monthly meetings to get their voices heard on how to improve quality patient care that promotes safety and well-being
  • Encourage clinical nurses to get involved with professional organizations and to get board-certified to learn evidence-based practice to deliver quality patient care that promotes safety and well-being

 

Then, all nurse manager roles were filled. Nursing leadership wanted to be proactive and have nurses ready to step into the nurse manager role, as opposed to reactively putting someone in the role at the last minute. Laken Harrell, BSN, RN, Clinical Nurse, PACU, went to the 2022 Magnet Conference and attended a concurrent session that had a succession program that got nurses ready for future leadership roles.

 

In reviewing the program that Harrell brought information back on and ideas that could be used, CHI SVHS developed and began the first Nurse Leader Academy program at CHI SVHS that launched in May 2023. The purpose of the Nurse Leader Academy program is to provide a comprehensive learning opportunity to develop clinical nurses interested in a future leadership role, including nurse managers, and to learn the dynamic aspects of the nurse leader role, develop leadership skills, and provide a mechanism for succession planning. (Evidence TL10a-2, Nurse Leader Academy Program with Application)

 

Each potential Nurse Leader Academy program candidate applied to participate in the program. The applications were reviewed by the Executive Leadership Team, and in-person interviews were set up for the applicants with the Executive Leadership Team.

 

For the first session, Amy Harkness, BSN, RN, Clinical Nurse, Emergency Department (ED), was one of applicants selected. Harkness was required to follow different members of the leadership team for three to six months, biweekly, and in four-hour intervals, including a nurse manager. This schedule was chosen to make it more adaptable for those participating while also working full-time hours. (Evidence TL10a-3, Harkness schedule)

 

Job Shadowing
First, on May 17, 2023, Harkness shadowed Patrick Lambert, BSN, RN, House Supervisor/Bed Control. Lambert was open to sharing the job duties and responsibilities of bed management and throughput, ensuring a smooth transition for the patients moving throughout all the different ambulatory areas of the hospital, including the ED, outpatient, PACU, and Cath Lab recovery.

 

Harkness was impressed by the scope of knowledge it takes to evaluate all the moving pieces and make sure all patients are placed in the safest place. Lambert is also responsible for the patients in the hospital and accepting transfers from outlying hospitals, as CHI SVHS is the referral center for the Southwest region of the state.

 

This role is a vital component for the hospital throughput, which nurse managers need to understand. This assisted Harkness in learning responsibilities that a nurse manager needs to know, including planning, prioritizing, organizing, and directing/meeting the daily needs of the staff and unit that a nurse manager needs to know.

 

Second, on May 30, 2023, Harkness shadowed Renee Fechuch, MSN, RN, Clinical Director of Nursing, Emergency Department, Intensive Care, and the Hospital-Based Clinics. Harkness was able to see the balance between departments. Harkness attended daily bed board meetings, where the nurse managers, directors, and ACNO discuss patients being discharged that day and any barriers there may be.

 

To follow was Safety Huddle, where all hospital disciplines, including nurse managers, attend and discuss safety issues that may have transpired over the last 24 hours. Lastly, Harkness witnessed Patient Experience, which is where each leader, including nurse managers, share patient rounding that was completed the day before and if there were any barriers or issues that needed to be addressed in real-time.

 

Fechuch’s job is critical to ensure processes flow smoothly and clinical nurses can perform patient care at their highest ability and with the proper tools for success. The clinical director is the bridge between the physician’s needs and the nursing staff. All of this helped Harkness understand how the ED nurse manager needs to have 24-hour accountability for the delivery of quality patient care that promotes safety and
well-being.

 

Next, on June 20, 2023, Harkness had a glimpse into the inpatient experience, as she shadowed Kaitlyn Atkins, MSN, RN, CPN, Clinical Director, Inpatient Units. This was very eye-opening as to what ED nurse managers must know to help their team interact well together as a cohesive group, while also allowing them to maintain a sense of autonomy and freedom of work and practice.

 

While with Atkins, Harkness attended morning huddles with the different leaders from different areas, which allowed the two to discuss differences between inpatient nursing management and ED nursing management. Harkness had a new respect for all the work performed for the inpatients while receiving different levels of care.

 

Harkness recognized as an ED nurse that it is easy to get tunnel vision and focus solely on the needs of one department. Watching Atkins’ interactions provided Harkness with the reminder that we truly are one small part of a larger team. This allowed Harkness to see how the nurse manager role requires exceptional leadership abilities and the ability to manage complex, stressful, and critically ill environments while abiding by the core values set by CHI.

 

The fourth session was spent with Shawna Corley in Quality Improvement (QI) on July 13, 2023. Corley’s job is unique. Harkness learned that Quality Improvement is responsible for tracking and reporting the numbers that account for much of the hospital reimbursement and government money. Members of the QI department review charts to ensure the hospital is compliant with all the required documentation.

 

This documentation provides an accurate way for CHI SVHS to track trends and evaluate the treatment of patients. Corley explained Medicaid reimbursement and different measures that show if the hospital is meeting the needed standards and is responsible for reporting those measures accurately. This assisted with Harkness learning more about the 24-hour accountability for delivery of quality patient care that promotes safety and well-being.

 

Next, on July 25, 2023, Harkness spent time with Trisha Nicholas, BSN, RN, Nurse Manager, Surgical Intensive Care Unit (SICU). Harkness witnessed firsthand the dedication of a nurse manager. It was evident to Harkness that Nicholas had strong relationships with all her employees.

 

This was shown through the respect Nicholas had for the employees and the respect the employees had for Nicholas. Nicholas shared the hardships of being a nurse manager along with the successes and failures learned along the way. Harkness gained a different understanding of overseeing a large group of coworkers.

 

Lastly, on August 7, 2023, Harkness spent a morning with Teresa Lambert, MSN, RN, Vice President of Patient Care Services and ACNO (role of CNO). The best part of Harkness and Lambert’s time was during the leader rounds. Lambert lights up when visiting with the patients, and the patients enjoy and feel privileged to be rounded on by the administrative team.

 

Harkness was also able to see payroll, new hire orientation, the morning safety huddle, and patient rounds. Harkness witnessed the different tasks that take place in all the departments and roles. Lambert also shared her journey to leadership and what those steps looked like.

 

Harkness gained insight into many different aspects of the facility and the unique individuals who make service to the community possible. She was able to witness and participate in many nurse managers’ daily activities. Harkness was honored for the opportunity to get a glimpse into leadership, including the ED nurse manager role. She described the meetings to be open and transparent and how CHI SVHS values honesty above the dollar bill, values a patient’s well-being above maintaining an image, and values their employees enough to invest in training them for possible leadership, including nurse managers.

 

Harkness states the time spent was worth it, allowing her to see the hospital at large and gain a new understanding of other departments and how we all function together. It built a sense of pride to be a part of this team, reminding her how many different parts work together to serve the community. The Nurse Leader Academy at CHI SVHS may not be a commitment that every employee can make, but Harkness feels every employee would benefit from being able to see the leadership team’s actions and learning from them. (Evidence TL10a-4, Harkness review)

 

Precepting/Relief Charge
Harkness has been an ambulatory preceptor for two years. Being a preceptor has given her more responsibility and learning about communicating with staff to promote teamwork and enhance work performance to prepare for an ED nurse manager role.

 

Harkness has been an ambulatory relief charge nurse since April 2023, which has given her more responsibility and learning how to effectively communicate with staff to promote teamwork and enhance work performance, while meeting daily needs of the staff and unit to prepare for an ED nurse manager role.

 

Unit-Based Council Chair
Harkness has been the ED UBC Council Chair since July 2023, which has been teaching her responsibilities that include leading, planning, prioritizing, organizing, and directing monthly meetings to get the nurses and other employees’ voices heard on how to improve quality patient care that promotes safety and well-being. This role has prepared Harkness to be an ED nurse manager.

 

External Organization Membership
Harkness is a member, serves on the Arkansas Forensic Nursing Association, and has obtained her Sexual Assault Nurse Examiner board certification. This has enabled Harkness to take evidence-based practice to deliver quality patient care that promotes safety and well-being. Harkness is invited to lecture at the community nursing schools and high schools to teach students about forensics in healthcare.

 

CHI SVHS paid for her professional organization membership and certification exam. In addition, Harkness won the 2023 Forensic Nursing Award for the state of Arkansas called “Forensic Nurse Horizon,” as she has been working towards advancing the field of nursing forensics in Arkansas. This has all prepared Harkness to be an ED nurse manager.

 

Harkness’s succession planning for the ED nurse manager role has been thorough with many opportunities to prepare and develop her to take the role of a nurse manager. Harkness would be a great candidate when the ED nurse manager role comes open at CHI SVHS.