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Even Leaders Need to Learn

Latoya L. Stewart, MSN, RN

Disclosures

October 08, 2021

In my best Sophia Petrillo voice, "Picture it: 2017, a fairly young and ambitious nurse manager decides to switch hospitals within a healthcare system to climb the ladder and challenge herself. She walks into her new unit and introduces herself to her staff, only to realize that of all the nurses on the unit, she is the youngest. This was definitely a Doogie Howser moment."

Growing Pains

Here I was, bright-eyed, with grand ideas on how to improve the unit and patient care. I just knew I was going to change their world for the better. Honestly, looking back, many of those ideas came from the needs of my former unit. I quickly learned that apples are most definitely not oranges. Each unit is unique, and the staff has various strengths and weaknesses related to their specialty.

One of my first challenges was the absence of the daily huddle. I was accustomed to huddling each day with the morning and night shift to go over updates, concerns, and goals of the day. On my first day of gathering the staff, one of the nurses stated, "We don't need a huddle. We already know everything that's going on."

After a slow blink, deep sigh, and internal scream, I reminded the staff that huddles were encouraged by the Joint Commission and the Institute for Healthcare Improvement — but most important, it is the expectation of the hospital.

Needless to say, the next few weeks presented resistance and finally, with great relief, acceptance. During each huddle, I made sure to incorporate the hospital census, call-outs, surges, possible constructions, and various forms of recognition. After a few weeks, I was impressed to see the staff begin to run the huddle without me prompting them.

Changing Behavior

While I was winning on daily huddles, changing behaviors took more time. I came from a Level 1 trauma center, where everything needed to happen right and right away. I soon learned that changing behaviors also meant changing my behavior. There is more than one way to get the job done, and a little community charm goes a long way.

I had to relearn therapeutic communication because my "shoot from the hip" style did not sit well with some of the staff. I had to go back to basics and remember the training I received when I first became a manager. Though I remained diligent about setting the standards and expectations, I also remembered that I had to meet my staff where they were in order to elevate them higher.

During each huddle, I would try to incorporate an acknowledgment of positive staff behavior. I soon learned that not everyone liked being acknowledged in a group setting, while others felt slighted if they were not recognized for their good deed.

Getting to Know YOU

Understanding each staff member and what made them feel special took some work. After about 2 months on the job, I had managed to meet with each member of the unit on a one-to-one level. I made it a point to remember one thing that was important to each of them. Soon I learned about their children, pets, parents, and even some unexpected past careers. The biggest takeaway from these sessions was what I learned about myself.

I didn't know everything, I didn't have it all together, and quite frankly, I was perfectly okay with that. With each patient satisfaction issue, each employee-related personal issue, and each near-miss, I learned to step back and ask myself, "If I was a staff nurse, how would I expect leadership to approach the situation?" Being a leader is more than a title. Your staff needs to know that you have their best interest at heart. Leadership requires trust, but what I find to be equally important is transparency. Owning up to your mistakes and being bold enough to say, "I don't know, but I'll get back to you."

What are characteristics are you looking for in a leader? If you are a leader, what was your biggest lesson during your formative years?

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About Latoya L. Stewart
Latoya Stewart is Jamaica-born and New Jersey–raised, this millennial mom of two is navigating her way through middle management while quieting her middle-child syndrome. A graduate of UMDNJ and Rutgers University, she received her bachelor's in journalism, history, and nursing as well as her master's of science in nursing. Like most nurses, she believes she has a heart of gold and the mouth of a drunken sailor. Follow her on Instagram: @mindoftoya

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