By Caroline Ashman
Director of Clinical Professional Practice & Innovation, Prolink
The Setting: A Tight-Knit Desert Community
In the northwest corner of New Mexico sits the city of Farmington, nestled in the heart of the desert and bordering the Navajo Nation. In addition to its historic downtown and beautiful, sprawling desert views, Farmington is home to San Juan Regional Medical Center (SJRMC), a community owned and operated non-profit hospital. In its 100+ years of existence, SJRMC has grown to a 150+ bed level III trauma center.
When the senior leadership team at SJRMC reached out about improving their retention and turnover rate, we—Prolink’s Clinical Team—were eager to help. The Clinical Team’s core mission is to drive retention by delivering a world-class clinician experience, and that all begins with a talent-first mindset. We began to craft a program with the goal of showing SJRMC’s nurses that we were investing in their growth as professionals and emerging leaders.
That said, developing leadership programs for nurses is always a challenge—even more so in an out of the-way facility they may have become overlooked. Using evidence-based practice, a Learning Needs Assessment (LNA) was developed using Core Competencies from the American Organization for Nursing Leadership (AONL).
The AONL Nurse Leader Competencies Model focuses on five domains. The anchoring domain, Leader Within, anchors the five core domains: Business Skills & Principles, Communication & Relationship Management, Knowledge of the Health Care Environment, Professionalism, and Leadership. It is the driver of motivation, beliefs, values, and interests, and recognizes that understanding one’s own abilities is essential to success.
Our LNA asked respondents to evaluate their own knowledge, skills, and abilities related to various topic areas within each domain, from “very low” to “very high.” The mean scores of the topic areas were calculated for each of the five domains, giving participants a broad view of their own strengths and areas for improvement. The LNA was distributed to the attendees of the Nurse Leader Workshop at SJRMC both before the workshop began and after the workshop was complete.
The Solution: Encouraging Emerging Leadership
When we first partnered with SJRMC, we needed to take stock of the clinicians currently in leadership roles and their comfort, competency, and confidence in their duties. Initial responses showed that 50% of SJRMC’s nurse leaders had less than five years of experience with a further 25% only having a year or less. The hospital had plenty of emerging leaders, many of which showed real potential.
Whereby a nurse leader may well have been in the profession for many years, their tenure in a leadership role was comparatively short. In fact, among SJRMC’s clinicians, the mean number of years since first licensure was 17.5. Even though these nurses had a wealth of experience, they were still coming into their own as leaders. With our development program, we knew our aim was to provide guidance and confidence to these emerging leaders. They needed encouragement and advanced training to continue developing their leadership skills.
The Response: Tailored Training Makes an Impact
When the program began, we immediately sensed a palpable level of energy and commitment among the participants. They were grateful not only for the content of the program, but also for the camaraderie and opportunity to share their experiences with their fellow nurses. They particularly enjoyed the interaction with the Prolink Clinical Solutions Team and their colleagues, and they took comfort in the fact that they were not alone in their struggles to manage both people and patients, directly and indirectly.
When we began our work with SJRMC, the initial response we received from clinicians was that they needed help with “everything” related to leadership. We got the sense that, in order to truly come into their own as leaders, these nurses not only needed to develop their core leadership competencies, but also their sense of confidence. Put more simply, they were overwhelmed with the task at hand. By using our LNA, our Clinical Team was able to help the participants feel less overwhelmed with their responsibilities and drill down on the most important content.
“The workshop was very well done,” said Cindy Baez, MSN, RN, CENP, Associate Chief Nursing Officer at SJRMC. “Not only did the group learn each other’s leadership style, team building was evident with this exercise.”
The Results: A More Confident Group of Leaders
To evaluate how their sense of confidence grew over the course of the program, participants were given a self-assessment before and after they completed their coursework. On the second administration of the LNA, after coursework had been completed, improvements in the domain scores of professionalism and relationship management were statistically significant, jumping from a self-reported confidence score of 3.00 to 3.56 and 3.28 to 3.85, respectively.
We can point to our investment in a tailored, clinician-focused program as the reason for these positive results. The development of a custom program spoke volumes with our participants and let them know they were heard and understood by our team. These development efforts provided an increase in confidence and competence when providing leadership to the nursing community, because they now know what areas of opportunity and growth to focus on.
In addition to our encouraging results, we gained insight into how to develop and implement these kinds of programs—especially among clinicians with limited experience in leadership roles—most effectively.