Employee Evaluation Interview

I interviewed a friend who is the manager at a boutique clothing store
1. How often do you perform employee evaluations?
I perform employee evaluations annually in December or January
2. What kinds of things are you looking for in an employee evaluation?
The employee evaluation is a good time to look at the employee's performance over the past year, discuss any problems, and successes. Raises are usually discussed in this evaluation.
3. Do you have any goals or plans that you discuss in your employee evaluations?
Our employee evaluations are pretty informal. I don't set specific goals with my employees, except looking over what they could improve on and things that they are doing well.
4. How important do you feel an employee evaluation is?
I think employee evaluations can be very beneficial to both me and the employee. It offers a chance for us both to sit down and discuss anything that needs to be addressed.
5. If an employee has not done a satisfactory job in the past year,
how do you approach the employee evaluation?
If they have not done an awesome job, I look at the evaluation as a way to discuss what has gone on. I try and see what I can do to help the employee succeed as well as identify ways for the employee to improve.

This was a great experience learning more about employee evaluations and how one manager approaches these evaluations.

Hiring/Firing Interview

I interviewed the owner of a new fast food chain. I listed the questions I prepared below as well as the answers that he gave.
1. What are the qualities you looked for in potential employees?
The biggest thing I look for is work ethic and if they will be able to get along well with the team and customers. I want hardworking employees that can communicate and be personable.
2. What stood out to you in interviews as something a candidate did well?
The candidates that were personable and outgoing in the interview stood out quite well to me.
3. What stood out to you in interviews as something a candidate did
not do so well?
Kind of the opposite of my previous answer. If the candidate was shy and hard to talk to, it was hard to envision them interacting with the customer.
4. What kinds of questions did you ask in the hiring process?
I asked them about their experience with customer service, their schooling, and how they approach difficult customers and stressful situations.
5. How important were the references in the hiring process?
The references are important, but as long as the references did not say anything negative and the candidate did well in the interview I usually felt good about hiring the candidate.
6. How important was the previous experience in the hiring process?
I wish we could hire only those with previous experience, but that is not plausible. Instead I looked for those candidates that had experience in working hard maybe in school or in an organization. I looked for quick learners.
7. What is your discipline policy?
We are still developing our discipline policy as we are a fairly new business. Obviously consistent absences and tardies will lead to a face to face meeting where I can discuss the problem.
8. How do you handle conflict between employees in the workplace?
I try to have my managers work on handling the conflicts by diffusing the situation. If it elevates then I will sit down with each of the employees and work to see their point of view and work towards a conclusion. If someone is consistently the cause of the conflict, they will be terminated.
9. Any tips for a future manager on how to handle disciplining an employee?
I just try to promote a healthy working environment. I want my employees to get along and have a good experience at work. If someone is consistently having issues, I try to work with them one on one and come to a conclusion.
10. Is it helpful for you to have other managers involved in the
hiring/discipline process? Why? Why not?
It is definitely very helpful to have other managers involved in the hiring and discipline process. It is nice to have another point of view as well as be present for legal issues.

Leadership Clinicals at UVRMC - 24 Hours

I was able to spend two shifts at Utah Valley Regional Medical Center "shadowing" the house supervisors. I learned a lot about their role in the hospital. To blog about my experience I am going to address each course objective for NURS 4405 and how I met those in my clinical experience at UVRMC.

1 - Apply concepts and theories of leadership, management and power as a foundation for nursing organizations.
I was able to see the concepts and theories that we have discussed in class in play at the hospital. In my 24 hours spent at the hospital I was able to follow three different house supervisors. Each had their own way of leading and managing. I would not say one was better then another, but all had their own strengths. I believe personality plays a huge role in how we manage.

2 - Investigate leadership and management competencies essential to a successful organization.
Like I said, I was able to see how managers and leaders work together at UVRMC to make it a successful hospital. From the staff nurse level, to the charge nurse, up through administration, there are certain leadership and management skills needed to help accomplish the goal of providing safe care to the patient.

3 - Evaluate effectiveness of cost and quality of care with consideration of budgetary constraints.
I wasn't able to really observe the budget side of UVRMC, but in my budget interview that I posted about earlier, I was able to see how budgets and constraints work into running a business.

4 - Analyze policies and procedures used in management of a nursing unit for providing optimum care.
Through my two shifts at UVRMC, I was able to see the policies and procedures that UVRMC follows throughout the day. The house supervisors are required to round to check up on the different floors. Certain things require the house supervisor to respond to for example a hard IV, Code, etc.. I was able to witness a charge nurse meeting where scheduling was discussed and planned for the next day.

5 - Examine principles of risk management and assisting employees with special needs.
I was able to witness all three house supervisors interact with many of the employees. Some of those employees did have special needs, and the house supervisors responded and communicated appropriately with these employees. Risk management is a big issue with hospitals. Everything that the house supervisor role includes in some way relates back to risk management. Adequate staffing, assisting in IVs, attending Codes, etc... all are part of risk management.

6 - Explore leadership and management competencies which contribute to optimal organizational climate and culture.
This objective seems similar to Number 2: Investigate leadership and management competencies essential to a successful organization. I guess one of the ways that they differ is how it leads to optimal organizational climate and culture. Without the house supervisor, especially at night, there would not be anyone representing administration. It is important to have a chain of command to keep the hospital running smoothly and have any complaints, issues, etc... handled in an organized fashion.

7 - Develop individual nursing philosophy related to leadership and management.
I am still working on developing my own individual nursing philosophy regarding leadership and management. I was able to witness how three different house supervisors manage and lead and was able to learn a lot about different styles. Some things I would use and other things I would not use. It was a good way for me to witness leadership styles in action.

8 - Examine leadership and management principles in a variety of health care systems.
I was able to examine leadership and management principles on the unit level up through administration. It was exciting to see how important leaders are on each level.

Coaching: An Essential Skill for Nurses (6 Hours)

To wrap up my 46 hours of clinical time for NURS 4405, I decided to take a 6 hour course on coaching. Coaching is an interesting topic. It is a specific leadership technique that nurses need to know. The objectives of this course were to:
"Identify the importance and value of coaching.
Distinguish coaching from mentoring, therapy, precepting and training.
Identify the basic components and the purposes of a coaching contract.
Create strategies for helping staff embrace change.
Describe the characteristics of a great coach.
Identify the ways in which coaching affects the bottom line as well as quality of care"
The idea of coaching is a very interesting one. The course presented statistics that showed companies that incorporated coaching into their management had an increase in productivity, quality, organizational strength, customer service, etc.. Coaching is defined as "a sustained learning strategy to help people enhance their skills, change their perspectives, behave differently and achieve their goals." People who coach need to have a certain set of skills. These skills and attributes include listening, confident, trustworthy and intelligent. Coaches will have barriers to overcome in order to reach their goals. One technique to achieve the unit's overall goal is to set interim goals or mini goals to reach along the way. Coaches offer encouragement and advice to support the staff on their way to the goal. Coaches are leaders who guide the team through the process. This course gave some great advice for goal setting including prioritizing and the importance of commitment. It also gave tips on handling resistance. One of the greatest tips it gave was for nurses to anticipate resistance. It is much better to be proactive then reactive in the face of resistance. The last chapter of this course talked about the leadership qualities found in a coach. I loved this quote, "Two of the leadership competencies that effective coach/managers will display are “modeling the way” and “encouraging the heart.” " If a coach can follow those competencies, then the rest will fall into place.

Overall this course was great! I learned a lot about leadership skills needed in coaching. This clinical experience has been great as I have gained knowledge about what it takes to be a leader in nursing. These CE credits were a great resource for me to come up with my 46 hours of clinical time. I am motivated and inspired to develop my own leadership skills after taking these classes.

Learning to Lead: From Staff Nurse to Charge Nurse (5 Hours)

I decided to take a bit of a longer course that was very specific to nurse leadership. This course took 5 hours to complete. The purpose of the course was "to inform nurses about the key elements of management, focusing particularly on skills that enable nurses to coordinate resources and achieve desired outcomes in patient care settings. These resources may be staff, technological or financial in nature. After studying the information presented here, you will be able to -

1. Describe key aspects of the environment in which nurses assume management roles and functions, and how the climate influences care giving and management practices.
2. Depict the transitions that nurses make—either temporarily or permanently—from the role of caregiver to the role of manager.
3. Identify supervisory practices that promote good performance, workforce commitment and professional satisfaction.
4. Identify key skills that nurses will want to develop to excel as managers—whether they are managers for the shift or managers in full-time management positions.
5. Describe important interpersonal and coaching skills such as communication, delegation and feedback that promote mutual respect and solid teamwork.
6. Discuss ways to evaluate outcomes at the end of your shift.
7. Demonstrate an understanding of how to control costs on your unit."

One of the first things this course explored was the importance of a nurse manager understanding the mission and values of the company. Three charge nurses' experiences were then shown as they took on the role of a charge nurse. The role of a charge nurse includes planning, organizing, critical thinking, conflict management, and relationship management. The next charge nurse's experience focused on the role a charge nurse plays as a coach and communicator. A coach is different then a boss in that a coach lifts and supports instead of drives and pushes. Essential skills for a charge nurse to have include:
"Open lines of communication between staff and supervisory nurses
Respect and credibility among team members
Clear statements demonstrating desired outcomes and processes for achieving them
Good listening skills among all parties to a given communication
Well-articulated requests, responses, statements and questions that convey
important information to both parties."
As part of communication, nurses need to be able to listen to those they manager.

The next part of the course talked about delegation and teamwork. Both are essential skills for a successful charge nurse to have. Delegation and teamwork are needed to reach the goals of the unit. The authors of the course also discussed evaluation. Much like the nursing process, evaluation is important in leading a unit. Evaluation can help the charge nurse identify needs in the unit.

Overall this course was very educational. It took me through the steps that are required for a staff nurse to make the transition to the role of a charge nurse. The leadership skills discussed were explored in much detail.

Partnership Making the Most of Mentoring (1 Hour)

This next course that I took for CE credit focused on mentoring. Mentorship is directly related to leadership skills in nursing. In order to be an effective mentor, the nurse must have leadership skills. The definition of a mentor is, "Mentoring involves two parties and occurs when the senior person in terms of maturity and experience — the mentor — provides information, advice, and emotional support for the junior person — the mentee or protégé." The authors of this course discussed how any senior leader can be a mentor to another. They best mentors are those with experience and leadership skills. According to the course, the average mentorship relationship is 5-10 years. This is a very long term relationship, so mentors need to be chosen wisely. Some tips for mentors and mentee are:
Good communication skills
Insight, authenticity, and honesty
A strong sense of trust and mutual respect
The ability to be flexible and caring
Humility, an insatiable curiosity, and the courage to take risk
Each of these qualities will enhance the mentorship relationship. This course was very educational to me on the importance of mentors in nursing. Mentors are another example of the importance of developing leadership skills in the health care setting.

Precepting The Chance to Shape Nursing’s Future (1 Hour)

I decided to take another class on precepting. Like I said in a previous blog post about another precepting class, precepting is very relevant to me as I am about to being a preceptor experience for my new job. "Preceptors are role models for professionalism and best practices in the clinical setting, socializing nurses into the work group, educating and orienting." Preceptors are leaders for the new grad nurse as they make a transition from new grad to bedside nurse. In this course, the authors tried to emphasize that to be a good preceptor you must be a good leader. This course discussed techniques and tips for preceptors to use while precepting an new nurse. They ended with this quote, "Preceptors have an ability to take the newest nurses, “diamonds in the rough,” and go beyond teaching them the ropes to helping them discover their self-identity and confidence to deliver outstanding patient care. Preceptors, by their power and leadership, can create a caring environment in which nurses can grow and thrive, contributing to that next generation of professional excellence." I love that quote! I hope to be lucky enough to have a good preceptor in my upcoming experience and hopefully someday utilize my experience and leadership skills to act as a preceptor.

Shared Governance What It Can Mean for Nurses (1 Hour)

I decided to take this class because it directly relates to nursing leadership. This class was just a basic overview of what shared governance means for nurses. The definition of shared governance is as follows, "Shared governance is an organizational model that provides a structure for shared decision-making among professionals about practice and clinical outcomes." There are four aspects to shared governance in the health care setting. These include practice, quality, learning and generating new knowledge. Shared governance allows nurses to develop their leadership potential because they become stakeholders under shared governance. Their work environment encourages the nurses to get involved and share ideas to make positive changes in their workplace. This course identified three ways that healthcare facilities could fail at shared governance.

1. Establishing shared governance only in a single department or an isolated “pilot” unit
2. Fostering competition rather than collaboration among units and disciplines
3. Tolerating nurse leadership at executive or middle management levels that fails to support shared governance

It's quite obvious why each of these scenarios could lead to failed shared governance. The course on the flip side identified three ways organizations can succeed at shared governance.

1. Engage frontline staff and leadership in creating a plan for a shared governance model and bylaws regarding nursing practice, quality and competence.
2. Build relationships to support shared governance at the unit level, including leadership and administrative relationships, interprofessional and interdisciplinary team members and collaboration and collegiality
3. Establish unit-level councils and bylaws based on the overall strategic plan for organizational shared governance.

By following these three rules, organizations can use shared governance and benefit from it. This course was a really informative course. I learned a lot about shared governance and it is something I would like to know more about. It seems to me, that shared governance is an excellent way to structure an organization and develop leadership skills in all employees.

Spread Your Wings: RNs Have What It Takes To Be Effective Leaders (1 Hour)

"Spread Your Wings: RNs Have What It Takes To Be Effective Leaders" The title of this course drew my interest. It is the type of course that fits exactly with my nursing leadership class. This course talked a lot about how nurses can be leaders even on the staff nurse level. Five skills that staff nurse leaders need are:
Becoming future-oriented
Seeing the “big picture”
Communicating persuasively
Viewing change as an opportunity
Being proactive rather than reactive
My favorite skill that is listed is seeing the big picture. As nurses we tend to have so much going on we lose sight of the big picture. By understanding the reasons behind change, nurses can effectively lead others to overcome the change or obstacle. I also liked the idea of being proactive rather than reactive. This is so important for nurses to understand. In order to get something done, nurses need to be proactive. I really loved this quote "As new graduates, we all begin our nursing careers in a "followership" position. With time and experience, this should change. However, many nurses depend on their nursing administrators to provide all the leadership that the nursing component needs in an organization. Yet this model does not always provide the most effective leadership. Some of the most powerful leaders have no position of authority in an organization, but are able to point the way to both small and large improvements in patient service delivery." As a new graduate I have often felt I have no part in learning about leadership. But it is important for me to understand that even as a new grad I can become a leader.

Staying Cool Under Fire: How Well Do You Communicate? (1 Hour)

We have talked a lot about communication styles in our leadership class. We have discussed how there are differences even between men and women on how they lead and that may be because of different communication styles. Understanding communication styles is important for a nurse to effectively lead her team. This course discussed barriers to effective communication and tools to better communication. There were little clinical vignettes that gave examples of excellent communication and poor communication. I took away from this class that everyone needs to be continually working on improving their communication skills. Communication is essential for a nurse to be an effective leader.

Surviving and Thriving with Conflict on the Job (1 Hour)

One of the most important skills a leader can have is knowing how to deal with conflict. Nurse leaders are no exception to that rule. Conflict will occur in all healthcare facilities. Nurse leaders need to know how to resolve that conflict and move on. This course stated, "Most organizational conflict in healthcare organizations emerges at the interpersonal and intergroup levels. Major sources include:
Divergent management and staff perspectives
Competition for limited resources, such as staff, space, equipment and funds
Difficulties arising from interdependence of work activities
Differences in values and goals among work groups"
I have seen all four sources of conflict in my clinical experiences. There are different techniques to overcome conflict. Some techniques work positively and other techniques work negatively. It is important for the nurse leader to approach each conflict individually and use the technique that meets the need of that problem best. "Whatever strategy is used, successful conflict resolution starts by identifying the problem and the desired behavior or outcome and then confronting the conflict. " This course gave me some good tips with dealing with conflict in my work place. Even though, I am not in a management position, I have learned some skills that I can apply when I am facing conflict.

The "Golden Rules" for Preceptors and Preceptees (1 Hour)

This CE course really interested me because I am about to embark in a preceptorship experience at my new job. I will be on the preceptee side of the relationship, but this class helped me to prepare for the day that I will be on the preceptor side. A preceptor is a great example of leadership in nursing. Fortune magazine stated "The single best predictor of overall excellence is a company's ability to attract, motivate and retain talented people." This is where preceptors come into play. Having a strong orientation program and preceptors in place can ensure new employees have the training and skill needed to perform the job well. This course talked about the most basic golden rule and how it applies to preceptors. Preceptors and preceptees need to treat each other how they would like to be treated in order to create an environment of learning and growth. An important part of this course talked about how one preceptor may not be the best preceptor for all and just because someone is a good employee does not mean they are a good preceptor. Preceptors require a specific set of leadership skills in order to lead and train the new nurse. I learned a lot from this course and am excited to one day become the preceptor and help in the transition from new nurse to competent nurse.

The Transformational Power of Leading With Head, Heart, Hands, and Habits (1 Hour)

This course really goes along with my nursing leadership class. It discussed a lot about transformational leadership. I hold to the belief that leaders are not born but made. The authors of this course stated "Competence in leadership develops over time and through mentorships that focus on the sociopolitical tasks and aspects of leading and managing." I really like that. I think leadership really does develop over time as the nurse gains more experience. Relationships are also key to successful leadership skills. The authors of this course then went on to describe how leaders can be transformed internally through there head and heart and externally through their hands and habits. Leaders are motivated with their "heart". Their head helps them see different perspectives. The hands represent public leadership behaviors. There were some great quotes used in this webinar. My favorite came from Aristotle. He said, "We are what we repeatedly do. Excellence, then, is not an act but a habit." I love that quote! This course motivated me to always practice good habits and to be continually learning and developing my leadership potential.

Use Your Power! Structural Empowerment and Nursing (1 Hour)

This course was a webinar put on by Kaplan. The course's objective was to "develop an understanding of structural empowerment for nurses specific to descriptions, emerging trends, and examples of supporting activities and outcomes." The course began by talking about the traditional structure in nursing. The traditional structure includes power and authority at the top of the triangle relying on communication and roles. Other structural patterns were then discussed. Technology is changing how nursing is structured. There are some assumptions that the course went over when it comes to nursing power.
" 1. Power rests where the knowledge is; decisions are made by knowledge holders and key stakeholders
2. Nursing is the voice for nursing
3. The patient care delivery model reflects the mission, vision and values of the organization
4. Principles for practice drive the work of caregivers; policies are minimized"
Understanding the assumptions of power and how communication and roles come into play, is important for nurses to understand the power they have. Nurses have different kinds of power. Probably the most valuable power nurses have is expert power. Nurses receive this power through the experience they have at the bedside. Understanding the power nurses have can help nurses develop their leadership potential.

UVU Nursing Research Conference (3 Hours)

The keynote speaker at the UVU Nursing Research Conference was Dr. Lauren Clark who is a professor of nursing at the University of Utah. She discussed how research can break down barriers to humanized care. According to Dr. Clark, the three barriers to humanized care are perverse policies, technophilia, and biases by nurses. Research helps nurses overcome these barriers. She gave examples of three works that address biases by nurses. These works included Violence & Hope, The Hot Spotters, and Cutting for Stone. This keynote address made me excited about nursing research and how it can humanize the care I give to my patients.
The first breakout session I attended was presented by Dianne McAdams-Jones, EdD, RN. She discussed the benefits of using a human simulator in a nursing program. A human simulator was used in the presentation. Different scenarios were presented using the human simulator. The human simulator was able to talk, sweat, bleed, increase heart rate, and a multitude of other performances. This session was a very informative class on how human simulators can function as an alternative to live patients for nursing students. This is beneficial, because no harm can be brought upon the human simulator.
The last breakout session I attended was presented by Dale Maughan, PhD, RN. He presented preliminary findings of Utah Valley University’s use of the admissions interviews as an admission factor to the undergraduate nursing program. At this point, the first cohort of nurses to have gone through the admission’s interviews are still in their fourth semester. It is unknown whether the use of the interviews will increase NCLEX pass rates. Different statistics were presented that showed that the interview process did effect who was accepted into the program. Some students who would have been accepted to the program without the interview process, were not accepted because of interview performance. The purpose of the interview process, according to Dale, is to allow the admissions committee a look at the caring and communicating skills the applicants possess. This interview process has been deemed beneficial and changed the admissions process from applicants just being a number on a spreadsheet. Faculty are now able to get to know applicants and put faces to names during the application process.

Budget Interview

I interviewed Wendy who is in charge of the budget at a local fast food restaurant. This restaurant is a fast food chain. I prepared the following questions and have listed her response next to each question.

1. How often do you review your budget? Monthly basis, weekly basis,
yearly basis? and who all is involved in the budget review?

The budget at this company is reviewed bimonthly. The budget is complex, because it involves food product, wages, building utilities, etc... Food orders are made every week and wages are paid bimonthly. Because Wendy is also part-owner in this company, she reviews the budget sometimes on a daily basis as sales are evaluated. The people involved in the budget review is Wendy and her husband, who is also part owner, and the store manager.

2. If you are over budget, what is cut first?

Obviously, with the fast food industry, food product is what is sold. So food orders can not be cut first. The first thing to get cut is "labor". First to go, is all overtime. Strict schedules are created to avoid having to pay out any overtime to employees.

3. How do you determine how much is alloted to employee pay, product, etc?

Because this company is part of a franchise agreement, much of the budget is set up standardized by the company. There is wiggle room depending on sales and the need of the store. Collaboration between partners and the store manager are used to help create the budget.

4. What is the consistent "problem" area of your budget? What
consistently is causing your business to go over budget?

This store just opened up about two months ago. The consistent problem this early on has been overtime. A lot of work was needed to get this restaurant open. Many of the employees were required to work overtime in order to accomplish a strong opening. In the future, the plan is to cut overtime so as not to go over budget.

5. How do you communicate changes in the budget to your employees and staff?

The store manager is in charge of communicating changes in the budget to employees. The only effect the employees will feel is the cut in hours. The store manager is in charge of writing schedules and contacting employees to discuss their individual schedule and hours.

This budget interview was a very good experience for me. I was able to sit down with an owner of a restaurant and learn from a non-healthcare perspective the importance of a budget. It is amazing to me how all companies depend on a budget. Without a budget, the company would ultimately fail. There needs to be a plan and specific numbers for the company to be successful at making money. Even though this restaurant is relatively new, I believe that they have a good idea of how to budget their company.

Budget Interview Questions

1. How often do you review your budget? Monthly basis, weekly basis,
yearly basis? and who all is involved in the budget review?
2. If you are over budget, what is cut first?
3. How do you determine how much is alloted to employee pay, product, etc?
4. What is the consistent "problem" area of your budget? What
consistently is causing your business to go over budget?
5. How do you communicate changes in the budget to your employees and staff?

Nursing Leadership and the IT Initiative (1 Hour)

Another CE course that I have taken to fulfill clinical hours for this course was titled "Nursing Leadership and the IT Initiative". This 1 hour course focused on the technology aspect of nursing and how nurse leaders can successfully implement technologies into their work places. It started the course out by talking about nursing informatics. "Nursing informatics is a specialty that integrates nursing
science, computer science, and information science to manage and communicate data, information, knowledge and wisdom in nursing practice." There are four parts to implementing a new technology directive in the workplace. The first stage is implementation, then utilization, followed by adoption and finally transformation. It is important for all nurse leaders to understand each stage of the implementation process in order to effectively implement the change. I liked this quote in the class, "Implementations are 20% about the technology and 80% about the sociocultural issues such as change management, leadership, risk tolerance, incentives, etc." I love this quote because it shows how important leadership is in implementation. It is not so much about the change, but how you present the change and manage the change in the workplace.

HCAHPS Is All About Patient Satisfaction (1 Hour)

This course was all about HCAHPS. The objectives of this course was to "The goal of this program is to provide information about the benefits of patient satisfaction surveys, specifically the Hospital Consumer Assessment of Healthcare Providers and Systems. After studying this information, you will be able to —
* Describe the benefits of patient satisfaction surveys.
* Discuss the effect of patient satisfaction scores on hospital reimbursement.
* Describe ways to increase patient satisfaction scores."
HCAHPS are a huge issue for nursing management right now. Medicaid will soon start requiring higher HCAHPS to determine reimbursement. The course explored the different survey types that HCAHPS scores are gathered from. The course also gave strategies on how to increase HCAHPS scores. Nurse management need to understand how HCAHPS scores will effect funding and how to increase those scores. This course was very relevant for anyone looking to get into nursing management.

Expert Nurse Delegation Skills: Teamwork at the Bedside (1 Hour)

The goal of this next 1 hour CE course that I took was to "gain knowledge and skills that will help improve RN leadership skills and teamwork at the bedside, ultimately resulting in optimal patient/family outcomes and staff satisfaction". I really like the idea of this course because it explores leadership at the bedside. This type of leadership is just as important if not more important then leadership in management. This course explored different causes of delegation deficit in the clinical setting. They really tried to reinforce that "complex critical thinking leadership skills requires both education and application". I love that. It takes education and application to truly develop leadership skills. The course also touched on the Five Rights of delegation. These five rights include right circumstance, right person, right task, right direction, and right supervision/feedback. These five rights are crucial in successfully delegating care. This course gave some great suggestions to being a better leader and delegator at the bedside as care as administered to the patient.

Emerging Roles and Model of Care: How to Affect Change at the Bedside (1 Hour)

The class titled, "Emerging Roles and Model of Care: How to Affect Change at the Bedside". The goals for this course were to "Describe importance of matching nursing practice and skills to future needs, not past demands, describe implications for graduate education, and explain the Campaign for Action." This course talked about current issues and trends in healthcare. As nurse leaders, we need to be educated on current events in healthcare so we can be leaders as we get involved and influence change. The healthcare reform is focused on three things, reducing cost, increasing quality and improving safety. This course gave great advice on how to become involved in influencing healthcare policy. There are many organizations that nurses can join that offer resources to become involved in healthcare policy. This course also encouraged nurses to seek higher and advanced degrees. There is a need for more nurses with advanced degrees in the healthcare system. These nurses are needed to replace the current leaders that will eventually retire and leave the workforce. This course was a good broad course that really covered current trends that all nurses need to be informed about.

Create Your “Nursing Dream Team” by Bridging Generation Gaps (1 Hour)

Another CE class that I took was titled "Create your Nursing Dream Team by Bridging the Generation Gaps". Nurse managers and leaders will have to work with a variety of different people from different generations. Understanding and bridging the generation gap is an important part in becoming an effective leader. This course broke down the four generations that are currently in the workforce. There are the traditionalists or veterans born between 1920-1943. There are boomers born between 1943-1960. The Gen X generation were born between 1960-1980. The Gen-Y and Net-Gen were born between 1980-2000. Despite this categorization of the generations, it is important to remember and the course did point out not to stereotype. Each person is individualized and not all will adhere to the qualities of their generation. Each generation has a different approach to work and to how things were when they entered the workforce. Communication styles differ from one generation to another. Traditionalists prefer face to face, while Gen-Y and Net-Gen are much more likely to use technology to communicate. Leaders and managers in nursing need to understand the strengths and weaknesses of each generation and how to effectively communicate with each generation. By understanding and educating themselves, leaders can then more effectively lead a team made up of multitude of generations.

Conquering Conflict in the Clinical Setting (1 Hour)

Another CE class I have decided to take for the clinical hours of my Nursing Leadership class is titled "Conquering Conflict in the Clinical Setting". The goal of this class was to identify sources of conflict in the clinical setting and developing skills to overcoming that conflict. Conflict is a topic that is very much related to leadership and management. Being in a management role means that at some point or another you will run into conflict. As the leader or manager, you would then have to be able to overcome the conflict. Conflict can be very destructive in the clinical setting. This class stated conflict can be destructive when it "diverts energy away from the goal, destroys morale, reduces cooperation, intensifies value differences, and produces irresponsible behavior". On the flipside conflict can be constructive when it "opens up issues, leads to problem solving, increases involvement, causes honest communication, allows release of emotions, helps build team spirit, and helps individuals grow." This class explored both types of conflict and gave some good strategies for nurse managers and leaders. They gave examples of words to avoid in communication to avoid destructive conflict and words to use to promote constructive conflict. They gave a strategy to approach conflict called the "AEIOU" approach. A for assuming the person means well. E for expressing your thoughts and feelings. I for identifying what you would like to have happen. O for the outcome you expect. and U for understanding on a mutual basis. Some examples of using this approach was explored. I really appreciated this course and took away some great strategies for dealing with conflict in a management role.

Succession Planning in Nursing - Who Are Tomorrow’s Leaders? (1 Hour)

The authors of this course introduced the topic of succession by talking about the nursing shortage. There will be a shortage of 340,000 registered nurses in acute care hospitals by the year 2020. One of the biggest reasons for this shortage is the baby boomer generation moving to retirement. These baby boomer nurses are the current nurse leaders today. Because of this looming problem, hospitals need to have succession planning in order to keep their business going. Succession planning involves grooming and getting ready nurses to lead in the future. Succession candidates should have the skills including experiential training, development through training and education, and coaching and mentoring. In order to groom future leaders, organizations need to have a mentoring program in place. Most nurse managers stated that their interest in management was a result of being mentored. The course authors state that most leaders are made not born, so leadership training programs need to be implemented in hospitals and healthcare facilities. As I look to grow in my career, I will take advantage of every leadership, and mentoring opportunity offered to me. It is through these programs that I will be able to learn more about what it means to lead and advance my career.

The Art of Suggestion (1 Hour)

The art of suggestion was a course I took that was basically what the title states. The course taught about how to cultivate the art of suggestion and use it in nursing practice and leadership. This course was very interesting and showed how leaders can use suggestion to help motivate followers. It was stated that once you capture someone's attention you have an opportunity to embed many suggestions. I really liked this quote from the lesson, "Suggestion as opposed to persuasion, threat, or force is a powerful way to influence change. Persuasion, threat, and force often set up mental barriers that prevent an idea from taking root in the mind. Suggestion implants an idea into the mind in such a way that it bypasses critical thinking and enters freely." Now, I know that sounds a little "Inception" like, but according to this course it works. The course went on to describe different nursing scenarios and laws associated with the art of suggestion. This course taught me that in order to be a good leader, I need to cultivate the art of suggestion.

The Power of Change (1 Hour)

"The nursing profession has often been viewed as the target of change rather than a force that proposes, leads and implements change." This course talked about how nurses can and should propose, lead and implement change. There are many different ways leaders can bring about change. The first strategy is the power-coercive strategy. This strategy involves implementing the change and giving people the choice to either follow the change or leave. The next strategy is a rational-empirical strategy. This strategy is based on the belief that people will use rational thinking and will act on behalf of the change if provided enough information. With any type of change, the authors suggest there will be anxiety and stress in some of those involved. Change is necessary for growth, so nurses must overcome barriers set in their way. The class talked about different scenarios where nurses were able to bring about great change in their workplace. Leaders are needed to bring about change in healthcare. Nurses can be those leaders.

The Rap on Rapport (1 Hour)

Rapport is a very important part of nursing and an even more important part in nursing leadership. In nursing, we are leaders. Leaders with our patients and with each other. Rapport is essential in building relationships with our patients and colleagues. This course defined rapport as "the ability to relate to ourselves and others in ways that create a climate of respect, trust and cooperation." With this definition we can see that rapport is not just for the nurse and patient, but for the nurse leader and those who are led. This course really emphasized that rapport does not just exist but is a process. Body language is a major part of building rapport. Leaders must be aware of their posture, gestures, facial expressions, etc...Tone of voice and the words used are also a big part of building rapport. It is important for nurses to develop rapport with each other in order to successfully lead and create a healthy working environment.

Unlock Your Creativity (1 Hour)

The title "Unlock Your Creativity" caught my eye when looking through the list of Continuing Education classes under leadership and management. I was curious how creativity could be related back to leadership. The course explored the concept of creativity and how important it is to be creative as nurse leader. The authors of the course said nurses have to think outside the box toward the ultimate goal in order to achieve goals in leadership and healthcare. I really loved this quote from the course, "Nurses as individuals and nursing as a profession must be willing to shift easily and to adapt creatively to the tsunami of ongoing change." The profession of nursing is constantly changing. The day to day work for a nurse is always changing. Nurses have to be able to adapt to the change and create solutions for problems that arise. In order to be creative, the course listed these rules:
- Claim creativity as your birthright.
- Value your own uniqueness.
- Avoid mental ruts.
- Recognize freedom and play as the DNA of creativity.
- Learn to minimize the fear that impedes creativity.
- Go with the flow.
- Exercise your creativity muscles regularly.
- Join other people to power creativity.
- Disregard all rules that fail to stimulate new insight and creativity.
The course then listed these questions to consider and realize creativity is needed in nursing:
- How can we attract and retain highly competent, enthusiastic nurses?
- How can we create conditions of unity within the profession?
- How can we promote diversity of thinking within nursing?
- How can we most effectively promote ourselves as the healthcare champions that we are?
- How can we blend technology and human compassion to the advantage of our patients and ourselves?
- How can we promote interdisciplinary collegiality and collaboration?
- How can we integrate spontaneity and creativity into nursing practice?
These questions really helped me to understand the link between creativity and nursing leadership. Nurse leaders need to be creative to be good leaders.

Course was taken on http://ce.nurse.com

Transformational Leadership — A Growing Promise for Nursing (1 Hour)

Transformational leadership was explored in this course. Transformation leadership is based James MacGregor Burn's theory of leadership. Burns wanted to study the leadership of people like Gandhi, Franklin D. Roosevelt, and John F. Kennedy. Burns defined transformational leadership as, "two or more persons engage with others in such a way that the leader and followers raise one another to high levels of motivation and morality." This was different then the traditional sense of leadership in that it involved a dependency on the followers. Transformational leadership is the belief that it takes both the leader and the follower(s) to achieve the goal. There is a relationship between Burn's theory and Maslow's Hierarchy of needs. Most hospitals and leaders reward their staff with the first three needs met by compensation. Burns suggested that leaders strive to meet the top needs of self-esteem and self-acualization. To do this leaders need to have these elements:
Idealized influence
Inspirational motivation
Intellectual stimulation
Individual consideration
Nurse leaders that are transformational leaders will have staff that are more committed to their organization and a happpier, healthier work environment. This was an interesting course to me. I had never heard of transformational leadership. I really like the idea of interdependence to achieve the goal. I think it is a great idea to put into practice in all healthcare facilities.

Transitioning From Staff to Management: The New Leader’s Toolkit (1 Hour)

This course was different then my other courses in that it involved video! It was fun to watch and learn from this video. The video discussed management vs. leadership and how to become an effective leader. At the beginning of the video a scenario was discussed where a staff nurse was promoted to management. The nurse all of a sudden had a smaller "peer" group at work, was in charge of and made decisions that not everyone liked, became the bridge between staff and management, and was responsible for the unit's financial health. The authors of this class stated that nurse leaders need to have the following competencies:
Visibility
Flexibility,
Authority
Assistance
Feedback
Respectability
Trustworthiness
The video then went on to talk about the difference between managers and leaders. Management is a "science in which a series of steps can be followed to implement the rule." Leadership is the process of motivating people to accomplish a goal. It is "the most observed and least understood phenomena" Nurse leaders have to have good time management skills, financially and technologically savvy, professional role models, advanced skills and education in management and business. The video was much more in depth then this blog post, but it gave some great advice for new leaders. I learned a lot about what a new leader needs to have. I have a mental list now of skills I want to develop in order to become a better leader.

Florence Nightingale (1 Hour)

We have talked a lot about Florence Nightingale in nursing school. I decided to take the continuing education course about Florence Nightingale to learn more about Florence and how she was a leader in nursing. Florence focused on promoting health. She wrote many health guides and reports to lead people in their quest for health. Florence started a nursing school to teach and lead future nurses. The nurses she taught were able to provide nursing care all over the world. This course discussed eight Millenium Development Goals that were created by the United Nations. Each of these goals relate back to Nightingale. She was an early leader in nursing and the effects of her leadership extend to today. The eight goals are to eradicate poverty, achieve universal primary education, promote gender equality, reduce child mortality, improve maternal health, combat infectious disease, ensure environment sustainability, and develop a global partnership for development. The authors of this course went through each goal individually and discussed how Nightingale had similar goals and actions related to each one. The authors talked about how Nightingale was a leader in nursing and how we all can be leaders and promote change. The course inspired and motivated me to want to become a nurse leader and bring about change in the world.

Don’t Worry‚ Be Happy! Harmonize Diversity Through Personality Sensitivity (1 Hour)

Nurse leaders have always and will always need to deal with personality conflicts. When a group of people work together, there will almost always inevitably be a personality clash. In order to be good leaders, nurses need to understand different personality types and how to create a personality-sensitive work place. There are many different personality tools out there. This course discussed the Myers-Briggs Type Indicator which is based on behavior. It also discussed the Disc which is based on four types of behavior. The last tool they discussed in detail was Hartman's Color Code. The color code is divided up into four colors; Red, blue, white, and yellow. Reds want to have power, blues want intimacy, whites want peace, and yellows want to have fun. Hartman believes that everyone has one core color. Each person may have a mix of colors, but will always have one core color and motive. Nurses work with many different people on a daily basis. In order for nurses to be effective leaders they need to strive to understand each person's personality and identify ways to connect with a variety of personalities.

Do You Reflect a Positive Image of Nursing? (1 Hour)

This course was designed to educate nurses on the importance of reflecting a positive image of nursing. As nurses, we are all leaders. Part of the responsibility of nursing leaders is to reflect a positive image of our career. This course explored different ways nurses can do just that. Some tips they had were to identify ourselves as nurses, get involved in politics, serve on community boards, and utilize nursing skills by serving in the community. The course also had specific tips for nurse leaders to reflect a positive image of nursing. They said to promote nurses' self image. To do this use recognition and encouragement. They also encouraged nurse leaders to make sure nurses were represented on key committees, provide continuing education and professional development opportunities, and promote ways for the community to interact with nurses. The career of nursing is a respected one, but still has some stereotypes and negative images to overcome. As a nurse and a leader, I will strive to reflect a positive image of nursing throughout my career and personal life.

Novice to Expert Through the Stages to Success in Nursing (1 Hour)

In Nursing Theory we learned about Patricia Benner's 5 stages in nursing. In nursing leadership, it is important to understand these stages in order to effectively lead and manage. The five stages of nursing are
1. Novice
2. Advanced Beginner
3. Competent
4. Proficient
5. Expert
The novice is the student nurse. They need almost a micro-manager in order to function properly. They need very specific directions. The advanced beginner is the new graduate. This level lacks experience to back up their clinical knowledge. I would consider myself an advanced beginner. The competent nurse has worked in the same area of nursing for two to three years. The proficient nurse recognizes "salient points" of nursing and make anticipatory plans of action. The expert nurse has a solid foundation and is expert in critical thinking. The expert nurse is a valuable resource to all nurses. This course discussed the importance for management to identify what stage the nurse is in, in order to effectively lead and manage.

Networking for Career Advancement (1 Hour)

Networking is crucial for career advancement. This course offered tips and strategies to successfully network for career advancement. One of the biggest things I learned from this course was the importance of staying connected. As nurses and students we tend to have very busy lives. We need to stay connected with many different groups despite our busy schedules. We need to find time to branch out, meet new people, and reinforce relationships that we already have. This course talked about finding mentors and references. Many people we already know can become mentors and coaches in nursing. The course referenced Dear Donna and said "“Networking has long been touted by career experts and others in the know as the most effective way to stay cutting-edge with your information and knowledge, remain visible and connected to your profession, promote a business or service, and keep your social skills sharp. Plus, networking can make you better at your current job.” I hope to utilize these strategies learned to continue to network and network more effectively in the future.

Keeping Colleagues Nurse Retention is Everyone's Responsibility (1 Hour)

Every nurse is a leader and every nurse has responsibility. This course explored nurse retention. There are many different reasons that nurses leave jobs. There were five reasons that this class focused on.
Intense workload
Lack of scheduling flexibility
Low compensation
Inadequate access to continuing education
Minimal opportunity for career growth
Each of these areas have caused poor nurse retention. The authors of this course made a great point that nurses are great at caring for the patient, but need to be better at caring for colleagues. Poor nursing retention leads to an unhealthy working environment and poor patient outcomes. Nurses can really make a difference in nurse retention. By knowing our colleagues and treating them how they would like to be treated, we can create a more healthy working environment. Nurse managers can address issues such as workload, scheduling, compensation, etc... In my career, if I get the opportunity to be a nurse manager, I will keep these top 5 reasons present in my mind. I will try to address issues and initiate change to increase nurse retention on my unit.

Interviewing for Career Avancement (1 Hour)

Interviewing is a topic that is very critical in today's economy. The title of the course caught my eye because it talked about career advancement. In order to be considered for jobs in this job market, you have to really succeed in the interview portion. This course gave me a lot of tips to use in my next nursing interview. It talked about how to present yourself and how to act in an interview. The course also discussed how to advance in your career through interviewing. I know that my idea of a "perfect" job will continually change as I get more experience. I hope to always be advancing and growing. Interviewing is not just going to be part of this phase in my life, but will probably be something I will do throughout my career. This course is related to nursing leadership and management in many ways. The most obvious way is that nurses have to apply for and interview for most career advancements (including management). I hope to refine my interviewing skills and utilize what I have learned in this course in my future interviews.

Get Down to Business with a Business Plan (1 Hour)

This class focused on the business side of leadership in nursing. It is so important for nurse leaders to understand that healthcare really is a business. In order to effectively change things, nurses need to understand the business of healthcare. This course educated me on what a business plan is and how to create one. This will be important for me to understand in my career. If I see a service that is needed in my workplace, I will be able to create a proposal to present to the administration. As a nurse leader I will want to bring about change many times over the course of my career. In order to do this, I will need to have the skills needed to create proposals, business plans and presentations. These are all forerunners to change.

Evidence-Based Effective Nursing Leadership (1 Hour)

This course was interesting because I am so used to hearing the term "evidence-based" when discussing practice and skills in nursing. This course explored evidence-based nursing leadership. Leadership is such a huge part of nursing, so it should not have surprised me that there has been a lot of research and evidence found on the topic. This course discussed being an "authentic leader". An authentic leader is true to their values, while showing compassion and being trustworthy and genuine. This course encouraged nurses to find leadership development opportunities. They also encouraged nurses to create a healthy work environment. Studies have shown that healthy work environments are linked to better patient outcomes. Other pointers in the class were to keep staff engaged in work and help new graduates transition to the work place. As a new graduate, I hope that someone will take this to heart and help me transition to the work place. Overall, this course motivated me to strive to become an authentic leader.

Delegating to Unlicensed Assistive Personnel (1 Hour)

Another continuing education class that I have taken is titled Delegating to Unlicensed Assistive Personnel. This class was very valuable to me. I have already in my career been exposed to managing and delegating to unlicensed assistive personnel, mostly CNAs. This will continue to be apart of my career. This course explored how to effectively and safely delegate and manage unlicensed assistive personnel. It was a good reminder and refresher of what to do and what not to do. I was reminded that I am held responsible for whatever I delegate. I need to use effective management and leadership skills when making delegating decisions.

Coaching Makes Nurse's Careers Grow (1 Hour)

For a good part of my 46 hours of clinical I will be doing continuing education through Gannett Education at ce.nurse.com. This website offers a wide variety of classes with varying subjects. My continuing education that I will do, will be in the areas of management and leadership. My first class that I have successfully completed is called Coaching Makes Nurses' Careers Grow. This class discussed the meaning of coaching. Coaching is different then precepting in that precepting is about 75% teaching skills and only 25% of a psychosocial component. Coaching is different then mentoring, in that mentoring is an "intense psychosocial relationship". Coaching, according to Gannett Education is aimed to improve work performance and professional development for all nurses. This course explored different steps involved in coaching and different scenarios where coaching would come into play. I hope that in my nursing career I will have the opportunity to be coached and to coach others. Coaching is essential for the career of nursing to continue to grow.