Leadership Innovation, Crisis Management, Ethics and More: Insights from a Nurse Leader

Innovative approach to solve an issue

Leadership innovation

Tell me about a time when you took an innovative approach to solve an issue.

How do you experiment with new ideas – the best thing you can do is get the team by in. try to have the team come up with the ideas. The team is usually who have the concern. If they have a concern they should have an idea of a solution. Then once a solution is presented then we work on a proposal together. For example people use foleys because of retention. people with foleys get taken out at 6am following day and they switch to straight catheters. We have reduced foleys days from 110-20 days. We have had zero cauty UTIs on the unit.

It was hard to get the physicians on board to switch the patients from having foleys put in to having patients use straight catheters instead. They wanted research to be presented first.

Emotional Competence-

Tell me about a time you face an ethical dilemma at work. How did you deal with it and what was the result.

Ethical dilemma we have here on the floor. It’s the competency of patients making their own decisions, patients live alone they are here after a stroke and they want to go home. Patients are allowed to make poor decisions. We give the patients recommendations and they are well assessed for competency. It is ethically difficult to tell the patient that this is a poor decision but were sending you home anyway, when the patients are competent. We tried to set patients for success. We figure out what resources they need at home and what is necessary to be successful. We figure out what setting they need to be placed to help them be successful. We want them to have a quality of life but also want them to be safe.

How would you resolve a dispute between two colleagues-

If you have a conflict with the employee, I would ask the team member if they had tried talking to them about it first. If the answer is no, then you should take the person aside and express your concern to them. I give tips on having the conversation with the person they are having a issue with and I also tell them that I can be present as well if they feel more comfortable with having someone else there.

Emotional Competence: Facing ethical dilemmas at work

Crisis management-

Tell me about a time when your team had to work together to solve a crisis situation. What happened and what did you do. How did you handle it

-We had a patient that was going to be discharged to Guatemala. They did not speak or write English but we wanted to make sure that the family and patient knew how the patient should be taken care of. We had everything like instructions written in Spanish, we had interpreters and provided videos in Spanish for the patient that demonstrated things that the patient needed for example how to transfer the patient and how to use the equipment. This particular patient had a stroke and would drag his feet when walking, so we provided him with where to stand when walking with him or transferring him to the bathroom. We provided medication and therapy instructions. We also had follow ups with the patient where we would facetime and have the patient send pictures as well. This was successful because the patient was able to go home and be able to still be taken care of.

Spirituality-

Who are your most influential people what role did they play

My husband. Husband and I met when we were 15 and I got married at 18. He helped me with the path in my life in becoming a nurse. There was always this goal setting and he was always supportive. I would say my children as well though because I wouldn’t be who I am today without them.

Who is your spiritual hero role model – the clergy at the hospital. The clergy can provide security and support in terms of being spirituality active and maintaining faith.

Change and conflict-

Explain a situation when you had a conflict at work or boss and how you handled it

I Present information to them as SBAR Situational Background, Assessment and Recommendation. Its important to be part of a solution and not just pick out a problem. You won’t always agree on things. Its easy to point out what is not working well, its harder to implement nothing to make that change and consistently be part of the change and follow up with it. There will be times where you will get shut down, but keep going and rework it . Coming up with evidence and outcomes that supports the data.

Leading teams-

What techniques have you used to motivate your team? What are qualities of a successful team leader?

Resolving disputes between colleagues

Structure and clear expectations. I like to lead by example.  “If I ask them to do something, know that I am doing it also.” I will help out if someone needs help in the unit. Recognition is important. I like to celebrate the teams birthdays, work anniversaries, employee of the month. I bring bday gifts to them, something that they will appreciate. I have asked them things what they would like in the unit and they asked for a massage chair and expresso machine. I have gotten these things for them to use. I know these things mean a lot to them so I did that. Support is also important. I care about my team and their individual needs. I like to support my team and provide guidance if needed. I know work/life balance can be difficult sometimes.

What are your preferred methods of communication and why

Face to face is preferred. That gives the opportunity to have eye contact. People can misinterpret things over text. We can facetime or zoom to connect.

Coaching and mentoring-

What do you enjoy most about training

I enjoy training rehab. Rehab and communication is important to me. I like building the relationship with my team. For rehab, a lot of the things we do with the patients here, are things we take for granted every day. You never think about these simple things until you cannot do them yourself, for example simply getting up from bed. There’s patients here that cannot even do that or go to the bathroom by themselves. It’s important to educate the patient and families on how to properly do these things or how to help someone do these things. For example how to put on socks. Or what kind of skin preventative things do you need to prevent skin breakdown.

What do you consider your biggest strength?

Communication or resolving challenging situations.

What motivates you to succeed as a mentor/leader

My staff and patients. But most importantly, my staff. My staff is the reason why I am here everyday.

Financial responsibility-

What is the most challenging part of budgeting for you-

Staffing. When your census is on the border where you can have an extra nurse or not. For example, 17 (patients) census means only 3 nurses and 2 techs budget wise. It would be nice to have an extra nurse or tech sometimes but budget wise, we would be really tight and overbudgeting. So its important when charge nurses are staffing to take that into account. Challenge is making sure you are supporting the needs on the unit but also understanding there is some dollars behind the decision you are making. It’s important to be strategic in how you manage the staffing.

Can you think of an example of when you have been involved in your organizations financial decisions? What was your role?

Annual budget. Supplies is something we have recently discussed. During covid we had PPE supplies budget was off the charts. It was hard to predict what we need because you only can really predict from how much you used the year before. Par levels for supplies and not goo over those levels. Sometimes knowing the prices of the supplies help with managing the supplies. Its important to have that awareness. Everyone should be using the supplies efficiently

What kind of data did you use in making the decision?

Monthly budget. I work with nurses teach and the warehouse for supplies. It can be frustrating to always order things frequently. Sometimes warehouse over pars the unit and overstocks us.

Jennifer, the patient care director went to nursing school in Connecticut. Within six months of being a nurse she became the (DON) Director of Nursing. I learned a lot about myself and the business part. I understood if you had expectations and set standards and lead by example, you will have positive patient outcomes. I enjoyed working with my staff and seeing their professional growth. My priority is my staff.  With the right staff you will have good outcomes and you will provide the best care to the patients. Staff is definitely important and patients come after.