Online RN to MSN
Clinical Systems Leadership

Future of Leadership in Health Care. Are you ready?

To prepare for your role as a successful clinical systems leader, please join us for a special year-end webinar presented by our Program Director and faculty members of our online RN-MSN program.
In this webinar, our speakers will provide an overview of leadership opportunities in health care, discuss the competencies required for successful leaders and how to attain life balance as leaders.


[Start of recorded material] [00:00:00]

Kira:                  Hi everyone and welcome to our special year end webinar. Today we’ll get to hear from the University of Arizona, the program director and faculty members of our online Master of Science in Nursing Clinical Systems Leadership MSN program. My name is Kira and I will be your moderator for today. I know everyone’s excited to hear from our feature speakers so let’s go over the logistics of today’s events.

Please note our participants’ conference lines are currently placed on mute or listen only mode to ensure that we have a smoother line of communication. As you know this presentation is being recorded. To communicate with me please type your messages to me via the chat box, it’s the roundish bubble icon that lights up when activated. And there will be a great opportunity to have your questions answered by our speakers in our Q&A segment. So, please don’t hesitate to send me your questions via the chat box even while the presentation is in progress as I will be collecting them and forwarding them to our speakers who will be going through them during our Q&A.

If we’re not able to get through all of your questions within the hour, as you know the webinar is for one hour, we will be sure to get in touch with you after our event. Also our enrollment advisors will be happy to follow up with you at a later time on any program related questions. Now let’s introduce you to our panellists. First we have Professor Cheryl Lacasse. She is the clinical professor at The University of Arizona College of Nursing core faculty and director for the online RN MSN program. She has clinical expertise as an advanced practice nurse in geriatric and oncology care management. She also has a variety of leadership experiences in clinical practice, education and professional organizations.

Also joining us today is Mary Walters who is a clinical instructor at The College of Nursing and is a core faculty member in the online RN MSN program. Her clinical expertise is in the area of geriatrics and nursing administration. She has held a variety of senior nursing leadership positions and most recently was a chief nursing officer for the VA Medical Centre in Southern Arizona. Thank you for being here Cheryl and Mary. Cheryl let’s get started with you. Please take the stage.

Cheryl L:           Okay, welcome to all of you. I just want to do a quick sound check Kira, am I coming through okay?

Kira:                  Oh yes loud and clear.

Cheryl L:           Excellent. So today we’re going to talk about several things having to do with leadership. We’re going to talk a little bit about the opportunities that may be available to you in today’s healthcare climate. The competencies that today’s healthcare climate and circumstances demand out of successful leaders, what those leaders look like as far as their characteristics that you might have or night want to develop. And then a little bit about life balance as a leader. So, Mary and I are going to dialogue back and forth on several of these topics.

So, I’ll start with just sort of painting the landscape if you will and looking at where are we in healthcare and how has healthcare reform really shaped the leaders that we are today and we need to be for the future. One of the things that we look at and have been looking at for a long, long time is patient centred care. That has become more of a focal point in recent years in healthcare, that the patient is truly the centre of the care and is involved in every aspect.

We are also looking at community centred care. And community centred care is looking at that caring for groups. Some of you might see this as population health or population management but really looking at populations wherever they are, whether they be in acute care of clinical areas or in rural areas or in schools, there are so many different sites that you can look at a population.

We also in the last few years have really focused in on interprofessional practice; the disciplines are there by name as far as nursing, medicine, pharmacy, OT, PT. We work very tightly with all of our patient care in teams. And many of you have been working in teams for perhaps many years in your professional practice. But that’s something that is very much in the forefront and the patient is part of that team.

Global and national health awareness is something that we are more and more tuned into because of global economies and the way that our country is situated in how it treat’s people’s diversity. People who come to the United States to visit, people who come for longer periods of time and that sensitivity towards what’s going on with health and wellness in across the globe is very, very important. And we have a lot to learn from our sister countries and how they operate and perhaps they have models of efficiency that we can certainly learn how to deliver healthcare better as well as they can learn from us.

We also our tuned into our local and regional healthcare needs and that’s more what does a community do and what is special about a community that may spur on healthcare needs and how can leader’s position themselves to be able to lead a group to meet those needs.

The other thing that is coming up that nursing leaders are really taking a huge leap in is that of being integral in policy making and advocacy. Not only at the local level, at the institutional level certainly but at the national level. And we’ll be talking a little bit more about how people can do that.

So, I’m going to ask Mary then to talk a little bit about leading change in healthcare and the future of nursing.

Mary W :           I always like to say it’s a great time to be a nurse. And one of the I think really exciting things that has happened recently within nursing and in our country is the Institute of Medicine report on the future of nursing. And there were kind of four key things that came out of that report. And as a result of those recommendations I think there really has been – a change driver was in the profession.

So, the first key point out of The Institute of Medicine report on the future of nursing is nurses should practice to the full extent to the full extent of their education and training. And that really focuses in on what were you prepared to do? What has your license prepare you to do and how do we ensure that nurses are able to practice that way within healthcare across the country.

Kind of an example of that that’s going on nationally right now is the VA, Veteran’s Affair’s healthcare system has a movement afoot that any nurse who is prepared as an advance practice nurse should be able to function fully as an advanced practice nurse. And I’m sure most of you are aware that there’s a lot of variation across states as to what an advance practice nurse is legally allowed to do. So, that has been a real lightening rod for discussion.

The next thing is that nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. And I just commend each of you for being on the line today ’cause I’m hoping that that kind of means that you are considering advancing your education. And a state that really has done a nice job with this is Oregon. And in Oregon when a nurse pursues an associate degree in nursing there is a seamless progression toward a bachelor’s degree. And also what we’re really, really seeing as job openings occur for nurses across the country is healthcare organizations really want nurses with advanced degrees. They’re really realizing the advantage that an advance degree brings for a nurse within their organization.

Next key point is nurses should be full partners with physicians and other health professionals in redesigning healthcare in the United States. And what this really means is nurses have to be at the table. They have to be at the decision making table as we redesign healthcare for the United States. Nurses are the ones that are the closest to the patient and have the most information to ensure of a good design or a good redesign.

And lastly as effective work for planning and policy making require better data collection and improved information structure. And this really kind of leads us to the electronic health record. And we’ve seen major advances with the electronic health record. But as we dig into the electronic health record it’s really going to inform us about what is going on with patients and how might we apply the role of the nurse differently as we learn from the process of care that’s reflected in an electronic health record.

Moving on to leading in boardrooms which just goes along with nurses making decisions about healthcare, in November of 2014 there was a group pulled together called Nurses On Boards Coalition. And 20 national nursing organizations came together lead by The American Nursing Association to establish a goal that we would want 10,000 on board by the year 2020. We are not specific about the type of board, ideally they would be Fortune 500 Companies but we really want the nursing voice to serve on boards and bring that information to a much larger group with a goal of improving health of all Americans.

Nurses truly impact the Triple Aim and when we talk about the Triple Aim that’s improving population health and the patient experience of care while reducing per capita costs. And this was developed by the institute on healthcare improvement in 2008 and I think we hear reference to the Triple Aim very, very frequently as we plan care in organizations and when we look at the affordable care act, many of the provisions of the affordable care act, had as their basis the Triple Aim.

Nurses really are the authority on patient and experience, quality and safety and they’re the largest part of the hospital workforce. The voice is so important. It is vital for our future.

When we look at boards in general and we look across the United States, women are really, women/nurses are really underrepresented on boards. Only about 15% of Fortune 500 company board members are women. And Warren Buffet talks about how much better things would be if boards had 50% women. So, I’m going for women/nurses even though I’m fully aware that not all nurses are women. But it would make a difference with women on boards.

So, you ask how do I get on a board? I think the easiest way to get on a board is volunteer and we’re really looking at a variety of situations where a nurse could serve on a board. Things like alumni associations, nursing organizations and if someone ever asks you to serve on a board, please say yes, you have so much to bring. And if you see an organization where you think you have something to contribute speak up, ask, have they considered board membership and you might be interested in serving on that board. Because wherever you sit in a public place in front of a group of people you really are on stage as a nurse and our knowledge and your skill comes through that way. So, I advise people never to turn down an opportunity to speak in front of an audience. As scary as that sounds you never know who is out there, who is listening and the impact that you will have.

Another way that you can lead is to lead in clinical care and many nurses are right there with their patients in partnership in care wherever their care setting is. One of the things that we see quite often come up is that need for an individual that has many, many complex healthcare needs to have a co-ordinator or a case manager or a transition manager. And we’re seeing more and more organized approaches across our healthcare systems looking at care co-ordination.

And really the bottom line in care co-ordination is to be sure that those individuals with complex needs – the exact care they need, when they need it in the hopes to decrease their care costs overall. So, for example if you have someone who is 86 years old who comes into the emergency room with pneumonia, they’re most probably going to have several co-morbidities that may impact their care. And even though they’re in acute care setting for a short period of time to manage their pneumonia when you go to discharge that patient they have many complex needs, things like can they care for themselves? If so do they have other supports that might help them manage if they can’t fully care for themselves? Maybe they can manage their activities of daily living but perhaps not their instrumental activities of daily living, things like shopping, cooking, cleaning, managing their finances, those sorts of things.

So, that’s one brief example of how a care co-ordinator that has a global view of a particular case or a group of individuals can make a big difference in keeping people out of the more expensive care but still make sure that they get the exact care and support that they need to be able to recover from whatever illness that is most acute at the time and be able to live their lives with a sense of quality of life. So, you will see a lot more care co-ordination happening and some of you may be working in acute care areas where you have worked with case managers perhaps.

The new manager now is the transitions manager and that is a person who helps in the transitions along in the healthcare continuum so if a person needs to go from a acute care to home, what are the supports that need to be set up? Or if they’re going to acute care to rehab, how did that happen? So, some of what we’ve seen in the past is being reformed and looked at a little bit differently to meet the healthcare needs of today’s patients.

Mary L:             And something there in terms of care co-ordination. Probably the greatest area of job growth from our end right now in the United States is in the area of care co-ordination. The insurance companies are kind of leading the pack because they realize how important it is that if we’re managing healthcare well that it’s probably a less costly endeavour. So, there’s a huge future I think job wise for care co-ordination.

And the other comment I received actually from a student in the last two weeks or so when they were writing on care co-ordination because we do a lot discussion on these various topics was in the program. And the student put forth she said well why can’t the family be a care co-ordinator? And I thought that was such an interesting concept that before we had this term care co-ordinator it was the family who was probably doing all of the care co-ordination. And to think of a way that the family member or the patient, him or herself, would serve as a co-care co-ordinator. It isn’t totally somebody else’s responsibility. It gave me pause for thought with that comment. I learn so much from students.

Cheryl L:           Thank you Mary and I think the other thing that comes to mind, I do know family members who have partnered with their care co-ordinator counterparts who are healthcare professionals. Everybody has some critical knowledge to bring to the table to make sure that the care of that particular person who needs care is met. So it really completes the circle, the 360 circle around that patient. And, you know, that means that the patient is fully supported with the professional support they need and the one point person in the family who has the critical knowledge. And for some families that means that they have zip drive that they carry around. For other families it may be a three ring binder with all of the critical documents in it. So, we’re going to see a lot more of the partnering going on as well as care co-ordination evolves over time.

So, another part of this is looking at as a leader or looking at how you could fit in as a leader is what is your role in transforming care and how do you start and where are you in all of this. And one place that Mary has already alluded to is saying yes, saying yes when people ask you and networking with professionals. Meet a new person everyday in your institution that does something different than what you do. Make those connections, find out, be a willing participant in learning about people. And not only what they do but how they do it and how you might be able to work together in partnership to make care better or to do something innovative in your institution.

The other thing is to network within your community. There are healthcare professions within your community that you can network with. There are also other people who are non healthcare professionals who might be equally as important, people who specialize in the legal field in doing living wills or lots of different estate planning. There’s a lot of value in learning about other professions and how they might be able to support your particular group of patients. So, it’s always good to do that kind of networking because you just never know, when you might be able to tap into that person who has that particular specialty knowledge.

The other kind of professional care networking which I think is really fun is to do that within your speciality care. So, if you’re in cardiac care go to a professional conference and find out what your colleagues are doing across the country. Because practice varies across the country and you can learn so much from your counterparts as you’re interacting and you’re bringing home lots of good ideas from professional conferences and that interactivity. And you can start a network that may benefit you for years and years to come when you do that.

The other place to network is on social media. Looking at the professional sites like LinkedIn, looking at what’s going on on Twitter is fascinating to me how there’s discussions, and these are professionals discussions happening on Twitter. And it’s just been a very finite amount of characters but you can find out a lot of information in a very short period of time. Just by that networking and joining groups and social media, joining Facebook groups that are in your area of interest.

So, networking has really never been more important and we have so many different modalities to do that.

But if you choose the electronic way please remember that face to face is your best way to network for longevity of a relationship and for strength of a relationship. So you don’t want to ever overlook that piece.

When we look at knowledge application and looking how do you attain that knowledge, think about the ways that you gain knowledge in your daily professional life. You may be attending rounds, perhaps patient care rounds, grand rounds, seminars that are held in your institution. That’s a great way to not only network but to find out some informal information and then that formal education through academic education or through professional continuing education.

A lot of times people can pick up free continuing ed in their area of expertise or they can pay for a subscription to continuing ed that may be helpful in helping them move their career along. And as Mary allude to again, active participation, looking for those opportunities. Maybe you have an opportunity to go with the International Red Cross to a relief area for a week. And I know people who have done that and they say that is life changing. It’s an opportunity to network but it’s also an opportunity to gain some critical leadership skills and looking at sensitivity in a different area, how to work as a team, how to be a good team member, how to be a good team leader and also how to be sensitive to diversity. Because you’re going in, very often you’re going in to an area that you know little or nothing about the culture there.

There’s also different opportunities as the local regional national levels that you can participate in. When somebody asks you would you like to do this? Say yes because it’s a great way to get experience and it can be very, very scary but it is so rewarding. Do you have anything to add to this discussion Mary at all?

Mary W:            The only thing I would emphasize kind of going back to the social media that LinkedIn and Twitter are part of the course that we teach also. So, if it isn’t experience that you have it is certainly experience that you will develop and be able to utilize it professionally.

Cheryl L:           So, Mary’s going to talk a little bit about some of our national competencies and leadership. And then I’ll follow that up with a discussion of some of the more boots on the ground competencies that can lead to leadership. So, I’ll let Mary start that discussion.

Mary W:            So, as you look at your future as a nursing leader, a professional organization that I really recommend that you join or even if you don’t join definitely go to their website is The American Organization of Nurse Executives. And they’ve really done a beautiful job of defining and delineating the leadership competency domains and the kinds of – what your skill set should look like as an excellent nursing leader.

So, the way the domains have been broken down is first it’s communication and relationship building/management. And I think there’s sort of two parts to that. Communication is key to everything. How you present yourself orally and in writing will have everything to do with not only your success as a leader but your success as a nurse of course. And I think in terms of relationship building and management, as we go through out work lives as leaders we don’t always agree with everyone. And so, it’s very important to have the skills how do you negotiate when you’re working on a team or working with people that you don’t necessarily agree with. And these are definitely skills that can be learned and are included as part of our program.

The next leadership competency domain is the knowledge of the healthcare environment. As a leader you have to know what’s going on and the real strength that you have as a nurse is you can tell the real patient’s stories. You can be at the table and you can give a real life example that so often other leaders in healthcare do not, they do not have that benefit and they do not necessarily have that firsthand knowledge. And I think nurses can truly sway decisions based on the stories they can tell and the experience that they have. So, the knowledge of the healthcare environment is also a key competency.

Next is leadership and, you know, I think it’s like well how do you do it? It’s both an art and a science. Leaders lead people where they don’t want to go but they really need to be going in that direction. And it takes a special skill set to accept that challenge and provide that leadership. I would also say that nurses lead all day every day. The work of nursing is leading the patient to health, participating on the team to lead and navigate for the best care for the patients. So, nurses are born leaders and regardless of where you are, you’re probably doing some of it.

Professionalism is so key because when you are functioning as nurse or functioning as a nursing leader you’re saying to the world this is what a professional nurse looks like, this is how a professional nurse things, these are the kinds of values that are important to us as nursing. So, you always have to think about it. I was preparing for this talk today, I read this one sentence from [Tim Porter O'Grady] and I don’t know if you’ve read much by him but I’m a fan and I think his thoughts are very thought provoking. But he was talking about nursing leaders and he said every time a nursing leader speaks up or advocates, they’re reading advocating for the three million nurses behind them. And that is a pretty strong statement and I think there’s a lot of truth to it particularly when you’re speaking as a nurse to non nurses. So, you have tremendous power.

And the last is business skills. You’ve got to know the financial side of healthcare to be a competent leader, things cost money, you have to understand how that works. Again, so you can advocate what’s best for the patient but also being a very good steward of the finances that you have some responsibility for.

Cheryl L:           The next leadership competency domains look at some different pieces and these are domains that have come out of the oncology nursing society has put these forward and it really looks at leadership domains and the individual, the group and then the governance level. So, a little bit different than what Mary talked about but there is certainly some overlap.

The first domain that they talk about is the domain of personal mastery. And that’s really have some true understanding of yourself and being able to assess yourself as a leader for personal growth and some of the characteristics that go along with that particular competency are the art of introspection, being able to really look at yourself in a very honest way also being able to embrace the notion of self care which tends to be not the easiest thing for nurses to do. That sense of authenticity, being authentic, being honest with yourself, mastering the lifelong learning which I believe many nurses do very well and then being very adaptable at where you need to go and many nurses are extremely flexible and certainly in today’s healthcare arena.

The next domain that they have put forth is that of vision and that’s really being a strategic thinker, being a clear communicator of a strategic direction or of outcome. And then also being inspirational and those are hallmarks of good leaders as well.

The knowledge domain incorporates lots of different perspectives of knowledge but really looking at that spirative enquiry, asking the way questions, looking at how do you translate knowledge? How do you utilize knowledge? What is evidence base care look like in your setting? How does it look system wide? Can we do a better job? Are we using the very best practice possible for our outcome? And how are we evaluating the outcomes that may lead to generating best practice, so, that innovative nature of not only using knowledge but moving it forward in an innovative way.

The next competency that the Oncology Nursing Society is put forth is that of interpersonal effectiveness. And that really looks at that relationship building, the networking, the ability to care, to show caring behaviours, the ability to have good life balance, effective and efficient communication and then this notion of having emotional intelligence. And part of that is not only knowing what others are feeling around you and being sensitive to that but also having self awareness. And being able to immerse and engage when you need to but also being able to step back when that is necessary as well and to have a full intuitive sense about that as a leader.

The final domain is extremely important in today’s healthcare and that is the domain of system’s thinking and that was multiple dimensions. As we look at what a leader could be and should be in healthcare today and lots of different pieces to that. Some of them include like navigating change, looking at how might you change something and then what would be the process that you would use and doing that with amazing use of interprofessional collaboration, partnership, good fiscal responsibility, using scare resources in creating in innovative ways, being able to use our technologies that are available to us in the best way possible.

And then having the sensitivity also of the diverseness within a system and being able to take all of the strengths that the system has and put them into obtaining quality outcomes. And doing that in a sense that is ethical and that also being an advocate, not only for the patients that you care for but also for all of the nurses behind you as Mary said. And I think that is such a wonderful image, that when you step up in your system, you’re stepping up for everybody in the system. And I think that’s just a wonderful way to view that dialogue that you may have with yourself. Do I say something? Do I not say something, and knowing the power in speaking pup in a professional manner.

So, now we’re going to talk a little bit about leadership skills and knowledge. And again you’ve heard about some of these. But on this slide is a very comprehensive list of the types of things that you need to know about and need to demonstrate as a strong leader. And again, I think when I look at this list one of the things that comes to mind is not only knowing and knowing a body of knowledge and knowing how to do something but also knowing your resources.

And it’s extremely important to know who you can count on, to be able to lead the team but also know that you don’t have to do everything in the team, you can lead the team but you know somebody else has handled the technology piece. And perhaps somebody else is exceptional in their communication skills with patience and families in communities, so they’re going to handle that piece. Another person may be an extraordinary educator so really being able to pull together not only the skills that you have but to know the skills of your team and to be able to move that team forward.

There’s lots of different knowledge that you might need to have. And you might need to go and seek that out, so things like population health. If you’re a graduate of the era of community health, perhaps it’s time to look at what does population health mean and figure out are you practicing it if you need to lead care, perhaps that’s a direction you need to lead in so you might need some more education in that area. Being able to do a system’s assessment and to do that comprehensively and to look at all those pieces that we talked about in leadership competencies because those are the particular issues that you’re going to have a really sharp sense about so you can lead change in areas that need change. To be able to do this you have to be able to plan well, communicate well, coach well and educate.

And I have health coaching on this slide but it’s beyond health coaching. We are health coaches very often for our patients. And sometimes for our neighbours and friends, as nurses people come to us for a wide variety of things. But also being able to coach a team and I think that’s another really important skill to have.

We also need to have a really good working knowledge of today’s reimbursement system which changes quite frequently in the detail. But just that general sense of what insurance can cover, what benefits are available to people, how they might navigate those systems. Perhaps you wanted to network with insurance navigators as allies to be able to help patient populations out. Also that notion of how do you broker information, how do you broker resources in the community for patient care, that sense of brokering is really, really important to have and then also keeping your eye on all of the quality and safety.

So, that is a really tall order for today’s leaders to not only have the skills to do but the knowledge base to do. And Mary’s going to talk a little bit more about preparing for some of these competencies, skills and knowledge that we’ve talked about.

Mary:                 I’d also mention and reinforce too that the list that Cheryl has just covered we cover all of this within our RN MSN program. These are key components and you will certainly graduate from the program with strengths and knowledge in these areas.

So, talking about population management with a patient centred care perspective. Again, this whole concept of population health and when we talk about population health kind of the quick definition I come up with in my mind is we’re looking at people with like diagnosis or similar situations. So, there are certainly things that we can do to manage a particular population, never forgetting that one size does not fit all. So, you always have to tailor your population management to the individual patient.

Next is systems and global thinking. I think we come up in nursing thinking nursing and as we work in our organizations today whenever we think about how to change things or how to make things different we always have to be thinking about the impact of the system. And a lot of our curriculum is based in system’s thinking. When I think about global thinking, I think about alright global thinking was in the system but I also think about global thinking just in terms of international healthcare. And I think there was probably no stronger lesson learned when you think about global health than our experiences this past year with Ebola. We learned so much as individual organizations and really learning new ways to approach global health.

Innovative care deliver models are really cropping up and are really happening. And there’s things like the patient centred medical home and the accountable care organization. And what is the outcome from those? Are we getting the outcomes that we were looking for? Healthcare business principles reaffirming the importance of finance reimbursement, strategic thinking and marketing. The nurse leader has got to be skilled, has got to be able to walk the walk and talk the talk when it comes to the business side of healthcare and how the business side dovetails and support of excellent patient care.

Policy and politics I think our new president of the A&A, Pam Cipriano, she has a platform for nursing and she uses that platform. Some of the things that, two things I think of recently she really has used the platform for ethical questions. And one of the nurses that she got behind was the navy nurse who was working in Guantanamo in the POW area there and really had nurses, forced nurses to think of the ethics of that and forced the powers that be to think about the ethics of that. Another thing that I think she’s pushing in terms of the political arena is there’s a bill before congress right now looking at nurse staffing. And what should there be legislation in regards to nurse staffing? And depending on where you are, particularly if you’re living in California you have some firsthand experience with that. And there’s pros and cons. But at least it’s out there and it’s getting people thinking and talking.

Transitions management truly the name of the game in cost effective healthcare in making sure that patients are coming out of acute care or out of wherever and I would say to each nurse here thinking about okay what happened to the patient before he got here and what’s going to happen when the patient gets discharged? I think for too long we’ve kind of been focused on the particular care we delivered and delivered very well. But we have to think of the before and after and manage that transition.

Read a really interesting study this week linking patient satisfaction with discharge preparation. And they said the single most important question that you can ask a patient before he or she goes home is are you ready for discharge? Do you feel ready to go home? I believe we’ve made a lot of assumptions as the time has gone on that we’ve done our job so surely the patient’s ready to go home. But have we asked the question? That was another one of those questions that really just hit me hard like oh yes we should be doing that.

Lastingly information and communication technology the use of the electronic health record which I’m so glad to see that that’s a much more generalizable thing, use of tele medicine and this concept of data driven decision making. What does the data say before you make that decision?

Interprofessional team approach, learning to work with others. Another term that I’ve seen recently is team should be a verb and not a noun. That the work we do is the verb team. We’re working with a team, we’re going to team the solution or the care for the patient.

Quality improvement, safety and risk management, you need to have knowledge in all of these areas and I believe within our RN and MSN program we have great focus on these areas. And one of the things that we use is something called disaster of the week where they’re very real life things that students learn on a team to process as how you would manage that. And also as a part of our quality and safety course, each student does earn and IHI certificate in quality and safety. And the faculty have all learned that too.

So, program development implementation and evaluation, your capstone project in this program is exactly that. You will be responsible for developing with a team a program. And you will be responsible for deciding how would you implement that and how would you evaluate that, very real experience as part of the program.

Outcomes, measurement and management, how do we measure the outcome? What’s the information that we collect? Are we getting the outcomes that we think we want? Constantly looking at what do the outcomes look like and what kind of changes do we need to make if the outcomes are not what we had expected?

Self care and healing environment, you are the tool and you’re – it’s you who you bring to the patient. It’s you that you bring to the team. So, taking care of you ensures some success in what you’re doing. Healing environment is of course to and you talk students and it’s truly their favourite course. They learn so much about how you create a healing environment for a patient and they also walk away with an awful lot of new knowledge about taking care of themselves.

Something that’s happening here at the University of Arizona in the next week or so is there’s going to be a salon. The world salon you saw used a lot actually in the 20′s where the thinkers of the time or the painters of the time would come together and they would discuss a topic. And so, the salon here at the University of Arizona College of Nursing in the next week is going to be on healing, what does healing mean? What does healing mean to individuals who are doing the work of healing?

Strategic networking, relationship building and collaboration it’s all about the relationship, it’s all about working with others.

Characteristics of successful leaders, love this quote from John Quincy Adams. If your actions inspire others to dream more, learn more, do more and become more you are a leader. Lead from where you are, all nurses have that opportunity every day. And then a quick list of characteristics and again, the capstone course has a big focus on leadership and we asked students to come up with what do they think are the important characteristics for leaders.

And many of the things you see on this list came directly from students. That you’re open to possibilities, that you’re adaptable and flexible, that you have a strong emotional intelligence and the research shows that a strong emotional intelligence trumps a high IQ, that your emotional intelligence is what’s going to get you there. A capacity to inspire and I think that capacity to inspire involves smiling, involves having a sense of humour, involves seeing the potential in others and bringing them along, advocacy, integrity, honesty, embracing those opportunities for change. Listening more and talking less, when in doubt listen you can always talk later.

And being resilient because not everything goes the way we plan. Not everything works out exactly as we wanted it to be. I heard a presentation by a skier one time and she was talking about winners and losers and she says the one who gets up first is the winner, the one who gets up the quickest. You fall, get yourself back up. That’s resilience; you got to get back in the game. Being a good coach, being encouraging and being a teacher.

So, we have quite a tall order for leaders. So, how to become a leader, what the competencies are, once you are a leader how do you keep yourself in balance? And on the slide the elephant is very precariously balancing on a beach ball and it says balance is the key to life. And I think that’s so important not only as a nurse but also as a leader because you’re responsible for a large group of people very often and behind all of those people you’re responsible for, are vulnerable people that they’re responsible for. So, that tends to blossom into a huge group. So, your reach and your impact is way beyond that you might expect it to be. If you look at who your direct reports are for example. But trying to attain that balance

The American Nurse Association has had a focus on healthy nurses and defining a healthy nurse for several years now. And they define it as one who actively focuses on creating and maintaining a balance and a synergy so that working together, physical, intellectual, emotional, social, spiritual, personal and professional wellbeing. And it’s really difficult I think for nurses to attend to all those different areas equally if at all in a day’s work but really keeping that in focus because that truly is that sense of balance.

Some of the ways to do that is to start with self assessment. On this slide I have two websites; The American Nurses Association has a health risk assessment or appraisal which is a wonderful, wonderful exercise to go through. You will find things out about yourself that perhaps you didn’t want to acknowledge or you knew all along and it’s right there on a piece of paper in front of you and the nice thing is whatever you assess from that it gives you lots and lots of tools on how to deal with it. And it’s just a wonderful exercise for people to go through.

Also the University of Minnesota Centre for Spirituality has a wonderful assessment that you can take and that really helps people explore the dimensionality of their lives and what might be really strong and what might be missing. So, trying to plan for the balance once you’ve assessed things and trying to figure out where do I start? And usually people start at the area of greatest need or most acute need at the time. And fix something small there and look at the bigger picture and make a bigger plan. But the plan for balance really includes things like what is your health like? And this is your own health as a healthcare provider and then as a leader. Do you have healthy relationships? Do you feel secure and what does that mean? What is your purpose in life? Do you have a good trajectory in your purpose or do you need to shift gears a little bit. Do you have a sense of community and then what does your work environment look like? And all of these different areas can be explored at the University of Minnesota website.

And behind each of these areas is probably about five or six different sections that have all sorts of different ways that you can attain balance and you can help in those particular areas. So, things like nutrition tips for people on the go. How do you exercise when you’re on a 12 hour shift? Do you need to exercise when you’re on a 12 hour shift, all those sorts of things. How do you decompress at the end of one of the worst days in your life, in the job.

All of those things that we think about and how do you attain that sense of balance, figuring out what a realistic care plan is for you. If somebody says oh you have go to and relieve your stress and you should go take this yoga class, well if you’re not a yoga person that’s not going to be relaxing for you. You need to find what helps you unwind or relax or help you figure out what is best for your self-care plan. And that’s so very important. It doesn’t matter what everybody else is doing, it matters, it really matters what works for you. And what works in moments that you have to decompress on the job, what works after work and what works on the weekends when you really do need to do some deep relaxation so you can recharge your battery so you can go back and do it all over again the next week.

So, there’s different levels that you do want to explore. And then with each thing that you do you always want to evaluate and adjust. Well maybe you’re trying lots of different things and after each thing you try you say well did that work for me or not? And if it didn’t work then you have to course correct and say gee what else can I do? So, it’s all about trying to find that perfect balance.

I just love the picture, for those of you who are looking at the slides of the donkey up in the air with the cart. And that is probably one of the quintessential pictures of not having good work balance. That donkey is strapped in not going anywhere and can’t help itself ’cause the load is too heavy. So, again I go back to assessment. And thinking about your work balance, think about what are the stressors and what are the relaxers that you have at work or what are your energizers? Because you don’t have to be totally relaxed but you have to be energized so you can engage and you can really, truly and honestly engage in what you’re doing and in who you’re leading. Because you can’t coach somebody when you’re so tired you can barely walk forward. So, you know, to be able to lead you have to have an output of energy. You have to make sure that your gaining energy to be able to have that output.

Think about your to do list. Is your to do list bigger than the load on the donkey that has tipped the cart over? If so, you need to think about how do you manager your to do list. And it may be that you break it down. I personally break down the to do list like a stop light. So, red means stuff that I have to get done before I leave today. Yellow means if it spills over to tomorrow it’s okay and green means I get to it when I get to it, no one will die today if I don’t or next week even. But everybody has a way to do that. And I think that’s so important to be able to manage your to do list because it will grow and grow and grow.

And for some people you also have to think about who is the best person for the job and that might not be me. And that is very hard for nurses ’cause we want to do it all. But to really delegate because you may not be the right person for the job and you may be able to find something, somebody who can do a job much more efficiently and better than you and being okay to let that go. And part of that assessment and trying to create the balance and looking at the balance.

Look at your critical team members; they’re your support on the job. Look at your critical partnerships ’cause they’re your support in your job that you need to do. Both of them are extremely important. You want to make sure if you’re picking team members that you pick the right team members and those are team members that aren’t exactly like you. Those are team members who have wide diversity so that they can support you in the job that you need to do. Also those partnerships and we talked about that earlier. And how does that play in the job that you have to do? What is your balancing strategy and then evaluate how you lead change and how all these things come into play as you have that balance.

Our final slide in wrapping things up is the words of our graduates and I think, you know, I’ll just read some of these quotes. [Beth High] says by far this is the most comprehensive and innovative program available. And Beth was one of our graduates a year ago. And she is actually now giving back by teaching in the program. [Michele Alcoba] says the program itself is very well rounded and the pace is not too fast or not too slow. And then [Stacy Slader] says the faculty is 110% invested in the successful outcome for each and every student. And Stacy is also giving back my teaching in the program.

So, we have a wonderful faculty who not only know where they’re speaking from in leadership but they also are engaging our students. And our students, our former students are engaging students as well. So, I know we’ve run a bit short on time so if there’s any questions Mary and I can answer for you we would be happy to do so.

Kira:                  Thank you so much Cheri, Kira here. Hi again everyone. So, before we go into a Q&A I know we’re going to a little bit over time so we have a few minutes left. I just want to mention currently the enrollment team is accepting application for our spring 2016. Start date as you know the program is very unique. We have two [tracks for 80 N's] to complete their MSN completely online within about two years, so 24 months. And then for RN’s who already have the BSN they can go directly to the MSN in as few as 15 months and everything is completely online so it’s very flexible and feasible for working nurses. And we also have the very unique clinical systems immersion course which is a 16 week course and that’s done also entirely online. So, Cheri would you like so speak on the uniqueness of our immersion course?

Cheryl L:           Sure. As Mary said, the immersion course is 16 weeks and one of the key features of that course is as Mary had alluded to students work in small teams to put together a care management program and they literally use all the knowledge they have gained in the program up to that time and then some. Because hallmark of a good leader is to continue to learn and to gain the knowledge they need to get a job done and that component.

And the other component is a clinically based component where students demonstrate their ability to put together their knowledge in patho-physiology pharmacology assessment for a particular patient population that they choose. And we also do several other activities but those are the two main activities that you would see in the capstone course. Are there other questions?

Kira:                  Yes, so one more. This question is for Mary. So, you mentioned the very interesting fact or observation there was a study that founded emotional intelligence actually gets people further than IQ. So, the question is can emotional intelligence be taught and what is the, I guess the implication on that for healthcare professionals?

Mary W:            Emotional intelligence can be taught. And there’s definitely a body of literature available that describes it and talks about it. And probably the key component of emotional intelligence is self awareness first being how are you working in the situation? And when you become self aware it’s easier to watch what’s going on around you. And it kind of goes back to listening more, talking less so that you’re really paying attention to understanding what’s going on with the people that you are working with so that you can figure out how to take the group or the individual forward. That’s kind of a very short nutshell response but I know if you Google emotional intelligence you will not believe the list of things that comes up.

Respondent:      That’s great Mary. I’m sure a lot of our audience will be hitting Google soon. So, I’d like to thank Cheri and Mary for your time to presenting to us the key competencies in being a leader and as well giving advice on how to balance the work life for healthcare professionals who are taking care of others but sometimes will forget to take care of themselves. So, really great messages there and I hope our audience found that this presentation has been beneficial and it’s going to help with your lives as well as healthcare professionals and caretakers.

So, if you’re looking to prepare yourself for advancement and a leader within healthcare, within your organizations, do get in touch with our enrollment advisors that can be reached at 1-855-789-7046 and they will be working with you to help assess your GPA, on your transcripts and carving out the best path for you in terms of taking on your academic future. And thank you very much once again for reserving the time to be here with us today. And I hope you have a wonderful rest of the year and see you in 2016. Thanks again Cheri and Mary.

[End of recorded material] [01:10:29]

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