Nurse's Watch: Conversations on contemporary nursing,
nursing education, leadership, spirituality and blogging.
~Start date February 2010~

Sunday, October 30, 2011

Leading by example...

                 Leadership in Clinical Education and Leadership Growth

                                             Creative Clinical Leadership

Jones (2005) proposes that senior nursing students can practice leadership by delegating responsibilities to novice nursing students. She outlines how they must gather patient information and give report to the junior students, as well as, inform them of the  time they are expected to arrive, while also providing directions to the medical facility (Jones, 2005). Most importantly, they must evaluate the patient and student to determine which duties can be delegated safely and within the student’s scope of practice (Jones, 2005). This takes quite a bit of preparatory planning and organization.

Further, Jones (2005) notes that Bos (1998) identified five benefits of this type of delegation; students receive practice in prioritization, critical thinking, technical skills, use of peers as resources, and management. Other authors also relate that this type of peer tutoring increases confidence, personal leadership and personal relationships between students (Jones, 2005).

Kling (2010) had two classes of senior students lead sophomore students on their first and second days of clinical. The purpose of this endeavor was to allow the senior students to be able to participate in an active leadership position (Kling, 2010). This also allowed the students to experience life as an educator and mentor (Kling, 2010). Additionally, numerous other benefits became apparent after the implementation of this project. Friendships and support groups between the students that were initiated during this time period continued (Kling, 2010). Most notably, however, several students reflected that they might consider the possibility of someday aspiring to be nurse educators (Kling, 2010). Lastly, this leadership class took place before the NCLEX exam; this allowed the senior students time to review skills and processes as they explained these to the younger students (Kling, 2010).

In order for this scenario to be successful, students must be prepared, have a good understanding of the expectations and they must be familiar with their state’s Nurse Practice Act (Jones, 2005). If the student does not understand or is not prepared, this learning experience can fail to produce the expected outcomes.

In conclusion, this is an excellent way to introduce leadership with senior level nurses and this could be expanded upon in a number of ways. What if these senior students were assigned a sophomore or junior level student at the first of the year? They could be responsible for many aspects of the student nurse experience. Perhaps they could call a couple of times each month to see how the student is doing and if the student has any needs for tutoring or support. Not only does this provide extra direction and understanding for the novice but it could also increase the empathy level of the senior nurses toward the junior students. Is it possible this type of peer support could eventually impact lateral violence by increasing this sense of caring, collaboration and camaraderie toward other nurses early in the educational experience?

It is possible that this type of activity could be associated with the nursing honor society or the student nurse association where it could be voluntary or it could flow from one class to another. The students that feel comfortable with this experience may desire to continue to mentor the novice students after the year is over. In conclusion, this method of leadership training has tremendous potential beyond the activity itself.

       Final Thoughts on Personal Growth

 Fights (2011) suggests that nurses from the floor to the boardroom need to assess where they wish to be in 5 years, set career goals, discern how to accomplish them, commit to lifelong learning and get involved in policymaking, data collection and planning. She poignantly states, “As nurses, we must measure the value of what we do. Nurses are counted upon; yet if we don’t count what nurses do, nurses don’t count” (Fight, 2011, p. 59). This is very prophetic; nurses must cease to be invisible. How can this be accomplished?

This course has increased my appreciation and understanding for who I am so that I too can effectively lend my voice, vision and energy to the profession I love in an educated and intelligent manner. As Fights (2011) suggested I have been encouraged to set career goals and determine what I must do to accomplish them. This is vital to the growth, empowerment and consequent visibility of all nurses.

As I look back over this last year and a half, my growth as a professional has been incredible. This course and program of study has helped me define leadership and followership; it has helped me identify my personal leadership potential and creativity (Grossman & Valiga, 2009). Further, this course has helped me identify my personal role as a visionary, expert, achiever, critical thinker, communicator and mentor (Feldman & Greenberg, 2005). Additionally, as an educator, it has provided instruction on compelling ways to integrate and teach leadership (Feldman & Greenberg, 2005). This transformation has been subtle, continuous and at times unperceivable, yet as I look back from where I came, I am in awe.

Just a year ago, when we were instructed to write our personal philosophy; I wrote that the development of a philosophy is a process. I reflected, “Someday, I will more intimately know and understand my own personal philosophy. It will move beyond a way of doing and being to a personal philosophy of knowing. The journey has just begun” (Hiott, 2010). This has been accomplished! This class has expanded upon my “ways of knowing” (Jackson, Clements, Averill, & Zimbro, 2009, p.152). I know myself much more fully and have an appreciation for my strengths, my weaknesses, gifts, and passions all the better for participating in this program. I have been equipped, not only to teach, but also to dream and serve! Personal and professional exploration and education has increased my knowledge and confidence. Empirical knowledge helps me define the vision and set goals, while confidence from my personal, aesthetic and ethical knowing supplies the creative energy to embark upon the first step. Tyrrell (1994) shares, “Facilitation of student leadership development is an act of empowerment and an expression of caring” (Aroian, 2005, p.22). Thank you very much, Dr. Kling.
Feldman, H. R., & Greenberg, M. J. (2005). Educating nurses for leadership. New York, NY: Springer Publishing Company, Inc.
Fights, S. D. (2011). Future of nursing initiative: Nurses are the key. MEDSURG Nursing, 20(2), 58-59.
Grossman, S. C., & Valiga, T. M. (2009). The new leadership challenge: Creating the future of nursing (3rd ed.). Philadelphia, PA: F.A. Davis Company.
Hiott, D. B. (2010, October). Towards a personal philosophy of nursing education.
Jackson, J. P., Clements, P. T., Averill, J. B., & Zimbro, K. (2009). Patterns of knowing: Proposing a theory for nursing leadership. Nursing Economic$, 27(3), 149-159.
Jones, J. M. (2005). Chapter 26: Practicing delegation skills. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 279-287). New York, NY: Springer Publishing Company.
Kling, V. G. (2010). Clinical leadership project. Journal of Nursing Education, 49(11), 640-643. doi:10.3928/01484834-20100831-02


Friday, October 28, 2011

Reflecting on Nursing History

Focus on nursing history and the art of reflection
In the future leadership will be an even more important aspect of nursing education. Feldman and Greenberg (2005) have included several chapters, which demonstrate creative ways to tie this information into nursing classes. Many of these ideas are creative and relevant.
One chapter captured my attention due to its emphasis on nursing history. Lewenson (2005) uses nursing history to illustrate nursing leadership. This is a great way to integrate nursing history, ethics and leadership into any class. Many nursing leaders were revolutionary individuals who bravely stepped outside of the social expectations of their time. Holmes (2008) states, “ It is the vehicle for understanding and appreciating the human situation as it has developed and evolved over time, and without it we can not claim to understand our culture, institutions or practices…” (p.104).This teaching technique engages students with inspiring stories and shows what is possible with passion, persistence and creativity.
Lewenson (2005) recounts the value of our history by quoting Lynaugh (1996) noting this is “our cultural DNA” (p.103). Further, she reflects that Christy (1969a, 1969b, 1969c, 1969d, 1970a, 1970b, 1975) wrote a series about historical nursing leaders; she has used these to inspire students to see what these nurses had to overcome to achieve their goals (Lewenson, 2005). Lewenson (2005) cautions against students using “present-mindedness” however, when interpreting these leaders actions; “present-mindedness” occurs when one judges historical information using a contemporary perspective (p.108). This can be remedied by having the students include information regarding the historical environment at the time. In 1917 the National League for Nursing Education (NLNE) suggested nursing history be added to the nursing curriculum to generate enthusiasm in nursing’s history and in the occupation, as well as, to create an appreciation for the obstacles, which had been overcome; these issues and objectives are still relevant today (Lewenson, 2005).
Lewenson (2005) notes that serendipitously nursing students noted many of the issues related to nursing have not changed, shortages, recruitment difficulties, and entry into practice debates. Further, Kearney (2010) suggests that nurses reconnect with their past to continue to fuel their passion for their daily work.
I feel that the study of history is vital for nurses. Lewenson (2005) indicated the ways which she has integrated history into the classroom, however, I feel that she has just scratched the surface of what can be done with this medium. One suggestion that could be added to this strategy would be to add present day leaders into the class through visiting lecturers, contemporary journal or news articles. While history is important visualizing current events and efforts for improvement at the local and state level can also inspire. I know that I would love to hear of contemporary educators and leaders ideas and visions for the future. Dossey (2010) states that Florence Nightingale would not want us to focus too heavily on the past but look forward to the future; thus we should look back with pride but forward with vision and anticipation.
Another very vital chapter in Feldman and Greenberg’s book was chapter nine. Morgan, Johnson, and Garrison (2005) report on the importance of the use of reflection in teaching nursing leadership. This is such an important concept for teaching, however it particularly applies to leadership. Morgan et al. note that Schon (1982) emphasizes that reflection enhances nursing skills by allowing the student to relive an experience, think about it, evaluate it, and learn from it. This reflective process promotes learning in the cognitive domain, as well as, the affective domain (Morgan et al., 2005). Consequently, reflection promotes prioritization, clarification and understanding of individual nursing practice (Morgan et al., 2005).
Reflection encourages self-appraisal, fosters critical thinking, encourages values clarification and cultivates communication (Morgan, Johnson, & Garrison, 2005). Reflection also helps students recognize patterns, form relationships, generate hypotheses, provide explanations, and draw conclusions (Morgan et al., 2005). Occasionally, students have a tendency to concentrate only on the problems, which occurred during the experience, while this is appropriate, they should be encouraged to name at least one thing that went well (Morgan et al., 2005). Langley and Brown (2010) note that most researchers value the use of reflection and feel this medium provides nurses with numerous opportunities for growth; trust between teacher and student is vital, however. I love this particular type of exploratory writing and feel that the author’s description and usage is appropriate.
While reflection is a beneficial device for students, one could argue that the addition of a rubric would provide parameters to guide the student’s thoughts and measure outcomes. In this same vein asking students to back up their insights and opinions with references from current sources will ensure optimal growth and educated conclusions. Reflection without guidance and educational expectations offers little opportunity for measurable outcomes and the development of critical thinking.
In conclusion, Dossey (2010) emphasizes that nurses must “communicate to a wider audience. This means learning to write clearly and powerfully, not only for our colleagues but also for patients, consumers, and other health care professionals, about how we as nurses integrate caring and healing” (p.223). Practicing the art of reflection can help develop the skill of writing with insight and passion. This will be particularly important as the nursing profession heads into the future.


Dossey, B. M. (2010). Florence Nightingale's vision for health and healing. Journal of Holistic Nursing, 28(4), 221-224. doi:10.1177/0898010110383111
Holmes, C. A. (2008). Historical enquiry and understanding our past. Contemporary Nurse, 30(2), 101-105.
Kearney, G. (2010). We must not forget what we once knew: An exemplar for helping nurses reconnect with their history and rediscover their passion for nursing. Journal of Holistic Nursing, 28(4), 260-262. doi:10.1177/0898010110376322
Langley, M. E., & Brown, S. T. (2010). Perceptions of the use of reflective learning journals in online graduate nursing education. Nursing Education Perspectives, 31(1), 12-17.
Lewenson, S. B. (2005). Chapter 8: Using nursing history to educate for leadership. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 101-109). New York, NY: Springer Publishing Company.
Morgan, D. A., Johnson, J. G., & Garrison, D. R. (2005). Chapter 9: Reflective journaling: Bridging the theory-practice gap. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 110-118). New York, NY: Springer Publishing Company.

Saturday, October 22, 2011

Nursing Theorists ~

Today when I checked the stats on this blog, I found I have had over 5,000 visitors! Thanks for visiting!

I notice that a lot of people are looking up the nursing theorist page. So In an effort to be collegial I want to share my nursing wiki that I have developed for teaching. I have a page on my Nursing Class Wiki that covers most of the major theorists. I am fascinated by them. I found several videos on You Tube and have these on this page. So for all you budding nurse theorist enthusiasts, enjoy!

Nursing Class wiki

By the way, this is a photo of the Yale library. Isn't it beautiful? Someday I want to go there... if only to breathe in the beauty...

Sunday, October 16, 2011

Mentoring: To be or not to be...

                                         Mentoring: To be or not to be
      Results of mentor assessments
       The results of the mentor assessment were enlightening. On the one hand, it indicated I am 95% ready to be mentored. This I suspected. I have been on the lookout for a mentor but I often feel reluctant and hesitant to ask anyone to commit to such a task. Personally, I would enjoy the wisdom of an older woman in my life, especially since the deaths of my mother and mother in law. I have missed having older women in my life, who are secure in who they are and what they have been through. Harris and DeSimone (1998) propose that mentors can address life and career development (Vance, 2005).
       Often women of the same age can be quite competitive. This is not what I am looking for at all. Grossman and Valiga (2009) write that often the mentor serves as a mixture of “good parent” and “good friend” by providing counsel during stressful moments, encouragement during challenges, and assistance with the development of professional skills (p.169). Optimally, they serve as exemplary role models and provide honest feedback (Grossman & Valiga, 2005).
       The second part of the survey detailed my personal characteristics and what I am looking for in a mentor relationship. This portion of the survey indicated I value partnerships over competition and am overwhelmingly trusting. I like to question more than being told and my teaching style is also largely learner-centered. I am very tolerant but tend toward enjoying social interaction.
       Having a mentor is not having someone to hold my hand as I negotiate the future. I perceive them more as a comrade in arms. Vance (2005) reflects that teaching and learning go together hand in hand and mentoring is also relational. Further, she purports that the mentor inspires, guides, models, encourages, facilitates, and nurtures (Vance, 2005). Mentoring often is reciprocal, with the mentee also committing to mentor others (Vance, 2005). What a beautiful picture.
      Importance of mentors
       Zilembo and Monterosso (2008) report that our current nursing shortage is global; this shortage combined with an aging nursing force and work recruitment and retention difficulties make it imperative that we proactively begin to recruit and mentor. Recently, as I reflected on my RN-BSN program, I felt that additional guidance would have been so helpful as I searched for and applied to graduate schools. This is an area that I would love to propose to explore in a PhD program. Do our RN-BSN students get the additional guidance and encouragement they need to enter graduate school?
       It appears that undergraduate advisors help steer students but second degree nursing students’ or generational students who opt to enter accelerated programs or RN-BSN programs often are not afforded this guidance. These students frequently work full-time, in conjunction with raising families. Though they may be distracted by familial or financial obligations, they may be more inclined to pursue masters or doctoral degrees, if identified and encouraged. They generally have the bedside experience. Methods of identification and guidance could easily be implemented into the academic environment. This early identification could provide mentors to students interested in continuing their education. What are we doing to capture these motivated students? Are there methods of identification in place? In order to continue to ‘grow’ the profession, the best and brightest need to be gleaned from every level of the nursing educational environment. This activity needs to be purposeful. Chance and individually motivated students will not address this looming shortage. Nursing needs to proactively recruit, support, mentor and educate with an eye on the future. 
      Views supported
       The literature supports the benefits of mentors. Dattilo, Brewer, and Streit (2009) note that new educators need an orientation to the educational environment and after they are acclimated, they need a mentor to help them with their professional goals. Sauter, Johnson, and Gillespie (2009) also report on the need for these same measures. Zilembo and Monterosso (2008) further expound upon the benefits of knowledgeable preceptors who demonstrate leadership skills. And finally, Murphy (2007) proposes that partnering with other faculty can help the novice nurse educator attain success. The literature overwhelmingly points to the benefits of mentors.
       In addition to the benefits of mentors, Vance (2005) points to Erikson’s theory of human development and the stage called generativity to demonstrate that the concept is supported by theory. Jung also purports that the first part of life is spent on an outward journey and the second half of life is spent on an inner journey (Wiggs, 2010). Further Wiggs (2010) quotes Schachter-Shalomi and Miller (1995) as noting:

Many of us are rich without knowing it, because we have not permitted ourselves to examine and take delight in the successes that we planted in the past. When we harvest our lives, we receive return on our investment in the form of inner riches. We see that our work wasn’t in vain; that our relationships have brought forth rich fruit; that our struggles for meaning and value have been worthwhile; and that even our failures, stumbling, and ill-conceived actions unwittingly have led to unexpected successes and to wisdom that is beyond any price tag. (pp. 53–54)

                  Steps to find and become a mentor
       Consequently, it is my goal to continue to look for a mentor and I believe that God will provide. While this may sound simplistic, the literature supports the need for the relationship to be the right fit, so I will be patient (Vance, 2005). Grossman and Valiga (2009) suggest that nurses who wish to find a mentor should reflect upon their strengths and weaknesses and examine their vision, goals, abilities, character and persistence. This I have done. They note that the individuals should be willing to take responsibility, respect confidences, provide feedback, accept constructive criticism and move through the logical phases of a mentoring relationship (Grossman & Valiga, 2009). I am ready for these steps.
       In the mean time, I will continue to help those who ask me for assistance and direction for their plans with school. I will continue to apply myself at work and at school to increase my leadership potential and abilities. I will forge ahead with the plans I have made and follow God’s lead. Lastly, I will continue to enjoy my peer pals, guides and sponsors and try to continue to be the same to those in need (Grossman & Valiga, 2009).

Dattilo, J., Brewer, M.  K., & Streit, L. (2009). Voices of experience: Reflections of nurse educators. The Journal of Continuing Education in Nursing, 40(8), 367-370.
Grossman, S. C., & Valiga, T. M. (2009). The new leadership challenge: Creating the future of nursing (3rd ed.). Philadelphia, PA: F.A. Davis Company.
Murphy, J. (2007). Role transition: Using partnerships and cognitive apprenticeship to become a nurse educator. In Moyer, F. (Ed.), Nursing education: Foundations for practice excellence (pp. 265-281).
Sauter, M. K., Johnson, D. R., & Gillespie, N. N. (2009). Educational program evaluation. In D. M. Billings &J. A. Halstead (Eds.), Teaching in nursing: A guide for faculty (3rd ed., pp. 467-511). St. Louis, Missouri: Saunders Elsevier.
Vance, C. (2005). Chapter 7: Leader as mentor. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 80-97). New York, NY: Springer Publishing Company.
Wiggs, C. M. (2010). Creating the self: Exploring the life journey of late-midlife women. Journal of Women & Aging, 22, 218-233. doi:10.1080/08952841.2010.495574
Zilembo, M., & Monterosso, L. (2008). Nursing students' perceptions of desirable leadership qualities in nurse preceptors: A descriptive survey. Contemporary Nurse, 27(2), 194-206.

Monday, October 10, 2011

Leadership ~ Sometimes means following...

Leadership week 2: Follower, critical thinker and achiever
Followership Assessment
The Grossman and Valiga (2009) follower test was very insightful. Prior to starting the test, I envisioned myself as a good follower. I always try and devote myself to my work environments and educational projects by following those in the lead. My goal is to be an excellent follower and support my leader because I value and appreciate my leaders efforts. It is not an easy job. As a follower, I realize that while my role is often invisible, it is practical and important.
The Grossman and Valiga (2009) test demonstrated that I have a pretty good idea of my strengths and weaknesses as a follower. My score was 4.06; this indicates that I am a democratic self-starter who occasionally enjoys a challenge to a moderately participative follower who is an independent worker that, while not needing close supervision, does appreciate a bit of feedback (Grossman & Valiga, 2009). This I can see. I love assessing a situation or environment and seeing what I can suggest or do to make it better. Sullivan (1998) notes that followers are adept at finding solutions, not just pointing out problems (Grossman & Valiga, 2009). My natural tendency is to optimistically help things run smoothly and make sure everyone else is also a happy camper. I love encouraging people. I find that it seems everyone from our secretaries to other nurses’ come to me to ask me for advice concerning their educational ventures. I enjoy encouraging people to take the leap of faith into furthering their career and education. 
 I have also learned a lot about leaders and followers by participating actively in the work environment and observing those around me. Leaders who are not emotionally secure may not be able to appreciate or utilize followers to the best of their ability. Followers enjoy leaders who provide for autonomy, resources, individuality, as well as leaders who value relationships and lead effectively (Germain & Cummings, 2010). Kerfoot (2011) reports that when nurses feel safe and empowered the brain engages more actively in the work at hand, while insecurity propagates withdrawal from this same work environment. I have witnessed nurse managers whose insecurity led them to passively thwart their follower’s best efforts to support their leadership; this prompts an atmosphere of confusion and hurt. This makes sense as Kerfoot (2011) notes that leaders must manage themselves and their environment to gain and maintain the trust of employees.
Morrison (2008) also reflects that emotional intelligence can help nurses handle job stress and notes that these traits can be acquired. Therefore, I hope to continue to observe and learn how to handle conflict and collaborate with nursing colleagues to increase teamwork and productivity (Morrison, 2008).
Sullivan (1998) notes the role differences between leaders and followers are often very fluid with followers often performing as leaders and vice versa (Grossman & Valiga, 2009). Grossman and Valiga (2009) also reflect that being a good follower is excellent preparation for becoming a good leader. I agree. Most of the leaders I have followed were in positions of legitimate authority (Grossman & Valiga, 2009). Observing these different leaders has given me amazing insight into the mechanics of management, more so than leadership. However, personal growth can occur during times of good and bad leadership. My goal as a future leader is to remember not only what I have read, studied, and learned but also what I have seen and experienced. It is my hope that combining history, theory and reality can aid me to become an effective leader in the not too distant future.
Critical Thinker
The longer I have been a nurse the more my critical thinking has developed; Lemire (2005) noted that this is often the case. Each area I have worked in has had its own inherent needs and potential patient emergencies. On my first job, in labor and delivery, I can remember playing out in my mind the emergency steps necessary for various scenarios. I wanted to be ready and prepared. Each job since then has called for different skill sets and emergency applications.
The first challenge in each new job, after I determined possible emergencies, was to understand the mechanisms behind the emergency. Remembering systemically what was happening helped me determine correct nursing actions and understand the mechanisms behind them. The interventions were easier to remember when the dynamics of the situation were understood. Morgan, Johnson, and Garrison (2005) note that reflective thinking is “essential to identifying, analyzing, and solving complex problems” (p.111). After understanding the actual systemic mechanics of the emergency, the interventions were easier to remember, as were the expected nursing outcomes. Though I could not know it at the time, this process of reflection is an ongoing skill for all nurses (Morgan, Johnson, & Garrison, 2005). My graduate education has helped me name the processes I used as a young nurse to understand and organize my environment and patient care. This education will now enable me to equip others to do the same.
Further, my education challenges me as an instructor to try and find ways to increase critical thinking in the class. Lemire (2005) reports that is often difficult to execute due to the vast amounts of information, which needs to be taught. However, each step in the critical thinking process can help students remember and respond. Consequently, the skills I have developed as a nurse will now assist me as a nurse educator.
My new patient, in essence, is a student eager to pass the class and boards. Possible emergencies are misunderstanding of classroom material, which can delay learning. My goal is to assess ways to help the student assimilate the necessary knowledge, understand it, plan nursing interventions and measure outcomes. Helping them understand this process can assist them to prepare for each new unit they may work on and equip them with the skills to learn and prepare long after I have exited their lives. Vance (2005) concludes, “the teacher-mentor inspires, guides, models, encourages, facilitates, and nurtures students in their learning journey” (p.87). My education has equipped me to be a life-long learner and to influence others to recognize the value and merit in this choice as well.
 Dienemann (2005) notes “evidence of leadership is achievements” (p.37). My accomplishments as a nurse achiever stem from my personal desire to be an active part of each department I work in and my personal tendency to dissect the environment for possible improvements. When I started to teach in the clinical environment, I noticed that from week to week much of the basic clinic specific information we discussed did not change. I felt that if I could provide this basic information to the students’ prior to the clinical class, more time could be spent on discussing the experiential portion of the class. Consequently, I developed a clinical wiki, which provided the students with background information about the clinic. This allowed my co-teacher and I to concentrate on the more immediate and practical nursing interventions that the students were responsible for.
At the Center of Pediatric Medicine (CPM) my goal has been to participate in the CPM community and offer what support I can. The wiki has been useful for the clinic, as well as, the students in that it offers great basic information to assist with student and employee orientation. 
            Teaching is near and dear to my heart, consequently, I also joined the literacy committee at CPM. This committee serves as a liaison with the Reach Out and Read Initiative. Reach Out and Read is a grant that provides children ages 6 months to six years with a new book each time they attend a well child check up. While serving on this committee, I suggested that we find a way to give out books to older children, which do not qualify for this initiative. Therefore, we have had several book drives to collect books for these children. Being an achiever is a goal of mine wherever I go.
Dienemann (2005) reflects that nursing interventions and outcomes currently are somewhat invisible to the public; this makes outcomes for nursing care hard to measure and quantify. The more nurses find ways to achieve recognition and visibility in their perspective nursing arenas the easier it will be to see the value of the profession in measurable terms.
I feel that I have a great deal to offer the nursing profession. My graduate education has enabled me to see weaknesses in the media portrayals of nurses and opened my eyes to numerous ways the image of nursing could be improved upon and projected into the community at large. Ultimately, nurses who are passionate about what they do, need to ensure that the work of nurses is no longer invisible. We must labor to increase the public’s knowledge and appreciation of nursing so that the profession is portrayed as the valuable asset it is to humanity.


Dienemann, J. A. (2005). Chapter 4: Leader as achiever. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 37-50). New York, NY: Springer Publishing Company.
Germain, P. B., & Cummings, G. G. (2010). The influence of nursing leadership on nurse performance: a systematic literature review. Journal of Nursing Management, 18, 425-439.
Grossman, S. C., & Valiga, T. M. (2009). The new leadership challenge: Creating the future of nursing (3rd ed.). Philadelphia, PA: F.A. Davis Company.
Kerfoot, K. M. (2011). The art and neurobiology of connection: The leader's challenge. Nursing Economic$, 29(2), 94-95.
Lemire, J.  A. (2005). Chapter 5: Leader as critical thinker. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 51-66). New York, NY: Springer Publishing Company.
Morgan, D. A., Johnson, J. G., & Garrison, D. R. (2005). Chapter 9: Reflective journaling: Bridging the theory-practice gap. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 110-118). New York, NY: Springer Publishing Company.
Morrison, J. (2008). The relationship between emotional intelligence competencies and preferred conflict-handling styles. Journal of Nursing Management, 16, 974-983. doi:10.1111/j.1365-2834.2008.00876.x
Vance, C. (2005). Chapter 7: Leader as mentor. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 80-97). New York, NY: Springer Publishing Company.

Monday, October 3, 2011

"Let me tell you the secret that has led me to my goal. My strength lies solely in my tenacity." ~ Louis Pasteur

I have decided to post my leadership portfolio on my nursing blog, Nurse’s Watch. This blog began as an undergraduate RN-BSN attempt to explore nursing blogs in informatics. It has since included discussions on theory and ethics as I have progressed through my undergraduate RN-BSN program and my Masters in Nursing Education program.
Further, I have discussed how I have used wikis in the classroom and the developed an e-portfolio. These posts have not been written as a showy demonstration of anything that I can do, but as a guide to others who may be called upon to navigate these self-same waters.
    Therefore, Nurse’s Watch will now house my Leadership portfolio. My personal objectives for this course are simple; by the conclusion of this course I hope to have a even clearer idea of my future goals as a nurse and a plan on how to get there! I hope to refine my personal vision to more fully harness the energy and passion I have for nursing. Consequently, I invite you to follow along as I conclude my MSN program and begin the next chapter of my career as a nurse leader with my sights set on a PhD in nursing!
  I feel so very, very fortunate to have been able to attend graduate school. I love nursing; what could be more perfect than teaching others what you love? The program I am attending has been phenomenal. I cannot believe how much I have learned and grown! This program has taught me about a myriad of teaching methodologies that are utilized in the classroom with the accompanying rationale and evaluative techniques. I am ready to teach! However, this program has also developed me as a leader. How, you may ask?
Leading does not necessarily involve holding positions of power (Grossman & Valiga, 2009).  Grossman and Valiga (2009) note that often leadership and management are used interchangeably; they are, however, vastly different. Aroian (2005) reflects “ great leadership demands the ability to create and communicate a personal vision that points the way for others” (p.16). Further, she ends the chapter by noting that educators need to assist students to create and share their visions of the future (Aroian, 2005). Consequently, finding and developing a personal vision is important for me on two levels, as an educator and as an aspiring leader.
Jackson, Clements, Averill, and Zimbro (2009) discussed the attributes of a theory for leadership that involves Carper’s Ways of Knowing. I am intrigued by theories of all shapes and sizes and this one I especially liked. Basically, they observed that just as nurses must practice with a holistic approach to patient care, so must nurse leaders (Jackson et al., 2009). Carper’s Ways of Knowing (1978) includes empirical, aesthetic, ethical, and personal knowing (Jackson et al., 2009). It has been added to through the years with the inclusion of sociopolitical and unknowing ways of knowing (Jackson et al., 2009). Further, Jackson, Clements, Averill, and Zimbro (2009) contrast this leadership theory with the transformational leader. This explorative article concludes with the proposal of a leadership theory that encompasses all the appropriate and theory specific ways of knowing for nurses (Jackson et al., 2009). Over the next few weeks I intend to study this theory and others to increase my understanding and ‘knowing’ of leadership (Jackson et al., 2009).
                                                    The Vision
In order to reach my full leadership potential, there are steps I must accomplish in the short run and the long run. First, I am hoping to secure a full-time teaching position! Once I find my university ‘home’, I want to immerse myself in teaching and also find other areas to contribute in the overall academic environment. Public service is an area that I feel is part of this job as well.
Next, I hope to join my local and national nursing associations. This I would have done before now, except that I have no money for these things at present. Currently, any extra funds are going towards PhD program application fees, transcripts and the GRE! However, lending our voices and talents to our local and national associations ensures that they reflect our values and vision. Also, as Aroian (2005) suggests interaction can bring together people with a common vision and this is what will be needed to set the future course of nursing practice.
Which brings me to my ultimate goal, to begin a PhD program by next summer or fall! Why you may query would I just finish one program and desire to begin another? First, I am afraid if I stop and get out of the paper writing, studying mode I may never wish to return to this level of commitment. More importantly though, I have spent time reflecting upon my ultimate goals and this is where it led me. I asked myself, if I could do tomorrow what I most desire, what would it be? The answer is to teach, lead and write; I love to write. There is only one degree that really supports these goals, and that is a PhD in nursing. Holland (1996) and Schumaker (1998) reflect, “a vision is not just a direction; it also has a destination” (Aroian, 2005, p.22). Consequently, the journey continues. 
                                           Leader as Expert
Frank (2005) notes, “the leader as expert is one who uses multiple ways of knowing for gathering information” (p.25). Further, the expert leader is skillful and knowledgeable; he or she is able to impact their surroundings in a positive and creative way to accomplish goals (Frank, 2005). I have been fortunate to have accumulated quite a bit of life experience; this has led to growth in empirical, personal, ethical, and aesthetic knowing.
Fifteen years in labor and delivery and pediatrics has contributed to empirical knowing, as has my educational background. While Frank (2005) notes that this type of knowledge is an important foundation for leading, “having knowledge of self helps one to use the empirical knowledge gained” (p. 26). Reflective practices experienced during writing and blogging have increased my personal knowing or “knowledge of self” tremendously (Frank, 2005, p. 26). My faith and service opportunities have impacted my ethical knowing. Frank (2005) reports that ethical knowing helps leaders with decision making, while aesthetic knowing beautifully weaves these areas of strength together. I love to reflect, write, garden and create; these experiences have increased my awareness of aesthetic knowing. Consequently, I feel that I am a expert leader due in part to the diversity of my life experiences. Embracing all these facets of my life has increased my ways of knowing and increased my leadership abilities and potential.
Aroian, J. (2005). Chapter 2: Leader as visionary. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 16-23). New York, NY: Springer Publishing Company.  
Frank, B. (2005). Chapter 3: Leader as expert. In H. R. Feldman & M. J. Greenberg (Eds.), Educating nurses for leadership (pp. 24-36). New York, NY: Springer Publishing Company.  Grossman, S. C., & Valiga, T. M. (2009). The new leadership challenge: Creating the future of nursing (3rd ed.). Philadelphia, PA: F.A. Davis Company.
Jackson, J. P., Clements, P. T., Averill, J. B., & Zimbro, K. (2009). Patterns of knowing: Proposing a theory for nursing leadership. Nursing Economic$, 27(3), 149-159.