Beyond credentials: Cultivating authentic leadership in uncertain times

“Leadership is lifting a person’s vision to high sights, the raising of a person’s performance to a higher standard, the building of a personality beyond its normal limitations.” – Peter Drucker

Twenty years ago this May, I stood at the far end of a crowded hallway that was alive with students in starched white uniforms, light flashes from clicking cameras, and the collective sighs of relief characteristic of new graduate nurses. There we were in alphabetical order—porcelain nursing lamp in one hand, fresh red rose in the other—anxiously awaiting the moment of pinning that granted us official status as nurses. Ahead was the auditorium, where we would be met by faculty and hear final speeches on leadership and the nobility of the nursing profession. The specifics of the messages offered that evening are long gone, but what remains is my vision of one faculty member, in particular, who embodied authentic leadership without ever speaking a word on what it meant to be a leader.

Angel Shannon, 1993

A young, soft-spoken woman of few words, she balanced a full-time teaching schedule at the junior college with four young children, a husband, and full-time enrollment in a PhD program. Always impeccably groomed, she was known amongst students as a natural mentor in whom you could confide without fear of admonishment or embarrassment. To her, every mistake was forgivable. Indeed, every transgression was an opportunity to learn, even those that others may have considered of sufficient offense to warrant prompt dismissal from the nursing program. She viewed nursing not as a job but a noble profession, and she believed in the philosophy of nursing and the nursing process—ADPIE (more on that later)— as tenets for meeting the challenges of everyday life.

In the clinical setting, she demanded that we be “prepared for anything,” as there is no way to foresee the change or crisis that can completely make void the best laid care plan. From tasks as simple as making a bed to those requiring more critical thinking, every nursing intervention either added to or subtracted from the collective patient experience. The ability to memorize the chemical makeup of a medication was nice, she said, but no more impressive than displaying compassion by wrapping an arm around the shoulders of a grieving mother or inconsolable child. Raised in the Caribbean, this faculty member had a palpable sense of community and lived by the dictum of working together, urging us to study together and draw upon the collective wisdom of our cohort rather than traveling the difficult road alone. In a word, she was the kind of nurse leader many of us aspired to be.

Over the years, much has been written about leadership and timeless questions still remain: Are leaders born, or do they develop over time? Are good leadership skills innate, or can they be taught? In a rapidly shifting economy, in the face of globalization and amidst constant health policy reform, what skill sets do future nursing leaders need? Aside from credentials and long lists of certifications, what are the personal—and sustainable—attributes of great leadership? A few thoughts come to mind when considering these questions.

1. Great leaders are great listeners.

Hearing is not the same as attentive listening. Hearing is simply a neurological response to the presence of sound. Attentive listening evokes memory, conjures up compassion and helps convey the message that the concerns, opinions, and ideas of another are not only heard but understood and valued. Whether engaging an individual or a group, great leaders value the credibility and trust that is gained through paying attention and listening deeply.

2. Great leaders are lifelong students.

The pursuit of a doctoral degree is not for everyone and certainly not necessary for every career path, but education and advancement of skill sets are. Whether through formal higher education or self-paced, continuing education, great leaders teach and lead from their own wellspring of knowledge and experience, driven by the personal satisfaction and fulfillment that comes through sharing knowledge with others.

3. Great leaders are eternal optimists.

Every experience is an opportunity to learn and grow, even suboptimal experiences that we view as contrary to our well-laid plans. The job that went sour, the research proposal that wasn’t funded, the unit project that fell flat despite endless hours of meetings and hard work—all are opportunities to gain new knowledge and refine processes for the next time around. Great leaders learn from the past, operate in the present, and focus on the future to improve the chances of team success and avoid repeating costly mistakes. (It’s a process we nurses know as ADPIE—assess, diagnose, plan, intervene, and evaluate.)

4. Great leaders tap human potential.

Desmond Tutu, one of the greatest leaders of our time, once said, “A person is a person through other persons.” Every member of a group matters and, whether they know it or not, has something of value to contribute. Great leaders learn from others. They tap the sparks and tiny flickers of possibility that burn deep on the inside of every individual, nurturing potential rather than harping on limitations and deficits. As individuals learn and recognize their own strengths, they are better prepared to work collectively, nurturing the strengths and potential of others.

5. Great leaders are resilient.

Resilience, by definition, is the power or ability to return to original form or position after being bent, compressed, or stretched; the ability to recover readily from adversity and the like. In other words, resiliency is the ability to “bounce back.” Great leaders are those who anticipate adversity and accept change as a natural part of living. Great leaders are flexible in the face of uncertainty and ambiguity, recognizing that rigidity to fixed rules negates one’s ability to overcome adversity, obstacles, and setbacks. Always committed to growth, great leaders learn—and teach others—how to “go with the flow.”

The faculty member I’m referring to in this post later earned her PhD in nursing and went on to become a pillar of strength, not only at the junior college but in her community, embodying the kind of authentic leadership skills required of nurses in these uncertain times. For those of us who are advanced practice nurses, it is just as important in this era of rapid change to maintain ownership of our profession and develop vision for the scope of our practice as it is to collect credentials—not only for ourselves, but also for the communities we serve and represent.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

So you want to be an NP?

No pessimist ever discovered the secrets of the stars, or sailed to an uncharted land, or opened a new heaven to the human spirit.  — Helen Keller

“I want to be a nurse practitioner. I’m going back to school!” As soon as I spoke the words, I felt their weight and intensity.

We were a group of night-shift nurses—weekend warriors, we called ourselves—commiserating over all that seemed to be missing, not only on our unit but in our careers. We were a mixed bunch. Some, fresh out of nursing school, were dismayed by their new reality, an overwhelming set of responsibilities that hardly matched the “Grey’s Anatomy” image of nursing. There were no organized Code Reds with a well-scrubbed physician yelling “Stat,” nor was there a faculty preceptor to lean on. Some, much older, reminisced about the “good old days,” when nursing didn’t involve complicated EMR systems, committee meetings and unit-based research projects.

As soon as I made my declaration, questions and rapid-fire judgments quickly followed. How? With what resources? Why? Who in their right mind would want to take on student loans, late-night studying, clinical rotations and research papers at this stage in an already established career?

These questions, common for nurses who feel the urge to pursue graduate studies, are surely valid. Graduate school is expensive, requires self-directed study and ongoing individual assessment of learning style and learning needs, and it demands focus if one is to successfully juggle multiple tasks, set priorities, and meet deadlines. More importantly, especially for aspiring nurse practitioners who will incorporate unpaid clinical rotations into their schedules, graduate school usually requires students to reduce their employment workload, which lowers personal income over the course of the program.

Bedside nursing has tremendous perks, not the least of which are shorter workweeks; open and continuous opportunities for overtime; and casual “uniforms,” the cost of which pale in comparison to the professional wardrobe required in corporate settings. However, advanced practice nursing has its own share of perks, including opportunities for leadership, scholarship and management, as well as regular work schedules and potential for independent practice.

The barrage of who, what, where, why and when can lead to doubt, worry, and complete derailment of one’s quest for professional and personal growth. Success requires not only a leap of faith but the parachute of careful planning. The following are five key considerations for the journey to becoming a nurse practitioner.

1. Do your research.

Nurse practitioner programs are not all created equal. Speak directly to program directors and admission counselors about the number of credits required, the average length of time for completion, and graduation rates. Assure that the program holds solid accreditation and sufficient faculty-to-student ratios. Check national ratings for each school and the length of time the program has existed. Investigate the experience levels of the program’s faculty members, to ensure you’ll be learning from experienced nurse practitioners, rather than novices. Beware of new programs “awaiting accreditation” and lacking a track record. Speak with other nurse practitioners you know, to be sure you understand the role and responsibilities of a nurse practitioner. Consider “shadowing” an NP for a day or two, to get a clear picture of what the career path entails.

2. Assess your needs.

Carefully consider your learning style and weigh the options between traditional on-campus programs and those designed for distance learning. While distance learning may offer convenience, it also requires discipline, strong commitment, and strict time management. There is no one to hold you accountable for showing up to class, viewing lectures, reviewing content, and reminding you of deadlines. It is very easy to fall behind or become distracted by everyday life responsibilities, family and work obligations, and unexpected emergencies. Because traditional on-campus programs require a reduced employment workload to accommodate classes, clinical rotations and exams, you may need to line up additional financial resources to replace lost income.

3. Create a financial plan.

Add up all costs for the program, including tuition, books, clinical supplies, fees, parking, and commuting costs. To help offset these costs, investigate existing scholarships, graduate assistantships, grants and nursing education loans. When creating your budget, allow a reasonable amount for unplanned expenses such as car repairs, fluctuating gas and commuting costs, and household repairs that may occur. Realistically decide how many hours you will be able to work each week and compare this figure to current expenses. If attending graduate school requires you to move to another city, fully investigate the complete cost of living in the new location. Will you need a car to get to school and clinical sites? Is reasonably priced, safe housing affordable? What are average costs for utilities? Your NP studies will prove difficult enough. Inadequate income will not only create stress; it will distract from the time and focus needed for your studies.

4. Rally support.

If you have a spouse, significant other, or children, be sure you have their support early on in the decision-making process. In all fairness, these are the people who are going to be most affected by your decision. They will endure your late-night studying, early-morning clinical rotations, and perpetual absence at family events and affairs. Openly and honestly explain the time and financial commitments you’re planning to take on. Be realistic about the time you will need to study and the help that others will need to provide for day-to-day household management. If you are an adult learner with children, be sure to include extended family and friends in these discussions, and ask for their support as needed for carpooling and assistance with after-school activities. Once in the program, be considerate of their time, and remember to thank your “village” for helping you succeed.

5. Make your decision and stick with it.

If everything aligns properly, stick to your decision and move confidently in the direction of your passion. Equipped with your research and careful planning, beware of pessimists and naysayers who lack the insight you now have. No matter which direction the economy turns, graduate education in nursing will always yield a high return, and there will always be room for new nursing leaders who seek out opportunities for professional growth and advancement.

Consider every minute and every dollar spent an investment in yourself. Opportunities for nurse practitioners are endless and include such specialties as clinical research, global health, teaching, consulting, independent practice, and much more. Take your leap of faith with passion and optimism!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.