A Nurse Leader's Initiative: Enhancing Standards of Nursing Practice for Older Adults in the Philippines

Saturday, 28 October 2017

Pearl Ed G. Cuevas, PhD, MAN, RN, FGNLA
School of Nursing, Centro Escolar University, Manila, Philippines
Rose Constantino, PhD
School of Nursing Department of Health and Community Systems, University of Pittsburgh, Pittsburgh, PA, USA
Deborah Cleeter Bailey, EdD, MSN
Sawgrass Leadership Institute, Ponte Vedra Beach, FL, USA

Individual Leadership Development

My personal leadership development is a journey that relates to the exemplary leadership practices of the Kouzes - Posner (K-P) model. My area of greatest expansion is in challenging the process wherein I sought new and unfamiliar leadership opportunities. At present, I am leading nurses at the national level and am in a position to suggest changes, make recommendations, and initiate policies for the health and wellbeing of older persons in the Philippines. For example, the nurse managed adult day care program that was founded based on my dissertation is in the process of making policy changes to our existing Expanded Senior Citizen’s Act (Republic Act 9994, Philippines). Despite challenges, I have continued with the task that I am committed to doing, which is to engage with nursing leaders in the formulation of Gerontology and Geriatric Nursing Practice Standards in the Philippines. As secretary of the Gerontology Nurses Association of the Philippines, I have collaborated with the leadership in research and practice to ensure that safe and quality care is provided to older persons through the development of evidence-based practice standards.

The international expansion of my leadership came as I networked with other countries and interprofessional teams after completing two-courses in social gerontology from the United Nations Institute of Aging in Malta and with the Philippine Society of Geriatrics and Gerontology. I presented a completed a research on “Training Module Development for the Health Promotion of Older Persons in the Philippines” and engaged in collaborating with other Sigma Theta Tau members globally by participating and volunteering at the International Nursing Research Congress in Cape Town, South Africa. It was a humbling experience to be a part of this huge gathering of nurse leaders who are driven towards better outcomes of care.

The second assessment data by leadership practice based on the K-P Model showed an increase in all five practices of exemplary leadership. I have “modeled the way” by being a good role model of a leader. I listen more actively and communicate clearly, effectively and convincingly with team members in face-to-face and virtual meetings and conferences.

I have inspired a shared vision with my colleagues in increasing situations or encounters. Now, I am able to dream bigger than my workplace and I am consistently expanding my scope of influence; this is one way of challenging the process. I challenge myself into taking risks and to innovate procedures based on evidence-based practice. I consistently enhance collaboration and enable others by showcasing the accomplishments of others in my team. I acknowledge the contributions of teammates in meeting a goal and celebrate quick wins with them. I have remained cognizant of all five practices and made a conscious effort to inculcate and integrate them in my daily practice. For example, I was able to lead the team from the School of Nursing in the pilot study of our University Research on Aging by engaging and inspiring the entire team to accomplish the goals of this research project.

Advancing Nursing Practice through an Interprofessional Team Leadership Project

The title of my interprofessional team project “Nurse Leader’s Initiatives: Toward Gerontology and Geriatric Nursing Practice Standards in the Philippines”. The purpose of this team project is to draft practice standards for gerontology and geriatric nursing towards the delivery of safe and quality nursing care for older persons in the Philippines.

Initially, I gathered an interprofessional team consisting of a social worker, statistician, psychologist, nurses, biologist, and a physician. However, with the changes in the research plan, the project evolved into a historical research.

Historically, standards of practice in the Philippines came from the nursing practice arena and codified in hospital policy and procedure manuals. The Standards of Nursing Practice started with the National Nursing Core Competency Standards (2012). Philippine nursing leaders benchmarked core competency standards with several Asian countries and had them validated both regionally in the Philippines and internationally. The output came from the collective minds of nursing leaders, stakeholders, policymakers, interest groups and many others who gave their time, effort and talent to serve on the task groups or committees to develop the standards of nursing practice.

Our project is an important work for the future of nursing care for older adults because it will serve as a codified evidence-based standard of care of the highest quality and sustainability. The specific expected result of this project is standardized nursing care that is responsive to the personal preferences of older persons and coordinated around their needs. The outcomes are measurable through nursing education research and practice in the delivery of safe, effective, timely and efficient care for older persons.

Increasing the Scope of Influence and Impact.

There are three levels within the fellowship experience that I accomplished that directly impacted the scope of influence—institutional, community, and national level. At the institutional level, I became the team leader in the curriculum study group for the Masters of Science degree, major in Gerontology Nursing and the Diploma course in Gerontology in 2016. In 2017, I was asked to teach in the PhD program on Health Sciences among other professors with a PhD. Then in the same year, I was invited to become a member of the University Council. The council is an administrative group who reviews and revises policies, guidelines and their implementation in the institution.

At the community level, I was invited to serve as a research panel member to review and critique research presentations and forums for other schools and universities in Manila. In 2016, I was elected member of the Board of Directors for the Manila Chapter of the Philippine Nurses Association (PNA).

At the national level, I have been re-elected as officer of the Gerontology Nurses Association of the Philippines (GNAP) and was elected Secretary of the GNAP. In 2016, I was elected to the post of officer/secretary of the House of Delegates of the PNA. Meanwhile, I have accepted a position as committee member of the Publications Committee of PNA. In the area of research, I was appointed Board Representative for the National Capital Region of the Philippine Nursing Research Society.

There are two things that I expect to become involved within the next year or so and these are to expand my network with nursing leaders and to provide a new platform for communicating my passion for safe and effective older adult care. These can be accomplished by 1) becoming a committee member that lobby for the cause of older persons in the Philippine Senate or Congress and 2) as Board Representative for the National Capital Region of the Philippine Nursing Research Society. The first position drafts policies for the health and wellbeing of older persons and the second one allows me to visit other jurisdictions (within the 3 island-regions of the Philippines: Luzon, where Manila is situated as a capital city, Visayas and Mindanao) and network with gerontological nursing leaders in drafting policies based on the national standards for the health and wellbeing of older persons and if necessary, lead in disseminating outcomes with other Asian countries.