Developing Indian American Nurse Leaders Through a Transformational Leadership Training Program

Tuesday, 19 November 2019: 8:00 AM

Nitha Mathew Joseph, PhD, RN, CNE
Department of Undergraduate Studies-Cizik School of Nursing, University of Texas Houston Health Science Center, Houston, TX, USA
Nancy Dias, PhD, RN, CNE
College of Nursing, Department of Nursing Science, East Carolina University, Greenville, NC, USA
Jackie L. Michael, PhD, APRN, WHNP-BC
College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA

Background: The National Association of Indian Nurses of America (NAINA) represents first-generation immigrant nurses, second-generation nurses, and students of Indian heritage in the United States (National Association of Indian Nurses of America, 2018). The number and representation of internationally educated nurses from India in the U.S. nursing workforce increased substantially in 2008 to become the third largest group of internationally educated nurses in America, in spite of the changing immigration policies (Budden, Zhong, Moulton, & Jeannie, 2013; Health Resources and Services Administration, 2010). Indian nurses, as a minority group, face challenges in accessing appropriate leadership positions and are underrepresented among leaders who deal with emerging issues related to nursing and healthcare reform and policies (Carter, Powell, Derouin & Cusatis, 2015). Several agencies, hospital systems, and organizations have formal leadership programs to train nurses to be effective leaders (MacPhee et al., 2014). Unfortunately, few programs target the specific challenges of minority nurses for leadership roles in the healthcare system. NAINA’s goal is to advocate for diversity in healthcare leadership and increase the representation of Indian nurses in leadership roles in the healthcare system.

Aim: The purpose of the Aspiring Leaders Development (ALD) program was to develop and implement a transformational leadership program for a cohort of aspiring nurse leaders (ANLs) of Indian heritage that draws upon our strong heritage, focuses on individual leadership development, and furthers the mission of NAINA.

Methods: The ALD program curriculum focused on the development of five core principles: modeling (model the way), inspiring (inspire a shared vision), challenging (challenge the process), enabling (enable others to act), and encouraging (encourage the heart). The curriculum targeted ANLs using interactive and experiential learning activities, including assessments (pre- and post-tests), self- reflections, lectures, workshops, and group activities. Additionally, Betty Moore’s speaker series, “Lessons in Nursing Leadership,” (Betty Moore Foundation, 2018) which highlights the journey of exemplary nurse leaders, was integrated in the curriculum as an instructional activity. The program focused on identifying the learning needs of potential participants through the Leadership Practices Inventory (LPI), a 360° tool developed by Kouzes and Posner (Kouzes & Posner, 2013). The LPI was used as a pretest to guide the curriculum and a posttest to evaluate the effectiveness of the program. A total of 14 ANLs, 12 females and 2 males, representing 10 NAINA chapters were selected for the program.

Results: The posttest scores showed an improvement in the overall LPI score. Upon the completion of the ALD program, all participants expressed that they were able to identify individual leadership opportunities, demonstrate leadership skills, apply leadership behaviors for their professional development, and engage in leadership roles identified in their individual leadership development plan.

Conclusion: Leadership programs such as the ALD program can help in the successful integration of internationally educated nurses into leadership positions in the healthcare system and impact patient outcomes. In the United States, nurses are underrepresented on the boards of private nonprofit and philanthropic organizations, which do not provide healthcare services but often have a large impact on healthcare decisions. Therefore, the transformational leadership programs organized by NAINA have the potential to develop strong leaders not only in hospitals but also on the advisory committees, commissions, and boards where policy decisions are made to advance health systems and improve patient care. Transformational leadership programs can increase nurses’ job satisfaction and commitment to the organization and organizational culture (Shaughnessy, Quinn Griffin, Bhattacharya & Fitzpatrick, 2018). Engaging internationally educated Indian nurses in transformational leadership training helps them to develop a common mission, vision, and goals, which are keys to success in healthcare settings. The short-term implication of this program was ANLs who were better prepared and eager to serve NAINA. The long-term implication is the development of a cadre of Indian nurse leaders who share not only NAINA’s mission and vision but also the commitment to increase NAINA members’ excellence in nursing practice and leadership through empowering, networking, and collaboration.