Leadership with Intention and Impact

Saturday, 7 November 2015

Heidi K. Holmes, RN, BA, BScN, MScN, RN, GNC(C), FGNLA
Faculty of Nursing, Collaborative BScN Program, Conestoga College, Kitchener, ON, Canada
Veronique Boscart, RN, MScN, MEd, PhD
Schlegel-University of Waterloo Research Institute for Aging (RIA), Conestoga College Institute of Technology, Kitchener, ON, Canada
Deborah Cleeter, EdD, MSN, RN
Sawgrass Leadership Institute, Ponte Vedra Beach, FL, USA


The Geriatric Nursing Leadership Academy (GNLA), “prepares nurses to lead multidisciplinary teams to improve health care to older adults…” (STTI, 2015).  In addition to scopes of influence that are assessed and developed, the GNLA also, “assists and supports each participant to develop and implement an interprofessional project centered on improving geriatric health outcomes” (STTI, 2015).  The measurement of success as a Fellow in the GNLA is not based on awareness and knowledge, but on behavioral changes and impact on care.  My development and transition as a leader in gerontological nursing occurred over the last 18 months.  These changes in behavior were accomplished with the support and guidance of a Faculty Advisor (Dr. Deborah Cleeter) and Leadership Mentor (Dr. Veronique Boscart), who constituted a triad.  Support via funding was also provided by Sigma Theta Tau International (STTI), The Hearst Foundations and Hill Rom Inc.  The Fellow’s employer, Conestoga College, was also in support of the GNLA Fellowship and project as it is in line with Conestoga College’s mandate to advance healthy communities.  An interprofessional team, which I led, worked together to develop a continuing education module focused on the aging population and the care of older adults.  


Using Kouzes and Posner’s Leadership Challenge text (2012) as a foundation, I developed an Individual Leadership Development Plan (ILDP), which outlined strategies to achieve behavioral changes as a leader.  The ILPD was also a means to measure outcomes and impact of my leadership related to the care of older adults.  Formal feedback was solicited from colleagues who served as Leadership Observers (LOs), as well as from people in my personal and professional life.  In addition to leadership related changes assessed within the organizational setting, scopes of influence were also determined, considered, and tracked, to evaluate progress in professional and community leadership.  Meeting every 2 weeks by phone with my Faculty Advisor and Leadership Mentor, the pathway for leadership was planned, assessed, and modified, and progress was quickly identified by noting changes in behavior and reactions of others.

One of the components of the GNLA Fellowship is a project, serving as one of the means with which to develop and measure my leadership capabilities. I led an interprofessional team to develop an educational module focused on depression in older adults, and how to better prepare health care professionals to understand, assess and treat depression in this age group.



The GNLA’s purpose is to, “prepare and position nurses in leadership roles in various health care settings…” (GNLA, 2014).   Specific behavioral based goals I developed to meet this vision included

  1. Being an inspiration to those I work with as a leader, by inspiring a shared vision and encouraging the heart.
  2. Communicating with those in my personal and professional life in a manner that is seen to be mutually beneficial, effective and positive
  3. Demonstrating and being known by others for my brand of perseverance, idea generating, honest and forthcoming, and enthusiastic.

The aim of the project within my Fellowship was to develop an educational  module to be used to improve competencies and influence the behaviors of health care professionals, who care for older adults at risk for or living with depression, in all settings.  It is imperative that health care professionals become more aware of this issue, how to assess depression using best practices and more importantly what to do with their findings; communication, documentation and advocacy. 


My progress was assessed through a variety of methods.  As mentioned, an ILDP was drafted, edited, and finalized as a working document to guide me as a Fellow.  It was often revisited in triad meetings, as well as discussed at GNLA milestones, such as workshops and site visits.  The ILDP served as a plan for action to change my behaviors in measurable ways, and was tracked regularly.  Changes in behavior that demonstrated strength in leadership included:

  • Committing to spending regular time to future oriented thinking and planning
  • Inviting and being open to discussions and input versus reporting
  • Becoming aware of and using positive and purposeful language, both verbal and nonverbal
  • Demonstrating appreciation for those I lead, by getting to know them personally and showing gratitude via small but meaningful gestures
  • Living out my brand of perseverance, idea generation, honesty/forthrightness, and enthusiasm

Changes in behavior were noted and measured by 4 LOs, who completed surveys and sit down discussions both 1:1 with me, as well as in small groups with the triad.  These discussions focused on assessing and providing data regarding communication styles (verbal and nonverbal) as well as reactions of others to the Fellow as a leader.  Regular group GNLA Fellow teleconferencing calls were attended (once a month) to learn more about leadership behaviors and methods to achieve leadership goals.  As well, individual methods to learn more about leadership styles were brainstormed and trialed, such as Lunch with Leaders.  Regular meetings with organizational management were also scheduled, which centered on the project, but also on leadership development and progress.  I also made a commitment to more actively engage as a leader in professional and community organizations and events.  I became actively involved with professional nursing organizations (CGNA, GNAO, RNAO) and political forums, such as those facilitated by Ministers of Federal Parliament.   After attending GNLA Workshop II, and following a Fellow’s teleconference on the use of Social Media, I also began a Twitter account, engaging others in recognizing the issues facing the health of older adults and what can be done to resolve these.   

The topic of depression as the focus for the educational module was decided upon after an extensive gap analysis of accredited continuing education programs in Canada, consultations with community health care agency partners, and a literature review.  A letter of permission was received from the Research Ethics Board at Conestoga College, in recognition of this projet as program evaluation.  The educational module was piloted at a professional development conference at Conestoga College in June 2015, with faculty and professionals in attendance providing data.  The educational module will also be assessed by curriculum experts, community partner agencies, and community experts in this field.  Feedback was collected via online survey and focus group comments, to assess participant’s recall of content, module evaluation methods, and frequency of use of similar methods and content within their practice/teaching.  Early on however, it was evident that the educational module is being considered by community partner agencies, with great potential being recognized for meeting needs, not previously considered, such as with adults with developmental disabilities.  Outcomes include:

  • Enhanced awareness of depression in older adults and the risks
  • Increased screening for depression in older adults
  • Improved interprofessional communication regarding risks and diagnosis of depression

All of this occurred as a result of the changes I have made in my behavior as a leader, impacting my organization, community, profession and most importantly older adults.  It is very exciting that these outcomes are occurring in a variety of settings (LTC, acute care, community), which is a new way of addressing depression and its impact on the overall health of individuals and systems.



I have achieved many of my leadership goals.  I have received improved ratings and data in my leadership abilities to encourage the heart and inspire a shared vision, and have improved the way with which I consistently communicate with others as a leader.  I have also begun to market my brand of persevering, generating ideas, being honest and forthcoming, and always enthusiastic.

These results were tabulated from survey data and verbal feedback I solicited from peers/family members, Leadership Observers, management at Conestoga College, community partners, as well as professional organization associates.  In addition, the GNLA Scope of Influence portfolio evidences growth in many areas, such as:

  • New roles obtained in professional organizations
  • Conferences attended related to gerontology
  • Consulting
  • Policy work
  • Professional Networks
  • Impact numbers

Following the pilot presentation of the module, the plans for assessing data, refining the educational module and presenting formally to more community partners and health care professionals will occur in the next few months.  The project team will analyze data gathered during June and October sessions, and assess how participants have utilized the module.  These results will then be correlated with care of older adults via current education programs that are offered.  The team will also assess in Fall 2015/Winter 2016 if the educational module is taken up as part of post graduate certificate in gerontology. 

As mentioned, development and change has been measured and will continue to be, both from project data as well as data related to my leadership goals.  What is most exciting however is the transition that has been noted by all those involved with this Fellowship and by myself.  Most recently I was nominated and accepted as a cohort representative to present at a Symposium at the STTI convention in Fall 2015.  For me this summed up and evidenced how I have committed to making effective leadership a part of me and what I do; making the impact and integration of my experiences correlate with the care of older adults.