Building a Transformational Nurse Manager Workforce Through Interactive Competencies

Among nursing leadership roles, the nurse manager role has been identified as critical for the provision of high-performing, evidence-based, and efficient care in the patient care delivery setting. The nurse manager has 24-hour/7-day accountability for the performance of a defined unit or area. Excellence in horizontal and vertical communication is imperative. The nurse manager leads by example to create and manage change in the practice environment and is therefore the most influential communicator and change agent for clinical providers.

Nurse Managers are accountable for the clinical microsystem environment and must create learning and care delivery environment that is open and respectful. They must facilitate communication and sharing of expertise to promote quality of care, a culture of safety, improved patient satisfaction, and an effective practice environment. The American Nurses Association (ANA) identified communication as Standard 11 of the Standards of Professional Practice. It is a requirement for all registered nurses to communicate effectively in a variety of ways (American Nurses Association [ANA], 2010). Eight defined competencies guide the professional practice. Standard 12 defines additional communication competencies such as communicating effectively with the health-care consumer and colleagues, modeling expert practices, providing direction to enhance effectiveness, and influencing decision making (ANA, 2010). Additionally, the promotion of internal talent to positions of nursing leadership has been found to be an effective and positive practice that motivates clinical bedside nurses to pursue such leadership roles at this hospital and in other hospitals mentioned in the literature.

Aim: This session aims to provide an innovative teaching approach for leadership development to improve the nurse manager’s daily communication in staff interactions by validating an interactive simulation bundle communication competency and creating a daily communications toolkit that can provide critical data to prepare nurses for their day-to-day work. Currently nurse manager development to improve standard leadership competency and unit metrics in defined work practices is lacking. Nurse Managers working in an acute care hospital were selected from a subset of inpatient nurse managers for the initial project and has been replicated at all levels of leadership development.

This project used a multi-pronged approach to improve the nurse manager’s daily communication with staff through (1) core nurse leader curriculum, (2) validation of an effective communication competency, and (3) creation of a daily communication toolkit that would standardize and enhance the communication of critical data to nurses and reduce the existing gap regarding the provision of critical information as they prepare for their work day.

Methods: Data were collected by multiple means: observation, nursing survey, pretest/posttest competency assessment, monitoring of standard communication practices as standard work, and the use of selected core communication competency tools. Data focused on nurse managers, leadership course participation, simulation bundle participation, and unit data metrics, including the development of a unit specific vision statement, huddle participation, and problem identifications.

Results: Each unit consistently held 100% manager-led daily huddles that included all designated metrics for the unit. Incremental overtime was reduced by project evaluations, validating that the participants found the project valuable.

Conclusion: Results suggest that nurse managers in in situ simulations, coupled with reflection and standard communication tools, can communicate more effectively. Improved self-reported nurse manager competency embedded daily standard work practices and these nurse managers were influential role models for staff creating an environment to best support learning and improvement activities. Improved staff satisfaction was demonstrated through nursing satisfaction survey.

Keywords: nurse manager competencies, complex adaptive systems, leadership practices, succession planning, simulation, transformational leadership, innovative competencies, empowerment, appreciative inquiry, communication.