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View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
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View All ProductsMitigate risk and elevate your quality of care. Improving both clinical and business outcomes starts with a smarter, more integrated approach to regulatory training, continuing education and quality management.
Learn MoreBy Mary Koloroutis, MSN, RN, Consultant at Creative Healthcare Management
I recently surveyed a group of clinical managers who were identified by their supervisors as exemplars based on these key outcomes:
I asked them questions designed to get at what inspires them about their work, what they need in order to thrive in their work, and what particular ways they think about their work. In a survey that offered dozens of valuable take-aways, I’d like to focus on a few that stood out for me as fundamentally important.
3 Qualities Shared by Clinical Managers Who Thrive
The nurse managers who described themselves as thriving describe values and beliefs that support the following three areas:
Imagine a continuum. On one end you’ve got “It’s my job to police these people,” and on the other end you’ve got “It’s my job to believe in, inspire, and support my team.” Obviously, where you sit on that continuum is going to have a very big influence on how your team functions, partly because one way of thinking sets up a “domination paradigm” and the other sets up a “partnership paradigm.”
Domination vs. Partnership
This language—domination paradigm versus partnership paradigm—comes from the work of Dr. Riane Eisler, and since I happened upon it a few years ago, it has helped to put language to what I have experienced in healthcare organizations through the years. I was not at all surprised to see the contrast between partnership and domination thinking show up as a key factor (though not in those words) in the survey of clinical nurse manager exemplars as well.
Domination paradigms set us up to perceive ourselves as either above or below others. Even if we work in a culture that invites those doing the work to take ownership for their own processes and policies, we live in a larger culture in which we can clearly see that there are people “at the top” and people “at the bottom.” In this culture—and really in most, if not all “civilized” cultures—this reality is so pervasive that it becomes invisible to most of us. We look right through it as if it isn’t there. But it is.
Command Action Doesn't Work
It would be easy (in theory) for nurse managers to primarily pull rank and command action. What we find, however, is that that approach to leading simply doesn’t work. It dehumanizes those being led which in turn affects how they relate to those in their care. It’s essential that nurses be respected and granted the autonomy to be creative in their work—to use their critical thinking abilities to respond to their patients’ complex and ever changing issues. This is very likely to happen when clinical nurse managers hold high standards and nurture and support their teams to achieve them. It’s not at all likely to happen when clinical nurse managers are policing those “below them” or when managers are reacting out of fear of displeasing those “above them.”
In a domination paradigm, creativity may be expected from those at the top, but from those at the bottom, we want and expect obedience.
There is no way to fix a domination paradigm. Instead, a domination paradigm is dissolved when partnerships are actively created. The nurse manager exemplars I surveyed seem to be actively creating partnerships with their team members. They describe themselves as being part of the team, and they respect the clinical team as being key to quality care.
It was no surprise to find that those who seemed to have the deepest sense of partnership threading through their work also felt supported by their own supervisors. Here is an excerpt from one participant’s comments:
When I was first in the role of interim manager I asked my supervisor, "What happens if I hate this role in a month?" She replied, "If you hate this role in a month it will be my fault for not providing the support and mentoring you need. I know you have the ability to succeed in this role."
Perhaps the quickest way to turn clinical nurse managers into good partners is for their own supervisors (and the entire administrative team, of course) to partner with them. It’s even possible for this sort of thinking to become the norm in an organization, provided that it is modeled consistently and visibly. Decrees and edicts can earn obedience or compliance, but it is through partnership that we can invite the full participation and the very best thinking of a dedicated staff into the pursuit of a shared vision. It is through partnerships and fundamental human respect that we create extraordinary cultures with extraordinary results.
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As a co-creator, author, and editor of the Relationship-Based Care series of books and seminars, Mary helps health care organizations create a framework for delivering world-class care with strong underlying values and principles, and then works with them to implement that framework. Her most recent book, See Me as a Person: Creating Therapeutic Relationships with Patients and their Families, co-authored with Michael Trout, helps clinicians in all disciplines to connect authentically with the patients and families in their care no matter how chaotic their care environments may be. Contact Mary at mkoloroutis@chcm.com
HealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsThe leadership development program from HealthStream helps mold your high-potential healthcare employees into proven leaders.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
View All ProductsLearn about what HealthStream's healthcare policy management software and how it can help aid your organization efforts.
View All ProductsHealthStream's education helps address diversity, equity, and inclusion within your organization, as well as promoting health equity in the communities you serve.
View All ProductsHealthStream offers professional training and education on how to best optimize your reimbursement process within your healthcare organization.
View All ReimbursementTeach your healthcare staff about the revenue cycle and claim management through targeted training and video tools from HealthStream.
View All ProductsLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ResuscitationIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsNurture the skills of your nurses and medical staff to help mold them into effective leaders with development training from HealthStream.
View All ProductsExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
View All ProductsLearn more about HealthStream's provider credentialing, privileging, & enrollment solutions for healthcare organizations.
View All CredentialingExperience standardized and centralized healthcare provider credentialing, privileging, and enrollment that is smarter and faster than ever before.
View All ProductsAutomated, web-based provider credentialing and enrollment software for growing medical groups.
View All ProductsNCQA-certified CVO verification services for initial and re-credentialing files in an overflow or full-service capacity for healthcare organizations.
View All ProductsSearch, review, and add providers into the Epic provider master file with our Epic app integration, Provider Validate.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All SchedulingHealthcare scheduling software designed to optimize staffing requirements & elevate patient care
View All ProductsPrecisely align staffing and needed resources to enable efficient patient flow and high-quality, cost-effective patient care.
View All ProductsHealthStream’s free nurse schedule app, NurseGrid™, is built to help you care for your staff and engage with their specific needs.
View All Products