RCN Clinical Leadership Programme RCN Clinical Leadership Programme

Ian GovierIan GovierRCN Associate ConsultantRCN Associate Consultant

Turning Turning Voices Voices

opportunitynowhereopportunitynowhere

Effective clinical Effective clinical leadership leadership

improves improves patient carepatient care

The same 5 common themes The same 5 common themes emerge from each emerge from each

inquiry.inquiry.

Since the inception of the NHS, Since the inception of the NHS, more than 50 NHS public inquiries more than 50 NHS public inquiries have been conducted to address have been conducted to address

catastrophic failures in patient care. catastrophic failures in patient care.

Walshe & Higgins (2002)Walshe & Higgins (2002)

Disempowerment of Disempowerment of staff and patients staff and patients

Disempowerment of Disempowerment of staff and patients staff and patients

IsolationIsolationIsolationIsolation

Poor Poor communicationcommunication

Poor Poor communicationcommunication

Inadequate Inadequate leadership / leadership /

managementmanagement

Inadequate Inadequate leadership / leadership /

managementmanagementFailure of Failure of systems systems

and and processesprocesses

Failure of Failure of systems systems

and and processesprocesses

John Harvey-Jones (2002)John Harvey-Jones (2002)

““Leaders in the NHS Leaders in the NHS need imagination, vision need imagination, vision & charisma, & charisma,

allied with allied with outstanding communication outstanding communication

skills & the skills & the ability to fire ability to fire their staff with enthusiasm”their staff with enthusiasm”

““Lots of ordinary nurses are leaders Lots of ordinary nurses are leaders – it is in the very nature of the job. – it is in the very nature of the job.

Good care involves winning your Good care involves winning your patient’s confidence, convincing them to patient’s confidence, convincing them to

keep to their treatment regimes and inspiring keep to their treatment regimes and inspiring them to battle their way back to health”them to battle their way back to health”

(Crouch, 2002)

Who are Who are the leaders?the leaders?

ExemplaryExemplary (Clinical) (Clinical) LeadersLeaders

(Kouzes and Posner, 2002)(Kouzes and Posner, 2002)

ChallengeChallenge

InspireInspire

ModelModel EnableEnable

EncourageEncourage

Exemplary Exemplary Clinical LeadersClinical Leaders

ChallengeChallenge

Challenges to Challenges to Clinical LeadershipClinical Leadership

““The greatest The greatest difficulty in the difficulty in the world is not for world is not for

people to accept people to accept new ideas, but to new ideas, but to make them forget make them forget their old ideas!” their old ideas!”

John Maynard KeynesJohn Maynard Keynes ‘Are you kidding? I like it here!’

““The one indisputable The one indisputable fact that characterises fact that characterises

organisational life, is that organisational life, is that

CHANGECHANGE is inevitable.”is inevitable.”

(Beverley Alimo-Metcalfe, 2005)

Two choices regarding Two choices regarding CHANGE:CHANGE:

GET ORGANIZED GET ORGANIZED or or

‘go with the ‘go with the flow’flow’

(Yoder-Wise, 1999)(Yoder-Wise, 1999)

The truth is that our finest The truth is that our finest moments are most likely to occur moments are most likely to occur

when we are feeling deeply when we are feeling deeply uncomfortable, unhappy, or uncomfortable, unhappy, or

unfulfilled. For it is only in such unfulfilled. For it is only in such moments, propelled by our moments, propelled by our

discomfort, that we are likely to discomfort, that we are likely to step out of our ruts and start searching step out of our ruts and start searching

for different ways or truer answers.for different ways or truer answers. M.Scott PeckM.Scott Peck

““If you want If you want to to

see change, see change, be the change be the change you you

want to want to see”see”

Beware of Beware of Change Saboteurs!!Change Saboteurs!!

Exemplary Exemplary Clinical LeadersClinical Leaders

InspireInspirea shared a shared

VVIISSIIOONN

The most important The most important task of leadership is totask of leadership is to

define and nurture define and nurture

a shared a shared VVIISSIIOONN that energises and brings that energises and brings

out the best in people out the best in peopleJames A. VaughanJames A. Vaughan

Let’s look Let’s look at some at some

VVIISSIIOONNSS!!

To make people happyTo make people happy

To enable people & businesses throughout To enable people & businesses throughout the world to realize their full potentialthe world to realize their full potential

To experience the emotion of competition, To experience the emotion of competition, winning & crushing competitorswinning & crushing competitors

To be the world’s favourite airline To be the world’s favourite airline & the undisputed leader in world & the undisputed leader in world

travel for the millennium travel for the millennium

Visions without Visions without actions are actions are

merely merely hallucinations!hallucinations!

The vision must be The vision must be followed by the venture followed by the venture

It is not It is not enough to enough to

stare up the stepsstare up the steps

What is my What is my

VVIISSIIOONN for my for my

NURSING NURSING CARECAREER?ER?

Welsh Regional Welsh Regional Burns Unit Burns Unit

So many of our dreams at first So many of our dreams at first seem impossible, then they seem seem impossible, then they seem improbable, but when we summon improbable, but when we summon

the will, they soon become the will, they soon become inevitable. inevitable.

Exemplary Exemplary Clinical LeadersClinical Leaders

EnableEnable

To become a leader one To become a leader one must believe in one’s own must believe in one’s own ability to achieve results ability to achieve results for one’s self, but the real job for one’s self, but the real job of the leader is not of the leader is not

doing it but doing it but ENABLING ENABLING others to do it.others to do it.

Saskin & Rosenbach 1993Saskin & Rosenbach 1993

Where once leaders were aloof Where once leaders were aloof decision-makers, today they are decision-makers, today they are

dedicated collaborators & networkers dedicated collaborators & networkers whose role is to whose role is to ENABLEENABLE & give & give power to their team rather than power to their team rather than

wield power to their own ends. wield power to their own ends.

Leaders on Leadership – an intimate view of life at the top of Europe plc Development Dimensions International (DDI), Research Report, January 2006

Sister Thomas Sister Thomas - a great enabler - a great enabler

& clinical leader & clinical leader

Exemplary Exemplary Clinical LeadersClinical Leaders

ModelModel

The The main thing main thing is to keep is to keep the the main thing main thing - - the the MAIN THINGMAIN THING

CARINGCARING

It may seem a strange principle It may seem a strange principle to enunciate as the very first to enunciate as the very first

requirement in a hospital that it requirement in a hospital that it should do the sick no harm.should do the sick no harm.

Make the CARE OF PEOPLE your first concern, treating them as individualsand respecting their dignity

The biggest disease today is not leprosy or tuberculosis but rather the feeling of

being unwanted, uncared for and

deserted by everybody

Compassion and CareCompassion and Care

A patient is the most A patient is the most important person in our Hospital. important person in our Hospital.

He is not an interruption to our work. He is not an interruption to our work. He is the purpose of it. He is the purpose of it. He is not an outsider in our He is not an outsider in our Hospital. He is part of Hospital. He is part of

it. it.

We are not doing him a We are not doing him a favour by serving him. favour by serving him.

He is doing us a favour by giving He is doing us a favour by giving us the opportunity to do so. us the opportunity to do so.

As nurses, we have to be caring. As nurses, we have to be caring. We also need to be clever, We also need to be clever,

articulate and determined.articulate and determined. Strong and visible nursing leadership Strong and visible nursing leadership

is part of effective nursing care. is part of effective nursing care.

Nurses need to be in leadership Nurses need to be in leadership positions at every level, from the positions at every level, from the

bedside to the boardroom.bedside to the boardroom.

Exemplary Exemplary Clinical LeadersClinical Leaders

EncourageEncourage

...is about the principles & ...is about the principles & practices that support the basic practices that support the basic

human need human need to be appreciatedto be appreciated for what we do & who we are.for what we do & who we are.

(Kouzes & Posner, 1997)(Kouzes & Posner, 1997)

EncouragingEncouraging

The modern nurse The modern nurse is viewed by the public is viewed by the public

as a skilled and as a skilled and independent professionalindependent professional

Melissa Fitzpatrick (2005), former editor-in-chief of

Nursing Management, wrote:

‘‘To the public To the public these ads these ads

showcase diversity, showcase diversity, intelligence, intelligence,

competence, and competence, and caring - the essence caring - the essence

of nursing.of nursing.’

Exemplary Exemplary Clinical LeadersClinical Leaders

ChallengeChallenge

InspireInspire

ModelModel EnableEnable

EncourageEncourage

Final Final

ThoughtsThoughts

……what am Iwhat am Igoing to going to dodo differently differently

after today?after today?

Clinical Leadership…

……I’ll probably I’ll probably

do nothing about it!do nothing about it!

If I do nothing If I do nothing about it in 24 hours… about it in 24 hours…

If we always do what If we always do what we’ve always done… we’ve always done…

……we’ll always get what we’ll always get what we’ve always got! we’ve always got!

and and finally…finally…

We do not lead by being We do not lead by being corporate, professional corporate, professional

or institutional. or institutional.

Clinical Clinical Leadership Leadership

Thank YouThank You

DiolchDiolch

Clinical Clinical Leadership Leadership